OBJECTIVES: To describe the treatment regimens and persistence of use in Colombian patients diagnosed with rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS) or juvenile idiopathic arthritis (JIA) after failure of conventional disease-modifying antirheumatic drugs (DMARDs).

METHODS: Retrospective, descriptive, longitudinal study of patients with diagnosis of RA, PsA, AS, JIA follow-up in a center specialized in rheumatological diseases in Colombia. Patients who started treatment with a first biological DMARDs or tofacitinib between February 1, 2016 and December 31, 2019 were included. Demographic and clinical characteristics, and treatments were collected. Follow-up ended when patients discontinued therapy or when they completed 24 months of treatment.

RESULTS: Four hundred twenty-six patients were included, with a mean age of 51.4 years and 78.8% were women. The most frequent diagnosis was RA (71.8%). 89.9% and 77.2% of patients had respectively received conventional DMARDs and glucocorticoids in the last six months. The biological DMARDs most frequently used in treatment at baseline were rituximab (31.2%), etanercept (23.0%), and adalimumab (14.6%). 80.3% continued to receive concomitant conventional DMARDs. During a mean follow-up of 635.2 days, 12.9% were switched to other treatments, 26.3% had interruptions, and 23.9% discontinued biologic DMARDs or tofacitinib. Patients who received conventional DMARDs concomitantly were more likely to persist with biological therapy (OR:8.50; 95%CI:32.49-210.73; p<0.001).

CONCLUSIONS: Patients who fail treatment with conventional DMARDs more frequently receive rituximab, etanercept or adalimumab as advanced therapy. These patients underwent few medications switching after starting the first biological DMARD; however, a quarter interrupted or discontinued the therapy. Combination therapy with conventional DMARDs decrease probability of switching.