AB0708 HIGH DRUG RETENTION RATES DESPITE B/TSDMARD INTERRUPTIONS IN COVID-19 PANDEMIC CHAOS
Authors: S. Gulle, Y. Erez, A. Karakas, T. Yüce İnel, S. B. Kocaer, T. Demirci Yildirim, G. Can, İ. Sari, M. Birlik, F. Onen
Journal: Annals of the Rheumatic Diseases (2021)

Background: A significant increased risk of COVID-19 related adverse outcomes of the biological or target-directed synthetic DMARDs (b/tsDMARDs) has not yet been reported. For this reason, it is recommended to continue b/tsDMARD treatments with maximum compliance with pandemic measures. Objectives: The aim of this study was to evaluate the effects of patients using b/tsDMARDs on drug survival and rheumatic disease control during pandemic. Methods: In this study, patients diagnosed with rheumatic disease using b/tsDMARDs and who were followed up during the 12-month period (January 2020-2021) including the onset of the Covid-19 pandemic at Dokuz Eylul University Faculty of Medicine Rheumatology Clinic were evaluated. In the first 3 months of the pandemic (March-June 2020), the patients skipped at least 2 cycles of treatment with the fear of Covid-19 infection except for infection / surgical reasons was considered as a disruption of the drug. The drug retention rates of the patients on b/tsDMARDs treatments during the pandemic process and the factors affecting this situation were evaluated. Results: The rate of disrupting their b/tsDMARDs was higher in patients&gt; 65 years of age, with a diagnosis of RA and who needed to come to the hospital for bDMARD treatment (p=0.007, p=0.015 and p=0.004, respectively). The overall 1-year b/tsDMARD retention rates was found 91%. It was determined that a history of interruption in b/tsDMARD treatments in the first 3 months of the pandemic [OR: 1.28 (CI: 1.042-8.71), p=0.014] and the need to come to the hospital to receive bDMARD [OR: 0.59 (CI: 0.64-13.11), p=0.041] caused unresponsiveness to return to the same bDMARD treatment and a significant increase in the risk of discontinuation of the biologic treatment. Conclusion: We conclude that it is important for patients to continue taking b/tsDMARD treatments without interruption in the days past abnormal periods such as pandemic conditions and to make sufficient effort for minimum dose of CS and low disease activity by determining patient-based risk. Table 1. Demographic and clinical characteristics of b/tsDMARDs patients Total (n=521 ) b/tsDMARD Continue (n=424) (82.4% ) b/tsDMARD Interruption (+) (n=97) (17.6% ) P Median (Min./Max. ) Median (Min./Max. ) Median (Min./Max. ) Age, years 48 (18/86) 47 (18/82) 52 (21/81) 0.008 t Disease Duration, years 11,2 (2/43.3) 130 (22/490) 142 (22/519) 0.41 t b/ts DMARD Duration, months 40 (12/192) 40 (12/192) 40 (12/156) 0.176 t n (% ) n (% ) n (% ) Female 278 (53.4) 225 (53.1) 53 (54.6) 0.826 Most common rheumatic diseases AxSpa or other SpA 283 (54.3) 232 (54.7) 51 (52.6) 0.737 RA 134 (25.7) 100 (23.6) 34 (35.1) 0.015 l PsA 44 (8.4) 40 (9.4) 4 (4.1) 0.109 Vasculitis 32 (6.1) 27 (6.4) 5 (5.2) 0.817 Others 28 (5.4) 25 (5.9) 3 (3.1) 0.338 b/tsDMARD at Hospital/Health center 140 (26.9) 102 (24.1) 38 (39.2) 0.004 l (OR: 0.59 ) b/tsDMARD administration route (IV ) 137 (26.3) 100 (23.6) 37 (38.1) 0.005 l Active/Progressive Disease 92 (17.7) 14 (3.3) 78 (80.4) &lt;0.001 l (OR: 4.8 ) Start/continue with the same b/tsDMARD 55 (10.6) 3 (0.7) 52 (53.6) &lt;0.001 p Unresponsiveness, b/tsDMARD switch 16 (3.1) 9 (2.1) 7 (7.2) 0.017 p b/tsDMARD stopped permanently/deceased 29 (5.6) 9 (2.1) 20 (20.6) &lt;0.001 ff b/tsDMARD retention (Total ) 474 (91) 406 (95.8) 68 (70.1) &lt;0.001 t Independent Samples t Test (Bootstrap), p Pearson Chi-Square Test (Monte Carlo), ff Fisher freeman Halton Test (Monte Carlo), l Linear-by-Linear Association Test(Monte Carlo, Exact), SD.: Standard deviation; * OR, Odds Ratio, Disclosure of Interests: None declared