Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
Rheumatology, Theme Inflammation and Infection, Karolinska University Hospital, Stockholm, Sweden.
Scand J Rheumatol. 2022 Jan;51(1):10-20. doi: 10.1080/03009742.2021.1887928. Epub 2021 Mar 23.
: To determine whether a family history of spondyloarthritis (SpA) is associated with clinical presentation at the start of tumour necrosis factor inhibitor (TNFi) treatment, or predictive of TNFi drug survival and treatment response in patients with SpA.: Family history of SpA in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA), and undifferentiated SpA (uSpA) from the Swedish Rheumatology Quality register starting a TNFi as their first biologic in 2006-2018 was assessed through national registers. Clinical characteristics at treatment start were compared by family history status. We used Cox regression to estimate hazard ratios for drug discontinuation, and analysed treatment response at 3 and 12 months with linear regression. Multiple imputation was used to address missing data.: We included 9608 patients. Patients with family history had an earlier age at onset and longer disease duration at TNFi treatment start, but did not differ regarding disease activity and presence of SpA manifestations. Hazard ratios for drug discontinuation were 1.08 [95% confidence interval (CI) 0.89-1.31] for AS patients with a family history of AS, 1.02 (95% CI 0.89-1.18) for PsA patients with a family history of PsA, and 1.11 (95% CI 0.85-1.45) for uSpA patients with a family history of uSpA, after adjusting for demographic, socioeconomic, and SpA-related factors. Treatment response at 3 and 12 months was similar between groups.: Family history of SpA was not found to be associated with clinical presentation at the start of TNFi treatment, nor was it associated with drug survival or treatment response in SpA patients starting a first TNFi.
为了确定强直性脊柱炎（SpA）家族史是否与肿瘤坏死因子抑制剂（TNFi）治疗开始时的临床表现相关，或是否与 SpA 患者 TNFi 药物生存和治疗反应相关：通过国家登记处评估了 2006 年至 2018 年期间开始使用 TNFi 作为首个生物制剂的瑞典风湿病质量登记处中患有强直性脊柱炎（AS）、银屑病关节炎（PsA）和未分化 SpA（uSpA）的患者的家族史中 SpA 的情况。通过家族史状况比较治疗开始时的临床特征。我们使用 Cox 回归估计停药风险比，并使用线性回归分析 3 个月和 12 个月时的治疗反应。使用多重插补法处理缺失数据。我们纳入了 9608 名患者。有家族史的患者在 TNFi 治疗开始时发病年龄更早，疾病持续时间更长，但在疾病活动度和 SpA 表现方面无差异。在调整了人口统计学、社会经济和 SpA 相关因素后，AS 患者有 AS 家族史的停药风险比为 1.08（95%置信区间[CI]0.89-1.31），PsA 患者有 PsA 家族史的停药风险比为 1.02（95% CI 0.89-1.18），uSpA 患者有 uSpA 家族史的停药风险比为 1.11（95% CI 0.85-1.45）。3 个月和 12 个月时的治疗反应在两组之间相似。未发现 SpA 家族史与 TNFi 治疗开始时的临床表现相关，也与开始使用首个 TNFi 的 SpA 患者的药物生存或治疗反应相关。
