Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Biologic therapy has revolutionised patient prognosis in rheumatoid arthritis (RA). In the UK, continuing biologic therapy requires a sustained response as determined by the 28 joint-count disease activity score (DAS28). Adherence to DMARDs is low but little is known about adherence to biologic therapies and its relationship to treatment response.
The purpose of this study is to investigate the association of adherence to subcutaneous (SC) biologics and EULAR response criteria in subjects with RA.
Methods: Participants were recruited to the Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate (BRAGGSS), a large UK multicentre prospective observational cohort study. Demographic information for patients receiving SC biologic therapy and disease characteristics were assessed at baseline. Self-reported adherence was recorded at 3 and 6 months if the biologic was taken on the day agreed with the healthcare professional. Non-adherence was defined as ‘ever non-adherent’ for these periods. DAS28 was recorded at baseline and following 3 and 6 months of therapy and categorised according to the EULAR response criteria. Descriptive statistics, Student’s t-test, chi-squared test and Mann-Whitney U test statistics were used to analyse the data.
Results: Data were collected for 390 patients with median disease duration of 7 years (IQR 3 – 15). Adherence data were collected in 286 patients. 27% reported non-adherence with biologic therapy according to our criteria. There were significantly smaller changes in DAS28, ESR and poorer EULAR response in patients reporting non-adherence as shown in table 1. There were no differences between the adherent and the non-adherent group in terms of other DAS components; tender or swollen joint counts nor patient visual analogue scale. Age, disease duration and baseline DAS28 were not significantly associated with adherence status in this cohort; however it was associated with gender with self-reported adherence lower in women.
|
|
Total sample |
Adherent group |
Non-adherent group |
P-value |
|
Age in years: mean (SD) |
57.2 (11.5) |
57.7 (11.4) |
56.1 (12.0) |
0.205 |
|
Gender F: n (%) |
291 (74.6) |
146 (69.9) |
64 (83.1) |
0.024 |
|
Change in DAS28 at 6 months: median (IQR) |
-2.9 (-1.7 to – 3.8) |
-3.1 (-2.0 to -3.8) |
-2.35 (-1.1 to -3.7) |
0.025 |
|
Change in ESR at 6 months: median (IQR) |
-8.5 (0 to -20) |
-10 (-1 to -25) |
-3.5 (4 to -14) |
0.004 |
|
EULAR non response: n (%) |
26 (11.0) |
13 (7.6) |
13 (20.3) |
|
|
EULAR moderate response: n (%) |
91 (38.6) |
66 (38.4) |
25 (39.1) |
|
|
EULAR good response: n (%) |
119 (50.4) |
93 (54.1) |
26 (40.6) |
0.014 |
Conclusion: RA patients who reported not taking their biologic on the day agreed with their healthcare professional showed poorer clinical outcomes than their counterparts, emphasising the need for strict adherence to biologics in patients with RA. Female gender was a baseline predictor of patient reported non-adherence.
Disclosure:
J. Bluett,
None;
C. Morgan,
None;
L. Thurston,
None;
D. Plant,
None;
A. W. Morgan,
None;
A. G. Wilson,
None;
J. Isaacs,
None;
K. L. Hyrich,
None;
L. Cordingley,
None;
A. Barton,
None.
« Back to 2013 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-inadequate-adherence-on-clinical-outcomes-results-from-the-biologics-in-rheumatoid-arthritis-genetics-and-genomics-study-syndicate-cohort/