Pos0645 real life safety and survival of targeted therapies in arthritis patients over age of 65

Background Prognosis for chronic inflammatory arthritis is drastically improved over previous decades and older patients are treated with targeted therapies (TTs) (biological or synthetic targeted therapies). Clinical trials provide mainly information about TTs in patients below the age of 65, so real-life studies are needed to provide more information about TTs in patients over 65 years of age. Objectives To compare clinical and therapeutic profile of arthritis patients undergoing TTs and to analyze safety and therapeutic survival according to different age groups. Methods We performed an observational cross-sectional study in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients, older than 40 years old, who started biological or anti-JAK therapy between 2000 and 2022 in the Rheumatology Department of HUP La Fe. A comparative analysis and a Kaplan-Meier survival analysis was performed. Results 938 patients (62% female) were included in the study, of which 20.3% are PsA, 55.6% RA and 24.1% AS, with a mean age at the beginning of treatment of 57 (10) years and a mean duration of treatment of 68 (64) months. Patients were classified according to the age at the beginning of treatment: 40-65 years and ≥ 65 years of age. 219 patients (23.3%) were over 65 years of age. In the Table 1 we show the comparative analysis between both groups. Higher proportion of arterial hypertension, diabetes mellitus and dislipemia in patients older than 65 years was observed. Using a logistic regression model, an association between conventional DMARD prescription and patients older than 65 years was found (P<0.001), being the methotrexate the most used (44.8%). Anti-TNF therapy was the most extended treatment in both groups of patients, and an association between anti-IL6 therapy and older patients than 65 years was observed (P<0.001). Previous TTs were more frequent in older patients (P=0.002) and treatment duration was lower in those patients (P<0.001). Adverse events were more commonly found in patients older than 65 years as the reason to TT discontinue (P=0.008), being infections the more frequent. Table 1. Comparative analysis of clinical profile of different age groups at the beginning of TTs. Variable 40-65 years N=719 ≥65 years N=219 P-value Mean (SD)/ n (%) Mean (SD)/ n (%) Age at diagnosis (years) 43 (11) 56 (14) < 0.001 Age at the beginning of treatment (years) 53 (7) 72 (5) < 0.001 Time from the diagnosis to the beginning of treatment (years) 10 (10) 17 (12) < 0.001 Treatment duration (months) 73 (66) 52 (52) < 0.001 Female sex 425 (59.1%) 156 (71.2%) 0.001 Diagnosis: •RA •PsA •AS 359 (49.93%) 168 (23.37%) 192 (26.7%) 163 (74.43%) 22 (10.05%) 34 (15.53%) < 0.001 < 0.001 < 0.001 Arterial hypertension 130 (29%) 84 (57.9%) < 0.001 Diabetes mellitus 47 (10.5%) 32 (22%) < 0.001 Dislipemia 124 (27.7%) 61 (42.1%) < 0.001 Malignancy 54 (13%) 27 (22.5%) 0.016 DMARD concomitant •No DMARD •Methotrexate •Leflunomide •Others 355 (49.4%) 246 (34.2%) 72 (10%) 37 (5.2%) 79 (36.1%) 98 (44.8%) 22 (10.1%) 20 (9.1%) < 0.001 0.006 0.999 0.045 Targeted therapies: •ANTI-TNF •ANTI-JAK •ANTI-IL17 •ANTI-IL6 •Others 399 (55.5%) 114 (15.9%) 84 (11.7%) 55 (7.7%) 67 (9.3%) 86 (39.3%) 33 (15.1%) 12 (5.5%) 32 (14.6%) 56 (25.6%) < 0.001 0.862 0.012 0.003 < 0.001 Continuing treatment Discontinued treatment by: Primary non-response Secondary non-response Other causes Adverse events •Infection •Malignancy 559 (77.9%) 10 (1.4%) 27 (3.8%) 57 (7.9%) 65 (9.1%) 11 (1.5%) 26 (3.6%) 158 (72.1%) 3 (1.4%) 5 (2.3%) 18 (8.2%) 35 (15.9%) 8 (3.7%) 7 (3.2%) 0.746 0.895 0.401 0.999 0.005 0.093 0.932 Conclusion The use of conventional DMARDs, adverse events as the reason of treatment suspension and lower therapeutic survival are more frequent in patients older than 65 years of age. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests None Declared.