Background In clinical practice, about 30% of RA patients had comorbidities or drug intolerance that made difficult their treatment with Synthetic DMARDs in combination with biologics.
Objectives To compare the characteristic of patients who were treated with commercial available biologic plus synthetic DMARDs vs. those patients treated with biologics without synthetic DMARDs.
Methods Design: An observational, prospective cohort of patients with RA (ACR, 1987) attended in daily clinical practice. Setting: 17 Rheumatology Units of the Andalucian Service of Health. The Rheumatologist filled in a web page with clinical data for each patient at baseline and after 6 months of the first biologic. This data were saved and analiysed in a centralized way. This work was supported by the Central Services of the SAS and approved by the Autonomic Ethic Committee.
Results From May, 2006 to March de 2010, 1.360 patients were included and 1.150 patients were analyzed. 238 (21%) were treated with biologic without synthetic DMARDs; 775 (67%) with biologic and one DMARD; 123 (11%) with biologic and two synthetic DMARDs; and 14 (1%) with biologic and three synthetic DMARDs. The main clinical characteristics are shown in the table. Patient treated with biologics without DMARDs were older and with longer RA duration; they had higher activity, as well as more comorbidity (hepatitis virus infection). Patient treated with biologic plus one synthetic DMARD had FR+ y/o Anti CCP+ more frequently, and nodular disease. Patients treated with biologics and ≥2 DMARDs were younger, with shorter disease duration. FR and/or Anti CCP were negative with higher frequency, and they had higher HAQ. The DAS at six months was similar in the groups. However, the HAQ improvement was different, regarding with the baseline HAQ.
Conclusions The RA patients treated with biologics with or without synthetic DMARDS were different. However the response of DAS and HAQ improvement at six months was similar and clinically relevant in all groups.
Disclosure of Interest B. Hernández Cruz Grant/research support from: From the Sociedad Andaluza de Reumatología, Employee of: FISEVI, R. Ariza Ariza: None Declared, R. Caliz Caliz: None Declared, E. Marquez Saavedra: None Declared, F. Navarro Sarabia: None Declared