Treatment schemes and persistence in Colombian patients diagnosed with inflammatory arthritis after the failure of conventional disease-modifying antirheumatic drugs v1

Introduction:Inflammatory arthritis is related to disability, chronic pain, and prematuredeath. A lack of treatment persistence leads to poor control of symptoms, inflammation,and joint damage, thereby worsening quality of life. Objective: Todetermine the effectiveness of antirheumatic drug treatment and the persistenceof use in Colombian patients diagnosed with rheumatoid arthritis (RA),psoriatic arthritis (PsA), ankylosing spondyloarthritis (AS), and juvenilerheumatoid arthritis (JIA) after the failure of conventional disease-modifyingantirheumatic drugs. (cDMARDs). Methods: In this retrospectivedescriptive study, patients who were diagnosed with RA, PsA, AS, or JIA; weretreated at a center specializing in rheumatological diseases; who started theirfirst treatment with biological DMARDs (bDMARDs) or tofacitinib betweenFebruary 2016 and December 2019; and who were followed up until thediscontinuation of treatment or 24 months were evaluated. Results: A total of 426patients were included; 78.8% were women, and the mean age was 50.2±14.1 years.The majority had a diagnosis of RA (71.8%). A total of 89.9% had receivedcDMARDs, and 77.2% had received glucocorticoids. The most frequently initiatedbDMARDs were rituximab (31.2%), etanercept (23.0%), and adalimumab (14.6%). Atotal of 80.3% of patients received concomitant cDMARDs. During an averagefollow-up of 635.2±189.6 days, 12.9% of patients had changes in their treatmentregimen, 26.3% had interruptions in their treatment regimen, and 23.9%discontinued bDMARDs or tofacitinib. Patients who received concomitant cDMARDswere more likely to continue their biological therapy (odds ratio: 8.50; 95% confidenceinterval: 3.49-20.73; p<0.001). Conclusions: Follow-upevaluation of this group of patients revealed that they were treated mainlywith non-TNF-α inhibitors associated with cDMARDs, and a low proportion of thepatients had changes in therapy, although one-quarter had treatment interruptionsor discontinuations.