Impact of discordance between patient's and evaluator's global assessment on treatment outcomes in 14 868 patients with spondyloarthritis

Brigitte Michelsen; Lykke Midtbøll Ørnbjerg; Tore K Kvien; Karel Pavelka; Michael J Nissen; Dan Nordström; Maria José Santos; Suleyman Serdar Koca; Johan Askling; Ziga Rotar; Bjorn Gudbjornsson; Catalin Codreanu; Anne Gitte Loft; Eirik Klami Kristianslund; Herman F Mann; Adrian Ciurea; Kari K Eklund; Elsa Vieira-Sousa; Ayten Yazici; Lennart Jacobsson; Matija Tomšič; Thorvardur Jón Löve; Ruxandra Ionescu; I E van der Horst-Bruinsma; Florenzo Iannone; Manuel Pombo-Suarez; Gareth T Jones; Lise Hejl Hyldstrup; Niels Steen Krogh; Merete Lund Hetland; Mikkel Østergaard

doi:10.1093/rheumatology/kez656

Impact of discordance between patient's and evaluator's global assessment on treatment outcomes in 14 868 patients with spondyloarthritis

Brigitte Michelsen^* (Corresponding Author), Lykke Midtbøll Ørnbjerg, Tore K Kvien, Karel Pavelka, Michael J Nissen, Dan Nordström, Maria José Santos, Suleyman Serdar Koca, Johan Askling, Ziga Rotar, Bjorn Gudbjornsson, Catalin Codreanu, Anne Gitte Loft, Eirik Klami Kristianslund, Herman F Mann, Adrian Ciurea, Kari K Eklund, Elsa Vieira-Sousa, Ayten Yazici, Lennart JacobssonMatija Tomšič, Thorvardur Jón Löve, Ruxandra Ionescu, I E van der Horst-Bruinsma, Florenzo Iannone, Manuel Pombo-Suarez, Gareth T Jones, Lise Hejl Hyldstrup, Niels Steen Krogh, Merete Lund Hetland, Mikkel Østergaard

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

15 Downloads (Pure)

Abstract

OBJECTIVES: To assess the impact of 'patient's minus evaluator's global assessment of disease activity' (ΔPEG) at treatment initiation on retention and remission rates of TNF inhibitors (TNFi) in psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) patients across Europe.

METHODS: Real-life data from PsA and axSpA patients starting their first TNFi from 11 countries in the European Spondyloarthritis Research Collaboration Network were pooled. Retention rates were compared by Kaplan-Meier analyses with log-rank test and by Cox regression, and remission rates by χ2 test and by logistic regression across quartiles of baseline ΔPEG, separately in female and male PsA and axSpA patients.

RESULTS: We included 14 868 spondyloarthritis (5855 PsA, 9013 axSpA) patients. Baseline ΔPEG was negatively associated with 6/12/24-months' TNFi retention rates in female and male PsA and axSpA patients (P <0.001), with 6/12/24-months' BASDAI < 2 (P ≤0.002) and ASDAS < 1.3 (P ≤0.005) in axSpA patients, and with DAS28CRP(4)<2.6 (P ≤0.04) and DAPSA28 ≤ 4 (P ≤0.01), but not DAS28CRP(3)<2.6 (P ≥0.13) in PsA patients, with few exceptions on remission rates. Retention and remission rates were overall lower in female than male patients.

CONCLUSION: High baseline patient's compared with evaluator's global assessment was associated with lower 6/12/24-months' remission as well as retention rates of first TNFi in both PsA and axSpA patients. These results highlight the importance of discordance between patient's and evaluator's perspective on disease outcomes.

Original language	English
Pages (from-to)	2455-2461
Number of pages	7
Journal	Rheumatology
Volume	59
Issue number	9
Early online date	20 Jan 2020
DOIs	https://doi.org/10.1093/rheumatology/kez656
Publication status	Published - 1 Sept 2020

Bibliographical note

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

Keywords

axial spondyloarthritis
psoriatic arthritis
TNF inhibitors
treatment outcomes
PHYSICIAN
PSORIATIC-ARTHRITIS

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This is a pre-copyedited, author-produced version of an article accepted for publication in Rheumatology following peer review. The version of record Michelsen etal, Impact of discordance between patient’s and evaluator’s global assessment on treatment outcomes in 14 868 patients with spondyloarthritis, Rheumatology, Volume 59, Issue 9, September 2020, Pages 2455–2461,] is available online at: https://doi.org/10.1093/rheumatology/kez656
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Cite this

