Disease-Modifying Medications in Patients with Rheumatoid Arthritis in the USA: Trends from 2016 to 2021.

IF 1.9 Q3 PHARMACOLOGY & PHARMACY Drugs - Real World Outcomes Pub Date : 2024-06-01 Epub Date: 2024-02-18 DOI:10.1007/s40801-024-00416-3
Samuel K Peasah, Elizabeth C S Swart, Yan Huang, Sandra L Kane-Gill, Amy L Seybert, Urvashi Patel, Chronis Manolis, Chester B Good
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Abstract

Background: Disease-modifying anti-rheumatic drugs (DMARDs), since their introduction in 1990, have revolutionized the management of rheumatoid arthritis. Newer DMARDs have recently been approved, influencing treatment patterns and clinical guidelines.

Objective: To update the current prescribing patterns of DMARDs in the pharmacotherapy of rheumatoid arthritis (RA) to include the pandemic era.

Methods: This was a retrospective cross-sectional multi-year study. Using Optum's Clinformatics® Data Mart Database, we summarized trends in the prevalence of DMARD use in the USA from 2016 to 2021 by year for adult patients ≥ 18 years old with at least one medical RA claim and one pharmacy/medical claim of a DMARD medication. Trends included type of DMARD, class of DMARD (conventional (csDMARDs), biologics [tumor necrosis factor (TNFi) and Non-TNFi), and Janus kinase inhibitors (JAKs)], and triple therapy [methotrexate (MTX), hydroxychloroquine (HCQ), sulfasalazine (SUL)] used.

Results: The total sample from 2016 to 2021 was 670,679 commercially insured patients. The average age was 63.7 years (SD 13.6), and 76.7% were female and 70% were White. csDMARDs remain the most prescribed (ranging from 77.2 to 79.2%). Although JAKs were the least prescribed DMARD class, their proportion more than doubled from 2016 (1.5%) to 2021 (4%). MTX utilization declined from 40% in 2016 to 34% in 2021. In contrast, HCQ use increased during the pandemic era from < 25% in 2018 to 30% in 2021. Although there is evidence of the therapeutic benefit of triple therapy, its use was very low (~ 1%) compared to biologics only (~ 17%) or biologics+MTX (~ 10%).

Conclusion: About half of patients with RA were on DMARDs. As expected, csDMARDs were highly used consistently. The COVID-19 pandemic might have influenced the use of HCQ and infusion DMARDs. Triple therapy use remains low.

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美国类风湿关节炎患者的疾病修饰药物治疗:2016 年至 2021 年的趋势。
背景:改变病情抗风湿药(DMARDs)自1990年问世以来,已彻底改变了类风湿关节炎的治疗方法。最近又有新的 DMARDs 获得批准,对治疗模式和临床指南产生了影响:更新类风湿性关节炎(RA)药物治疗中 DMARDs 的当前处方模式,将大流行时代纳入其中:这是一项回顾性横断面多年研究。利用 Optum 的 Clinformatics® Data Mart 数据库,我们总结了 2016 年至 2021 年美国 DMARD 使用的流行趋势,该趋势是针对年龄≥18 岁、至少有一次 RA 医疗索赔和一次 DMARD 药物的药房/医疗索赔的成年患者。趋势包括使用的DMARD类型、DMARD类别(常规(csDMARDs)、生物制剂[肿瘤坏死因子(TNFi)和非TNFi]和Janus激酶抑制剂(JAKs)],以及三联疗法[甲氨蝶呤(MTX)、羟氯喹(HCQ)、磺胺沙拉嗪(SUL)]:2016 年至 2021 年的样本总数为 670 679 名商业保险患者。平均年龄为 63.7 岁(SD 13.6),76.7% 为女性,70% 为白人。csDMARDs 仍然是处方最多的药物(占 77.2% 至 79.2%)。虽然JAKs是处方最少的DMARD类药物,但其比例从2016年(1.5%)到2021年(4%)增加了一倍多。MTX的使用率从2016年的40%降至2021年的34%。与此相反,HCQ的使用在大流行时期从结论中有所增加:大约一半的 RA 患者正在使用 DMARDs。不出所料,csDMARDs的使用率一直很高。COVID-19 大流行可能影响了 HCQ 和输液 DMARDs 的使用。三联疗法的使用率仍然很低。
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来源期刊
Drugs - Real World Outcomes
Drugs - Real World Outcomes PHARMACOLOGY & PHARMACY-
CiteScore
3.60
自引率
5.00%
发文量
49
审稿时长
8 weeks
期刊介绍: Drugs - Real World Outcomes targets original research and definitive reviews regarding the use of real-world data to evaluate health outcomes and inform healthcare decision-making on drugs, devices and other interventions in clinical practice. The journal includes, but is not limited to, the following research areas: Using registries/databases/health records and other non-selected observational datasets to investigate: drug use and treatment outcomes prescription patterns drug safety signals adherence to treatment guidelines benefit : risk profiles comparative effectiveness economic analyses including cost-of-illness Data-driven research methodologies, including the capture, curation, search, sharing, analysis and interpretation of ‘big data’ Techniques and approaches to optimise real-world modelling.
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