A Multi-Centre Retrospective Study To Describe The Impact on Healthcare Resource Use And Real World Effectiveness of Golimumab In Ankylosing Spondylitis (AS) In UK Clinical Practice

Abstract

Objectives Study aims were to describe the impact of Tumour Necrosis Factor-α (TNF-α) inhibitor golimumab on UK real-world healthcare resource use (HRU) and evaluate the clinical effectiveness of golimumab in the treatment of Ankylosing Spondylitis (AS). This abstract presents HRU data for the 6 months pre- and post-golimumab initiation as well as effectiveness data at 6 months post-golimumab initiation compared with the closest observation pre-golimumab initiation. Methods This multicentre observational study of consenting adult patients was carried out via retrospective medical chart review in six UK NHS hospital rheumatology departments between November 2015 and October 2016. Inclusion criteria included AS diagnosis, anti-TNF-α-naive, received minimum three doses of golimumab for AS, and first dose at least 12 months before data collection. Effectiveness was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Spinal Pain Visual Analogue Scale (VAS) and Bath Ankylosing Spondylitis Functional Index (BASFI). Patients with missing data are excluded from the effectiveness analysis. Results The study enrolled 47 eligible patients, 74% male, mean age of 46.4 years, mean golimumab treatment duration of 2.3 years. A significant reduction of 30.4% (Mann-Whitney p<0.005) in mean number of rheumatology clinic visits (from 2.3 to 1.6) and a 27.3% reduction in mean number of clinical investigations (from 13.4 to 9.7) over the 12-month period was observed (Mann-Whitney p<0.05). 74% (32/43) of patients achieved a clinically meaningful change (BASDAI score reduced by 2 or more), and overall mean BASDAI score reduced by 3.9 points [n=43] (Mann-Whitney p<0.001). 75% (18/24) of patients achieved a reduction in spinal pain VAS by 2cm or more indicating a treatment response. Overall mean BASFI score improved by 4.1 points [n=26] (Mann-Whitney p<0.001). Conclusions Golimumab was associated with statistically significant reductions in HRU and clinically meaningful improvements in UK patients with AS during the first 6 months of treatment.