BackgroundBiological based therapies, such as subcutaneous anti-tumour necrosis factor α, including etanercept or adalimumab, or ustekinumab, an agent which targets interleukin (IL)-12 and IL-13 cytokines, has greatly improved treatment of psoriasis. Medication persistence, defined as ‘the duration of time from initiation to discontinuation of therapy’, is an important element in determining the success of any long term therapy.PurposeTo evaluate the persistence of firstline adalimumab, etanercept and ustekinumab in psoriasis.Material and methodsObservational, retrospective, longitudinal study. All adult psoriasis (Pso) patients treated with etanercept, adalimumab and ustekinumab as a firstline biological treatment were included.Persistence was calculated as the number of days from the index prescription to the date of the final dispensing or end of the observation period (September 2015). Persistence was also calculated as a dichotomous variable measured at the end of the first, second and third years of therapy (calculated over patients who started treatment 1, 2 or 3 years before the analysis, respectively).For analysis of persistence, a survival analysis with the Kaplan–Meier estimator was used. Cox regression was used to compare persistence between different drugs, and the hazard ratio was calculated.Data were collected from medical and drug dispensation records (Farmatools). Data management and statistical analyses were performed using SPSS Statistics v.15.0 (IBM, Armonk, New York, USA).Results124 patients were included (38.7% etanercept, 41.9% adalimumab and 19.4% ustekinumab). Mean ± SD age was 52.1 ± 14.5 years. 69.4% were male. Persistence rates at the first, second and third years of treatment were 83.0%, 75.0% and 60.5% for etanercept, 63.3%, 54.3% and 48.8% for adalimumab, and 90.5%, 91.8% and 88.9% for ustekinumab. Hazard ratios for comparisons were 0.20 (95% CI 0.05 to 0.84; p = 0,028) for ustekinumab versus etanercept, 0.18 (95% CI 0.045 to 0.77; p = 0.028) for ustekinumab versus adalimumab and 1.10 (95% CI 0.65 to 1.88; p = 0.720) for adalimumab versus etanercept. Estimated mean persistence time was 1.798 ± 205,1.525 ± 173 and 1.889 ± 106 days for etanercept, adalimumab and ustekinumab, respectively.ConclusionPersistence was greater in Pso patients treated with ustekinumab than those achieved with etanercept or adalimumab. Time to discontinuation was similar between adalimumab and etanercept. Less than 50% of adalimumab patients persisted by the third year.No conflict of interest.

BackgroundKnowledge of HIV+ patients about their disease and antiretroviral treatment (ART) has been associated with adherence and clinical outcomes.PurposeTo determine the degree of knowledge about disease and treatment in HIV+ patients and to analyse related variables.Material and methodsObservational, cross sectional, descriptive 5 month study. Adult HIV+ patients who were dispensed ART and signed the informed consent were selected. Data collected were sociodemographic (age, gender, nationality, education) and clinical (time on ART, naïve, CD4 count, viral load (VL) and hepatitis C virus (HCV) coinfection). Knowledge about disease/ART was assessed by a 37 item interview regarding HIV mechanism (1), transmission (15), monitoring (5) and treatment (16). Adequate knowledge was considered if >85% of answers were correct with no critical items (13) failed.Health literacy was evaluated by the SAHL-S questionnaire.Bivariate analysis was performed to identify variables associated with knowledge: χ2 test for qualitative variables and the Student’s t or the Mann-Whitney U test for quantitative variables.Results86 patients were included (80.2% male, 46.7 ± 10.3 years); 86.1% native; 58.1% unschooled.Mean CD4 was 597.3 ± 229.8; 90.7% undetectable VL; 3.5% naïve. Mean time on ART was 10.9 ± 7.3 years. 48.8% were HCV coinfected.Mean percentage of correct responses was 84.3 ± 15.9% (97.7 ± 0.2% for mechanism; 92.4 ± 0.1% for transmission; 73.5 ± 0.3% for monitoring; 83.7 ± 0.1% for treatment).64% patients did not have adequate knowledge. Most common critical errors were: attitude when a pill is missed (40.7%), VL concept (30.2%) and “believe that remove penis before ejaculation prevents transmission” (12.8%). 20.9% thought HIV+ mothers always had HIV+ babies. Regarding transmission, some believed it was possible by mosquitoes (16%), public toilets (8%) and coughing/sneezing or kissing (7%). For 10.5% there is no risk if VL is undetectable. The CD4 concept and monitoring was unknown by 34.9% and 39.5%, respectively. 7% of patients did not know their own ART, adverse reactions (23.3%) or interactions (74,4%).There was an association between lack of knowledge and age (mean difference=5.91, 95% CI 1.46 to 10.36; p = 0,02) and health literacy (OR=1.67, 95% CI 1.39 to 2.01; p = 0,02). There was a non-significant trend for non-native nationality and self-perception of knowledge.ConclusionKnowledge about disease and ART is deficient in HIV+ patients. Age and health literacy may be risk factors for a lesser degree of knowledge.No conflict of interest.

