AB0319 DRUG SURVIVAL OF BIOLOGICS IN RHEUMATOID ARTHRITIS: PRELIMINARY DATA FROM THE TUNISIAN BINAR REGISTRY
Authors: K. Ben Abdelghani, L. Rouached, A. Fazaa, S. Miladi, K. Ouenniche, L. Souabni, S. Kassab, S. Chekili, L. Abdelmoula, S. Baklouti, N. Bergaoui, E. Bouajina, M. Elleuch, I. Gharsallah, Y. Mohamed, M. M. Kchir, S. Kochbati, A. Laatar
Journal: Annals of the Rheumatic Diseases (2020)

Background: The arrival of Biotherapy has changed the management and prognosis of rheumatoid arthritis (RA). However, drug survival of the first biotherapy is changing according to the studies. Objectives: We aimed to report the data on the drug survival of biotherapies in RA, collected from the Tunisian BIologics National Registry (BINAR) Methods: BINAR is a multicenter non-interventional and prospective study, conducted in Tunisia with 80 rheumatologists over a period of three years. It included patients with RA (ACR / EULAR 2010 criteria) and refractory to conventional background treatments (csDMARDs), who required the use of biological treatment of anti TNF, anti IL6 or Rituximab type. Data were collected and analyzed through an electronic platform managed by DACIMA. Sociodemographic data (age, gender, body mass index (BMI), smoking) and characteristics of RA (duration of evolution, erosive character) were collected. RA activity was studied by the DAS28-VS score and drug survival was evaluated by the duration of the biologics. Results: We included 175 patients with a sex ratio of 5.7 and a mean age of 54.1 ± 12.6 years [19-79]. Patients were smoking in 6.7% of cases and mean BMI was 27.9 ± 5.2 kg/m 2 [15.1-45.2]. RA was erosive in 73.1% of cases and the mean disease duration was 6.7±3.5 years. Disease activity was moderate (mean DAS28vs: 4.9±1.5). Concerning the treatments, 139 (79.4%) of the patients received TNFα inhibitor, 31 (17.7%) of the patients were on IL6 inhibitor and 15 (8.6%) were on Rituximab. The mean duration of drug survival for TNFα inhibitor agents was 15.2 months, 18 months for anti IL6 and 16.3 months for Rituximab. The drug was discontinued by 19 patients (10.8%). The causes of discontinuation were primary failure in 31.8% (7 subjects), secondary escape in 9.1% (4 subjects), the occurrence of adverse effects in 31.8% (7 subjects), intolerance to drug in 9.1% (2 subjects), non-compliance for one patient and for other reasons in one case. The drug survival of TNF inhibitor was not associated with socio-demographic data (gender (p=0.9), age (p=0.4), smoking (p=0.9), BMI (p=0.9)), nor with the characteristics of the disease duration (p = 0.5), DAS28 vs (p = 0.9), association with a csDMARDs (p = 0.2)) except the presence of erosion (p = 0.013). Also, drug survival of IL6 inhibitor drugs was not associated with socio-demographic parameters (gender (p = 0.1), age (p= 0.6), smoking (p= 0.6), BMI (p = 0.4)) and the characteristics of the disease (duration (p = 0.9), erosive character (p = 0.6), DASvs (p = 0.1), association with a csDMARDs (p = 0.2)). Similarly, drug survival of Rituximab was not associated with socio-demographic data (gender (p = 0.6), age (p = 0.7), BMI (p = 0.7)) or with the characteristics of RA (duration of evolution (p= 0.5), erosive character (p = 0.6), DASvs (p = 0.08), association with a csDMARDs (p = 0.5)) Conclusion: Our study demonstrated that IL6 inhibitor had the longest duration of drug survival (18 months). The major causes of cessation were dominated by primary failure and the occurrence of an adverse event. Finally, the drug survival of TNF inhibitor agents was associated with the erosive character. Acknowledgments: none Disclosure of Interests: None declared