Seminars in arthritis and rheumatism · 2025
Incidence and predictors of primary failure of targeted therapy in patients with Psoriatic Arthritis.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Kharouf Fadi, Gao Shangyi, AlHadri Ali, Pereira Daniel, Cook Richard J, Chandran Vinod, Gladman Dafna D
Аннотация
OBJECTIVES: Primary failure of targeted DMARDs (biologic or synthetic) is common in rheumatologic practice. We aimed to define the incidence of primary failure in patients with psoriatic arthritis (PsA) and identify the factors associated with its occurrence.
METHODS: We included patients with PsA followed at our prospective observational cohort. We defined primary failure as either the physician's judgment of ineffectiveness during the first year of therapy or failure, at the one-year visit, to achieve ≥40 % reduction in baseline swollen joint count (SJC) and ≥50 % reduction in PASI (provided that PASI was >2 after therapy). We identified patients with primary failure of targeted DMARDs and compared them to responders and patients who discontinued treatment for reasons not related to effectiveness. We used univariable and multivariable multinomial logistic regression, adjusted for calendar time, to model the effect of each variable on the outcome.
RESULTS: Among 591 patients on targeted DMARDs, 209 (35.4 %) experienced primary failure. In the multivariable model, adjusted for calendar time, daily alcohol consumption (OR 3.57, 95 % CI 0.1.32-9.6) and higher BMI (OR 1.04, 95 % CI 1.01, 1.08) were associated with the development of primary failure. In contrast, higher educational attainment (OR 0.45, 95 % CI 0.26-0.78]), SJC ≥5 at baseline (OR 0.45, 95 % CI 0.25-0.80), and a higher damaged joint count (OR 0.96, 95 % CI 0.93, 0.995) were associated with a reduced risk of primary failure.
CONCLUSION: Primary failure of targeted DMARDs is common in PsA and may be influenced by socioeconomic and disease-related features.
METHODS: We included patients with PsA followed at our prospective observational cohort. We defined primary failure as either the physician's judgment of ineffectiveness during the first year of therapy or failure, at the one-year visit, to achieve ≥40 % reduction in baseline swollen joint count (SJC) and ≥50 % reduction in PASI (provided that PASI was >2 after therapy). We identified patients with primary failure of targeted DMARDs and compared them to responders and patients who discontinued treatment for reasons not related to effectiveness. We used univariable and multivariable multinomial logistic regression, adjusted for calendar time, to model the effect of each variable on the outcome.
RESULTS: Among 591 patients on targeted DMARDs, 209 (35.4 %) experienced primary failure. In the multivariable model, adjusted for calendar time, daily alcohol consumption (OR 3.57, 95 % CI 0.1.32-9.6) and higher BMI (OR 1.04, 95 % CI 1.01, 1.08) were associated with the development of primary failure. In contrast, higher educational attainment (OR 0.45, 95 % CI 0.26-0.78]), SJC ≥5 at baseline (OR 0.45, 95 % CI 0.25-0.80), and a higher damaged joint count (OR 0.96, 95 % CI 0.93, 0.995) were associated with a reduced risk of primary failure.
CONCLUSION: Primary failure of targeted DMARDs is common in PsA and may be influenced by socioeconomic and disease-related features.