Tanja Schjødt Jørgensen1, Lars Erik Kristensen2, Robin Christensen3, Henning Bliddal1, Tove Lorenzen4, Michael S Hansen5, Mikkel Østergaard6, Jørgen Jensen7, Lida Zanjani6, Toke Laursen8, Sheraz Butt9, Mette Y Dam10, Hanne M Lindegaard11, Jakob Espesen12, Oliver Hendricks13, Prabhat Kumar14, Anita Kincses15, Line H Larsen16, Marlene Andersen17, Esben K Næser4, Dorte V Jensen18, Jolanta Grydehøj19, Barbara Unger20, Ninna Dufour21, Vibeke Sørensen22, Sara Vildhøj23, Inger Marie Jensen Hansen24, Johnny Raun25, Niels Steen Krogh26, Merete Lund Hetland27. 1. Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark, henning.bliddal@regionh.dk. 2. Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark, Department of Rheumatology, Lund University Hospital, Lund, Sweden. 3. Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark. 4. Department of Rheumatology, Diagnostic Centre, Silkeborg Regional Hospital. 5. ReumaKlinik Roskilde, Roskilde. 6. Copenhagen Centre for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Glostrup. 7. Department of Rheumatology, Region Hospital Køge, Køge. 8. Department of Rheumatology, Copenhagen University Hospital, Gentofte. 9. Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg. 10. Department of Rheumatology, Aarhus University Hospital, Aarhus. 11. Department of Rheumatology, Odense University Hospital, Odense. 12. Department of Rheumatology, Hospital Lillebælt, Vejle. 13. King Christian 10th Hospital for Rheumatic Diseases, Gråsten. 14. Department of Rheumatology, Sydvestjysk Hospital, Esbjerg. 15. Department of Rheumatology, Copenhagen University Hospital, Rigshospitalet. 16. Department of Rheumatology, Aalborg University Hospital, Aalborg. 17. Department of Rheumatology, Hospital Vendsyssel, Hjørring. 18. Department of Rheumatology, Copenhagen University Hospital, Gentofte, and Bornholms Hospital, Rønne. 19. Department of Rheumatology, Region Hospital Viborg, Viborg. 20. Department of Rheumatology, Region Hospital Horsens, Horsens. 21. Department of Rheumatology, Nordsjællands Hospital, Helsingør. 22. Department of Rheumatology, Region Hospital Randers, Randers. 23. Department of Rheumatology, Region Hospital Holstebro, Holstebro. 24. Department of Rheumatology, Odense University Hospital, Svendborg. 25. Department of Rheumatology, Hospital Lillebælt, Fredericia. 26. ZiteLab ApS, Copenhagen, Denmark. 27. Copenhagen Centre for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Glostrup, Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen and Danish Rheumatologic Database (DANBIO), Center for Rheumatology and Spine Diseases, Glostrup Hospital, Glostrup, Denmark.
Abstract
OBJECTIVES: To estimate the prevalence of Danish RA patients currently on biologic monotherapy and compare the effectiveness and drug adherence of biologic therapies applied as monotherapy. METHODS: All RA patients registered in the Danish biologics database (DANBIO) as receiving biologic DMARD (bDMARD) treatment as monotherapy without concomitant conventional synthetic DMARDs (csDMARDs) during the study period 1 May, 2011 through 30 April 2013 were eligible for inclusion. All patient files were checked to ensure that they were in accordance with the treatment registration in DANBIO. Descriptive statistics for prevalence, effectiveness and drug adherence of bDMARD monotherapy were calculated. RESULTS: Of the 775 patients on bDMARD monotherapy, adalimumab (21.3%), etanercept (36.6%) and tocilizumab (15.3%) were the most prevalent biologic agents administered. At the 6-month follow-up, the overall crude clinical disease activity index remission rate in patients still on a biologic drug was 22%, the 28-joint DAS remission rate was 41% and the response rate of those with a 50% improvement in ACR criteria was 28%. At the 6-month follow-up, the drug adherence rates were similar for the different bDMARDs, with the exception of infliximab, which had significantly poorer drug adherence (P < 0.001). The overall drug adherence (except for infliximab) was approximately 70% after 2 years. CONCLUSION: Nearly one in five (19%) biologic treatments for RA was prescribed in Denmark as monotherapy, of which 70% were on monotherapy from bio-initiation and 30% were on monotherapy after cessation of a concomitant csDMARD. Acceptable drug adherence and remission rates were achieved with bDMARDs. With the exception of infliximab, no statistically significant differences were observed between anti-TNFs and biologics with other modes of action.
OBJECTIVES: To estimate the prevalence of Danish RApatients currently on biologic monotherapy and compare the effectiveness and drug adherence of biologic therapies applied as monotherapy. METHODS: All RApatients registered in the Danish biologics database (DANBIO) as receiving biologic DMARD (bDMARD) treatment as monotherapy without concomitant conventional synthetic DMARDs (csDMARDs) during the study period 1 May, 2011 through 30 April 2013 were eligible for inclusion. All patient files were checked to ensure that they were in accordance with the treatment registration in DANBIO. Descriptive statistics for prevalence, effectiveness and drug adherence of bDMARD monotherapy were calculated. RESULTS: Of the 775 patients on bDMARD monotherapy, adalimumab (21.3%), etanercept (36.6%) and tocilizumab (15.3%) were the most prevalent biologic agents administered. At the 6-month follow-up, the overall crude clinical disease activity index remission rate in patients still on a biologic drug was 22%, the 28-joint DAS remission rate was 41% and the response rate of those with a 50% improvement in ACR criteria was 28%. At the 6-month follow-up, the drug adherence rates were similar for the different bDMARDs, with the exception of infliximab, which had significantly poorer drug adherence (P < 0.001). The overall drug adherence (except for infliximab) was approximately 70% after 2 years. CONCLUSION: Nearly one in five (19%) biologic treatments for RA was prescribed in Denmark as monotherapy, of which 70% were on monotherapy from bio-initiation and 30% were on monotherapy after cessation of a concomitant csDMARD. Acceptable drug adherence and remission rates were achieved with bDMARDs. With the exception of infliximab, no statistically significant differences were observed between anti-TNFs and biologics with other modes of action.
Authors: F Iannone; G Ferraccioli; L Sinigaglia; E G Favalli; P Sarzi-Puttini; F Atzeni; R Gorla; C Bazzani; M Govoni; I Farina; E Gremese; A Carletto; A Giollo; M Galeazzi; R Foti; L Bianchino; L La Grasta; G Lapadula Journal: Clin Rheumatol Date: 2017-10-05 Impact factor: 2.980
Authors: Tanja Schjødt Jørgensen; Carl Turesson; Meliha Kapetanovic; Martin Englund; Aleksandra Turkiewicz; Robin Christensen; Henning Bliddal; Pierre Geborek; Lars Erik Kristensen Journal: PLoS One Date: 2017-02-02 Impact factor: 3.240