Background Biological treatment (BT) has changed the evolution of rheumatic diseases. A way to evaluate the effectiveness of BTs is considering therapeutic survival as an effectiveness subrogate marker
Objectives To describe BT use; To evaluate BT survival in indications according to product label, in clinical practice, in 3 Spanish hospitals
Methods Observational retrospective study, based on clinical history (CH) revisions of patients with Rheumatoid arthritis (RA), Psoriasic Arthritis (PA), and Espondiloarthiritis (EA) treated with BT.
CH standardization was performed by data collected since 2013 by rheumatologists thought MEDiadd® RHEUMA tool.
Variables: age, gender, indication (RA, PA, EA) TB: Etanercept (ETN), adalimumab (ADA), certolizumab (CRT), golimumab (GOLI), infliximab (IFX), abatacept (ABA), tocilizumab (TCZ), rituximab (RTX). Start and end date from 2002 to 2016
Exclusion criteria: Patients and/or treatment lines with incomplete data (lack data or n<15) were also excluded.
Descriptive statistics and Kaplan-Meier survival analysis were performed with r-project.com
Results From initial 1155 patients, 76 were excluded because of incomplete data. Almost half of the patients (42.35%) were diagnosed with RA, 30.03% have EA and 18.07% PA. 10% were excluded because of other indications. 79.46% of patients with RA are women, as 36.36% of EA and 50.96% of PA; Most of the patients are over 55y. In all indications, the range of 36–54y is the one that present a higher percentage of patients.
For the Kaplan-Meier survival analysis, the complete set of BT that each patient had received was analyze independently, considering 1206 cases. Table 1 shows average time and percentage survival at 1st year
After 1 year, ETN showed the higher rates of survival in RA (98.5%); IFX (100%), and ETN (99%) in PA; and GOLI (100%) followed by ETN (95.8%) in EA. Those BT were used to compare survival curves, finding differences in all cases (α=0.05) except in IFXvsETN in RA; ETNvsIFX in PA; and IFXvs GOLI in EA. Analysis after 5 years showed that the higher survival rates were for IFX in RA (94.4%) and PA (94.7%) and for ETN in EA (89.4%)
Conclusions BTs with highest survival rates are ETN and IFX for RA and Aps; In EA, GOLI presents a higher rate at 1-year, but at 5-year is overcome by ETN
Standardized information is crucial to assess the global impact of BT. CH analysis reveals clinical practices which describe the effectiveness of treatments in the world, which can help in the decision-making process
Acknowledgements By their collaboration: Dr Casado; Dr Valls; Dr Martinez; Dr Aguilar; Dr Vergara; Dr Begazo
Disclosure of Interest None declared