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A retrospective review of the persistence on bDMARDs prescribed for the treatment of rheumatoid arthritis in the Australian population
Citation
Jones, G and Hall, S and Bird, P and Littlejohn, G and Tymms, K and Youssef, P and Chung, E and Barrett, R and Button, P, A retrospective review of the persistence on bDMARDs prescribed for the treatment of rheumatoid arthritis in the Australian population, International Journal of Rheumatic Diseases pp. 1-10. ISSN 1756-1841 (2017) [Refereed Article]
Copyright Statement
© 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd
DOI: doi:10.1111/1756-185X.13243
Abstract
Method: RA patients, from the 10% Australian Medicare random sample, aged ≥18 for whom bDMARDs were dispensed were included. Individual sub-cutaneous (SC) anti-tumor necrosis factor-α (anti-TNFα) agents were combined as they were equivalent.
Results: Data from 1230 patients were analyzed. For all patients the 12-month persistence rates (based on Kaplan-Meier estimates) were 76% for intravenous (IV) tocilizumab, 63% abatacept (SC/IV), 61% SC-anti-TNFs and 36% IV-infliximab. Persistence rates on first-line bDMARDs were 79% (tocilizumab and abatacept), 64% (SC-anti-TNFs) and 13% (infliximab); rates were sustained for tocilizumab but dropped to 49% for abatacept and 51% for SC-anti-TNFs in the second-line setting. Median treatment persistence was 40 months tocilizumab (95% CI: 30-ND), 33 months abatacept (95% CI: 20-ND); 22 months SC-anti-TNF (95% Cl: 18-27), and 4 months infliximab (95% CI: 2-13). Longer persistence was observed for SC-anti-TNFs and abatacept combined with methotrexate or other cDMARDs. For tocilizumab, persistence was robust with or without concomitant medications. The median oral glucocorticoid doses decreased from 4.1 mg/day (min 0, max 21) to 2.0 mg/day (min 0, max 17.3) over 2 years.
Conclusions: Treatment persistence was longer on tocilizumab followed by abatacept then SC-anti-TNF therapy and was influenced by co-therapy. Glucocorticoid dosage decreased with bDMARD use. This real-world data highlights that persistence on bDMARDs differs according to biologics mode of action and co-therapy.
Item Details
| Item Type: | Refereed Article |
|---|---|
| Keywords: | DMARD, biologics, glucocorticoids, rheumatoid arthritis |
| Research Division: | Biomedical and Clinical Sciences |
| Research Group: | Clinical sciences |
| Research Field: | Rheumatology and arthritis |
| Objective Division: | Health |
| Objective Group: | Clinical health |
| Objective Field: | Clinical health not elsewhere classified |
| UTAS Author: | Jones, G (Professor Graeme Jones) |
| ID Code: | 123934 |
| Year Published: | 2017 |
| Web of Science® Times Cited: | 4 |
| Deposited By: | Menzies Institute for Medical Research |
| Deposited On: | 2018-02-01 |
| Last Modified: | 2018-07-23 |
| Downloads: | 0 |
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