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Optimizing biologic therapy in rheumatology: frequency and characteristics from an argentine referral centre

Girard Bosch MP, Garcia Salinas RN, Martire MV, Arturi P, Magri SJ, Giacomone D & Arturi AS

Background: Treatment strategy after achieving sustained remission in rheumatic conditions remains uncertain. Objetives: to evaluate biologic therapy treatment doses and intervals in rheumatic patients in daily practice. Methods: An observational study including consecutive patients receiving biologic treatment was carried out. Treating physicians determined whether to continue with standard or reduce dose of biologic drugs, considered as a reduction in dose or increased dosing intervals. Sociodemographic, biologic and concomitant treatments, laboratory test and clinimetric data were recorded. Descriptive analysis, variables are described as frequencies, means and medians. In the Rheumatoid Arthritis population, categorical variables were compared using Chi2, and variables with a p≤0.2 were included in multiple logistic regression models, considering dose reduction as the dependent variable. Results: 186 patients were included, 73.1% with Rheumatoid Arthritis, 10.8% Psoriatic Arthritis, 3.8% Ankylosing Spondylitis, 1.1% Lupus and 11.3% with other conditions. Of the total population, 24.7% received reduced dose of biologic therapy. Mean DAS28 of Rheumatoid Arthritis patients was 3.85 (SD 1.32), HAQ 1.1 (SD 0.7), and 35.8% had low disease activity (LDA)/ remission according to DAS28 criteria. 23.4% of Rheumatoid Arthritis patients received reduced dose, more frequently sustaining LDA/remission according to DAS28 compared to standard dose patients (54.9 vs. 28.6% p=0.001). Multivariate analysis showed a significant association with LDA/remission (OR 3.65 (IQR: 1.6-8.3) p=0.0010), and with negative Anti Citrullinated Proteins Antibodies [OR 0.1099 (IC: 0.04-0.27) p<0.0001]. Conclusion: 24.7% of this cohort received reduced dose of biologic treatment as well as 23.4% of Rheumatoid Arthritis patients, being found to be associated with lower disease activity and negative Anti Citrullinated Proteins Antibodies.