Mengqin Ge1, Kenneth K Man1,2,3, Celine S Chui1,4, Esther W Chan1,5, Ian C Wong1,2,5, Xue Li6. 1. Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 2/F, 21 Sassoon Road, Laboratory Block, Hong Kong, China. 2. Research Department of Practice and Policy, UCL School of Pharmacy, London, UK. 3. Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, The Netherlands. 4. WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. 5. The University of Hong Kong Shenzhen Hospital, Shenzhen, China. 6. Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 2/F, 21 Sassoon Road, Laboratory Block, Hong Kong, China. sxueli@hku.hk.
Abstract
BACKGROUND: Biologic agents were initially introduced as treatment for rheumatoid arthritis (RA) but have since been used for other medical conditions. As new biologics become increasingly widespread in treatment regimens, it is important to understand their safety and utilization in the post-marketing context. PURPOSE: The aim of this study was to investigate long-term prescribing patterns and the safety of biologics in real clinical settings in Hong Kong. METHODS: This was a population-based drug utilization study in Hong Kong using a territory-wide electronic medical database Clinical Data Analysis and Reporting System (CDARS). Patients who received biologic treatments from 2001 to 2015 were identified and their corresponding demographic and clinical details retrieved from CDARS. The annual prevalence of biologic prescriptions, the long-term retention rates and incidence rates of infections associated with biologic treatments were evaluated. RESULTS: A total of 30,298 patients (male: 44%) prescribed biologic treatments were identified from CDARS from 2001 to 2015. The annual prevalence of biologic prescriptions increased from 0.1 to 16.1 per 100 persons for both sexes. Infliximab had the highest first-year retention rate of 95.6% among all biologics and continuously attained the highest retention rate from second to fifth year. The overall incidence rate of serious infections was less than five per 100 person-years. Specifically, the incidence rates of tuberculosis, upper and lower respiratory infections and herpes zoster were 0.52, 3.24, 4.99 and 1.01 per 100 person-years, respectively. CONCLUSION: This population-based study revealed an increasing prevalence of biologic prescribing. Results from the study described the long-term retention rates and incidence rates of serious infections of biologic treatments for all indications, and confirmed the safety of biologic treatments. Since this study provides an overview of all biologic utilization, further studies on cost effectiveness, safety and compliance of treatment in different patient groups are still warranted.
BACKGROUND: Biologic agents were initially introduced as treatment for rheumatoid arthritis (RA) but have since been used for other medical conditions. As new biologics become increasingly widespread in treatment regimens, it is important to understand their safety and utilization in the post-marketing context. PURPOSE: The aim of this study was to investigate long-term prescribing patterns and the safety of biologics in real clinical settings in Hong Kong. METHODS: This was a population-based drug utilization study in Hong Kong using a territory-wide electronic medical database Clinical Data Analysis and Reporting System (CDARS). Patients who received biologic treatments from 2001 to 2015 were identified and their corresponding demographic and clinical details retrieved from CDARS. The annual prevalence of biologic prescriptions, the long-term retention rates and incidence rates of infections associated with biologic treatments were evaluated. RESULTS: A total of 30,298 patients (male: 44%) prescribed biologic treatments were identified from CDARS from 2001 to 2015. The annual prevalence of biologic prescriptions increased from 0.1 to 16.1 per 100 persons for both sexes. Infliximab had the highest first-year retention rate of 95.6% among all biologics and continuously attained the highest retention rate from second to fifth year. The overall incidence rate of serious infections was less than five per 100 person-years. Specifically, the incidence rates of tuberculosis, upper and lower respiratory infections and herpes zoster were 0.52, 3.24, 4.99 and 1.01 per 100 person-years, respectively. CONCLUSION: This population-based study revealed an increasing prevalence of biologic prescribing. Results from the study described the long-term retention rates and incidence rates of serious infections of biologic treatments for all indications, and confirmed the safety of biologic treatments. Since this study provides an overview of all biologic utilization, further studies on cost effectiveness, safety and compliance of treatment in different patient groups are still warranted.
Authors: Wallis C Y Lau; Esther W Chan; Ching-Lung Cheung; Chor Wing Sing; Kenneth K C Man; Gregory Y H Lip; Chung-Wah Siu; Joanne K Y Lam; Alan C H Lee; Ian C K Wong Journal: JAMA Date: 2017-03-21 Impact factor: 56.272
Authors: Kenneth K C Man; David Coghill; Esther W Chan; Wallis C Y Lau; Chris Hollis; Elizabeth Liddle; Tobias Banaschewski; Suzanne McCarthy; Antje Neubert; Kapil Sayal; Patrick Ip; Martijn J Schuemie; Miriam C J M Sturkenboom; Edmund Sonuga-Barke; Jan Buitelaar; Sara Carucci; Alessandro Zuddas; Hanna Kovshoff; Peter Garas; Peter Nagy; Sarah K Inglis; Kerstin Konrad; Alexander Häge; Eric Rosenthal; Ian C K Wong Journal: JAMA Psychiatry Date: 2017-10-01 Impact factor: 21.596
Authors: William J Sandborn; Christopher Gasink; Long-Long Gao; Marion A Blank; Jewel Johanns; Cynthia Guzzo; Bruce E Sands; Stephen B Hanauer; Stephan Targan; Paul Rutgeerts; Subrata Ghosh; Willem J S de Villiers; Remo Panaccione; Gordon Greenberg; Stefan Schreiber; Simon Lichtiger; Brian G Feagan Journal: N Engl J Med Date: 2012-10-18 Impact factor: 91.245