AB0766 Biologic Drug Preferences of Turkish Rheumatologists in Spondiloartropathy Patients with Advanced Chronic Renal Disease

Autor: R. Mercan, M. E. Tezcan, B. Yağiz, A. Ateş, O. Küçükşahin, N. S. Yasar Bilge, N. A. Kanitez, E. Gönüllü, S. Yilmaz, D. Ersözlü, D. Solmaz, T. Kaşifoğlu, B. N. Coşkun, S. S. Koca, E. Bilgin, V. Yazisiz, E. Dalkiliç, R. Yilmaz, G. Kimyon, G. Ayan, A. Erden, C. Bes, H. Emmungil, Y. Pehlivan, A. İ. Ertenli, S. Kiraz, U. Kalyoncu
Rok vydání: 2022
Předmět:
Zdroj: Annals of the Rheumatic Diseases. 81:1509.2-1510
ISSN: 1468-2060
0003-4967
DOI: 10.1136/annrheumdis-2022-eular.3042
Popis: BackgroundBiological therapies are the main treatment options for patients with active spondyloarthropathy (SpA) who do not respond to nonsteroidal anti-inflammatory drugs or conventional synthetic disease-modifying drugs. Kidney diseases are not a contraindication to biologic therapies. However, there are some safety concerns for these drugs for patients with advanced chronic kidney disease. De novo infection or recurrence of infections are the main challenges in patients with multiple comorbidities during biologic treatments. Neverthless, physicans should initiate these treatments in active and resistant diseases.ObjectivesHere, we evaluated which biologic therapies clinicians’ first option to initiate in SpA patients with advanced chronic kidney disease (CRD).MethodsTotal 140 patients of TREASURE database who fullfield axial and/or peripheral ASAS SpA criteria with glomerular filtration rate < 60 ml/dk (stage 3,4 or 5 CRD according to The National Kidney Foundation classification) were included to the study. Renal stages of the patients were evaluated when biologic therapy was initiated. Five anti-TNF (adalimumab, certolizumab, etanercept, golimumab, infliximab) and an interleukin-17A blocker (secukinumab) were on the market during the study. We evaluated physicans’ first choice for biologic therapy for patients with stage 3,4 and 5 CRD respectively.ResultsMore than two thirds of the patients had stage 3 CRD. Anti-TNF drugs were the first choice of biologic treatment in the patients with advanced CRD. Etanercept was started at most to the patients in general, in stage 3 and in stage 5 CRD groups. However, adalimumab was the first choise in stage 4 CRD. Both etanercept and adalimumab were the first drug of choise in three fourth of the stage 4 and stage 5 patients. All two patients on Il-17A blocker had stage 3 CRD (Table 1).Table 1.Drug of choise in the SpA patients with advanced chronic renal diseasesNTotal n (%)NStage 3 n (%)NStage 4 n (%)NStage 5 n (%)Adalimumab14044 (31.4)10830 (27.8)209 (45.0)125 (41.6)Etanersept52 (37.1)41 (38.0)5 (25.0)6 (50.0)Golimumab9 (6.0)7 (6.5)2 (10.0)0 (0)Infliksimab28 (20.0)23 (21.3)4 (20.0)1 (8.4)Secukinumab3 (2.1)3 (2.8)0 (0)0 (0)Sertolizumab4 (2.8)4 (3.7)0 (0)0 (0)ConclusionWe show that rheumatologists in the TREASURE group prefer to initiate anti-TNF drugs first in all advanced CRD stages. Etanercept was the first choice in these patients.References[1]Sieper J, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Ann Rheum Dis. 2009 Jun;68 Suppl 2:ii1-44. doi: 10.1136/ard.2008.104018. PMID: 19433414.[2]Antoni C, Braun J. Side effects of anti-TNF therapy: current knowledge. Clin Exp Rheumatol. 2002 Nov-Dec;20(6 Suppl 28):S152-7. PMID: 12463468.[3]Kalyoncu U, et al. Methodology of a new inflammatory arthritis registry: TReasure. Turk J Med Sci. 2018 Aug 16;48(4):856-861. doi: 10.3906/sag-1807-200. PMID: 30119164.Disclosure of InterestsNone declared
Databáze: OpenAIRE
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