{
  "abstract": "Objectives To investigate associations between cardiometabolic comorbidities and clinical characteristics, prescription patterns and retention of first biologic/targeted synthetic disease-modifying anti-rheumatic drug (b/tsDMARD) in patients with psoriatic arthritis (PsA).Methods Patients with PsA initiating a first b/tsDMARD treatment in 2015 or later were identified in eight European rheumatology registries. Patients with information on five cardiometabolic comorbidities (obesity, dyslipidaemia, diabetes, hypertension, ischaemic heart disease) at treatment start (baseline) were included. All analyses were conducted according to patients’ comorbidity burden (count: 0/1/≥2) and status (presence/absence of each comorbidity). Patient characteristics and prescription patterns were described. Twelve-month treatment retention rates were estimated and compared using Kaplan-Meier plots, log-rank tests and multivariable Cox regression analyses.Results Among 5299 patients, 36% had at least one cardiometabolic comorbidity. Patients with comorbidity were older, had higher disease activity and more disability. Regardless of comorbidity, most patients were prescribed a tumour necrosis factor inhibitor (76%). The use of interleukin-17 inhibitors increased with comorbidity burden (0/1/≥2 comorbidities: 13%/18%/19%), whereas Janus kinase inhibitor use declined (2.3%/1.6%/0.8%). Retention rates were marginally lower with higher comorbidity burden (80%/76%/78%) (log-rank, p=0.036) and obesity (absent 79% vs present 77%) (log-rank, p=0.04). The risk of treatment withdrawal was only marginally higher in patients with higher comorbidity burden (one comorbidity: HR 1.19; 95% CI 1.02 to 1.40; ≥2 comorbidities: HR 1.18; 0.98 to 1.42).Conclusion Patients with cardiometabolic comorbidities had higher disease activity at treatment initiation of the first b/tsDMARD. Prescription patterns varied with comorbidity burden. Cardiometabolic comorbidity burden, especially obesity, was associated with marginally lower treatment retention.",
  "authors": [
    {
      "affiliations": [
        "Copenhagen Center for Arthritis Research (COPECARE), Rigshospitalet Center for Rheumatology and Spine Diseases, Glostrup, Denmark",
        "Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"
      ],
      "name": "Zohra Faizy Ahmadzay"
    },
    {
      "affiliations": [
        "Copenhagen Center for Arthritis Research (COPECARE), Rigshospitalet Center for Rheumatology and Spine Diseases, Glostrup, Denmark"
      ],
      "name": "Lykke Midtbøll Ørnbjerg"
    },
    {
      "affiliations": [
        "Copenhagen Center for Arthritis Research (COPECARE), Rigshospitalet Center for Rheumatology and Spine Diseases, Glostrup, Denmark",
        "Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"
      ],
      "name": "Mikkel Østergaard"
    },
    {
      "affiliations": [
        "Copenhagen Center for Arthritis Research (COPECARE), Rigshospitalet Center for Rheumatology and Spine Diseases, Glostrup, Denmark"
      ],
      "name": "Kasper Yde Jensen"
    },
    {
      "affiliations": [
        "Copenhagen Center for Arthritis Research (COPECARE), Rigshospitalet Center for Rheumatology and Spine Diseases, Glostrup, Denmark"
      ],
      "name": "Jacob Brauner Jørgensen"
    },
    {
      "affiliations": [
        "Copenhagen Center for Arthritis Research (COPECARE), Rigshospitalet Center for Rheumatology and Spine Diseases, Glostrup, Denmark"
      ],
      "name": "Jette Heberg"
    },
    {
      "affiliations": [
        "Department of Rheumatology and DANBIO, Aarhus University Hospital, Aarhus, Denmark",
        "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"
      ],
      "name": "Anne Gitte Loft"
    },
    {
      "affiliations": [
        "Copenhagen Center for Arthritis Research (COPECARE), Rigshospitalet Center for Rheumatology and Spine Diseases, Glostrup, Denmark",
        "Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway",
        "Research Unit, Sørlandet Hospital, Kristiansand, Norway"
      ],
      "name": "Brigitte Michelsen"
    },
    {
      "affiliations": [
        "Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, UK"
      ],
      "name": "Gareth T Jones"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Clinical Immunology, Free University of Amsterdam, Amsterdam University Medical Centres, Amsterdam, The Netherlands",
        "Amsterdam UMC, Amsterdam Rheumatology and Immunology Center (ARC), Amsterdam, The Netherlands"
      ],
      "name": "Pasoon Hellamand"
    },
    {
      "affiliations": [
        "Copenhagen Center for Arthritis Research (COPECARE), Rigshospitalet Center for Rheumatology and Spine Diseases, Glostrup, Denmark",
        "Reumaklinik Roskilde, Rheumatology Specialist Practice, Roskilde, Denmark"
      ],
      "name": "Signe Møller-Bisgaard"
    },
    {
      "affiliations": [
        "Copenhagen Center for Arthritis Research (COPECARE), Rigshospitalet Center for Rheumatology and Spine Diseases, Glostrup, Denmark"
      ],
      "name": "Mehrdad Shoae Kazemi"
    },
    {
      "affiliations": [
        "Copenhagen Center for Arthritis Research (COPECARE), Rigshospitalet Center for Rheumatology and Spine Diseases, Glostrup, Denmark",
        "ParHub RnD ApS, Copenhagen, Denmark"
      ],
      "name": "Parham Karimi Reikandeh"
    },
    {
      "affiliations": [
        "Institute of Rheumatology, Prague, Czech Republic",
        "Department of Rheumatology, Charles University First Faculty of Medicine, Prague, Czech Republic"
      ],
      "name": "Jakub Závada"
    },
    {
      "affiliations": [
        "Department of Internal Medicine—Nephrology, Rheumatology, Endocrinology, University Hospital Olomouc, Olomouc, Czech Republic"