BackgroundAbiraterone is indicated for the treatment of metastatic castration-resistant prostate cancer. One of the most common side effects (affecting more than 10% of patients) associated with abiraterone is urinary tract infection (UTI).PurposeTo assess abiraterone-associated UTI prevalence in cancer patients and the potential factors that contribute to this adverse effect.Material and methodsRetrospective observational study (September 2011–September 2014). All patients on treatment for at least one cycle of 28 days with abiraterone were included. The data recorded were: age, duration of treatment with abiraterone, whether patients suffered UTI during treatment with abiraterone, the urinary pathogen and the treatment of the infection. The potential risk factors found were: pre-infection surgical manipulation of the urinary tract, previous use of antibiotics and urinary catheterization. Categorical variables were compared by Chi-square test. Multivariate analysis was performed on parameters with p < 0.10 in univariate models. The p-values <0.05 were regarded as significant.Results31 patients were included in the study. The mean duration of treatment was 195.28 days. 5 patients suffered UTI (16%).In the univariate analysis, variables related to UTI were urinary catheterization (OR = 10.67; CI 95% 1.91–59.62; p = 0.007) and surgical manipulation of the urinary tract (OR = 14.67; CI 95% 1.83–117.68; p = 0.011). In multivariate analysis, none of these factors were significantly associated with UTI (urinary catheterization: OR = 8.07; CI 95% 0.7–96.52; p = 0.099); surgical manipulation: OR = 9.17; CI 95% 0.97–87.25; p = 0.054).Nonetheless, there was a trend towards a higher risk of UTI in patients with previous urologic surgery.Abstract CP-098 Table 1 Urinary pathogenRisk factors UTI UTI- pathogen *Non typical UTI-pathogen Surgical manipulation Use of antibiotic Catheter Number of patients52 (Proteus)1 (E.coli)2335*SARM and Enterococcus ConclusionThere are patients treated with abiraterone who suffer UTI, but it is necessary to consider other possible risk factors before thinking of it as a direct side effect.References and/or AcknowledgementsHoy SM. Abiraterone acetate: a review of its use in patients with metastatic castration-resistant prostate cancer with metastatic castration-resistant prostate cancer. Drugs 2013;73:2077–91No conflict of interest.

BackgroundMultiple sclerosis is a chronic inflammatory disorder of the central nervous system. Statins have demonstrated anti-inflammatory and immunomodulatory properties in this setting. Several clinical studies of different statins, given alone or in combination with interferon, for relapsing-remitting multiple sclerosis (RRMS) have been conducted with conflicting results.PurposeTo review the efficacy and safety of statins in combination with interferon treatment in patients with RRMS.Material and methodsA systematic review of the literature and meta-analysis was performed by searching in MEDLINE, Cochrane CENTRAL Registry and EMBASE, to October 2014. Trials comparing the use of interferon alone or combined with statins in adult patients with RRMS were identified. Trials with a score ≥3 according to the Jadad scale were considered. Pooled effect was calculated for the following outcomes: risk of relapse, treatment withdrawal due to adverse effects and risk of myalgia.A DerSimonian-Laird random-effects model was used to calculate pooled Odds Ratios. Statistical heterogeneity was examined using the I2 statistic. For significant differences, publication bias was estimated by using the Rosenthal index.ResultsSix trials were included in the analysis (n = 1,484; range of follow-up = 6–36 months). The evaluated statin was simvastatin in three trials and atorvastatin in two trials. The other trial also included pravastatin, lovastatin and fluvastatin. No significant difference was found between the statin and control group regarding the risk of relapse (OR, 1.06; 95% confidence interval [CI], 0.64 to 1.74; p = 0.82), risk of myalgia (OR, 1.56; 95% CI, 0.59, 4.11; p = 0.36) or risk of withdrawal due to adverse effects (OR, 1.37; 95% CI, 0.57 to 3.30; p = 0.49). I2 test revealed that heterogeneity was low for all the analyses performed.ConclusionOur results revealed that the addition of statins to interferon treatment did not significantly affect the risk of relapse, myalgia or treatment withdrawal due to adverse effects in patients with RRMS.References and/or AcknowledgementsNo conflict of interest.

BackgroundTreatment of human immunodeficiency virus (HIV) infected patients usually involves the use of complex regimens and adverse effects. Current guidelines recommend treatment simplification in patients with effective infection control by switching from Boosted Protease Inhibitors (PI/r) to another group of drugs and by using once daily (qd) schedules where possible in order to improve tolerance and adherence.PurposeTo analyse the results of a pharmaceutical intervention program to promote the simplification of antiretroviral treatment (ART) in HIV+ eligible patients and to assess associated cost savings.Material and methodsProspective study (July 2013 to April 2014). Adult patients on ART with PI/r-based combinations for more than 6 months, undetectable viral load and no known resistance mutations for Reverse Transcriptase Inhibitors Nucleoside analogues (NNRTIs) were selected. After evaluating the patient, the pharmacist suggested switching the current regimen to a simpler one according with patient characteristics.Based on the annual cost for each combination, switch-derived savings were calculated.Results488 HIV+ patients were treated during the study period, 32% with PI/r combinations. 66 potential candidates for simplification were selected. Pharmaceutical intervention was accepted in 10 patients (15.2%). Of these, 40% were taking atazanavir, 50% lopinavir and 10% fosamprenavir. Main reason for non-acceptance was the lack of updated drug resistance studies. All patients switched, swapped an IP/r for a qd NNRTI (90% rilpivirine and 10% efavirenz). 60% of patients changed to a single tablet regimen.Overall calculated cost savings were €17,500 per year.ConclusionA pharmaceutical intervention program of antiretroviral treatment simplification led to cost savings in HIV infection treatment. However the rate of acceptance was low due to lack of updated resistance reports.References and/or AcknowledgementsNo conflict of interest.