Finckh leads clinical research in the Division of Rheumatology at the University of Geneva. He trained in Internal Medicine and Rheumatology in Paris, Geneva and Lausanne and received his MSc in Epidemiology from Harvard School of Public Health. Finckh chairs the Scientific Commission of the Swiss Rheumatoid Arthritis (RA) cohort (SCQM-RA) and the EULAR standing Committee of Epidemiology and Health Services Research. His research includes the identification of modifiable risk factors in autoimmune diseases, impact of early therapeutic interventions in RA, comparative effectiveness research and identification of pre-clinical phase (asymptomatic forms) of RA. He is leading a multicenter study entitled “evaluation of a novel screening strategy for rheumatoid arthritis” in Switzerland.
Resume Objectif Les resultats mesures d’activite de la maladie telles que le score d’activite cli... more Resume Objectif Les resultats mesures d’activite de la maladie telles que le score d’activite clinique (DAS 28) ou les scores echographiques sont souvent divergents. Les objectifs de cette etude etaient de determiner la proportion de desaccords entre ces deux methodes d’evaluation chez des patients atteints de polyarthrite rhumatoide (PR) et de decrire les facteurs associes a ces divergences. Methodes Tous les patients atteints de PR inscrits dans le registre suisse des arthrites inflammatoires (SCQM) pour lesquels au moins un score DAS 28 et un score echographique concomitant etaient disponibles ont ete inclus. L’activite de la maladie a ete classee dans plusieurs categories (remission, faible a moderee et forte) selon des seuils etablis pour les deux scores etudies. Une analyse longitudinale a ete realisee pour les patients ayant beneficie d’au moins deux evaluations. Resultats Sur les 2369 evaluations incluses (1091 patients), 1196 (50,4 %) etaient divergentes. Par rapport au score DAS 28, le score echographique surestimait et sous-estimait l’activite de la maladie (23,5 % et 26,8 %, respectivement). Les facteurs cliniques et demographiques significativement associes aux resultats divergents etaient les composantes individuelles du score DAS 28 lorsque l’echographie etait utilisee comme reference et l’âge, la duree de la maladie et le nombre d’articulations gonflees lorsque la reference etait le score DAS 28. Le principal facteur lie a l’echographie ayant ete associe a une divergence etait la presence d’une tenosynovite echographique. Dans l’analyse longitudinale de 1081 patients, la proportion de desaccords est restee essentiellement la meme. Conclusion Les taux de desaccord entre les evaluations cliniques et echographiques de l’activite de la maladie dans la PR etaient eleves et le sont restes au cours du suivi, meme lorsque les evaluateurs echographiques avaient connaissance des resultats de l’examen clinique. Des facteurs lies a l’examen clinique et a l’echographie ont ete associes aux divergences.
Joint Bone Spine - In Press.Proof corrected by the author Available online since vendredi 29 dece... more Joint Bone Spine - In Press.Proof corrected by the author Available online since vendredi 29 decembre 2017
BackgroundThe development of biologic and targeted synthetic (b/ts)DMARDs contributed to improved... more BackgroundThe development of biologic and targeted synthetic (b/ts)DMARDs contributed to improved treatment outcomes in rheumatoid arthritis (RA). However, high medications costs may limit their use. Previously we showed that in countries with a lower socioeconomic status (SES), b/tsDMARDs were prescribed to fewer patients than in countries with higher SES. In this study we take a more detailed look at b/tsDMARD prescription behavior between countries.ObjectivesTo explore cross-country relationships between Gross Domestic Product (GDP) per capita, specific indicators of b/tsDMARDs use and disease outcomes in patients with RA.MethodsThis multinational, observational study included countries that had contributed ≥100 patients using b/tsDMARDs, with available follow up, to one of 2 registries: METEOR, an international registry capturing daily clinical practice data of patients with a clinical diagnosis of RA, and JAK-POT, an investigator-initiated collaboration between national registr...
