ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0839

Comparative Treatment Effectiveness in Rheumatoid Arthritis with and Without Concomitant Sjögren’s Syndrome – Results from the Swiss Clinical Quality Management Cohort

Lisa Christ1, Seraphina Kissling2, Ruediger B. Mueller3, Axel Finckh4, Benjamin Fisher5, Britta Maurer1, Burkhard Moeller6 and Florian Kollert1, 1Department of Rheumatology and Immunology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland, 2Statistics and Data Management Group, Swiss Clinical Quality Management Foundation, Zurich, Switzerland, 3Clinic of Rheumatology, Medical University Hospital Aarau, Aarau, Switzerland, 4University Hospital of Geneva, Geneve - Vesenaz, Switzerland, 5Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham; National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre and Department of Rheumatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom, 6Inselspital - University Hospital Bern, Bern, Switzerland

Meeting: ACR Convergence 2021

Keywords: ,

Session Information

Date: Sunday, November 7, 2021

Title: RA – Treatments Poster I: Comparative Effectiveness, Biosimilars, Withdrawal, & the Real World (0813–0845)

Session Type: Poster Session B

Session Time: 8:30AM-10:30AM

Background/Purpose: The variety of treatment options in RA contrasts with a lack of personalized medicine. The presence of concomitant SjS might be associated with differerences in RA pathobiology. We hypothesize that the clinical phenotype and treatment response differs in RA/SjS compared to RA alone with an inferior response to TNF-inhibitors (TNFi) over other target specific therapies.

Methods: In this retrospective observational cohort study data from the Swiss Clinical Quality Management in Rheumatic Diseases (SCQM) registry were obtained (01.01.2000-01.01.2021). All treatment courses (TC) from patients aged 18 and older with RA as diagnosed by the treating rheumatologist and definite SjS status undergoing TNFi, other modes of action (OMA) bDMARD (Abatacept, IL6-inhibitors, Rituximab) or JAK-inhibitors (JAKi) were assessed. Two group-comparison between RA/SjS and RA/non-SjS were performed. P-values are from Fisher test for nominal and Kruskal test for continuous variables. We estimated crude hazard ratios (HR) from univariate Cox models with the outcome of stop or start of a new bDMARD.

Results: A total of 9601 TCs were analyzed (5373 TNFi, 3201 OMA, 1027 JAKi). RA/SjS were more likely to be female, non-smoker, to have longer RA disease duration, a higher DAS28 and HAQ-score. Additionally, RA/SjS patients were more likely to receive OMA or concomitant steroid treatment and had a higher number of prior biologic treatments. Patients’ characteristics at the start of each eligible TC are displayed in table 1. Figure 1 shows the Kaplan Meier plot for TNFi TCs (p-value corresponds to the log-rank test). Median retention time for RA/SjS versus RA/non-SjS was: TNFi 489 versus 714d; OMA 619 versus 768d; JAKi 693 versus 801d. There was evidence that RA/SjS have a higher hazard for stopping TNFi treatment than RA/non-SjS (crude HR 1.35, 95%; CI 1.05 to 1.74, p=0.02). No evidence was found for a difference in OMA (crude HR 1.13, 95% CI 0.92 to 1.39, p=0.23) or JAKi (crude HR 1.12, 95% CI 0.76 to 1.67, p=0.57).

Conclusion: The unadjusted Cox model suggests that patients with RA and associated SjS have an inferior response to TNFi than RA patients without SjS.

Table 1: Patient characteristics at the start of an eligible treatment course. Displayed are n (%) for nominal and median (Q1-Q3) for continuous variables.

Figure 1: Kaplan Meier plot of retention time for eligible TNF-inhibitor treatment courses.

Disclosures: L. Christ, Novartis, 1, Gilead Sciences, 5, 11, F. Hoffmann-La Roche Ltd, 5, 11, Sanofi, 12, Pfizer, 5, Bristol-Myers Squibb, 6; S. Kissling, None; R. Mueller, None; A. Finckh, Eli Lilly, 5, 6, Pfizer Inc, 2, 5, 6, AbbVie, 2, 5, UCB, 2, Roche, 2, Galapagos, 5, MSD, 2, A2 Biotherapeutics, 2, Bristol-Myers Squibb, 2, 5; B. Fisher, Novartis, 2, BMS, 1, Janssen, 1, 5, Servier, 2, 5, Galapagos, 2, 5, Roche, 5; B. Maurer, Novartis, 2, 5, Boehringer Ingelheim, 1, 2, 6, Janssen Cilag, 2, Abbvie, 5, Protagen, 5, Pfizer, Roche, Actelion, mepha, MSD, 12, Congress Support; B. Moeller, Amgen, 5, Janssen, 6; F. Kollert, Roche, 3, Gilead, 5, Roche, 5, Pfizer, 5, Roche, 11, Pfizer, 1, Boehringer-Ingelheim, 1.

To cite this abstract in AMA style:

Christ L, Kissling S, Mueller R, Finckh A, Fisher B, Maurer B, Moeller B, Kollert F. Comparative Treatment Effectiveness in Rheumatoid Arthritis with and Without Concomitant Sjögren’s Syndrome – Results from the Swiss Clinical Quality Management Cohort [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/comparative-treatment-effectiveness-in-rheumatoid-arthritis-with-and-without-concomitant-sjogrens-syndrome-results-from-the-swiss-clinical-quality-management-cohort/. Accessed .

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