title: Changes in Treatment Patterns in Patients with Psoriatic Arthritis Initiating Biologic and Nonbiologic Therapy in a Clinical Registry.
abstract: Treatment options for psoriatic arthritis (PsA) have increased and improved in the past decade; treatment patterns in PsA remain poorly understood. Understanding current practices would aid in treatment management of patients with PsA.
  
  
  
  This observational study was based on data from the Corrona registry of adult patients with PsA in North America collected between January 1, 2004, and December 31, 2012. Patients were divided among 3 therapy cohorts: tumor necrosis factor inhibitor (TNFi) monotherapy, methotrexate (MTX) monotherapy, and TNFi and MTX combination therapy. Patients were further divided among 3 study periods to understand changes over time: 2004-2006, 2007-2009, and 2010-2012. Data were collected on persistence, discontinuation, restarting, switching, adding/dropping therapy, and dose stretching.
  
  
  
  This study included 520 patients: 190 TNFi monotherapy, 217 MTX monotherapy, and 113 combination therapy; 110 from 2004 to 2006, 192 from 2007 to 2009, and 218 from 2010 to 2012. Over time, the proportion of patients initiating TNFi monotherapy decreased, while the proportion initiating combination therapy remained constant. The percentage of patients who were persistent decreased over time across all therapy cohorts, but remained higher in TNFi monotherapy than in other cohorts. Duration of persistence decreased over time. Patients initiating MTX monotherapy were more likely than their TNFi counterparts to add therapy.
  
  
  
