5PSQ-102 Ambulatory subcutaneous biologic therapy optimisation in rheumatology: implementation over time

• Published in: European journal of hospital pharmacy. Science and practice 2020-03, Vol.27 (Suppl 1), p.A196-A197
• Main Authors: Lorenzo Martin, S, Villacañas Palomares, MV, Barbadillo Villanueva, S, Uriarte Estefania, F, Parra Alonso, E, Colon Lopez De Dicastillo, A
• Format: Article
• Language: English
• Subjects: Drug dosages; Monoclonal antibodies; Prescription drugs; Rheumatology
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2020-eahpconf.419

Background and importanceBiologic treatment optimisation (BTO) consists of reducing the dose and/or increasing the interval between doses in patients who have maintained their therapeutic goal for at least 6 months. In 2013, our hospital created a BTO protocol for chronic inflammatory arthropathies, based on the consensus established between the Spanish Rheumatology Society and the Hospital Pharmacy Society.Aim and objectivesTo analyse the percentage development of BTO for subcutaneous biologic therapy (SBT) in patients with chronic inflammatory arthropathies, and to determine the drugs involved after implementation of the protocol.Material and methodsThis was an observational retrospective study comparing patients with chronic inflammatory arthropathies being treated with SBT and BTO in 2016 and 2019. Optimisation was defined as any prescription with a lower dose or a longer administration interval than usual. Variables measured were number of patients being treated with SBT, optimisation percentage (patients with optimised prescriptions/patients treated) and optimisation percentage for each drug (optimised prescriptions of a drug/prescriptions of that drug). Data were collected from the electronic prescription software.ResultsIn September 2016, 246 patients were treated with SBT: 22% patients had their prescription optimised. Higher percentages for optimisation were observed for tocilizumab, adalimumab and etanercept (44%, 34% and 22%, respectively). Golimumab, certolizumab and abatacept had lower percentages for optimisation (15%, 11% and 8%, respectively).In September 2019, 337 patients were treated with SBT: 32% patients had their prescription optimised, 10% more than in 2016. A higher percentage of optimisation was observed for tocilizumab, etanercept and adalimumab (55%, 45% and 44%, respectively). Golimumab, certolizumab and abatacept had a lower percentage of optimisation (32%, 27% and 27%, respectively). Optimisation of secukinumab was very limited (2016, 0%; 2019, 3%). No prescriptions for ustekinumab or sarilumab were optimised.Conclusion and relevanceThe rise in patients treated with SBT for chronic inflammatory arthropathies has been accompanied by a rise in the optimisation percentage over time, showing how rheumatologists consider BTO effective and safe. This strategy pursues the minimal effective dose with a consequent reduction in adverse events and economic savings. Optimisation was performed mainly for drugs that have been commercialise