AB0402 THERAPEUTIC ADHERENCE AND PERSISTENCE OF TOFACITINIB AND BARICITINIB IN RHEUMATOID ARTHRITIS PATIENTS IN DAILY CLINICAL PRACTICE.

Abstract

BackgroundThe use of Janus kinase inhibitors (JAKi) is approved for adults with rheumatoid arthritis (RA) with moderate to severe activity. Although there is increasing data about baricitinib and tofacitinib in daily clinical practice, data about adherence and persistence in real-life is scarce.Objectives(i) To evaluate the adherence and persistence of tofacitinib and baricitinib in RA patients in a real-life setting. (ii) To assess the influence of treatment adherence to therapeutic persistence.MethodsRetrospective longitudinal observational study that included all patients with RA who were treated with tofacitinib and/or baricitinib between 2017/10 and 2021/05 in a tertiary hospital. Demographic, clinical and pharmacological data were collected from electronic medical and pharmacy claim records. Kaplan-Meier survival analysis and log-rank test were performed to calculate and compare treatment persistence, respectively. Drug adherence was assessed with the Medication Possession Ratio (MPR). The effect of therapeutic adherence on treatment persistence was evaluated with a linear regression model.ResultsWe included 136 cases: 30 treated with tofacitinib [28.6%], 44 with baricitinib [41.9%] and 31 with both [29.5%] corresponding to 105 RA patients. In our sample 86.7% of the patients were women with a mean age (± SD) of 63 (± 13) years. At the start of treatment, patients had a mean disease activity score DAS28-ESR (± SD) of 5.1 (± 1.2) and they had previously received a median (range) of 3 (0-8) biologic agents for RA.During the study period, 40 (29.4%) and 38 (27.9%) patients treated with tofacitinib and baricitinib, respectively, discontinued the treatment.Mean treatment persistence was 363 days (95%CI=2-1.282) in tofacitinib group and 406 days (CI95%=8-1.300) in baricitinib group. There were no statistical differences in treatment survival (HR=1.01 [95CI%=0.59-1.71]; p=0.97).Mean MPR was 91% in both groups. There was no statistically significant correlation between therapeutic adherence and treatment persistence (p=0.21).ConclusionThe results showed no significant differences between treatment persistence and adherence of tofacitinib and baricitinib in our patients with rheumatoid arthritis. In our cohort, therapeutic adherence was high and it did not influence treatment persistence.Disclosure of InterestsNone declared