Evidence map›Paper›PMID 38846940›Full record

ArticleFrontiers in immunology2024

Drug survival superiority of tumor necrosis factor inhibitors and interleukin-17 inhibitors over Janus kinase inhibitors and interleukin-12/23 inhibitors in German psoriatic arthritis outpatients: retrospective analysis of the RHADAR database.

Patrick-Pascal Strunz, Matthias Englbrecht, Linus Maximilian Risser, Torsten Witte, Matthias Froehlich, Marc Schmalzing, Michael Gernert, Astrid Schmieder, Peter Bartz-Bazzanella, Cay von der Decken and 9 more

Abstract read
In one paragraph

Article in Frontiers in immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Observational
  2. Review
  3. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Patrick-Pascal StrunzDepartment of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany.
Matthias EnglbrechtIndependent Researcher, Greven, Germany.
Linus Maximilian RisserDepartment of Rheumatology and Immunology, Medical School Hannover, Hannover, Germany.
Torsten WitteDepartment of Rheumatology and Immunology, Medical School Hannover, Hannover, Germany.
Matthias FroehlichDepartment of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany.
Marc SchmalzingDepartment of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany.
Michael GernertDepartment of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany.
Astrid SchmiederClinic for Dermatology, Venereology and Allergology, University Hospital Wuerzburg, Wuerzburg, Germany.
Peter Bartz-BazzanellaKlinik für Internistische Rheumatologie, Rhein-Maas-Klinikum, Würselen, Germany.
Cay von der DeckenKlinik für Internistische Rheumatologie, Rhein-Maas-Klinikum, Würselen, Germany.
Kirsten KarbergRheumatologisches Versorgungszentrum Steglitz, Berlin, Germany.
Georg GaulerPrivate Practitioner, Osnabrück, Germany.
Patrick WurthPrivate Practitioner, Osnabrück, Germany.
Susanna Späthling-MestekemperRheumapraxis München, Munich, Germany.
Christoph KuhnPraxis für Rheumatologie, Karlsruhe, Germany.
Wolfgang VorbrüggenVerein zur Förderung der Rheumatologie e.V., Würselen, Germany.
Johannes HeckInstitute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany.
Martin WelckerVerein zur Förderung der Rheumatologie e.V., Würselen, Germany.
Stefan KleinertDepartment of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Treatment options with disease-modifying antirheumatic drugs (DMARDs) for psoriatic arthritis (PsA) have evolved over recent years. In addition to Janus kinase inhibitors (JAKi), four classes of biologic DMARDs (bDMARDs; interleukin [IL]-23 inhibitors [IL-23i], IL-12/23 inhibitors [IL-12/23i], tumor necrosis factor inhibitors [TNFi], and IL-17 inhibitors [IL-17i]) are currently approved for moderate to severe PsA treatment. There is minimal evidence of the persistence of these drugs among PsA outpatients in a real-world scenario during the period following the approval of JAKi. Therefore, we aimed to analyze the drug survival rates of biologic and JAKi therapies among German PsA outpatients during routine clinical care. Methods: We retrospectively analyzed PsA patients with a new prescription for a biologic or JAKi in the RHADAR database between January 2015 and October 2023. Kaplan-Meier Curves and Cox regression modelling were used to compare drug survival rates. Results: 1352 new prescriptions with bDMARDs (IL-12/23i [n=50], IL-23i [n=31], TNFi [n=774], IL-17i [n=360]) or JAKi (n=137) were identified. The 5-year drug survival rate was 67.8% for IL-17i, 62.3% for TNFi, 53.3% for JAKi, and 46.0% for IL-12/23i. Discontinuation probabilities for JAKi and IL-12/23i were significantly higher compared with TNFi (JAKi hazard ratio [HR] 1.66, [95% CI 1.23-2.24], p=0.001; IL-12/23i HR 1.54, [95% CI 1.02-2.33], p=0.042) and IL-17i (JAKi HR 1.77, [95% CI 1.27-2.47], p=0.001; IL-12/23i HR 1.64, [95% CI 1.06-2.55], p=0.027). JAKi-treated patients had more severe disease and more osteoarthritis (OA) compared to TNFi and more OA compared to IL-17i. Conclusion: German PsA outpatients might persist longer with TNFi and IL-17i compared with IL-12/23i or JAKi. For TNFi, differences in subgroup characteristics and comorbidities (OA) may have affected drug survival rates. For IL-17i, the longer drug survival might not only be related to less OA compared to JAKi and, therefore, might be affected by other factors.

Indexed as

Antirheumatic AgentsArthritis, PsoriaticInterleukin-12Interleukin-17Interleukin-23Janus Kinase InhibitorsAdultAgedDatabases, FactualFemaleGermanyHumansMaleMiddle AgedOutpatientsRetrospective StudiesAntirheumatic AgentsInterleukin-12Interleukin-17Interleukin-23Janus Kinase InhibitorsTumor Necrosis Factor InhibitorsbiologicsKaplan-Meier analysispsoriasis vulgarisreal-worldtofacitinibtreatment persistenceupadacitinibustekinumab

Identifiers

PMID38846940
PMCPMC11153701

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.