Author: Jean-Guillaume Letarouilly
Webers et al. (OP0060) investigated which ASDAS cut-off values correspond best with treatment intensification (TI) in practice through the prospective multicentre Dutch registry for patients with SpA (SpA-Net). They included 350 patients with axSpA with a median follow-up of 2.8 (IQR 1.0-4.4) years. The ROC AUC was 0.71 (95%CI 0.68-0.75) with an optimal ASDAS cut-off of 2.7.
Van Es et al. (OP0081) compared the 3-year drug retention rate and 1-year disease activity of a second TNFi (cycle) versus an IL-17i (swap) strategy in a quasi-experimental study cohort. They included 335 patients with axSpA (270 cyclers and 65 swappers). Swappers were more likely to experience treatment failure (HR adjusted for sex and discontinuation reason first TNFi: 1.47 (95% CI: 1.04 – 2.09), p = 0.03.
Hermans et al. (OP0120) investigated the cost-effectiveness of patient initiated follow-up supported by asynchronous telemonitoring (PIFU/TM) for the follow-up of patients with spondyloarthritis (SpA) compared with usual care (UC) in daily practice. TeleSpA was a multicentre, pragmatic, non-blinded, randomised controlled trial. They included 200 patients (PIFU/TM: n=100 and UC: n=100). After 1 year, non-inferiority of PIFU/TM was demonstrated for all health outcomes of interest. Healthcare costs were lower (-€364/year), but societal costs higher (+€385/year), in PIFU/TM compared to UC. At a willingness-to-accept threshold of €20,000/QALY, this resulted in an added value of PIFU/TM in monetary terms (incremental net monetary benefit) of +€273 from a healthcare perspective.
Berg et al. (LBA0004) determined whether (i) Remote Monitoring or (ii) Patient-initiated Care for axSpA were non-inferior to (iii) Usual Care in maintaining low disease activity (Ankylosing Spondylitis Disease Activity Score (ASDAS) <2.1) over 18 months. They enrolled 242 patients randomly allocated to the 3 study arms. Both Remote Monitoring and Patient-initiated Care were deemed non-inferior to Usual Care, and Patient-initiated Care to Remote Monitoring. The number of consultations was higher in Usual Care than in Remote Monitoring and Patient-initiated Care, but the number of telephone calls was higher in Remote Monitoring than Usual Care and Patient.
Ariani et al. (POS0266) compared the 3-year drug retention rate and 1-year disease activity of a second TNFi (cycle) versus an IL-17i (swap) strategy in a retrospective cohort of 347 patients with PsA. The 5 years retention rate in swappers was numerically higher than in cyclers (57,8% vs 45,2%; p=0.1).
ABOUT THE AUTHOR
Jean-Guillaume Letarouilly
Jean-Guillaume Letarouilly is a rheumatologist at Lille University Hospital (France). Since November, he has been doing a Clinical Research Fellowship at the University of Oxford. Research interests include axial spondyloarthritis, psoriatic arthritis and the crosstalk with inflammatory bowel diseases and psoriasis.
Jeani-Guillaume is a member of the Visibility and Global Affairs Sub-committee.