Biologic and Targeted Synthetic DMARD Utilization in the United States: Adelphi Real World Disease Specific Programme for Rheumatoid Arthritis.
Biologic and Targeted Synthetic DMARD Utilization in the United States: Adelphi Real World Disease Specific Programme for Rheumatoid Arthritis.
复制标题
DOI：
10.1007/s40744-021-00357-1
复制
发表时间：
2021-12
影响因子：
3.8
通讯作者：
Furst DE
中科院分区：
文献类型：
--
作者：
Holdsworth EA;Donaghy B;Fox KM;Desai P;Collier DH;Furst DE
对于第一生物抗风湿药物（bDMARD）反应不足或不耐受的患者，指南建议改用不同作用机制的药物或另一种bDMARD。然而，在bDMARD/靶向合成（ts）DMARD之间切换的原因在许多研究中没有很好的记录。本研究的目的是评估风湿病学家对选择初始b/tsDMARD治疗的看法和行为，以及在当前治疗模式下在bdmard /tsDMARD之间切换的原因。这是对第12届阿德尔菲真实世界疾病类风湿性关节炎（RA）特定项目收集的数据的回顾性分析。参与治疗决策的合格风湿病学家每月完成患者病历表(prf)≥10例。患者年龄≥18岁，诊断为RA并接受bDMARD/tsDMARD治疗。评估的结果是在分子和分类水平上接受bDMARD/tsDMARD治疗的患者比例；风湿病学家报告的选择治疗的原因；切换bdmard / tsdmard的患者比例；以及风湿病学家报告的转换治疗的原因。86名风湿病学家为1027名患者完成了PRFs。其中621个在数据收集时接收bDMARD/tsDMARD。大多数（73%）患者接受了一线bDMARD/tsDMARD治疗，68%的患者接受了肿瘤坏死因子抑制剂（TNFi）治疗，21%的患者接受了Janus激酶抑制剂（JAKi）治疗。总疗效强的应答选项是选择一线和二线bDMARD/tsDMARD的主要原因。共有163名患者从一线b/tsDMARD治疗转为二线b/tsDMARD治疗。其中，分别有44,28和17%的患者从TNFi切换到另一种TNFi， TNFi切换到非tnf生物，TNFi切换到JAKi。缺乏疗效和病情恶化是切换治疗的最常见原因。tnfi仍然是一线和二线治疗中最常用的药物。总体疗效强是选择治疗的主要原因，疗效丧失是转换治疗的主要原因。在线版本包含补充材料，可在10.1007/s40744-021-00357-1获得。
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. 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. 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. 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. The online version contains supplementary material available at 10.1007/s40744-021-00357-1.
登录
查看更多内容
影响因子：
3.9
作者：
Youssef, Peter;Marcal, Bruno;Littlejohn, Geoff
通讯作者：
Littlejohn, Geoff
影响因子：
4
作者：
Hunter, Theresa M.;Boytsov, Natalie N.;Araujo, Andre B.
通讯作者：
Araujo, Andre B.
影响因子：
2.5
作者：
Narongroeknawin, Pongthorn;Chevaisrakul, Parawee;Katchamart, Wanruchada
通讯作者：
Katchamart, Wanruchada
影响因子：
2.3
作者：
Anderson, P.;Benford, M.;Piercy, J.
通讯作者：
Piercy, J.
影响因子：
4.7
作者：
Fraenkel, Liana;Bathon, Joan M.;England, Bryant R.;St Clair, E. William;Arayssi, Thurayya;Carandang, Kristine;Deane, Kevin D.;Genovese, Mark;Huston, Kent Kwas;Kerr, Gail;Kremer, Joel;Nakamura, Mary C.;Russell, Linda A.;Singh, Jasvinder A.;Smith, Benjamin J.;Sparks, Jeffrey A.;Venkatachalam, Shilpa;Weinblatt, Michael E.;Al-Gibbawi, Mounir;Baker, Joshua F.;Barbour, Kamil E.;Barton, Jennifer L.;Cappelli, Laura;Chamseddine, Fatimah;George, Michael;Johnson, Sindhu R.;Kahale, Lara;Karam, Basil S.;Khamis, Assem M.;Navarro-Millan, Iris;Mirza, Reza;Schwab, Pascale;Singh, Namrata;Turgunbaev, Marat;Turner, Amy S.;Yaacoub, Sally;Akl, Elie A.
通讯作者：
Akl, Elie A.