Journal
JOURNAL OF RHEUMATOLOGY
Volume 42, Issue 1, Pages 101-105Publisher
J RHEUMATOL PUBL CO
DOI: 10.3899/jrheum.140229
Keywords
AXIAL SPONDYLOARTHRITIS; TREATMENT RESPONSE; TUMOR NECROSIS FACTOR INHIBITORS
Categories
Funding
- Swiss Ankylosing Spondylitis Foundation
- Merck Sharp & Dohme in collaboration
- Swiss Clinical Quality Management (SCQM)
- Swiss Society of Rheumatology
- Balgrist Foundation
- ARCO Foundation
- Abbott
- Bristol-Myers-Squibb
- Merck Sharp Dohme
- Pfizer
- Roche
- UCB
- Abbvie
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Objective. To evaluate the initiation of and response to tumor necrosis factor (TNF) inhibitors for axial spondyloarthritis (axSpA) in private rheumatology practices versus academic centers. Methods. We compared newly initiated TNF inhibition for axSpA in 363 patients enrolled in private practices with 100 patients recruited in 6 university hospitals within the Swiss Clinical Quality Management (SCQM) cohort. Results. All patients had been treated with >= 1 nonsteroidal antiinflammatory drug and > 70% of patients had a baseline Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) >= 4 before anti-TNF agent initiation. The proportion of patients with nonradiographic axSpA (nr-axSpA) treated with TNF inhibitors was higher in hospitals versus private practices (30.4% vs 18.7%, p = 0.02). The burden of disease as assessed by patient-reported outcomes at baseline was slightly higher in the hospital setting. Mean levels (+/- SD) of the Ankylosing Spondylitis Disease Activity Score were, however, virtually identical in private practices and academic centers (3.4 +/- 1.0 vs 3.4 +/- 0.9, p = 0.68). An Assessment of SpondyloArthritis international Society (ASAS40) response at 1 year was reached for ankylosing spondylitis in 51.7% in private practices and 52.9% in university hospitals (p = 1.0) and for nr-axSpA in 27.5% versus 25.0%, respectively (p = 1.0). Conclusion. With the exception of a lower proportion of patients with nr-axSpA newly treated with anti-TNF agents in private practices in comparison to academic centers, adherence to ASAS treatment recommendations for TNF inhibition was equally high, and similar response rates to TNF blockers were achieved in both clinical settings.
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