SAT0323 Adverse drug reactionsrelated to disease-modifying drugs (DMARD) in psoriatic arthritis patients in daily clinical practice. (12th June 2018)

• Record Type: Journal Article
• Authors: Freites Nuñez, D.; Rosales, Z.; León, L.; Font, J.; Lois, P.; Vadillo, C.; Pato, E.; Fernández, B.; Rodríguez-Rodríguez, L.; Jover, J.A.; Abasalo, L.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1026
• Page End: 1027
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.2577
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Psoriatic arthritis (PsA) benefits from DMARDs and to know more about the adverse drug reactions (ADRs) represent an advance for the management and safety of these patients in clinical practice. Objectives: To evaluate the discontinuation due to ADRs of DMARDs used in PsA patients and to analyse the possible associated factors. Methods: Retrospective longitudinal observational study. Subjects: inception cohort of patients from January 2010 to, December 2014 and followed up to December 2016, diagnosed with PsA according to ICD-10code. Main outcome : discontinuation of conventional synthetic DMARDs (csDMARDs) and biological originator DMARDs (boDMARDS) due to ADR (moderate: drug suspension regardless of the repercussions, severe: hospital admission required or death). Covariables: sociodemographic and clinical. Statistical analysis: To estimate DMARDs discontinuation rates, survival techniques were used, expressing the incidence rate (IR) per 100patients*year with their respective CI at 95%. Multivariate Cox regression models were performed to analyse the factors associated with DMARDs discontinuation due to ADRs and results were expressed in Hazard ratio(HR) and 95% CI. Results: 191 patients were included, with a follow-up of 379.70 Patients*year. 50.3% were male, mean age at diagnosis was 50±14.6 years old. 46.6% of the patients had a history of cutaneous psoriasis. HLA-B27 was positive in 20% of patients. Throughout the follow-up, all patients received csDMARDs and 23 used boDMARDs. Methotrexate(MTX) was the most used drug 69.7%. 30% were on combination therapy, the most frequent was antiTNF +MTX. There were 44 discontinuations due to ADRs, IR 11.59 [8.62–15.57] and 3 were severe, requiring hospital admission (two infections and one cancer), no deaths were recorded. Among the most frequent causes of discontinuation related to ADRs were digestive intolerance 32%, nonspecific manifestations 11%, infections 9% and abnormal transaminase levels 9%. Table1 shows the DMARDs discontinuation rates due to ADRs. In the final discontinuation model related with ADRs (Table2), we observed that distress, high disease activity, corticosteroids at diagnosis and combination therapy were associated with a higher rate of discontinuation. Conclusions: The discontinuation rate due to ADRs was 11.59, although most of them did not have an important clinical impact. We have found some psychological, clinical and treatment factors that can modify the DMARDs survival on PsA patients. We also observed that MTX, seems to be safe in the treatment of PsA, presenting the lowest probability of suspension related to ADRs compared with the rest of treatments. Disclosure of Interest: None declared