ObjectivesBiologics are medications widely applied in the management of inflammatory rheumatic diseases. The drugs were found to be effective but their application is associated with some disadvantages. Medication with biologics is relatively expensive, and in Poland, it is carried out in specialized centers. The study was designed to evaluate various aspects of satisfaction and dissatisfaction of Polish patients treated with biologics.Material and methodsAn anonymous questionnaire was distributed in 23 Polish rheumatological centers involved in the treatment; 1212 returned questionnaires were used for analysis. Responses were received from 606 patients with rheumatoid arthritis, 427 with ankylosing spondylitis, 117 psoriatic arthritis, and 62 adult patients with juvenile idiopathic arthritis (in whom administration of the drugs had been introduced before they were 18 years old). The investigated group constituted about one-fifth of all rheumatic patients on biologics in Poland.ResultsA beneficial or very beneficial influence of the medication on the state of physical health was found mostly in patients with rheumatoid arthritis (51.3 and 30.5%) and ankylosing spondylitis (51.0 and 36.8%). Family life was improved by the treatment especially in patients with ankylosing spondylitis (40.7 and 35.6% beneficial and very beneficial, respectively), sleep quality and sexual life mostly in those with ankylosing spondylitis (beneficial/very beneficial influence 41.5/38.4, and 38.7/23.9, respectively). There was a rather small influence of biological treatment on the financial situation of the patients. In general, satisfaction with the treatment was evaluated as positive or very positive in 88% of all investigated patients.In a significant part of the patients, transportation to the medical center was considered as a disadvantage of the treatment. About one-third of the patients considered laboratory and imaging tests to be done before initiation of the medication as a difficulty, and for about 40% waiting time for qualification for the medication was a significant disadvantage. The route of drug administration was without importance for 4/5 of the patients.ConclusionsSumming up, the results were similar in the patients suffering from various diseases although those with psoriatic arthritis felt the highest satisfaction (possibly due to the positive aesthetic effect), and those with ankylosing spondylitis had significant improvement in sexual life (probably due to younger age). Relatively low satisfaction was found in patients with juvenile idiopathic arthritis. There was a small influence of medication on financial status of the patients. Application of biologics has few disadvantages and most of them are associated with the organization of health services (waiting time for the tests, transportation to the medical centers).

<b>Celem pracy</b> była ocena skuteczności i bezpieczeństwa leczenia adalimumabem (ADA), w ramach programu terapeutycznego NFZ, chorych na reumatoidalne zapalenie stawów (RZS), zesztywniające zapalenie stawów kręgosłupa (ZZSK) i łuszczycowe zapalenie stawów (ŁZS).<br /> <b>Materiał i metody</b>: Przebieg leczenia ADA analizowano w grupie 41 cho­rych (24 na RZS, 11 na ZZSK, 6 na ŁZS). Do leczenia kwalifikowano chorych wg zasad programu terapeutycznego NFZ, z dużą aktywnością choroby, pomimo dotychczas stosowanego leczenia. Adalimumab podawano podskórnie w dawce 40 mg raz na 2 tygodnie.<br /> <b>Wyniki</b>: Wśród chorych na RZS u 13 (54,2%) obserwowano adekwatną odpowiedź na leczenie: remisję u 8 osób (33,3%) i małą aktywność u 5 (20,9%), która po przerwaniu leczenia ADA utrzymywała się u 5 chorych przez średnio 4,5 miesiąca. Nieskuteczność pierwotną stwierdzono po 3 miesiącach (brak adekwatnej odpowiedzi) u 4 chorych (16,7%), po 6 miesiącach (brak remisji/małej aktywności) u 10 osób (41,7%). W okresie remisji/małej aktywności u 6 z 13 chorych obserwowano zaostrzenie RZS; u 2 z 13 chorych wystąpiła nieskuteczność wtórna. Wśród chorych na ZZSK u 1 chorego (9,1%) obserwowano nieskuteczność pierwotną. U 10 osób (90,9%) uzyskano małą aktywność choroby, która po przerwaniu leczenia ADA utrzymywała się przez średnio 5,4 miesiąca. W okresie poprawy, po przerwaniu terapii, u 8 z 10 cho­rych nastąpiło zaostrzenie; nieskuteczność wtórna wystąpiła u 1 z 10 chorych. U chorych na ŁZS małą aktywność choroby uzyskano u 5 chorych (83,3%), utrzymującą się podczas podawania leku; nieskuteczność pierwotną u 1 chorego (16,7%). W całej grupie 41 chorych leczonych ADA u 17 (41,5%) wystąpiły objawy niepożądane: infekcje dróg moczowych, oddechowych, nawracające infekcje wirusowe, zmiany skórne. Objawy te były przyczyną przerwania leczenia u 5 chorych (4 chorych na RZS i 1 chory na ZZSK). Liczba adekwatnych odpowiedzi na leczenie ADA była statystycznie istotnie większa u chorych na ZZSK niż RZS (p = 0,04). <br /> <b>Wnioski</b>: Leczenie ADA jest skuteczną i bezpieczną formą terapii u chorych na RZS, ZZSK i ŁZS, z utrzymującą się dużą aktywnością choroby oraz niereagujących na dotychczasową terapię.

