Objectives The objective of this study was to describe and compare over time the demographics and disease parameters at infliximab treatment initiation and to assess the effectiveness of treatment at 6 and 12 months in real life cohort AS patients.
Methods BioTRAC is an ongoing, prospective registry of patients initiating treatment for rheumatoid arthritis (RA), ankylosing spondylitis (AS), or psoriatic arthritis (PsA) with infliximab or golimumab as first biologics or after having been treated with a biologic for less than six months. People with AS treated with infliximab who were enrolled between 2002 and 2013 were included in this analysis (N=303) and stratified to two groups (2005-2007: n=135; 2008-2013: n=168) based on the year of enrolment in the registry.
Results Patient demographics were comparable in the two cohorts with a mean (SD) age of 45.72 (11.74) years and the majority being males (62.4%). A significant change in the geographic distribution of patients enrolled in the BioTRAC registry was observed (P=0.001) and more patients with provincial coverage were enrolled in 2008-2013 compared to 2005-2007 (P=0.012). A trend towards earlier initiation of infliximab was observed in more recent years as indicated by the shorter disease duration (11.12 vs. 8.24 years; P=0.013) and the lower number of prior traditional DMARDs used (0.83 vs. 0.59; P=0.078). Furthermore, overall, patients recruited in 2008-2013 had lower disease activity compared to those enrolled in 2005-2007. ESR (29.96 vs. 19.91 mm/hr; P<0.001), physician global assessment (MDGA; 6.99 vs. 6.26; P=0.001) were significantly lower in the 2008-2013 cohort while a statistical trend was observed in morning stiffness (78.96 vs. 70.11 minutes; P=0.064) and ASDAS (3.90 vs. 3.70; P=0.103).
Treatment for 6 months resulted in a greater proportion of patients in the 2008-2013 cohort achieving inactive disease (ASDAS<1.3) without reaching statistical significance (20.7% vs. 34.9%; P=0.140).
Conclusions The results of this analysis show that the profile of the AS patient population in the BioTRAC registry has changed over time towards lower disease activity and earlier initiation in the patient management process. These results may reflect differences in patient management over time or may be related to earlier access to care. Irrespective of enrolment period, 6-month treatment with infliximab was effective in reducing disease activity in AS patients.
Disclosure of Interest D. Choquette: None declared, M. Starr: None declared, M. Khraishi: None declared, W. Bensen: None declared, S. Shaikh: None declared, J. Rodrigues: None declared, D. Sholter: None declared, M. Sheriff: None declared, J. Vaillancourt: None declared, J. Sampalis: None declared, A. Lehman Employee of: Janssen, S. Otawa Employee of: Janssen, F. Nantel Employee of: Janssen, M. Shawi Employee of: Janssen