AB0399 Real-World Experience with Tofacitinib vs Adalimumab (ADA), Etanercept (ETN) and Abatacept (ABA) in Biologic-Experienced Patients with Rheumatoid Arthritis (RA): Data from A US Administrative Claims Database

BackgroundTofacitinib is an oral JAK inhibitor for the treatment of RA. Limited real-world data exist comparing tofacitinib with biologic DMARDs (bDMARDs) in biologic-experienced (BE) RA patients (pts).ObjectivesTo compare pt characteristics, treatment patterns and costs in BE RA pts receiving tofacitinib vs ADA, ETN and ABA using US claims data.MethodsThis retrospective cohort study included pts aged ≥18 years with RA (ICD9: 714.0x–714.4x; 714.81) and ≥1 tofacitinib (identified first) or bDMARD claim in the Truven MarketScan® Commercial and Medicare Supplemental healthcare claims database (01/11/2012–31/10/2014). Pts were continuously enrolled for ≥12 months (mos) pre- /post-index and had 1 bDMARD pre-index (due to greater imbalance in number of tofacitinib/bDMARD pts with ≥2 prior bDMARDs). Monotherapy was defined as absence of select conventional synthetic DMARDs within 90 days post-index. Outcomes were treatment persistence (index refills without a 60-day gap after prescription/administration days' supply expiration), adherence (proportion of days covered [PDC]), and 12-mo pre-/post-index RA-related costs. Adjusted analyses were performed using generalized linear models, which included demography, disease status/duration and pre-index therapy variables; 12-mo pre-index costs were included for cost-related dependent variables.Results392 tofacitinib, 178 ADA, 118 ETN and 191 ABA pts met selection criteria. 12-mo pre-index bDMARD use was most common for tofacitinib (78%) vs ADA (60%), ETN (49%) and ABA (48%) pts (all p