  Treatment patterns in patients with PsA have changed from 2004 to 2012. Physicians are not more likely to initiate TNFi monotherapy, although clinical evidence supporting its effectiveness has increased over this study period, and patients remain more persistent with it.
authors.affiliation: From the Swedish Medical Center and University of Washington, Seattle, Washington; Amgen Inc., Thousand Oaks, California; Corrona LLC, Southborough, Massachusetts, USA. pmease@philipmease.com.|Sponsored by Corrona LLC and funded by Amgen Inc. The Corrona Rheumatoid Arthritis registry has been supported through contracted subscriptions in the last 2 years by AbbVie, Amgen Inc., AstraZeneca, Bristol-Myers Squibb, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB. P.J. Mease has received research grants from AbbVie, Amgen Inc., Bristol-Myers Squibb, Eli Lilly, Novartis, Pfizer, and UCB; consulting fees from AbbVie, Amgen Inc., Bristol-Myers Squibb, Corrona, Crescendo, Eli Lilly, Merck, Novartis, Pfizer, and UCB; and speaker fees from AbbVie, Amgen Inc., Biogen Idec, Bristol-Myers Squibb, Crescendo, Eli Lilly, Pfizer, and UCB. T. Lesperance is a contractor for and has received salary from Amgen Inc. M. Liu is an employee of Corrona LLC. D.H. Collier is an employee and stockholder of Amgen Inc. M. Mason is an employee of Corrona LLC. S. Deveikis is an employee of Corrona LLC. N.A. Accortt is an employee and stockholder of Amgen Inc. P.J. Mease, MD, Swedish Medical Center and University of Washington; T. Lesperance, MPH, Amgen Inc.; M. Liu, PhD, Corrona LLC; D.H. Collier, MD, Amgen Inc.; M. Mason, PhD, Corrona LLC; S. Deveikis, MPH, Corrona LLC; N.A. Accortt, PhD, Amgen Inc. pmease@philipmease.com.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Mease
authors.affiliation: From the Swedish Medical Center and University of Washington, Seattle, Washington; Amgen Inc., Thousand Oaks, California; Corrona LLC, Southborough, Massachusetts, USA.|Sponsored by Corrona LLC and funded by Amgen Inc. The Corrona Rheumatoid Arthritis registry has been supported through contracted subscriptions in the last 2 years by AbbVie, Amgen Inc., AstraZeneca, Bristol-Myers Squibb, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB. P.J. Mease has received research grants from AbbVie, Amgen Inc., Bristol-Myers Squibb, Eli Lilly, Novartis, Pfizer, and UCB; consulting fees from AbbVie, Amgen Inc., Bristol-Myers Squibb, Corrona, Crescendo, Eli Lilly, Merck, Novartis, Pfizer, and UCB; and speaker fees from AbbVie, Amgen Inc., Biogen Idec, Bristol-Myers Squibb, Crescendo, Eli Lilly, Pfizer, and UCB. T. Lesperance is a contractor for and has received salary from Amgen Inc. M. Liu is an employee of Corrona LLC. D.H. Collier is an employee and stockholder of Amgen Inc. M. Mason is an employee of Corrona LLC. S. Deveikis is an employee of Corrona LLC. N.A. Accortt is an employee and stockholder of Amgen Inc. P.J. Mease, MD, Swedish Medical Center and University of Washington; T. Lesperance, MPH, Amgen Inc.; M. Liu, PhD, Corrona LLC; D.H. Collier, MD, Amgen Inc.; M. Mason, PhD, Corrona LLC; S. Deveikis, MPH, Corrona LLC; N.A. Accortt, PhD, Amgen Inc.
authors.forename: Tamara
authors.initials: T
authors.lastname: Lesperance
authors.affiliation: From the Swedish Medical Center and University of Washington, Seattle, Washington; Amgen Inc., Thousand Oaks, California; Corrona LLC, Southborough, Massachusetts, USA.|Sponsored by Corrona LLC and funded by Amgen Inc. The Corrona Rheumatoid Arthritis registry has been supported through contracted subscriptions in the last 2 years by AbbVie, Amgen Inc., AstraZeneca, Bristol-Myers Squibb, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB. P.J. Mease has received research grants from AbbVie, Amgen Inc., Bristol-Myers Squibb, Eli Lilly, Novartis, Pfizer, and UCB; consulting fees from AbbVie, Amgen Inc., Bristol-Myers Squibb, Corrona, Crescendo, Eli Lilly, Merck, Novartis, Pfizer, and UCB; and speaker fees from AbbVie, Amgen Inc., Biogen Idec, Bristol-Myers Squibb, Crescendo, Eli Lilly, Pfizer, and UCB. T. Lesperance is a contractor for and has received salary from Amgen Inc. M. Liu is an employee of Corrona LLC. D.H. Collier is an employee and stockholder of Amgen Inc. M. Mason is an employee of Corrona LLC. S. Deveikis is an employee of Corrona LLC. N.A. Accortt is an employee and stockholder of Amgen Inc. P.J. Mease, MD, Swedish Medical Center and University of Washington; T. Lesperance, MPH, Amgen Inc.; M. Liu, PhD, Corrona LLC; D.H. Collier, MD, Amgen Inc.; M. Mason, PhD, Corrona LLC; S. Deveikis, MPH, Corrona LLC; N.A. Accortt, PhD, Amgen Inc.
authors.forename: Mei
authors.initials: M
authors.lastname: Liu
authors.affiliation: From the Swedish Medical Center and University of Washington, Seattle, Washington; Amgen Inc., Thousand Oaks, California; Corrona LLC, Southborough, Massachusetts, USA.|Sponsored by Corrona LLC and funded by Amgen Inc. The Corrona Rheumatoid Arthritis registry has been supported through contracted subscriptions in the last 2 years by AbbVie, Amgen Inc., AstraZeneca, Bristol-Myers Squibb, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB. P.J. Mease has received research grants from AbbVie, Amgen Inc., Bristol-Myers Squibb, Eli Lilly, Novartis, Pfizer, and UCB; consulting fees from AbbVie, Amgen Inc., Bristol-Myers Squibb, Corrona, Crescendo, Eli Lilly, Merck, Novartis, Pfizer, and UCB; and speaker fees from AbbVie, Amgen Inc., Biogen Idec, Bristol-Myers Squibb, Crescendo, Eli Lilly, Pfizer, and UCB. T. Lesperance is a contractor for and has received salary from Amgen Inc. M. Liu is an employee of Corrona LLC. D.H. Collier is an employee and stockholder of Amgen Inc. M. Mason is an employee of Corrona LLC. S. Deveikis is an employee of Corrona LLC. N.A. Accortt is an employee and stockholder of Amgen Inc. P.J. Mease, MD, Swedish Medical Center and University of Washington; T. Lesperance, MPH, Amgen Inc.; M. Liu, PhD, Corrona LLC; D.H. Collier, MD, Amgen Inc.; M. Mason, PhD, Corrona LLC; S. Deveikis, MPH, Corrona LLC; N.A. Accortt, PhD, Amgen Inc.
