AB0445 CHARACTERISTICS OF FIRST-LINE UPADACITINIB INITIATORS AND FACTORS CONTRIBUTING TO PRESCRIBING UPADACITINIB AS FIRST-LINE B/TSDMARD

Background EULAR guidelines recommend switching to or adding a b/tsDMARD in patients with rheumatoid arthritis (RA) who do not respond have an inadequate response csDMARDs. Traditionally, TNF inhibitors (TNFi) are prescribed as the first b/tsDMARD. In Dec 2021, upadacitinib (UPA) label US was updated restrict use those had intolerance one more TNFi. Objectives period prior UPA change (through Jan 2022), (1) compare characteristics of RA receiving initiated TNFi their b/tsDMARD, and (2) explore reasons why chosen first-line advanced therapy. Methods Using CorEvitas registry data from Aug 2019 2022, at after enrollment no history were evaluated. The patients’ providers indicated which factors (they could choose than one) contributed prescribing therapy based on medical record chart review. Results Few differences demographics, comorbidities, disease activity initiation observed between 815 initiators 142 identified. older (mean [SD] age 58.9 [12.8] vs 56.7 [13.9] yrs), higher proportion White (87% 83%), less likely be working (44% vs. 53%), private insurance (73% 68%). frequent cardiovascular (16% 10%), joint deformity (17% 12%), subcutaneous nodules (13% but anxiety/depression (29% 34%) initiators. greater severity, including mean CDAI (23.7 [14.9] 19.0 [13.0]), tender (8.4 [7.7] 6.6 [6.7]) swollen (6.1 [5.1] 4.3 [5.1]) counts, self-reported pain (54.5 [28.7] 50.3 [28.3]), morning stiffness (89% 85%). multiple csDMARDs (43% 35%), monotherapy (32% 22%) NSAIDs (53% 48%). For initiating first-line, 34 rate) major choice patient’s level (75%), progression (61%), patient preference (51%), profile (43%). These any part prescription decision 99%, 96%, 77%, 79% patients, respectively. Oral delivery contributing factor by almost all (91%) 109 that UPA. Side effects concern when deciding prescribe least 50% included this study. Conclusion real-world cohort received previously failed csDMARDs, initiate monotherapy, both physician measures compared Clinical activity, progression, influenced well preference. References NIL. Acknowledgements AbbVie authors thank study sites, investigators participated funded design, research, analysis, collection, interpretation data, review, approval abstract. All access relevant drafting, publication. No honoraria payments made for authorship. Disclosure Interests Whitney Krueger Shareholder of: full-time employee may hold stock and/or options patents, Employee Leslie Harrold shareholder CorEvitas, Speakers bureau: Bristol Myers Squibb, Consultant AbbVie, Roche, Adam Sima LLC (formerly Corrona, LLC). is supported through contracted subscriptions pharmaceutical companies. presentation collaborative effort financial support provided Thomas Eckmann Ryan Kilpatrick patents.