FRI0149 Attributes of Maximum Relevance in The Choice of A Biological dMARD in The First Line Treatment of Rheumatoid Arthritis. Acordar 2015 Project. (15th July 2016)

• Record Type: Journal Article
• Authors: Muñoz-Fernandez, S.; Bustabad, S.; Calvo, J.; Castaño, M.; Chamizo, E.; Corominas, H.; Fernández-Llanio, N.; Hidalgo, M.C.; Pérez, J.J.; Rodríguez, J.M.; Romero, S.; Ruiz-Esquide, V.
• Is Part Of: Annals of the rheumatic diseases. Volume 75(2016)Supplement 2
• Page Start: 482
• Page End: 483
• Publication Date: 2016-07-15
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2016-eular.2710
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: According to clinical guidelines, treatment with a DMARD should be initiated as soon as possible, and any patient who does not improve with at least one relevant synthetic DMARD is a candidate for a biological one. However, up to one third of the patients treated with a biological DMARD do not accomplish the therapeutic objective. Objectives: To identify and assess the attributes of the biological DMARDs which determine the most suitable treatment of patients with RA. Methods: We performed a systematic search with the following MeSH terms: rheumatoid arthritis, biologic, DMARD, characteristic, efficacy, safety, side effects, pharmacology, route–administration, adherence y cost. More than 500 publications were reviewed, from which we selected 77 attributes: 7 about general aspects, 5 about pharmacological aspects, 18 about efficacy, 31 about safety, 6 administration aspects and 10 related with cost. Between May and September 2015, 12 meetings were held, followed by a Delphi process of 2 rounds in which the degree of importance was awarded to each attribute on a Likert scale from 1 (minimum) to 9 (maximum). The consistency and concordance of the agreement were determined and they were circulated, obtaining the percentage supported for each one of them. Results: 83 Spanish rheumatologists participated, reaching a high degree of agreement with the attributes, 75 with a high importance (97.4%) and none of low importance. Fifteen attributes were ratified by all the participants: – Product with approved indication in RA as first-line biological. – Product recommended in the guidelines as first-line biological. – Product that shows efficacy following the failure of another biological. – Treatment accompanied by a reduction in articular damage progression. – Treatment that reduces comorbidities associated with RA. – Treatment characterised by a sustained long-term response. – Safe product (globally). – Proven long-term safety. – Treatment with a low incidence of serious infections. – Product that does not increase the incidence of solid malignancies. – Product that does not increase the incidence of haematological neoplasms. – Safe product in patients with cardiovascular pathology. – Safe product in patients with interstitial pulmonary disease. – Product that has demonstrated a reduction in mortality. – Product that presents a scant incidence of serious adverse events. Conclusions: There was a high degree of agreement with the selected attributes, none of which were regarded as being of low importance; 15 of them received the full support of the work group. These attributes would help to define the ideal profile of the biological DMARD following the failure of a synthetic or previous biological DMARD. Acknowledgement: Financing: Bristol-Myers Squibb Disclosure of Interest: None declared