authors.forename: David H
authors.initials: DH
authors.lastname: Collier
authors.affiliation: From the Swedish Medical Center and University of Washington, Seattle, Washington; Amgen Inc., Thousand Oaks, California; Corrona LLC, Southborough, Massachusetts, USA.|Sponsored by Corrona LLC and funded by Amgen Inc. The Corrona Rheumatoid Arthritis registry has been supported through contracted subscriptions in the last 2 years by AbbVie, Amgen Inc., AstraZeneca, Bristol-Myers Squibb, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB. P.J. Mease has received research grants from AbbVie, Amgen Inc., Bristol-Myers Squibb, Eli Lilly, Novartis, Pfizer, and UCB; consulting fees from AbbVie, Amgen Inc., Bristol-Myers Squibb, Corrona, Crescendo, Eli Lilly, Merck, Novartis, Pfizer, and UCB; and speaker fees from AbbVie, Amgen Inc., Biogen Idec, Bristol-Myers Squibb, Crescendo, Eli Lilly, Pfizer, and UCB. T. Lesperance is a contractor for and has received salary from Amgen Inc. M. Liu is an employee of Corrona LLC. D.H. Collier is an employee and stockholder of Amgen Inc. M. Mason is an employee of Corrona LLC. S. Deveikis is an employee of Corrona LLC. N.A. Accortt is an employee and stockholder of Amgen Inc. P.J. Mease, MD, Swedish Medical Center and University of Washington; T. Lesperance, MPH, Amgen Inc.; M. Liu, PhD, Corrona LLC; D.H. Collier, MD, Amgen Inc.; M. Mason, PhD, Corrona LLC; S. Deveikis, MPH, Corrona LLC; N.A. Accortt, PhD, Amgen Inc.
authors.forename: Marc
authors.initials: M
authors.lastname: Mason
authors.affiliation: From the Swedish Medical Center and University of Washington, Seattle, Washington; Amgen Inc., Thousand Oaks, California; Corrona LLC, Southborough, Massachusetts, USA.|Sponsored by Corrona LLC and funded by Amgen Inc. The Corrona Rheumatoid Arthritis registry has been supported through contracted subscriptions in the last 2 years by AbbVie, Amgen Inc., AstraZeneca, Bristol-Myers Squibb, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB. P.J. Mease has received research grants from AbbVie, Amgen Inc., Bristol-Myers Squibb, Eli Lilly, Novartis, Pfizer, and UCB; consulting fees from AbbVie, Amgen Inc., Bristol-Myers Squibb, Corrona, Crescendo, Eli Lilly, Merck, Novartis, Pfizer, and UCB; and speaker fees from AbbVie, Amgen Inc., Biogen Idec, Bristol-Myers Squibb, Crescendo, Eli Lilly, Pfizer, and UCB. T. Lesperance is a contractor for and has received salary from Amgen Inc. M. Liu is an employee of Corrona LLC. D.H. Collier is an employee and stockholder of Amgen Inc. M. Mason is an employee of Corrona LLC. S. Deveikis is an employee of Corrona LLC. N.A. Accortt is an employee and stockholder of Amgen Inc. P.J. Mease, MD, Swedish Medical Center and University of Washington; T. Lesperance, MPH, Amgen Inc.; M. Liu, PhD, Corrona LLC; D.H. Collier, MD, Amgen Inc.; M. Mason, PhD, Corrona LLC; S. Deveikis, MPH, Corrona LLC; N.A. Accortt, PhD, Amgen Inc.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Deveikis
authors.affiliation: From the Swedish Medical Center and University of Washington, Seattle, Washington; Amgen Inc., Thousand Oaks, California; Corrona LLC, Southborough, Massachusetts, USA.|Sponsored by Corrona LLC and funded by Amgen Inc. The Corrona Rheumatoid Arthritis registry has been supported through contracted subscriptions in the last 2 years by AbbVie, Amgen Inc., AstraZeneca, Bristol-Myers Squibb, Genentech, Horizon Pharma USA, Janssen, Eli Lilly, Novartis, Pfizer, and UCB. P.J. Mease has received research grants from AbbVie, Amgen Inc., Bristol-Myers Squibb, Eli Lilly, Novartis, Pfizer, and UCB; consulting fees from AbbVie, Amgen Inc., Bristol-Myers Squibb, Corrona, Crescendo, Eli Lilly, Merck, Novartis, Pfizer, and UCB; and speaker fees from AbbVie, Amgen Inc., Biogen Idec, Bristol-Myers Squibb, Crescendo, Eli Lilly, Pfizer, and UCB. T. Lesperance is a contractor for and has received salary from Amgen Inc. M. Liu is an employee of Corrona LLC. D.H. Collier is an employee and stockholder of Amgen Inc. M. Mason is an employee of Corrona LLC. S. Deveikis is an employee of Corrona LLC. N.A. Accortt is an employee and stockholder of Amgen Inc. P.J. Mease, MD, Swedish Medical Center and University of Washington; T. Lesperance, MPH, Amgen Inc.; M. Liu, PhD, Corrona LLC; D.H. Collier, MD, Amgen Inc.; M. Mason, PhD, Corrona LLC; S. Deveikis, MPH, Corrona LLC; N.A. Accortt, PhD, Amgen Inc.
authors.forename: Neil A
authors.initials: NA
authors.lastname: Accortt
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D001688:Biological Products / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012042:Registries; D019233:Retreatment; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha; D008727:Methotrexate
keywords: PERSISTENCE; PSORIATIC ARTHRITIS; TUMOR NECROSIS FACTOR INHIBITOR