ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1541

First Line Biological Treatment in Ankylosing Spondylitis, Prescription Rates, Baseline Demographics and Disease Activity. a Collaboration between Biological Registers in the Five Nordic Counties

Bente Glintborg1, Ulf Lindström2, Kalle Aaltonen3, Eirik K Kristianslund4, Björn Gudbjornsson5, Katerina Chatzidionysiou2, Johan Askling6, Dan Nordström7, Merete Lund Hetland8, Daniela Di Giuseppe9, Lene Dreyer10, Tanja Schjødt Jørgensen11, Lars Erik Kristensen10, Kari Eklund3, Gerdur Grondal12, Sofia Ernestam2, Jaana Joensuu3, Tore K Kvien13, Elisabeth Lie13, Karen M Fagerli13, Arni Jon Geirsson12, Helgi Jonsson12 and Lennart TH Jacobsson14, 1The DANBIO registry and the Danish Departments of Rheumatology, Copenhagen, Denmark, 2On behalf of the SRQ/ARTIS registry, Stockholm, Sweden, 3On behalf of the ROB-FIN registry, Helsinki, Finland, 4Dept. of Rheumatology, On behalf of the NOR-DMARD registry, Oslo, Norway, 5ICEBIO, Reykjavik, Iceland, Reykjavik, Iceland, 6Unit of Clinical Epidemiology, Department of Medicine, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden, 7ROB-FIN, Helsinki, Finland, Helsinki, Finland, 8The DANBIO registry and the Danish Departments of Rheumatology, Glostrup, Denmark, 9Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden, 10On behalf of the DANBIO registry, Copenhagen, Denmark, 11On behalf of the DANBIO registry, Copenhagen F, Denmark, 12On behalf of the ICEBIO registry, Reykjavik, Iceland, 13On behalf of the NOR-DMARD registry, Oslo, Norway, 14Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: , ,

Session Information

Date: Monday, November 6, 2017

Title: Spondyloarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment Poster II

Session Type: ACR Poster Session B

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

Background/Purpose:

Large-scale observational cohorts identified in national biological registries may be used to study effectiveness of biological disease modifying drugs (bDMARDs) in ankylosing spondylitis (AS). However, aggregation of data and generalizability of results depends on whether baseline characteristics and disease activity are comparable across countries.

The aims of this interim report, which is part of an ongoing collaborative project between the five Nordic countries, were to explore the following in AS patients who started first line treatment with a bDMARD during 2010-2016 A) baseline characteristics and disease activity per country, B) prescription rate of first line bDMARD per capita per country in 2016.

 

Methods:

An observational, prospective cohort study conducted in parallel in the 5 Nordic countries. Data regarding the numbers of AS patients (ICD10 code M45) who initiated bDMARD treatment  during 2010-2016 were collected from the Nordic rheumatologic biological registries SRQ (Sweden), NOR-DMARD (6 Norwegian treatment centres), DANBIO (Denmark), ROB-FIN (Finland) and ICEBIO (Iceland).

For the calculation of prescription rate, background population numbers (year 2016) were retrieved from each country.

No statistical comparisons were conducted for the current interim analysis.

 

Results:

In total, 4392 bDMARD treatment initiations were identified in AS patients 2010-2016 (Sweden 1986, Norway 663, Denmark 970, Finland 623, Iceland 150). Demographics and baseline characteristics are presented in Table. The age at start of bDMARD and the proportion of HLA-B27-positivity appeared similar across the countries whereas there seemed to be differences in baseline disease activity,  use of conventional synthetic (cs)DMARDS and rate of smoking.

The crude incidence rate of first line bDMARD start in 2016 ranged from 1.3 (Finland) to 10.7 (Iceland), per 100000 capita.  

 

Conclusion:

The biological registries of the Nordic countries can be used to conduct large scale observational studies in AS. However, despite the relatively homogenous populations and health-care systems in the region, variations in the incidence of bDMARD use and in the patient baseline characteristics were observed. National differences in disease classification and in treatment strategies need to be explored further and taken into account when interpreting merged data from several countries.

 

BG and UL contributed equally to the writing of this abstract.

