Summary

Introduction: the Ricarte Soto Law (LRS) allows patients with refractory rheumatoid arthritis to access biological drugs. However, with this regulation, patients start these with high disease activity for a prolonged period, after receiving at least 3 synthetic drugs. Prior to the implementation of this law, it was not necessary to meet these requirements. Objectives: to compare the response to treatment achieved with the use of biological drugs according to activity levels at the beginning by comparing patients with biologicals before and after LRS. Methods: taking data from the Care Program for patients with rheumatoid arthritis of the UC-Christus Health Network, groups of patients who accessed biologics before and after implementation of the LRS were compared. The change in DAS28 and the categorization of disease activity according to DAS28 were analyzed. A linear regression was performed evaluating age, seropositivity and DAS28 before treatment. Results: a significant difference was found in the change of DAS28 at 6 months of treatment (p=0.02) and in the regression only with the pre-treatment DAS28 (p=0.00). Within the group of patients that required a change of biologic, the post-law patients started the therapy more active and had a greater persistence of severe activity at 6 months of treatment (11% vs 25%). Conclusions: although the level of activity at the beginning did not influence the response after 6 months of treatment, it did influence the persistence of severe activity in those who required a change of biologic.