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THU0212 (2020)
FIRST LINE TREATMENT WITH CONVENTIONAL SYNTHETIC DISEASE MODIFYING ANTIRHEUMATIC DRUGS IN RHEUMATOID ARTHRITIS: A MULTINATIONAL POPULATION-BASED COHORT FROM 14 REAL WORLD HEALTHCARE DATABASES AND 9 COUNTRIES - REALITY VERSUS GUIDELINES
A. G. Sena1, D. Granados2, N. Hughes3, W. Fakhouri4, A. Hottgenroth5, R. Kolde6, S. Reisberg7, C. O. Torre8, T. Duarte-Salles9, Y. Díaz10, J. F. Golib-Dzib11, E. S. Brouwer12, E. Burn13, J. Lane14, D. Vizcaya15, S. Bruce Wirta16, M. De Wilde17, K. Verhamme18, P. Rijnbeek19, E. Theander20, K. Chatzidionysiou21, D. Prieto-Alhambra22, P. Ryan12,23, on behalf of ‘European Health Data and Evidence Network (EHDEN) RA Research Group’
1Janssen Research And Development, New Jersey, United States of America
2Sanofi Aventis Group, Chilly-Mazarin, France
3Janssen Europe, Middle East and Africa, Beeres, Belgium
4Eli Lilly and Company, Erl Wood, Windlesham, Surrey, United Kingdom
5Lilly Deutschland GmbH, Homburg, Germany
6Institute of Computer Science, University of Tartu, Tartu, Estonia
7Institute of Computer Science of University of Tartu, Tartu, Estonia
8Real-World Solutions, IQVIA, London, United Kingdom
9Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
10Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
11Real World Evidence Market Access Department Janssen-Cilag, Madrid, Spain
12Janssen Europe, Middle East and Africa, New Jersey, United States of America
13Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
14Centre for Statistics in Medicine (CSM), Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
15Epidemiology, Bayer, Barcelona, Spain
16Janssen EMEA, New Jersey, United States of America
17Department of Medical Informatics, Erasmus MC, Rotterdam, Netherlands
18Department of Medical Informatics, Erasmus MC, Rotterdam, Netherlands
19Department of Medical Informatics, Erasmus MC, Rotterdam, Netherlands
20Janssen Europe, Middle East and Africa, New Jersey, United States of America
21Dep of Medicine, Solna, Rheum Unit, Karolinska Institutet, Stockholm, Sweden
22University of Oxford, Centre for Statistics in Medicine (CSM), Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, United Kingdom
23Observational Health Data Sciences and Informatics, New York, United States of America

Background: Treatment guidelines recommend early initiation of csDMARDs following diagnosis of rheumatoid arthritis (RA), with methotrexate (MTX) as first-line therapy. Scarce evidence exists on adherence to this guidance


Objectives: To characterize first-line csDMARD treatment during the first year following an RA diagnosis.


Methods: 14 real world databases (3 Primary care, 6 primary/secondary care records, 5 claims) from 9 countries were included, all mapped to the OMOP common data model.

Patients were included on the earliest event of: 1st diagnosis of RA or 1st DMARD prescription with an RA diagnosis within 30 days. Patients were >18 years-old, required 1+ year pre-index data, and at least 1-year follow-up. Study period covered 2000-2018. Previous users of DMARDs or non-RA inflammatory arthritis history were excluded. Only MTX, Hydroxychloroquine (HCQ), Sulfasalazine (SSZ) and Leflunomide (LEF) were available in all databases.


Results: We identified 323,547 eligible participants. Large variation was observed internationally ( Figure 1 ). MTX as first-line monotherapy ranged from 33.3% to 74.5%, and in combination with HCQ from 2.1% to 6.7%. Three additional csDMARDs were used as first-line: HCQ in 10.1% to 30.2%, SSZ in 0.9% to 28.7%, and LEF in 1.8% to 15.2%.

First line csDMARD treatment during 1yr from first observed RA diagnosis


Conclusion: We report wide heterogeneity of first-line csDMARDs regimens internationally. Despite recommendations for MTX to be first line therapy, data suggest that a large proportion of patients receive alternative csDMARD.


Disclosure of Interests : Anthony G Sena Shareholder of: J&J shares, Grant/research support from: Full-time employment salary from Janssen, Consultant of: Full-time employment salary from Janssen, Employee of: Janssen employee, Paid instructor for: Janssen employee, Speakers bureau: Janssen employee, Denis Granados: None declared, Nigel Hughes Shareholder of: J&J shares, Grant/research support from: Full-time employment salary from Janssen, Consultant of: Janssen employee, Employee of: Janssen employee, Paid instructor for: Janssen employee, Speakers bureau: Janssen employee, WALID FAKHOURI Shareholder of: E Lilly Shares, Employee of: Eli Lilly and Company, Antje Hottgenroth Shareholder of: Eli Lilly shares, Employee of: Lilly Deutschland GmbH, Raivo Kolde: None declared, Sulev Reisberg: None declared, Carmen Olga Torre: None declared, Talita Duarte-Salles: None declared, Yesika Díaz: None declared, Jose Felipe Golib-Dzib Grant/research support from: Full-time employment salary from Janssen, Employee of: Yes, Janssen employee, Paid instructor for: Janssen Employee, Speakers bureau: Janssen Employee, Emily S. Brouwer Shareholder of: J&J shares, Takeda shares, Grant/research support from: Full-time employment salary from Janssen, Consultant of: Janssen employee, Employee of: Janssen employee, Paid instructor for: Janssen Employee, Speakers bureau: Janssen Employee, Edward Burn: None declared, Jennifer Lane: None declared, David Vizcaya Employee of: Bayer, Sara Bruce Wirta Employee of: Janssen-Cilag Sweden AB, Marcel de Wilde: None declared, Katia Verhamme: None declared, Peter Rijnbeek: None declared, Elke Theander Employee of: Janssen-Cilag Sweden AB, Katerina Chatzidionysiou Consultant of: AbbVie, Pfizer, Lilly., Daniel Prieto-Alhambra Grant/research support from: Professor Prieto-Alhambra has received research Grants from AMGEN, UCB Biopharma and Les Laboratoires Servier, Consultant of: DPA’s department has received fees for consultancy services from UCB Biopharma, Speakers bureau: DPA’s department has received fees for speaker and advisory board membership services from Amgen, Patrick Ryan: None declared


Citation: Ann Rheum Dis, volume 79, supplement 1, year 2020, page 327
Session: Rheumatoid arthritis - non biologic treatment and small molecules (Poster Presentations)