Long-term remission and biologic persistence rates: 12-year real-world data

Area of Science:

• Rheumatology
• Immunology
• Clinical Medicine

Background:

• Biologic therapies have improved rheumatoid arthritis (RA) and psoriatic arthritis (PsA) outcomes.
• Predicting long-term remission and therapy persistence remains a challenge.

Purpose of the Study:

• To explore predictors of remission and initial biologic therapy persistence after 12 years.
• To compare outcomes of adalimumab and etanercept in RA and PsA patients.

Main Methods:

• Prospective recruitment of RA and PsA patients from a biologic clinic.
• Data collection included demographics, medications, disease activity markers (morning stiffness, joint counts, CRP, HAQ), and antibody status.
• Analysis of outcomes at 1 and 12 years, examining predictors of persistence and EULAR-defined remission using univariate and multivariate analyses.

Main Results:

• PsA patients demonstrated higher remission rates than RA patients at both 1 year (60.3% vs. 34.5%) and 12 years (91.3% vs. 60.6%).
• High biologic continuation rates were observed: 49.6% (RA) and 58.9% (PsA) at 1 year; 38.2% (RA) and 52.3% (PsA) at 12 years.
• One-year persistence and low disease activity predicted 12-year persistence (OR 4.28 and 3.90, respectively). 12-year persistence and male gender predicted 12-year remission (OR 4.98 and 4.48, respectively).

Conclusions:

• This study is the first to report superior long-term response to biologic therapy in PsA compared to RA.
• Long-term persistence with initial biologics is high and predicted by early treatment success.
• PsA patients exhibited higher employment, educational attainment, and remission rates than RA patients.