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Strunz PP, Englbrecht M, Risser LM, Witte T, Froehlich M, Schmalzing M, Gernert M, Schmieder A, Bartz-Bazzanella P, von der Decken C, Karberg K, Gauler G, Wurth P, Späthling-Mestekemper S, Kuhn C, Vorbrüggen W, Heck J, Welcker M, Kleinert S. Drug survival superiority of tumor necrosis factor inhibitors and interleukin-17 inhibitors over Janus kinase inhibitors and interleukin-12/23 inhibitors in German psoriatic arthritis outpatients: retrospective analysis of the RHADAR database. Front Immunol 2024; 15:1395968. [PMID: 38846940 PMCID: PMC11153701 DOI: 10.3389/fimmu.2024.1395968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/06/2024] [Indexed: 06/09/2024] Open
Abstract
Objective Treatment options with disease-modifying antirheumatic drugs (DMARDs) for psoriatic arthritis (PsA) have evolved over recent years. In addition to Janus kinase inhibitors (JAKi), four classes of biologic DMARDs (bDMARDs; interleukin [IL]-23 inhibitors [IL-23i], IL-12/23 inhibitors [IL-12/23i], tumor necrosis factor inhibitors [TNFi], and IL-17 inhibitors [IL-17i]) are currently approved for moderate to severe PsA treatment. There is minimal evidence of the persistence of these drugs among PsA outpatients in a real-world scenario during the period following the approval of JAKi. Therefore, we aimed to analyze the drug survival rates of biologic and JAKi therapies among German PsA outpatients during routine clinical care. Methods We retrospectively analyzed PsA patients with a new prescription for a biologic or JAKi in the RHADAR database between January 2015 and October 2023. Kaplan-Meier Curves and Cox regression modelling were used to compare drug survival rates. Results 1352 new prescriptions with bDMARDs (IL-12/23i [n=50], IL-23i [n=31], TNFi [n=774], IL-17i [n=360]) or JAKi (n=137) were identified. The 5-year drug survival rate was 67.8% for IL-17i, 62.3% for TNFi, 53.3% for JAKi, and 46.0% for IL-12/23i. Discontinuation probabilities for JAKi and IL-12/23i were significantly higher compared with TNFi (JAKi hazard ratio [HR] 1.66, [95% CI 1.23-2.24], p=0.001; IL-12/23i HR 1.54, [95% CI 1.02-2.33], p=0.042) and IL-17i (JAKi HR 1.77, [95% CI 1.27-2.47], p=0.001; IL-12/23i HR 1.64, [95% CI 1.06-2.55], p=0.027). JAKi-treated patients had more severe disease and more osteoarthritis (OA) compared to TNFi and more OA compared to IL-17i. Conclusion German PsA outpatients might persist longer with TNFi and IL-17i compared with IL-12/23i or JAKi. For TNFi, differences in subgroup characteristics and comorbidities (OA) may have affected drug survival rates. For IL-17i, the longer drug survival might not only be related to less OA compared to JAKi and, therefore, might be affected by other factors.
