BackgroundAdherence in the treatment of rheumatoid arthritis (RA) ranges 20% to 70% in worldwide population.1 In Colombia there are no studies comparing adherence and persistence to conventional and biological treatment.ObjectivesTo determine adherence and persistence and associated factors to the treatment of conventional disease-modifying anti-rheumatic drugs (cDMARD) and biological DMARD (bDMARD) in patients with RA under real world data.MethodsWe conducted an observational, analytical retrospective cohort study from January 2015 to December 2016. The study population was 552 RA patients older than 18 years who received any cDMARD treatment in monotherapy or combined with two or more cDMARD and bDMARD (Rituximab and Tofacitinib were excluded). Clinical information was obtained from electronic clinical records and Morisky-Green test was performed during the follow-up. Univariate analysis (proportions and medians), bivariate analysis [relative risk (RR)] and multivariate analysis (logistic regression and Kaplan-Meier survival curve) were developed.ResultsEighty nine percent were women, the median age was 59 years, 50% have ≥12 years of duration of disease. Adherence for cDMARD was 61% and for bDMARD 56%. There was an association between adherence and high degree education level (adjusted RR=2.1; CI: 1.09–4.14) and non-adherence with clinical factors such as high disease activity (adjusted RR=0.41; CI: 0.22–0.75); in the cDMARD group the greatest persistence was leflunomide (mean: 631 days) followed by methotrexate (mean: 526 days) and in the bDMARD group was etanercept (mean 1577 days) and tocilizumab (mean 1064 days). Patients with social support had greater persistence in the treatment with cDMARD (adjusted HR=2.1; CI: 1.11–4.28).Abstract THU0213 – Table 1Sociodemographic, clinical and therapeutic characteristics in 552 Colombian patients with rheumatoid arthritisCharacteristicsn(%) Rheumatoid factor(+)41581 ACPA(+)15071DAS-28<2,6267492,6–3,268123,2–4,912923>58816Methotrexate28155cDMARDLeflunomide13025Sulfasalazine7114Chloroquine306bDMARDTocilizumab4124Adalimumab3822Abatacept3219Etanercept2917Infliximab148,2Golimumab116,4Certolizumab63,5IQR: interquartile range, ACPA: anti-cyclic citrullinated protein/peptide antibodiesAbstract THU0213 – Figure 1The median time of follow-up of the studied population was 822 days, IQR 429–727 days.ConclusionsIn real world data, education level and disease activity significantly impact adherence level in RA patients. Social support positively impacts the persistence of the treatment of RA patients, which suggest the implementation of care programs taking this aspect into consideration in order to improve outcomes.Reference[1] De Klerk E, van der Heijde D, Landewé R, van der Tempel H, Urquhart J, van der Linden S. Patient compliance in rheumatoid arthritis, polymyalgia rheumatica, and gout. J Rheumatol2003;(1):44–54.Disclosure of InterestNone declared
BackgroundIdiopathic inflammatory Myopathies are a group of diseases characterised by weakness due to muscle inflammation, with or without dermatological involvement, that classically includes pathognomonic findings like Gottron sign. There have been different criteria used to classify these diseases, being Peter and Bohan the most used in time, but recently the ARC/EULAR group proposed a new wat to approach the classification.ObjectivesTo compare ACR/EULAR 2017 versus Peter and Bohan criteria for Idiopathic Inflammatory Myopathy in a Colombian cohortMethodsA cross-section retrospective research was done with data collected between 2014 and 2017 from a population diagnosed with Idiopathic Myopathy according to Peter and Bohan criteria and followed up for at least six months. The new ACR/EULAR criteria were applied to each individual using the online tool (hhtp://www.imm.ki.se/biosatistics/calculators/iim). Both sets of criteria were compared using Cohen’s kappa coefficient and concordance was evaluated.ResultsData of 149 patients were obtained. Anti-Jo1 results were not available for 75% of the patients. Biopsy was available in 44,3% of patients. Biopsy results were compatible with inflammatory myopathy in 66,7% and non-compatible in 33,3%. According to Peter and Bohan criteria the diagnosis of idiopathic inflammatory myopathy was definite in 63,1% of the patients, and probable in 27,5%. Using ACR/EULAR 2017 criteria instead the diagnosis was definite in 63,1%, probable 10,1% and non-possible in 20,8%. According to the new criteria, 31 patients had polymyositis, 47 dematomyositis, 4 amyopathic dermatomyositis, 35 juvenile myositis and 1 inclusion body myositis. The concordance analysis between the two sets of criteria showed agreement of 54% (kappa 0,22 p<0,001) in the whole group, 59% (kappa 0,21 p<0,001) in adults, 32% (kappa 0,18 p=0,05) in children, 44% (kappa 0,05 p=0,3) in polymyositis and 42% (kappa 0,16 p=0,1) in dermatomyositis.ConclusionsData of 149 patients were obtained. Anti-Jo1 results were not available for 75% of the patients. Biopsy was available in 44,3% of patients. Biopsy results were compatible with inflammatory myopathy in 66,7% and non-compatible in 33,3%. According to Peter and Bohan criteria the diagnosis of idiopathic inflammatory myopathy was definite in 63,1% of the patients, and probable in 27,5%. Using ACR/EULAR 2017 criteria instead the diagnosis was definite in 63,1%, probable 10,1% and non-possible in 20,8%. According to the new criteria, 31 patients had polymyositis, 47 dematomyositis, 4 amyopathic dermatomyositis, 35 juvenile myositis and 1 inclusion body myositis. The concordance analysis between the two sets of criteria showed agreement of 54% (kappa 0,22 p<0,001) in the whole group, 59% (kappa 0,21 p<0,001) in adults, 32% (kappa 0,18 p=0,05) in children, 44% (kappa 0,05 p=0,3) in polymyositis and 42% (kappa 0,16 p=0,1) in dermatomyositis.Reference[1] I. Lundberg, et al. 2017European League Against Rheumatism/American College of Rheumatology classification criteria for adult an...
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