FRI0530 Factors influencing selection of biologic therapy and comparative effectiveness in patient reported outcomes among patients with rheumatoid arthritis
Authors: J. R. Curtis, I. Navarro-Millan, L. Chen, L. R. Harrold, L. Liu
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Biologic use among patients with rheumatoid arthritis (RA) is increasingly common. Given different anti-tumor necrosis factor (TNF) options, a better understanding of factors that influence physicians' and patients' selection of RA therapies and comparative effectiveness between them is warranted. <h3>Objectives</h3> To describe physicians' and patients' preferences in selecting specific biologics and comparing clinical response using patient reported outcomes (PROs) among RA patients started on different anti-TNF therapies. <h3>Methods</h3> Eligible patients for this analysis were enrollees in Kaiser Permanente Northern California, a large, well-characterized integrated care organization. RA patients with at least 2 Kaiser visits who started a new anti-TNF therapy from 10/2010 – 8/2011 were initially eligible for participation in a longitudinal telephone survey at baseline (initiation of anti-TNF therapy) and 6 months later. There were 384 patients eligible available to be contacted. Ordinary least squares regression evaluated the change at 6 months across PROs comparing etanercept (ETA) vs. adalimumab (ADA) initiators and controlled for multiple potential confounders. <h3>Results</h3> A total of 267 RA patients were recruited and completed the baseline survey; 244 completed the follow-up survey. Mean age was 54.4 (SD ± 12.1) and 73.4% were females. Of these, 42% were employed and 14% were disabled. A total of 56% of patients self-reported that they were involved in the selection of their specific biologic. The majority of patients (57%) preferred an injectable biologic, 22% preferred an infused biologic, and 21% had no preference. Preferences for injection biologics were mainly motivated by convenience (92%); those preferring infusion therapy were motivated by dislike or lack of self-efficacy for self-injection (15.7%). After 6 months of treatment with anti-TNF biologics, 44% of the patients reported a level of burning and stinging with injection of ≤ 4 in a scale of 0-10 with the last biologic dose, 30% experienced a level &gt; 5 and 26% reported no burning and stinging. RAPID 3, MDHAQ and SF12_pcs were significantly better at 6 months favoring ETA compared to ADA (table). <h3>Image/graph</h3> <h3>Conclusions</h3> Convenience, fears of self-injection and self-efficacy for self-injection were important aspects to patients when selecting an individual therapy. There were small but statistically significant differences in efficacy based on PROs at 6 months between etanercept and adalimumab. <h3>Acknowledgements</h3> Thi work was supported by (R01 HS01857). Dr. Curtis receives support from the NIH (AR 053551). <h3>Disclosure of Interest</h3> J. Curtis Grant/research support from: Roche/Genentech, UCB, Janssen, CORRONA, Amgen, Pfizr, BMS, Crescendo, AbbVie, Consultant for: Roche/Genentech, UCB, Janssen, CORRONA, Amgen, Pfizr, BMS, Crescendo, AbbVie, I. Navarro-Millan: None Declared, L. Chen: None Declared, L. Harrold Grant/research support from: NIH K23AR053856, Consultant for: CORRONA, L. Liu: None Declared