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Affiliation(s)
- Patrick-Pascal Strunz
- Department of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany
| | | | | | - Torsten Witte
- Department of Rheumatology and Immunology, Medical School Hannover, Hannover, Germany
| | - Matthias Froehlich
- Department of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany
| | - Marc Schmalzing
- Department of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany
| | - Michael Gernert
- Department of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany
| | - Astrid Schmieder
- Clinic for Dermatology, Venereology and Allergology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Peter Bartz-Bazzanella
- Klinik für Internistische Rheumatologie, Rhein-Maas-Klinikum, Würselen, Germany
- Medizinisches Versorgungszentrum, Stolberg, Germany
| | - Cay von der Decken
- Klinik für Internistische Rheumatologie, Rhein-Maas-Klinikum, Würselen, Germany
- Medizinisches Versorgungszentrum, Stolberg, Germany
- Verein zur Förderung der Rheumatologie e.V., Würselen, Germany
| | - Kirsten Karberg
- Rheumatologisches Versorgungszentrum Steglitz, Berlin, Germany
| | | | | | | | | | | | - Johannes Heck
- Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Martin Welcker
- Verein zur Förderung der Rheumatologie e.V., Würselen, Germany
- Medizinisches Versorgungszentrum für Rheumatologie Dr. M. Welcker GmbH, Planegg, Germany
| | - Stefan Kleinert
- Department of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany
- Praxisgemeinschaft Rheumatologie-Nephrologie, Erlangen, Germany
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Albrecht K, Binder S, Minden K, Poddubnyy D, Regierer AC, Strangfeld A, Callhoff J. Systematic review to estimate the prevalence of inflammatory rheumatic diseases in Germany. Z Rheumatol 2024; 83:20-30. [PMID: 36749363 PMCID: PMC10879227 DOI: 10.1007/s00393-022-01302-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This study aimed to update the prevalence estimates of inflammatory rheumatic diseases (IRD) in Germany. METHODS A systematic literature search in PubMed and Web of Science (last search 08 November 2022) identified original articles (regional and nationwide surveys and claims data analyses for arthritides, connective tissue diseases, and vasculitides) on prevalences for the period 2014-2022. Data sources, collection period, case definition, and risk of bias are reported. Prevalences were estimated from available national data, with consideration of international data. RESULTS Screening by two authors yielded 263 hits, of which 18 claims data analyses and 2 surveys met the inclusion criteria. Prevalences ranged from 0.42 to 1.85% (rheumatoid arthritis), 0.32-0.5% (ankylosing spondylitis), 0.11-0.32% (psoriatic arthritis), 0.037-0.14% (systemic lupus erythematosus), 0.07-0.77% (Sjögren's disease/sicca syndrome), 0.14-0.15% (polymyalgia rheumatica, ≥ 40 years), 0.04-0.05% (giant cell arteritis, ≥ 50 years), and 0.015-0.026% (ANCA-associated vasculitis). The risk of bias was moderate in 13 and high in 7 studies. Based on the results, we estimate the prevalence of IRD in Germany to be 2.2-3.0%, which corresponds to approximately 1.5-2.1 million affected individuals. The prevalence of juvenile idiopathic arthritis was reported to be around 0.10% (0.07-0.10%) of 0-18-year-olds, corresponding to about 14,000 children and adolescents in Germany. CONCLUSION This systematic review shows an increase in the prevalence of IRD in Germany, which is almost exclusively based on claims data analyses. In the absence of multistage population studies, the available data are, overall, uncertain sources for prevalence estimates, with a moderate to high risk of bias.
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Affiliation(s)
- Katinka Albrecht
- Programme Area Epidemiology and Health Services Research, German Rheumatism Research Centre Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Sebastian Binder
- Programme Area Epidemiology and Health Services Research, German Rheumatism Research Centre Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Kirsten Minden
- Programme Area Epidemiology and Health Services Research, German Rheumatism Research Centre Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Denis Poddubnyy
- Programme Area Epidemiology and Health Services Research, German Rheumatism Research Centre Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Department of Gastroenterology, Infectiology and Rheumatology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Anne C Regierer
- Programme Area Epidemiology and Health Services Research, German Rheumatism Research Centre Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Anja Strangfeld
- Programme Area Epidemiology and Health Services Research, German Rheumatism Research Centre Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Johanna Callhoff
- Programme Area Epidemiology and Health Services Research, German Rheumatism Research Centre Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
