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Treatment with tumor necrosis factor inhibitors in axial spondyloarthritis: comparison between private rheumatology practices and academic centers in a large observational cohort.
Journal article

Treatment with tumor necrosis factor inhibitors in axial spondyloarthritis: comparison between private rheumatology practices and academic centers in a large observational cohort.

  • Ciurea A From the Department of Rheumatology, University Hospital; Department of Rheumatology, Uniklinik Balgrist; Swiss Clinical Quality Management Foundation, Zurich; Department of Rheumatology, Bethesda Hospital, Basel; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn; Department of Rheumatology and Clinical Immunology, University Hospital, Bern; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne; Praxis Rheuma-Basel, Basel, Switzerland.A. Ciurea, MD; M. Toniolo, MD; B.A. Michel, MD, Department of Rheumatology, University Hospital Zurich; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; R.O. Kissling, MD, Uniklinik Balgrist; D. Stekhoven, PhD; A. Scherer, PhD, SCQM Foundation; G. Tamborrini, MD, Bethesda Hospital; J. Bernhard, Department of Rheumatology and Rehabilitation, Bürgerspital Solothurn; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, University Hospital Bern; P. Zufferey, MD, Department of Rheumatology, Centre Hospitalier Universitaire Vaudois; P. Exer, MD, Praxis Rheuma-Basel. adrian.ciurea@usz.ch.
  • Weber U From the Department of Rheumatology, University Hospital; Department of Rheumatology, Uniklinik Balgrist; Swiss Clinical Quality Management Foundation, Zurich; Department of Rheumatology, Bethesda Hospital, Basel; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn; Department of Rheumatology and Clinical Immunology, University Hospital, Bern; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne; Praxis Rheuma-Basel, Basel, Switzerland.A. Ciurea, MD; M. Toniolo, MD; B.A. Michel, MD, Department of Rheumatology, University Hospital Zurich; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; R.O. Kissling, MD, Uniklinik Balgrist; D. Stekhoven, PhD; A. Scherer, PhD, SCQM Foundation; G. Tamborrini, MD, Bethesda Hospital; J. Bernhard, Department of Rheumatology and Rehabilitation, Bürgerspital Solothurn; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, University Hospital Bern; P. Zufferey, MD, Department of Rheumatology, Centre Hospitalier Universitaire Vaudois; P. Exer, MD, Praxis Rheuma-Basel.
  • Stekhoven D From the Department of Rheumatology, University Hospital; Department of Rheumatology, Uniklinik Balgrist; Swiss Clinical Quality Management Foundation, Zurich; Department of Rheumatology, Bethesda Hospital, Basel; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn; Department of Rheumatology and Clinical Immunology, University Hospital, Bern; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne; Praxis Rheuma-Basel, Basel, Switzerland.A. Ciurea, MD; M. Toniolo, MD; B.A. Michel, MD, Department of Rheumatology, University Hospital Zurich; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; R.O. Kissling, MD, Uniklinik Balgrist; D. Stekhoven, PhD; A. Scherer, PhD, SCQM Foundation; G. Tamborrini, MD, Bethesda Hospital; J. Bernhard, Department of Rheumatology and Rehabilitation, Bürgerspital Solothurn; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, University Hospital Bern; P. Zufferey, MD, Department of Rheumatology, Centre Hospitalier Universitaire Vaudois; P. Exer, MD, Praxis Rheuma-Basel.
  • Scherer A From the Department of Rheumatology, University Hospital; Department of Rheumatology, Uniklinik Balgrist; Swiss Clinical Quality Management Foundation, Zurich; Department of Rheumatology, Bethesda Hospital, Basel; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn; Department of Rheumatology and Clinical Immunology, University Hospital, Bern; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne; Praxis Rheuma-Basel, Basel, Switzerland.A. Ciurea, MD; M. Toniolo, MD; B.A. Michel, MD, Department of Rheumatology, University Hospital Zurich; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; R.O. Kissling, MD, Uniklinik Balgrist; D. Stekhoven, PhD; A. Scherer, PhD, SCQM Foundation; G. Tamborrini, MD, Bethesda Hospital; J. Bernhard, Department of Rheumatology and Rehabilitation, Bürgerspital Solothurn; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, University Hospital Bern; P. Zufferey, MD, Department of Rheumatology, Centre Hospitalier Universitaire Vaudois; P. Exer, MD, Praxis Rheuma-Basel.
  • Tamborrini G From the Department of Rheumatology, University Hospital; Department of Rheumatology, Uniklinik Balgrist; Swiss Clinical Quality Management Foundation, Zurich; Department of Rheumatology, Bethesda Hospital, Basel; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn; Department of Rheumatology and Clinical Immunology, University Hospital, Bern; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne; Praxis Rheuma-Basel, Basel, Switzerland.A. Ciurea, MD; M. Toniolo, MD; B.A. Michel, MD, Department of Rheumatology, University Hospital Zurich; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; R.O. Kissling, MD, Uniklinik Balgrist; D. Stekhoven, PhD; A. Scherer, PhD, SCQM Foundation; G. Tamborrini, MD, Bethesda Hospital; J. Bernhard, Department of Rheumatology and Rehabilitation, Bürgerspital Solothurn; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, University Hospital Bern; P. Zufferey, MD, Department of Rheumatology, Centre Hospitalier Universitaire Vaudois; P. Exer, MD, Praxis Rheuma-Basel.
  • Bernhard J From the Department of Rheumatology, University Hospital; Department of Rheumatology, Uniklinik Balgrist; Swiss Clinical Quality Management Foundation, Zurich; Department of Rheumatology, Bethesda Hospital, Basel; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn; Department of Rheumatology and Clinical Immunology, University Hospital, Bern; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne; Praxis Rheuma-Basel, Basel, Switzerland.A. Ciurea, MD; M. Toniolo, MD; B.A. Michel, MD, Department of Rheumatology, University Hospital Zurich; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; R.O. Kissling, MD, Uniklinik Balgrist; D. Stekhoven, PhD; A. Scherer, PhD, SCQM Foundation; G. Tamborrini, MD, Bethesda Hospital; J. Bernhard, Department of Rheumatology and Rehabilitation, Bürgerspital Solothurn; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, University Hospital Bern; P. Zufferey, MD, Department of Rheumatology, Centre Hospitalier Universitaire Vaudois; P. Exer, MD, Praxis Rheuma-Basel.
