Journal Article

AB0483 THE IMPACT OF DELAY IN DIAGNOSIS ON BIOLOGICAL DMARD TREATMENT EFFICACY AND RETENTION RATES: REAL-LIFE DATA FROM NATIONWIDE TREASURE REGISTRY

Ates, A., Ayan, G., Kanitez, N. A., Solmaz, D., Dalkilic, E., Mercan, R., Küçükşahin, O., Ertenli, A. İ., Pehlivan, Y., Gönüllü, E., Kalyoncu, U., Coşkun, B. N., Küçük, H., Çinar, M., Kimyon, G., Yağiz, B., Kaşifoğlu, T., Kiraz, S.

2024

Overview

Background:Identifying psoriatic arthritis (PsA) poses challenges, leading to diagnostic delays that have not been thoroughly examined for their impact on the efficacy and retention rates of advanced therapies.Objectives:Our study investigates this gap within a biologic disease-modifying anti-rheumatic drug (bDMARD) registry cohort.Methods:Utilizing data from the TReasure database, a national multicenter observational database in Turkey, this study focused on 360 PsA patients who commenced bDMARD treatment after 2017. Of these, 193 individuals with known time intervals between symptom onset and diagnosis were included. Patient demographics, disease characteristics, and outcomes were gathered at baseline, first, and last visits. Patients were classified based on diagnostic delays (6, 12, or 24 months) to facilitate comparisons.Results:The mean (SD) age was 46 (12) years, the mean duration of PsO was 11 (12) years and the mean duration of PsA was 4.0 (4.9) years. Median (IQR) time between the first symptom onset and diagnosis 24 (48) months, with 70.9%, 51.3%, and 36.2% experiencing more than 6, 12, and 24-month delays, respectively. When there is dactylitis the odds of delay in diagnosis more than 6 months tends to decrease OR 0.46 (95% CI 0.21-1.05, p=0.006). The odds of delay in diagnosis more than 24 months increased with higher Charlson comorbidity index CCI (OR 1.82 (95% CI 0.89-3.68, p=0.006). Patients with delays exceeding 6 months demonstrated significant difference in change in disease activity scales and function scores at the last visit. Patients with delays exceeding 12 months and 24 months had significantly shorter times to switch compared to those with shorter delays (p=0.01 for both) (Figures 1, 2).Conclusion:The prolonged diagnostic delay observed in TReasure PsA underscores its impact: patients with delays exceeding 6 months experienced a more pronounced improvement in pain, disease activity, functionality and fatigue scores compared to baseline. Furthermore, when the delay exceeded 12 months, the time to the first bDMARD change was notably shorter.REFERENCES:NIL.Figure 1.Kaplan-meier curve for retention period on first bDMARD according to diagnostic delay of 12 monthsFigure 2.Kaplan-meier curve for retention period on first bDMARD according to diagnostic delay of 24 monthsAcknowledgements:NIL.Disclosure of Interests:None declared.

• Publisher: BMJ Publishing Group Ltd and European League Against Rheumatism,Elsevier B.V,Elsevier Limited
• Subject: biological DMARD / Comorbidity / Dactylitis / Diagnosis / Medical treatment / Observational studies/ registry / Psoriatic arthritis / Registries / Retention / Scientific Abstracts