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He K, Wang Z, Liu M, Du W, Yin T, Bai R, Duan Q, Wang Y, Lei H, Zheng Y. Exploring the Effect of Xiao-Chai-Hu Decoction on Treating Psoriasis Based on Network Pharmacology and Experiment Validation. Curr Pharm Des 2024; 30:215-229. [PMID: 38532341 DOI: 10.2174/0113816128288527240108110844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/27/2023] [Indexed: 03/28/2024]
Abstract
BACKGROUND Psoriasis is a chronic, inflammatory and recurrent skin disease. Xiao-Chai-Hu Decoction (XCHD) has shown good effects against some inflammatory diseases and cancers. However, the pharmacological effect and mechanisms of XCHD on psoriasis are not yet clear. OBJECTIVE To uncover the effect and mechanisms of XCHD on psoriasis by integrating network pharmacology, molecular docking, and in vivo experiments. METHODS The active ingredients and corresponding targets of XCHD were screened through Traditional Chinese Medicine Systems Pharmacology Database and Analysis (TCMSP) and Traditional Chinese Medicine Integrated Database (TCMID). Differentially expressed genes (DEGs) of psoriasis were obtained from the gene expression omnibus (GEO) database. The XCHD-psoriasis intersection targets were obtained by intersecting XCHD targets, and DEGs were used to establish the "herb-active ingredient-target" network and Protein-Protein Interaction (PPI) Network. The hub targets were identified based on the PPI network by Cytoscape software. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed next. Molecular docking was executed via AutoDockTools-1.5.6. Finally, in vivo experiments were carried out further to validate the therapeutic effects of XCHD on psoriasis. RESULTS 58 active components and 219 targets of XCHD were screened. 4 top-active components (quercetin, baicalein, wogonin and kaempferol) and 7 hub targets (IL1B, CXCL8, CCND1, FOS, MMP9, STAT1 and CCL2) were identified. GO and KEGG pathway enrichment analyses indicated that the TNF signaling pathway, IL-17 signaling pathway and several pathways were involved. Molecular docking results indicated that hub genes had a good affinity to the corresponding key compounds. In imiquimod (IMQ)-induced psoriasis mouse models, XCHD could significantly improve psoriasis-like skin lesions, downregulate KRT17 and Ki67, and inhibit inflammation cytokines and VEGF. CONCLUSION XCHD showed the therapeutic effect on psoriasis by regulating keratinocyte differentiation, and suppressing inflammation and angiogenesis, which provided a theoretical basis for further experiments and clinical research.
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Affiliation(s)
- Ke He
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Ziyang Wang
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Meng Liu
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Wenqian Du
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Tingyi Yin
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Ruimin Bai
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Qiqi Duan
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Yuqian Wang
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Hao Lei
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Yan Zheng
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
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Albrecht K, Binder S, Minden K, Poddubnyy D, Regierer AC, Strangfeld A, Callhoff J. [Systematic review to estimate the prevalence of inflammatory rheumatic diseases in Germany. German version]. Z Rheumatol 2023; 82:727-738. [PMID: 36592211 PMCID: PMC10627889 DOI: 10.1007/s00393-022-01305-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To update the estimated prevalence of inflammatory rheumatic diseases (IRD) in Germany. METHODS A systematic literature search in PubMed and Web of Science (last search 8 November 2022) identified original articles (regional and nationwide surveys and routine data analyses for arthritides, connective tissue diseases, and vasculitides) on the prevalence for the period 2014-2022. Data sources, collection period, case definition, and risk of bias are reported. The prevalences were estimated from available national data, with consideration of international data. RESULTS Screening by 2 authors yielded 263 hits, of which 18 routine data analyses and 2 surveys met the inclusion criteria. Prevalence data ranged from 0.42% to 1.85% (rheumatoid arthritis), 0.32-0.5% (ankylosing spondylitis), 0.11-0.32% (psoriatic arthritis), 0.037-0.14% (systemic lupus erythematosus), 0.07-0.77% (Sjoegren's disease/sicca syndrome), 0.14-0.15% (polymyalgia rheumatica, ≥ 40 years), 0.04-0.05% (giant cell arteritis, ≥ 50 years), and 0.015-0.026% (ANCA-associated vasculitis). The risk of bias was moderate in 13 and high in 7 studies. Based on the results, we estimate the prevalence of IRD in Germany to be 2.2-3.0%, which corresponds to approximately 1.5-2.1 million affected individuals. Prevalence data of juvenile idiopathic arthritis was reported to be around 0.10% (0.07-0.10%) of patients 0-18 years old, corresponding to about 14,000 children and adolescents in Germany. CONCLUSION This systematic review shows an increase in the prevalence of IRD in Germany, which is almost exclusively based on routine data analyses. In the absence of multistage population studies, the available data are overall uncertain sources for prevalence estimates at moderate to high risk of bias.