Michelsen, B., Ørnbjerg, L. M., Kvien, T. K., Pavelka, K., Nissen, M. J., Nordström, D., Santos, M. J., Koca, S. S., Askling, J., Rotar, Z., Gudbjornsson, B., Codreanu, C., Loft, A. G., Kristianslund, E. K., Mann, H. F., Ciurea, A., Eklund, K. K., Vieira-Sousa, E., Yazici, A., ... Østergaard, M. (2020). Impact of discordance between patient's and evaluator's global assessment on treatment outcomes in 14 868 patients with spondyloarthritis. Rheumatology, 59(9), 2455-2461. https://doi.org/10.1093/rheumatology/kez656

Michelsen, B, Ørnbjerg, LM, Kvien, TK, Pavelka, K, Nissen, MJ, Nordström, D, Santos, MJ, Koca, SS, Askling, J, Rotar, Z, Gudbjornsson, B, Codreanu, C, Loft, AG, Kristianslund, EK, Mann, HF, Ciurea, A, Eklund, KK, Vieira-Sousa, E, Yazici, A, Jacobsson, L, Tomšič, M, Löve, TJ, Ionescu, R, van der Horst-Bruinsma, IE, Iannone, F, Pombo-Suarez, M, Jones, GT, Hyldstrup, LH, Krogh, NS, Hetland, ML & Østergaard, M 2020, 'Impact of discordance between patient's and evaluator's global assessment on treatment outcomes in 14 868 patients with spondyloarthritis', Rheumatology, vol. 59, no. 9, pp. 2455-2461. https://doi.org/10.1093/rheumatology/kez656

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title = "Impact of discordance between patient's and evaluator's global assessment on treatment outcomes in 14 868 patients with spondyloarthritis",

abstract = "OBJECTIVES: To assess the impact of 'patient's minus evaluator's global assessment of disease activity' (ΔPEG) at treatment initiation on retention and remission rates of TNF inhibitors (TNFi) in psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) patients across Europe.METHODS: Real-life data from PsA and axSpA patients starting their first TNFi from 11 countries in the European Spondyloarthritis Research Collaboration Network were pooled. Retention rates were compared by Kaplan-Meier analyses with log-rank test and by Cox regression, and remission rates by χ2 test and by logistic regression across quartiles of baseline ΔPEG, separately in female and male PsA and axSpA patients.RESULTS: We included 14 868 spondyloarthritis (5855 PsA, 9013 axSpA) patients. Baseline ΔPEG was negatively associated with 6/12/24-months' TNFi retention rates in female and male PsA and axSpA patients (P <0.001), with 6/12/24-months' BASDAI < 2 (P ≤0.002) and ASDAS < 1.3 (P ≤0.005) in axSpA patients, and with DAS28CRP(4)<2.6 (P ≤0.04) and DAPSA28 ≤ 4 (P ≤0.01), but not DAS28CRP(3)<2.6 (P ≥0.13) in PsA patients, with few exceptions on remission rates. Retention and remission rates were overall lower in female than male patients.CONCLUSION: High baseline patient's compared with evaluator's global assessment was associated with lower 6/12/24-months' remission as well as retention rates of first TNFi in both PsA and axSpA patients. These results highlight the importance of discordance between patient's and evaluator's perspective on disease outcomes.",

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author = "Brigitte Michelsen and {\O}rnbjerg, {Lykke Midtb{\o}ll} and Kvien, {Tore K} and Karel Pavelka and Nissen, {Michael J} and Dan Nordstr{\"o}m and Santos, {Maria Jos{\'e}} and Koca, {Suleyman Serdar} and Johan Askling and Ziga Rotar and Bjorn Gudbjornsson and Catalin Codreanu and Loft, {Anne Gitte} and Kristianslund, {Eirik Klami} and Mann, {Herman F} and Adrian Ciurea and Eklund, {Kari K} and Elsa Vieira-Sousa and Ayten Yazici and Lennart Jacobsson and Matija Tom{\v s}i{\v c} and L{\"o}ve, {Thorvardur J{\'o}n} and Ruxandra Ionescu and {van der Horst-Bruinsma}, {I E} and Florenzo Iannone and Manuel Pombo-Suarez and Jones, {Gareth T} and Hyldstrup, {Lise Hejl} and Krogh, {Niels Steen} and Hetland, {Merete Lund} and Mikkel {\O}stergaard",

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

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month = sep,

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doi = "10.1093/rheumatology/kez656",

language = "English",

volume = "59",

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TY - JOUR

T1 - Impact of discordance between patient's and evaluator's global assessment on treatment outcomes in 14 868 patients with spondyloarthritis

