Abstract

Methotrexate and leflunomide survival in patients with psoriatic arthritis

Author(s): Landi M, Zaffarana CA, Cerda O, Gallino Yanzi J, Schneeberger EE, Carrillo I, Gonzalez MC and Citera G

Abstract:The objectives of this study were to estimate the survival rate of the most frequently used DMARDs in a cohort of PsA patients and factors associated with a higher survival rate.

Methods: Patients ≥ 18 years of age with PsA according to CASPAR criteria, belonging to the RAPSODIA cohort were studied. Socio-demographic, clinical and treatment data were collected. Statistical analysis: Kaplan Meier survival curves and log rank were used to analyse and compare drugs’ survival rate. Cox proportional analysis was performed to determine associated factors with drug survival.

Results: 87 patients with PsA were included with a median age of 52 years (IQR 40.2-61.7) and a slight female predominance (52.9%). Seventy patients (80.5%) received MTX, 23 (32.9%) had to discontinue it due to adverse events (65%) or treatment failure (35%). The median survival time of MTX treatment was 13 years (IQR 8.5-17.4). The cumulative survival rate after 10 years of treatment was 55%, being significantly higher among patients receiving concomitant steroid therapy (median 16.4 ± 2.3 years vs. 10 ± 2 years, p=0.01).

Of the 16 patients receiving LFN, 56.25% had to discontinue, estimating a median survival time of 6 years (IQR 1.6-10.3). The cumulative survival rate after 10 years was 35%. Using a cut-off value of 50 years, elderly patients had a higher drug survival (median 5.5 ± 1.5 years vs. 3 ± 1 years, p=0.03).

Conclusion: MTX was the most frequently DMARD used. MTX cumulative survival was greater than that of LFN and was favoured by concomitant steroid therapy. LFN survival was higher amongst elderly patients.


PDF