目的:描述托法替尼的治疗模式和持久性,白细胞介素17抑制剂(IL-17Ai)和肿瘤坏死因子抑制剂(TNFi),银屑病关节炎(PsA)患者。
方法:来自患有PsA且接受过至少一种托法替尼处方的成年患者的数据,2019年5月至2021年9月之间的IL-17Ai或TNFi来自澳大利亚OPAL数据集。坚持不懈,通过Kaplan-Meier方法进行分析,在托法替尼和bDMARD(IL-17Ai和TNFi)组之间进行倾向评分匹配。
结果:在16,692例PsA患者中,1486(n=406托法替尼,包括n=416IL-17Ai和n=664TNFi)。托法替尼组(75.4%)的女性多于IL-17Ai组(61.1%)和TNFi组(64.8%)的女性。总的来说,19.2%的托法替尼患者为一线患者,与41.8%的IL-17Ai和62.8%的TNFi患者相比。在总人口中,中位持续时间为16.5个月(95%CI13.8至19.5个月),托法替尼治疗17.7个月(95%CI15.8至19.6个月)和17.2个月(95%CI14.9至20.5个月),IL-17Ai和TNFi组,分别。托法替尼/IL-17Ai匹配人群的持久性相似;然而,在托法替尼/TNFi匹配的人群中,托法替尼组的持续时间更长(18.7个月,95%CI15.6至21.4个月)与TNFi组(12.2个月,95%CI19.9至14.9个月)。
结论:在这个澳大利亚现实世界的数据集中,与IL-17Ai或TNFi相比,托法替尼更常用于后来的治疗系和女性患者的比例略高.总的来说,托法替尼的治疗持久性相似,IL-17Ai和TNFi,但托法替尼在匹配人群中表现出比TNFi更长的持久性.要点•这是第一个,来自澳大利亚的大型真实世界研究调查人口统计学,使用托法替尼和生物疾病改善药物(bDMARDs)治疗的银屑病关节炎(PsA)患者的治疗模式和比较治疗持久性。•研究表明,托法替尼是一种有效的PsA干预措施,其持久性至少与bDMARDs相当:肿瘤坏死因子抑制剂(TNFi)和白介素17A抑制剂(IL-17Ai)。
OBJECTIVE: To describe treatment patterns and persistence of tofacitinib, interleukin 17 inhibitors (IL-17Ai) and tumour necrosis factor inhibitors (TNFi), in patients with psoriatic arthritis (PsA).
METHODS: Data from adult patients with PsA and who had received at least one prescription of tofacitinib, IL-17Ai or TNFi between May 2019 and September 2021 were sourced from the Australian OPAL dataset. Persistence, analysed via Kaplan-Meier methods, and propensity score matching between tofacitinib and bDMARD (IL-17Ai and TNFi) groups were conducted.
RESULTS: Of 16,692 patients with PsA, 1486 (n = 406 tofacitinib, n = 416 IL-17Ai and n = 664 TNFi) were included. More females were in the tofacitinib group (75.4%) than in the IL-17Ai (61.1%) and TNFi (64.8%) groups. Overall, 19.2% of tofacitinib patients were first line, compared with 41.8% of IL-17Ai and 62.8% of TNFi patients. In the overall population, the median persistence was 16.5 months (95% CI 13.8 to 19.5 months), 17.7 months (95% CI 15.8 to 19.6 months) and 17.2 months (95% CI 14.9 to 20.5 months) in the tofacitinib, IL-17Ai and TNFi groups, respectively. Persistence was similar in the tofacitinib/IL-17Ai matched population; however, in the tofacitinib/TNFi matched population, persistence was longer in the tofacitinib group (18.7 months, 95% CI 15.6 to 21.4 months) compared with the TNFi group (12.2 months, 95% CI 19.9 to 14.9 months).
CONCLUSIONS: In this Australian real-world dataset, tofacitinib was more frequently used in later lines and among a slightly higher proportion of female patients than IL-17Ai or TNFi. Overall, treatment persistence was similar for tofacitinib, IL-17Ai and TNFi, but tofacitinib exhibited longer persistence than TNFi in a matched population. Key Points • This is the first, large real-world study from Australia investigating the demographics, treatment patterns and comparative treatment persistence of patients with psoriatic arthritis (PsA) treated with tofacitinib and biologic disease-modifying drugs (
bDMARDs). • The study suggests that tofacitinib is an effective intervention in PsA with at least comparable persistence to
bDMARDs: tumour necrosis factor inhibitors (TNFi) and interleukin-17 A inhibitors (IL-17Ai).