Subcutaneous Biologics Research Articles

AB1077 Treatment Patterns and Persistence with Subcutaneous Biologic Therapies in Patients with Ankylosing Spondylitis

BackgroundAnkylosing Spondylitis (AS) is a chronic, systemic disease that predominantly affects the axial skeleton with sacroiliac joints involvement as its hallmark, causing characteristic inflammatory back pain and resulting in varying...

AB1091 Treatment Persistence with Subcutaneous Biologic Therapies in Patients with Rheumatoid Arthritis

BackgroundSubcutaneous biologic therapies are usually prescribed to patients with moderate to severe Rheumatoid Arthritis (RA), particularly in patients whose condition is not responding to conventional disease-modifying antirheumatic drugs (DMARDs).ObjectivesThe objective...

SAT0089 Cost Minimization Observational Study after Dose Optimization in A Specialized Outpatient Clinic on Subcutaneous Biological Therapy

ObjectivesTo estimate annual cost in the use of subcutaneous BT (scBT) in patients with rheumatic diseases when dose modifications are undertaken in daily practice in a specialized outpatient clinic of...

Differential management of mild-to-severe psoriasis with biologic drugs: An Italian Delphi consensus expert panel

Background: In the management of moderate-to-severe psoriasis, increasingly complex clinical scenarios necessitate practical tools for appropriate biologic therapy selection in individual patients. An Italian Delphi consensus panel provided guidance on biologic use in selected clinical scenarios.Methods: Ten experts defined statements under consideration, which were distributed as an online survey to a dermatologist panel. Plenary discussions of contentious statements were held to achieve consensus.Results: The survey was sent to 30 clinicians. After plenary discussions, consensus was reached on all 20 statements on the following topics: special populations; infections; comorbidities; immunogenicity; extra-cutaneous involvement; pregnancy; and adherence. Three statements required further discussion in order to gain consensus: use of subcutaneous biologics in mild liver impairment (final 94% agreement), use of any biologic in discoid lupus erythematosus (final 100% disagreement), and use of etanercept in patients with history of hypersensitivity reactions to drugs and/or food (final 75% disagreement).Conclusions: This Delphi expert consensus on the use of biologics in psoriasis provides practical recommendations for dermatologists to use when choosing an appropriate biologic in challenging but common clinical scenarios. More data are required to clarify clinical differences of biologic drugs used to treat psoriasis.

A critical evaluation of the role of subcutaneous abatacept in the treatment of rheumatoid arthritis: patient considerations

There are now more therapeutic options for the treatment of rheumatoid arthritis (RA) than ever before, involving a range of mechanisms of action and different routes of administration. The T-cell costimulation modulator abatacept is the first biologic therapy for RA to be available in both subcutaneous (SC) and intravenous (IV) formulations. This review evaluates the utility of SC abatacept, with a particular focus on patient-reported outcomes, including physical function, pain, fatigue, and quality of life. Practical questions relating to the clinical use of SC abatacept are also addressed, including the relevance of abatacept’s mechanism of action; whether IV and SC abatacept are comparable; if patients can easily switch from IV to SC abatacept; whether an IV loading dose is needed; and if temporary treatment interruptions or lack of concomitant methotrexate can affect efficacy or safety. Topics that are of particular concern to patients when using SC biologics, such as injection-site reactions, are also discussed. Observational data from registries and meta-analyses of clinical studies suggest comparable clinical efficacy between biologic disease-modifying antirheumatic drugs; however, such analyses rarely focus on key determinants of patient quality of life such as pain, fatigue, and physical function. The head-to-head AMPLE study is one of the first studies powered to directly compare two biologics in patients with RA. Patient-reported outcomes from year 1 of the ongoing study are evaluated, demonstrating comparable improvements in physical function, pain, fatigue, Short Form-36 Health Survey, and Routine Assessment of Patient Index Data 3 scores between SC abatacept and SC adalimumab when administered with concomitant methotrexate. In summary, the data presented herein show that the SC formulation of abatacept provides a valuable addition to the range of available therapy options for patients with RA, capable of significantly improving key patient considerations such as pain, disability, loss of function, fatigue, and quality of life.

THU0540 How Good is the Coverage and how Accurate are Exposure Data in Biologics Registers? An Assessment of the Swedish Biologics Register (ARTIS)

BackgroundBiologics registers have been established in many countries. However, the usefulness of these registers and the interpretation of results from analyses based on such data both hinge upon an understanding...

An audit of calls to a specialist nurse-led rheumatology advice line related to antibiotic treatment and biological therapies

One of the primary goals of our nurse-led telephone advice line is to enhance and support self-management of our rheumatology patients. Over the recent years, evaluation of such nurse-led advice lines has been proven to be beneficial in such areas as promotion of self-management. One potential area in promotion of self-management is the area of biological therapies among inflammatory arthropathy patients. Patients receiving biological therapies have been shown to have an increased risk of infections. In response to this, prior to commencing biological therapies, all our rheumatology patients are educated in relation to infections while prescribed biological therapies and also regarding deferral of biological therapy while receiving antibiotic treatments. An information pack, with relevant advice concerning individual biological therapy, is also given to patients. Those on intravenous (I.V.) biological infusions are advised to contact the nurse-led advice line if on antibiotic treatment during the week prior to infusion, to facilitate a potential IV biological therapy schedule adjustment. The aims of this education programme are to empower patients and promote self-management. Recently, we conducted a retrospective audit of all calls received by our nurse-led advice line, in relation to antibiotic usage over a period of 6 months, was carried out (July–Dec 2009). Recorded data included the nature of call, the number of calls received, patients’ demographics and source of call (patient, carer or primary care team). The primary objectives were to: (1) assess the calls received by the nurse-led advice line in relation to antibiotic treatment while on biological therapy and (2) promote patient confidence and encouragement to enhance self-management on biological therapies. A total of 30 calls were received relating to antibiotic treatment while on biological therapies. Twenty-seven patient calls (90 %; 9 female, 18 male) and three general practitioner (GP) calls (all female patients) were received. Twenty-four calls (80 % of all calls) related to subcutaneous biological therapies of which 12 (50 %) calls resulted in deferral of subcutaneous biologics for one dose only. Six calls concerned IV biological therapies, with no call resulted in rescheduling of IV biological therapy. In conclusion, our nurse-led advice line has been shown to be beneficial in minimising missed biological therapies while receiving antibiotic therapy. The number of calls in relation to antibiotic treatment while on biological therapies was higher than expected. However, no follow-up call was received following the advice given. Following consultation with rheumatology nurses, rheumatologists and pharmacists, a decision has been made to develop an information leaflet, giving clear explanations on management, for all patients receiving antibiotics while on biological therapies. A guidance document published by the Royal College of Nursing supports this new approach [1].

Medicines reconciliation in paediatric rheumatology patients

A number of Paediatric Rheumatology patients have methotrexate or biologics prescribed by the hospital, via a homecare company. When these patients are admitted to hospital, it was identified that these...