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Affiliation(s)
- Katinka Albrecht
- Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - Sebastian Binder
- Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Kirsten Minden
- Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
- Klinik für Pädiatrie mit SP Pneumologie, Immunologie und Intensivmedizin, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - Denis Poddubnyy
- Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
- Rheumatologie am Campus Benjamin Franklin - Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - Anne C Regierer
- Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Anja Strangfeld
- Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
- Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - Johanna Callhoff
- Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité Universitätsmedizin Berlin, Berlin, Deutschland
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Sewerin P, Borchert K, Meise D, Schneider M, Mahlich J. Health resource utilization and associated healthcare costs of biologic disease modifying antirheumatic drugs in German patients with psoriatic arthritis. Arthritis Care Res (Hoboken) 2021; 74:1435-1443. [PMID: 33742791 DOI: 10.1002/acr.24598] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/23/2021] [Accepted: 03/16/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate healthcare costs associated with biologic disease-modifying antirheumatic drugs (bDMARDs) in a German real-world cohort of adult biologic-naïve patients with psoriatic arthritis (PsA). METHODS Claims data from the InGef research database for patients with a PsA diagnosis and bDMARD claims record (index date) between January 1st , 2014 and December 31st , 2017; and no bDMARD prescription for 365 days before the index date, were retrospectively analyzed. Primary outcomes were determination of healthcare resource utilization (HRU) and associated annual healthcare costs for overall and individual bDMARDs in the 12-month pre- and post-index periods. These outcomes were compared between persistent and non-persistent groups. Non-persistence was defined as treatment gap or switch to bDMARD other than the index therapy. RESULTS Among 10,954 patients with a PsA diagnosis, 348 were eligible. Although mean (SD) post-index costs were significantly higher in the persistent group than the non-persistent group (€27,869 [8,001] vs. €21,897 [10,600]; P<0.001) due to higher bDMARD acquisition costs (€23,996 [4,818] vs. €16,427 [9,033]; P<0.001), persistence reduced inpatient treatment costs (-€760), outpatient treatment costs (-€192), other drug costs (-€724), and sick leave costs (-€601). CONCLUSION Although initiation of bDMARDs increased the total healthcare costs irrespective of persistence status, partial cost offsets were observed in the persistent patient population.
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Affiliation(s)
- Philipp Sewerin
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich-Heine University, Düsseldorf, Germany
| | | | | | - Matthias Schneider
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich-Heine University, Düsseldorf, Germany
| | - Jörg Mahlich
- Health Economics and Outcomes Research, Janssen, Pharmaceutical Companies of Johnson & Johnson, Neuss, Germany.,Düsseldorf Institute of Competition Economics (DICE), University of Düsseldorf, Germany
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Sewerin P, Borchert K, Meise D, Schneider M, Mahlich J. Real-World Treatment Persistence with Biologic Disease-Modifying Antirheumatic Drugs Among German Patients with Psoriatic Arthritis-A Retrospective Database Study. Rheumatol Ther 2021; 8:483-497. [PMID: 33611778 PMCID: PMC7991063 DOI: 10.1007/s40744-021-00286-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/29/2021] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION To investigate drug survival for biologic disease-modifying antirheumatic drugs (bDMARDs) in a real-world cohort of German adult biologic-naïve patients with psoriatic arthritis (PsA). METHODS Claims data for patients with a diagnosis of PsA, a bDMARD claims record (index date) between 1 January 2014 and 31 December 2017, and no bDMARD prescription for 365 days before the index date were retrospectively analyzed. The primary outcomes were the overall and individual bDMARD persistence rates over 12 months. Nonpersistence was defined as a treatment gap exceeding the days of supply plus 60 days or switching to a bDMARD other than the index therapy. Sensitivity analysis was performed, wherein the treatment gap was found to vary depending on the bDMARD regimen. Kaplan-Meier curves were plotted to determine persistence; the log-rank test was used to evaluate differences in the persistence rate. Factors associated with treatment discontinuation were evaluated using Cox regression analysis. RESULTS Among 10,954 patients with a PsA diagnosis, 348 were eligible. The overall bDMARD persistence rate was 57.5%; individual bDMARD persistence rates were 81.3% for ustekinumab, 66.7% for infliximab, and 60.0% for golimumab. The mean (SD) overall persistence with bDMARDs was 289 (103) days; the mean persistence was 334 (72) days for ustekinumab, 309 (82) days for golimumab, and 305 (92) days for infliximab. The main reasons for nonpersistence were switching to another bDMARD (15.8%) and treatment discontinuation (26.7%). Male gender was significantly associated with a lower risk of treatment discontinuation (hazard ratio 0.54, 95% confidence interval 0.39-0.77; P < 0.001). The sensitivity analysis yielded similar results. CONCLUSION The one-year persistence rate for bDMARDs in German PsA patients is modest, although the persistence rate depends on the bDMARD considered.
