SAT0109 DISTINCT EFFECTS OF METHOTREXATE IN COMBINATION WITH ADALIMUMAB OR ETANERCEPT ACCORDING TO CCP ANTIBODY STATUS IN PATIENTS WITH RHEUMATOID ARTHRITIS. (2nd June 2020)

• Record Type: Journal Article
• Authors: Greenwood, M.; Shipa, M.; Ehrenstein, M.
• Is Part Of: Annals of the rheumatic diseases. Volume 79(2020)Supplement 1
• Page Start: 988
• Page End: 988
• Publication Date: 2020-06-02
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2020-eular.1858
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Considerable evidence suggesting enhanced efficacy of anti-TNF therapy for rheumatoid arthritis (RA) when co-administered with methotrexate (MTX) led us to explore the applicability of the published data to our patient cohort. Objectives: This retrospective study aimed to investigate the efficacy of MTX in combination with adalimumab (ADA) and etanercept (ETN) for RA, examining changes in disease activity score (DAS28-CRP) on first starting treatment, and rates of withdrawal due to inefficacy over up to 10 years of treatment in routine clinical practice. Methods: 309 patients with RA who had started ADA or ETN as a first-line biologic at UCLH from 2003 onwards were identified. Demographic and treatment details, DAS28-CRP (DAS) at the biologic-naïve baseline and at a first appointment for review on anti-TNF were extracted from clinical records. ANOVA was used to investigate the level of association between change in DAS and anti-TNF type, concomitant therapy, anti-CCP (CCP), rheumatoid factor (RF), age, disease duration and number of DMARD trials by anti-TNF initiation, year of initiation and gender. Kaplan-Meier with log rank tests were used to explore associations between anti-TNF type, MTX, CCP and RF and rates of withdrawal due to inefficacy, and Cox Proportional Hazards to check whether these remained significant after controlling for any other significant factors. Results: 179 patients were on ADA and 130 ETN; 44% were on concomitant MTX (Table 1 ). Conclusion: There was no apparent benefit of MTX with anti-TNF with respect to initial DAS response, but MTX was associated with a reduction in withdrawals for inefficacy though only in CCP positive patients treated with ETN. Disclosure of Interests: None declared