AB0907 CHARACTERISTICS OF PATIENTS WITH SPONDYLOARTHRITIS WHO STARTED bDMARDs IN THE EARLY PERIOD (≤2 YEARS) - HURBIO REAL-WORLD DATA
Authors: B. Firlatan, G. S. Kart Bayram, E. Bilgin, Z. Özsoy, G. Ayan, G. Sandal Uzun, M. Ekici, E. Ünaldi, B. Bulat, L. Kiliç, A. Akdogan, O. Karadag, Ş. A. Bilgen, A. İ. Ertenli, S. Kiraz, U. Kalyoncu
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The concept of a 'window of opportunity' is well accepted in rheumatoid arthritis. Whether a similar approach applies to spondyloarthritis (SpA) remains uncertain. <h3>Objectives:</h3> This study aims to evaluate the characteristics of SpA patients started on biologic disease-modifying antirheumatic drugs (bDMARDs) within two years of symptom onset and compare them with patients started on bDMARDs later. <h3>Methods:</h3> Hacettepe University Rheumatology Biologic Registry (HUR-BIO) is a prospective, single center registry of rheumatic disease patients treated with bDMARDs. A total of 3161 SpA patients enrolled in the database were included in the study. Patient demographic characteristics, date of disease onset and diagnosis, HLA-B27 results and radiographic findings, if present, extra-articular lesions, synthetic DMARDs used before bDMARDs, bDMARD initiation date, number of tender/swollen joints at bDMARD initiation and at the last visit, ESR, CRP, and BASDAI, BASFI, VAS, and HAQ scores were recorded. <h3>Results:</h3> It was found that 665 of the 3161 SpA patients (51.3% male) included in the study were started on a bDMARD within a median of 11 months (6-18 months) after the onset of symptoms. Patients who started bDMARDs in the early period had an older age at symptom onset (32 years (25-41) vs. 27 years (21-35), p&lt;0.001) and shorter disease duration according to symptom onset (9 years (5-11) vs. 16.5 years (12-23), p&lt;0.001). Age at diagnosis was similar between the groups. Syndesmophyte, bamboo spine, and hip involvement were more common in patients with longer disease duration and later bDMARD initiation (p&lt;0.001, p&lt;0.001 and p=0.002, respectively). While there was no difference between the groups regarding extra-articular involvement, such as psoriasis and inflammatory bowel disease, uveitis was observed to be less common in patients started on early bDMARDs (6.8% vs. 13.3%, p&lt;0.001). While the use of methotrexate (26% vs. 30%), salazopyrine (60% vs. 77%), and hydroxychloroquine (11% vs. 17%) was lower in the early bDMARD group than in the late bDMARD group, the use of steroids was higher (31% vs. 26%) (p=0.021, p&lt;0.001, p&lt;0.001 and p=0.021, respectively). The early and late bdMARD groups were similar for the first bDMARD selection [TNFi (98.5% vs. 98.1%) and IL-17i (%1.5 vs. 1.9%)]. There were no significant differences between groups in bDMARD switch rates (45.8% vs. 42.9%), drug adherence and disease activity indicators at first and last visit. Only the proportion of patients with a BASFI ≥4 at the time of bDMARD initiation was higher in the late bDMARD group (60.3% vs. 54.8%) (p=0.043). While the initial BASFI scores were similar between the groups, the BASFI score at the last visit was found to be lower in patients who started bDMARD early (2.3 (0.4-4.8) vs. 2.8 (0.9-5.3), p&lt;0.001). <h3>Conclusion:</h3> This study showed no significant difference in medication adherence and disease activity in patients who started treatment earlier. However, this group had a lower rate of functional decline and a lower incidence of uveitis. Treatment decisions should be based not only on disease activity control but also on preserving the patient's functional ability. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>