SAT0412 Biological Therapy in Psoriatic Arthritis (PSA): Differences between Switchers and Non-Switchers

BackgroundSwitching biological therapies is becoming increasingly common in routine management of PsA patients. However, evidence in this topic is still scarce. Predictive markers for an optimal approach to the sequential prescription of biologics are lacking.ObjectivesIn a population of PsA patients, we aimed to determine differences in baseline clinical and laboratory features between switchers and non-switchers.MethodsWe conducted a retrospective analysis of the PsA patients followed at our outpatient clinic in the last 24 months. Demographic, clinical and laboratory data were collected. Severity of skin manifestations and peripheral arthritis at PsA onset were recorded using PASI and DAS28 score. Patients who changed biological therapies due to therapeutic failure (primary or secondary) or toxicity were defined as switchers.For comparison of clinical and laboratory features we used chi-square test for categorical variables and Mann-Whitney or T-Student test for continuous variables.Results58 PsA patients were included, 60.3% were women; the mean age at PsA and psoriasis (PsO) onset was 46.4 (±15) and 34.8 (±15) years, respectively. At PsA onset, 24.1% of patients had a PASI score>10 and a mean DAS of 3.76 (±1.0). Laboratory features, arthritis and extra-articular manifestations were assessed (Image). 94.8% of patients were prescribed with non-biologic DMARD therapy and 55.2% with biological therapy, after failing to respond to a classic DMARD treatment alone. Median time from diagnosis until biological therapy prescription was 25.9 (±56,5) months.Out of 32 patients prescribed with biologics, 15 (46.9%) switched to another biologic agent, mainly due to secondary failure (63.6%), primary failure (18.2%) and adverse events (13.6%). 15.65% and 3.1% of patients required 2 or 3 switches. Etarnacept was the first line agent prescribed in the majority (78.8%) of patients. Adalimumab (73.3%) and ustekinumab (50.0%) were the most used agents as second and third line biological therapies, respectively.Switchers were significantly younger at psoriasis onset (25.6 (±13.8) vs 37.4 (±13.3) years, p=0.020) and also at PsA onset (33.3 (±9.6) vs 50.0 (±13.1) years, p