FRI0453 DOES DISCORDANCE BETWEEN BASELINE PATIENT’S AND EVALUATOR’S GLOBAL ASSESSMENT OF DISEASE ACTIVITY IMPACT RETENTION AND REMISSION RATES OF TNF INHIBITORS IN PATIENTS WITH PSORIATIC ARTHRITIS? DATA FROM THE EUROSPA RESEARCH COLLABORATION
Authors: Brigitte Michelsen, Lykke Ørnbjerg, Heřman Mann, Joseph Sexton, Michael Nissen, Maria Jose Santos, Dan Nordström, Lennart T.H. Jacobsson, Ziga Rotar, Björn Gudbjornsson, Süleyman Serdar Koca, Catalin Codreanu, Manuel Pombo-Suarez, Irene van der Horst-Bruinsma, Anne Gitte Loft, Karel Pavelka, Eirik Kristianslund, Burkhard Moeller, Elsa Vieira-Sousa, Anna-Mari Hokkanen, Ulf Lindström, Matija Tomsic, Thorvardur Jon Love, Berna Goker, Ruxandra Ionescu, Carlos Sánchez-Piedra, Marleen van de Sande, Gary Macfarlane, Florenzo Iannone, Lise Hyldstrup, Niels Steen Krogh, Mikkel Ǿstergaard, Merete L. Hetland
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Discordance between baseline patient's and evaluator's global assessment of disease activity is common<sup>1</sup> and may reduce the likelihood of remission following tumor necrosis factor inhibitor (TNFi) treatment in patients with psoriatic arthritis (PsA).<sup>2</sup> However, the impact of such discordance on retention rates of TNFi in PsA patients remains unexplored. <h3>Objectives</h3> To explore the impact of discordance, defined as patient's minus evaluator's global assessment (ΔPEG), on retention rates and remission rates (DAS28(3)CRP (which does not include patient's global) and DAS28(4)CRP (which includes patient's global)) in PsA patients initiating their first TNFi treatment. We used pooled data from the European Spondyloarthritis Research Collaboration (EuroSpA). <h3>Methods</h3> TNFi naïve PsA patients from 11 European registries in EuroSpA were included. Kaplan-Meier analyses were used to estimate TNFi retention rates after 6/12/24 months, with comparison between baseline ΔPEG quartiles using the log rank test, stratified by gender. Remission rates were compared between different ΔPEG quartiles with Chi-square test, stratified by gender. <h3>Results</h3> A total of 5422 PsA patients were included. Mean (SD) age for women(n=2988)/men(n=2867) were 49.3(12.5)/47.4(11.7) years, disease duration 6.6(7.3)/6.7(7.2) years, median(25-75 percentiles) baseline ΔPEG 17(0-38)/10(0-30) mm. Retention rates and DAS28(4)CRP but not DAS28(3)CRP remission rates were lower for higher quartiles of baseline ΔPEG (table, figure). <h3>Conclusion</h3> High baseline discordance (ΔPEG) was associated with lower TNFi retention rates and with DAS28(4)CRP but not DAS28(3)CRP remission rates after 6, 12 and 24 months' follow-up in both male and female PsA patients. The choice of remission criteria in the follow-up of PsA patients may affect important treatment decisions, and may be of particular impact in patients with high baseline ΔPEG. <h3>References</h3> [1] Lindstrom, et al., J Rheumatol 2015;42:1781-5; 2 Michelsen, et al. Ann Rheum Dis 2016;76:708-11. <h3>Acknowledgement</h3> Novartis Pharma AG and IQVIA for supporting the EuroSpA collaboration.<b>:</b> <h3>Disclosure of Interests</h3> Brigitte Michelsen Grant/research support from: Unrestricted grant: Novartis, Consultant for: Novartis, UCB, Lykke Ørnbjerg Grant/research support from: Unrestricted grant: Novartis, Heřman Mann Consultant for: Pfizer, Eli Lilly, Sanofi, Speakers bureau: AbbVie, Roche, Pfizer, MSD, Eli Lilly, Sanofi, Joseph Sexton: None declared, Michael Nissen Consultant for: AbbVie, Lilly, Novartis, and Pfizer, Maria Jose Santos: None declared, Dan Nordström Grant/research support from: MSD, Pfizer, Consultant for: AbbVie, BMS, MSD, Novartis, Roche, Pfizer, UCB, Speakers bureau: Novartis, UCB, Lennart T.H. Jacobsson Consultant for: LJ has received lecture and consulting fees from Pfizer, Abbvie, Novartis, Eli-Lily and Janssen, Ziga Rotar: None declared, Björn Gudbjornsson: None declared, Süleyman Serdar Koca: None declared, Catalin Codreanu: None declared, Manuel Pombo-Suarez: None declared, Irene van der Horst-Bruinsma Grant/research support from: MSD, Pfizer, AbbVie, Consultant for: Abbvie, UCB, MSD, Novartis, Speakers bureau: BMS, AbbVie, Pfizer, MSD, Anne Gitte Loft: None declared, Karel Pavelka: None declared, Eirik kristianslund: None declared, Burkhard Moeller Consultant for: Swissmedic Human Medicines Expert Committee Member (regulatory agency), Elsa Vieira-Sousa Grant/research support from: MSD, Novartis, Anna-Mari Hokkanen: None declared, Ulf Lindström: None declared, Matija Tomsic: None declared, Thorvardur Jon Love Consultant for: Received reimbursment from Celgene for speaking about guidelines for the treatment of psoriatic arthritis, Berna Goker: None declared, Ruxandra Ionescu: None declared, Carlos Sánchez-Piedra: None declared, Marleen van de Sande Grant/research support from: van Janssen, Novartis, Eli Lily, Consultant for: Novartis and Abbvie, Gary Macfarlane Grant/research support from: Have received research grants (not current) from Abbvie and Pfizer. Have received research grants (not current) from the British Society for Rheumatology, who received the funds from Abbive, Pfizer and UCB. Have received research grant (current) from the British Society for Rheumatology, who received the funds from Celgene., Florenzo Iannone: None declared, Lise Hyldstrup: None declared, Niels Steen Krogh: None declared, Mikkel Ǿstergaard Grant/research support from: Abbvie, Celgene, Centocor, Merck, Novartis, Consultant for: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, and UCB, Speakers bureau: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, and UCB, Merete L. Hetland Grant/research support from: BMS, MSD, AbbVie, Roche, Novartis, Biogen, Pfizer, Consultant for: Eli Lilly, Speakers bureau: Orion Pharma, Biogen, Pfizer, CellTrion, Merck, Samsung Bioepis