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Affiliation(s)
- Philipp Sewerin
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich-Heine University, Düsseldorf, Germany.
| | | | | | - Matthias Schneider
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich-Heine University, Düsseldorf, Germany
| | - Jörg Mahlich
- Health Economics and Outcomes Research, Janssen, Pharmaceutical Companies of Johnson & Johnson, Neuss, Germany
- Düsseldorf Institute of Competition Economics (DICE), University of Düsseldorf, Düsseldorf, Germany
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Perrone V, Giacomini E, Sangiorgi D, Andretta M, Menti AM, Naclerio M, Ritrovato D, Degli Esposti L. Treatment Pattern Analysis and Health-care Resource Consumption on Patients with Psoriatic Arthritis or Ankylosing Spondylitis Treated with Biological Drugs in a Northern Italian Region. Ther Clin Risk Manag 2020; 16:509-521. [PMID: 32606710 PMCID: PMC7293402 DOI: 10.2147/tcrm.s248390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/13/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To analyze the treatment patterns of psoriatic arthritis (PSA) or ankylosing spondylitis (AS) patients under biological therapies and to evaluate in this population the health-care resource consumption and related costs. Patients and Methods A retrospective analysis was performed on administrative databases of the Veneto region. Patients ≥18 years with at least one prescription of biological drugs and a diagnosis at any level for PSA or AS from January 1, 2011 to December 31, 2016 (inclusion period) were included. Index date (ID) was defined as date of first biological drug prescription during inclusion period. Patients were characterized the year before ID and followed-up for one year after ID. The drug utilization profile in terms of adherence, persistence and therapeutic regimen changes, and the health-care resource consumption was analyzed during follow-up. Results A total of 2602 patients were included: 1857 with PSA and 745 with AS. In the PSA cohort, 40.3% of patients were prescribed adalimumab, 35.6% etanercept, 8.0% golimumab, 7.5% infliximab, 5.6% ustekinumab and 3.0% certolizumab. Percentage of PSA patients adherent to treatment was higher among ustekinumab patients (91.3%) and lower among etanercept users (54.3%). Persistence ranged from 53.2% (infliximab) to 70.3% (etanercept). Regarding AS cohort, 45.5% of patients were prescribed adalimumab, 26% etanercept, 17.3% infliximab, 9.7% golimumab and 1.5% certolizumab. Adherence ranged from 46.9% (etanercept) to 90.9% (certolizumab) and persistence from 62.8% (adalimumab) to 81.8% (certolizumab). Mean annual health-care costs (including costs for drug treatment, diagnostic services, specialist visits and hospital admissions) ranged from €9727 (certolizumab) to €14,994 (ustekinumab) among PSA patients and from €9875 (infliximab) to €12,991 (golimumab) among AS patients. Conclusion This study in Veneto region gave a picture of biological treatment patterns among PSA and AS patients in a real-world setting. Our findings showed the high degree of variability concerning utilization of each biological drug and provided insight on the economic burden of both diseases.
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Affiliation(s)
| | - Elisa Giacomini
- CliCon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy
| | - Diego Sangiorgi
- CliCon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy
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