S u m m a r y A Ai im m o of f t th he e s st tu ud dy y: : To investigate the effectiveness and safety of etanercept (ETA) treatment in patients with active rheumatoid arthritis (RA) and ankylosing spondylitis (AS) enrolled in the national therapeutic program. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : The study was conducted in 55 adult patients with active RA (DAS28 > 5.8) and 33 adult patients with active AS (BASDAI > 7) who were enrolled in the ETA national therapeutic program as a first (40 RA patients) or second (15 RA patients) line biological therapy. The period of observation of RA patients lasted from 3 months to 9 years, whereas in AS patients it lasted from 1 to 30 months. The safety; rate of long-term remissions and primary or secondary ineffectiveness of ETA treatment were analyzed. R Re es su ul lt ts s: : Permanent remission (over 12 months without biological therapy) occurred in a similar percentage of RA patients (5-9%) and AS patients (3-9%). There were 7 non-responders (12.7%) to the initial treatment with ETA in a group of RA patients and 3 (9%) in AS patients (NS). Secondary ineffectiveness of ETA therapy was observed in 19 (34.5%) RA patients and in 2 (6.1%) AS patients. Side effects (infections and allergic skin reactions) were relatively rare, mainly at the beginning of therapy. C Co on nc cl lu us si io on ns s: : We conclude that ETA treatment is a safe and effective form of therapy in patients with active, long-term RA previously treated with various DMARDs, and in patients with active form of AS. Primary ineffectiveness of ETA therapy is relatively rare in RA and AS patients. On the other hand, the secondary ineffectiveness of therapy in RA patients is the reason for its discontinuation in about onethird of patients after ca. 28 months of treatment.

BackgroundBiologics are still considered by patients as a new and partially enigmatic tool for management of rheumatic diseases.ObjectivesThe study was designed to evaluate educational needs and sources of knowledge in patients with rheumatic diseases treated with biologics.MethodsAnonymous questionnaires were distributed in 23 Polish rheumatological centers involved in the treatment, 1231 questionnaires were used for analysis. Responses were received from 606 patients with rheumatoid arthritis, 427 with ankylosing spondylitis, 117 psoriatic arthritis, and 62 adult patients with juvenile idiopathic arthritis (in whom administration of the drugs had been introduced before they were 18-year-old), as well as 19 ones receiving the drugs due to other musculoskeletal disorders. The investigated group constituted about one-fifth of all rheumatic patients on biologics in Poland.ResultsAlmost all the patients had learnt for the first time on biologics from their rheumatologist (93%). Few only patients had got such data from internet or from other patients. Likewise, most of the patients got majority of educational data on treatment with biologics from rheumatologist who was supervising the therapy (82%). Remaining sources included internet (8%) and other patients (5%). Relative low number of patients was educated by nurses (2%). Most of the patients (87%) were looking for more details on biological treatment. The patients with rheumatic disease lasting less than 10 yrs. were more interested in the management than those suffering longer. Most of the patients (94%) considered their rheumatologist as the main person responsible for their education on biologics. There was no difference between patients with various rheumatic diseases as well as no difference was found between female and male patients. Biological treatment attracted more interest in younger than older patients.ConclusionsEducation is still a challenge in patients receiving biologics. Most of the patients represented traditional attitude to health education, expecting almost all educational data to be provided by their physician. We were surprised that role of the nurses was found to be rather low. An increase in role of nurses seems to be the future aim of the educational efforts in Polish rheumatology.Disclosure of InterestNone declared

Objectives Biologics are medication widely applied in management of inflammatory rheumatic diseases. The drugs were found to be effective but their application is associated with some disadvantages. Medication with biologics is relatively expensive, and in Poland, it is carried out in specialized centers. The study was designed to evaluate various aspects of satisfaction and dissatisfaction of the Polish patients treated with biologics. Methods Anonymous questionnaires were distributed in 23 Polish rheumatological centers involved in the treatment, 1231 questionnaires were used for analysis. Responses were received from 606 patients with rheumatoid arthritis (RA), 427 with ankylosing spondylitis (SA), 117 psoriatic arthritis (PS), and 62 adult patients with juvenile idiopathic arthritis (JIA) (in whom administration of the drugs had been introduced before they were 18-year-old), as well as 19 ones receiving the drugs due to other musculoskeletal disorders. The investigated group constituted about one-fifth of all rheumatic patients on biologics in Poland. Results The main reasons for satisfaction were positive influence of the treatment on family life (41% RA, 41% SA, 41% PS), general physical status (51% RA, 51% SA, very positive 43% PS), mental well-being (46% RA, 47% SA, 48% JIA, very positive 43% PS), sexual life (39% SA, 38% PS, 31% RA), sleep (39% RA, 41% SA, 36% PS, 40% JIA), in smaller part of the patients it had effect on working and financial situation. In general, satisfaction of the treatment was evaluated as positive or very positive in 84% patients with RA, 72% with SA, 87% with PS and 81% with JIA. In almost half of the patients, transportation to the medical center was a disadvantage of the treatment. 79% did not consider blood sampling as a problem for them. About one-third of the patients considered laboratory and imagine tests to be done before initiation of the medication as a difficulty, and for 27-47% waiting time for qualification for the medication was a significant disadvantage. The route of drug administration was without importance for 4/5 of the patients. Conclusions Summing up, the results were similar in the patients suffering from various diseases although those with PS felt the highest satisfaction (possible due to positive aesthetic effect), and those with SA had significant improvement in sexual life (probably due to younger age). Relatively low satisfaction was found in patients with JIA. There was low influence of medication on financial status of the patients however some of them returned to work. Application of biologics has low disadvantages and most of them are associated with organization of health services (waiting time for the tests, transportation to the medical centers). Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.3923