Impact of different infliximab dose regimens on treatment response and drug survival in 462 patients with psoriatic arthritis: results from the nationwide registries DANBIO and ICEBIO

Bente Glintborg, Bjorn Gudbjornsson, Niels Steen Krogh, Emina Omerovic, Natalia Manilo, Mette Holland-Fischer, Hanne M Lindegaard, Anne Gitte Loft, Henrik Nordin, Laura Johnsen, Sussi Maria Flejsborg Oeftiger, Annette Hansen, Claus Rasmussen, Gerdur Grondal, Arni Jon Geirsson, Merete Lund Hetland

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVE: The aim of this study was to describe dose regimens, dose escalation and clinical outcomes in TNF-α inhibitor (TNFi)-naive patients with PsA treated with infliximab in routine rheumatology care.

METHODS: We conducted an observational cohort study based on the nationwide Danish Rheumatologic Database (DANBIO) and Center for Rheumatology Research (ICEBIO) registries. Stratified by country, characteristics of patients treated with ≤3 mg infliximab/kg body weight, 3-5 mg/kg or ≥5 mg/kg every 8 weeks were described. Outcomes were evaluated by ACR 20%, 50% and 70% (ACR20/50/70) responses and European League Against Rheumatism good response after 6 months, disease activity after 12 months, Kaplan-Meier plots and regression analyses.

RESULTS: Four hundred and sixty-two patients (376 Danish, 86 Icelandic) received treatment with infliximab. In Danish patients, the starting dose was ≤3 mg/kg in 110 patients (29%), 3-5 mg/kg in 157 (42%), ≥5 mg/kg in 38 (10%) and unregistered in 71 (19%). In Icelandic patients, corresponding numbers were 64 (74%), 17 (27%), 0 (0%) and 5 (6%). Patients with a higher body weight received lower doses per kilogram. Danish patients received higher doses than Icelandic patients at baseline [median 3.1 (interquartile range 3.0-3.8) vs 2.3 (2.1-2.9) mg/kg, P < 0.05] and after 12 months [3.3 (3.0-4.5) vs 2.9 (2.2-3.5) mg/kg, P < 0.0001]. After 12 months, 58% of Danish and 66% of Icelandic patients maintained treatment. Danish patients had shorter drug survival than Icelandic patients (1183 vs 483 days). In univariate analyses stratified by country, time until dose escalation, response rates, drug survival and 1-year's disease activity were independent of starting dose. Drug survival was shorter among patients not receiving concomitant MTX.

CONCLUSION: In clinical practice, > 70% of Icelandic and Danish PsA patients treated with infliximab received sustained doses below the 5 mg/kg every 8 weeks recommended in international guidelines. Lower starting doses did not affect drug survival or response.

OriginalsprogEngelsk
TidsskriftRheumatology
Vol/bind53
Udgave nummer11
Sider (fra-til)2100-9
ISSN1462-0324
DOI
StatusUdgivet - nov. 2014

Fingeraftryk

Psoriatic Arthritis
Registries
Pharmaceutical Preparations
Rheumatology
Cohort Studies
Regression Analysis
Databases
Guidelines

