AB0450 REAL-WORLD USE OF JAK INHIBITORS IN RHEUMATOLOGICAL PRACTICE IN SOUTH LONDON

Background Janus Kinase inhibitors (JAKi) are targeted synthetic disease modifying anti-rheumatic drugs (tsDMARDs) used in the treatment of inflammatory arthritis. Whilst evidence for their efficacy and side-effect profile is supported by data from randomised control studies, real world lacking. Objectives The objectives study were to evaluate safety JAKi real-world clinical rheumatological practice South London region. Methods Data was collected two hospitals; St Georges University Hospitals NHS Trust (SGH; a tertiary centre) Kingston Hospital Foundation (KH; district general hospital). All rheumatology patients who prescribed between January 2017 June 2022 included analysis. Baseline patient demographic age, gender, diagnosis comorbidities. A retrospective analysis evaluated prescribing practice, drug (measured using Disease Activity Score (DAS-28)), adverse events discontinuation rates. Results total 288 analysis; 184 SGH 104 KH. average age 55.6 (range 20-82), 87% female. Baricitinib most frequently (231 patients), followed tofacitinib, filgotinib upadacitinib (49, 7 1 respectively). with seropositive rheumatoid arthritis (RA) (62%), seronegative RA (17%) (10%). 73% on tofacitinib had psoriatic arthritis, 20% RA. one overlap RA/systemic lupus erythematosus. In 53% patients, following biological DMARD (bDMARD) therapy. these patients; 32%, 13%, 5% 3% previously received 1, 2, 3 4 bDMARDs respectively. Median DAS-28 scores improved all This summarised Figure 1. frequent documented bacterial infection (25) hypercholesterolaemia (18), gastrointestinal side effects viral (15) deranged liver function tests (LFTs) [10]. These Table Adverse Number (n=231) Tofacitinib (n=49) Filgotinib (n=7) Gastrointestinal 18 0 Bacterial 19 2 Lower respiratory tract 10 Urinary 5 Genitourinary Skin Not specified Viral/fungal 15 Shingles 6 COVID-19 Upper Fungal nail Herpes Simplex Virus Biochemical abnormalities 22 Hypercholesterolaemia 14 Deranged Liver functions 8 Neutropenia Venous thromboembolism (VTE ) Other 11 died whilst therapy (8 baricitinib, tofacitinib). COVID-19, pancreatic cancer unknown cause death. Excluding deceased 77 discontinued (56 filogitinib). Mean duration 9.3 months (baricitinib), 11.7 (tofacitinib) 4.5 (filgotinib). For JAKis, inefficacy commonly reported reason (40 patients). reasons [8], LFTs [6], perceived high risk VTE [4], shingles [2] other [8]. Conclusion effective across range diagnoses analysis, including bDMARD-naïve bDMARD-refractory disease. generally well tolerated this keeping current literature. REFERENCES: NIL. Acknowledgements: Disclosure Interests Kathryn Biddle: None declared, Olivia Buckeldee: Afzal Latheef: Israa Al-Shakarchi: Nidhi Sofat Consultant of: Professor has done Consultancy work Pfizer Eli Lilly., Grant/research support from: funding Bristol Myers Squibb an Investigator-initiated been responsible research funded Pfizer, Lilly, Centrexion Merck, Sharp Dohme.