THU0074 EVALUATION OF MEDICATION PERSISTENCE IN PATIENTS WITH RHEUMATOID ARTHRITIS AND SJÖGREN’S SYNDROME/INTERSTITIAL LUNG DISEASE TREATED WITH NON-TNFI DISEASE-MODIFYING ANTI-RHEUMATIC DRUGS
Authors: Leticia Ferri, Evo Alemao, Aarti Rao
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> RA is a systemic disease driven by pathogenic autoantibodies and inflammatory cytokines that can involve tissues and organs as well as synovial joints. Sjögren's syndrome (SS) and interstitial lung disease (ILD) are frequently reported extra-articular manifestations of RA. However, there are currently limited data on the persistency of non-TNF inhibitor (TNFi) biologic (b)DMARDs and targeted synthetic DMARDs, such as tofacitinib (TOF), in patients (pts) with SS and ILD secondary to RA (RA-SS and RA-ILD). <h3>Objectives</h3> To compare medication persistence between non-TNFi DMARDs including abatacept (ABA), TOF and tocilizumab (TOC) in RA-SS and RA-ILD. <h3>Methods</h3> Pts (≥18 years) from the Truven MarketScan™ administrative claims database with RA (≥2 prescription claims for RA identified with International Classification of Diseases [ICD]-9 or ICD-10) being treated with a non-TNFi DMARD from Jan 2006 to Sep 2017 were included. The date of the first claim for a drug of interest on or after diagnosis of RA was considered the index date. Pts were required to have at least 6 months of continuous enrolment prior to the index date (baseline). Pts with claims for other bDMARDs on the index date were excluded from the study. Pts with a diagnosis of SS or ILD any time in the baseline or follow-up periods were included in the RA-SS or RA-ILD cohorts, respectively. Persistence was defined as the number of days from index date to first switch or discontinuation of the index date DMARD, or end of the study period, or end of enrolment, whichever came first. Pts in both cohorts were stratified by prior TNFi use (TNFi-naïve or TNFi-experienced) and by prior corticosteroid (CS) use. Pairwise comparison of persistence between the non-TNFi DMARDs was performed with ABA as the reference, using the Kruskal–Wallis test for both cohorts separately. A p value of &lt;0.05 was considered statistically significant. <h3>Results</h3> A total of 2503 and 3856 pts satisfied the inclusion and exclusion criteria for the RA-SS and RA-ILD cohorts, respectively. In the RA-SS cohort, 1767, 378 and 358 pts were taking ABA, TOF and TOC, respectively; in the RA-ILD cohort, these numbers were 2937, 343 and 576. The majority (90% in RA-SS and 75% in RA-ILD) of the study population was female. In the RA-ILD cohort, the proportion of pts with prior CS use was significantly lower in pts taking ABA (vs TOF). In the RA-SS cohort, the comorbidity index between treatment cohorts was similar; however, ABA pts had significantly lower pulmonary nodules vs TOF pts (Table 1). In the RA-ILD cohort, the comorbidity index was significantly lower for ABA (vs TOF and TOC), with differences in types of comorbidities at baseline (Table 1). In the RA-SS cohort, the mean time on therapy for pts in the ABA cohort was longer compared with pts in the TOF cohort. Persistency of ABA was higher compared with TOF in the TNFi-experienced pts and in CS-experienced pts (Table 2). In the RA-ILD cohort, overall mean time on therapy for pts taking ABA was longer compared with TOC. Persistency of ABA was higher compared with TOC in the TNFi-naïve cohort. <h3>Conclusion</h3> Based on the analysis of a large US claims database, pts with RA-SS prescribed ABA (vs TOF) had higher persistency, and pts with RA-ILD prescribed ABA (vs TOC) had higher persistency. Further analysis of medication persistence, adjusting for pt characteristics, is warranted. <h3>Disclosure of Interests</h3> Leticia Ferri Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Evo Alemao Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Aarti Rao Consultant for: Bristol-Myers Squibb