Yahya F, et al. - This investigation was pursued to analyze long-term survival and efficacy of TNFi, reasons for switching or discontinuing, baseline predictors of response and remission in axial spondyloarthritis (axSpA) patients in a UK cohort. Good TNFi survival rates, best for first TNFi and unaffected by drug choice, were observed.

Methods

• Researchers retrospectively reviewed the routinely recorded patient data from all patients with a physician-verified diagnosis of axSpA attending 2 specialist centres who fulfilled the eligibility criteria for TNFi.
• Initial TNFi was recorded as the index drug.

Results

• This study included a total of 651 patients (94% AS); adalimumab (n = 332), etanercept (n = 205), infliximab (n = 51), golimumab (n = 40) and certolizumab pegol (n = 23) were index TNFi.
• Findings demonstrated that the mean (S.D.) duration from symptom onset to time of diagnosis was 8.6 (8.7) years and mean (S.D.) duration from diagnosis to TNFi initiation was 12.6 (11.5) years.
• Cessation of index TNFi was reported in a total of 224 (34.4%), and switching to a second TNFi in 105/224.
• Data showed that median drug survival for index and second TNFi were 10.2 years (95% CI: 8.8, 11.6 years) and 5.5 years (95% CI: 2.7, 8.3 years), respectively (P < 0.05).
• In addition, researchers noted no impact of choice of TNFi on survival rates.
• Results revealed that HLA-B27 predicted BASDAI50 and/or two or more point reduction within 6 months and long-term drug survival (P < 0.05).
• Non-smoking and low baseline BASDAI (P < 0.05) were identified as the predictors of low disease activity.