Baseline disease activity and patient-reported outcomes in TNFi-naive and TNFi-experienced patients with PsA overall and in those who continued versus discontinued their index TNFi by the first follow-up visit
| Characteristic* | Total population (N=318) | TNFi naive | TNFi experienced | ||||
| Overall (n=171) | Continued (n=122) | Discontinued (n=49) | Overall (n=147) | Continued (n=88) | Discontinued (n=59) | ||
| Enthesitis, n (%) | 73 (23.0) | 35 (20.5) | 24 (19.7) | 11 (22.5) | 38 (25.9) | 19 (21.6) | 19 (32.2) |
| SPARCC Enthesitis Index (1–16)† | 3.8 (3.3) | 2.9 (2.3) | 2.5 (1.5) | 3.8 (3.4) | 4.6 (3.9) | 4.2 (3.9) | 5.0 (3.9) |
| Dactylitis, n (%) | 37 (11.6) | 21 (12.3) | 13 (10.7) | 8 (16.3) | 16 (10.9) | 9 (10.2) | 7 (11.9) |
| Dactylitis count (1–20)‡ | 2.5 (2.1) | 2.3 (2.3) | 1.8 (1.7) | 3.1 (3.0) | 2.6 (1.9) | 2.8 (2.3) | 2.4 (1.5) |
| Tender joint count (0–68) | 4.9 (9.2) | 4.2 (8.4) | 3.0 (4.9) | 7.3 (13.4) | 5.7 (10.0) | 5.5 (10.9) | 6.1 (8.7) |
| Swollen joint count (0–66) | 2.2 (3.8) | 2.2 (3.7) | 1.8 (2.8) | 3.2 (5.1) | 2.2 (4.0) | 2.1 (4.3) | 2.2 (3.6) |
| Spinal mobility measures, cm | |||||||
| Occiput-to-wall distance | 2.1 (4.6) | 0.6 (2.0) | 0.8 (2.3) | 0.2 (0.5) | 3.2 (5.6) | 3.6 (7.1) | 2.8 (4.2) |
| Lateral lumbar flexion (average of right and left) | 18.4 (13.9) | 13.5 (5.0) | 14.7 (4.9) | 9.8 (3.4) | 21.8 (16.9)§ | 21.1 (16.2) | 22.3 (18.0) |
| MDA, n (%)¶ | 93 (33.9) | 59 (39.3) | 45 (42.1) | 14 (32.6) | 34 (27.4)§ | 23 (30.3) | 11 (23.0) |
| ASDAS-CRP | 2.0 (0.8) | 2.1 (0.9) | 2.0 (0.9) | 2.3 (1.0) | 1.9 (0.7) | 1.9 (0.7) | 1.9 (0.8) |
| BASDAI (0–10) | 4.3 (2.7) | 4.1 (2.8) | 4.0 (2.7) | 4.5 (2.8) | 4.5 (2.6) | 4.2 (2.5) | 4.9 (2.7) |
| BASFI (0–10) | 3.3 (2.7) | 3.1 (2.8) | 3.0 (2.7) | 3.4 (2.9) | 3.6 (2.6) | 3.3 (2.4) | 4.0 (2.8) |
| CDAI | 11.2 (9.7) | 10.7 (10.0) | 9.2 (7.6) | 14.1 (13.6)** | 11.9 (9.2) | 10.5 (8.3) | 13.5 (10.1) |
| DAS28-CRP | 2.7 (1.2) | 2.7 (1.3) | 2.4 (1.0) | 3.5 (1.7)** | 2.8 (1.1) | 2.7 (1.0) | 2.8 (1.2) |
| CRP, mg/L | 2.7 (6.9) | 3.8 (9.0) | 3.0 (7.2) | 6.0 (12.8) | 1.5 (3.2) | 1.5 (3.1) | 1.5 (3.4) |
| ESR, mm/hour | 17.1 (15.6) | 17.6 (15.8) | 17.6 (16.6) | 17.4 (13.3) | 16.7 (15.6) | 16.5 (17.3) | 17.1 (12.2) |
| Physician global assessment of psoriasis | 21.4 (21.5) | 21.9 (21.9) | 20.4 (21.3) | 25.4 (23.2) | 20.8 (21.1) | 16.4 (16.9) | 27.2 (24.6)** |
| BSA, % affected | 4.9 (9.6) | 4.9 (8.7) | 5.3 (9.6) | 3.8 (5.7) | 4.9 (10.6) | 5.0 (11.3) | 4.6 (9.2) |
| Patient global assessment | 46.3 (29.1) | 41.1 (28.0) | 38.2 (27.8) | 48.2 (27.6)** | 52.2 (29.2)§ | 50.5 (30.5) | 54.7 (27.3) |
| Patient-reported pain (VAS 0–100) | 43.9 (29.7) | 40.9 (29.6) | 37.6 (28.9) | 49.5 (29.8)** | 47.3 (29.5) | 46.4 (29.8) | 48.7 (29.4) |
| Patient-reported fatigue (VAS 0–100) | 45.6 (28.5) | 43.9 (28.4) | 42.5 (28.3) | 47.3 (28.6) | 47.6 (28.7) | 43.8 (26.5) | 53.0 (31.0)** |
| Morning stiffness, n (%) | |||||||
