Switching between biological DMARDs and associated reasons in rheumatoid arthritis and spondyloarthritis treatments: TReasure study-real life data/Romatoid artrit ve spondiloartritte biyolojik DMARD'lar arasinda gecis ve nedenleri: TReasure gercek yasam verileri

Objective: To determine features of patients switching between biological (b) DMARDs in rheumatoid arthritis (RA) and spondyloarthritis (SpA) treatments and to investigate associated reasons. Methods: This multicenter, prospective, observational cohort study used the TReasure database in which web-based registration of RA and SpA patients are being performed in 15 centers across Turkey. In this study, switching rates between bDMARDs, associated reasons, and features were analyzed in patients continuing bDMARD treatments during their follow-up periods. Results: Analysis included 2115 RA patients and 3138 SpA patients, of whom 829 (39.2%) RA and 1165 (37.1%) SpA patients switched to another bDMARD and 1286 (60.8%) RA and 1973 (62.9%) SpA patients continued to receive their current therapies (continued group). Median follow-up duration was 3.7 (range: 0-58.4) years in RA patients and 3.8 (range: 0-45.1) years in SpA patients. Female proportion was higher in both RA and SpA patients in the switched group. The first bDMARD used was an anti-TNF in 60.9% of RA patients and another bDMARD in 39.1%. According to switching patterns between bDMARDs, of RA patients, 41% switched from one anti-TNF to another and 38.4% switched from one anti-TNF to a bDMARD with other mechanism of action. The main reasons for switching in both RA and SpA patients were primary or secondary ineffectiveness and side effects. Conclusion: Further data on compliance to bDMARD treatment and treatment discontinuation or switching from one bDMARD to another in rheumatologic patients are needed to improve outcomes of patients and to ensure rational use of health expenditures. Keywords: Rheumatoid arthritis, spondyloarthritis, biological DMARD, anti-TNF Amac: Bu calismada romatoid artrit (RA) ve spondiloartrit (SpA) hastalarinda tedavide kullanilan biyolojik (b) DMARD'lar arasinda gecis gosteren hastalarin ozelliklerini belirlemek ve bu gecisin nedenlerini arastirmak amaclanmistir. Yontem: Bu cok merkezli, prospektif gozlemsel kohort calismasinda Turkiye'nin farkli bolgelerinden 15 merkezde RA ve SpA hastalarinin web-tabanli kaydini yapan TReasure veritabani kullanildi. Calismada bDMARD tedavisine devam eden hastalarda takipleri sirasinda bDMARD'lar arasindaki degisim oranlari, nedenleri ve hasta ozellikleri incelendi. Bulgular: Analize 2115 RA ve 3138 SpA hastasi dahil edildi. RA hastalarinin 829'u (%39.2) ve SpA hastalarinin 1165'i (%37.1) baska bir bDMARD'a gecerken (gecis grubu) 1286 (%60.8) R