2026-05-16T22:07:40Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/164842025-01-29T18:58:29Zcom_20.500.12105_2052com_20.500.12105_2051com_20.500.12105_15322col_20.500.12105_19612col_20.500.12105_16989

00925njm 22002777a 4500 dc Exposito, Lorena author Sanchez-Piedra, Carlos author Vela-Casasempere, Paloma author Moreno-Ramos, Manuel José author Campos, Cristina author Bohorquez, Cristina author Manero, Javier author Calvo-Gutiérrez, Jerusalem author Rodríguez-Lozano, Carlos author Ruiz-Montesino, Dolores author Busquets, Noemí author García-González, Javier author Castrejón, Isabel author Alonso, Fernando author Bustabad, Sagrario author Díaz-González, Federico author 2024 Objective: The persistence of biologic (b) and targeted synthetic (ts) disease-modifying antirheumatic drugs(DMARDs) in monotherapy versus in combination with conventional synthetic (cs) DMARDs is still a controversial topic in rheumatic diseases. To clarify this issue, the retention of the initial treatment strategy of b/tsDMARD in combination with csDMARD versus monotherapy in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients under real-life conditions was evaluated. Factors associated with maintenance of the initial strategy were analysed. Methods: Nested cohort study within the Spanish BIOBADASER III registry. Bivariate comparisons and multivariate Cox proportional hazards models were used for the analyses. Results: A total of 2521 patients were included in the study. In the multivariate model, the initial strategy of combination therapy was associated with shorter persistence in patients with RA (hazard ratio [HR] 1.58;95% confidence interval [CI] 1.00-2.50; p = .049), PsA (HR 2.48; 95% CI 1.65-3.72) and AS (HR 16.77; 95% CI 7.37-38.16; p < .001), regardless of sex, time of disease progression, baseline disease activity, glucocorticoid use or type of b/tsDMARD. Overall, the combination strategy was associated with an increased incidence of adverse events (incidence rate ratio [IRR] 1.13; 95% CI 1.05-1.21). Conclusions: In this real-life study, the strategy of combining a b/tsDMARD with a csDMARD is associated with lower persistence and worse safety profile compared to monotherapy in RA and especially in PsA and AS, suggesting that combination therapy should be rethought as first choice in RA patients, but especially in PsA and AS patients. Eur J Clin Invest. 2024 Feb;54(2):e14095. 10.1111/eci.14095 1365-2362 European journal of clinical investigation 37715584 http://hdl.handle.net/20.500.12105/16484 Ankylosing spondylitis Antirheumatic agents Biologic therapy Psoriatic arthritis Rheumatoid arthritis Real-world persistence of initial targeted therapy strategy in monotherapy versus combination therapy in patients with chronic inflammatory arthritis