AB0400 THE PATTERN OF INTERLEUKIN-6 INHIBITORS VERSUS OTHER BIOLOGIC DRUG USE IN PATIENTS WITH RHEUMATOID ARTHRITIS IN WALES, UK: A REAL-WORLD STUDY USING ELECTRONIC HEALTH RECORDS

Background Rheumatoid arthritis (RA) guidelines highlight the importance of early treatment to reduce disease activity and prevent long term damage [1-4]. Infection risk must be considered when starting biologic therapy as infections account for significant morbidity mortality in RA [5]. Tocilizumab sarilumab are anti-interleukin-6 (IL-6) receptor antibodies also effective treating symptoms preventing progression structural [6-9]. Risk patients treated with IL-6 inhibitors have been reported [10]. However, inhibitor monotherapy has a superior efficacy than adalimumab [11]. More information is required assess real-life burden predict infection using biologics [12]. Objectives Examine pathway, factors associated drug initiation discontinuation either versus non-IL-6 modifying anti-rheumatic drugs (bDMARDs). Methods A retrospective cohort study Secure Anonymised Information Linkage databank, including primary care, secondary care rheumatology clinic records over 90% population Wales, UK. Patients initiated on first initiation, clinical outcomes hospitalisation were analysed cox regression analysis. Results Data from 4922 analysed. The majority had taken at least one conventional synthetic (csDMARD) 95.7%, (4,691/4,922) while 29.6% (1,457) went take bDMARDs. Of these, 2% (97) biologic-naïve inhibitors. Earlier bDMARDs was increasing duration (HR: 1.11, 95% CI: 1.07 1.15) younger age diagnosis, orthopaedic surgery pre-treatment kidney reduced likelihood being biologics. Previous history increased rather 1.73, 1.15 2.59). rate significantly higher bDMARDs-treated compared individuals (difference: 9.4, 1.1 15.7). Treatment failure, steroid use failure 1.64, 1.00 2.68; HR: 1.62, 1.26 2.08, respectively). No patients. Conclusion other similar demographics but different comorbidities pre- treatment; there more those who prior References [1]Drug rheumatoid arthritis. National Institute Health Care Excellence (2018) [2]Bykerk VP, Akhavan P, Hazlewood GS, Schieir O, Dooley A, Haraoui B, et al. (2012) [3]Singh JA, Saag KG, Bridges SL, Jr., Akl EA, Bannuru RR, Sullivan MC, (2015) [4]Smolen JS, Landewe R, Bijlsma J, Burmester G, Chatzidionysiou K, Dougados M, (2017) [5]Hazlewood Bombardier C, Tomlinson Thorne Bykerk Thompson (2016) [6]Nishimoto N, Hashimoto Miyasaka Yamamoto Kawai S, Takeuchi T, (2007) [7]Maini RN, Taylor PC, Szechinski Pavelka Broll Balint (2006) [8]Smolen Beaulieu Rubbert-Roth Ramos-Remus Rovensky Alecock E, (2008) [9]Jones Sebba Gu Lowenstein MB, Calvo Gomez-Reino JJ, (2010) [10]Lang VR, Englbrecht Rech Nusslein H, Manger Schuch F, [11]Gabay Emery van Vollenhoven Dikranian Alten (2013) [12]Jani Barton Hyrich K. (2019). Acknowledgements This work uses data provided by collected Service part their support held (SAIL) databank which national e-health-records research infrastructure Wales. conducted Research – UK (HDRUK) project Centre Population Wellbeing centre. Disclosure Interests Roxanne Cooksey Grant/research from: Grant Pfizer. Conducted Sanofi, Biogen Novartis., Jonathan Kennedey: None declared, Rahman Muhammad: Sinead Brophy: Ernest Choy Speakers bureau: Abbvie, Amgen, BMS, Boehringer Ingelheim, Chugai Pharma, Eli Lilly, Fresenius Kai, Galapagos, Gilead, Hospira, MSD, Novartis, Pfizer, Regeneron, Roche, Sanofi-Aventis, UCB, Consultant of: Biogen, Janssen, Sanofi-Genzyme, Bio-Cancer, Sanofi.