Tumour Necrosis Factor α Inhibitors during Spondylarthritis: Therapeutic Maintenance, Reasons, and Predictive Factors of Discontinuation (Data from RBSMR Registry)

Abstract

Objectives: The aim of this study was to study the therapeutic maintenance of tumour necrosis factor α inhibitors (TNFα-I) for spondyloarthritis patients enrolled in the Moroccan biotherapy registry and to analyse the reason and the predictive factors of stopping TNFα-I. Methods: Data were collected from a historical-prospective multicentre registry of adult patients with spondyloarthritis, treated with biological treatment, in the 10 rheumatology departments in Morocco. Maintenance was defined as the interval between the introduction and the suspension of the same TNFα-I. Results: 190 patients under TNFα-I were included, their average age was 40.2 +/-13.6 years. The male gender predominated. On average, the duration of the disease was 11.7 years +/-6.7 years. The ongoing therapeutic maintenance of all TNFα-I drugs in our study was relatively high and exhibited a decline over time, decreasing from 63.8% at 1 year to 45% at 3 years. At the 36-month follow-up, 27.7% had stopped their treatment. It was found that taking nonsteroidal anti-inflammatory drugs (NSAIDs) between visits and having a high average Ankylosing Spondylitis Disease Activity Score with C-reactive protein on the day of the visit were identified as predictive factors for therapeutic discontinuation in multivariate analysis. Conclusion: The therapeutic maintenance level of TNFα-I in our study was satisfactory and comparable to other series. our study provides a more comprehensive understanding of the factors that contribute to the improved maintenance of treatment with TNFα-I. It delves into the reasons influencing treatment continuity and identifies predictive factors of discontinuation.