Acknowledgements: partly funded by a grant from Nordforsk and Foreum

 

Table. Baseline characteristics in patients with ankylosing spondylitis starting a first bDMARD 2010-2016 in the five Nordic countries, and incidence rate for start of bDMARD in 2016

 

Iceland

Norway

Sweden

Denmark

Finland

Number of patients

150

663

1986

970

623

Baseline characteristics

Age, years, mean (SD)

41 (13)

42 (12)

43 (14)

42 (13)

41 (11)

Females, %

36

41

31

29

39

HLA-B27 positive, %

90

90

NA

83

89

Current smoking, %

25

24

17

27

26

Concomitant csDMARD, %

23

11

24

15

72

Swollen joints, %1)

24

18

26

15

23

Prednisolone, %

3

NA

7

1

17

BASDAI, mean (SD)

6.3 (1.7)

4.9 (2.1)

5.3 (2.1)

5.9 (1.9)

3.5 (2.5)

CRP mg/L, median (IQR)

7 (11)

5 (9)

8 (16)

9 (17)

8 (16)

ASDAS, mean (SD)

3.8 (0.7)

3.0 (0.9)

3.2 (1.0)

3.6 (1.0)

2.7 (1.0)

BASFI, median (IQR)

4.7 (2.2)

NA

3.8 (3.8)

5.1 (3.5)

2.2 (3.9)

PGA, mm, mean (SD) 2)

73 (16)

53 (24)

55 (24)

69 (22)

46 (27)

HAQ, median (IQR)

0.9 (0.8)

0.5 (0.5)

0.6 (0.8)

0.8 (0.5)

NA

Incidence rate for start of bDMARD3)

10.7

4.2

3.2

2.8

1.3

1) ≥1 swollen joint at baseline

2) Patient global assessment

3) Crude incidence rate for first line bDMARD in 2016 per 100’000 capita

 

Disclosure: B. Glintborg, Abbvie, Biogen, 2; U. Lindström, None; K. Aaltonen, AbbVie, BMS, Janssen, MSD, Pfizer, Roche and UCB, 2; E. K. Kristianslund, None; B. Gudbjornsson, Actavis, Celgene, MSD, Pfizer, 2; K. Chatzidionysiou, None; J. Askling, AbbVie, Eli Lilly, Janssen, Merck, Pfizer, Roche, UCB, Samsung, 2; D. Nordström, AbbVie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, UCB, 8; M. Lund Hetland, Orion, BMS, AbbVie, Biogen, Pfizer, MSD, 2; D. Di Giuseppe, None; L. Dreyer, MSD, UCB and Janssen Pharmaceutical, 8; T. S. Jørgensen, AbbVie, Roche, Novartis, UCB, and Biogen, 8; L. E. Kristensen, Pfizer, AbbVie, Amgen, UCB, Celgene, BMS, Biogen, Forward Pharma, MSD, Novartis, Eli Lilly, and Janssen pharmaceuticals, 8; K. Eklund, None; G. Grondal, None; S. Ernestam, None; J. Joensuu, Pfizer Inc, 8; T. K. Kvien, AbbVie, 2,Pfizer Inc, 2,Roche Pharmaceuticals, 2,UCB, 2,BMS, 2,MSD, 2,AbbVie, 5,Pfizer Inc, 5,BMS, 8,MSD, 8,Roche Pharmaceuticals, 8,UCB, 8,AbbVie, 8; E. Lie, AbbVie, Celgene, Hospira and Pfizer, 8; K. M. Fagerli, None; A. J. Geirsson, None; H. Jonsson, None; L. T. Jacobsson, Abbvie, Celegen, MSD, Novartis and UCB, 5.

To cite this abstract in AMA style:

Glintborg B, Lindström U, Aaltonen K, Kristianslund EK, Gudbjornsson B, Chatzidionysiou K, Askling J, Nordström D, Lund Hetland M, Di Giuseppe D, Dreyer L, Jørgensen TS, Kristensen LE, Eklund K, Grondal G, Ernestam S, Joensuu J, Kvien TK, Lie E, Fagerli KM, Geirsson AJ, Jonsson H, Jacobsson LT. First Line Biological Treatment in Ankylosing Spondylitis, Prescription Rates, Baseline Demographics and Disease Activity. a Collaboration between Biological Registers in the Five Nordic Counties [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/first-line-biological-treatment-in-ankylosing-spondylitis-prescription-rates-baseline-demographics-and-disease-activity-a-collaboration-between-biological-registers-in-the-five-nordic-counties/. Accessed .

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