AB0329 PHYSICIANS’ PRE-LAUNCH AWARENESS AND CONCERNS WITH PIPELINE JANUS KINASE INHIBITORS (JAKIS) VERSUS TOFACITINIB AND BARICITINIB IN RHEUMATOID ARTHRITIS IN THE UNITED STATES AND EUROPE
Authors: D. Baldock, G. Giannakopoulou
Journal: Annals of the Rheumatic Diseases (2020)

Background: Clinical data regarding use of tofacitinib and baricitinib in rheumatoid arthritis patients have recently posed safety concerns, with regulatory bodies suggesting limiting use of higher dosages. Investigating physicians’ awareness and views of each of these products leading up to their launch, as well as the physicians’ patient characteristics, may provide evidence of how pipeline JAKis could be received in the treatment landscape once approved. Objectives: The objective of the study was to investigate awareness and anticipated concerns of upcoming versus already launched JAKis among a sample of treating rheumatologists in the US and EU5 countries, and assess potential correlation between sampled physicians’ views on JAKis and their managed patient characteristics. Methods: A multi-country, multi-center online medical chart review study of patients with RA was conducted across 2011 – 2019 among rheumatologists in hospitals and private practices to collect de-identified data on a sample of patients who were recently treated with a biologic/JAKi in the USA &amp; EU5 (UK, France, Italy, Spain, Germany). Physicians were screened for duration of practice (3-30 years) and patient volume (≥2 RA biologic/JAKi patients per week) and recruited from a large, geographically representative access panel. Patient charts were recorded for the next 5 eligible patients seen during the screening period. Respondents abstracted patient demographics and personal awareness and concerns for drugs in development. Sites waived local ethics review owing to collection of retrospective de-identified data. Data were analyzed using descriptive statistics. Results: In Q1 19, 56.2% and 56.2% of sampled US physicians were aware of upadacitinib (upa) and filgotinib (filgo), respectively 1 . Prior to US launch, tofacitinib (tofa) and baricitinib (bari) achieved respective awarenesses of 89.9% (Q4 11, n = 109) 2 and 85.2% (Q2 17, n= 101) 3 . Among 262 sampled EU5 rheumatologists, pre-launch awareness in of upa and filgo in Q1 19 was 46.2% and 45.8% 1 , while for tofa and bari it was 46.2% and 45.8%, respectively (Q2 16, n= 380) 4 . ‘Poor safety profile’ was cited as a common anticipated concern for upa and filgo, 9.9% of sampled physicians aware of upa (n=121) and 7.5% of those aware of filgo (n=120) 1 , with the respective scores for tofa and bari prior to their launch being 16.9% (n = 296) and 14.5% (n= 227) 4 . Sampled patient characteristics in each physician segment (upa concerned n= 449 patients /non-concerned, n= 155 patients; filgo concerned, n= 454 patients /non-concerned, n= 145 patients) included: (a) age in years 54.6/51, p&lt;0.01; 53.9/51.2, p&lt;0.05 (b) retired employment status 31%/20.6%, p&lt;0.05; 29.5%/20%, p&lt;0.05 1 . Conclusion: In this sample, upa and filgo achieved lower awareness scores, compared to tofa and bari prior their launch. Sampled EU5 physicians were less concerned with upa and filgo’s safety profiles, than for the other two JAKis before launch. Sampled physicians holding concerns with upa/filgo manage significantly older patients and a significantly higher number of retired patients. Further investigation using comparator cohort is warranted. References: [1]Ipsos Global Rheumatoid Arthritis Therapy Monitor (Q1 2019, 262 sampled rheumatologists in the EU and 115 sampled rheumatologists in the US reporting on a sample of RA patients seen in their practice; data collected online). [2]Ipsos Global Rheumatoid Arthritis Therapy Monitor (Q4 2011, 109 sampled rheumatologists in the US reporting on a sample of RA patients seen in their practice; data collected online). [3]Ipsos Global Rheumatoid Arthritis Therapy Monitor (Q2 2017, 101 sampled rheumatologists in the US reporting on a sample of RA patients seen in their practice; data collected online). [4]Ipsos Global Rheumatoid Arthritis Therapy Monitor (Q2 2016, 380 sampled rheumatologists in the EU reporting on a sample of RA patients seen in their practice; data collected online). © Ipsos 2020, all rights reserved Disclosure of Interests: None declared