Ab0239 persistence to Biological Dmards TNF Inhibitors vs Biological Dmards No TNF Inhibitors After Failure to Synthetic Conventional Dmards in Ra Patients Treated in Standard Clinical Practice

Abstract

Background:There are no RA response predictors for our patients. The decision to initiate a first biological depends on multiple factors such as rheumatologist experience, clinical characteristics of the patient and health system. What is clear is that the best strategy is T2T.Objectives:To know the clinical characteristics and persistence of the first biological DMARD in patients receiving bDMARDS TNF inhibitors vs DMARDs aimed at other targets.Methods:A observational cohort of adult RA patients (ACR/EULAR 2010) in a rheumatology department of a third-level university hospital. All patients were treated with a first bDMARD marketed in Spain, from 2010 to December 2020 and prescribed according to product data sheet. Biological drugs were divided into TNF inhibitors drugs (adalimumab, etanercept, infliximab, golimumab, certolizumab) and Other targets (abatacept, rituximab, sarilumab, tocilizumab). Clinical data, duration of treatment and EULAR response were collected from each patient. The data were analyzed with descriptive, bivariate statistics and survival analysis adjusted for age, sex, FR, erosions and duration of the disease.Results:Data were collected from 332 patients (table 1). Patients treated with other target bDMARDs were mostly female, with higher activity, shorter disease duration, and treated without MTX.b Survival graphs showed that regardless of the target chosen as fist bDMARD, EULAR response rates and persistence to the drug were similar.Table 1.VariableTNF inhibitorsn=194Other targetsn = 138Totaln =332pn (%)n (%)n (%)0.02Female142 (73)115 (83)257 (77)0.2FR +163 (82)121 (88)284 (86)0.6ACPA +125 (63)84 (61)209 (63)0.9Erosions177 (89)80 (58)257 (77)0.01Concomitant MTX153 (77)62 (47)215 (65)0.003EULAR response Good103 (77)67 (71)170 (75)0.2 Moderate24 (18)16 (17)40 (17) No7 (5)11 (11)18 (8)Mean ± SDMean ± SDMean ± SDAge (years)55.7 ± 13.357.6 ± 11.956.5 ± 12.70.1Evolution of RA (years)9.6 ± 10.27.5 ± 7.58.7 ± 9.20.04Persistence (months)19.3 ± 20.516.07 ± 15.1117.5 ± 18.50.04DAS28VSG4V basal5.02 ± 1.55.59 ± 1.035.25 ± 1.30.001DAS28VSG4V final2.68 ± 1.12.84 ± 1.42.7 ± 1.250,31Conclusion:Patients receiving Anti-TNF vs bDMARD with other mechanisms of action have clinical differences. However, the response and persistence to the drug are similar, perhaps due to the implementation of the correct T2T strategy.Disclosure of Interests:None declared