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In Arthritis care & research ; h5-index 56.0

BACKGROUND : Real-world studies are needed to identify factors associated to response to biological therapies in patients with axial spondyloarthritis (axSpA).

OBJECTIVE : To assess gender differences in response to tumor necrosis factor-α inhibitors (TNFi) and to explore possible risk factors associated with TNFi efficacy.

PATIENTS AND METHODS : A total of 969 patients with axSpA (315 females, 654 males), enrolled in the BIOBADASER registry (2000-2019) who initiated a TNFi (first, second or further lines) were studied. Statistical and artificial intelligence (AI)-based data analyses were used to explore the association of gender differences, and other factors, to TNFi response (BASDAI50 and ASDAS-CRP).

RESULTS : Females had a lower probability of reaching a BASDAI50 response with a first line TNFi treatment at the second year of follow-up (p=0.018) and a lesser reduction of the ASDAS-CRP scores at this time-point. The logistic regression model showed lower BASDAI50 responses to TNFi in females (p=0.05). Other factors, such as older age (p=0.004) were associated with unfavorable responses. The AI data analyses reinforced that age at the beginning of the treatment was the main factor associated with an unfavorable response. Its combination with other clinical characteristics (female sex or cardiovascular risk factors and events) potentially contributed to an unfavorable response to TNFi.

CONCLUSIONS : In this national multicentric registry, female gender was associated with less response to a first line TNFi by the second year of follow-up. A higher age at the start of the TNFi was the main factor associated to unfavorable response to TNFi. This article is protected by copyright. All rights reserved.

Fernández-Carballido Cristina, Sanchez-Piedra Carlos, Valls Raquel, Garg Kristin, Sánchez-Alonso Fernando, Artigas Laura, Mas José Manuel, Jovaní Vega, Manrique Sara, Campos Cristina, Freire Mercedes, Martínez-González Olga, Castrejón Isabel, Perella Chiara, Coma Mireia, Van der Horst-Bruinsma Irene E