Disease Duration and Withdrawal of Biologic Agents Predict Radiological Progression in a Cohort of Rheumatoid Arthritis Patients in Latin America. a Real World Study

Rocio V. Gamboa-Cardenas^1,2, Manuel Ugarte-Gil³, Francisco Zevallos⁴, Mariela Medina⁴, Claudia Elera-Fitzcarrald⁴, Victor Pimentel-Quiroz⁴, Cristina Reategui-Sokolova⁴, Omar Sarmiento-Velasquez⁴, Zoila Rodriguez-Bellido⁴, José Alfaro⁴, Mariano Cucho-Venegas⁴, Cesar A. Pastor-Asurza⁴ and Risto Perich-Campos⁵, ¹Rheumatology, Hospital Guillermo Almenara, EsSalud, Lima, Peru, ²Universidad Nacional Mayor de San Marcos, Lima, Peru, ³Peru, GLADEL, Lima, Peru, ⁴Rheumatology, Hospital Guillermo Almenara Irigoyen. EsSalud, Lima, Peru, ⁵Rheumatology, Hospital Guillermo Almenara Irigoyen, Lima, Peru

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: joint damage and rheumatoid arthritis (RA)

Session Information

Date: Sunday, November 5, 2017

Title: Rheumatoid Arthritis – Clinical Aspects Poster I: Treatment Patterns and Response

Session Type: ACR Poster Session A

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

Background/Purpose: Optimal management of Rheumatoid Arthritis (RA) based in identification of patients with risk factors for Joint Damage (JD) progression, is a main strategy, but there is scarce evidence regarding this aspect in Latin-America (LA).Objective: To determine factors associated with JD and predictors of radiographic progression (RP) in a RA cohort

Methods: Prospective analysis of Hospital Almenara RA cohort (Lima-Perú). JD and RP were determined with Sharp-VDH score. A single reader evaluated all X-ray films. Age, gender, ethnicity, socioeconomic level(Graffar), education, age at diagnosis, disease duration, diagnosis delay, tobacco, comorbidities(Charlson), current/past DMARDs, biologic and corticosteroids, biologic withdrawal ,DAS28, EULAR-remission, AntiCCP, JD (Sharp-VDH score) and disability (MHAQ) at baseline were analyzed as RP predictors. We applied a multivariate linear regression elimination model (p <0.05) and SPSS-21.0. Results: 313 patients from the 432 subjects of the hospital Almenara RA cohort were included , 91.4% women, 98.4% Mestizos, disease duration was 14.94 (12.79) and diagnosis delay 1.71 (2.59) years. Baseline Sharp-VDH was 94.53 (95.81). Most patient were using DMARDs (92%), but only 11.5% biologics. Current (B=42.86, CI: 6.49-79.24, p=0.021) or past (B=45.76, IC: 6.42-85.09, p=0.023) corticosteroids, current biologic (B=28.63, CI: 4.86-52.40, p=0.018) and longer disease duration (B=3.62, CI: 3.02-4.22, p<0.01) were associated with baseline JD. One hundred and eighty-four patients were prospectively followed, in this group the rate of RP total/erosion was 4.41(9.24) and 2.17(5.74)/year respectively, there was a DMARDs prescription delay of 6.56(8.02) years and 176 (95.7%) subjects without remission-EULAR criteria. Predictors of RP (erosions) were a longer disease duration (B=0.14, CI 0.01-0.27, p=0.04) and withdrawal of biologic (B=8.63 CI 2.28-14.98 p=0.008)

Conclusion: This cohort had a high disease duration and delay of DMARD introduction. Disease duration and biologic withdrawal predicted RP. Carefully biologic withdrawal in these patients could be a good strategy to prevent adverse results in our population

Disclosure: R. V. Gamboa-Cardenas, None; M. Ugarte-Gil, None; F. Zevallos, None; M. Medina, None; C. Elera-Fitzcarrald, None; V. Pimentel-Quiroz, None; C. Reategui-Sokolova, None; O. Sarmiento-Velasquez, None; Z. Rodriguez-Bellido, None; J. Alfaro, None; M. Cucho-Venegas, None; C. A. Pastor-Asurza, None; R. Perich-Campos, None.

To cite this abstract in AMA style:

Gamboa-Cardenas RV, Ugarte-Gil M, Zevallos F, Medina M, Elera-Fitzcarrald C, Pimentel-Quiroz V, Reategui-Sokolova C, Sarmiento-Velasquez O, Rodriguez-Bellido Z, Alfaro J, Cucho-Venegas M, Pastor-Asurza CA, Perich-Campos R. Disease Duration and Withdrawal of Biologic Agents Predict Radiological Progression in a Cohort of Rheumatoid Arthritis Patients in Latin America. a Real World Study [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/disease-duration-and-withdrawal-of-biologic-agents-predict-radiological-progression-in-a-cohort-of-rheumatoid-arthritis-patients-in-latin-america-a-real-world-study/. Accessed .

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