SAT0142 DIFFERENCES IN PATIENT CHARACTERISTICS AND PATTERNS OF TREATMENT BY DISEASE-MODIFYING ANTIRHEUMATIC DRUGS (DMARD) IN BDMARD NAIVE VERSUS EXPERIENCED PATIENTS
Authors: Robin K. Dore, Leslie Harrold, Taylor Blachley, Kelechi Emeanuru, Jenya Antonova, Joel Kremer
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> For RA patients (pts), EULAR and ACR recommend various DMARDs. Available treatments have short durability and low persistency. Understanding differences between patients who initiate DMARDs as biologic naive vs experienced may help clinicians tailor treatment decisions to pts needs. <h3>Objectives</h3> This study aimed to compare DMARD initiation events in biologic naïve vs experienced pts. <h3>Methods</h3> In the Corrona registry (as of 2/28/2018), we selected DMARD initiation events (with at least one 6-month follow up) and stratified them on whether the initiator was biologic naive or experienced. We compared pts baseline characteristics (demographic, clinical, treatment) between strata. We used Kaplan-Meier curves to describe time to discontinuation and log rank test to assess differences in persistence. <h3>Results</h3> For 48,246 RA pts, 10,347 DMARD initiations (index date, baseline; on 11/2012 or thereafter) in 6,858 adults were identified. Within initiations, 38% (n=3,931) occurred in bDMARD naïve pts. Females comprised 76% (naive) vs 80% (experienced). Despite comparable age and retirement status (Table), the bDMARD experienced initiators had RA for longer (mean: 12.6 vs 5.4), were more likely to be disabled (19.6% vs 11.0%), had marginally higher CDAI scores (mean: 19.1 vs 17.6), were more likely to discontinue index treatment due to elevated CDAI (15.5% vs 10.9%), and had a shorter treatment duration (mean: 13.8 vs 15.1 months) than bDMARD naïve initiators. Persistency was higher in the bDMARD naïve than in experienced initiators (Figure) <h3>Conclusion</h3> The marked difference in RA duration and pts disability status, despite comparable age, confirms prior reports that bDMARD experienced pts do not respond as well to therapy as bDMARD naïve pts. The increased CDAI scores and shortened durability of response suggests that there is still a need for new efficacious and well-tolerated RA therapy. <h3>Acknowledgement</h3> Study sponsored by Corrona, LLC. Corrona is supported by contracted subscriptions with multiple companies. Abstract was a collaboration between Corrona and Gilead with financial support by Gilead. <h3>Disclosure of Interests</h3> Robin K Dore Grant/research support from: Gilead Sciences, AbbVie, Amgen, Lilly, Pfizer, Regeneron, Sanofi, Consultant for: AbbVie, Amgen, Lilly, Speakers bureau: AbbVie, Amgen, Lilly, Sanofi, Regeneron, Pfizer, UCB, Leslie Harrold Grant/research support from: Pfizer, Consultant for: AbbVie, BMS, Genentech, Taylor Blachley Employee of: Corrona, LLC, Kelechi Emeanuru Employee of: Corrona, LLC, Jenya Antonova Shareholder of: Gilead Sciences, Employee of: Eli Lilly and Company, Medimmune, Genentech, Gilead Sciences, Joel Kremer Grant/research support from: AbbVie, Genentech, Lilly, Novartis, Pfizer, Consultant for: AbbVie, Amgen, BMS, Genentech, Lilly, Regeneron, Sanofi, Pfizer