1
|
Lee S, Kim Y, Lee S, Lee SH, Kim Y, Jeon J, Jo J, Yoo H, Lee J, Kim T. Treatment pattern, satisfaction, and productivity loss of patients with ankylosing spondylitis treated with tumor necrosis factor inhibitors in Korea: A multicenter cross‐sectional observational study. Int J Rheum Dis 2022; 25:523-531. [PMID: 35187866 PMCID: PMC9303183 DOI: 10.1111/1756-185x.14304] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 12/17/2022]
Affiliation(s)
- Sang‐Hoon Lee
- Department of Rheumatology, Hospital at Gangdong Kyung Hee University Seoul Korea
| | - Yong‐Gil Kim
- Department of Rheumatology Asan Medical Center University of Ulsan College of Medicine Seoul Korea
| | - Seung‐Geun Lee
- Department of Rheumatology Pusan National University Hospital Pusan Korea
| | - Soo Hyun Lee
- Division of Medical Pfizer Biopharmaceuticals Group Pfizer Pharmaceuticals Korea Limited Seoul Korea
| | - Young‐Joo Kim
- Division of Medical Pfizer Biopharmaceuticals Group Pfizer Pharmaceuticals Korea Limited Seoul Korea
| | - Ja‐Young Jeon
- Division of Medical Pfizer Biopharmaceuticals Group Pfizer Pharmaceuticals Korea Limited Seoul Korea
| | - Joo‐Young Jo
- Division of Medical Pfizer Biopharmaceuticals Group Pfizer Pharmaceuticals Korea Limited Seoul Korea
| | - Hyun‐Jeong Yoo
- Division of Medical Pfizer Biopharmaceuticals Group Pfizer Pharmaceuticals Korea Limited Seoul Korea
| | - Juneyoung Lee
- Department of Biostatistics College of Medicine Korea University Seoul Korea
| | - Tae‐Hwan Kim
- Department of Rheumatology Hanyang University Hospital for Rheumatic Diseases Seoul Korea
| |
Collapse
|
2
|
Aceves-Ávila FJ, Hernández Vásquez JR, Sicsick S, Olguín Ortega MDL, Ramos Sánchez MA, Urenda Quezada A, Tinajero Nieto L, Faccin FJ, Ramírez Ramírez MA, Serra-Bonett N, Coll Muñoz AM. Not the same, but is it the same? Cycling of biologic agents in rheumatoid arthritis. Experience in the Instituto Mexicano del Seguro Social. ACTA ACUST UNITED AC 2021; 18:361-367. [PMID: 34366291 DOI: 10.1016/j.reumae.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 02/11/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Available data for biocomparable drugs are not enough to make clear decisions with respect to the potential consequences of a change for non-medical reasons in efficacy, security and inmunogenicity in patients. In the near future, options on biological treatments, biocomparable drugs, non biocomparable drugs and new chemical synthesis options will grow. Therefore, it is important to know how patients behave in persistence of treatment after a change for non- medical reasons, which already happens on a regular basis in social security institutions in Mexico. This information will help us to better understand the standard of treatment for patients with chronic immunomediated conditions. OBJECTIVE The primary objective was to measure the impact of change for non-medical reasons in patients with rheumatoid arthritis (RA) treated with an innovative biological on persistence of treatment after changing to a biocomparable drug or a non-biocomparable drug, compared with those patients staying with the innovative biological. STUDY DESIGN This is an observational study (non-interventionist) of paired cohorts, where an historic cohort obtained by review of clinical records of stable patients in which no modifications to treatment were made for at least six months is compared with two cohorts of patients whose treatments were switched to another treatment with the same therapeutic mechanism for-non-medical reasons (cycling). RESULTS We included 264 RA patients (ACR/EULAR, 2010); 132 were switched for non-medical reasons, and 132 were not switched. Two-hundred and thirty (87.1%) were female. Average age was 53.9 years, ranging from 16 to 84 years. Two-hundred and sixty-three patients were Latino (99.6%); one was Caucasian. Persistence of treatment 12 months after the change was 84.8% (85.8% in Enbrel/Infinitam, 78.9% for Remicade/Remsima). No statistical difference was found with respect to RA clinical activity measured by DAS28 12 months after the switch (P > .05). In the 134 switched patients, 20 discontinued the new treatment due to lack of efficacy of the new drug and were changed to a different drug with a different biologic target. Although no differences were found in the cohorts of switched patients with respect to DAS 28 after 12 months of use, we did find differences in the frequency of adverse events. Forty-two patients had an adverse event in the drug switch cohorts: 33 in the Enbrel-Infinitam group and 9 in the Remicade-Remsima group. CONCLUSIONS The persistence of treatment after switching from an innovative drug to a biocomparable or a non- biocomparable in RA patients did not show statistically significative differences in our cohorts, but we did find a higher number of adverse events when comparing those who were changed with those who continued on an innovative drug. Twenty patients in the switch groups had to receive a new drug with a different biological target due to lack of efficacy of the switched drug.
