AB0774 Does prescription year influence the pattern of biologics use for rheumatoid arthritis?. (23rd January 2014) - Alvaro-Gracia, J. M.
Abstract : Background: Choice and pattern of use of biological therapies in rheumatoid arthritis (RA) depends on many factors. Distinct timing of availability in the market as well as of supportive scientific information on efficacy and safety, and changing guidelines or recommendations, make pattern of use probably affected by time. We aimed to analyze the pattern of biologic use along 13 years, in a single center as a previous step to further studying potential influencing factors. Objectives: To analyze the effect of annual period on 1) choice of first biologic, 2) drug survival, and 3) reason for discontinuation of first biologic. Methods: Pharmacy dispensation databases were searched for all biological drugs and filtered by diagnosis. All data on patients with a clinical diagnosis of RA on any biologic from year 2000 to 2012 were selected for analysis. Reason for discontinuation was extracted from clinical records. Annual periods were divided into 2000-2005, 2006-2010, and 2011 and thereafter. The association of time period with the type of first biologic and with the reason of discontinuation was analyzed by chi-square. Kaplan-Meier survival tables were used to assess drug survival, which was compared between periods by log-rank test. Results: The study comprises 466 patients with RA (mean age at first biologic 58±14; 80% women). The most frequently used biologic in first place (Table 1 ) and the reason for discontinuing first biologic changed significantly by period (p<0.001). Notably, infliximab started strong and decayed afterwards, rituximab had a head start in the medium period and then decayed, and lately all biologics tend to even, with TNF antagonists on the lead. The most frequent reason for discontinuation in 2000-2005 was loss of efficacy (39%), and then inefficacy in 2006-2010 (33%) and 2011+ (56%). There were no differences in drug survival of first biologic between periods ( p >0.05). Conclusions: The pattern of use and reasons for discontinuation of biologics in RA are markedly influenced by the time period of first prescription. Calendar year or time period is a clear confounding factor that must be adjusted for in longitudinal data analyses comprising long periods of time. Disclosure of Interest: J. M. Alvaro-Gracia Grant/research support from: Abbott, MSD, BMS, Roche, UCB, Pfizer, Janssen-Cilag, M. Arredondo Grant/research support from: Abbott, MSD, BMS, Roche, UCB, Pfizer, Janssen-Cilag, A. Aranguren Grant/research support from: Abbott, MSD, BMS, Roche, UCB, Pfizer, Janssen-Cilag, E. Daudén Grant/research support from: Abbott, MSD, BMS, Roche, UCB, Pfizer, Janssen-Cilag, G. Fernández-Jiménez Grant/research support from: Abbott, MSD, BMS, Roche, UCB, Pfizer, Janssen-Cilag, V. Meca Grant/research support from: Abbott, MSD, BMS, Roche, UCB, Pfizer, Janssen-Cilag, A. Morell Grant/research support from: Abbott, MSD, BMS, Roche, UCB, Pfizer, Janssen-Cilag, J. P. Gisbert Grant/research support from: Abbott, MSD, BMS, Roche, UCB, Pfizer, Janssen-Cilag, F. J. Aspa: None Declared, M. J. García de Yébenes Grant/research support from: Abbott, MSD, BMS, Roche, UCB, Pfizer, Janssen-Cilag, L. Carmona Grant/research support from: Abbott, MSD, BMS, Roche, UCB, Pfizer, Janssen-Cilag