THU0137 Effectiveness and Adverse Reactions of Long-Term Use of Biologic Agents in Patients with Rheumatoid Arthritis: A Retrospective Study

Background Rheumatoid arthritis (RA) is an autoimmune disease with involvement of small and large joints. Biologic agents (BA) represent treatment options if disease is not controlled by DMARDs. Many questions regarding the safety of BA (especially the infections) remain unanswered. Objectives To estimate the effectiveness of BA, the adverse reactions (AR) and their severity compared to DMARDs. To search whether we can achieve better results and fewer AR when BA are administered according to EULAR guidelines, than delayed. Methods This is a retrospective study of 1.118 patients files (875 women and 243 men, mean age at disease initiation 48.2 and 47.4 years respectively). Demographic and clinical data were recorded. There were 691 incident (61.8%) and 427 prevalent cases (38.2%), while 340 patients (30.4%) received one or more BA. Disease activity was classified with DAS-28 score. All AR were categorized according to the international system CTCAE (grades 1-2 for mild/moderate reactions with local or noninvasive intervention, 3 for severe reactions that need hospitalization, 4 for life-threatening reactions and 5 for death). Effectiveness and AR of BA were analyzed, taken in to account their administration according to EULAR guidelines or not. Results Mean duration of follow-up for all patients was 47.5 months; for those received BA was 80.6 months (mean duration of BA administration 52.1 months) and for DMARDs 40.6 months. DAS-28 score before treatment was 4.97 for all patients (for BA 5.3 before and 2.84 after treatment). For patients with DMARDs, 295/1.118 achieved remission (26.4%) and 185/1.118 low disease activity (16.5%), while of those on BA, 159/340 achieved remission (46.8%) and 84/340 low activity (24.7%). Effectiveness of BA was significantly higher compared to that of DMARDs (p