THU0137 Non-Adherence To Subcutaneous Biological Therapy in Patients with Rheumatoid Arthritis. Arco Study

Abstract

BackgroundLack of adherence to medication in rheumatoid arthritis (RA) can worsen disease activity, but data on adherence to biological drugs is scarce.ObjectivesTo evaluate RA patients adherence to the subcutaneous (SC) biological treatment prescribed by the physician during the first year of treatment.MethodsRetrospective study in RA patients ≥18 years-old from 42 Spanish hospitals, which had been prescribed a SC biological drug 12 to 18 months prior to the study visit. Data were collected from patients' clinical records and hospital pharmacy drug-dispensing logs. Adherence was evaluated through the Medication Possession Ratio (MPR) (actual number of days covered by the taken medication/theoretical number of days covered by the prescribed medication). The number of days theoretically covered was calculated considering the interval of administration of the prescribed biological drug, if induction dose was prescribed, and if there were suspension periods or changes in the dose. The actual number of days covered was calculated with the number of vials that the patient had taken from the hospital pharmacy during the study period. Non-adherence was diagnosed if MPR was ≤80%.Results364 patients were included (age 54.9 years [12.5]; 77.5% women, median RA duration 7.8 years). The initial interval of administration of the biological drug was weekly (44.2%), biweekly (39.1%) and monthly (17.3%); the median duration of the period studied was 14.8 months. For the primary analysis, 363 patients were valid, of which 52 patients were non-adherent (MPR ≤80%) to the prescribed schedule (14.3%; 95% CI: 11.1–18.3). There were no differences in adherence by age ranges, gender or other socio-demographic factors, such as level of education, smoking habit or alcohol intake, employment status, comorbidities or polypharmacy (all, p= NS). Non-adherence was less frequent in patients with a monthly administration schedule (6.4%) than in patients with a weekly (17.4%, p=0.034) or biweekly administration (14.4%, p=0.102), and slightly more frequent in those receiving induction (21.6% vs 12.5% without induction, p=0.068). No differences were observed between patients who used syringes or pen devices, or in patients who had periods of treatment interruption.ConclusionsIn RA patients, 14.3% were non-adherent to the prescribed SC biological medication during the first year of treatment, with no differences related to socio-demographic variables. Adherence was higher in those patients with monthly subcutaneous administration.AcknowledgementThe ARCO study was funded by Merck Sharp & Dohme of Spain.Disclosure of InterestNone declared

Comparative effectiveness of subcutaneous tocilizumab versus intravenous tocilizumab in a pan-European collaboration of registries

“…Adherence is reported to be lower with subcutaneous bDMARDs and more frequent dosing schedule. 28 29 Despite this, we did not find a difference in effectiveness when comparing TCZ-SC with TCZ-IV. Finally, we do not have data outside of the bDMARDs courses and thus could not explore other aspects as for example the rate of biologic-free remission between groups.…”

Persistence with Biological Disease-modifying Antirheumatic Drugs and Its Associated Resource Utilization and Costs

“…Another factor that is associated with persistence is the administration frequency: Patients using the monthly administration period had better adherence than those using more frequent dosing schedules [39]. …”

Persistence with golimumab in immune-mediated rheumatic diseases: a systematic review of real-world evidence in rheumatoid arthritis, axial spondyloarthritis, and psoriatic arthritis

“…One potential explanation is the sustained clinical efficacy and safety observed in the long-term extension of clinical trials 13–15,45. Another reason may be the monthly administration frequency;55 this point was also reflected by a retrospective multicenter observational study conducted in Spain, in which it was found that adherence was higher with a monthly administration of SC biologics compared with fortnightly or weekly administration 56. In addition, a study in axial SpA found that combination therapy of TNFis and DMARDs affects drug retention,57 while a study in RA identified the reason for persistence with biologics in RA to be multifactorial, including age, comorbidities, and patient type 58.…”