0722: Cardiovascular and Oncologic Outocomes of Anti-TNF Alfa and JAK Inhibitors in Patients with Rheumatoid and Psoriatic Arthritis. Real World Data and Insights of BIOBADASAR 3.0 Registry

Alejandro Brigante¹, Rosana Quintana², Carolina Isnardi³, Karen Roberts⁴, Gimena Gomez⁵, Maria Haye Salinas⁶, Enrique Soriano⁷, Guillermo Pons-Estel⁸, Maria De la Vega⁸, Osvaldo kerzberg⁷, Julieta Gamba⁷, Anastasia Secco⁹, Gustavo Citera¹⁰, Cesar Graf⁷, Veronica Savio¹¹, Maria de los Angeles Gallardo⁷, Nora Aste⁷, Mercedes A Garcia¹², Gustavo Casado⁷, Carla Gobbi⁷, Graciela Gomez⁷, Joan Manuel Dapeña¹³, Guillermo Berbotto⁷, Malena Viola⁷, Jonathan Rebak⁷, Diana Dubinsky⁷, Veronica Saurit¹⁴, Ingrid Petkovic⁷, Ana Bertoli⁷, Erika Catay⁷, C Leoni⁷, Ida Elena Exeni⁷, Bernardo Pons-Estel¹⁵, Sergio Paira⁷, GH Bovea Castelblanco⁷, Mercedes De la Sota⁷, Dora Pereira⁷, Gustavo Medina⁷, Amelia Granel⁷, Maria s Larroude⁷, Analia Patricia Alvarez⁷, Santiago Agüero¹⁶, Cecilia Pisoni¹⁷, Monica Sacnun⁷ and Edson Velozo¹⁸, ¹UNISAR, Lobos, Argentina, ²Centro Regional de Enfermedades Autoinmunes y Reumáticas. Grupo Oroño (GO CREAR) and Research Unit Argentine Society of Rheumatology, Buenos Aires, Argentina, ³SAR-COVID Coordinator, Research Unit Argentine Society of Rheumatology, Buenos Aires, Argentina, ⁴UNISAR, Rosario, Argentina, ⁵Sanatorio Guemes, Buenos Aires, Argentina, ⁶UNLAR, La Rioja, Argentina, ⁷On behalf of the BIOBADASAR 3.0 registry, Buenos Aires, Argentina, ⁸Argentine Society of Rheumatology, Buenos Aires, Argentina, ⁹Rivadavia Hospital, Buenos Aires, Argentina, ¹⁰Instituto de Rehabilitación Psicofísica (IREP), Buenos Aires, Argentina, ¹¹Hospital Córdoba; Consultora Integral de Salud CMP, Cordoba, Argentina, ¹²HIGA San Martin, La Plata, Argentina, ¹³Hospital General de Agudos Dr. Enrique Tornu, Buenos Aires, Argentina, ¹⁴Hospital Privado Universitario, Cordoba, Argentina, ¹⁵Grupo Oroño - Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina, ¹⁶Centro de Rehabilitación Dr Mauricio Figueroa, Catamarca, Argentina, ¹⁷CEMIC- Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina, ¹⁸SAR COVID Investigator, Caba

Background/Purpose: Major adverse cardiovascular events (MACE) and neoplasms are a concern in autoimmune diseases. RA and PsA are diseases where inflammation plays a key role in the development of the disease and the production of short- and long-term damage. TNF alpha plays a significant role in inflammation and the JAK/STAT signaling pathway is an important regulatory signaling cascades of intracellular processes, both used in the treatment of these conditions. It is extremely important to evaluate the effect of this treatments in long-term comorbidities associated with these diseases. The aim of this study is to provide real-world data on the influence of Anti-JAK, Anti-TNFa and cs-DMARDs treatment on cardiovascular events and non-melanoma cancer in patients with RA and PsA

Methods: Data from the BIOBADASAR 3.0 registry of patients diagnosed with RA and PsA (ACR-EULAR 2010 / CASPAR 2006) from June 2010 to May 2022. This data was extracted from patients treated with cs-DMARDs (control group), Anti-TNF alpha and JAK inhibitors. History of specific comorbidities and the appearance of AE were recorded. Event-free survival was evaluated by Kaplan Meier curves and the comparison between the different treatments was performed by Log Rank analysis. A p value less than 0.05 was considered statistically significant. We used R statistical package.

Results: Of a total of 6,209 patients, 4,817 (77.6%) with RA and 510 (8.2%) with PsA were studied.The overall frequency of non-melanoma cancer was 49 (2.1%) patients in the Anti-TNFa group, 6 (2.6%) in the Anti-JAK group, and 52 (2.4%) in the control group (p = 0.3). We observed a frequency of MACE of 48 (2.2%) in the Anti-TNFa group, 5 (2.37%) in the Anti-JAK group and 38 (1.84%) in the control group (p=0.6). The median time to the appearance of a MACE or cancer was 0.75 years for the APS group while in the RA group it was 3.25 years (p=0.21). Median MACE-free survival for Anti-JAK group was 0.5 years (CI95% 0.3 – NA), 1.8 years (CI95% 0.8 - 3.8) for Anti-TNFa group and it was 4.3 years (CI95% 3 - 6.5) for the control group (p=0.04).

Conclusion: In this study, we observed a higher MACE-free survival time in the group not exposed to biological drugs than in the Anti-TNFa group and lower in the Anti-JAK group with a statistically significant difference. However, these differences were not observed in the multivariate model adjusted for demographics data and comorbidities. We found no statistically significant difference in the appearance of the adverse events of interest between the RA and APS groups.

Disclosures: A. Brigante, None; R. Quintana, None; C. Isnardi, AbbVie/Abbott, Pfizer, Elea Phoenix, International League of Associations of Rheumatology; K. Roberts, None; G. Gomez, None; M. Haye Salinas, None; E. Soriano, None; G. Pons-Estel, AbbVie/Abbott, Pfizer, Elea Phoenix, International League of Associations of Rheumatology; M. De la Vega, None; O. kerzberg, None; J. Gamba, None; A. Secco, None; G. Citera, AbbVie, Amgen, Bristol Myers Squibb, Gema, Janssen, Pfizer, Sandoz, Boehringer Ingelheim; C. Graf, None; V. Savio, AbbVie/Abbott, Pfizer, Elea Phoenix, International League of Associations of Rheumatology; M. Gallardo, None; N. Aste, None; M. Garcia, None; G. Casado, None; C. Gobbi, None; G. Gomez, None; J. Dapeña, None; G. Berbotto, None; M. Viola, None; J. Rebak, None; D. Dubinsky, None; V. Saurit, None; I. Petkovic, None; A. Bertoli, None; E. Catay, None; C. Leoni, None; I. Exeni, None; B. Pons-Estel, None; S. Paira, None; G. Bovea Castelblanco, None; M. De la Sota, None; D. Pereira, None; G. Medina, None; A. Granel, None; M. Larroude, None; A. Alvarez, None; S. Agüero, None; C. Pisoni, AbbVie/Abbott, Pfizer, Elea Phoenix, International League of Associations of Rheumatology; M. Sacnun, None; E. Velozo, None.