AB0479 LONGTERM RETENTION RATE OF CERTOLIZUMAB PEGOL IN AXIAL SPONDYLOARTHRITIS IS HIGHER: DATA FROM TURKBIO
Authors: S. S. Koca, Y. Pehlivan, S. Akar, S. Şenel, A. Avanoglu Guler, O. Sosyal, A. Yazici, S. Yilmaz, R. Piskin Sagir, N. Inanc, A. Karatas, G. Yildirim Cetin, P. Atagündüz, F. Onen
Journal: Annals of the Rheumatic Diseases (2021)

Background: Choosing the best treatment strategy for a patient is one of the most difficult issues in modern rheumatology, as there are various factors affecting drug therapy in chronic diseases, such as efficacy, safety, and compliance. Physicians take care of long-term retention rate and responses for discontinuation of candidate drug. Objectives: The purpose of this study to assess the drug survival of certolizumab pegol (CZP) in patients with axial spondyloarthritis (ax-SpA) and to identify the predictors and reasons for discontinuation. Methods: Data on patient characteristics, demographics, diagnosis, duration of disease, treatment and outcomes have been collected since 2011 in Turkish Biologic (TURKBIO) Registry. By the end of December 2020, 410 ax-SpA patients received CZP and were included. Kaplan Meier plot was used for drug survival analysis. Cox regression analysis was performed to evaluate the predictor associated with drug survival. Results: During the median 54 months follow-up, 92 (22.4%) patients discontinued the CZP treatment. The reasons for discontinuation: ineffectivity was 58.7% (n=54), adverse events was 6.5%, pregnancy was 3.3% and surgery was 4.3%. The baseline characteristics of patients continue with CZP and discontinuation due to ineffectiveness were shown in the Table 1. Patients who discontinued CZP had higher HAQ, BASFI and BASDAI values. Moreover, they were more co-treated with NSAIDs and csDMARDs. At the month 36, retention rate of CZP was 71.5% in patients with ax-SpA (Figure 1). Conclusion: Real life experience from this nationwide TURKBIO registry show higher long-term retention rate of CZP in ax-SpA. Higher baseline disease activity and functional limitation predict discontinuation of CZP. Adding NSAIDs and csDMARDs to the treatment of the patient with poor prognosis cannot increase retention rates. Figure 1 Drug survival of CZP in patients with Ax-SpA Table 1. Baseline characteristics of ax-SpA patients who continue and discontinue CZP All patients (n=410 ) Continue to CZP (n=318 ) Discontinue to CZP* (n=54 ) p Females, n (% ) 185 (49,7) 157 (49,4) 28 (51,9) 0,736 Age, years 42 (34-49) 41 (34-49) 45 (34-54) 0,064 Symptom duration, years 11 (7-17) 11 (6-16) 12 (8,5-20) 0,054 HLA-B27, n (% ) 150 (63,8) 129 (64,5) 21 (60) 0,609 Previous bDMARDs, n (% ) Adalimumab 54 (14,5) 42 (13,2) 12 (22,2) 0,082 Etanercept 53 (14,2 ) 40 (12,6 ) 13 (24,1 ) 0,025 Golimumab 11 (3) 7 (2,2) 4 (7,4) 0,060 Infliximab 39 (10,5) 35 (11) 4 (7,4) 0,425 Co-treated drugs, n (% ) NSAID 206 (55,4 ) 169 (53,1 ) 37 (68,5 ) 0,036 Methotrexate 35 (9,4 ) 22 (6,9 ) 13 (24,1 ) &lt;0,001 Sulphasalazine 61 (16,4 ) 40 (12,6 ) 21 (38,9 ) &lt;0,001 Leflunomide 5 (1,3 ) 2 (0,6 ) 3 (5,6 ) 0,023 ESH, mm/h 21,5 (10-37) 21 (10-37) 23 (10-34) 0,999 CRP, mg/dl 7 (3-20) 7 (3-20) 7 (3-22) 0,727 HAQ 0,63 (0,25-0,94 ) 0,5 (0,25-0,88 ) 0,75 (0,38-1,25 ) 0,009 BASFI 21 (7-45 ) 20,5 (6-41 ) 31 (13-58 ) 0,011 BASDAI 30,5 (13-52 ) 30 (12-50 ) 43 (23-61,5 ) 0,002 ASDAS 2,7 (1,8-3,7) 2,7 (1,8-3,6) 2,9 (2,3-4) 0,062 *Discontinue due to ineffectivity. References: [1]Iannone F, et al. Effectiveness of Certolizumab-Pegol in Rheumatoid Arthritis, Spondyloarthritis, and Psoriatic Arthritis Based on the BIOPURE Registry: Can Early Response Predict Late Outcomes? Clin Drug Investig. 2019;39(6):565-575. Disclosure of Interests: None declared.