Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registries
Abstract Background Efficacy of tumour necrosis factor inhibitors (TNFi) for peripheral arthritis in patients with psoriatic arthritis (PsA) has been established in randomized clinical trials that have used improvement in summated joint counts as an outcome. Whether joints at different anatomical lo...
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2025-01-01
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| Series: | Arthritis Research & Therapy |
| Online Access: | https://doi.org/10.1186/s13075-025-03488-w |
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| author | Adrian Ciurea Seraphina Kissling Andrea Götschi Lykke Midtbøll Ørnbjerg Simon Horskjær Rasmussen Bálint Tamási Burkhard Möller Michael J. Nissen Bente Glintborg Anne Gitte Loft Almut Scherer René Bräm Karel Pavelka Jakub Závada Joao Madruga Dias Paula Valente Bjorn Gudbjornsson Olafur Palsson Vappu Rantalaiho Ritva Peltomaa Catalin Codreanu Corina Mogosan Florenzo Iannone Marco Sebastiani Gareth T. Jones Gary J. Macfarlane Isabel Castrejon Ziga Rotar Brigitte Michelsen Johan K. Wallman Irene van der Horst-Bruinsma Oliver Distler Mikkel Østergaard Merete Lund Hetland Raphael Micheroli Caroline Ospelt |
| author_facet | Adrian Ciurea Seraphina Kissling Andrea Götschi Lykke Midtbøll Ørnbjerg Simon Horskjær Rasmussen Bálint Tamási Burkhard Möller Michael J. Nissen Bente Glintborg Anne Gitte Loft Almut Scherer René Bräm Karel Pavelka Jakub Závada Joao Madruga Dias Paula Valente Bjorn Gudbjornsson Olafur Palsson Vappu Rantalaiho Ritva Peltomaa Catalin Codreanu Corina Mogosan Florenzo Iannone Marco Sebastiani Gareth T. Jones Gary J. Macfarlane Isabel Castrejon Ziga Rotar Brigitte Michelsen Johan K. Wallman Irene van der Horst-Bruinsma Oliver Distler Mikkel Østergaard Merete Lund Hetland Raphael Micheroli Caroline Ospelt |
| author_sort | Adrian Ciurea |
| collection | DOAJ |
| description | Abstract Background Efficacy of tumour necrosis factor inhibitors (TNFi) for peripheral arthritis in patients with psoriatic arthritis (PsA) has been established in randomized clinical trials that have used improvement in summated joint counts as an outcome. Whether joints at different anatomical locations might respond differentially to TNFi remains unknown. The aim of the study was to investigate potential variations in the responsiveness to a first tumour necrosis factor inhibitor (TNFi) among joints at distinct locations in patients with psoriatic arthritis (PsA) treated in routine clinical care. Methods Bionaive PsA patients from nine European countries were included in this observational cohort study if ≥ 1 joint was swollen at the initiation of a first TNFi as monotherapy or added to methotrexate. Only the 28-joint count was available without imaging data confirming the presence of synovitis. The primary outcome was time to first resolution of joint swelling at each joint level. Hazard ratios (HR) for resolution comparing different joint locations were estimated using interval-censored mixed-effects Cox proportional hazards models, including a random effect for country and patient, adjusted for age and sex. Results A total of 1729 patients with 8397 swollen joints at the start of TNFi were included. Considering the upper extremity, a higher rate of resolution of joint swelling (HR, 95% CI) was observed for the shoulder (1.65, 1.16–2.35) and elbow (1.90, 1.38–2.61), while a lower rate was found for the wrist (0.72, 0.62–0.83) compared to the joints of digit 3. Within fingers, and using the same reference, joint swelling resolved fastest in digit 4 (1.77, 1.49–2.11) and digit 5 (1.88, 1.53–2.31). A lower rate of resolution of joint swelling was found for the knee in comparison to the elbow, the corresponding joint on the upper limb (0.56, 0.40–0.78). Conclusion The time to resolution of joint swelling upon treatment with TNFi in patients with PsA seems to depend on the localisation of the affected joints. |
| format | Article |
| id | doaj-art-234e0c422cb349309310f7018d183e07 |
| institution | Kabale University |
| issn | 1478-6362 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthritis Research & Therapy |
| spelling | doaj-art-234e0c422cb349309310f7018d183e072025-02-02T12:35:40ZengBMCArthritis Research & Therapy1478-63622025-01-0127111610.1186/s13075-025-03488-wDifferences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registriesAdrian Ciurea0Seraphina Kissling1Andrea Götschi2Lykke Midtbøll Ørnbjerg3Simon Horskjær Rasmussen4Bálint Tamási5Burkhard Möller6Michael J. Nissen7Bente Glintborg8Anne Gitte Loft9Almut Scherer10René Bräm11Karel Pavelka12Jakub Závada13Joao Madruga Dias14Paula Valente15Bjorn Gudbjornsson16Olafur Palsson17Vappu Rantalaiho18Ritva Peltomaa19Catalin Codreanu20Corina Mogosan21Florenzo Iannone22Marco Sebastiani23Gareth T. Jones24Gary J. Macfarlane25Isabel Castrejon26Ziga Rotar27Brigitte Michelsen28Johan K. Wallman29Irene van der Horst-Bruinsma30Oliver Distler31Mikkel Østergaard32Merete Lund Hetland33Raphael Micheroli34Caroline Ospelt35Department of Rheumatology, University Hospital Zurich, University of ZurichStatistics Group, Swiss Clinical Quality Management in Rheumatic Diseases (SCQM) FoundationStatistics Group, Swiss Clinical Quality Management in Rheumatic Diseases (SCQM) FoundationCopenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, RigshospitaletCopenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, RigshospitaletSwiss Tropical and Public Health InstituteDepartment of Rheumatology and Immunology, Inselspital