D'Angelo Salvatore, Cantini Fabrizio, Ramonda Roberta, Cantarini Luca, Carletto Antonio, Chimenti Maria Sole, Delle Sedie Andrea, Foti Rosario, Gerli Roberto, Lomater Claudia, Lubrano Ennio, Marchesoni Antonio, Zabotti Alen, Salvarani Carlo, Scrivo Rossana, Scarpa Raffaele, Tramontano Giuseppina, Nannini Carlotta, Lorenzin Mariagrazia, Fabbroni Marta, Martinis Federica, Perricone Roberto, Carli Linda, Visalli Elisa, Rovera Guido, Perrotta Fabio Massimo, Quartuccio Luca, Altobelli Alessio, Costa Luisa, Niccoli Laura, Ortolan Augusta, Caso Francesco
Rheumatology Department of Lucania, Rheumatology Institute of Lucania (IReL), Potenza, Italy.
Basilicata Ricerca Biomedica (BRB), Potenza, Italy.
Front Pharmacol. 2019 Dec 13;10:1497. doi: 10.3389/fphar.2019.01497. eCollection 2019.
Few studies have evaluated the effectiveness of adalimumab in the real-life setting in psoriatic arthritis (PsA). To evaluate the 2-year retention rate of adalimumab in PsA patients. Potential baseline parameters influencing persistence on treatment were also evaluated. PsA patients from 16 Italian Rheumatology Units treated with adalimumab as first- or second-line biological therapy were retrospectively evaluated. Adalimumab retention rate was evaluated at 12 and 24 months. Logistic regression was used to evaluate the association between predictor variables and adalimumab retention rate. From 424 patients (53.5% male, aged 48.3 ± 12.8 years) who started treatment with adalimumab, 367 (86.6%) maintained treatment for 12 months and 313 (73.8%) for 2 years. At 24-months, Disease Activity in PsA (DAPSA) remission (defined as ≤4) and Low Disease Activity (LDA) (≤14) were achieved in 22.8% and 44.4% of patients, respectively. Adalimumab treatment significantly decreased the number of tender (7.0 ± 5.7 at baseline vs. 2.3 ± 3.5 at 24 months, p < 0.001) and swollen joints (2.7 ± 2.8 at baseline vs. 0.4 ± 0.9 at 24 months, p < 0.001), DAPSA (25.5 ± 10.9 at baseline vs. 11.0 ± 8.4 at 24 months, p < 0.001), PASI (5.3 ± 5.7 at baseline vs. 2.7 ± 2.8 at 24 months, p < 0.001) and CRP (3.8 ± 6.3 at baseline vs. 1.2 ± 1.7 at 24 months, p < 0.001). Among a range of laboratory and clinical variables, only female gender was associated with improved adalimumab persistence at 24 months (OR: 1.98, 95% CI: 1.2-3.2, p = 0.005). Independent of a range of predictor variables, adalimumab was shown to be effective, while maintaining a high retention rate after 2 years in PsA patients.
很少有研究评估阿达木单抗在银屑病关节炎（PsA）实际临床环境中的有效性。为了评估阿达木单抗在PsA患者中的2年保留率，还评估了影响治疗持续性的潜在基线参数。对来自16个意大利风湿病科单位接受阿达木单抗作为一线或二线生物治疗的PsA患者进行了回顾性评估。在12个月和24个月时评估阿达木单抗的保留率。采用逻辑回归评估预测变量与阿达木单抗保留率之间的关联。在424例开始使用阿达木单抗治疗的患者中（男性占53.5%，年龄48.3±12.8岁），367例（86.6%）维持治疗12个月，313例（73.8%）维持治疗2年。在24个月时，分别有22.8%和44.4%的患者达到银屑病关节炎疾病活动度（DAPSA）缓解（定义为≤4）和低疾病活动度（LDA）（≤14）。阿达木单抗治疗显著减少了压痛关节数量（基线时7.0±5.7个，24个月时2.3±3.5个，p<0.001）和肿胀关节数量（基线时2.7±2.8个，24个月时0.4±0.9个，p<0.001）、DAPSA（基线时25.5±10.9，24个月时11.0±8.4，p<0.001）、银屑病面积和严重程度指数（PASI）（基线时5.3±5.7，24个月时2.7±2.8，p<0.001）以及C反应蛋白（CRP）（基线时3.8±6.3，24个月时1.2±1.7，p<0.001）。在一系列实验室和临床变量中，只有女性性别与24个月时阿达木单抗的持续使用改善相关（比值比：1.98，95%置信区间：1.2 - 3.2，p = 0.005）。在一系列预测变量之外，阿达木单抗被证明是有效的，同时在PsA患者中2年后仍保持较高的保留率。
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