Tight control in patients with rheumatoid arthritis treated with targeted therapies across the COVID-19 pandemic era.

IF 3.5 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Journal of Telemedicine and Telecare Pub Date : 2024-10-01 Epub Date: 2023-01-24 DOI:10.1177/1357633X221150724
Angela Flavia Luppino, Gilberto Cincinelli, Annalisa Orenti, Patrizia Boracchi, Ennio Giulio Favalli, Roberto Caporali, Francesca Ingegnoli
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引用次数: 0

Abstract

Objectives: To analyze the impact of different patterns of healthcare delivery on remission of rheumatoid arthritis (RA) patients treated with targeted therapies during the first wave (2020) and second/third waves (2021) of the pandemic compared to the pre-pandemic period (2019).

Methods: In this observational real-life study, data from RA patients treated with biologic or targeted synthetic drugs were extracted from a longitudinal registry. Clinical Disease Activity Index (CDAI) was analyzed in the same period from the 22nd of February to the 18th of May for three consecutive years. These three periods were characterized by different patterns of healthcare delivery: (1) before the pandemic (2019) only in-person visits, (2) during the first wave (2020) both in-person visits and telehealth, and (3) during the second/third waves (2021) only in-person visits. A generalized linear model with the binomial error was fitted to evaluate the difference in the proportion of patients in CDAI remission. Quantile regression was used to compare the median of CDAI in difficult-to-treat (D2T) patients.

Results: In the three periods, we included 407, 450, and 540 RA patients respectively. The percentages of patients in CDAI remission were similar in the three periods (prevalence ratio 1.07, p value 0.423 between 2020 and 2019, and 1.01, p-value 0.934 between 2021 and 2019). The CDAI remission rate was 40.55% (N = 163), 43.18% (N = 155) and 40.82% (N = 220) in 2019, 2020 and 2021, respectively. Among our cohort of D2T patients, CDAI remission was similar across the three periods (N = 30, 22.22%; N = 27, 23.68%; and N = 34, 21.52% respectively).

Conclusion: Although the pandemic has imposed changes in our healthcare delivery, these different strategies seem to be effective in ensuring satisfactory management of RA treated with targeted therapies. The approaches modulated in the context of the different periods have been a feasible compensation for ensuring disease control even in D2T patients.

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在 COVID-19 大流行时代,使用靶向疗法治疗类风湿关节炎患者的病情得到严格控制。
目的与大流行前(2019 年)相比,分析大流行第一波(2020 年)和第二/第三波(2021 年)期间不同医疗服务模式对接受靶向疗法治疗的类风湿关节炎(RA)患者病情缓解的影响:在这项观察性真实生活研究中,从纵向登记中提取了接受生物或靶向合成药物治疗的 RA 患者的数据。临床疾病活动指数(CDAI)在连续三年的同一时期(2 月 22 日至 5 月 18 日)进行分析。这三个时期的医疗服务模式各不相同:(1) 大流行前(2019 年)仅有亲自就诊,(2) 第一波期间(2020 年)有亲自就诊和远程医疗,(3) 第二波/第三波期间(2021 年)仅有亲自就诊。采用二项误差的广义线性模型来评估 CDAI 缓解患者比例的差异。量子回归用于比较难以治疗(D2T)患者的 CDAI 中位数:在三个阶段中,我们分别纳入了 407、450 和 540 名 RA 患者。三个时期的 CDAI 缓解率相似(2020 年和 2019 年的患病率比为 1.07,P 值为 0.423;2021 年和 2019 年的患病率比为 1.01,P 值为 0.934)。2019年、2020年和2021年的CDAI缓解率分别为40.55%(163人)、43.18%(155人)和40.82%(220人)。在我们的 D2T 患者队列中,三个时期的 CDAI 缓解率相似(分别为 30 人,22.22%;27 人,23.68%;34 人,21.52%):尽管大流行病给我们的医疗服务带来了变化,但这些不同的策略似乎能有效确保对接受靶向治疗的 RA 患者进行令人满意的管理。根据不同时期调整的方法是一种可行的补偿,即使对 D2T 患者也能确保疾病得到控制。
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来源期刊
CiteScore
14.10
自引率
10.60%
发文量
174
审稿时长
6-12 weeks
期刊介绍: Journal of Telemedicine and Telecare provides excellent peer reviewed coverage of developments in telemedicine and e-health and is now widely recognised as the leading journal in its field. Contributions from around the world provide a unique perspective on how different countries and health systems are using new technology in health care. Sections within the journal include technology updates, editorials, original articles, research tutorials, educational material, review articles and reports from various telemedicine organisations. A subscription to this journal will help you to stay up-to-date in this fast moving and growing area of medicine.
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