SAT0273 Golimumab retention rate in patients with spondyloarthritis. differences between ankylosing spondylitis and non-radiographic axial spondyloarthritis

Abstract

BackgroundThe efficacy of Golimumab treatment in spondyloarthritis (SpA) has been widely documented.ObjectivesThe aim of this study was to analize the long-term retention rate of Golimumab and to identify independent predictors of retention in patients with SpA.MethodsProspective monocentric cohort of SpA patients treated with Golimumab according with clinical practice. Study was approved by local Ethics Committee. Demographic and clinical variables were analysed with Cox proportional hazard regression model.Results105 patients were included, 49 (46.7%) Ankylosing Spondylitis (AS), 40 (38.1%) non-radiographic axial SpA (nr-AxSpA) and 16 (15,2%) peripheral SpA. The baseline characteristics of the patients are shown in table 1. Follow-up time was 206.6 patients-year. Mean survival time was 47.2 months (95% CI: 39.4–54.9). Age, gender, HLA-B27, radiographic or nr-AxSpA and previous biological use were significant in the univariate analysis. Concomitant DMARD had no influence on Golimumab retention rate (HR: 1.2; 95% CI: 0.6–2.4; p: 0.6).Abstract SAT0273 – Table 1Baseline demographic and clinical characteristics of the patients.All (axial and peripheral SpA)ASnr-AxSpA Age -mean (SD)-years45.1 (13.2)51.1 (10.8)39,8 (10.1)Male gender (%)52 (49.5%)30 (61.2%)19 (47.5%)Mean evolution time (SD)- years11.8 (12.3)18.8 (10.1)7.3 (10.3)Positive HLA-B27 (%)73 (69.6%)44 (90.7%)21 (52.6%)Uveitis (%)17 (16.2%)12 (24.5%)4 (10.0%)Back pain -mean (SD)7.5 (7.0)6.5 (2.4)9.1 (10.7)BASDAI -mean (SD)6.2 (1.6)6.3 (2.1)6.2 (1.2)BASFI -mean (SD)5.8 (2.3)6.0 (2.4)5.4 (2.1)CRP mg/dl – mean (SD)1.1 (1.7)1.5 (2.1)0.65 (1.4)Concomitant DMARD (%)31 (29.8%)15 (31.3%)3 (7.5%)Biological Therapy naïve (%)48 (45.7%)15 (30.6%)24 (60%)Golimumab retention rate of patients with nr-AxSpA and objective inflammation (positive MRI or CRP) was not different compared to AS patients (p=0.19). Patients with nr-AxSpA without objective inflammation (negative MRI and CRP) had worse retention rate compared to AS patients (HR: 2.47; 95% CI: 1.09–5,57; p<0.03), figure 1. There was a numerically better Golimumab retention rate in patients treated previously with less number of biologicals, but did not reach statistical significance. 39/105 patients (37%) withdrew Golimumab treatment. 26/39 (66.7%) due to lack of efficacy, 6/39 (15.4%) due to adverse events and 7/39 (17.5%) due to other reasons.Abstract SAT0273 – Figure 1retention rateConclusionsReal-world Golimumab retention rate in patients with Spondyloarthritis was good and did not depend on concomitant treatment with DMARD. Patients with Ankylosing Spondylitis and non-radiographic axial SpA with objective inflammation had a better Golimumab retention rate than patients with non-radiographic axial SpA without objective inflammation. A better retention rate was expected in patients who had previously used less biological, but was not found.Disclosure of InterestNone declared

Real-world treatment persistence of golimumab in the management of immune-mediated rheumatic diseases in Europe: a systematic literature review

“…Of the 19 studies that reported gender distribution in the patient cohort, the proportion of females ranged from 38.8% (AS patient subpopulation)51 to 89.2% (RA patient subpopulation) 35. Eight studies did not report the proportion of female versus male patients36–40 46 47 49; these were all conference abstracts.…”

“…The same eight studies did not report mean or median age of patients included in the cohorts. The reported mean age ranged between 39.8±10.1 years (nr-AxSpA patient subpopulation)51 and 58.3±13.3 years (RA patient subpopulation) 35. Two studies reported median as opposed to mean age; one investigating PsA patients (median age 50 years (IQR 41–57)27) and one studying RA patients (median age 55 years (IQR 46–62)28).…”

“…Fourteen studies29 30 32 33 35–37 42 44 45 47–49 52 included at least two different IMRD patient populations, and one study53 did not provide any data on disease distribution within the cohort. Mean or median disease duration was reported in 13 studies,27 28 31–33 35 41 44–46 48 51 52 and ranged between a median of 6.1 years (IQR 1.7–13) among a cohort of PsA patients27 and a mean of 18.8 years (SD 10.1) in a cohort of AS patients 51. A total of 19 studies reported patient treatment history with regard to previous usage of biologic treatments; the proportion of biological-naïve patients ranged from 30% (AS patient subpopulation)35 to 63% (IMRD patient population) 42.…”