4CPS-041 Analysis of adherence to Janus kinase inhibitors in patients with autoimmune diseases: influencing factors and outcomes

<h3>Background and Importance</h3> Janus kinase inhibitors (JAKi) have been used for years in autoimmune diseases (AD). Adherence to these treatments is important to understand the clinical response. This study aimed to evaluate the adherence of different JAKi used in different pathologies in a real-world setting. <h3>Aim and Objectives</h3> Evaluate the adherence to treatment with JAKi in patients with AD, to determine those variables that most influence it and analyse in-depth those patients with poor adherence. <h3>Material and Methods</h3> Observational, retrospective, single-centre study was conducted between August 2017 and August 2024 in patients with JAKi. We included patients ≥14 years old, with different diagnosis: dermatological disease (alopecia areata, atopic dermatitis); rheumatological (psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, axial spondylitis); digestive (ulcerative colitis, Crohn’s disease). We excluded patients with ≤ 3 months of treatment. Sociodemographic data, adherence and treatment were evaluated. Percentages were used for categorical variables; means and standard deviations for continuous variables. <h3>Results</h3> 161 patients were included, 63.35% female, the median age was 56 years (IQR=47–63). 13% were naïve to biologics. 54.66% received upadacitinib, 34.78% baricitinib, 7.45% tofacitinib, 2.48% filgotinib and 0.62% ritlectinib. 75% were rheumatological patients, 13% digestive and 12% dermatological. The mean exposure was 13months. 70% were treated previously with anti TNFα. During the treatment with JAKi, 44 patients (31%) receive at the same time DMARD (Disease-modifying antirheumatic drugs) treatment such as methotrexate, sulfasalazine, hydroxychloroquine or leflunomide. Therefore, just 14.59% of the patients receive oral corticoids during the study. The mean adherence was 95.92% (SD±6.82). 20 patients have adherence &lt;90% (just 6 ≤80%). Analysing these patients, 16 are rheumatological (13 rheumatoid arthritis, 2 ankylosing spondylitis and 1 axial spondylitis), 3 digestive (ulcerative colitis) and 1 dermatological (atopic dermatitis). That is, 13% of rheumatologists are poor adherents, 14% digestive and 6% dermatological. Only 3 patients take the treatment twice a day (tofacitinib-ulcerative colitis). <h3>Conclusion and Relevance</h3> The majority of patients exhibited a good adherence to treatment. The use of corticosteroids can predict poor control of the disease. The least adherent were the rheumatological patients, although they were also the most prevalent with an JAKi as treatment. This study helps us to identify the patients with adherence problems and produce some pharmaceutical interventions. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest