Ab0683 What Happens in Rheumatoid Arthritis Treatment Adherence, Two Years After the Introduction of Targeted Therapy? Results From the Stratege2 Study

Background: Treatment adherence is a major challenge in chronic inflammatory rheumatic diseases. Mainly studied in rheumatoid arthritis (RA), adherence rates range from 30 to 80% 1. Given the impact of non-adherence to disease-modifying therapy among RA patients, guidelines aiming to facilitate adherence's management were published in 2019 2. These guidelines highlight the multifactorial characteristics and importance of clarifying the factors contributing to non-adherence. Additionally, an EULAR task force highlighted the importance of addressing treatment adherence in the management of difficult-to-treat RA 3. Objectives: Based on STRATEGE2 results, we investigated real-life treatment adherence in RA patients treated with methotrexate (MTX) at time of initiation of a first b/tsDMARD and during a two-year follow-up. Methods: The STRATEGE2 cohort included RA patients who have been treated with MTX for at least 3 months (M) and were eligible for the initiation of their first targeted biological (bDMARD) or synthetic (tsDMARD) therapy due to RA activity. At 3 steps (baseline, M12 and M24) patients completed the Compliance Questionnaire for Rheumatology (CQR) 4, a 19-item self-administered questionnaire specifically designed for rheumatology to assess treatment adherence. A CQR19≤80 indicates a non-adherent patient (N-Ad). The profile of N-Ad at all 3 steps were compared with the profile of patients considered adherent (Ad) at least once during these steps. In addition, participation in shared decision-making (SDM) was evaluated using a 5-point Likert scale, adapted for both patient and physician use. Results: Between Feb. 2019 and Dec. 2020, 180 RA patients were enrolled, with 100 patients having an analyzable CQR19 at all 3 steps. Patient were divided in 2 groups: 32 patients were N-Ad throughout the study and 68 were Ad at least once. At baseline, no significant difference in patient profiles (except in MTX route): 75.0% females, mean age 57.2±12.8 years, diagnosed 6.1±7.8 years previously, treatment with MTX for 4.8±5.5 years and a mean MTX dose 18.9±4.2 mg/week. B/tsDMARD management was identical for both groups with 92.0% bDMARD and 8.0% tsDMARD initiation. The evolution of the therapeutic strategy over 24 months showed no difference between the 2 groups. 55.0% of patients had at least one adaptation to their b/tsDMARD treatment and 16.0% discontinued this treatment. The mean dose of MTX decreased overall to 14.9±4.7 mg/week and only 21.0% of patients discontinued it. The main difference between the 2 groups was the significant (pConclusion: This analysis comparing the profiles of N-Ad patients to treatment throughout the study vs Ad patients at least once, identifies 2 particularities of N-Ad patients. During the 24 months follow-up period, N-Ad used MTX SC route less than Ad patients, and feel less involved in SDM, although this perception is not shared by the physician. REFERENCES: 1 Beauvais C, et al. Joint Bone Spine 2020;87(6):668-669. 2 Gossec C, et al. Joint Bone Spine 2019;86(1):13-19. 3 Nagy G, et al. Ann Rheum Dis 2021;0:1–14. 4 De Klerk E, et al. J Rheumatol 2003;30(11):2469-2475 Acknowledgements: The authors wish to acknowledge RCTs for their contribution to the statistical analysis, the investigators, centres and patients. Disclosure of Interests: Cécile Gaujoux-Viala AbbVie; Amgen; Boehringer Ingelheim, Bristol-Myers Squibb; Celgene; Eli Lilly; Galapagos; Gilead Sciences, Inc.; Janssen; Medac; Merck-Serono; Mylan; Nordic Pharma; Novartis; Pfizer; Roche; Sandoz; Sanofi; UCB Pharma and Viatrix., AbbVie; Amgen; Boehringer Ingelheim, Bristol-Myers Squibb; Celgene; Eli Lilly; Galapagos; Gilead Sciences, Inc.; Janssen; Medac; Merck-Serono; Mylan; Nordic Pharma; Novartis; Pfizer; Roche; Sandoz; Sanofi; UCB Pharma and Viatrix., Emmanuelle Dernis AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, Janssen, MSD, Nordic Pharma, Novartis, Pfizer, Roche, Roche-Chugaï, Sandoz, Sanofi and UCB Pharma., AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, Janssen, MSD, Nordic Pharma, Novartis, Pfizer, Roche, Roche-Chugaï, Sandoz, Sanofi and UCB Pharma., Eric Senbel Abbvie, Amgen, Biogen, Celltrion, Fresenius Kabi, Janssen, Lilly, MSD, Nordic Pharma, Pfizer, Roche-Chugai Sandoz and Sanofi, Abbvie, Amgen, Biogen, Celltrion, Fresenius Kabi, Janssen, Lilly, MSD, Nordic Pharma, Pfizer, Roche-Chugai Sandoz and Sanofi, Hélène Herman-Demars Nordic Pharma France, Jennifer Becker Nordic Pharma France, Agnès Courbeyrette Nordic Pharma France, René-Marc Flipo Abbvie, Amgen, Bristol-Myers Squibb, Galapagos, Janssen-Cilag, Lilly, Medac, MSD, Nordic-Pharma, Novartis, Pfizer, Roche-Chugaï, Sandoz and Sanofi-Genzyme, Abbvie, Amgen, Bristol-Myers Squibb, Galapagos, Janssen-Cilag, Lilly, Medac, MSD, Nordic-Pharma, Novartis, Pfizer, Roche-Chugaï, Sandoz and Sanofi-Genzyme.