Background: Comparative safety assessments are important for informed treatment decisions. Recent... more Background: Comparative safety assessments are important for informed treatment decisions. Recently, serious infections related to tofacitinib (TOF) have raised considerable interest. This study aims to compare the risk for serious infections in patients with rheumatoid arthritis (RA) upon receiving TOF versus biologic disease-modifying antirheumatic drugs (bDMARDs) by age at treatment initiation. Methods: We identified adult RA patients exposed to TOF or bDMARDs using data collected by the Swiss registry for inflammatory rheumatic diseases (SCQM) from 2015 to 2018. The event of interest was the first non-fatal serious infection (SI) during drug exposure. Missing or incomplete event dates were imputed as either the lower (left) or upper (right) limit of the interval in which the event must have occurred. Separate analyses were done with the left and right imputed dates and interpreted together. The comparative risk (hazard ratio, HR) of TOF versus bDMARDs was estimated as a function...
Objectives JAK Inhibitors (JAKi) are recommended DMARDs for patients with moderate-to-severe RA w... more Objectives JAK Inhibitors (JAKi) are recommended DMARDs for patients with moderate-to-severe RA who failed first-line therapy with methotrexate. There is a lack of data allowing an evidence-based choice of subsequent DMARD therapy for patients who had discontinued JAKi treatment. We aimed to compare the effectiveness of TNF inhibitor (TNFi) therapy vs JAKi vs other mode of action (OMA) biologic DMARD (bDMARD) in RA patients who were previously treated with a JAKi. Methods RA patients who discontinued JAKi treatment within the Swiss RA registry SCQM were included for this observational prospective cohort study. The primary outcome was drug retention for either TNFi, OMA bDMARD or JAKi. The hazard ratio for treatment discontinuation was calculated adjusting for potential confounders. A descriptive analysis of the reasons for discontinuation was performed. Results Four hundred treatment courses of JAKi were included, with a subsequent switch to either JAKi, TNFi or OMA bDMARD. The crud...
Background Large observational studies become more common in rheumatoid arthritis (RA). Disease r... more Background Large observational studies become more common in rheumatoid arthritis (RA). Disease registers [1] allow to analyse the effectiveness and safety of RA treatments in real-world populations, but observational studies suffer from missing data. To minimise bias, it has been shown that imputing missing data is superior to the use of complete case analysis [2]. Although some imputation methods have been studied in clinical trials of rheumatic diseases [3] and in small registers [4], the various imputation techniques have never been systematically compared in large registers. Objectives To compare the effects of available imputation methods on the estimated values and on RA remission rate for missing disease activity measures in large registers. Methods We used 1000 patients with complete data for disease activity (Disease Activity Score (DAS28) and Clinical Disease Activity Index (CDAI)) at baseline (treatment initiation), 6, 12, and 24 months after initiation of abatacept or a...
Resume Objectif Les resultats mesures d’activite de la maladie telles que le score d’activite cli... more Resume Objectif Les resultats mesures d’activite de la maladie telles que le score d’activite clinique (DAS 28) ou les scores echographiques sont souvent divergents. Les objectifs de cette etude etaient de determiner la proportion de desaccords entre ces deux methodes d’evaluation chez des patients atteints de polyarthrite rhumatoide (PR) et de decrire les facteurs associes a ces divergences. Methodes Tous les patients atteints de PR inscrits dans le registre suisse des arthrites inflammatoires (SCQM) pour lesquels au moins un score DAS 28 et un score echographique concomitant etaient disponibles ont ete inclus. L’activite de la maladie a ete classee dans plusieurs categories (remission, faible a moderee et forte) selon des seuils etablis pour les deux scores etudies. Une analyse longitudinale a ete realisee pour les patients ayant beneficie d’au moins deux evaluations. Resultats Sur les 2369 evaluations incluses (1091 patients), 1196 (50,4 %) etaient divergentes. Par rapport au score DAS 28, le score echographique surestimait et sous-estimait l’activite de la maladie (23,5 % et 26,8 %, respectivement). Les facteurs cliniques et demographiques significativement associes aux resultats divergents etaient les composantes individuelles du score DAS 28 lorsque l’echographie etait utilisee comme reference et l’âge, la duree de la maladie et le nombre d’articulations gonflees lorsque la reference etait le score DAS 28. Le principal facteur lie a l’echographie ayant ete associe a une divergence etait la presence d’une tenosynovite echographique. Dans l’analyse longitudinale de 1081 patients, la proportion de desaccords est restee essentiellement la meme. Conclusion Les taux de desaccord entre les evaluations cliniques et echographiques de l’activite de la maladie dans la PR etaient eleves et le sont restes au cours du suivi, meme lorsque les evaluateurs echographiques avaient connaissance des resultats de l’examen clinique. Des facteurs lies a l’examen clinique et a l’echographie ont ete associes aux divergences.
