Publication

Long-term drug survival and clinical effectiveness of etanercept treatment in patients with ankylosing spondylitis in daily clinical practice

Arends, S., Brouwer, L., Efde, M., van der Veer, E., Bootsma, H., Wink, F. & Spoorenberg, A., 2017, In : Clinical and Experimental Rheumatology. 35, 1, p. 61-68 8 p.

Research output: Contribution to journalArticleAcademicpeer-review

Objective

Randomised controlled trials and open-label extension studies have demonstrated the clinical efficacy and safety of tumour necrosis factor-alpha (TNF-alpha) blocking therapy in pre-selected study patients with ankylosing spondylitis (AS). Our aim was to investigate the 7-year drug survival and clinical effectiveness of etanercept treatment in AS patients in daily clinical practice.

Methods

Consecutive AS patients from the prospective observational GLAS cohort who started etanercept because of active disease were included and evaluated over 7 years according to a fixed protocol. Continuation of treatment was based on BASDAI improvement and/or expert opinion.

Results

Of the 89 included AS patients, 45 (51%) were still using etanercept at 7 years of follow-up. Reasons for treatment discontinuation were adverse events (n=22), inefficacy (n=13), or other reasons although good clinical response (n=9). Etanercept treatment resulted in a rapid (after 6 weeks) and sustained improvement in disease activity (BASDAI, ASDAS, CRP, physician GDA), spinal mobility, physical function (BASFI), quality of life (ASQoL), and extra-spinal manifestations (swollen joints, tender joints and tender entheses). Furthermore, concomitant NSAID or DMARD use decreased significantly during follow-up. At 7 years, low disease activity and remission were present in 67-73% and 29-30% of the 45 patients, respectively. Of the patients who discontinued etanercept, 18 switched successfully to a second or third TNF-a blocker during follow-up.

Conclusion

In a large cohort of AS patients treated with etanercept, approximately 50% continued this treatment for 7 years. Our broad evaluation of clinical endpoints proves the long-term effectiveness of etanercept treatment in daily clinical practice.

Original languageEnglish
Pages (from-to)61-68
Number of pages8
JournalClinical and Experimental Rheumatology
Volume35
Issue number1
Publication statusPublished - 2017

    Keywords

  • ankylosing spondylitis, etanercept, effectiveness, safety, daily clinical practice, NATIONWIDE DANBIO REGISTRY, ALPHA BLOCKING THERAPY, BASE-LINE PREDICTORS, QUALITY-OF-LIFE, AXIAL SPONDYLOARTHRITIS, DISEASE-ACTIVITY, RHEUMATOID-ARTHRITIS, PHYSICAL FUNCTION, EFFICACY, COHORT

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