European bio-naïve spondyloarthritis patients initiating TNF inhibitor: time trends in baseline characteristics, treatment retention and response

Sara Nysom Christiansen* (Corresponding Author), Lykke Midtbøll Ørnbjerg, Simon Horskjær Rasmussen, Anne Gitte Loft, Johan Askling, Florenzo Iannone, Jakub Zavada, Brigitte Michelsen, Michael Nissen, Fatos Onen, Maria Jose Santos, Manuel Pombo-Suarez, Heikki Relas, Gary J. Macfarlane, Matija Tomsic, Catalin Codreanu, Bjorn Gudbjornsson, Irene Van der Horst-Bruinsma, Daniela Di Giuseppe, Bente GlintborgElisa Gremese, Karel Pavelka, Eirik Klami Kristianslund, Adrian Ciurea, Nurullah Akkoc, Anabela Barcelos, Carlos Sánchez-Piedra, Ritva Peltomaa, Gareth T. Jones, Ziga Rotar, Ruxandra Ionescu, Gerdur Grondal, Marleen G.H. Van de Sande, Karin Laas, Mikkel Østergaard, Merete L. Hetland

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


OBJECTIVES: To investigate time trends in baseline characteristics and retention, remission and response rates in bio-naïve axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) patients initiating TNF inhibitor (TNFi) treatment. METHODS: Prospectively collected data on bio-naïve axSpA and PsA patients from routine care in 15 European countries were pooled. Three cohorts were defined according to year of TNFi initiation: A (1999-2008), B (2009-2014) and C (2015-2018). Retention, remission and response rates were assessed at 6, 12 and 24 months. RESULTS: In total, 27 149 axSpA and 17 446 PsA patients were included. Cohort A patients had longer disease duration compared with B and C. In axSpA, cohort A had the largest proportion of male and HLA-B27 positive patients. In PsA, baseline disease activity was highest in cohort A. Retention rates in axSpA/PsA were highest in cohort A and differed only slightly between B and C. For all cohorts, disease activity decreased markedly from 0 to 6 months. In axSpA, disease activity at 24 months was highest in cohort A, where also remission and response rates were lowest. In PsA, remission rates at 6 and 12 months tended to be lowest in cohort A. Response rates were at all time points comparable across cohorts, and less between-cohort disease activity differences were seen at 24 months. CONCLUSION: Our findings indicate that over the past decades, clinicians have implemented more aggressive treatment strategies in spondyloarthritis. This was illustrated by shorter disease duration at treatment initiation, decreased retention rates and higher remission rates during recent years.

Original languageEnglish
Pages (from-to)3799-3807
Number of pages9
JournalRheumatology (Oxford, England)
Issue number9
Early online date23 Dec 2021
Publication statusPublished - 1 Sept 2022

Bibliographical note

The authors acknowledge Novartis Pharma AG and IQVIA for supporting the EuroSpA collaboration.

Funding: This work was supported by Novartis. Novartis had no influence on the data collection, statistical analyses, manuscript preparation or decision to submit.

Data Availability Statement

The data underlying this article will be shared upon reasonable request to the corresponding author.


  • axial spondyloarthritis
  • psoriatic arthritis
  • remission
  • response
  • time trends
  • TNFi retention


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