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Abstract Number: 2669

Persistency of Patient Reported Morning (AM) Stiffness in a Large US Registry Cohort of Rheumatoid Arthritis (RA) Patients Initiating New DMARD Therapy

Vibeke Strand1, Robert J. Holt2, Heather J. Litman3, Jeffrey D. Kent4, Hristina Pashova5, John T. Nguyen3 and Carol J. Etzel6,7, 1Division of Immunology/Rheumatology, Stanford University School of Medicine, Portola Valley, CA, 2University of Illinois - Chicago, Chicago, IL, 3Corrona, LLC., Southborough, MA, 4Horizon Pharma USA, Inc., Deerfield, IL, 5Axio Research, LLC., Seattle, WA, 6The University of Texas MD Anderson Cancer Center, Houston, TX, 7Corrona, LLC, Southborough, MA

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: DMARDs, Outcome measures, registry and rheumatoid arthritis (RA)

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Session Information

Date: Tuesday, November 10, 2015

Title: Rheumatoid Arthritis - Clinical Aspects Poster Session III

Session Type: ACR Poster Session C

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

Background/Purpose: AM
stiffness is a common yet under-
appreciated
symptom in RA
. The
longitudinal impact of AM stiffness has not been previously investigated.
This
study evaluate
d
persistency
of AM stiffness over
time and
prevalence of improvement based
on
decreases in stiffness duration following
initiation of
new
DMARD therapy in the Corrona
RA
Registry.

Methods: Adult
patients enrolled as of December 31, 2014
who initiated new biologic or synthetic DMARDs and maintained treatment for ≥90 days were analyzed and followed until last visit. The proportion and frequency of
patients who reported no
ne or decreased duration of AM stiffness were compared with those with persistent or increased
duration at last visit. Among patients with AM stiffness at treatment
initiation, baseline characteristics and
categorical improvement in stiffness duration
were evaluated
. Patients reporting <1hr of AM stiffness were considered
improved if they
had no stiffness; those reporting 1-<2hrs were improved if <0.5 hours and those with 2-<3 and ≥3hrs improved if <1hr by last visit.

Results:
Of 9377 total patients, 4972 (53%) continued
stiffness free or reported decrease
d
duration and 4405 (47%) had persistent or worsened duration of stiffness at
last visit (Table 1). 644 (42.2%) with no stiffness at treatment initiation reported stiffness by last visit. Among 7851 with
AM stiffness
at treatment initiation, a large majority
were biologic
DMARD na
ïve
(56.5%) and initiated
combination therapy
(56.4%) (Table 2).
When categorical improvement in stiffness
duration
criteria were analyzed, 5432
(69.2%) among
patients reporting AM stiffness at
treatment
initiation reported no improvement at
last visit.

Conclusion: In this
analysis,
longitudinal and categorical
change data demonstrate that AM
stiffness is a recurring symptom
which persists as an unmet need
in a large majority of RA patients despite initiation of new DMARD therapy.
Further research is needed to evaluate clinically meaningful metrics from the
patients
‘
perspective for improvement in AM stiffness duration. Clinical factors associated with improved responses should be
evaluated to address persistency of AM stiffness that continues to affect a
large number of RA patients.


Disclosure: V. Strand, Abbvie, Afferent, Alder, Amgen, Ampio, Antares, Anthera, AstraZeneca, Atreon, aTyr, BiogenIdec, BioMarin, Biotest, BMS, Carbylan, Celgene, Celltrion, Corrona LLC, Covidien, Crealta, Crescendo, CymaBay, Eupraxia, Flexion, Forest, Galderma, Genentech/Roche,, 5,Abbvie, Amgen, BiogenIdec, BMS, Crescendo, Forest, Genentech/Roche, GlaxoSmithKline, Idera, Incyte, Iroko, Janssen, Jazz Pharmaceuticals, Lilly, Novartis, NovoNordisk, Pfizer, Regeneron, Rigel, Sanofi-Genzyme, Savient, Takeda, Teikoku, UCB, Vertex, 9; R. J. Holt, Horizon Pharma USA, 5; H. J. Litman, Corrona, LLC, 3; J. D. Kent, Horizon Pharma USA, 3; H. Pashova, Axio Research, LLC, 3; J. T. Nguyen, Corrona, LLC., 3; C. J. Etzel, Corrona, LLC, 3.

To cite this abstract in AMA style:

Strand V, Holt RJ, Litman HJ, Kent JD, Pashova H, Nguyen JT, Etzel CJ. Persistency of Patient Reported Morning (AM) Stiffness in a Large US Registry Cohort of Rheumatoid Arthritis (RA) Patients Initiating New DMARD Therapy [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/persistency-of-patient-reported-morning-am-stiffness-in-a-large-us-registry-cohort-of-rheumatoid-arthritis-ra-patients-initiating-new-dmard-therapy/. Accessed .
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