Evaluation of the performance of biological drugs in the treatment of ankylosing spondylitis: cohort study, Minas Gerais, 2018-2023.

Objectives: To assess the persistence and time until discontinuation of biological drugs used by people with ankylosing spondylitis treated in the Brazilian Unified Health System and to investigate the factors associated with them.

Methods: Data were collected from an open historical cohort between 2018 and 2023 on the administrative processes required for requesting medicines from the specialized component of pharmaceutical assistance in Minas Gerais, Brazil. Sociodemographic and clinical data and treatment history were collected. A descriptive analysis of the variables was performed. The Cox proportional hazards model was used to identify factors associated with time to discontinuation of the first biological drug. The logistic regression model was used to evaluate the factors associated with persistence at 12 and 24 months of treatment.

Results: A total of 530 participants were included, with an average age of 46 years, of which 50.0% were male. Adalimumab and golimumab were the most prescribed drugs. The mean follow-up time was 26.4 months, and the median time to discontinuation was 34 months. Persistence at 12 and 24 months was 82.0% and 63.0%. No significant differences were observed between biological drugs.

Conclusion: The analysis of persistence and time to discontinuation showed no differences between the drugs, which justified their maintenance in the first line of treatment of the protocol. Factors associated with the clinical profile of users may be related to differences in effectiveness, but more in-depth studies are needed to confirm these results, given the limitations of using administrative data in epidemiological research.