Collapse
Affiliation(s)
- Francisco Javier Aceves-Ávila
- Hospital General Regional No. 46, Instituto Mexicano del Seguro Social, Unidad de Investigación en Enfermedades Crónico-Degenerativas S.C, Guadalajara, Jalisco, Mexico.
| | - José Ramiro Hernández Vásquez
- Departamento clínico de Reumatología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Sandra Sicsick
- Hospital de Especialidades 71, Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social, Torreón, Coahuila, Mexico
| | - María de Lourdes Olguín Ortega
- Servicio de Reumatología, Hospital de Especialidades, Centro Médico La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - María Azucena Ramos Sánchez
- Servicio de Reumatología, Hospital de Especialidades 25, Centro Médico Nacional Noreste, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, Mexico
| | - Adelfia Urenda Quezada
- Hospital General Regional No. 1, Unidad Morelos, Instituto Mexicano del Seguro Social, Chihuahua, Chihuahua, Mexico
| | - Lizbet Tinajero Nieto
- Servicio de Reumatología, Hospital General Regional No. 1, Instituto Mexicano del Seguro Social, Querétaro, Querétaro, Mexico
| | | | | | | | | |
Collapse
|
3
|
Han X, Lobo F, Broder MS, Chang E, Gibbs SN, Ridley DJ, Yermilov I. Persistence with Early-Line Abatacept versus Tumor Necrosis Factor-Inhibitors for Rheumatoid Arthritis Complicated by Poor Prognostic Factors. JOURNAL OF HEALTH ECONOMICS AND OUTCOMES RESEARCH 2021; 8:71-78. [PMID: 34046511 PMCID: PMC8133796 DOI: 10.36469/jheor.2021.23684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/27/2021] [Indexed: 05/08/2023]
Abstract
Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by joint swelling and destruction that leads to severe disability. There are no clear guidelines regarding the order of therapies. Gathering data on treatment patterns outside of a clinical trial setting can provide useful context for clinicians. Objectives: To assess real-world treatment persistence in early-line abatacept versus tumor necrosis factor-inhibitors (TNFi) treated patients with RA complicated by poor prognostic factors (including anti-cyclic citrullinated peptide antibodies [ACPA] and rheumatoid factor [RF] seropositivity). Methods: We performed a multi-center retrospective medical record review. Adult patients with RA complicated by poor prognostic factors were treated with either abatacept or TNFis as the first biologic treatment at the clinic. Poor prognostic factors included ACPA+, RF+, increased C-reactive protein levels, elevated erythrocyte sedimentation rate levels, or presence of joint erosions. We report 12-month treatment persistence, time to discontinuation, reasons for discontinuation, and risk of discontinuation between patients on abatacept versus TNFi. Select results among the subgroup of ACPA+ and/or RF+ patients are presented. Results: Data on 265 patients (100 abatacept, 165 TNFis) were collected. At 12 months, 83% of abatacept patients were persistent versus 66.1% of TNFi patients (P=0.003). Median time to discontinuation was 1423 days for abatacept versus 690 days for TNFis (P=0.014). In adjusted analyses, abatacept patients had a lower risk of discontinuing index treatment due to disease progression (0.3 [95% confidence interval (CI): 0.1-0.6], P=0.001). Among the subgroup of ACPA+ and/or RF+ patients (55 abatacept, 108 TNFis), unadjusted 12-month treatment persistence was greater (83.6% versus 64.8%, P=0.012) and median time to discontinuation was longer (961 days versus 581 days, P=0.048) in abatacept versus TNFi patients. Discussion: Patients with RA complicated by poor prognostic factors taking abatacept, including the subgroup of patients with ACPA and RF seropositivity, had statistically significantly higher 12-month treatment persistence and a longer time to discontinuation than patients on TNFis. Conclusions: In a real-world setting, RA patients treated with abatacept were more likely to stay on treatment longer and had a lower risk of discontinuation than patients treated with TNFis.
