POS0943 GEOGRAPHIC VARIATION OF ANKYLOSING SPONDYLITIS (AS) DIAGNOSIS AND TREATMENT IN THE UNITED STATES: A REAL-WORLD EVIDENCE STUDY

Background: AS is a chronic inflammatory immune-mediated disease primarily affecting the sacroiliac joints and spine, with prevalence of 0.2%–0.5% in United States. 1 Because radiographic features can take years to develop, diagnosis may be delayed by up 10 2 , which negatively affect patients’ function, ability work, overall quality life. Objectives: To describe geographic variations diagnostic treatment Methods: This study utilized IBM® MarketScan® Administrative Claims Database from 2014–2019. Patients (pts) ≥18 age AS, continuous medical pharmacy enrollment during calendar year, complete information period were included. Pts identified having ≥1 claim ICD-9-CM or ICD-10-CM codes for (720.0 M45.x, respectively). Two definitions used; Definition (D1): an year any provider (D2): ≥2 claims within 18 months rheumatologists. Annual rates calculated both groups; was evaluated among pts D2. Diagnosis assessed 2014–2019 at national state levels reported states where >20 received (D1 D2) respective (D2). The effect age, sex, race (surrogate HLA-B27), rheumatologist per capita on variation assessed. Results: number included ranged between 10,811–13,077 (D1) 3,775–4,901 increased over time groups, annual rate 10,000 persons D2 increasing 2.5 2014 3.5 2019 (Table 1). highest Idaho (13) Colorado (6), lowest Michigan (2). did not appear explained racial distribution, rheumatologists capita. percentage receiving advanced therapies (all FDA-approved indicated biologic disease-modifying antirheumatic drugs [bDMARDs] AS) >70% each whereas use conventional synthetic DMARDs (csDMARDs) decreased (Figure 1. next page). While opioid decreased, 37% prescribed such 2019. Percentage therapy (91) Minnesota South Carolina (69) Indiana (70). In 2019, using csDMARDs Oklahoma (33) (16) North New York, while opioids it Wisconsin (28). Conclusion: nationally, significant variability observed across that differences race, Among confirmed (D2), are decreasing although still high, high exist therapies. Rates all treatments also vary substantially states. Observed indicate opportunity further education targeted based regional need improve treatment. References: [1]Reveille JD. Am J Med Sci . 2011. 2. Deodhar A, et al. Arthritis Rheumatol 2016. Table ) diagnoses (D2 Year Number enrollees patients Prevalence rate/10,000 19,470,780 13,077 6.7 4,901 2015 15,159,118 11,863 7.8 4,278 2.8 2016 14,836,594 12,801 8.6 4,473 3.0 2017 12,618,301 10,811 3,775 2018 13,460,224 12,259 9.1 4,302 3.2 12,105,049 11,646 9.6 4,294 Acknowledgements: Medical writing services provided Alan Saltzman Fishawack Facilitate Ltd, part Health, funded AbbVie. design, conduct, financial support AbbVie participated interpretation data, review, approval abstract. No honoraria payments made authorship. Disclosure Interests: Atul Speakers bureau: Novartis, Pfizer, Consultant of: AbbVie, Eli Lilly, UCB Pharma, GlaxoSmithKline, Galapagos, Janssen, Boehringer Ingelheim, Celgene, Amgen, Grant/research from: Denise Kruzikas Shareholder Employee Lili Zhou Ana Biljan Christopher Saffore Figure