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POS0633 (2021)
DURATION OF STARTINGbDMARDs ARE ALMOST 3 TIMES LONGER IN RA PATIENTS THAN PsA PATIENTS: HUR-BIO REAL LIFE RESULTS
G. K. Yardimci1, B. Farisoğullari1, E. C. Bolek1, E. Bilgin1, E. Duran1, G. Ayan1, Z. Özsoy1, G. Sandal Uzun1, L. Kiliç1, A. Akdoğan1, O. Karadag1, Ş. A. Bilgen1, S. Kiraz1, A. İ. Ertenli1, U. Kalyoncu1
1Faculty of Medicine; Hacettepe University, Rheumatology, Ankara, Turkey

Background: Before using biological DMARDs, EULAR suggests the use of synthetic DMARDs (especially methotrexate) for RA and PsA [1-2].


Objectives: It was aimed to evaluate the differences of disease duration and csDMARDs till first bDMARD in RA and PsA patients.


Methods: HUR-BIO (Hacettepe University Biologic Registry) is a prospective, single center database of biological treatments since 2005 and to date 2070 RA and 520 PsA patients have been recorded. Demographic, clinical and laboratory data before bDMARDs of the patients were noted. When investigating the differences between groups, the effects of gender, age and disease duration wereadjusted using two-way ANOVA and ANCOVA tests. The selection was made for the gender, age and for indifference of the relevant groups by using prospensity score matching.


Results: We incuded 481 RA, and 482 PsA age and gender matched patients in the study. Age, gender and disease duration information were given in the Table 1 . 72.8% of the RA patients were RF or anti-CCP positive. Overall, 56.3, 100% of the RA, and PsA patients first biologic therapies were anti-TNFs, respectively. All RA patients started with csDMARDs before bDMARD treatments, whereas 450 of 482 (93.4%) PsA patients. Methotrexate was the anchor csDMARD for both diseases. RA patients more frequently used all csDMARDs included methotrexate, leflunomide, sulphasalazine hydroxychloroquine and corticosteroids as well. Median disease duration till bDMARD treatments in RA and PsA patients were 55 and 18.5 months respectively (p<0.001) ( Table 1 ).

emographic characteristics and csDMARDs before first bDMARD

RA (n=481 ) PsA (n=482 ) P value
Female, n (% ) 319 (66.3) 332 (68.9) 0.218
Age, years (mean±SD ) 48.2 ± 13.5 47.4 ± 12.2 0.332
Disease duration, years* 10 (6-16) 7 (3-12) 0.000
Symptom duration before diagnosis, years ¥ 0 (0-1) 1 (0-4) 0.000*
The period of time between diagnosis and bDMARD initiation, months ¥ 55 (24-115) 18.5 (8-58) 0.000*
The period of time between symptoms and bDMARD initiation, months ¥ 70 (35-151) 48 (20-124) 0.000*
Methotrexate Ever n (% ) 400 (83.3) 373 (77.5) 0.015
Just before bDMARD initiation n (% ) 251 (52.2) 230 (47.7) 0.093
Hydroxychloroquine sulfate Ever n (% ) 292 (60.8) 170 (35.3) 0.000*
Just before bDMARD initiation n (% ) 262 (54.5) 99 (20.5) 0.000*
Leflunomide Ever n (% ) 237 (49.4) 129 (26.8) 0.000*
Just before bDMARD initiation n (% ) 160 (33.3) 96 (19.9) 0.000*
Sulphasalazine Ever n (% ) 353 (73.5) 265 (55.1) 0.000*
Just before bDMARD initiation n (% ) 156 (32.4) 146 (30.3) 0.259*
Corticosteroids Ever n (% ) 419 (87.3) 281 (58.4) 0.000*
Just before bDMARD initiation n (% ) 335 (69.6) 187 (38.8) 0.000*

¥Median (IQR )


Conclusion: According to HUR-BIO real life data, for inflammatory arthritis patients who started bDMARDs, the periods of time between diagnosis and bDMARDs were more reasonable (18 months) in PsA patients than RA patient’s periods which were approximately three times longer. RA patients were used much more and longer duration of csDMARDs. This explicit distinction may be explained by synthetic DMARDs on activity differences between the RA and PsA.


REFERENCES:

[1]Gossec, L., et al., EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis, 2020. 79(6): p. 700-712.

[2]Smolen, J.S., et al., EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis, 2020. 79(6): p. 685-699.


Disclosure of Interests: None declared

Citation: Ann Rheum Dis, volume 80, supplement 1, year 2021, page 554
Session: Rheumatoid arthritis - biological DMARDs (POSTERS only)