POS1499-PARE PATIENT PERSPECTIVES OF BIOLOGIC TREATMENTS FOR AXIAL SPONDYLOARTHRITIS: SATISFACTION, WEAR-OFF BETWEEN DOSES, AND USE OF SUPPLEMENTAL MEDICATIONS
Authors: W. B. Nowell, K. Gavigan, T. Hunter, W. Malatestinic, R. Bolce, J. Lisse, C. Himelein, J. Curtis, J. A. Walsh
Journal: Annals of the Rheumatic Diseases (2021)

Background: Biologic disease-modifying antirheumatic drug (bDMARD) therapy has been shown to be effective in the treatment of axial spondyloarthritis (axSpA). 1,2 Little is understood about patients’ experience of axSpA treatment from their own perspective. Objectives: To characterize patient experiences and perspectives with bDMARD treatments for axSpA, including satisfaction, and use of supplementary treatments when wear-off between doses is perceived among those currently treated with bDMARD therapy. Methods: Adult US participants (pts) within the ArthritisPower registry with physician-diagnosed axSpA were invited to complete electronic PRO measures, such as the BASDAI (0-10 scale, score ≥4 indicates suboptimal disease control), and an online survey about their perspectives of treatment. Analysis compared pt characteristics and treatment satisfaction by whether or not pt reported wear-off between bDMARD doses. Results: 128 pts with axSpA and on bDMARD therapy met inclusion criteria of whom 82.8% were female, with mean age of 47 years. Mean BASDAI scores indicated poor disease control (6.4, SD 1.8), worse for those perceiving wear-off between doses compared with those who did not [6.8 (1.6) vs. 5.9 (2.0), p=0.01]. A majority of pts on a bDMARD reported being somewhat (57.8%) or very satisfied (26.6%) with their current axSpA treatment, and about 53.1% were satisfied with how well it controls axSpA-related pain. However, 60.9% (n=78) of pts reported that their current bDMARD typically wears off before the next dose. Treatment satisfaction was lower for pts experiencing wear-off compared to pts without wear-off (highly satisfied: 21.8% vs. 34%; somewhat satisfied: 60.3% vs. 54%; dissatisfied: 17.9% vs. 12%). 82.1% (n=64) of pts reporting wear-off used additional medications or supplements when that happened, chiefly NSAIDs (68.8%, n=44), muscle relaxers (42.2%, n=27) and/or opioids (37.5%, n=24). Among the 20 pts not satisfied with current axSpA treatment, side effects (6/20, 30.0%), or worry about risk of side effects (2/20, 10%) were the main reasons. Conclusion: In a predominantly female sample of bDMARD-treated axSpA patients with high disease activity, most expressed satisfaction with treatment. However, most experienced wear-off between doses and took supplementary medications, including opioids, to manage. References: [1]Dubash S, et al. Ther Adv Chronic Dis. 2018;9(3):77–8. [2]Van Der Heijde D, et al. Ann Rheum Dis. 2017;76(6):978–91. Table 1. Demographic and clinical characteristics by wear-off between bDMARD doses (n=128) Pts currently on bDMARD (N=128) Wear-off between bDMARD oses (N=78) No wear-off / Not sure (N=50) p-value Number or mean (% or SD) Age 46.9 (10.3) 46.1 (9.2) 48.2 (11.8) 0.25 Female 106 (82.8) 69 (88.5) 37(74.0) 0.03 White 115 (89.8) 70 (89.7) 45 (90.0) 0.96 Body Mass Index 30.9 (7.8) 31.2 (8.5) 30.4 (6.6) 0.57 Current Medications, addition to bDMARD Conventional Synthetic DMARD (e.g. methotrexate, sulfasalazine) 17 (13.3) 15 (19.2) 2 (4.0) 0.01 Prescription NSAID 59 (46.1) 39 (50.0) 20 (40.0) 0.27 Other prescription medication ¥ 70 (54.7) 44 (56.4) 26 (52.0) 0.62 Noticed improvement in symptoms related to axSpA since starting current bDMARD 80 (62.5) 51 (65.4) 29 (58.0) 0.40 Noticed improvement in symptoms NOT related to axSpA since starting current bDMARD 40 (31.3) 22 (28.2) 18 (36.0) 0.35 BASDAI ‡ 6.4 (1.8) 6.8 (1.6) 5.9 (2.0) 0.01 PROMIS Pain Interference ł 65.3 (5.7) 66.0 (5.1) 64.3 (6.4) 0.09 PROMIS Physical Function ł 36.7 (5.6) 36.1 (5.3) 37.7 (5.8) 0.11 PROMIS Sleep Disturbance ł 59.8 (8.5) 61.2 (7.7) 57.6 (9.3) 0.02 * Statistical significance between groups of pts who experienced wear-off between bDMARD or not, p &lt; 0.05 ¥ Other prescription medications: muscle relaxers, nerve pain medications or anti-depressants, and opioids ‡ BASDAI is scored on a 0-10 scale with score ≥4 indicating suboptimal control of disease ł PROMIS measures use T-score metric in which 50 is mean, 10 is standard deviation (SD), of US population; higher T-score = more of concept measured Acknowledgements: This study was sponsored by Eli Lilly and Company. We thank the patients who participated in this study. Disclosure of Interests: W. Benjamin Nowell Grant/research support from: Full-time employee of Global Healthy Living Foundation, an independent nonprofit research organization, which received funding pursuant to a contract from Eli Lilly to conduct the study that is the subject of this abstract; Principal Investigator for studies with grant support from AbbVie, Amgen and Eli Lilly, Kelly Gavigan Grant/research support from: Full-time employee of Global Healthy Living Foundation, an independent nonprofit research organization, which received funding pursuant to a contract from Eli Lilly to conduct the study that is the subject of this abstract, Theresa Hunter Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, William Malatestinic Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Rebecca Bolce Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Jeffrey Lisse Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Carol Himelein Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Jeffrey Curtis Consultant of: AbbVie, Amgen, BMS, Corrona, Eli Lilly, Janssen, Myriad, Pfizer, Roche, Regeneron, Radius, UCB, Grant/research support from: AbbVie, Amgen, BMS, Corrona, Eli Lilly, Janssen, Myriad, Pfizer, Roche, Regeneron, Radius, UCB, Jessica A. Walsh Consultant of: AbbVie, Amgen, Eli Lilly and Company, Janssen, Merck, Novartis, Pfizer, UCB, Grant/research support from: AbbVie, Merck, Pfizer