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Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

15.09. - 18.09.2021, virtuell

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Retention markers in biological therapy of patients with rheumatoid arthritis

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  • Eugenia Aronova - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Galina Lukina - Moscow Clinical Scientific Center named after Loginov A. S., Moscow
  • Galina Gridneva - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Anastasia Kudryavtceva - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Svetlana Glukhova - V.A. Nasonova Research Institute of Rheumatology, Moscow

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). sine loco [digital], 15.-18.09.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocRA.50

doi: 10.3205/21dgrh131, urn:nbn:de:0183-21dgrh1310

Published: September 14, 2021

© 2021 Aronova et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Introduction: Currently, in rheumatological practice, the choice of a biological product is carried out only on the basis of clinical indicators. In this case, treatment is discontinued within the first year in 30-40% of cases, according to different authors. Our study focused on finding predictors of drug survival of bDMARDs in bio-naive patients with rheumatoid arthritis (RA) during the first year of therapy.

Methods: 204 adult patients (173 women, 84.8%), with active RA were included into retrospective study. All of them initiated bDMARDs: infliximab (INF) - 65 patients (31.9%), rituximab (RTM) - 39 (19.1%), adalimumab (ADA) - 30 (14.7%), etanercept (ETA) - 28 (13.7%), abatacept (ABA) - 23 (11.3%), tocilizumab (TZ) - 15 (7.4%), certolizumab pegol - 4 (1.9%). Predictors of therapy inefficiency or AE were investigated in Cox proportional risk model.

Results: A year later, 92 patients (45%) remained on bDMARDs. Although the number of women continued after a year was significantly higher than that of men (84.8% and 15.2% respectively), female sex was not a reliable predictor of drug survival. At the same time, the rate of discontinuation due to AE in women was higher (96.55%). Discontinuation of bDMARDs due to inefficiency was noted in 18-44 years old patients more often (46.43%, 26 patients). Discontinuation therapy due to AE was also prevalent in 18-44 years old patients (50%, 14 patients). Discontinuation of therapy due to inefficacy was more common in the group of seronegative RA - 59.1%. In the seropositive RA group 24.8% of patients had interrupted bDMARDs for this reason, in the RA with extra-articular manifestations group it was 18.1%, in the adult-oneset Still’s disease group - 30% and in the juvenile RA group - 30%. Discontinuation of therapy due to remission was overwhelmingly observed in seropositive RA group (6 patients, 4%).

Conclusion: Female sex, young age (18-44 years), RA, seronegative by RF were associated with less survival of bDMARDs due to lack of effectiveness and/or AE, and RTM and seropositive RA - with more frequency of discontinuation of therapy due to remission.

Disclosures: None declared