Joint Bone Spine - In Press.Proof corrected by the author Available online since vendredi 29 dece... more Joint Bone Spine - In Press.Proof corrected by the author Available online since vendredi 29 decembre 2017
BackgroundThe development of biologic and targeted synthetic (b/ts)DMARDs contributed to improved... more BackgroundThe development of biologic and targeted synthetic (b/ts)DMARDs contributed to improved treatment outcomes in rheumatoid arthritis (RA). However, high medications costs may limit their use. Previously we showed that in countries with a lower socioeconomic status (SES), b/tsDMARDs were prescribed to fewer patients than in countries with higher SES. In this study we take a more detailed look at b/tsDMARD prescription behavior between countries.ObjectivesTo explore cross-country relationships between Gross Domestic Product (GDP) per capita, specific indicators of b/tsDMARDs use and disease outcomes in patients with RA.MethodsThis multinational, observational study included countries that had contributed ≥100 patients using b/tsDMARDs, with available follow up, to one of 2 registries: METEOR, an international registry capturing daily clinical practice data of patients with a clinical diagnosis of RA, and JAK-POT, an investigator-initiated collaboration between national registr...
Background: Comparative safety assessments are important for informed treatment decisions. Recent... more Background: Comparative safety assessments are important for informed treatment decisions. Recently, serious infections related to tofacitinib (TOF) have raised considerable interest. This study aims to compare the risk for serious infections in patients with rheumatoid arthritis (RA) upon receiving TOF versus biologic disease-modifying antirheumatic drugs (bDMARDs) by age at treatment initiation. Methods: We identified adult RA patients exposed to TOF or bDMARDs using data collected by the Swiss registry for inflammatory rheumatic diseases (SCQM) from 2015 to 2018. The event of interest was the first non-fatal serious infection (SI) during drug exposure. Missing or incomplete event dates were imputed as either the lower (left) or upper (right) limit of the interval in which the event must have occurred. Separate analyses were done with the left and right imputed dates and interpreted together. The comparative risk (hazard ratio, HR) of TOF versus bDMARDs was estimated as a function...
Objectives JAK Inhibitors (JAKi) are recommended DMARDs for patients with moderate-to-severe RA w... more Objectives JAK Inhibitors (JAKi) are recommended DMARDs for patients with moderate-to-severe RA who failed first-line therapy with methotrexate. There is a lack of data allowing an evidence-based choice of subsequent DMARD therapy for patients who had discontinued JAKi treatment. We aimed to compare the effectiveness of TNF inhibitor (TNFi) therapy vs JAKi vs other mode of action (OMA) biologic DMARD (bDMARD) in RA patients who were previously treated with a JAKi. Methods RA patients who discontinued JAKi treatment within the Swiss RA registry SCQM were included for this observational prospective cohort study. The primary outcome was drug retention for either TNFi, OMA bDMARD or JAKi. The hazard ratio for treatment discontinuation was calculated adjusting for potential confounders. A descriptive analysis of the reasons for discontinuation was performed. Results Four hundred treatment courses of JAKi were included, with a subsequent switch to either JAKi, TNFi or OMA bDMARD. The crud...
Background Large observational studies become more common in rheumatoid arthritis (RA). Disease r... more Background Large observational studies become more common in rheumatoid arthritis (RA). Disease registers [1] allow to analyse the effectiveness and safety of RA treatments in real-world populations, but observational studies suffer from missing data. To minimise bias, it has been shown that imputing missing data is superior to the use of complete case analysis [2]. Although some imputation methods have been studied in clinical trials of rheumatic diseases [3] and in small registers [4], the various imputation techniques have never been systematically compared in large registers. Objectives To compare the effects of available imputation methods on the estimated values and on RA remission rate for missing disease activity measures in large registers. Methods We used 1000 patients with complete data for disease activity (Disease Activity Score (DAS28) and Clinical Disease Activity Index (CDAI)) at baseline (treatment initiation), 6, 12, and 24 months after initiation of abatacept or a...
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