TNFi monotherapy initiation in PsA patients decline despite efficacy
There have been significant changes in the treatment patterns among patients with psoriatic arthritis (PsA) from 2004 to 2012, according to a recent study.
Patients remain persistent with the use of tumor necrosis factor inhibitor (TNFi) monotherapy, but physicians are not more likely to initiate it despite an increase in clinical evidence over this study period supporting its effectiveness.
To improve understanding of current practices in the treatment management of patients with PsA, an observational study was conducted based on data from the Corrona registry of adult patients with PsA in North America collected between 1 January 2004 and 31 December 2012.
Researchers divided the participants (n=520) into three therapy cohorts: TNFi monotherapy (n=190), methotrexate (MTX) monotherapy (n=217) and TNFi-MTX combination therapy (n=113). Patients were further classified into three study periods to understand changes over time: 2004 to 2006 (n=110), 2007 to 2009 (n=192) and 2010 to 2012 (n=218).
For the analysis, researchers collected data on persistence, discontinuation, restarting, switching, adding/dropping therapy and dose stretching.
A decrease in the proportion of patients initiating TNFi monotherapy occurred over time, but the proportion initiating combination therapy remained constant.
Participants who were persistent also decreased over time across all therapy cohorts, but the percentage of patients remained higher in TNFi monotherapy than in other therapy groups. In addition, the duration of persistence declined over time.
Compared with patients in the TNFi monotherapy cohort, those initiating MTX monotherapy were more likely to add therapy, according to researchers.