Rabia Piskin SAGIR, Ahmet KARATAS, Yavuz PEHLIVAN, Servet AKAR, Soner SENEL, Berna GOKER, Ozgul GUNDUZ, Ayten YAZICI, Sema YILMAZ, Nevsun INANC, Gozde Yildirim CETIN, Fatos ONEN
Rheumatology Quarterly - 2026;4(2):85-92
Objective: Several factors such as effectiveness, safety, and compliance affect the drug survival in chronic disorders. Physicians consider long-term retention rates and reasons for discontinuation when selecting therapies. Identification of predictors of clinical response to certolizumab pegol (CZP) may aid the decision-making process for treating patients with psoriatic arthritis (PsA). The purpose of this study is to assess the drug survival of CZP in patients with PsA and to identify the predictors and reasons for discontinuation. Methods: Data on patient characteristics, demographics, diagnosis, disease duration, treatment, and outcomes have been collected since 2011 in Turkish Biologic (TURKBIO) Registry. By the end of December 2020, 68 PsA patients received CZP and were included. Kaplan-Meier analysis was used for drug survival analysis. Cox regression analysis was performed to evaluate the predictors associated with drug survival. Results: During a median follow-up of 47 months, 17 patients discontinued CZP treatment. At 36 months, the retention rate was 61.6%. Patients who discontinued CZP were older and had longer disease duration (P = .012 and P = .002, respectively). HLA-B27 positivity was associated with lower drug survival (P = .035). Biologic-naive patients demonstrated higher drug survival in Kaplan-Meier analysis (log-rank P = .02), although baseline comparison did not reach statistical significance (P = .062). In Cox regression analysis, age was identified as an independent predictor of treatment discontinuation (hazard ratio: 1.063, 95% CI: 1.019-1.109, P = .004). Conclusion: In this real-world analysis from the TURKBIO registry, CZP demonstrated moderate long-term drug retention in patients with PsA. Older age was independently associated with reduced treatment persistence, while longer disease duration was also associated with lower retention. Biologic-naive status was linked to improved drug survival. HLA-B27 positivity was also associated with lower drug survival; however, this finding should be interpreted with caution due to limited data availability. These results support the potential benefit of earlier initiation of CZP, particularly in biologic-naive patients, while highlighting the need for further studies to clarify the role of genetic factors in treatment persistence.
