AB0561 DISEASE DURATION AND HLA-B27 POSITIVITY ALTER LONGTERM RETENTION RATE OF CERTOLIZUMAB PEGOL IN PATIENTS WITH PSORIATIC ARTHRITIS
Authors: S. S. Koca, Y. Pehlivan, S. Akar, S. Şenel, H. Karadeniz, O. Sosyal, A. Yazici, S. Yilmaz, R. Piskin Sagir, N. Inanc, A. Karatas, G. Yildirim Cetin, F. Onen
Journal: Annals of the Rheumatic Diseases (2021)

Background: Several factors such as effectiveness, safety and compliance affect the drug survival in chronic disorders. Physicians take care of long-term retention rate and responses for discontinuation of candidate drug. Identification of predictors of clinical response to certolizumab-pegol (CZP) may aid the decision-making process for treating patients psoriatic arthritis (PsA). Objectives: The purpose of this study to assess the drug survival of certolizumab pegol (CZP) in patients with PsA and to identify the predictors and reasons for discontinuation. Methods: Data on patient characteristics, demographics, diagnosis, disease duration, treatment and outcomes have been collected since 2011 in Turkish Biologic (TURKBIO) Registry. By the end of December 2020, 68 PsA patients received CZP and were included. Kaplan Meier plot was used for drug survival analysis. Cox regression analysis was performed to evaluate the predictors associated with drug survival. Results: During the median 47 months follow-up, 17 patients discontinued the CZP treatment. The reasons for discontinuation were ineffectivity (35.3%), adverse event (17.6%) and pregnancy (5.9%). The baseline characteristics of the patients who continued and discontinued CZP were shown in the Table 1. Patients who discontinued CZP had higher mean age and disease duration. HLA-B27 positive patients had lower retention rate while bDMARD naive patients had higher retention rate. At the month 36, retention rate of CZP was 61.6% on patients with PsA (Figure 1). Conclusion: Real life experience from this nationwide TURKBIO registry show that the retention rate of CZP in PsA are lower in older patients and with longer disease duration. Moreover, bDMARD naive patients have higher retention rate. Figure 1. Drug survival of CZP in patients with PsA Table 1. Baseline characteristics of PsA patients who continue and discontinue CZP All Patients (n=68 ) Continue to CZP (n=51 ) Discontinue to CZP (n=17 ) p Females, n (% ) 52 (76,5) 37 (72,5) 15 (88,2) 0,322 Age, years 44 (36-57 ) 40 (35-53 ) 51 (42-60 ) 0,012 Disease Duration, years 9 (5-13 ) 8 (5-12 ) 14 (10,5-17 ) 0,002 Symptom duration, years 11 (7-16 ) 10 (7-15 ) 15,5 (11,5-20 ) 0,014 Order of CZP in bDMARDs 1 (1-2) 1 (1-2) 2 (1-2) 0,062 HLA-B27, n (% ) 9 (28,1 ) 3 (14,3 ) 6 (54,5 ) 0,035 ESR, mm/h 23,5 (11-37) 23 (9-35) 24 (17-52) 0,246 Swollen Joint Counts, n 0 (0-2) 0 (0-2) 1 (0-2) 0,480 Tender Joint Counts, n 2 (0-4) 1 (0-4) 2 (1-5) 0,143 CRP, mg/dl 4 (3-13,65) 3,14 (3-13) 5 (3-19) 0,107 HAQ 0,63 (0,25-1) 0,63 (0,25-1) 0,75 (0,63-0,94) 0,097 VAS-Physicians 20 (12-31,5) 20 (12-26) 30 (15-50) 0,074 VAS-Patient Global 50 (27-70) 50 (20-70) 61,5 (46,5-70) 0,342 VAS-Patient Pain 53 (28-75) 50 (20-75) 69 (49,5-75) 0,122 DAS-28-CRP 3,35 (2,2-3,9) 2,85 (2-3,8) 3,6 (2,9-4,4) 0,086 BASFI 15 (8-27) 14 (5-26) 23,5 (12-30,5) 0,133 BASDAI 28 (16-40) 27,5 (14-36) 39 (22,5-41,5) 0,060 ASDAS 2,7 (1,9-3,2) 2,6 (1,9-3,1) 3 (2,35-3,4) 0,122 DAPSA-28 15,35 (7,2-21,9) 14,9 (6,1-21,17) 18,9 (14,15-29,3) 0,108 Disclosure of Interests: None declared.