SAT0614 DOES DRUG EFFECTIVENESS OF 2ND AND 3RD TNF INHIBITORS IN PATIENTS WITH PSORIATIC ARTHRITIS DEPEND ON THE REASON FOR WITHDRAWAL FROM THE PREVIOUS TREATMENT? – RESULTS FROM THE EUROSPA RESEARCH COLLABORATION

Background Tumour necrosis factor inhibitors (TNFi) are efficacious in patients with psoriatic arthritis (PsA), but some patients switch to a different TNFi because of adverse events (AE) or lack of effect (LOE). The EuroSpA Collaboration has previously demonstrated a 1-year retention rate of 77% and 6 months LUNDEX adjusted 28-joint count Disease Activity Score (DAS28) remission rates of 45% 1 in patients with PsA initiating the first TNFi treatment. Little is known about the effectiveness of switching to a second and third TNFi in patients with PsA. Objectives Firstly, to investigate retention and remission rates at 6, 12 and 24 months in patients with PsA initiating the 2 nd and 3 rd TNFi in clinical practice across Europe. Secondly, to investigate whether the outcomes are associated with the reason for withdrawal (AE or LOE) from the previous TNFi-treatment. Methods Prospectively collected data on PsA patients in routine care from 12 European registries were pooled. Kaplan-Meier estimation was used to investigate TNFi retention rates. LUNDEX adjusted 2 remission rates were calculated for DAS28 Results A total of 4971 patients initiating their 2 nd TNFi and 1768 patients initiating their 3 rd TNFi were included. Baseline characteristics are shown in the Table. The overall retention rates for 2 nd and 3 rd TNFi at 12 months were 69% (67-70%) and 66% (64-68%), (2 nd vs 3 rd p=0.053), respectively ( Figure ). Corresponding retention rates for the individual registries ranged from 48-100% and 49-91%, respectively. If patients had stopped the 1 st TNFi due to AE or LOE, 12-month retention rates for the 2 nd TNFi treatment were 66% and 65%, respectively. In patients who stopped the 2 nd TNFi due to AE or LOE, 12-month retention rates for the 3 rd TNFi treatment were 65% and 63%, respectively. For the 2 nd and 3 rd TNFi, 6 months LUNDEX adjusted DAS28 remission rates were 35% and 27% (p Table ). Conclusion The EuroSpA Collaboration demonstrated decreasing retention and remission rates with increasing number of previous TNFi, although with only minor difference between 2 nd and 3rd. Patients who had withdrawn from the previous TNFi due to LOE had retention rates and remission rates similar to those who had withdrawn due to AE. References [1] Brahe, et al. ACR 2018 [2] Arthritis Rheum, 2006, 54(2), p:600-6 Acknowledgement Novartis Pharma AG and IQVIA for supporting the EuroSpA collaboration. Disclosure of Interests Cecilie Heegaard Brahe Grant/research support from: Unrestricted grant: Novartis, Lykke Ornbjerg Grant/research support from: Unrestricted grant: Novartis, Lennart T.H. Jacobsson Consultant for: LJ has received lecture and consulting fees from Pfizer, Abbvie, Novartis, Eli-Lily and Janssen, Michael Nissen Consultant for: AbbVie, Lilly, Novartis, and Pfizer, Eirik kristianslund: None declared, Heřman Mann Consultant for: Pfizer, Eli Lilly, Sanofi, Speakers bureau: AbbVie, Roche, Pfizer, MSD, Eli Lilly, Sanofi, Maria Jose Santos: None declared, Manuel Pombo-Suarez: None declared, Dan Nordstrom Grant/research support from: MSD, Pfizer, Consultant for: AbbVie, BMS, MSD, Novartis, Roche, Pfizer, UCB, Speakers bureau: Novartis, UCB, Ziga Rotar: None declared, Bjorn Gudbjornsson: None declared, Ediz Dalkilic Grant/research support from: MSD and Abbvie, Consultant for: MSD, Abbvie,Roche, UCB, Pfizer and Novartis, Speakers bureau: MSD, Abbvie,Roche, UCB, Pfizer and Novartis, Catalin Codreanu: None declared, Anne Gitte Loft: None declared, Ulf Lindstrom: None declared, Burkhard Moeller Consultant for: Swissmedic Human Medicines Expert Committee Member (regulatory agency), Joe Sexton: None declared, Karel Pavelka: None declared, Anabela Barcelos: None declared, Carlos Sanchez-Piedra: None declared, Kari Eklund: None declared, Matija Tomsic: None declared, Thorvardur Jon Love Consultant for: Received reimbursment from Celgene for speaking about guidelines for the treatment of psoriatic arthritis, Ismail Sari: None declared, Ruxandra Ionescu: None declared, Marleen van de Sande Grant/research support from: van Janssen, Novartis, Eli Lily, Consultant for: Novartis and Abbvie, Irene van der Horst-Bruinsma Grant/research support from: MSD, Pfizer, AbbVie, Consultant for: Abbvie, UCB, MSD, Novartis, Speakers bureau: BMS, AbbVie, Pfizer, MSD, Gareth T. Jones Grant/research support from: Have received research grants (not current) from Abbvie and Pfizer. Have received research grants (not current) from the British Society for Rheumatology, who received the funds from Abbive, Pfizer and UCB. Have received research grant (current) from the British Society for Rheumatology, who received the funds from Celgene., Florenzo Iannone Consultant for: F Iannone has received consultancy fees and/or speaker honoraria from Pfizer, AbbVie, MSD, BMS, Novartis, Lilly, UCB outside this work, Speakers bureau: F Iannone has received consultancy fees and/or speaker honoraria from Pfizer, AbbVie, MSD, BMS, Novartis, Lilly, UCB outside this work, Brigitte Michelsen: None declared, Lise Hyldstrup: None declared, Niels Steen Krogh: None declared, Mikkel Ostergaard Grant/research support from: Abbvie, Celgene, Centocor, Merck, Novartis, Consultant for: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, and UCB, Speakers bureau: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, and UCB, Merete L. Hetland Grant/research support from: BMS, MSD, AbbVie, Roche, Novartis, Biogen, Pfizer, Consultant for: Eli Lilly, Speakers bureau: Orion Pharma, Biogen, Pfizer, CellTrion, Merck, Samsung Bioepis