AB0485 Comparative efficacy of tofacitinib and biologic dmards in patients with rheumatoid arthritis with insufficient response to subcutaneous methotrexate in clinical practice

Background Tofacitinib (TOFA) – the first registered member of the group of Janus-kinase inhibitors – actively entered into practice. Some clinical trials show efficacy similar to biological DMARDs, but we still do not have enough data from the practice of post-marketing use. Objectives To evaluate the comparative effectiveness of TOFA and biological DMARDs in clinical practice. Methods Patients with RA (according to the ACR/EULAR 2010 criteria) having active disease despite treatment by subcutaneous (SC) methotrexate (MTX) were included in post-marketing observational study (REMARCA trial). The patients received a combination of MTX and biologics or TOFA. The follow-up period was 12 months. Patients received biologics in clinical practice according to national standards of care. We used SDAI as a main parameter of disease activity. Results In total 163 patients were included (81,6% females, 80,4% anti-CCP positive, 79,8 RF-positive, 74,9% with erosive disease, mean age 50,65±12,54, disease duration 30,45±41,9, BMI 27,1±5,78). All patients received SC MTX in the mean dose 22,17±3,92 mg per week, but the most of them had high activity at baseline (SDAI=32,42±14,59). After switching to a combination treatment regimen 88 patients received TNF inhibitors (70 patients – adalimumab, 18 patients – certolizumab pegol), 34 patients – abatacept (ABA), 41 patients – TOFA. Patients in the groups were comparable according to age and the main characteristics of disease severity. We found significant decrease of disease activity in every group (see table 1). In the group receiving TOFA results at 12 months were comparable with patients on anti-TNFs and significantly better than in patients on ABA. Remission (SDAI Conclusions Tofacitinib demonstrated similar efficacy in comparison to TNF inhibitors and was slightly better than abatacept in clinical practice in RA patients who did not respond to SC methotrexate. Disclosure of Interest E. Luchikhina Grant/research support from: Biocad, Speakers bureau: Abbvie, Pfizer, Biocad, D. Karateev Consultant for: Pfizer, Biocad, Egis, Novartis, Speakers bureau: Abbvie, Bristol Myers Squibb, Pfizer, Roche, Biocad, Novartis, Egis, MSD, UCB, G. Loukina: None declared, M. Borisova: None declared, N. Demidova: None declared, E. Nasonov: None declared