{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T01:36:24Z","timestamp":1768095384797,"version":"3.49.0"},"reference-count":36,"publisher":"The Journal of Rheumatology","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>Because new modes of action for the treatment of psoriatic arthritis (PsA) are emerging, it is important to understand the use of switching to a second or third antitumor necrosis factor (anti-TNF) agent. This study investigated drug survival and treatment response rates of patients with PsA undergoing second- and third-line anti-TNF therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>Patients with PsA were monitored in a prospective, observational study. Patients who switched anti-TNF therapy once (first-time switchers, n = 217) or twice (second-time switchers, n = 57) between January 2003 and March 2012 were studied. American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) good response at 3 and 6 months, as well as drug survival, were reported and further analyzed using the Cox and logistic regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Median age for first-time switchers was 47 years and 42% were men. The corresponding values for second-time switchers were 48 years and 40% men. Three-month ACR20 Lund Efficacy Index (LUNDEX) response was achieved by 47% of first-time and 22% of second-time switchers; ACR50 LUNDEX rates were 21% and 14%, ACR70 LUNDEX rates were 12% and 2%, and EULAR good LUNDEX rates were 26% and 10%, respectively. Median drug survival time for patients switching anti-TNF for the first time was 64 months (95% CI 31\u201397) compared with 14 months (95% CI 5\u201323) for second-time switchers. Identified baseline predictor of ACR20 response to second-line treatment was the 28-joint Disease Activity Score values at baseline (OR 1.45, 95% CI 1.01\u20132.10), while higher Health Assessment Questionnaire scores predicted premature drug withdrawal (HR 1.60, 95% CI 1.03\u20132.48).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Response rates of first-time anti-TNF switchers are moderate, while the inferior response rates of second-time switchers suggest other therapeutic options should be considered in this situation.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.150744","type":"journal-article","created":{"date-parts":[[2015,12,2]],"date-time":"2015-12-02T03:04:06Z","timestamp":1449025446000},"page":"81-87","source":"Crossref","is-referenced-by-count":38,"title":["Effectiveness and Feasibility Associated with Switching to a Second or Third TNF Inhibitor in Patients with Psoriatic Arthritis: A Cohort Study from Southern Sweden"],"prefix":"10.3899","volume":"43","author":[{"given":"Lars Erik","family":"Kristensen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Lie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lennart T.H.","family":"Jacobsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin","family":"Christensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip J.","family":"Mease","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henning","family":"Bliddal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Geborek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2262","published-online":{"date-parts":[[2015,12,1]]},"reference":[{"key":"2018112909351263000_43.1.81.1","unstructured":"van der Linden S van der Heijde D . Spondyloarthropathies. In: Ruddy S Harris ED Jr Sledge CB . Kelley\u2019s textbook of rheumatology. Philadelphia: W.B. Saunders Company; 2001: 1039\u201353."},{"key":"2018112909351263000_43.1.81.2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.141598"},{"key":"2018112909351263000_43.1.81.3","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200826020-00003"},{"key":"2018112909351263000_43.1.81.4","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2004.034157"},{"key":"2018112909351263000_43.1.81.5","doi-asserted-by":"publisher","DOI":"10.1002\/art.20335"},{"key":"2018112909351263000_43.1.81.6","doi-asserted-by":"publisher","DOI":"10.1002\/art.20967"},{"key":"2018112909351263000_43.1.81.7","doi-asserted-by":"publisher","DOI":"10.1002\/art.21306"},{"key":"2018112909351263000_43.1.81.8","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203696"},{"key":"2018112909351263000_43.1.81.9","doi-asserted-by":"publisher","DOI":"10.1002\/art.24403"},{"key":"2018112909351263000_43.1.81.10","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.073544"},{"key":"2018112909351263000_43.1.81.11","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202229"},{"key":"2018112909351263000_43.1.81.12","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200350"},{"key":"2018112909351263000_43.1.81.13","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.094946"},{"key":"2018112909351263000_43.1.81.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60594-2"},{"key":"2018112909351263000_43.1.81.15","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-205056"},{"key":"2018112909351263000_43.1.81.16","doi-asserted-by":"publisher","DOI":"10.1002\/art.30176"},{"key":"2018112909351263000_43.1.81.17","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-203018"},{"key":"2018112909351263000_43.1.81.18","doi-asserted-by":"publisher","DOI":"10.1002\/art.37876"},{"key":"2018112909351263000_43.1.81.19","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.082925"},{"key":"2018112909351263000_43.1.81.20","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.073569"},{"key":"2018112909351263000_43.1.81.21","doi-asserted-by":"publisher","DOI":"10.2165\/11310770-000000000-00000"},{"key":"2018112909351263000_43.1.81.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2006.12.003"},{"key":"2018112909351263000_43.1.81.23","doi-asserted-by":"publisher","DOI":"10.1186\/ar3054"},{"key":"2018112909351263000_43.1.81.24","doi-asserted-by":"publisher","DOI":"10.1186\/ar2670"},{"key":"2018112909351263000_43.1.81.25","doi-asserted-by":"publisher","DOI":"10.1002\/art.21570"},{"key":"2018112909351263000_43.1.81.26","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.9.793"},{"key":"2018112909351263000_43.1.81.27","doi-asserted-by":"publisher","DOI":"10.1002\/art.21972"},{"key":"2018112909351263000_43.1.81.28","unstructured":"DAS-SCORE . [Internet. Accessed October 21, 2015.] Available from: www.das-score.nl\/das28\/en\/"},{"key":"2018112909351263000_43.1.81.29","unstructured":"Indices. In: van Riel PL Fransen J Scott DL , eds. EULAR handbook of clinical assessment in rheumatoid arthritis. Alphen aan den Rijn: Van Zuiden Communications B.V; 2004:33\u201340."},{"key":"2018112909351263000_43.1.81.30","doi-asserted-by":"publisher","DOI":"10.3109\/03009748809098795"},{"key":"2018112909351263000_43.1.81.31","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390105"},{"key":"2018112909351263000_43.1.81.32","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.081122"},{"key":"2018112909351263000_43.1.81.33","doi-asserted-by":"crossref","first-page":"862969","DOI":"10.1155\/2014\/862969","article-title":"Drug retention rates and treatment discontinuation among anti-TNF-\u03b1 agents in psoriatic arthritis and ankylosing spondylitis in clinical practice","volume":"2014","author":"Fabbroni","year":"2014","journal-title":"Mediators Inflamm"},{"key":"2018112909351263000_43.1.81.34","doi-asserted-by":"publisher","DOI":"10.1186\/ar2084"},{"key":"2018112909351263000_43.1.81.35","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204128"},{"key":"2018112909351263000_43.1.81.36","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204714"}],"container-title":["The Journal of Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3899\/jrheum.150744","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,11,29]],"date-time":"2018-11-29T19:03:09Z","timestamp":1543518189000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.jrheum.org\/lookup\/doi\/10.3899\/jrheum.150744"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12,1]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,1,1]]},"published-print":{"date-parts":[[2016,1]]}},"alternative-id":["10.3899\/jrheum.150744"],"URL":"https:\/\/doi.org\/10.3899\/jrheum.150744","relation":{},"ISSN":["0315-162X","1499-2752"],"issn-type":[{"value":"0315-162X","type":"print"},{"value":"1499-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12,1]]}}}