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SAT0097 (2020)
DO COMORBIDITIES IMPACT PERSISTENCE OF FIRST TUMOR NECROSIS FACTOR INHIBITOR TREATMENT IN RHEUMATOID ARTHRITIS? DATA FROM TURKBIO
T. Yüce İnel1, S. B. Kocaer1, Y. Erez1, S. Gulle1, A. Karakas1, A. Köken Avşar1, S. Uslu1, G. Can1, İ. Sari1, M. Birlik1, E. Dalkiliç2, Y. Pehlivan2, S. Akar3, B. Goker4, G. Yildirim Cetin5, S. Haznedaroglu4, Ş. Yavuz6, T. Pirildar7, H. Direskeneli8, N. Akkoc9, F. Onen1, on behalf of Turkbio Registry Group
1Dokuz Eylul University Faculty of Medicine, İzmir, Turkey
2Uludag University Faculty of Medicine, Bursa, Turkey
3Katip Celebi University, İzmir, Turkey
4Gazi University Faculty of Medicine, Ankara, Turkey
5Sutcu Imam University, Kahramanmaras, Turkey
6Bilim University, Istanbul, Turkey
7Celal Bayar University, Manisa, Turkey
8Marmara University, Istanbul, Turkey
9Celal Bayar University, Manisa, Turkey

Background: Studies indicate that patients with rheumatoid arthritis (RA) are at increased risk of developing several comorbid disorders. Comorbidities affect treatment decisions, the effectiveness of the treatment, quality of life, RA prognosis, and survival rate [1].


Objectives: The aim of this study to investigate the impact of comorbidity on the first TNF inhibitor treatment persistence in RA.


Methods: In the TURKBIO database, patients with an ICD 10-diagnosis of RA (M05 or M06) who started TNF inhibitor therapy between January 2011 and June 2019 were enrolled. Demographic and clinical characteristics, acute phase reactants, disease activity scores (DAS 28 CRP, HAQ, CDAI, VAS global), initial comorbidities and numbers, drug persistence, were evaluated. Kaplan-Meier plots and Cox proportional hazard regression analyses were performed.


Results: A total of 1172 patients >18 years of age treated with TNF-α inhibitors were included in the study. The most prevalent comorbidities were: hypertension in 262 patients (32.6%), obesity in 254 (32.6%), osteoporosis in 178 (22.3%), chronic lung disease in 143 (17.9%) and depression in 126 (15.8%). The baseline characteristics are summarised in Table 1. The presence of comorbidity did not affect the survival rate of the first TNF inhibitor therapy in the RA patients (p: 0.65). Comorbidities had no effect on DAS28 CRP (> 1.2 reduction) responses at 6 and 12 months of treatment (p: 0.18, p: 0.83, respectively). As the mean disease duration increases, the persistence of the first TNF inhibitor decreases by 5%.


Conclusion: This study demonstrated the increasing burden of comorbidities in RA. However, it suggested that the presence and number of comorbidities did not influence the rate of persistence in the first TNF inhibitor drug and the response to treatment.


REFERENCES:

[1] Gabriel, S.E. and K. Michaud, Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis research & therapy, 2009. 11 (3): p. 229.


Disclosure of Interests: None declared

Citation: Ann Rheum Dis, volume 79, supplement 1, year 2020, page 978
Session: Rheumatoid arthritis - comorbidity and clinical aspects (Poster Presentations)