POS0301 NO MAJOR DIFFERENCES BETWEEN PATIENTS WITH CHRONIC INFLAMMATORY RHEUMATIC DISEASE WHO UNDERWENT MONO- OR MULTISWITCHING OF BIOSIMILARS IN ROUTINE CARE (PERCEPTION STUDY)

Abstract

Background:The increasing availability of biosimilars (bsDMARDs) has created a financial incentive to encourage switching to cheaper products (“non-medical switch”) leading to different switching scenarios. While the clinical efficacy and safety of multiswitching seems to be established (1), limited data on patients’ knowledge about bsDMARDs and satisfaction with care are available.Objectives:The aim of our study was to learn more about the outcome of mono- and multiswitching scenarios in routine care with respect to patients’ attitudes towards bsDMARDs in chronic inflammatory rheumatic diseases (CIRD) such as rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA).Methods:Consecutive patients with CIRD who were planned to switch treatment of one adalimumab biosimilar (ADA-bsDMARD) to another ADA-bsDMARD were recruited. The number of previous ADA-bsDMARD categorized the patients into: monoswitch = 1 and multiswitch = >1. Demographics and standard assessments using validated outcome parameters for disease activity, physical function, and patient satisfaction with care (Leeds Satisfaction Questionnaire (LSQ) were documented. LSQ contains items on five subscales (provision of information; empathy with the patient; attitude to the patient; access to and continuity with the care giver; and technical competence) and a general satisfaction scale. Knowledge about bsDMARDs was recorded using a structured questionnaire.Results:Out of 90 patients in total, there were 42 with a monoswitch and 48 with a multiswitch scenario (Table 1). Patients were satisfied with care irrespective of the switching scenario. However, the knowledge about bsDMARDs was generally rather low (Figure 1). Less than one third of patients was able to identify correct answers about manufacturing, efficacy/safety issues, approval status and costs of bsDMARDs. However, when comparing the two switch scenarios, no differences in disease characteristics nor in satisfaction with care were found. Also the number of switches had not increased the knowledge about bsDMARDs.Table 1.Patients and disease characteristics stratified by switch scenarioVariables*Monoswitch (n=42)Multiswitch (n=48)P-WertSex, male, n (%)23 (54.7)26 (54.2)Age, years44 (14)51 (11)Rheumatoid Arthritis, n (%)14 (33.3)7 (14.6)Axial Spondyloarthritis, n (%)23 (54.8)31 (64.6)Psoriatic arthritis, n (%)5 (11.9)10 (20.8)Disease duration, years9.2 (2.5)10.6 (6.7)0.48DAS282.2 (1.2)2.9 (0.7)0.13HAQ1.2 (0.6)1.2 (0.5)0.91ASDAS2.1 (1.2)1.6 (1)0.70BASFI4.6 (2.9)3.7 (2.9)0.87Patient satisfactionLSQ-General (1-5) #3.7 (0.7)3.9 (0.6)0.58LSQ-Information (1-5)3.7 (0.6)3.6 (0.4)0.20LSQ-Empathy (1-5)3.6 (0.6)3.5 (0.5)0.57LSQ-Technical (1-5)4.1 (0.5)4.1 (0.5)0.51LSQ-Attitude (1-5)3.8 (0.7)3.9 (0.5)0.62LSQ-Access (1-5)3.7 (0.6)3.8 (0.6)0.70*values in mean (SD)# values of 1 indicate dissatisfactionConclusion:This study shows that multiswitching did not lead to reduced satisfaction with care in patients on treatment with bsDMARDs. Especially, the number of switches did have no negative impact on patients satisfaction. The observation that patients who underwent multiple switches had no more knowledge about bsDMARDs than patients who just had one switch may just be explained by the positive experience most patients had with switching.