064 Early experience with JAK inhibitor prescribing in the UK: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis (BSRBR-RA)

Background: In 2017, a new class of oral disease modifying anti-rheumatic drugs (DMARDs), janus kinase inhibitors (JAKi), were licensed for rheumatoid arthritis (RA): baricitinib and tofacitinib. They are licensed for use in patients with high disease activity, with or without methotrexate, following failure of conventional synthetic (cs) DMARDs or of at least one biologic DMARD. Patients starting JAKi were eligible for registration within the BSRBR-RA. This analysis aims to describe the baseline characteristics of patients participating in the BSRBR-RA who have received JAKi. Methods: The BSRBR-RA aims to capture exposure and outcome data in patients with RA receiving biologics, biosimiliars and targeted synthetic DMARDs. At the start of therapy, demographic and clinical data are collected. Characteristics of all patients receiving a JAKi for the first time with data recorded in the BSRBR-RA up to 18/09/2018 are described. Results: To 18/09/2018, 305 patients in the BSRBR-RA have been treated with a JAKi; 250 baricitinib and 55 tofacitinib. Twenty-eight percent of baricitinib and 9% of tofacitinib patients received a JAKi following csDMARDs, with no prior biologic exposure. Of these, 16% had a prior malignancy history. Of those with prior biologic exposure, the median number of previous biologics was 3 (IQR 2-4) and 53% had received rituximab. Forty-four percent were receiving concurrent methotrexate. Conclusion: To date, more patients starting baricitinib compared to tofacitinib have been recruited, likely owing to the later regulatory authorisation of tofacitinib. Two groups of patients are emerging; those receiving JAKi immediately following csDMARDS and those with later disease following multiple biologic DMARDs. Further recruitment and follow-up of patients receiving JAKi will allow for analysis of real-world safety and effectiveness, but differences in patient characteristics will need to be considered in comparative effectiveness analyses. Characteristics of the first 305 patients in the BSRBR-RA treated with JAKi Results are N(%) or median(IQR). DAS28(28-joint disease activity score), HAQ(health assessment questionnaire). #Comorbidities=hypertension, ischaemic heart disease, stroke, lung disease (asthma + COPD), renal disease, diabetes, depression, liver disease. Disclosures: J. Page: None. L. Kearsley-Fleet: None. R. Davies: None. K. Watson: None. M. Lunt: None. K.L. Hyrich: None.