A PRELIMINARY ALGORITHM INTRODUCING IMMUNOGENICITY ASSESSMENT IN THE MANAGEMENT OF RA PATIENTS RECEIVING BIOTECHNOLOGICAL THERAPIES

Background: Clinical remission is today the treatment goal for Rheumatoid Arthritis (RA), which requires fast and assertive therapeutic decisions for a tight control of disease activity. Few objective parameters are available to guide clinical decisions, namely in switcher patients. We designed a preliminary algorithm introducing immunogenicity assessment in the current approach to RA patients receiving biotechnologic therapies. Objectives: To evaluate the concordance between the new algorithm and current clinical practice, comparing the effectiveness of “immunogenicity-based” versus “empirical-based” switches in a cohort of patients with established RA receiving biologics. Methods: EULAR therapeutic response was evaluated in 105 RA patients (naive or switchers) over one year, through GEE analysis. Serum drug trough levels were assessed by ELISA and anti-drug antibodies (ADA) by Bridging ELISA. Results: During follow-up, 48.6% of patients (Group A) had concordant therapeutic decisions. One year after the therapeutic decision, patients from Group A had a higher probability of achieving response (OR=7.91, p<0.001, 95%CI=3.27-19.13) and low disease activity (OR=9.77, p<0.001, 95%CI=4.69-20.37). Image/graph: Conclusions: Immunogenicity assessment might help to optimize therapeutic decisions, leading to a better control of disease activity with significant better clinical outcomes in RA patients receiving biotechnologic therapies. Disclosure of Interest: None DeclaredCitation: , volume 72, supplement s3, year 2013, page Session: Poster session Friday ( )