Background Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have a high prevalence in Spain. Currently, the initiation of treatment with biologics and evaluation of its response are based on subjective markers such as DAS28, BASDAI or non-specific biochemical markers.
Purpose Analysing the differences in the analytical, clinical and disease activity variables, in patients with rheumatic diseases who start treatment with biologics.
Material and methods It is an observational, retrospective study of patients diagnosed with RA or AS who started treatment with adalimumab (ADL), etanercept (ETN) or infliximab (INF) between 2012 and 2016. The variables analysed were: study population, baseline disease parameters (RF, ESR, CRP, HAQ, HLA-B27, ASQoL, BASFI) and disease activity (DAS28 and BASDAI). The data were collected from medical records, reports by the local Advisory Commission and ATHOS-APD® software. A descriptive statistical analysis using SPSS 17.0 software was performed.
Results Ninety-four patients were included, 49 (52.1%) with RA and 45 (47.9%) with AS. 46.8% cases were treated with ADL (n=24 RA and n=20 AS), 41.5% with ETN (n=22 RA and n=17 AS) and the remaining 11.7% with IFN (n=3 RA and n=8 AS).
In AS, 93.8% of cases that started treatment with ADA (n=15) had a positive HLA B27, 100% (n=15) at baseline with ETN and 66.7% (n=4) beginning with IFN. It is also noted that the baseline ESR was significantly higher (p=0.014) in patients who began treatment with ADL (=28.88) and ETN (=22.56) compared to IFN (=12.57) and a baseline BASDAI significantly lower in the group ADL (=6.05) versus ETN (=7.35) and INF (=7.74) (p=0.033).
For RA patients, at the start of treatment with adalimumab, 66.7% (n=14) had positive FRI, 80% (n=12) at baseline with etanercept and 100% (n=1) at the beginning of infliximab treatment. In AR no statistically significant differences were observed in any of the baseline parameters.
Conclusion The results show that the registration of clinical data allows better pharmacotherapeutics study, although periodic analyses should be performed to determine if there is an improvement in health outcomes. It would also be desirable to perform additional tests (pharmacokinetic and genetic) to validate the results obtained.
No conflict of interest
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