Treatment with Tumor Necrosis Factor Inhibitors in Axial Spondyloarthritis: Comparison Between Private Rheumatology Practices and Academic Centers in a Large Observational Cohort

被引:11
作者
Ciurea, Adrian [1 ]
Weber, Ulrich
Stekhoven, Daniel [3 ]
Scherer, Almut [3 ]
Tamborrini, Giorgio [4 ]
Bernhard, Juerg [5 ]
Toniolo, Martin [1 ]
Villiger, Peter M. [6 ]
Zufferey, Pascal [7 ]
Kissling, Rudolf O. [2 ]
Michel, Beat A. [1 ]
Exer, Pascale [8 ]
机构
[1] Univ Zurich Hosp, Dept Rheumatol, CH-8091 Zurich, Switzerland
[2] Uniklin Balgrist, Dept Rheumatol, Zurich, Switzerland
[3] Swiss Clin Qual Management Fdn, Zurich, Switzerland
[4] Bethesda Hosp, Dept Rheumatol, Basel, Switzerland
[5] Burgerspital, Dept Rheumatol & Rehabil, Solothurn, Switzerland
[6] Univ Hosp Bern, Dept Rheumatol & Clin Immunol, CH-3010 Bern, Switzerland
[7] CHU Vaudois, Dept Rheumatol, CH-1011 Lausanne, Switzerland
[8] Praxis Rheuma Basel, Basel, Switzerland
关键词
AXIAL SPONDYLOARTHRITIS; TREATMENT RESPONSE; TUMOR NECROSIS FACTOR INHIBITORS; ANTI-TNF AGENTS; ANKYLOSING-SPONDYLITIS; RECOMMENDATIONS; INDEX; BATH; IMPROVEMENT; UPDATE;
D O I
10.3899/jrheum.140229
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. To evaluate the initiation of and response to tumor necrosis factor (TNF) inhibitors for axial spondyloarthritis (axSpA) in private rheumatology practices versus academic centers. Methods. We compared newly initiated TNF inhibition for axSpA in 363 patients enrolled in private practices with 100 patients recruited in 6 university hospitals within the Swiss Clinical Quality Management (SCQM) cohort. Results. All patients had been treated with >= 1 nonsteroidal antiinflammatory drug and > 70% of patients had a baseline Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) >= 4 before anti-TNF agent initiation. The proportion of patients with nonradiographic axSpA (nr-axSpA) treated with TNF inhibitors was higher in hospitals versus private practices (30.4% vs 18.7%, p = 0.02). The burden of disease as assessed by patient-reported outcomes at baseline was slightly higher in the hospital setting. Mean levels (+/- SD) of the Ankylosing Spondylitis Disease Activity Score were, however, virtually identical in private practices and academic centers (3.4 +/- 1.0 vs 3.4 +/- 0.9, p = 0.68). An Assessment of SpondyloArthritis international Society (ASAS40) response at 1 year was reached for ankylosing spondylitis in 51.7% in private practices and 52.9% in university hospitals (p = 1.0) and for nr-axSpA in 27.5% versus 25.0%, respectively (p = 1.0). Conclusion. With the exception of a lower proportion of patients with nr-axSpA newly treated with anti-TNF agents in private practices in comparison to academic centers, adherence to ASAS treatment recommendations for TNF inhibition was equally high, and similar response rates to TNF blockers were achieved in both clinical settings.
引用
收藏
页码:101 / 105
页数:5
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