{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T10:49:13Z","timestamp":1768906153430,"version":"3.49.0"},"reference-count":37,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,1,17]],"date-time":"2022-01-17T00:00:00Z","timestamp":1642377600000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","award":["Unrestricted grant"],"award-info":[{"award-number":["Unrestricted grant"]}],"id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019016","name":"ASAS","doi-asserted-by":"crossref","award":["ASAS grant"],"award-info":[{"award-number":["ASAS grant"]}],"id":[{"id":"10.13039\/100019016","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2021,12,17]]},"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate long-term effectiveness of tumour necrosis factor inhibitor (TNFi) after a first switch, and their associated factors in an early axial spondyloarthritis (axSpA) population, considering time-varying prescription bias.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Observational prospective cohort (DEvenir des Spondylarthropathies Indiff\u00e9renci\u00e9es R\u00e9centes) with 5 years of follow-up, including 708 TNFi-na\u00efve patients with early axSpA. Long-term effectiveness of TNFi after a first switch (ASAS40 response after at least 2 visits under treatment) were estimated using marginal structural models (implementing inverse-probability weighting and iterative propensity scores). Factors associated with the outcome were explored by multivariate Cox regression models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The hazard to present an ASAS40 response after a first TNFi switch was increased (HR=2.4 (95% CI 1.9 to 3.0)); this response ratio was slightly lower compared with the response in TNFi na\u00efve patients after a first TNFi (HR=3.3 (95% CI 2.9 to 3.8)). HLA-B27 positive was the only factor independently associated with ASAS40 response after a first TNFi switch.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>After application of innovative methods to overcome time-varying prescription bias, the magnitude of the TNFi response after a first switch was found to be numerically lower but clinically relevant from the response in TNFi-na\u00efve patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2021-001846","type":"journal-article","created":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T11:21:12Z","timestamp":1642504872000},"page":"e001846","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of long-term TNFi effectiveness after a first switch in early axial spondyloarthritis considering time-varying prescription bias: an inverse-probability weighting analysis of the DESIR cohort"],"prefix":"10.1136","volume":"8","clinical-trial-number":[{"clinical-trial-number":"nct01648907","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Marion","family":"Pons","sequence":"first","affiliation":[{"name":"INSERM U1153, Paris, France"},{"name":"Department of Rheumatology, Cochin Hospital, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvie","family":"Chevret","sequence":"additional","affiliation":[{"name":"INSERM U1153, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6238-2601","authenticated-orcid":false,"given":"Karine","family":"Briot","sequence":"additional","affiliation":[{"name":"INSERM U1153, Paris, France"},{"name":"Department of Rheumatology, Cochin Hospital, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria-Antonietta","family":"d\u2019Agostino","sequence":"additional","affiliation":[{"name":"Departement of rheumatology, Paris Ouest university and Ambroise-Par\u00e9 hospital, Boulogne-Billancourt, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5880-2933","authenticated-orcid":false,"given":"Christian","family":"Roux","sequence":"additional","affiliation":[{"name":"INSERM U1153, Paris, France"},{"name":"Department of Rheumatology, Cochin Hospital, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3009-6229","authenticated-orcid":false,"given":"Maxime","family":"Dougados","sequence":"additional","affiliation":[{"name":"INSERM U1153, Paris, France"},{"name":"Department of Rheumatology, Cochin Hospital, Paris, 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