Collapse
Affiliation(s)
- Xue Han
- Bristol-Myers Squibb Company, Health Economics and Outcomes Research, Princeton, NJ
| | - Francis Lobo
- Bristol-Myers Squibb Company, Health Economics and Outcomes Research, Princeton, NJ
| | - Michael S Broder
- Partnership for Health Analytic Research (PHAR), LLC, Beverly Hills, CA
| | - Eunice Chang
- Partnership for Health Analytic Research (PHAR), LLC, Beverly Hills, CA
| | - Sarah N Gibbs
- Partnership for Health Analytic Research (PHAR), LLC, Beverly Hills, CA
| | | | - Irina Yermilov
- Partnership for Health Analytic Research (PHAR), LLC, Beverly Hills, CA
| |
Collapse
|
4
|
Letarouilly JG, Salmon JH, Flipo RM. Factors affecting persistence with biologic treatments in patients with rheumatoid arthritis: a systematic literature review. Expert Opin Drug Saf 2021; 20:1087-1094. [PMID: 33926364 DOI: 10.1080/14740338.2021.1924146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Introduction: Biologic treatments are a milestone in the management of rheumatoid arthritis (RA) patients with an inadequate response to conventional synthetic treatments. With the increase in the number of biologic treatments, predictor factors of discontinuation are needed to choose the right treatment for the right patient.Areas covered: In this article, the factors affecting persistence with biologic treatments will be covered: factors associated with the demographic characteristics and comordidities of the patients, those with the characteristics of the disease, the biomarkers, and the adherence.Expert opinion: Seeking factors affecting persistence with biologic treatments is an important field of clinical research to offer the best management to the RA patients. Personalized medicine is the ultimate goal in this field to choose the biological therapy with the highest persistence for every patient. To achieve this goal, biomarkers could be a milestone.
Collapse
Affiliation(s)
| | - Jean-Hugues Salmon
- Department of Rheumatology, Université De Reims Champagne-Ardenne, Reims, France
| | | |
Collapse
|
5
|
Aceves-Ávila FJ, Hernández Vásquez JR, Sicsick S, Olguín Ortega MDL, Ramos Sánchez MA, Urenda Quezada A, Tinajero Nieto L, Faccin FJ, Ramírez Ramírez MA, Serra-Bonett N, Coll Muñoz AM. Not the same, but ¿is it the same? Cycling of biologic agents in rheumatoid arthritis. Experience in the Instituto Mexicano del Seguro Social. REUMATOLOGIA CLINICA 2021; 18:S1699-258X(21)00060-7. [PMID: 33931335 DOI: 10.1016/j.reuma.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/31/2020] [Accepted: 02/11/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Available data for biocomparable drugs are not enough to make clear decisions with respect to the potential consequences of a change for non-medical reasons in efficacy, security and inmunogenicity in patients. In the near future, options on biological treatments, biocomparable drugs, non biocomparable drugs and new chemical synthesis options will grow. Therefore, it is important to know how patients behave in persistence of treatment after a change for non-medical reasons, which already happens on a regular basis in social security institutions in Mexico. This information will help us to better understand the standard of treatment for patients with chronic immunomediated conditions. OBJECTIVE The primary objective was to measure the impact of change for non-medical reasons in patients with rheumatoid arthritis (RA) treated with an innovative biological on persistence of treatment after changing to a biocomparable drug or a non-biocomparable drug, compared with those patients staying with the innovative biological. STUDY DESIGN This is an observational study (non-interventionist) of paired cohorts, where an historic cohort obtained by review of clinical records of stable patients in which no modifications to treatment were made for at least six months is compared with two cohorts of patients whose treatments were switched to another treatment with the same therapeutic mechanism for-non-medical reasons (cycling). RESULTS We included 264 RA patients (ACR/EULAR, 2010); 132 were switched for non-medical reasons, and 132 were not switched. Two-hundred and thirty (87.1%) were female. Average age was 