Delay in biologic therapy and patient outcomes in patients with rheumatological conditions

Data (age, gender, diagnosis, dates of infusion therapy, flare status, impact on Activity of Daily Living (ADL), level of swelling, level of pain and stiffness) collected on patients who received abatacept infusion therapy between Aug 5, 2020 to Aug 4, 2022 was extracted from the Electronic Health Records system. Delayed versus on-time infusion therapy visits were compared with respect to observed decline in patient outcomes measures. A delay in therapy was estimated as a percentage delay (in days) from the FDA recommended schedule of administration at 0, 2, and 4 weeks, and every 4 weeks thereafter. Percentage of visits >33%, >50%, >100% and >200% delay were estimated.The visits with >100% delay showed consistently higher rates of worsened flare status (25.0% versus 10.9%), pain intensity (38.3% versus 20.9%), swelling (25.6% versus 20.2%), stiffness (31.8% versus 21.7%) and impact on ADL (12.5% versus 10.9%) compared to on-time visits. Thus, the delayed administration deviation from the labeled schedule was associated with worsened patient outcomes. A prolonged delay was associated with statistically significant negative impact across a broad range of end-points. The results can be used by rheumatology nurses to educate patients on the importance of adherence to the biologic therapy schedule so as to maximize the benefits from biologic therapies.