      ],
      "name": "Pavel Horák"
    },
    {
      "affiliations": [
        "Department of Medicine, University of Porto Faculty of Medicine, Porto, Portugal",
        "Rheumatology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal"
      ],
      "name": "Miguel Bernardes"
    },
    {
      "affiliations": [
        "Department of Rheumatology, ULSSM, Instituto Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Hospital de Santa Maria, Lisbon, Portugal"
      ],
      "name": "Elsa Vieira-Sousa"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Hospital General, Universitario Gregorio Marañón, Madrid, Spain",
        "Faculty of Medicine, Complutense University of Madrid, Madrid, Spain"
      ],
      "name": "Isabel Castrejón"
    },
    {
      "affiliations": [
        "Research Unit, Spanish Society of Rheumatology, Madrid, Spain"
      ],
      "name": "Lucía Otero-Varela"
    },
    {
      "affiliations": [
        "Centre for Rheumatic Disease, University of Medicine and Pharmacy, Bucharest, Romania"
      ],
      "name": "Catalin Codreanu"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Division of Medicine, Turku University Hospital, Turku, Finland",
        "Department of Internal Medicine, University of Turku, Turku, Finland",
        "Rheumatology, Department of Medicine, Satakunta Central Hospital, Rauma, Finland"
      ],
      "name": "Laura Kuusalo"
    },
    {
      "affiliations": [
        "Centre for Rheumatic Diseases, Tampere University Hospital, Tampere, Finland",
        "Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland",
        "Department of Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland"
      ],
      "name": "Vappu Rantalaiho"
    },
    {
      "affiliations": [
        "Epidemiology, German Rheumatology Research Center, Berlin, Germany"
      ],
      "name": "Anne C Regierer"
    },
    {
      "affiliations": [
        "Epidemiology, German Rheumatology Research Center, Berlin, Germany"
      ],
      "name": "Andreas Reich"
    },
    {
      "affiliations": [
        "Department Rheumatology and Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland"
      ],
      "name": "Burkhard Möller"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zürich, Switzerland"
      ],
      "name": "Raphael Micheroli"
    },
    {
      "affiliations": [
        "Section for Rheumatology, Department for Neurology, Rheumatology and Physical Medicine, Helse Førde, Forde, Norway"
      ],
      "name": "Pawel Mielnik"
    },
    {
      "affiliations": [
        "Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway",
        "Public Health Section, University of Inland Norway, Elverum, Norway"
      ],
      "name": "Sella Aarrestad Provan"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Hospital Zurich, University of Zurich, Zürich, Switzerland"
      ],
      "name": "Karin Lass"
    },
    {
      "affiliations": [
        "Section for Rheumatology, Department for Neurology, Rheumatology and Physical Medicine, Helse Førde, Forde, Norway"
      ],
      "name": "Sigrid Vorobjov"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia",
        "Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia"
      ],
      "name": "Ziga Rotar"
    },
    {
      "affiliations": [
        "Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia",
        "Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia"
      ],
      "name": "Katja Perdan Pirkmajer"
    },
    {
      "affiliations": [
        "Rheumatology Unit—Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Bari, Italy"
      ],
      "name": "Florenzo Iannone"
    },
    {
      "affiliations": [
        "Rheumatology, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza, University of Rome, Rome, Italy"
      ],
      "name": "Fabrizio Conti"
    },
    {
      "affiliations": [
        "Centre for Rheumatology Research, Landspítali—The National University Hospital of Iceland, Reykjavík, Iceland",
        "Faculty of Medicine, University of Iceland, Reykjavík, Iceland"
      ],
      "name": "Bjorn Gudbjornsson"
    },
    {
      "affiliations": [
        "Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden"
      ],
      "name": "Daniela Di Giuseppe"
    },
    {
      "affiliations": [
        "Department of Rheumatology & Clinical Immunology and Department of Experimental Immunology, Amsterdam Institute for Immunology & Infectious Diseases, University of Amsterdam, Amsterdam, The Netherlands",
        "Amsterdam Rheumatology and Immunology Center, Reade and Amsterdam UMC, Amsterdam, The Netherlands"
      ],
      "name": "Marleen van de Sande"
    },
    {
      "affiliations": [
        "Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, UK"
      ],
      "name": "Gary J Macfarlane"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey"
      ],
      "name": "Handan Yarkan-Tuğsal"
    },
    {
      "affiliations": [
        "Copenhagen Center for Arthritis Research (COPECARE), Rigshospitalet Center for Rheumatology and Spine Diseases, Glostrup, Denmark",
        "Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"
      ],
      "name": "Bente Glintborg"
    },
    {
      "affiliations": [
        "Copenhagen Center for Arthritis Research (COPECARE), Rigshospitalet Center for Rheumatology and Spine Diseases, Glostrup, Denmark",
        "Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"
      ],
      "name": "Merete Lund Hetland"
    }
  ],
  "title": "Impact of cardiometabolic comorbidities on clinical characteristics, prescription patterns and retention rate of first b/tsDMARD treatment in 5299 European real-world patients with psoriatic arthritis",
  "uid": "81f2ffc4-5951-57df-9998-23ad8882d8fa"
}