Search

Objective: To analyze the trends in biologics use at a specialized center over a period of 20 years. Methods: We performed a retrospective analysis of 571 patients diagnosed with psoriatic arthritis enrolled in the Toronto cohort who initiated biologic therapy between January 1, 2000, and July 7, 2020. The probability of drug persistence over time was estimated nonparametrically. The time to discontinuation of first and second treatment was analyzed using Cox regression models, whereas a semiparametric failure time model with a gamma frailty was used to analyze the discontinuation of treatment over successive administrations of biologic therapy. Results: The highest 3‐year persistence probability was observed with certolizumab when used as first biologic treatment, while interleukin‐17 inhibitors had the lowest probability. However, when used as second medication, certolizumab had the lowest drug survival even when accounting for selection bias. Depression and/or anxiety were associated with a higher rate of drug discontinuation due to all causes (relative risk [RR] 1.68, P = 0.01), while having higher education was associated with lower rates (RR 0.65, P = 0.03). In the analysis accommodating multiple courses of biologics, a higher tender joint count was associated with a higher rate of discontinuation due to all causes (RR 1.02, P = 0.01). Older age at the start of first treatment was associated with a higher rate of discontinuation due to side effects (RR 1.03, P = 0.01), while obesity had a protective role (RR 0.56, P = 0.05). Conclusion: Persistence in taking biologics depends on whether the biologic was used as first or second treatment. Depression and anxiety, higher tender joint count, and older age lead to drug discontinuation. [ABSTRACT FROM AUTHOR]

Observational cohorts have emerged as important resources to study course and prognosis of chronic disease, and also facilitate phenotype definition for genetic studies. We describe the development and accomplishments of the PsA cohort at the University of Toronto as an example of an observational cohort that has allowed the description of disease manifestations, course and prognosis of PsA. We also describe the development of an international collaboration based on this cohort, which will further be used to study the incidence, prevalence and predictive factors for the development of PsA among patients with psoriasis. [ABSTRACT FROM AUTHOR]

The article presents a study which determined the prevalence and types of malignancy in a large cohort of patients with psoriatic arthritis (PsA). The study performed a cohort analysis of patients who were followed up prospectively from 1978 to 2004 at the University of Toronto Psoriatic Arthritis Clinic in Ontario. The study found that of the 665 patients included, 68 developed a malignancy at an average of 62.4 years. It was also concluded that the standard incidence ratios (SIR) for all cancers was 0.98.