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Abstract Number: 635

Factors Associated to Lack of Adherence to Subcutaneous Biological Medications in Patients with Rheumatoid Arthritis from Spain. Arco Study

Jaime Calvo-Alen1, Indalecio Monteagudo2, Georgina Salvador Alarcón3, Enrique Raya Álvarez4, Loreto Carmona5, Luis Cea-Calvo6 and Carlos Marras Fernandez-Cid7, 1Rheumatology, Txagorritxu Hospital, Araba, Vitoria, Vitoria, Spain, 2Rheumatology Unit, HGU Gregorio Marañón, Madrid, Madrid, Spain, 3Rheumatology, HU Mutua de Terrassa, Barcelona, Terrassa, Spain, 4Rheumatology, Hospital Clínico San Cecilio, Granada, Spain, 5Instituto de Salud Musculoesquelética, Madrid, Spain, 6Medical Affairs Department, Merck Sharp & Dohme, Madrid, Spain, 7Rheumatology, Hospital Virgen de la Arrixaca, Murcia, Spain

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Biologic drugs, rheumatoid arthritis (RA) and rheumatoid arthritis, treatment

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Session Information

Date: Sunday, November 13, 2016

Title: Rheumatoid Arthritis – Small Molecules, Biologics and Gene Therapy - Poster I

Session Type: ACR Poster Session A

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

Background/Purpose: To investigate the variables associated to lack of adherence to subcutaneous (SC) biological drug in patients with rheumatoid arthritis (RA) after 1 year of starting therapy.

Methods: ARCO was a retrospective study in RA patients ≥18 years-old from 42 Spanish hospitals, who started a new SC biological drug 12 to 18 months prior to the study visit. Adherence was evaluated through the Medication Possession Ratio (MPR) (number of days covered by the taken medication / days of study period). The number of days covered was calculated with the vials taken by the patient from the hospital pharmacy, taken into account the prescribed interval of administration, changes in this interval and if induction was prescribed. The number of days was the study period, subtracting drug suspension periods. Patients with MPR ≤ 80% were considered non-adherent. Variables associated with non-adherence were studied in a multivariable model that included age, gender, RA duration, interval of administration, induction, order of administration, and changes in the interval of administration.

Results: 364 patients were included (age 54.9 years [12.5]; 77.5% women, median RA duration 7.8 years). The initial interval of administration was weekly (44.2%), biweekly (39.1%) and monthly (17.3%); the median duration of the period studied 14.8 months. A total of 52 patients were non‑adherent (MPR ≤ 80%) to the prescribed schedule (14.3%; 95% CI: 11.1 – 18.3). Non‑adherence was more frequent in patients with weekly administration (17.4%) and in those receiving induction (21.6% vs 12.5% without induction, p= 0.068) and less frequent in those with monthly administration (6.4%, figure). The multivariable analysis identified RA duration, induction and interval of administration as independently associated to lack of adherence (table).

Conclusion: Non-adherence to SC biological drugs occurred in 14.3% of patients with RA and was associated to RA duration above the median, weekly interval of administration and prescription of induction.

 

 

Figure. Percentage of non-adherent patients (MPR ≤80%) and administration intervals.

 

   

Multivariable analysis. Variables associated with non-adherence.

Odds ratio

95% CI

p-value

RA duration above median (>7.8 years)

1.63

0.89–3.05

0.117

No induction (vs. induction)

0.41

0.18–0.93

0.033

Biweekly administration (vs. weekly)

0.54

0.24–1.16

0.125

Monthly administration (vs. weekly)

0.32

0.09–0.87

0.042

 


Disclosure: J. Calvo-Alen, None; I. Monteagudo, None; G. Salvador Alarcón, None; E. Raya Álvarez, None; L. Carmona, None; L. Cea-Calvo, Merck Sharp and Dohme, 3; C. Marras Fernandez-Cid, None.

To cite this abstract in AMA style:

Calvo-Alen J, Monteagudo I, Salvador Alarcón G, Raya Álvarez E, Carmona L, Cea-Calvo L, Marras Fernandez-Cid C. Factors Associated to Lack of Adherence to Subcutaneous Biological Medications in Patients with Rheumatoid Arthritis from Spain. Arco Study [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/factors-associated-to-lack-of-adherence-to-subcutaneous-biological-medications-in-patients-with-rheumatoid-arthritis-from-spain-arco-study/. Accessed .
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