| Yes | 283 (89.0) | 151 (88.3) | 105 (86.1) | 46 (95.8) | 132 (89.8) | 81 (92.0) | 51 (86.4) |
| <30 min | 69 (24.4) | 40 (26.5) | 32 (30.5) | 8 (17.4) | 29 (22.0) | 19 (23.5) | 10 (19.6) |
| ≥30 min | 214 (75.6) | 111 (73.5) | 73 (69.5) | 38 (82.6) | 103 (78.0) | 62 (76.5) | 41 (80.4) |
| HAQ-S (0–3) | 0.78 (0.67) | 0.73 (0.66) | 0.67 (0.63) | 0.87 (0.73) | 0.85 (0.68) | 0.79 (0.66) | 0.94 (0.70) |
| EQ-5D (0–1) | 0.72 (0.21) | 0.74 (0.21) | 0.76 (0.19) | 0.70 (0.24) | 0.70 (0.21)§ | 0.72 (0.20) | 0.67 (0.22) |
| EQ VAS | 70.6 (45.4) | 70.9 (20.8) | 73.1 (19.1) | 65.6 (23.8) | 70.2 (63.1) | 75.7 (79.7) | 62.0 (19.7) |
| Current employment, n (%) | 188 (61.8) | 101 (62.4) | 74 (62.7) | 27 (61.4) | 87 (61.3) | 55 (65.5) | 32 (55.2) |
| WPAI domains, % | |||||||
| Absenteeism (work time missed) | 6.1 (17.9) | 2.6 (7.8) | 3.1 (8.3) | 1.6 (6.8) | 9.8 (24.0)§ | 4.5 (14.3) | 17.8 (32.4) |
| Presenteeism (impairment at work/reduced on-the-job effectiveness) | 24.3 (24.8) | 21.9 (21.3) | 22.1 (22.4) | 21.5 (18.7) | 27.0 (28.2) | 25.5 (27.2) | 29.3 (30.0) |
| Work productivity loss (overall work impairment/absenteeism plus presenteeism) | 27.4 (27.8) | 24.4 (23.2) | 25.3 (24.4) | 22.4 (20.3) | 30.5 (31.8) | 26.5 (28.5) | 36.0 (35.8) |
| Activity impairment | 35.5 (29.4) | 33.2 (29.2) | 31.1 (28.3) | 38.4 (31.1) | 38.1 (29.5) | 35.6 (28.1) | 41.7 (31.3) |
*All values were calculated based on available data and are presented as mean (SD) unless otherwise stated and had <20% missing data except for spinal mobility measures, ESR, CRP, DAS28-CRP, ASDAS-CRP and MDA.
†SPARCC Enthesitis Index among patients with enthesitis.
‡Dactylitis count among patients with dactylitis.
§P<0.05 for the comparison between the overall populations of TNFi-naive and TNFi-experienced patients.
¶MDA was defined as ‘yes’ if a patient met ≥5 of the following seven criteria: tender joint count ≤1, swollen joint count ≤1, BSA ≤3%, patient-reported pain VAS ≤15, patient global activity VAS ≤20, HAQ-S ≤0.5 and tender entheseal points ≤1.
**P<0.05 for the comparison between patients who continued versus discontinued their index TNFi within the TNFi-naive or TNFi-experienced cohort.
ASDAS-CRP, Ankylosing Spondylitis Disease Activity Score using C-reactive protein;BASDAI, Bath Ankylosing Spondylitis Disease Activity Index;BASFI, Bath Ankylosing Spondylitis Functional Index;BSA, body surface area;CDAI, Clinical Disease Activity Index;CRP, C-reactive protein;DAS28-CRP, Disease Activity Score in 28 joints with C-reactive protein;EQ-5D, EuroQol-five dimension; ESR, erythrocyte sedimentation rate;HAQ-S, Health Assessment Questionnaire for the Spondyloarthropathies;MDA, minimal disease activity;PsA, psoriatic arthritis;SPARCC, Spondyloarthritis Research Consortium of Canada;TNFi, tumour necrosis factor inhibitor;VAS, visual analogue scale;WPAI, Work Productivity and Activity Impairment questionnaire.