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Joint Bone Spine. 2015 Jan;82(1):31-7. doi: 10.1016/j.jbspin.2014.08.001. Epub 2014 Oct 11.

Treatment response, drug survival and safety of anti-tumour necrosis factor α therapy in 193 patients with psoriatic arthritis: a twelve-year "real life" experience.

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Department of Rheumatology, Lille University Hospital, Lille 2, 59037 Lille cedex, France.
Department of Biostatistics, Faculty of Medicine, Lille Hospital, Lille, France.
Department of Rheumatology, Lille University Hospital, Lille 2, 59037 Lille cedex, France. Electronic address:



To evaluate the performance of anti-TNFα therapy in psoriatic arthritis (PsA) in a routine care setting.


Inclusion criteria were patients with PsA who initiated anti-TNFα therapy between April 2001 and April 2013 with a follow-up of at least 6 months. For peripheral forms, treatment was considered to be effective for patients with a favourable expert opinion or>30% clinical improvement of swollen and tender joint counts. For axial forms, efficacy criteria were: improvement of BASDAI by at least 2 points on a scale from 0 to 10 or 50% improvement (BASDAI 50) or expert opinion. Drug survival of first anti-TNFα therapy was also investigated.


The study included 193 patients (107/86M/F, mean age: 46.8 years, mean disease duration: 6.7 years, 171/22 peripheral/axial forms). Only 48 (25%) patients received concomitant DMARD therapy (65% were treated with methotrexate). The majority of patients started with first-line etanercept (n=102), followed by adalimumab (n=46), infliximab (n=44) and golimumab (n=1). At 3 months, 90% of patients had obtained an adequate response, 7% had discontinued due to lack of efficacy and 3% due to adverse events. Median drug survival was 2 years. One-year and 2-year drug survival rates were 77% and 67%, respectively. Seventy-nine (41%) patients switched to a second anti-TNFα and 29 to a third anti-TNFα; 82% of switchers responded to second-line therapy and 83% responded to third-line therapy.


High drug survival and high response rates were observed in these patients with PsA receiving their first anti-TNFα therapy in routine clinical practice.


Anti-TNFα; Drug survival; Methotrexate; Psoriatic arthritis; Safety; Switching

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