Biologic Use and Reasons for Switching Biologic Therapy in Patients with Non-radiographic Axial Spondyloarthritis in the United States:Findings from a US Survey

Atul Deodhar ¹, Theresa Hunter², Elizabeth Holdsworth ³, Nicola Booth ⁴ and David Sandoval ⁵, ¹Oregon Health & Science University, Portland, OR, ²Eli Lilly and Company, Indianapolis, ³Adelphi Real World, Manchester, England, United Kingdom, ⁴Adelphi Real World, Bollington, United Kingdom, ⁵Eli Lilly and Company, Indianapolis, IN

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: axial spondyloarthritis, Biologics and treatment, non-radiographic

Session Information

Date: Monday, November 11, 2019

Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster II: Treatment of Axial Spondyloarthritis & Psoriatic Arthritis

Session Type: Poster Session (Monday)

Session Time: 9:00AM-11:00AM

Background/Purpose: The FDA approved the first biologic for the treatment of nr-axSpA in the US in March 2019. The objective of our study was to describe biologic use and reasons for switching biologic therapy among patients with non-radiographic axial spondyloarthritis (nr-axSpA).

Methods: Data from a real world, cross-sectional survey of rheumatologists and their consulting nr-axSpA patients in the United States were analyzed descriptively. Data were collected from Jun-Aug 2018 via physician-completed patient record forms and patient self-completed forms. Patients who had physician confirmed diagnosis of nr-axSpA were eligible to participate. Rheumatologists completed record forms for their patients, containing information on current medication use and reasons for switching biologics.

Results: Data from 88 rheumatologists and 495 nr-axSpA patients were included in this analysis. The majority of nr-axSpA patients were male (53.3%), with a mean age of 44.2 years, and 69.8% of patients reported working full-time. Of the 495 nr-axSpA patients, 48.1% were receiving a biologic agent and no csDMARD, 18.4% csDMARD (no biologic), 18.2% NSAIDS/COX-2 (no biologic or csDMARD), 11.5% a biologic and a csDMARD, 2.0% were receiving no therapy, and 1.8% other therapy (no biologic, csDMARD or NSAID/COX-2). Of the 295 patients receiving a biologic, 78.0% were receiving their first, 13.9% their second and 8.1% their third or more biologic. Of the 74 nr-axSpA patients that switched from a previous biologic to their current biologic, physicians reported that 51.4% switched due to condition worsening, 48.6% had a loss of response over time, 27.0% switched due to a lack of pain alleviation, and 25.7% of patients switched because remission was not induced (Figure 1).

Conclusion: This survey suggests that around 60% of nr-axSpA patients were receiving biologic therapy. Switching of biologics is frequent in nr-axSpA patients and is usually due to lack of efficacy, loss or response, and effort to accomplish remission.

Figure 1

Disclosure: A. Deodhar, AbbVie, 2, 5, 9, Abbvie, 5, 8, Abbvie, Amgen, Boehringer Ingelheim, BMS, Eli Lilly, GlaxoSmithKline, Janssen, Novartis AG, Pfizer, and UCB Pharma, 5, 8, AbbVie, Amgen, Boehringer Ingelheim, BMS, Eli Lilly, GSK, Galapagos, Janssen, Novartis, Pfizer and UCB, 5, AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Glaxo Smith and Klein, Janssen, Novartis, Pfizer, UCB, 5, Amgen, 5, 8, 9, BMS, 2, 5, 8, BMS, Eli Lilly, Glaxo Smith & Kline, Janssen, Novartis, Pfizer, UCB, 2, BMS, Eli Lilly, GlaxoSmithKline, Janssen, Novartis AG, Pfizer, UCB Pharma, 2, Boehringer Ingelheim, 5, 8, Boehringer-Ingelheim, 5, 8, Bristol Myers Squibb, 2, 5, Bristol-Myers Squibb, 2, 5, 8, Eli Lilly, 2, 5, 8, 9, Eli Lilly and Company, 2, 5, Eli Lilly,, 5, Eli Lilly, GSK, Novartis, Pfizer and UCB, 2, Galagagos, 5, Galapagos, 5, 8, 9, Glaxo Smith & Klein, 2, Glaxo Smith & Kline, 2, 5, 8, Glaxo Smith Klein, 5, Glaxo SmithKlein, 2, 5, GlaxoSmithKlein, 2, 5, GlaxoSmithKline, 2, 5, 8, GSK, 2, 5, Janssen, 2, 5, 8, 9, Janssen Pharmaceutica, 2, 5, Janssen Research & Development, LLC, 2, Lilly, 2, 5, Novartis, 2, 5, 8, 9, Pfizer, 2, 5, 8, 9, UCB, 2, 5, 8, 9; T. Hunter, Eli Lilly, 1, 3, Eli Lilly and Company, 1, 3; E. Holdsworth, None; N. Booth, Adelphi Real World, 3; D. Sandoval, Eli Lilly, 1, 3, Eli Lilly and Company, 1, 3.

To cite this abstract in AMA style:

Deodhar A, Hunter T, Holdsworth E, Booth N, Sandoval D. Biologic Use and Reasons for Switching Biologic Therapy in Patients with Non-radiographic Axial Spondyloarthritis in the United States:Findings from a US Survey [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/biologic-use-and-reasons-for-switching-biologic-therapy-in-patients-with-non-radiographic-axial-spondyloarthritis-in-the-united-statesfindings-from-a-us-survey/. Accessed .

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