COVERAGE OF THE SWEDISH RHEUMATOLOGY QUALITY REGISTER: TO WHAT DEGREE ARE B/TSDMARD TREATMENTS FOR PSORIATIC ARTHRITIS RECORDED?

• In a national context, the Swedish Rheumatology Quality register (SRQ) is a major source of information on clinical data for patients treated with biological and targeted synthetic disease-modifying anti-rheumatic drug (b/tsDMARD) for rheumatic diseases. Data from SRQ are fundamental for research on drug effectiveness and safety.ObjectivesTo understand to what degree patients with psoriatic arthritis (PsA) and their dispensed b/tsDMARD treatments are recorded in the SRQ.MethodsWe identified all dispensed oral or subcutaneously administered b/tsDMARDs, approved for use in PsA, from the Swedish Prescribed Drug register (PDR, with 100% coverage) in 2018-2019. We required the patients who received the dispensation to have at least one ICD code for PsA (L405, M070, M071, M072, M073) as main diagnosis from a visit to a rheumatology or internal medicine (IM) unit in the National Patient Register (NPR) before dispensation, but no main diagnosis of rheumatoid arthritis (ICD code: M05, M06 (excluding M06.1 and M06.4), M12.3). Furthermore, to limit the assessment to patients with contemporary contact with the specialized rheumatology care, we also required at least one visit with a PsA main diagnosis from rheumatology/IM during 2017-2019. We then checked if the patients and their treatments were registered in SRQ. In a sensitivity analysis, we excluded patients with a visit in dermatology within 6 weeks prior to the first prescription of each b/tsDMARD, in order to exclude patients being prescribed the drug for cutaneous psoriasis.ResultsIn 2018-2019, a total of 7922 unique b/tsDMARD prescriptions had been dispensed to 6311 patients with PsA, having contemporary contact with the specialized rheumatology care. Of them, 5687 patients were registered in SRQ (90.1%), of which 94.4% with a PsA diagnosis and 95.5% with at least one registration of a b/tsDMARD. The coverage of the single drugs in SRQ, as compared to dispensations in PDR, ranged between 53.5% to 93.3% (69.3% to 95.8% considering only patients also in SRQ), with the tumor necrosis factor inhibitors (TNFi) having the best coverage (79.4-93.3%) (Table 1). In a sensitivity analysis, among the 5290 patients without a main diagnosis of psoriasis before start of treatment, 4919 (93%) were registered in SRQ, of which 94% with a PsA diagnosis and 96% with at least one registration of a b/tsDMARD.Table 1.coverage of the single b/tsDMARD approved for use in PsA patients in the SRQ as compared to the prescribed drug register, 2018-2019ATCDrug*Total patients in PDRPatients with the same drug in SRQPercentagePercentage only considering patients included in SRQL04AB01Etanercept2753234885.3%92.5%L04AB04Adalimumab2436193379.4%88.8%L04AB05Certolizumab pegol24321387.7%89.9%L04AB06Golimumab41839093.3%95.8%L04AA24Abatacept947377.7%83.9%L04AA32Apremilast54729453.7%69.3%L04AC10Secukinumab83365678.8%84.8%L04AC13Ixekizumab1187160.2%74%L04AC05Ustekinumab21913863%76.2%L04AA29Tofacitinib26119474.3%77%* In Sweden intravenously administered drugs are not prescribed and therefore not included in the PDR. Also, some hospitals administer ustekinumab in hospital, due to its high cost. However, all b/tsDMARDs, irrespectively of administration route, can be registered in SRQ.ConclusionThe coverage of b/tsDMARD-treated PsA patients in SRQ as compared to the PDR in Sweden is ranging between 90 and 93%, and SRQ is performing well in the registration of the single drugs, especially for TNFi. These results suggest that research studies based on data from the SRQ are representative of the Swedish b/tsDMARD-treated PsA population.Disclosure of InterestsDaniela Di Giuseppe: None declared, Ulf Lindström: None declared, Johan K Wallman Consultant of: AbbVie, Amgen, Celgene, Eli Lilly, Novartis, Grant/research support from: AbbVie, Amgen, Eli Lilly, Novartis, Pfizer, Lotta Ljung: None declared, Johan Askling Grant/research support from: Abbvie, Astra-Zeneca, BMS, Eli Lilly, MSD, Pfizer, Roche, Samsung Bioepis, Sanofi, and UCB

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