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Holdsworth, EA, Donaghy, B, Fox, KM, Desai, P, Collier, DH and Furst, DE (2021) Biologic and Targeted Synthetic DMARD Utilization in the United States: Adelphi Real World Disease Specific Programme for Rheumatoid Arthritis. Rheumatology and Therapy, 8 (4). pp. 1637-1649. ISSN 2198-6584
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Biologic and Targeted Synthetic DMARD Utilization in the United States Adelphi Real World Disease Specific Programme for Rhe.pdf - Published Version Available under License Creative Commons Attribution Non-commercial. Download (1MB) | Preview |
Abstract
Introduction: In patients with inadequate response or intolerance to first biologic disease-modifying antirheumatic drug (bDMARD), guidelines recommend switching to an agent of different mechanism of action or to another bDMARD. However, the reasons behind switching between bDMARD/targeted synthetic (ts)DMARD are not well documented in many studies. The objective of this study was to assess the rheumatologists’ perceptions and behaviors towards choice of initial b/tsDMARD treatment and reasons for switching between bDMARDs/tsDMARDs, in the context of present treatment patterns.
Methods: This was a retrospective analysis of data collected from the 12th Adelphi Real World Disease Specific Programme for rheumatoid arthritis (RA). Qualified rheumatologists involved in treatment decision-making for ≥ 10 patients a month completed patient record forms (PRFs). Patients aged ≥ 18 years with RA diagnosis and receiving bDMARD/tsDMARD were included. The outcomes assessed were proportion of patients receiving bDMARD/tsDMARD at molecule and class levels; rheumatologist-reported reasons for choice of therapy; proportion of patients who switched bDMARDs/tsDMARDs; and rheumatologist-reported reasons for switching therapies.
Results: Eighty-six rheumatologists completed PRFs for 1027 patients. Of these, 621 were receiving bDMARD/tsDMARD at data collection. The majority (73%) of patients received first-line bDMARD/tsDMARD, and at first-line, 68% received a tumor necrosis factor inhibitor (TNFi) and 21% received a Janus kinase inhibitor (JAKi). The response option of strong overall efficacy was the primary reason for selecting first-line and second-line bDMARD/tsDMARD. A total of 163 patients had switched from first-line b/tsDMARD to second-line b/tsDMARD therapy. Of these, 44, 28, and 17% had switched from TNFi to another TNFi, TNFi to non-TNF biologic, and TNFi to JAKi, respectively. Lack of efficacy and worsening disease were the most frequent reasons for switching therapies.
Conclusions: TNFis remain the most prescribed b/tsDMARD for first-line and second-line treatments. Strong overall efficacy was the primary reason for selecting therapy and loss of efficacy was the primary reason for switching therapy.
| Item Type: | Article |
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| Uncontrolled Keywords: | Science & Technology; Life Sciences & Biomedicine; Rheumatology; Biologic DMARDs; Rheumatoid arthritis; Tumor necrosis factor inhibitors; Targeted synthetic DMARDs; TREATMENT PERSISTENCE; THERAPY; DISCONTINUATION; REASONS; AGENT; RATES |
| Subjects: | B Philosophy. Psychology. Religion > BF Psychology R Medicine > R Medicine (General) R Medicine > RM Therapeutics. Pharmacology R Medicine > RS Pharmacy and materia medica |
| Divisions: | Psychology (from Sep 2019) |
| Publisher: | Springer |
| Related URLs: | |
| Date Deposited: | 20 Jan 2022 10:31 |
| Last Modified: | 20 Jan 2022 10:31 |
| DOI or ID number: | 10.1007/s40744-021-00357-1 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/16091 |
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