Long-term TNF-inhibitor treatment in patients with psoriatic arthritis

What is it about?

The long-term effectiveness of tumour necrosis factor inhibitors (TNFi) has mainly been explored in patients with rheumatoid arthritis, and the data available on patients with psoriatic arthritis is limited. The aims of this study were to investigate patients with psoriatic arthritis starting their first TNFi, describing how long they stayed on treatment (or “persistence”), identifying which patients were more likely to stay on treatment for five years, and investigate how long patients stayed on their second and third TNFi.

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Why is it important?

The British Society for Rheumatology Biologics Register (BSRBR) collects data on patients starting TNFi therapy. Between 2002 and 2006, 625 patients with psoriatic arthritis started a TNFi for the first time and consented to participate in the study. At five years, 47% of patients were still on their initial TNFi treatment. Males were more likely to stay on TNFi treatment, as well as patients using etanercept or adalimumab (rather than infliximab), and those without any comorbidities when starting their TNFi treatment. Half the patients then starting a second different TNFi remained on treatment after five years, and 48% of the patients starting a third TNFi remained on treatment after five years. This study provides information on long-term outcomes of TNFi treatment in patients with very active psoriatic arthritis. Persistence of TNFi in the study population was high, particularly after switching to second and third TNFi suggesting that treatment might still be beneficial in these patients.

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