53.9years, ranging from 16 to 84years. Two-hundred and sixty-three patients were Latino (99.6%); one was Caucasian. Persistence of treatment 12months after the change was 84.8% (85.8% in Enbrel/Infinitam, 78.9% for Remicade/Remsima). No statistical difference was found with respect to RA clinical activity measured by DAS28 12months after the switch (P>.05). In the 134 switched patients, 20 discontinued the new treatment due to lack of efficacy of the new drug and were changed to a different drug with a different biologic target. Although no differences were found in the cohorts of switched patients with respect to DAS28 after 12months of use, we did find differences in the frequency of adverse events. Forty-two patients had an adverse event in the drug switch cohorts: 33 in the Enbrel-Infinitam group and 9 in the Remicade-Remsima group. CONCLUSIONS The persistence of treatment after switching from an innovative drug to a biocomparable or a non-biocomparable in RA patients did not show statistically significative differences in our cohorts, but we did find a higher number of adverse events when comparing those who were changed with those who continued on an innovative drug. Twenty patients in the switch groups had to receive a new drug with a different biological target due to lack of efficacy of the switched drug.
Collapse
Affiliation(s)
- Francisco Javier Aceves-Ávila
- Hospital General Regional No. 46, Instituto Mexicano del Seguro Social. Unidad de Investigación en Enfermedades Crónico-Degenerativas S.C, Guadalajara, Jalisco, México.
| | - José Ramiro Hernández Vásquez
- Departamento clínico de Reumatología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Sandra Sicsick
- Hospital de Espacialidades 71, Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social, Torreón, Coahuila, México
| | - María de Lourdes Olguín Ortega
- Servicio de Reumatología, Hospital de Especialidades, Centro Médico La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - María Azucena Ramos Sánchez
- Servicio de Reumatología, Hospital de Especialidades 25, Centro Médico Nacional Noreste, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, México
| | - Adelfia Urenda Quezada
- Hospital General Regional No. 1 Unidad Morelos, Instituto Mexicano del Seguro Social, Chihuahua, Chihuahua, México
| | - Lizbet Tinajero Nieto
- Servicio de Reumatología, Hospital General Regional No. 1, Instituto Mexicano del Seguro Social, Querétaro, Querétaro, México
| | | | | | | | | |
Collapse
|
6
|
Koo BS, Lim YC, Lee MY, Jeon JY, Yoo HJ, Oh IS, Shin JY, Kim TH. The risk factors and incidence of major infectious diseases in patients with ankylosing spondylitis receiving tumor necrosis factor inhibitors. Mod Rheumatol 2021; 31:1192-1201. [PMID: 33494621 DOI: 10.1080/14397595.2021.1878985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study aimed to evaluate the risk factor and incidence of infections in patients receiving tumor necrosis factor inhibitor (TNFi) therapy for ankylosing spondylitis using data from the national health insurance service. METHODS This was a retrospective cohort study. Data regarding patients with ankylosing spondylitis prescribed TNFis were obtained from an insurance claims database of the Health Insurance Review & Assessment Service in Korea. Outcomes used were incidence rates of serious infection, pneumonia, tuberculosis, and herpes zoster during the follow-up period as well as the relationship between each TNFi and sex, hazard ratio (HR) of infection-related risk factors, and incidence of infections. RESULTS A total of 2515 patients were included. There were no significant differences among the hazard ratios of TNFis for serious infection, pneumonia, and herpes zoster. However, the hazard ratio of tuberculosis was significantly higher for infliximab than for etanercept (adjusted HR 8.40 [95% confidence interval: 1.06-66.91]). In the subgroup analysis by sex, women treated with golimumab had a significantly higher hazard of herpes zoster than those treated with etanercept (adjusted HR 12.40 [95% confidence interval: 1.40-109.58]). CONCLUSION We recommend that risk factors for these infectious diseases be identified prior to prescribing TNFis in these patients.
