COMPARATIVE EFFECTIVENESS OF TOFACITINIB (TF) AND ADALIMUMAB (ADA) IN PSORIATIC ARTHRITIS (PSA) PATIENTS IN REAL CLINICAL PRACTICE.

Background: Tofacitinib (TF) is an oral Janus kinase inhibitor approved for PsA treatment. It has demonstrated comparable to ADA efficacy in RCT in reducing PsA clinical symptoms 1,2. There is currently no data concerning comparative effectiveness of TF and ADA in clinical practice. The Russian PsA RegisTry (RU-PsART) collected data from 43 rheumatology centers of the Russian Federation. Objectives: to study responses to TF or ADA over a period of 6 months (mo) treatment in patients (pts) with active PsA in real clinical practice. Methods: 77 (M/F=43/34) PsA pts fulfilling the CASPAR criteria from the RU-PsART cohort were divided into two groups according to the treatment given. 41pts (M/F=24 (58.5%)/17 (41.5%), mean age 42.4±10,3 years (yrs), median (Me) PsA duration 72 [35;120] mo were treated with TF 5 mg twice daily. 36 pts (M/F=19 (52.8%)/17 (47.2%), mean age 44±11.5 yrs, Me PsA duration 59 [22;102] mo were treated with ADA 40 mg/2 weeks, subcutaneous, as a first-line bDMARD. In TF/ADA groups 89%/52.8% pts accordingly were given combination therapy with Methotrexate (MTX). At baseline (BL) and at 6 mo of therapy PsA activity by DAPSA, BASDAI, the number of pts (NPts) with dactylitis, enthesitis by LEI, BSA, HAQ were evaluated in both groups. At 6 mo of therapy the NPts who achieved remission by DAPSA (≤4)/Low activity (LA)≤14) and Minimal disease activity (MDA, 5 of 7) were calculated in both groups. M±SD, Me [Q25; Q75], Min-Max, %, t-test, Pierson-χ2, Manna-Whitney, Wilcoxon tests were performed. All p Results: At BL TF pts had higher PsA activity by DAPSA compared to ADA group: 44.2[37.8; 55.3]/35.8 [21.1; 52] accordingly (p=0.03). At 6 mo of treatment DAPSA significantly decreased in TF/ADA groups - to 11 [4,3; 17,3]/9,1[6; 19,6] (p 3% significantly reduced in the TF group: from 20 (51,3%) to 8 (26,7%) pts (p Conclusion: In real clinical practice TF and ADA demonstrated comparable effectiveness in all clinical domains of active PsA and showed equal result in achievement of MDA/LA/Remission according to DAPSA. References: [1]Mease P, Hall S, FitzGerald O, et al. N Engl J Med 2017;377:1537–50. [2]Gladman D, Rigby W, Azevedo VF, et al. N Engl J Med 2017;377:1525–36. Acknowledgments: no Disclosure of Interests: Elena Loginova Speakers bureau: Janssen, Tatiana Korotaeva Consultant of: Pfizer, MSD, Novartis, AbbVie, Celgene, JSC BIOCAD, Janssen, UCB, Lilly and Novartis-Sandoz, Speakers bureau: Pfizer, MSD, Novartis, AbbVie, Celgene, JSC BIOCAD, Janssen, UCB, Lilly and Novartis-Sandoz, ELENA GUBAR: None declared, Yulia Korsakova: None declared, Svetlana Glukhova: None declared, Elizaveta Vasilenko: None declared, Aleksey Vasilenko: None declared, Natalia Kuznetsova: None declared, Irina Patrikeeva: None declared