Retention and response rates in 14 261 PsA patients starting TNF inhibitor treatment: results from 12 countries in EuroSpA

Cecilie Heegaard Brahe* (Corresponding Author), Lykke Midtbøll Ørnbjerg, Lennart Jacobsson, Michael J Nissen, Eirik Klami Kristianslund, Herman Mann, Maria José Santos, Juan Gómez Reino, Dan Nordström, Ziga Rotar, Bjorn Gudbjornsson, Fatos Onen, Catalin Codreanu, Ulf Lindström, Burkhard Möller, Tore K Kvien, Karel Pavelka, Anabela Barcelos, Carlos Sánchez-Piedra, Kari K EklundMatija Tomšič, Thorvardur Jon Love, Gercek Can, Ruxandra Ionescu, Anne Gitte Loft, I E van der Horst-Bruinsma, Gary J Macfarlane, Florenzo Iannone, Lise Hejl Hyldstrup, Niels Steen Krogh, Mikkel Østergaard, Merete Lund Hetland

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


OBJECTIVE: To investigate TNF inhibitor (TNFi) retention and response rates in European biologic-naïve patients with PsA.

METHODS: Prospectively collected data on PsA patients in routine care from 12 European registries were pooled. Heterogeneity in baseline characteristics between registries were explored (analysis of variance and pairwise comparison). Retention rates (Kaplan-Meier), clinical remission [28-joint count DAS (DAS28) <2.6; 28 joint Disease Activity index for Psoriatic Arthritis ⩽4] and ACR criteria for 20% improvement (ACR20)/ACR50/ACR70 were calculated, including LUNDEX adjustment.

RESULTS: Overall, 14 261 patients with PsA initiated a first TNFi. Considerable heterogeneity of baseline characteristics between registries was observed. The median 12-month retention rate (95% CI) was 77% (76, 78%), ranging from 68 to 90% across registries. Overall, DAS28/28 joint Disease Activity index for Psoriatic Arthritis remission rates at 6 months were 56%/27% (LUNDEX: 45%/22%). Six-month ACR20/50/70 responses were 53%/38%/22%, respectively. In patients initiating a first TNFi after 2009 with registered fulfilment of ClASsification for Psoriatic ARthritis (CASPAR) criteria (n = 1980) or registered one or more swollen joint at baseline (n = 5803), the retention rates and response rates were similar to those found overall.

CONCLUSION: Approximately half of >14 000 patients with PsA who initiated first TNFi treatment in routine care were in DAS28 remission after 6 months, and three-quarters were still on the drug after 1 year. Considerable heterogeneity in baseline characteristics and outcomes across registries was observed. The feasibility of creating a large European database of PsA patients treated in routine care was demonstrated, offering unique opportunities for research with real-world data.

Original languageEnglish
Pages (from-to)1640-1650
Number of pages11
Issue number7
Early online date30 Oct 2019
Publication statusPublished - Jul 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.


  • psoriatic arthritis
  • spondyloarthritis
  • TNFi
  • effectiveness
  • drug survival
  • epidemiology
  • response
  • register
  • DAS28
  • DAPSA28


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