  • Toniolo M From the Department of Rheumatology, University Hospital; Department of Rheumatology, Uniklinik Balgrist; Swiss Clinical Quality Management Foundation, Zurich; Department of Rheumatology, Bethesda Hospital, Basel; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn; Department of Rheumatology and Clinical Immunology, University Hospital, Bern; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne; Praxis Rheuma-Basel, Basel, Switzerland.A. Ciurea, MD; M. Toniolo, MD; B.A. Michel, MD, Department of Rheumatology, University Hospital Zurich; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; R.O. Kissling, MD, Uniklinik Balgrist; D. Stekhoven, PhD; A. Scherer, PhD, SCQM Foundation; G. Tamborrini, MD, Bethesda Hospital; J. Bernhard, Department of Rheumatology and Rehabilitation, Bürgerspital Solothurn; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, University Hospital Bern; P. Zufferey, MD, Department of Rheumatology, Centre Hospitalier Universitaire Vaudois; P. Exer, MD, Praxis Rheuma-Basel.
  • Villiger PM From the Department of Rheumatology, University Hospital; Department of Rheumatology, Uniklinik Balgrist; Swiss Clinical Quality Management Foundation, Zurich; Department of Rheumatology, Bethesda Hospital, Basel; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn; Department of Rheumatology and Clinical Immunology, University Hospital, Bern; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne; Praxis Rheuma-Basel, Basel, Switzerland.A. Ciurea, MD; M. Toniolo, MD; B.A. Michel, MD, Department of Rheumatology, University Hospital Zurich; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; R.O. Kissling, MD, Uniklinik Balgrist; D. Stekhoven, PhD; A. Scherer, PhD, SCQM Foundation; G. Tamborrini, MD, Bethesda Hospital; J. Bernhard, Department of Rheumatology and Rehabilitation, Bürgerspital Solothurn; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, University Hospital Bern; P. Zufferey, MD, Department of Rheumatology, Centre Hospitalier Universitaire Vaudois; P. Exer, MD, Praxis Rheuma-Basel.
  • Zufferey P From the Department of Rheumatology, University Hospital; Department of Rheumatology, Uniklinik Balgrist; Swiss Clinical Quality Management Foundation, Zurich; Department of Rheumatology, Bethesda Hospital, Basel; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn; Department of Rheumatology and Clinical Immunology, University Hospital, Bern; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne; Praxis Rheuma-Basel, Basel, Switzerland.A. Ciurea, MD; M. Toniolo, MD; B.A. Michel, MD, Department of Rheumatology, University Hospital Zurich; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; R.O. Kissling, MD, Uniklinik Balgrist; D. Stekhoven, PhD; A. Scherer, PhD, SCQM Foundation; G. Tamborrini, MD, Bethesda Hospital; J. Bernhard, Department of Rheumatology and Rehabilitation, Bürgerspital Solothurn; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, University Hospital Bern; P. Zufferey, MD, Department of Rheumatology, Centre Hospitalier Universitaire Vaudois; P. Exer, MD, Praxis Rheuma-Basel.
  • Kissling RO From the Department of Rheumatology, University Hospital; Department of Rheumatology, Uniklinik Balgrist; Swiss Clinical Quality Management Foundation, Zurich; Department of Rheumatology, Bethesda Hospital, Basel; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn; Department of Rheumatology and Clinical Immunology, University Hospital, Bern; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne; Praxis Rheuma-Basel, Basel, Switzerland.A. Ciurea, MD; M. Toniolo, MD; B.A. Michel, MD, Department of Rheumatology, University Hospital Zurich; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; R.O. Kissling, MD, Uniklinik Balgrist; D. Stekhoven, PhD; A. Scherer, PhD, SCQM Foundation; G. Tamborrini, MD, Bethesda Hospital; J. Bernhard, Department of Rheumatology and Rehabilitation, Bürgerspital Solothurn; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, University Hospital Bern; P. Zufferey, MD, Department of Rheumatology, Centre Hospitalier Universitaire Vaudois; P. Exer, MD, Praxis Rheuma-Basel.
  • Michel BA From the Department of Rheumatology, University Hospital; Department of Rheumatology, Uniklinik Balgrist; Swiss Clinical Quality Management Foundation, Zurich; Department of Rheumatology, Bethesda Hospital, Basel; Department of Rheumatology and Rehabilitation, Bürgerspital, Solothurn; Department of Rheumatology and Clinical Immunology, University Hospital, Bern; Department of Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne; Praxis Rheuma-Basel, Basel, Switzerland.A. Ciurea, MD; M. Toniolo, MD; B.A. Michel, MD, Department of Rheumatology, University Hospital Zurich; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; R.O. Kissling, MD, Uniklinik Balgrist; D. Stekhoven, PhD; A. Scherer, PhD, SCQM Foundation; G. Tamborrini, MD, Bethesda Hospital; J. Bernhard, Department of Rheumatology and Rehabilitation, Bürgerspital Solothurn; P.M. Villiger, MD, Department of Rheumatology and Clinical Immunology, University Hospital Bern; P. Zufferey, MD, Department of Rheumatology, Centre Hospitalier Universitaire Vaudois; P. Exer, MD, Praxis Rheuma-Basel.
  • Exer P
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  • 2014-11-03
Published in:
  • The Journal of rheumatology. - 2015
AXIAL SPONDYLOARTHRITIS
TREATMENT RESPONSE
TUMOR NECROSIS FACTOR INHIBITORS
Academic Medical Centers
Adult
Antirheumatic Agents
Female
Humans
Male
Middle Aged
Practice Patterns, Physicians'
Private Practice
Rheumatology
Spondylarthritis
Treatment Outcome
Tumor Necrosis Factor-alpha
English OBJECTIVE
To evaluate the initiation of and response to tumor necrosis factor (TNF) inhibitors for axial spondyloarthritis (axSpA) in private rheumatology practices versus academic centers.


