AB1364-HPR IS ADHERENCE TO TREATMENT RELATED TO THE EFFECTIVENESS OF ANTI-TNFS IN PATIENTS WITH RHEUMATOID ARTHRITIS? - ANALYSIS OF A REAL-WORLD COHORT
Authors: P. Osorio, L. Villarreal, M. Cabrera, O. Valencia, P. Santos-Moreno
Journal: Annals of the Rheumatic Diseases (2020)

Background: Several medicines are prescribed for chronic disease management of rheumatoid arthritis (RA) including biologics; however, adherence to long-term therapy remains poor because many causes; the latter results in worsening clinical results. Objectives: To analyze the relationship between adherence to treatment and the achievement of remission or low disease activity in patients with RA treated with three anti-TNF molecules of subcutaneous use. Methods: In patients treated with 3 subcutaneous anti-TNFs, with at least one year of follow-up previously, adherence was measured with Compliance Questionnaire for Rheumatology (CQR19) applied by psychologist; the CQR19 is a 19 item, self-administered questionnaire that was developed with the aim of correctly identify rheumatology patients that were classified as “low” adherers (taking &lt;80% of their medication correctly) and defining as high adhesion a result greater than 80%; adherence also was measured with medication possession rate (MPR) and attendance to scheduled consultations with the interdisciplinary team in each period measured. The effectiveness by DAS28, HAQ and the other measurements were made in three periods: at baseline (BL), 6 months (M6) and 12 months (M12). A Pearson correlation was made between the number of patients in remission and low disease activity by type of molecule and period, with adherence criteria. Results: 112 patients diagnosed with RA were included, 34.8% (39/112) treated with adalimumab, 38.4% (43/112) etanercept and 26.8% (30/112) golimumab; The results of CQR19 at BL, M6 and M12 were greater than 80%, with no statistically significant differences between the three molecules. The MPR was higher than 80% in the three periods, being very similar between the three molecules, but in M12 period the difference in MPR between adalimumab 86% and golimumab 92.1% was statistically significant (p &lt;0.005), for etanercept it was of 90%. Regarding to DAS28 and HAQ, there were no differences between the biologics analyzed; However, the highest percentage of patients with low disease activity and remission had a higher correlation with attendance to the consultations scheduled in the interdisciplinary RA care model (r = 0.78) p &lt;0.005 (see tables). CQR19 MPR BL M6 M12 BL M6 M12 ADALIMUMAB 89,7 89,3 90,1 98,5 90,5 86,1 ETANERCEPT 87,4 89,7 89,7 97,9 89,6 90,9 GOLIMUMAB 88,2 87,6 91,5 97,1 96,1 92,1 No statistical differences in adherence between biologics were found depending on sex, type of concomitant conventional treatment for RA or presence of comorbidities. RELATION BETWEEN Rem/LDA AND COMPLIANCE WITH APPOINTMENTS Rem LDA MDA HDA ADALIMUMAB 63% 60% 53% 29% P&lt;0,005 ETANERCEPT 66% 62% 73% - - GOLIMUMAB 68% 73% 55% - P&lt;0,005 Conclusion: There seems to be a higher MPR with the monthly golimumab compared to the biweekly adalimumab and weekly etanercept; however, it does not necessarily imply greater effectiveness. Longer term studies are needed to confirm if there is better adherence and clinical results with monthly anti-TNFs than to other dosing regimens. Patients with remission and low disease activity had greater assistance to scheduled consultations with the interdisciplinary group, regardless of the type of molecule used. This study confirms the relation between adherence to medications and care model with clinical results. Disclosure of Interests: Paola Osorio: None declared, Laura Villarreal: None declared, Michael Cabrera: None declared, Omaira Valencia: None declared, Pedro Santos-Moreno Grant/research support from: I have received research grants from Abbvie, Biopas-UCB, Janssen, Novartis, Pfizer., Speakers bureau: I have been a speaker for Abbvie, Biopas-UCB, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi.