PS-084 Negative results asocciated with TNF antagonists in rheumatoid arthritis and ankylosing spondylitis

Abstract

BackgroundDrug related problems (DRP) are defined as negative clinical outcomes resulting from pharmacotherapy, which do not achieve therapy objectives or produce undesirable effects. They can be necessity, safety or effectiveness DRP.PurposeTo measure the incidence of DRP (effectiveness and safety) in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AE) treated with TNF antagonists (anti-TNF).Material and methodsA transversal, prospective, observational study was carried out in patients with AR and AE from the rheumatology unit in our hospital. Patients were selected by controlled randomisation (C4-study design pack), with voluntary study participation. Exclusion criteria: patients with anti-TNF for <3 months and <18 years. Pharmacotherapy follow-up (PFU) was conducted according to Dáder methodology-Universidad de Granada. All patients were interviewed twice a year. Variables collected: demographics (age, sex); clinical (diagnosis, time from diagnosis (TFD); and therapeutic: (previous and actual anti-TNF drug, initiation of use, adverse effects). Statistical study was conducted with Epidat 3.1-programme.Results85 patients were included. RA: mean age 49.7±6.62 years (83.9% women), TFD 11.5±9.2 years. AE: mean age 41.6±6 years (31% women), TFD 9.5±7.6 years. The table shows the DRP since PFU. Disease-anti-TNF No of patients Total No of DRP-effectiveness Effectiveness DRP per patient Total No of DRP-safety Safety DRP per patient RA-infliximab2590.490.4RA-etanercept1430.2181.3RA-adalimumab1750.3301.8AE-infliximab1990.590.5AE-etanercept530.6132.6AE-adalimumab530.6102 Anti-TNF No of patients Total No of DRP DRP per patient Infliximab44360.8Etanercept19371.9Adalimumab22482.2There were statistically significant differences when comparing total number of DRP with each drug (p=0.005), with a higher prevalence using adalimumab. There were 5 treatment changes undertaken between the 2 interviews: 2 because of safety DRP (optic neuritis in a patient with adalimumab; recurrent herpes virus infections in a patient with infliximab) and 2 because of ineffectiveness (1 patient with adalimumab; 1 patient with infliximab) and 1 because of the patient’s comorbidities.ConclusionInfliximab presented less DRP per patient. The data suggest a better safety and effectiveness profile for infliximab according to the number or related DRP compared with other anti-TNF.References and/or acknowledgementsFaus MJ. Programa Dáder. Pharm Care Esp2000;2:73–4.No conflict of interest