Background Given the increasing use of biological therapies in rheumatologic diseases and the importance of their secondary effects, it has been promoted clinical Meetings for an accurate Biological Therapy Assessment (BTAM). In the BTAM rheumatologists consider the need to initiating biological therapy, changes in biological therapeutic targets, sustained biological treatment or their suspension.
Objectives To assess the BTAM effectiveness in patients with rheumatic diseases in a Rheumatology Department in a tertiary-level hospital.
Methods Prospective study including all consultations to BTAM between 2013 and 2015 in the Rheumatology Department of La Fe Hospital. Consultations were classified as: “therapeutic target modification”, “route of administration modification”, “dose treatment modification”, “new biological treatment”, “treatment continuation” and “treatment suspension”. In order to evaluate disease activity, we used DAS28, BASDAI, serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Biostatistical analysis was performed using R software 3.2.3.
Results We included 1683 BTAM consultations, corresponding to 517 patients with rheumatic diseases with a mean age of 39.94±14.88 and 13.37±8.75 years of disease progression. 51.6% of patients were rheumatoid arthritis, 27.9% spondyloarthritis, 15.3% psoriatic arthritis and 5.2% other diagnosis. 116 patients received a prior biological treatment. Disease activity evaluation of the 1683 BTAM consultations for the main categories is shown in the table.
Biostatistic analysis shows significant differences in Das28, BASDAI, CRP and ESR values between BTAM consultations for initiating new treatment or modify therapeutic target, and treatment continuation consultations (P<0.0001). There was also a significant association between the number of biological targets administered and the increase of DAS28 (P<0.0001) and BASDAI (P=0.014).
Conclusions We observed a increased disease activity in cases where a new biological treatment or different therapeutic target is administrated, and values of disease activity in treatment continuation are compatible with low activity. In the 5.2% of consultations it has prescribed modification treatment, in order to avoid treatment ineffectiveness. Moreover, some continuation treatment consultations showed low activity scores, leading to a therapeutic optimization. BTAM consultations are useful for optimal management of these patients with biological therapy
Disclosure of Interest None declared