AB0692 IMPACT OF THE EVOLUTION IN RHEUMATOID ARTHRITIS THERAPEUTICS ON TREATMENT OUTCOMES: A COMPREHENSIVE ANALYSIS IN KURAMA COHORT
Authors: T. Fujii, K. Murata, H. Onizawa, A. Onishi, K. Murakami, M. Tanaka, A. Morinobu, S. Matsuda
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Advances in rheumatoid arthritis (RA) treatment, highlighted by biological disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs), have transformed the paradigm of RA treatment over the last decade. However, despite the growing number of approved and available b/tsDMARDs, it remains unclear whether the increase in treatment options has improved RA treatment outcomes. <h3>Objectives:</h3> This study aims to investigate the relationship between RA treatment outcomes and the number of available b/tsDMARDs in real-world settings. <h3>Methods:</h3> Using a single-center observational RA cohort (KURAMA cohort), we compared the disease activity and functional disability based on the number of b/tsDMARDs available in the market (NOBTAM) during the observed period. We also evaluated the incidence of difficult-to-treat RA (D2TRA). We used the Clinical Disease Activity Index (CDAI) as the disease activity measure and the Health Assessment Questionnaire Disability Index (HAQDI) as the measure of functional disability. D2TRA was defined as patients who showed more than 10 in CDAI or needed to use no less than 7.5mg after they experienced treatment failures with more than two classes of b/tsDMARDs. A mixed-effect model with patient-specific random effect was applied to evaluate the effect of NOBTAM on CDAI and HAQDI. <h3>Results:</h3> We evaluated a cumulative total of 6166 RA patients between 2012 and 2023. The usage of b/tsDMARDs increased from 29.5% to 54.7%, and the average CDAI and HAQDI improved along with NOBTAM. The incidence of D2TRA ranged between 1.8% and 3.4% and was comparable across the NOBTAM period. A mixed-effect model showed that NOBTAM was significantly correlated with improvements in CDAI and HAQDI (p&lt;0.001). CDAI improvement was positively affected by the use of b/tsDMARDs and negatively affected by RA stage, class, dose of methotrexate and glucocorticoid, and titers of rheumatoid factor and anti-citrullinated protein antibody. The improvement of HAQDI was negatively affected by age, female sex, RA stage, use of b/tsDMARDs, and the titer of rheumatoid factor. None of the variables other than NOBTAM positively affected HAQDI improvement. <h3>Conclusion:</h3> The increase in the number of drugs available for RA was beneficial to the outcomes of RA patients. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Takayuki Fujii AbbVie GK, Asahi Kasei Pharma Corp., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Daiichi Sankyo Co. Ltd., Gilead Sciences, Inc., and Janssen Pharmaceutical K.K., Koichi Murata Eisai Co. Ltd., Chugai Pharmaceutical Co. Ltd.; Asahi Kasei Pharma Corp., Bristol-Myers Squibb, Mitsubishi Tanabe Pharma Co., Janssen Pharmaceutical K.K. and Daiichi Sankyo Co. Ltd., Hideo Onizawa AbbVie, Asahi Kasei, Astellas Pharma Inc., Eisai Co. Ltd., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Corporation, and Daiichi Sankyo Co. Ltd., Akira Onishi Pfizer Inc., Bristol-Myers Squibb., Advantest, Asahi Kasei Pharma Corp., Chugai Pharmaceutical Co. Ltd., Eli Lilly Japan K.K, Ono Pharmaceutical Co., UCB Japan Co., Mitsubishi Tanabe Pharma Co., Eisai Co. Ltd., Abbvie Inc., Takeda Pharmaceutical Co. Ltd., and Daiichi Sankyo Co. Ltd., Kosaku Murakami Eisai Co. Ltd, Chugai Pharmaceutical Co. Ltd., Pfizer Inc., Bristol-Myers Squibb, Mitsubishi Tanabe Pharma Corporation, UCB Japan Co. Ltd, Daiichi Sankyo Co. Ltd., and Astellas Pharma Inc., Masao Tanaka AbbVie GK, Asahi Kasei Pharma Corp., Astellas Pharma Inc., Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., Janssen Pharmaceutical K.K., Kyowa Kirin Co., Ltd., Pfizer Inc., Taisho Pharmaceutical Co., Ltd., Tanabe Mitsubishi Pharma Corp., Teijin Pharma, Ltd., UCB Japan Co., Ltd., Akio Morinobu AbbVie G.K., Chugai Pharmaceutical Co. Ltd., Eli Lilly Japan K.K., Eisai Co. Ltd., Pfizer Inc., Bristol-Myers Squibb., Mitsubishi Tanabe Pharma Co., Astellas Pharma Inc., and Gilead Sciences Japan., and has received research grants from AbbVie G.K., Asahi Kasei Pharma Corp., Chugai Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Co. and Eisai Co. Ltd., Shuichi Matsuda: None declared.