title: Impact of prior biologic use on persistence of treatment in patients with psoriatic arthritis enrolled in the US Corrona registry.
abstract: Psoriatic arthritis (PsA) is a chronic condition characterized by a diverse set of symptoms, from swollen joints to nail disease to skin disease. A variety of treatment options are available, including tumor necrosis factor inhibitors (TNFis). Little is known about treatment persistence in patients with PsA who initiate TNFi therapy, with and without prior biologic use. This study assessed persistence in these subgroups of patients with PsA and identified factors associated with persistence. This retrospective study utilized data from the Corrona registry of patients with PsA-with or without prior biologic experience-who initiated TNFi therapy between October 1, 2002, and March 21, 2013. Kaplan-Meier curves estimated median time to nonpersistence (discontinuation or switch to another biologic). Cox proportional hazards models identified factors associated with TNFi nonpersistence. A total of 1241 TNFi initiations were identified: 549 by biologic-naïve and 692 by biologic-experienced patients. Through 4 years of follow-up, more biologic-naïve than biologic-experienced patients remained persistent. Biologic-naïve patients had a greater mean time to nonpersistence compared with biologic-experienced patients: 32 vs 23 months (p = 0.0002). Moderate and high disease activities based on clinical disease activity index and disease duration were associated with persistence in both biologic-naïve and biologic-experienced patients. Additionally, in the biologic-experienced patients, the number of prior medications and skin disease were associated with persistence. The majority of patients with PsA in this study were persistent with their TNFi therapy; biologic-naïve patients had greater persistence compared with biologic-experienced patients. Predictors of persistence differed slightly between biologic-naïve and biologic-experienced patients.
authors.affiliation: Corrona, LLC, 325 Turnpike Road, Suite 325, Southborough, MA, 01772, USA. Leslie.Harrold@umassmed.edu.|Department of Medicine, University of Massachusetts Medical School, AC7-201, 55 Lake Avenue North, Worcester, MA, 01655, USA. Leslie.Harrold@umassmed.edu.
authors.forename: Leslie R
authors.initials: LR
authors.lastname: Harrold
authors.affiliation: Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA.
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Stolshek
authors.affiliation: Corrona, LLC, 325 Turnpike Road, Suite 325, Southborough, MA, 01772, USA.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Rebello
authors.affiliation: Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Collier
authors.affiliation: Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA.
authors.forename: Alex
authors.initials: A
authors.lastname: Mutebi
authors.affiliation: Wade Outcomes Research and Consulting, 136 U Street, Salt Lake City, UT, 84103, USA.
authors.forename: Sally W
authors.initials: SW
authors.lastname: Wade
authors.affiliation: Corrona, LLC, 325 Turnpike Road, Suite 325, Southborough, MA, 01772, USA.
authors.forename: Wendi
authors.initials: W
authors.lastname: Malley
authors.affiliation: Corrona, LLC, 325 Turnpike Road, Suite 325, Southborough, MA, 01772, USA.|New York University School of Medicine, 301 East 17th Street, Suite 1410, New York, NY, 10003, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Greenberg
authors.affiliation: Corrona, LLC, 325 Turnpike Road, Suite 325, Southborough, MA, 01772, USA.|Department of Epidemiology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Etzel
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D001688:Biological Products / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014481:United States
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha
keywords: Biologics; Disease severity; Persistence; Psoriatic arthritis; Tumor necrosis factor inhibitors