Collapse
Affiliation(s)
- Bon San Koo
- Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Yu-Cheol Lim
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, Korea
| | | | | | | | - In-Sun Oh
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, Korea
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, Korea
| | - Tae-Hwan Kim
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
| |
Collapse
|
7
|
Kim TH, Lee SS, Park W, Song YW, Suh CH, Kim S, Lee YN, Yoo DH. A 5-year Retrospective Analysis of Drug Survival, Safety, and Effectiveness of the Infliximab Biosimilar CT-P13 in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis. Clin Drug Investig 2020; 40:541-553. [DOI: 10.1007/s40261-020-00907-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
8
|
Park JA, Lee MY, Nam JH, Shin JY, Wood R, Holbrook T, Kwon SH. Real-world treatment persistence of non-tumor necrosis factor inhibitors versus tumor necrosis factor inhibitors among patients with rheumatoid arthritis in South Korea. Curr Med Res Opin 2020; 36:343-351. [PMID: 31670976 DOI: 10.1080/03007995.2019.1688271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Aims: We aimed to assess treatment persistence of tumor necrosis factor (TNF) inhibitors and non-TNF inhibitors in two groups of rheumatoid arthritis (RA) patients: biologic disease-modifying antirheumatic drug (bDMARD) initiators and switchers.Patients and methods: This retrospective cohort study utilized a national health insurance claims database. Patients aged ≥18 years initiating/switching bDMARD between 1 December 2013 and 31 December 2014, the index period, were followed for 12 months. Initiators who began treatment with a bDMARD during the index period were defined as having no bDMARD prescriptions for the previous year. Switchers who changed treatment from the previous bDMARD to the index bDMARD were defined as having different bDMARDs during the index period. Treatment persistence rates during the follow-up period were measured, and factors associated with non-persistence were assessed with the Cox proportional hazard model.Results: Of 2684 patients, treatment persistence rates were the highest for abatacept in initiators (69.3%) and tocilizumab in switchers (77.0%), while adalimumab showed the lowest persistence rates for both initiators and switchers (48.2%, 28.8%), followed by etanercept (51.3%, 41.0%). Adalimumab and etanercept were significantly more likely to show non-persistence (HR 1.58, 95% CI 1.27-1.96; HR 1.42, 95% CI 1.14-1.76) compared to infliximab for initiators, while tocilizumab was significantly more likely to show persistence (HR 0.411, 95% CI 0.206-0.819) in switchers.Conclusions: Non-TNF inhibitors showed higher persistence rates than TNF inhibitors in South Korean RA patients, and tocilizumab especially was associated with higher persistence in patients with inadequate response to TNF inhibitors. Good persistence with non-TNF inhibitors indicates the potential for long-term efficacy as first-line treatment.