METHODS
We compared newly initiated TNF inhibition for axSpA in 363 patients enrolled in private practices with 100 patients recruited in 6 university hospitals within the Swiss Clinical Quality Management (SCQM) cohort.


RESULTS
All patients had been treated with ≥ 1 nonsteroidal antiinflammatory drug and > 70% of patients had a baseline Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 4 before anti-TNF agent initiation. The proportion of patients with nonradiographic axSpA (nr-axSpA) treated with TNF inhibitors was higher in hospitals versus private practices (30.4% vs 18.7%, p = 0.02). The burden of disease as assessed by patient-reported outcomes at baseline was slightly higher in the hospital setting. Mean levels (± SD) of the Ankylosing Spondylitis Disease Activity Score were, however, virtually identical in private practices and academic centers (3.4 ± 1.0 vs 3.4 ± 0.9, p = 0.68). An Assessment of SpondyloArthritis international Society (ASAS40) response at 1 year was reached for ankylosing spondylitis in 51.7% in private practices and 52.9% in university hospitals (p = 1.0) and for nr-axSpA in 27.5% versus 25.0%, respectively (p = 1.0).


CONCLUSION
With the exception of a lower proportion of patients with nr-axSpA newly treated with anti-TNF agents in private practices in comparison to academic centers, adherence to ASAS treatment recommendations for TNF inhibition was equally high, and similar response rates to TNF blockers were achieved in both clinical settings.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/162918
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