University HospitalDepartment of Rheumatology, Geneva University HospitalCopenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, RigshospitaletDANBIO Registry, RigshospitaletStatistics Group, Swiss Clinical Quality Management in Rheumatic Diseases (SCQM) FoundationSwiss Ankylosing Spondylitis AssociationDepartment of Rheumatology, First Faculty of Medicine, Charles UniversityDepartment of Rheumatology, First Faculty of Medicine, Charles UniversityDepartment of Rheumatology, Centro Hospitalar Do Médio TejoDepartment of Rheumatology, Hospital de Sao Sebastio, Centro Hospitalar de Entre O Douro E VougaCentre for Rheumatology Research, Landspitali University HospitalFaculty of Medicine, University of IcelandTampere University Hospital, Centre for Rheumatic DiseasesDepartment of Rheumatology, Inflammation Center, Helsinki University Hospital and University of HelsinkiCenter for Rheumatic Diseases, University of Medicine and PharmacyCenter for Rheumatic Diseases, University of Medicine and PharmacyRheumatology Unit, University of Modena and Reggio EmiliaRheumatology Unit, University of Modena and Reggio EmiliaAberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of AberdeenAberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of AberdeenDepartment of Rheumatology, Hospital General, Universitario Gregorio MarañónDepartment of Rheumatology, University Medical Centre LjubljanaCopenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, RigshospitaletDepartment of Clinical Sciences Lund, Rheumatology, Skåne University Hospital, Lund UniversityDepartment of Rheumatology, Radboud University Medical CenterDepartment of Rheumatology, University Hospital Zurich, University of ZurichCopenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, RigshospitaletCopenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, RigshospitaletDepartment of Rheumatology, University Hospital Zurich, University of ZurichDepartment of Rheumatology, University Hospital Zurich, University of ZurichAbstract Background Efficacy of tumour necrosis factor inhibitors (TNFi) for peripheral arthritis in patients with psoriatic arthritis (PsA) has been established in randomized clinical trials that have used improvement in summated joint counts as an outcome. Whether joints at different anatomical locations might respond differentially to TNFi remains unknown. The aim of the study was to investigate potential variations in the responsiveness to a first tumour necrosis factor inhibitor (TNFi) among joints at distinct locations in patients with psoriatic arthritis (PsA) treated in routine clinical care. Methods Bionaive PsA patients from nine European countries were included in this observational cohort study if ≥ 1 joint was swollen at the initiation of a first TNFi as monotherapy or added to methotrexate. Only the 28-joint count was available without imaging data confirming the presence of synovitis. The primary outcome was time to first resolution of joint swelling at each joint level. Hazard ratios (HR) for resolution comparing different joint locations were estimated using interval-censored mixed-effects Cox proportional hazards models, including a random effect for country and patient, adjusted for age and sex. Results A total of 1729 patients with 8397 swollen joints at the start of TNFi were included. Considering the upper extremity, a higher rate of resolution of joint swelling (HR, 95% CI) was observed for the shoulder (1.65, 1.16–2.35) and elbow (1.90, 1.38–2.61), while a lower rate was found for the wrist (0.72, 0.62–0.83) compared to the joints of digit 3. Within fingers, and using the same reference, joint swelling resolved fastest in digit 4 (1.77, 1.49–2.11) and digit 5 (1.88, 1.53–2.31). A lower rate of resolution of joint swelling was found for the knee in comparison to the elbow, the corresponding joint on the upper limb (0.56, 0.40–0.78). Conclusion The time to resolution of joint swelling upon treatment with TNFi in patients with PsA seems to depend on the localisation of the affected joints.https://doi.org/10.1186/s13075-025-03488-w |
| spellingShingle | Adrian Ciurea Seraphina Kissling Andrea Götschi Lykke Midtbøll Ørnbjerg Simon Horskjær Rasmussen Bálint Tamási Burkhard Möller Michael J. Nissen Bente Glintborg Anne Gitte Loft Almut Scherer René Bräm Karel Pavelka Jakub Závada Joao Madruga Dias Paula Valente Bjorn Gudbjornsson Olafur Palsson Vappu Rantalaiho Ritva Peltomaa Catalin Codreanu Corina Mogosan Florenzo Iannone Marco Sebastiani Gareth T. Jones Gary J. Macfarlane Isabel Castrejon Ziga Rotar Brigitte Michelsen Johan K. Wallman Irene van der Horst-Bruinsma Oliver Distler Mikkel Østergaard Merete Lund Hetland Raphael Micheroli Caroline Ospelt Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registries Arthritis Research & Therapy |
| title | Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registries |
| title_full | Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registries |
| title_fullStr | Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registries |
| title_full_unstemmed | Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registries |
| title_short | Differences in the response to TNF inhibitors at distinct joint locations in patients with psoriatic arthritis: results from nine European registries |
| title_sort | differences in the response to tnf inhibitors at distinct joint locations in patients with psoriatic arthritis results from nine european registries |
| url | https://doi.org/10.1186/s13075-025-03488-w |
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