title: Treatment response, drug survival and safety of anti-tumour necrosis factor α therapy in 193 patients with psoriatic arthritis: a twelve-year "real life" experience.
abstract: OBJECTIVE
  To evaluate the performance of anti-TNFα therapy in psoriatic arthritis (PsA) in a routine care setting.
  
  
  METHODS
  Inclusion criteria were patients with PsA who initiated anti-TNFα therapy between April 2001 and April 2013 with a follow-up of at least 6 months. For peripheral forms, treatment was considered to be effective for patients with a favourable expert opinion or>30% clinical improvement of swollen and tender joint counts. For axial forms, efficacy criteria were: improvement of BASDAI by at least 2 points on a scale from 0 to 10 or 50% improvement (BASDAI 50) or expert opinion. Drug survival of first anti-TNFα therapy was also investigated.
  
  
  RESULTS
  The study included 193 patients (107/86M/F, mean age: 46.8 years, mean disease duration: 6.7 years, 171/22 peripheral/axial forms). Only 48 (25%) patients received concomitant DMARD therapy (65% were treated with methotrexate). The majority of patients started with first-line etanercept (n=102), followed by adalimumab (n=46), infliximab (n=44) and golimumab (n=1). At 3 months, 90% of patients had obtained an adequate response, 7% had discontinued due to lack of efficacy and 3% due to adverse events. Median drug survival was 2 years. One-year and 2-year drug survival rates were 77% and 67%, respectively. Seventy-nine (41%) patients switched to a second anti-TNFα and 29 to a third anti-TNFα; 82% of switchers responded to second-line therapy and 83% responded to third-line therapy.
  
  
  CONCLUSIONS
  High drug survival and high response rates were observed in these patients with PsA receiving their first anti-TNFα therapy in routine clinical practice.
authors.affiliation: Department of Rheumatology, Lille University Hospital, Lille 2, 59037 Lille cedex, France.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Soubrier
authors.affiliation: Department of Rheumatology, Lille University Hospital, Lille 2, 59037 Lille cedex, France.
authors.forename: Peggy
authors.initials: P
authors.lastname: Bele-Philippe
authors.affiliation: Department of Rheumatology, Lille University Hospital, Lille 2, 59037 Lille cedex, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Cortet
authors.affiliation: Department of Biostatistics, Faculty of Medicine, Lille Hospital, Lille, France.
authors.forename: Nassima
authors.initials: N
authors.lastname: Ramdane-Sebbane
authors.affiliation: Department of Rheumatology, Lille University Hospital, Lille 2, 59037 Lille cedex, France.
authors.forename: Marie-Astrid
authors.initials: MA
authors.lastname: Bacle-Boutry
authors.affiliation: Department of Rheumatology, Lille University Hospital, Lille 2, 59037 Lille cedex, France.
authors.forename: Lucie
authors.initials: L
authors.lastname: Lemeunier
authors.affiliation: Department of Rheumatology, Lille University Hospital, Lille 2, 59037 Lille cedex, France.
authors.forename: Rene-Marc
authors.initials: RM
authors.lastname: Flipo
authors.affiliation: Department of Rheumatology, Lille University Hospital, Lille 2, 59037 Lille cedex, France. Electronic address: julienpaccou@yahoo.fr.
authors.forename: Julien
authors.initials: J
authors.lastname: Paccou
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; C529000:golimumab; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept
keywords: Anti-TNFα; Drug survival; Methotrexate; Psoriatic arthritis; Safety; Switching