Real-World Treatment and Care Patterns in Patients With Rheumatoid Arthritis Initiating First-Line Tumor Necrosis Factor Inhibitor Therapy in the United States.
Journal
ACR open rheumatology
ISSN: 2578-5745
Titre abrégé: ACR Open Rheumatol
Pays: United States
ID NLM: 101740025
Informations de publication
Date de publication:
14 Jan 2024
14 Jan 2024
Historique:
revised:
29
11
2023
received:
12
07
2023
accepted:
04
12
2023
medline:
15
1
2024
pubmed:
15
1
2024
entrez:
14
1
2024
Statut:
aheadofprint
Résumé
Treatment guidelines for rheumatoid arthritis (RA) recommend targeting low disease activity or remission and switching therapies for patients not reaching those targets. We evaluated real-world use of disease activity measures, treatment discontinuation, and switching patterns among patients with RA initiating a first-line tumor necrosis factor inhibitor (TNFi). Data from adult patients with RA initiating a first-line TNFi were collected from the American Rheumatology Network (January 2014-August 2021). The proportion of patients with recorded disease activity scores (Clinical Disease Activity Index [CDAI] or Routine Assessment of Patient Index Data 3 [RAPID3]) at TNFi initiation was assessed. Among patients with moderate or severe RA at TNFi initiation, reasons for discontinuation and subsequent advanced therapy were evaluated. Among TNFi initiators (n = 15,182), 44.8% recorded a CDAI/RAPID3 score at treatment initiation; of those who did not, 47.0% had recorded a tender and/or swollen joint count or pain score. Among patients with moderate or severe RA (n = 1,651), 52% discontinued their initial TNFi during follow-up, of which 15%, 46%, 28%, and 12% initiated the same TNFi, another TNFi, a non-TNFi biologic, or a Janus kinase inhibitor, respectively. The proportion of patients restarting the same TNFi or initiating another TNFi varied according to TNFi discontinuation reason. In clinical practice, over half of patients with RA initiating a first-line TNFi did not have baseline disease activity assessments. Many patients cycled through TNFi despite citing lack of efficacy as the most common reason for discontinuation. Consistent, objective monitoring of treatment response and timely switch to effective therapy is needed in patients with RA.
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : AbbVie
Informations de copyright
© 2024 AbbVie Inc and The Authors. ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.
Références
Rein P, Mueller RB. Treatment with biologicals in rheumatoid arthritis: an overview. Rheumatol Ther 2017;4(2):247-261.
Radawski C, Genovese MC, Hauber B, et al. Patient perceptions of unmet medical need in rheumatoid arthritis: a cross-sectional survey in the USA. Rheumatol Ther 2019;6(3):461-471.
Fraenkel L, Bathon JM, England BR, et al. 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol 2021;73(7):1108-1123.
Smolen JS, Landewe RBM, Bijlsma JWJ, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis 2020;79(6):685-699.
Singh JA, Saag KG, Bridges SL, Jr, et al. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol 2016;68(1):1-26.
Saag KG, Teng GG, Patkar NM, et al. American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum 2008;59(6):762-784.
Bergman MJ, Kivitz AJ, Pappas DA, et al. Clinical utility and cost savings in predicting inadequate response to Anti-TNF therapies in rheumatoid arthritis. Rheumatol Ther 2020;7(4):775-792.
Arnell C, Bergman M, Basu D, et al. Guided therapy selection in rheumatoid arthritis using a molecular signature response classifier: an assessment of budget impact and clinical utility. J Manag Care Spec Pharm 2021;27(12):1734-1742.
Paula FS, Alves JD. Non-tumor necrosis factor-based biologic therapies for rheumatoid arthritis: present, future, and insights into pathogenesis. Biologics 2014;8:1-12.
Karpes Matusevich AR, Duan Z, Zhao H, et al. Treatment sequences after discontinuing a tumor necrosis factor inhibitor in patients with rheumatoid arthritis: a comparison of cycling versus swapping strategies. Arthritis Care Res (Hoboken) 2021;73(10):1461-1469.
Jin Y, Desai RJ, Liu J, et al. Factors associated with initial or subsequent choice of biologic disease-modifying antirheumatic drugs for treatment of rheumatoid arthritis. Arthritis Res Ther 2017;19(1):159.
Chastek B, Becker LK, Chen CI, et al. Outcomes of tumor necrosis factor inhibitor cycling versus switching to a disease-modifying anti-rheumatic drug with a new mechanism of action among patients with rheumatoid arthritis. J Med Econ 2017;20(5):464-473.
Helfgott S, Huston K, Singh J, et al. Development of the Patient-Important Outcomes Data Repository (PIONEER) for rheumatic diseases; an enhanced database combining electronic medical data with insight from chart reviews [abstract]. Arthritis Rheumatol 2022;74(Suppl 9).
Pincus T, Swearingen CJ, Bergman M, et al. RAPID3 (Routine Assessment of Patient Index Data 3), a rheumatoid arthritis index without formal joint counts for routine care: proposed severity categories compared to disease activity score and clinical disease activity index categories. J Rheumatol 2008;35(11):2136-2147.
Strand V, Tundia N, Song Y, et al. Economic burden of patients with inadequate response to targeted immunomodulators for rheumatoid arthritis. J Manag Care Spec Pharm 2018;24(4):344-352.
Curtis JR, Chen L, Greenberg JD, et al. The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights. Pharmacoepidemiol Drug Saf 2017;26(3):310-319.
Bergman M, Zhou L, Patel P, et al. Healthcare costs of not achieving remission in patients with rheumatoid arthritis in the united states: a retrospective cohort study. Adv Ther 2021;38(5):2558-2570.
Curtis JR, Chen L, Danila MI, et al. Routine use of quantitative disease activity measurements among US rheumatologists: implications for treat-to-target management strategies in rheumatoid arthritis. J Rheumatol 2018;45(1):40-44.
Pincus T, Yazici Y, Bergman MJ. RAPID3, an index to assess and monitor patients with rheumatoid arthritis, without formal joint counts: similar results to DAS28 and CDAI in clinical trials and clinical care. Rheum Dis Clin North Am 2009;35(4):773-778.
Cardarelli WJ. Managed care decision makers: understanding the full scope of rheumatoid arthritis management. Am J Manag Care 2016;22:S462-S469.
Bartlett SJ, De Leon E, Orbai AM, et al. Patient-reported outcomes in RA care improve patient communication, decision-making, satisfaction and confidence: qualitative results. Rheumatology (Oxford) 2020;59(7):1662-1670.
Taylor PC, Fautrel B, Piette Y, et al. Treat-to-target in rheumatoid arthritis: a real-world study of the application and impact of treat-to-target within the wider context of patient management, patient centricity and advanced therapy use in Europe. RMD Open 2022;8(2):e002658.
O'Neill KD, Marks KE, Sinicrope PS, et al. Importance of shared treatment goal discussions in rheumatoid arthritis-a cross-sectional survey: patients report providers seldom discuss treatment goals and outcomes improve when goals are discussed. ACR Open Rheumatol 2021;3(12):870-878.
Gavigan K, Nowell WB, Serna MS, et al. Barriers to treatment optimization and achievement of patients' goals: perspectives from people living with rheumatoid arthritis enrolled in the ArthritisPower registry. Arthritis Res Ther 2020;22(1):4.