Changes in Patterns of Use of Advanced Therapies Following Emerging Data About Adverse Events in Patients With Rheumatoid Arthritis From the Veterans Affairs Health System.
Changes in Patterns of Use of Advanced Therapies Following Emerging Data About Adverse Events in Patients With Rheumatoid Arthritis From the Veterans Affairs Health System.
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DOI：
10.1002/acr2.11602
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发表时间：
2023-10
影响因子：
3.4
通讯作者：
Baker, Joshua F.
中科院分区：
文献类型：
--
作者：
Jeong, Stephanie;George, Michael D.;Mikuls, Ted R.;England, Bryant R.;Sauer, Brian;Cannon, Grant W.;Baker, Joshua F.
确定在2021年1月口腔类风湿性关节炎试验（Oral）监测试验结果发布后，Janus激酶抑制剂（JAKi）、肿瘤坏死因子抑制剂（TNFi）和非TNFi生物制剂的处方做法是否发生了变化。这是一项回顾性研究，研究对象是2012年1月至2022年9月在退伍军人事务卫生系统接受先进治疗的成年类风湿性关节炎（RA）患者。符合条件的患者被要求至少有一个RA的诊断代码，并接受了生物疾病修饰抗风湿药物或JAKi。根据药房调剂数据定义疗程，并随时间量化每种高级治疗的新疗程数。我们评估了安全性数据（2021年1月）发布前后每种疗法的使用变化。共有88,253个单独的药物疗程（34,656个独特的患者）被纳入研究。在2021年1月之前，JAKi新课程的数量和比例持续增加，随后到2022年9月，JAKi的使用出现了显著的净减少。安全性数据发布后，托法替尼的使用明显减少，使用变化斜率随时间的变化有显著差异。相比之下，尽管TNFi的使用量在2021年之前有所下降，但在2021年1月之后，其使用量显著增加。对新证据作出的处方变化强调了安全性试验对处方实践的影响。这一领域正在进行的研究，关注具体的患者特征和风险概况，将有助于在实践中描述这些变化。
To determine whether prescribing practices for Janus kinase inhibitors (JAKi), tumor necrosis factor inhibitors (TNFi), and non‐TNFi biologic agents changed after the results of the Oral Rheumatoid Arthritis Trial (ORAL) Surveillance trial were released in January 2021. This is a retrospective study in adult patients with rheumatoid arthritis (RA) receiving advanced therapies within the Veterans Affairs Health System from January 2012 through September 2022. Eligible patients were required to have at least one diagnosis code for RA and to have received a biologic disease‐modifying antirheumatic drug or JAKi. Treatment courses were defined from pharmacy dispensing data and the number of new courses of each advanced therapy was quantified over time. We assessed changes in the use of each therapy before and after the release of safety data (January 2021). A total of 88,253 individual drug courses (in 34,656 unique patients) were included in the study. There was a consistent increase in the number and proportion of new courses of JAKi leading up to January 2021, which was followed by a significant net decrease in JAKi use through September 2022. There was significantly less tofacitinib use after the release of safety data, with a significant difference in the slope of change in use with time. In contrast, whereas TNFi use declined leading up to 2021, its use significantly increased after January 2021. Changes in prescribing in response to new evidence emphasize the impact that safety trials have on prescribing practices. Ongoing study in this area, with attention to specific patient characteristics and risk profiles, will help characterize these changes in practice.
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影响因子：
158.5
作者：
Lee, Eun Bong;Fleischmann, Roy;van Vollenhoven, Ronald F.
通讯作者：
van Vollenhoven, Ronald F.
DOI：
10.1002/art.20827
发表时间：
2004-12-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Singh, JA;Holmgren, AR;Noorbaloochi, S
通讯作者：
Noorbaloochi, S
影响因子：
13.3
作者：
Fleischmann, Roy;Pangan, Aileen L.;Genovese, Mark C.
通讯作者：
Genovese, Mark C.
影响因子：
158.5
作者：
Rubbert-Roth, Andrea;Enejosa, Jeffrey;Xavier, Ricardo M.
通讯作者：
Xavier, Ricardo M.
影响因子：
158.5
作者：
Ytterberg, Steven R.;Bhatt, Deepak L.;Connell, Carol A.
通讯作者：
Connell, Carol A.