AB1262 Tapering of biological antirheumatic drugs in rheumatoid arthritispatients is achievable and cost effective in daily clinical practice: data from the brussels ucl ra cohort. (12th June 2018)

• Record Type: Journal Article
• Authors: Dierckx, S.; Lauwerys, B.; Sokolova, T.; Meric De Bellefon, L.; Stoenoiu, M.; Nzeusseu, A.; Houssiau, F.; Avramoska, A.; Durez, P.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1726
• Page End: 1726
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.6342
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Several studies demonstrate that Rheumatoid Arthritis (RA) patients achieving low disease activity or remission are able to taper biological (b) DMARDs. Objectives: The aim of this study is to determine the number of patients suffering from RA in whom tapering of bDMARDs is achievable in daily practice and to evaluate the patient characteristics. Another objective is to analyse the budget impact and determine which bDMARDs are more adapted to dose reduction. 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 observed. Data from 357 eligible RA patients (247 women and 110 men) were collected. Patient characteristics and baseline features before the current bDMARDs and flares if happened were collected. Annual drug dosage and cost were calculated. Results: In 131 patients (35.7%), the dose of the bDMARD could be tapered. Patients in the decreased dose group were older (60.6 vs 55.9 years, p=0.005) and started bDMARDs earlier in their disease course (6.8 vs 8.4 years, p=0.025). As expected, the current DAS28-CRP was lower (2.26 vs 2.55, p=0.018) and interestingly, more patients were treated with a combination of Methotrexate (84% vs 73%, p=0.019). No differences between groups was observed for gender, disease duration, baseline HAQ, DAS28-CRP, erosion, ACPA, number of previous bDMARDs and use of Glucocorticoïds. In our cohort, Anti-TNF agents were the most commonly prescribed medications (see Table). Annual drug cost was largely decreased for Rituximab and anti-TNF agents. Only 11 patients experienced a flare during the follow-up. Conclusions: In daily practice, tapering of bDMARDs in RA patients with low disease activity or remission is an achievable goal, thereby reducing annual drug cost, especially for Rituximab, Infliximab, Etanercept and Adalimumab. Disclosure of Interest: None declared