ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1351

A Comparison Of The Clinical Effectiveness Of Treatment Strategies For Active RA Patients : Using a Prospective Biologic Registry (BIOPSY) and an RA Specific Cohort (KORONA)

Yoon-Kyoung Sung1,2, Soo-Kyung Cho1,2, Chan-Bum Choi3,4, Soyoung Won5, So-Young Bang6, Hoon-Suk Cha7, Jung-Yoon Choe8, Won Tae Chung9, Seung-Jae Hong10, Jae-Bum Jun4, Hyoun Ah Kim11, Jinseok Kim12, Seong-Kyu Kim8, Tae-Hwan Kim4, Hye-Soon Lee13, Jaejoon Lee7, Jisoo Lee14, Shin-Seok Lee15, Sung Won Lee16, Yeon-Ah Lee10, Seong-Su Nah17, Chang-Hee Suh18, Dae-Hyun Yoo4, Bo Young Yoon19 and Sang-Cheol Bae1,2, 1Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea, 2Department of Rheumatology, Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, South Korea, 3Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, South Korea, 4Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea, 5Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, South Korea, 6Hanyang University Guri Hospital, Guri, South Korea, 7Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, 8Catholic University of Daegu School of Medicine, Daegu, South Korea, 9Division of Rheumatology, Department of Internal Medicine, Dong-A University Hospital, Busan, South Korea, 10Division of Rheumatology, Department of Internal Medicine, Kyung Hee University, Seoul, South Korea, 11Ajou University Hospital, Suwon, South Korea, 12Division of Rheumatology, Internal Medicine, Jeju National University Hospital, Jeju, Korea, South Korea, 13Department of Rheumatology, Hanyang University Guri Hospital, Guri, South Korea, 14Internal Medicine, Ewha Womans University Mokdong Hospital, Seoul, South Korea, 15Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, South Korea, 16Rheumatology, Dong-A University Hospital, Busan, South Korea, 17Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea, 18Department of Rheumatology, Ajou University Hospital, Suwon, South Korea, 19Inje University Ilsan Paik Hospital, Goyang, South Korea

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: , , ,

Session Information

Title: Rheumatoid Arthritis - Clinical Aspects II: Predictors of Disease Course in Rheumatoid Arthritis - Treatment Approaches

Session Type: Abstract Submissions (ACR)

Background/Purpose: The results from RCTs may not be generalizable to clinical practice because of their inclusion and exclusion criteria. Instead, observational cohorts and registries might provide complement information for each treatment strategies in the real world. This study aimed to compare the clinical effectiveness of treatment strategies for active RA patients refractory to non-biologic DMARDs using independent biologic registry and disease specific cohort for Korean RA patients.

Methods: One year follow-up data on drug uses and clinical outcomes were compared between Korean biologics registry (BIOlogics Pharmacoepidemiologic StudY, BIOPSY) and established RA cohort (KORONA). Since all the BIOPSY patients had moderate to high disease activity (DAS28>3.2) and have started TNF inhibitors, we selected patients from KORONA with inclusion criteria at baseline: 1) DAS 28>3.2, 2) changing DMARDs within 3 months, and 3) non-biologic DMARD user. A total of 528 subjects (208 from BIOPSY and 320 from KORONA) were included in this study. Propensity score matching was used to equalize patient characteristics between TNF inhibitor user and non-biologic DMARD user groups. The one year remission rates with DAS 28 and HAQ scores were compared between two treatment strategies for active RA patients: starting TNF inhibitors vs. changing non-biologic DMARDs.

Results: Of the 208 TNF inhibitor users and 320 non-biologic DMARDs users identified from each registry and cohort, 184 patients (92 in BIOPSY and 92 in KORONA) were included in this analysis after the propensity score matching. Their baseline characteristics were comparable with age (46.5 vs. 46.6, P=0.97), female (89.1% vs. 91.3%, p=0.81), RF positivity (83.7% vs. 84.8%, p=1.0), disease duration (6.0 years vs. 5.2 years, p=0.39), DAS 28 (5.58 vs. 5.60, p=0.63) and HAQ scores (1.20 vs. 1.20, P=0.97). Remission rates after 1 year follow up with sustaining baseline treatment were 16.3% in TNF inhibitor users and 13.0% in non-biologic DMARDs users (P=0.68). For the patients with continuing initial treatment for 1 year, TNF inhibitor users had lower HAQ score than non-biologic DMARDs users (0.59 vs. 0.77, P<0.01).

Conclusion: We compared clinical effectiveness of TNF inhibitors and non-biologic DMARDs in active RA patients using independent biologics registry and RA cohort. Although the use of TNF inhibitors did not increase the one year remission rate compared to the use of non-biologic DMARDs, it decreased the one year functional disability in active RA patients.

Disclosure:

Y. K. Sung,
None;

S. K. Cho,
None;

C. B. Choi,
None;

S. Won,
None;

S. Y. Bang,
None;

H. S. Cha,
None;

J. Y. Choe,
None;

W. T. Chung,
None;

S. J. Hong,
None;

J. B. Jun,
None;

H. A. Kim,
None;

J. Kim,
None;

S. K. Kim,
None;

T. H. Kim,
None;

H. S. Lee,
None;

J. Lee,
None;

J. Lee,
None;

S. S. Lee,
None;

S. W. Lee,
None;

Y. A. Lee,
None;

S. S. Nah,
None;

C. H. Suh,
None;

D. H. Yoo,
None;

B. Y. Yoon,
None;

S. C. Bae,
None.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-comparison-of-the-clinical-effectiveness-of-treatment-strategies-for-active-ra-patients-using-a-prospective-biologic-registry-biopsy-and-an-ra-specific-cohort-korona/