Spondyloarthritis & psoriatic arthritis
Impact of initiation of targeted therapy on the use of psoriatic arthritis-related treatments and healthcare consumption: a cohort study of 9793 patients from the French health insurance database (SNDS)
Authors' conclusion
Targeted therapy initiation for PsA reduced the use of associated treatment and healthcare, with TNFi having a slightly greater effect than IL17i and IL12/23i, except for methotrexate discontinuation.
Study context
- Population
- Adults with psoriatic arthritis (PsA), new users of targeted therapies for ≥9 months, France 2015–2021 (mean age 51±13 years, 47% men)
- Participants
- 9,793 adults
- Exposure
- Use of PsA-related treatments and healthcare 3–9 months after vs 6 months before targeted therapy initiation; Tumour necrosis factor inhibitor (TNFi) vs IL17i vs IL12/23i
- Outcome
- Difference in proportion of users of associated treatments, hospitalisations and sick leaves between 3–9 months after and 6 months before targeted therapy initiation
- Follow-up
- 3 to 9 months after initiation
Methodological detailsnationwide, French health insurance database (SNDS), logistic regression adjusted for sex, age, psoriasis, IBD and Charlson Comorbidity Index
- Nationwide
- French health insurance database (SNDS)
- Logistic regression adjusted for sex, age, psoriasis, IBD and Charlson Comorbidity Index
Main finding
As reported in the abstract
Change in proportion of users after vs before targeted therapy initiation
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- −15%
- Opioid analgesics
- −9%
- Prednisone
- −9%
- MTX
- −15%
- Mood disorder treatments
- −2%
- Hospitalisations
- −12%
- Sick leaves
- −4%
Observational data: associations, not effects.
Further findings
| Outcome | ORa (95% CI) |
|---|---|
| NSAID use sparing effectTNFi vs IL17i | 1.04 (1.01–1.07) |
| NSAID use sparing effectTNFi vs IL12/23i | 1.07 (1.04–1.10) |
| Prednisone use sparing effectTNFi vs IL17i | 1.04 (1.02–1.06) |
| Prednisone use sparing effectTNFi vs IL12/23i | 1.06 (1.04–1.09) |
| MTX discontinuationTNFi vs IL17i | 0.96 (0.94–0.98) |
| MTX discontinuationTNFi vs IL12/23i | 0.94 (0.92–0.97) |
Original publication
Impact of initiation of targeted therapy on the use of psoriatic arthritis-related treatments and healthcare consumption: a cohort study of 9793 patients from the French health insurance database (SNDS). RMD Open. Published 7 August 2024. doi:10.
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