Citer dette

Glintborg, Bente ; Gudbjornsson, Bjorn ; Steen Krogh, Niels ; Omerovic, Emina ; Manilo, Natalia ; Holland-Fischer, Mette ; Lindegaard, Hanne M ; Gitte Loft, Anne ; Nordin, Henrik ; Johnsen, Laura ; Flejsborg Oeftiger, Sussi Maria ; Hansen, Annette ; Rasmussen, Claus ; Grondal, Gerdur ; Jon Geirsson, Arni ; Lund Hetland, Merete. / Impact of different infliximab dose regimens on treatment response and drug survival in 462 patients with psoriatic arthritis : results from the nationwide registries DANBIO and ICEBIO. I: Rheumatology. 2014 ; Bind 53, Nr. 11. s. 2100-9.
@article{3091d5a2b45f4ea5ab61fabbec560aff,
title = "Impact of different infliximab dose regimens on treatment response and drug survival in 462 patients with psoriatic arthritis: results from the nationwide registries DANBIO and ICEBIO",
abstract = "OBJECTIVE: The aim of this study was to describe dose regimens, dose escalation and clinical outcomes in TNF-α inhibitor (TNFi)-naive patients with PsA treated with infliximab in routine rheumatology care.METHODS: We conducted an observational cohort study based on the nationwide Danish Rheumatologic Database (DANBIO) and Center for Rheumatology Research (ICEBIO) registries. Stratified by country, characteristics of patients treated with ≤3 mg infliximab/kg body weight, 3-5 mg/kg or ≥5 mg/kg every 8 weeks were described. Outcomes were evaluated by ACR 20{\%}, 50{\%} and 70{\%} (ACR20/50/70) responses and European League Against Rheumatism good response after 6 months, disease activity after 12 months, Kaplan-Meier plots and regression analyses.RESULTS: Four hundred and sixty-two patients (376 Danish, 86 Icelandic) received treatment with infliximab. In Danish patients, the starting dose was ≤3 mg/kg in 110 patients (29{\%}), 3-5 mg/kg in 157 (42{\%}), ≥5 mg/kg in 38 (10{\%}) and unregistered in 71 (19{\%}). In Icelandic patients, corresponding numbers were 64 (74{\%}), 17 (27{\%}), 0 (0{\%}) and 5 (6{\%}). Patients with a higher body weight received lower doses per kilogram. Danish patients received higher doses than Icelandic patients at baseline [median 3.1 (interquartile range 3.0-3.8) vs 2.3 (2.1-2.9) mg/kg, P < 0.05] and after 12 months [3.3 (3.0-4.5) vs 2.9 (2.2-3.5) mg/kg, P < 0.0001]. After 12 months, 58{\%} of Danish and 66{\%} of Icelandic patients maintained treatment. Danish patients had shorter drug survival than Icelandic patients (1183 vs 483 days). In univariate analyses stratified by country, time until dose escalation, response rates, drug survival and 1-year's disease activity were independent of starting dose. Drug survival was shorter among patients not receiving concomitant MTX.CONCLUSION: In clinical practice, > 70{\%} of Icelandic and Danish PsA patients treated with infliximab received sustained doses below the 5 mg/kg every 8 weeks recommended in international guidelines. Lower starting doses did not affect drug survival or response.",
author = "Bente Glintborg and Bjorn Gudbjornsson and {Steen Krogh}, Niels and Emina Omerovic and Natalia Manilo and Mette Holland-Fischer and Lindegaard, {Hanne M} and {Gitte Loft}, Anne and Henrik Nordin and Laura Johnsen and {Flejsborg Oeftiger}, {Sussi Maria} and Annette Hansen and Claus Rasmussen and Gerdur Grondal and {Jon Geirsson}, Arni and {Lund Hetland}, Merete",
note = "{\circledC} The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.",
year = "2014",
month = "11",
doi = "10.1093/rheumatology/keu252",
language = "English",
volume = "53",
pages = "2100--9",
journal = "Rheumatology",
issn = "1462-0324",
publisher = "Heinemann",
number = "11",

}

Glintborg, B, Gudbjornsson, B, Steen Krogh, N, Omerovic, E, Manilo, N, Holland-Fischer, M, Lindegaard, HM, Gitte Loft, A, Nordin, H, Johnsen, L, Flejsborg Oeftiger, SM, Hansen, A, Rasmussen, C, Grondal, G, Jon Geirsson, A & Lund Hetland, M 2014, 'Impact of different infliximab dose regimens on treatment response and drug survival in 462 patients with psoriatic arthritis: results from the nationwide registries DANBIO and ICEBIO', Rheumatology, bind 53, nr. 11, s. 2100-9. https://doi.org/10.1093/rheumatology/keu252

Impact of different infliximab dose regimens on treatment response and drug survival in 462 patients with psoriatic arthritis : results from the nationwide registries DANBIO and ICEBIO. / Glintborg, Bente; Gudbjornsson, Bjorn; Steen Krogh, Niels; Omerovic, Emina; Manilo, Natalia; Holland-Fischer, Mette; Lindegaard, Hanne M; Gitte Loft, Anne; Nordin, Henrik; Johnsen, Laura; Flejsborg Oeftiger, Sussi Maria; Hansen, Annette; Rasmussen, Claus; Grondal, Gerdur; Jon Geirsson, Arni; Lund Hetland, Merete.

I: Rheumatology, Bind 53, Nr. 11, 11.2014, s. 2100-9.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Impact of different infliximab dose regimens on treatment response and drug survival in 462 patients with psoriatic arthritis