AU - Michelsen, Brigitte

AU - Ørnbjerg, Lykke Midtbøll

AU - Kvien, Tore K

AU - Pavelka, Karel

AU - Nissen, Michael J

AU - Nordström, Dan

AU - Santos, Maria José

AU - Koca, Suleyman Serdar

AU - Askling, Johan

AU - Rotar, Ziga

AU - Gudbjornsson, Bjorn

AU - Codreanu, Catalin

AU - Loft, Anne Gitte

AU - Kristianslund, Eirik Klami

AU - Mann, Herman F

AU - Ciurea, Adrian

AU - Eklund, Kari K

AU - Vieira-Sousa, Elsa

AU - Yazici, Ayten

AU - Jacobsson, Lennart

AU - Tomšič, Matija

AU - Löve, Thorvardur Jón

AU - Ionescu, Ruxandra

AU - van der Horst-Bruinsma, I E

AU - Iannone, Florenzo

AU - Pombo-Suarez, Manuel

AU - Jones, Gareth T

AU - Hyldstrup, Lise Hejl

AU - Krogh, Niels Steen

AU - Hetland, Merete Lund

AU - Østergaard, Mikkel

N1 - Funding: This work was supported by Novartis. Novartis had no influence on the data collection, statistical analyses, manuscript preparation or decision to submit.

PY - 2020/9/1

Y1 - 2020/9/1

N2 - OBJECTIVES: To assess the impact of 'patient's minus evaluator's global assessment of disease activity' (ΔPEG) at treatment initiation on retention and remission rates of TNF inhibitors (TNFi) in psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) patients across Europe.METHODS: Real-life data from PsA and axSpA patients starting their first TNFi from 11 countries in the European Spondyloarthritis Research Collaboration Network were pooled. Retention rates were compared by Kaplan-Meier analyses with log-rank test and by Cox regression, and remission rates by χ2 test and by logistic regression across quartiles of baseline ΔPEG, separately in female and male PsA and axSpA patients.RESULTS: We included 14 868 spondyloarthritis (5855 PsA, 9013 axSpA) patients. Baseline ΔPEG was negatively associated with 6/12/24-months' TNFi retention rates in female and male PsA and axSpA patients (P <0.001), with 6/12/24-months' BASDAI < 2 (P ≤0.002) and ASDAS < 1.3 (P ≤0.005) in axSpA patients, and with DAS28CRP(4)<2.6 (P ≤0.04) and DAPSA28 ≤ 4 (P ≤0.01), but not DAS28CRP(3)<2.6 (P ≥0.13) in PsA patients, with few exceptions on remission rates. Retention and remission rates were overall lower in female than male patients.CONCLUSION: High baseline patient's compared with evaluator's global assessment was associated with lower 6/12/24-months' remission as well as retention rates of first TNFi in both PsA and axSpA patients. These results highlight the importance of discordance between patient's and evaluator's perspective on disease outcomes.

AB - OBJECTIVES: To assess the impact of 'patient's minus evaluator's global assessment of disease activity' (ΔPEG) at treatment initiation on retention and remission rates of TNF inhibitors (TNFi) in psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) patients across Europe.METHODS: Real-life data from PsA and axSpA patients starting their first TNFi from 11 countries in the European Spondyloarthritis Research Collaboration Network were pooled. Retention rates were compared by Kaplan-Meier analyses with log-rank test and by Cox regression, and remission rates by χ2 test and by logistic regression across quartiles of baseline ΔPEG, separately in female and male PsA and axSpA patients.RESULTS: We included 14 868 spondyloarthritis (5855 PsA, 9013 axSpA) patients. Baseline ΔPEG was negatively associated with 6/12/24-months' TNFi retention rates in female and male PsA and axSpA patients (P <0.001), with 6/12/24-months' BASDAI < 2 (P ≤0.002) and ASDAS < 1.3 (P ≤0.005) in axSpA patients, and with DAS28CRP(4)<2.6 (P ≤0.04) and DAPSA28 ≤ 4 (P ≤0.01), but not DAS28CRP(3)<2.6 (P ≥0.13) in PsA patients, with few exceptions on remission rates. Retention and remission rates were overall lower in female than male patients.CONCLUSION: High baseline patient's compared with evaluator's global assessment was associated with lower 6/12/24-months' remission as well as retention rates of first TNFi in both PsA and axSpA patients. These results highlight the importance of discordance between patient's and evaluator's perspective on disease outcomes.

KW - axial spondyloarthritis

KW - psoriatic arthritis

KW - TNF inhibitors

KW - treatment outcomes

KW - PHYSICIAN

KW - PSORIATIC-ARTHRITIS

UR - http://www.scopus.com/inward/record.url?scp=85090080184&partnerID=8YFLogxK

U2 - 10.1093/rheumatology/kez656

DO - 10.1093/rheumatology/kez656

M3 - Article

C2 - 31960053

SN - 1462-0324

VL - 59

SP - 2455

EP - 2461

JO - Rheumatology

JF - Rheumatology

IS - 9

ER -