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Introduction: Upadacitinib (UPA) and TNF inhibitors (TNFi) are established therapies for patients with rheumatoid arthritis (RA) [1], [2], [3], [4], [5], [6], while digital health applications (DiGA) are relatively new [7]. The prospective German UP-RISING study evaluates 24-month retention of UPA, TNFi, and DiGA use. This interim analysis reports pooled six-month results.

Methods: Adults with moderate to severe active RA initiating UPA or TNFi per label were enrolled in routine care. Patient reported outcomes included the Rheumatoid Arthritis Impact of Disease (RAID) [8], and disease activity was assessed by DAS28-CRP.

Medication beliefs were assessed at baseline using the general beliefs about medicines questionnaire (BMQ-general) [9]. Pooled outcomes were summarized without between-group comparisons.

Results: 284 patients met the inclusion- and exclusion criteria; 247 received at least one study dose (SAF population), and 245 had at least one follow-up (FAS population; mean age 54.4±13.4 years, 70.2% female, Table 1 [Tab. 1]). At baseline the mean BMQ-general Harm and Overuse sections were 2.2±0.7 and 2.6±0.7 respectively, indicating that most patients did not believe that medicines are broadly harmful or overused by rheumatologists. After 6 months of treatment 66.7% of patients were in DAS28 remission. Patients achieving or missing remission at 6 months had numerically similar beliefs in medicines at baseline as presented in the harm (2.2±0.8 and 2.2±0.6) and overuse (2.4±0.7 and 2.7±0.7) domains of BMQ-general. Patients in DAS28 remission at 6 months had lower RAID values (3.1±1.9) compared to those patients that were not in remission (4.7±2.2), which illustrates that patients benefit in terms of patient-reported outcomes. Thirty-one patients were prescribed a digital health application at baseline, primarily for chronic pain (Figure 1 [Fig. 1]). Thereof, 16 (53.3%) of 30 patients with available data documented at 1 month follow-up visit that they have been using this DiGA since the previous visit. An analysis of the adverse events was implemented for the SAF population, 36.8% reported AEs and 3.6% had SAEs.

Conclusion: Advanced therapy initiation in routine German practice led to high remission rates and improvement in RAID, with low DIGA use. Medication beliefs at baseline were not associated with DAS28 remission at 6 months. Ongoing follow-up will assess 24-month treatment retention and DiGA outcomes.

Disclosures: Johannes Knitza Consultant of Abbvie, AstraZeneca, BMS, Boehringer Ingelheim, Chugai, GAIA, Galapagos, GSK, Janssen, Eli Lilly, Novartis, Pfizer, Rheumaakademie, Sanofi, Sobi, UCB, Vila Health; Grant/research support from: Abbvie, Alfasigma, Deutsche Rheumastiftung, GSK, Vila Health.

Patrizia Sternad received consulting fees and/or speaker honoria and/or Grant/research support form: AbbVie, Alfasigma, Astra Zeneca, Biogen, BMS, Fresenius, UCB.

Daniel Bestler received speaker honoraria and/or consulting fees and/or Grant/research support from: AbbVie, Alfasigma, AMGEN, Celltrion, Fresenius Kabi, GSK, Eli Lilly, Medac, Novartis, Pfizer, UCB.

Nicolai Steinchen received speaker honoraria and/or travel expenses from: AbbVie, UCB, Eli Lilly, Sandoz, Novartis, AstraZeneca, Fresenius Kabi, Johnson & Johnson.

Sixten Gnuechtel Employee of AbbVie and may own stock or options. Katharina Jeromin Employee of AbbVie and may own stock or options. Franziska Fries Employee of AbbVie and may own stock or options.

Uta Kiltz Consultant and/or speaker honoraria from: AbbVie, Alfasigma, BMS, Chugai, Eli Lilly, Grünenthal, Hexal, Janssen, MSD, Novartis, onkowissen.de, Pfizer, Roche and UCB. Grant/research support from: Abbvie, Amgen, Biogen, Forum, GBA, GSK, Hexal, Fresenius, Novartis und Pfizer and UCB.

Acknowledgements: AbbVie funded this study, contributed to its design, participated in data collection, analysis and interpretation of data, and in writing, review, and approval of the abstract. AbbVie and the authors thank all study investigators for their contributions and all patients that participated in this study. No honoraria or payments were made for authorship. Medical writing was supported by Konrad Goetz (employee of AbbVie). Statistical analysis was provided by StatConsult and was funded by AbbVie.

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