FRI0378 DOES DRUG EFFECTIVENESS OF 2ND AND 3RD TNF INHIBITORS IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS DEPEND ON THE REASON FROM WITHDRAWAL FROM THE PREVIOUS TREATMENT? – RESULTS FROM THE EUROSPA RESEARCH COLLABORATION

Lykke Midtbøll Ørnbjerg ,Servet Akar,Lise Hyldstrup,Florenzo Iannone,Dan Nordström,Adrian Ciurea,Cecilie Heegaard Brahe,Anabela Barcelos,Carlos Sánchez-Piedra,Johan Askling,Niels Steen Krogh,Brigitte Michelsen,Ruxandra Ionescu,Daniela Di Giuseppe,Karel Pavelka,Michael J Nissen ,Žiga Rotar ,H Mann ,Maria José Santos ,Joe Sexton ,Manuel Pombo‐Suárez ,Merete Lund Hetland ,Soner Şenel ,Eirik Klami Kristianslund ,Matija Tomšič ,Gary J Macfarlane ,Kari K Eklund ,Björn Guðbjörnsson ,Cătălin Codreanu ,Anne Loft ,Irene Van Der Horst‐Bruinsma ,Árni Jón Geirsson ,Mikkel Ǿstergaard

doi:10.1136/annrheumdis-2019-eular.4960

Abstract

Background Tumour necrosis factor inhibitors (TNFi) are efficacious in patients with axial spondyloarthritis (axSpA), but some patients switch to a different TNFi because of adverse effects (AE) or lack of effect (LOE). The EuroSpA Collaboration has previously demonstrated a 1-year retention rate of 79% and 6 months LUNDEX adjusted BASDAI Objectives Firstly, to investigate retention and response rates at 6, 12 and 24 months in patients with axSpA initiating the 2nd and 3rd TNFi in clinical practice across Europe. Secondly, to investigate whether the outcomes were associated with the reason for withdrawal (AE or LOE) from the previous treatment. Methods Prospectively collected data on axSpA patients in routine care from 12 European registries were pooled. Kaplan-Meier estimation was used to investigate TNFi retention rates. LUNDEX adjusted2 response rates were calculated for BASDAI Results A total of 7953 patients initiating their 2nd TNFi and 2782 patients initiating 3rd TNFi were included. Baseline characteristics are shown in the Table. The overall retention rates for both 2nd and 3rd TNFi at 12 months were 72% (Figure). Corresponding retention rates for the individual registries ranged from 52-90% and 54-89%, respectively. In both patients who stopped 1st TNFi due to AE or LOE, 12-month retention rate for the 2nd TNFi treatment was 68%. In patients who stopped the 2nd TNFi due to AE or LOE, 12-month retention rates for the 3rd TNFi treatment were 68% and 69%, respectively. For the 2nd and 3rd TNFi, 6 months LUNDEX adjusted BASDAI Conclusion Data from 12 European countries demonstrated decreasing response rates with increasing number of previous TNFi, although with only minor difference between 2nd and 3rd. Patients who had withdrawn from the previous TNFi due to LOE had retention rates and remission rates similar to those who had withdrawn due to AE.

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