T2 - results from the nationwide registries DANBIO and ICEBIO

AU - Glintborg, Bente

AU - Gudbjornsson, Bjorn

AU - Steen Krogh, Niels

AU - Omerovic, Emina

AU - Manilo, Natalia

AU - Holland-Fischer, Mette

AU - Lindegaard, Hanne M

AU - Gitte Loft, Anne

AU - Nordin, Henrik

AU - Johnsen, Laura

AU - Flejsborg Oeftiger, Sussi Maria

AU - Hansen, Annette

AU - Rasmussen, Claus

AU - Grondal, Gerdur

AU - Jon Geirsson, Arni

AU - Lund Hetland, Merete

N1 - © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

PY - 2014/11

Y1 - 2014/11

N2 - OBJECTIVE: The aim of this study was to describe dose regimens, dose escalation and clinical outcomes in TNF-α inhibitor (TNFi)-naive patients with PsA treated with infliximab in routine rheumatology care.METHODS: We conducted an observational cohort study based on the nationwide Danish Rheumatologic Database (DANBIO) and Center for Rheumatology Research (ICEBIO) registries. Stratified by country, characteristics of patients treated with ≤3 mg infliximab/kg body weight, 3-5 mg/kg or ≥5 mg/kg every 8 weeks were described. Outcomes were evaluated by ACR 20%, 50% and 70% (ACR20/50/70) responses and European League Against Rheumatism good response after 6 months, disease activity after 12 months, Kaplan-Meier plots and regression analyses.RESULTS: Four hundred and sixty-two patients (376 Danish, 86 Icelandic) received treatment with infliximab. In Danish patients, the starting dose was ≤3 mg/kg in 110 patients (29%), 3-5 mg/kg in 157 (42%), ≥5 mg/kg in 38 (10%) and unregistered in 71 (19%). In Icelandic patients, corresponding numbers were 64 (74%), 17 (27%), 0 (0%) and 5 (6%). Patients with a higher body weight received lower doses per kilogram. Danish patients received higher doses than Icelandic patients at baseline [median 3.1 (interquartile range 3.0-3.8) vs 2.3 (2.1-2.9) mg/kg, P < 0.05] and after 12 months [3.3 (3.0-4.5) vs 2.9 (2.2-3.5) mg/kg, P < 0.0001]. After 12 months, 58% of Danish and 66% of Icelandic patients maintained treatment. Danish patients had shorter drug survival than Icelandic patients (1183 vs 483 days). In univariate analyses stratified by country, time until dose escalation, response rates, drug survival and 1-year's disease activity were independent of starting dose. Drug survival was shorter among patients not receiving concomitant MTX.CONCLUSION: In clinical practice, > 70% of Icelandic and Danish PsA patients treated with infliximab received sustained doses below the 5 mg/kg every 8 weeks recommended in international guidelines. Lower starting doses did not affect drug survival or response.

AB - OBJECTIVE: The aim of this study was to describe dose regimens, dose escalation and clinical outcomes in TNF-α inhibitor (TNFi)-naive patients with PsA treated with infliximab in routine rheumatology care.METHODS: We conducted an observational cohort study based on the nationwide Danish Rheumatologic Database (DANBIO) and Center for Rheumatology Research (ICEBIO) registries. Stratified by country, characteristics of patients treated with ≤3 mg infliximab/kg body weight, 3-5 mg/kg or ≥5 mg/kg every 8 weeks were described. Outcomes were evaluated by ACR 20%, 50% and 70% (ACR20/50/70) responses and European League Against Rheumatism good response after 6 months, disease activity after 12 months, Kaplan-Meier plots and regression analyses.RESULTS: Four hundred and sixty-two patients (376 Danish, 86 Icelandic) received treatment with infliximab. In Danish patients, the starting dose was ≤3 mg/kg in 110 patients (29%), 3-5 mg/kg in 157 (42%), ≥5 mg/kg in 38 (10%) and unregistered in 71 (19%). In Icelandic patients, corresponding numbers were 64 (74%), 17 (27%), 0 (0%) and 5 (6%). Patients with a higher body weight received lower doses per kilogram. Danish patients received higher doses than Icelandic patients at baseline [median 3.1 (interquartile range 3.0-3.8) vs 2.3 (2.1-2.9) mg/kg, P < 0.05] and after 12 months [3.3 (3.0-4.5) vs 2.9 (2.2-3.5) mg/kg, P < 0.0001]. After 12 months, 58% of Danish and 66% of Icelandic patients maintained treatment. Danish patients had shorter drug survival than Icelandic patients (1183 vs 483 days). In univariate analyses stratified by country, time until dose escalation, response rates, drug survival and 1-year's disease activity were independent of starting dose. Drug survival was shorter among patients not receiving concomitant MTX.CONCLUSION: In clinical practice, > 70% of Icelandic and Danish PsA patients treated with infliximab received sustained doses below the 5 mg/kg every 8 weeks recommended in international guidelines. Lower starting doses did not affect drug survival or response.

U2 - 10.1093/rheumatology/keu252

DO - 10.1093/rheumatology/keu252

M3 - Journal article

C2 - 24939677

VL - 53

SP - 2100

EP - 2109

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 11

ER -