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SAT0269 Survival of The Second TNF Inhibitor in Patients with Poly-JIA
  1. T. Bzarova1,
  2. E. Alexeeva1,2,
  3. S. Valieva1,
  4. R. Denisova1,
  5. K. Isayeva1,
  6. T. Sleptsova1,
  7. E. Chistyakova1,
  8. A. Chomahidze1,
  9. O. Lomakina1,
  10. M. Soloshenko1,
  11. A. Fetisova1,
  12. E. Kashchenko1
  1. 1Rheumatology, Scientific center of children's health
  2. 2I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation

Abstract

Background TNFα is one of the most important cytokine in the pathogeneses of poly-JIA. There are several TNF inhibitors for the treatment poly-JIA. Switching TNF-blockers is often strategy in the treatment of poly-JIA.

Methods An open observational study in patients with poly-JIA taking the second TNFinhibitor. A total of 119 patients (46 boys and 73 girls) were included in this study. The mean age was 11 (7;14), disease duration was 5 (3;8) years. By the switching time 54/119 had active polyarthritis, 58/119 – olygoarthritis, 7/119 – active uveitis without arthritis. Infliximab was the first TNF inhibitor in 105/119, adalimumab – in 3/119, etanercept – 11/119. 81/119 were switched to adalimumab, 38/119 – to etanercept. Analysis of survival the second TNF blocker treatment was performed in all patients by Kaplan–Meier curve.

Results The causes for cancellation of the first and second TNF blockers were second inefficacy (3,7% and 8%), adverse events (5,6% and 2,5%) and administration causes (7% and 8%). Infliximab was cancelled because of primary inefficacy (7/105, 6.7%), second inefficacy (57/105, 54.3%), adverse events (12/105, 11.4%), relapse of uveitis (7/105, 6.7%), disease remission (19/105, 18.1%), administration causes (3/105, 2.8%). Etanercept was discontinued because of primary inefficacy (1/11, 9%), second inefficacy (2/11, 18%), adverse events (2/11, 18%), relapse of uveitis (6/11, 55%). Adalimumab was cancelled because of primary inefficacy (1/3), adverse events (1/3), administration causes (1/3). The second TNF inhibitor treatment survival in patients with the primary inefficacy of the first TNF inhibitor at 1,2 year was 73%, at 1,8 year was 73%, at 2,4 year was 53%. The second TNF inhibitor treatment survival in patients with the second inefficacy of the first TNF inhibitor at 1,2 year was 82%, at 1,8 year was 82%, at 2,4 year was 69%. The second TNF inhibitor treatment survival in patients with the remission of the first TNF inhibitor and relapse of disease at 1,2 year was 82%, at 1,8 year was 82%, at 2,4 year was 72%. The number of AE was 32.2 and 24.5 per 100 p.y. on the 1st and 2nd TNF blocker treatment, accordingly (p<0,0001).

Conclusions The highest percent of survival of the second TNF inhibitor treatment was registered in patients with poly-JIA whom the first TNF inhibitor was cancelled because of disease remission and the lowest percent – in patients with poly-JIA whom the first TNF inhibitor was cancelled because of the primary inefficacy of the first TNF inhibitor.

Disclosure of Interest T. Bzarova Grant/research support from: Pfizer, E. Alexeeva Grant/research support from: Roche, Novartis, UCB, S. Valieva Grant/research support from: Roche, R. Denisova Grant/research support from: Roche, Novartis, UCB, K. Isayeva Grant/research support from: Roche, Novartis, T. Sleptsova Grant/research support from: Novartis, UCB, E. Chistyakova: None declared, A. Chomahidze: None declared, O. Lomakina: None declared, M. Soloshenko: None declared, A. Fetisova: None declared, E. Kashchenko: None declared

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