I walked around some of the RA posters and tried to come away with high-level learning points that may impact my clinical practice. Here's what I found.
Poster #597 - It doesn't matter what TNF you start with. Researchers at the Karolinska Institute found no statistically significant difference (n=6112 patients) in initial response to different bDMARDs in the Swedish Rheumatology Register.
Poster #604 - In a study of 273 patients receiving Adalimumab (ADA) and methotrexate (MTX), 106 patients were switched to SB5 (ADA biosimiliar) at 24 weeks and 111 remained on ADA. There was no difference at week 52 in ACR or EULAR responses.
Poster #634 - People in Sweden are using a lot of biosimilars.
Poster #635 - After 1 year of SC biologic therapy, about 14% of patients are non-adherent as defined by a medication possession ration (MPR) of less than 80%. Patients with monthly dosing were more adherent than those with weekly dosing. Interestingly, induction therapy was also associated with increased levels of non-adherence. Finally, longer disease duration was associated with non-adherence.
Poster #1570: Working in a cold environment increases the risk for RA with an odds ration of 1.5 to 1.7. The odds ratio adjusted for age, sex, residential area, Cigarette smoking, BMI, alcohol consumption, university education and silica exposure. This is another reason to go South in the Winter!
Poster #1540: This is a study from the United Kingdom. It focussed on the burden of RA in patients with moderate to severe disease activity who were receiving active treatment with a focus on unmet treatment needs. Patients consistently reported pain, joint stiffness, and fatigue as their three most important symptoms.
That's what resonated with me on a clinical level.
Dr. Andy Thompson is an Associate Professor at Western University and founder of Rheuminfo.com, Rheumtalks.com, and RheumReports.com.
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