Short-term response in new users of anti-TNF predicts long-term productivity and non-disability: analysis of Czech ATTRA ankylosing spondylitis biologic registry
Abstract
Objectives: To assess the role of short-term response to first anti-TNF in long-term prediction of disability. Methods: In nationwide registry ATTRA, we identified ankylosing spondylitis patients starting anti-TNF between 01/2003 and 12/2016.
Full disability and work impairment (WI; WPAI questionnaire) were predicted via the Cox- and lagged-parameter mixed-effect regression. Results: 2,274 biologicals-naive patients newly indicated to anti-TNF were prospectively followed (6,333 patient-years; median follow-up 1.9 years).
Reaching BASDAI 50% or by >2 points (p = 0.902). ASDAS-CRP change >1.1 and >2.0 both failed to predict non-disability.
Once on anti-TNF therapy, the strongest predictor of WI was Pain (SF36). Yearly increase in indirect costs remains below euro3,000 in those reaching ASDAS-CRP < 2.1.
Conclusions: Low disease activity measured by ASDAS-CRP <= 2.1 should be used to measure the outcome of new anti-TNF therapy. Continuous WI could be decreased through pain management.