Ab0701 Drug Survival on First Biologic Therapy Among Elderly-Onset Rheumatoid Arthritis Pateints Compared to Young-Onset Patients: A Population-Based Cohort Study

Background: Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory joint disease leading to joint destruction. Patients can be divided according to the age of onset, and classified as elderly-onset (>60 years old) or young-onset (<60 years old). Elderly-onset patients are underrepresented in clinical trials, and treatment strategies in these patients is based on extrapolation of the recommendations for young-onset patients. Current treatment guidelines do not stipulate any preference regarding the biologic that should be used first in elderly-onset patients. Objectives: This study aims to compare the drug survival times on first biologic disease modifying anti rheumatic drugs (bDMARDs) between elderly-onset and young-onset patients. Methods: This is a retrospective cohort study based on the electronic medical records of Leumit healthcare services. We collected all data of RA patients between the years 2000-2017. RA patients were identified according to ICD-9 code 714, in addition to one of the following criteria: 1) being positive for RF or ACPA, 2) diagnosis made by a rheumatologist or, 3) at least a single purchase of conventional synthetic disease modifying anti rheumatic drug (csDMARD). Patients' demographics, comorbidities, laboratory parameters and medications' purchase data were collected. RA patients were divided into elderly-onset and young-onset and were compared according to the drug survival times on the first biologic therapy. Results: The final cohort included 3814 RA patients, 2807 (73.6%) were young-onset RA patients. Overall, bDMARDs were used more often among young-onset patients compared to elderly-onset (16.9% vs. 7.8%, p <0.001). Etanercept was associated with the longest drug survival time on first biologic among young-onset patients, and adalimumab and infliximab were associated with the longest drug survival times among elderly-onset patients. No differences were observed in drug survival times on the first bDMARD between elderly-onset and young-onset, except for abatacept and golimumab. Conclusion: Elderly-onset RA patients are treated with biologics at a lesser extent than young-onset patients, but no differences were observed in drug survival times on first bDMARD between the two groups. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.