Ab0699 effect of Switching Between Tumor Necrosis Factor Inhibitor in Spondyloarthritis

Abstract

BackgroundThe introduction of new drugs, in particular tumour necrosis factor inhibitor (TNFi) has revolutionized the treatment of spondyloarthritis (SpA). Meanwhile, about 30% of patients do not react to first-line TNFi. To date,there is no recommendations available forthe treatment of SpA patients after first TNFi failure.ObjectivesIn this study we assessed the effectiveness of a second and third biotherapy in patients with SpA with an inadequate response to previous TNFi and to analyze the survival of the second biotherapyMethodsThis study included patients with SpA who had had at least two biotherapies. Treatment response was noted at 3 months. At 6 months, we assessed the maintaining of effectiveness in Spa. We studied the elements of a good response to the second biotherapy.ResultsOur population of study included 30 SpA. During the second treatment, response rate was achieved by 80% after 3 months. No difference was noted between first and second TNFi among switchers. 86, 7%maintained response at twelve months. For axial forms, decrease in BASDAI was significant at 3 months. For peripheral forms, an improvement of the swollen and tender joint counts was observed and was significant at 3 months. Four patients have received a third TNFi. Response rate was achieved by all of them after 3 months. All of them maintained response at 6 months.The elements of a good response founded were;the early age of the SpA starting(<30y.o), the high value of initial CRP,the use of ESSG criteria,the SpA type,the extra articular signs, the first biotherapy and the reponse at 3 months to it, the drugs taken when second biotherapy were initiated a low initial EVA and BASFI.ConclusionThese real-life data show that, after discontinuation of a first TNFi, switching to a second biotherapy in SpA is related to significantly improving of clinical effectiveness compared to a first TNFi.ReferencesnoneDisclosure of interestsNone declared