Session Information
Date: Sunday, October 21, 2018
Session Title: Rheumatoid Arthritis – Treatments Poster I: Strategy and Epidemiology
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose:
Several studies have demonstrated that Rheumatoid Arthritis (RA) patients achieving low disease activity or
remission are able to taper biological disease-modifying antirheumatic drugs (bDMARDs). The aim of this
study is to evaluate the proportion of patients in whom the bDMARD can be tapered in daily practice and to
analyse the characteristics of these patients e. Another objective is to determine which bDMARDs are more
adapted to dose reduction and the cost saving.
Methods:
Inclusion criteria were RA patients from our Brussels UCL cohort treated with a bDMARD for at least one
year. A dose reduction was proposed by the senior physician when sustained low disease activity or remission
was achieved. Patient characteristics and baseline features before the introduction of the current bDMARD were
collected as well as flares if happened. We also calculated, for each bDMARD, the proportion of patients who
received a decreased dose and the annual cost.
Results: Data from 332 eligible RA patients were collected, 140 patients (42,1%) had a tapered regimen and
192 received a full dose of bDMARD. In the decreased dose group, age at diagnosis (43.1 vs 38.7 years,
p=0.004), HAQ ( 1.3 vs 1.5, p=0.048), RF (83.3 vs 72.9%, p=0.026) and disease duration at the bDMARDs
introduction (9.7 vs 12.1 years, p=0.034) were statistically different. As expected, the current DAS28-CRP was
lower (2.26 vs 2.64, p=0.001) in the decreased dose group and interestingly, more patients receiving a decreased
dose were treated with a combination of methotrexate when the bDMARD was introduced (86.7% vs 73.8%,
p=0.005). No difference between groups was observed for gender, ACPA, erosion, number of previous
bDMARDs, time to first conventional synthetic DMARD and biological DMARD, baseline DAS28-CRP and
use of glucocorticoids. In our cohort, anti-TNF agents were the most commonly prescribed medications (anti-
TNF 68%, tocilizumab 15%, rituximab 10%, abatacept 7%). Only 15 patients experienced a flare during the
follow-up. Adalimumab, etanercept and rituximab were the most frequent decreased bDMARD and were
associated with the most important reduction of annual cost. Figure: Proportion of patients with decreased dose
for each bDMARD
Conclusion:
In daily practice, tapering of bDMARDs in RA patients with low disease activity or remission is an achievable
goal in a large proportion of patients, thereby reducing annual drug cost. The combination with methotrexate
could be a positive predictive factor for the success of bDMARD tapering but further prospective research in
daily practice are needed to confirm this result.
Disclosure: S. Dierckx, None; B. R. Lauwerys, None; T. Sokolova, None; L. Meric de Bellefon, None; M. Stoenoiu, None; A. Nzeusseu Toukap, None; F. A. Houssiau, None; A. Avramovska, None; P. Durez, None.
To cite this abstract in AMA style:
Dierckx S, Lauwerys BR, Sokolova T, Meric de Bellefon L, Stoenoiu M, Nzeusseu Toukap A, Houssiau FA, Avramovska A, Durez P. Tapering of Biological Antirheumatic Drugs in Rheumatoid Arthritis Patients Is Achievable and Cost Effective in Daily Clinical Practice: DATA from the Brussels UCL RA Cohort [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/tapering-of-biological-antirheumatic-drugs-in-rheumatoid-arthritis-patients-is-achievable-and-cost-effective-in-daily-clinical-practice-data-from-the-brussels-ucl-ra-cohort/. Accessed January 24, 2020.« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/tapering-of-biological-antirheumatic-drugs-in-rheumatoid-arthritis-patients-is-achievable-and-cost-effective-in-daily-clinical-practice-data-from-the-brussels-ucl-ra-cohort/