AB0693 Patients with chronic inflammatory arthropathies treated with golimumab achieve a higher serum level of drug if used as the first or second biological drug

Abstract

Objectives: To know the influence of the order of introduction of Golimumab (GLM), on clinical efficacy in ankylosing spondylitis (AS), psoriatic arthritis (PSA) and rheumatoid arthritis (RA). Method(s): A prospective, observational study, in 46 consecutive patients with AS, APS and RA, treated with GLM. Data: epidemiological, concomitant DMARD, time of disease evolution, HLA-B27, RF and ACPA; from GLM: order of introduction, time in treatment, serum level and anti-GLM Ab. The clinical response was assessed in AS patients using BASDAI, BASFI, ASDAS-VSG. In patients with RA or peripheral APS, DAS28-VSG, DAS28-PCR and SDAI. Serum levels of GLM and anti-GLM Ab were determined by ELISA (Progenika, Grifols SA, Spain). Serum cutoff levels for serum GLM levels: 36 ng/mL and for anti-GLM Ab: UA>20 AU/mL. Samples were extracted just prior GLM administration (trough level) and stored frozen at -80degreeC until analysis. Result(s): Of 33 (72%) AS patients: 52% were males, mean age 53+/-12 years, mean BMI 28+/-4, disease mean evolution 16+/-12 years and in GLM: 1.3+/-1.1 years, 30% received DMARD, being GLM the first anti-TNF in 25%, second 37%, third 25% and fourth in 13%. The mean GLM level was 0.77+/-0.62 mg/mL and the prevalence of anti-GLM antibodies was 6%. In the 5 patients with RA and 8 with APS: 23% were men, mean age of 55+/-11 years, mean BMI 28+/-6, mean disease evolution of 10.5+/-8 years and in GLM of 2+/-1.5 years, the 85% of patients received DMARD, being GLM the first anti-TNF in 31%, second 15%, third 31% and fourth 23%. The mean GLM level was 0.703+/-0.53 mg/L. No anti-GLM Ab were detected. Conclusion(s): 1. The overall prevalence of anti-GLM Ab was 6% and 17% in AS patients. Not detecting in patients with RA or PSA. 2. Serum GLM level was higher among the patients receiving it as the 1st or 2nd anti-TNF. 3. In AS GLM as 3rd or 4th anti-TNF were able to achieve clinical remission, similar to that achieved as 1st or 2nd drug. (Table Presented).