Collapse
Affiliation(s)
- Jae-A Park
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | | | - Jin Hyun Nam
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Robert Wood
- Real-World Evidence Generation, Adelphi Real World, Bollington, UK
| | - Tim Holbrook
- Real-World Evidence Generation, Adelphi Real World, Bollington, UK
| | - Sun-Hong Kwon
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| |
Collapse
|
9
|
Association between Exposure to Ambient Air Pollution and Rheumatoid Arthritis in Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071227. [PMID: 30959862 PMCID: PMC6480037 DOI: 10.3390/ijerph16071227] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 12/13/2022]
Abstract
Environmental factors may play roles in the development of rheumatoid arthritis (RA), and some studies have shown that air pollution was associated with the development of autoimmune disease. This study was designed to investigate the effect of air pollutants on the development of adult RA. A nested case-control cohort study was performed using the National Health Insurance Service-National Sample Cohort during 2002⁻2014 in Korea. Air pollution data were collected from the National Ambient Air Monitoring System (NAMIS), and exposure levels were extrapolated using geographic information systems. The group with RA (n = 444) was compared with a propensity score-matched control group (n = 1776), and one-year average concentrations of air pollution were predicted at each patient's residence. The adjusted binary logistic regression analysis showed a positive association between O₃ exposure and the incidence risk of RA for the third (odds ratios (OR) = 1.45, 95% confidence intervals (CI): 1.08⁻1.96) and fourth (OR = 1.35, 95% CI: 1.00⁻1.83) quartiles in adults over 20 years of age. The third quartile CO exposure was also associated with an increased risk of RA (OR = 1.57, 95% CI: 1.16⁻2.12). The results of this nationwide population-based study showed that a one-year exposure to CO and O₃ in adults was associated with an increased risk of RA.
Collapse
|
10
|
Lee HN, Kim YK, Kim GT, Ahn E, So MW, Sohn DH, Lee SG. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio as predictors of 12-week treatment response and drug persistence of anti-tumor necrosis factor-α agents in patients with rheumatoid arthritis: a retrospective chart review analysis. Rheumatol Int 2019; 39:859-868. [DOI: 10.1007/s00296-019-04276-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 03/08/2019] [Indexed: 12/19/2022]
|
11
|
Persistence and treatment-free interval in patients being prescribed biological drugs in rheumatology practices in Germany. Eur J Clin Pharmacol 2019; 75:717-722. [DOI: 10.1007/s00228-019-02627-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/02/2019] [Indexed: 02/07/2023]
|
12
|
Jacob L, Chevalier T, Kostev K. Persistence with biological drugs in patients treated in rheumatology practices in Germany. Rheumatol Int 2018; 39:525-531. [PMID: 30474720 DOI: 10.1007/s00296-018-4194-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 11/02/2018] [Indexed: 12/19/2022]
Abstract
The goal of this study was to investigate the persistence with biological drugs in patients treated in rheumatology practices in Germany. This study included patients diagnosed with rheumatoid arthritis (RA), psoriatic arthritis (PA), or ankylosing spondylitis (AS) who received a first prescription of biological drugs between 2008 and 2016 (index date) in 21 rheumatology practices in Germany (n = 4925; Disease Analyzer database). The main outcome measure was the rate of persistence within 5 years of the index date. Kaplan-Meier analyses were performed to study treatment persistence as a function of diagnosis, gender and age. A Cox proportional hazards regression model was used to estimate the relationship between non-persistence and diagnosis, gender, age, and comorbidities. After 5 years of follow-up, the rate of persistence was 31.8% in patients with RA, 35.2% in those with AS, and 33.2% in those with PA (log-rank p value = 0.028). Furthermore, 33.8% of men and 31.9% of women were persistent (log-rank p value = 0.035). The rate of persistence was 20.8%, 27.9%, 33.0%, 36.6%, 35.2%, and 32.0% in people aged ≤ 30, 31-40, 41-50, 51-60, 61-70, and > 70 years, respectively (log-rank p value = 0.002). The risk of discontinuation was lower in participants diagnosed with AS than in those diagnosed with RA [hazard ratio (HR) = 0.87; 95% confidence interval (CI) 0.79-0.96]. In addition, patients aged ≤ 30 years were more likely to discontinue their biological therapy than those aged > 70 years (HR = 1.29; 95% CI 1.10-1.52). Persistence with biological drugs was low after 5 years of follow-up in rheumatology practices.
Collapse
Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
| | | | - Karel Kostev
- Epidemiology, IQVIA, Commercial GmbH & Co OHG, Unterschweinstiege 2-14, 60549, Frankfurt am Main, Germany.
| |
Collapse
|