Biologic use in psoriatic arthritis and ankylosing spondylitis patients: a descriptive epidemiological study using linked, routine data in Wales, UK.
Biologic use in psoriatic arthritis and ankylosing spondylitis patients: a descriptive epidemiological study using linked, routine data in Wales, UK.
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DOI：
10.1093/rap/rkab042
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发表时间：
2021
影响因子：
3.1
通讯作者：
Choy E
中科院分区：
文献类型：
--
作者：
Cooksey R;Rahman MA;Kennedy J;Brophy S;Choy E
PsA和AS是与显著发病率相关的慢性疾病。国家和国际管理指南包括生物疗法治疗，以改善预后和生活质量。在英国，关于患者从症状发作到诊断和治疗的真实数据有限。我们使用现实生活中的相关健康数据来探索患者的途径以及生物制剂对患者结局的影响。来自威尔士安全匿名信息链接数据库的数据用于评估≥18岁患者的诊断和治疗，在风湿病临床数据中至少有一个国际疾病分类第十版PsA/AS代码，在初级保健记录中至少有一个Read代码。我们调查了641例AS患者和1312例PsA患者的人口统计学资料、合并症和外科手术，同时调查了生物制剂的使用情况。AS患者在诊断时显着年轻，主要是男性。从出现症状到诊断为AS和PsA的平均时间为7.9（s.d.）。5.5)和9.3（s.d.）5.5)年，分别。AS患者接受生物制剂治疗的比例（46%）显著高于PsA患者（28.8%）;其中，23.1%的AS患者和22.2%的PsA患者停用/改用生物制剂。有一个显着减少初级保健的参与，病假条和残疾生活津贴的AS和PsA患者后，生物启动。这项真实世界的描述性研究证实，接受生物制剂治疗的患者尽管在首次出现症状后13年和诊断后6年开始治疗，但残疾和休假时间减少。
PsA and AS are chronic diseases associated with significant morbidities. National and international management guidelines include treatment with biologic therapies to improve outcomes and quality of life. There are limited real-world data on the patients’ journey from symptom onset to diagnosis and treatment in the UK. We use real-life, linked health data to explore patient pathways and the impact of biologics on patient outcomes. Data from the Secure Anonymised Information Linkage databank in Wales were used to assess diagnosis and treatment of patients ≥18 years of age with at least one International Classification of Diseases, Tenth Revision code present for PsA/AS in rheumatology clinic data and at least one Read code present in primary care records. We investigated the use of biologics while exploring demographics, comorbidities and surgical procedures of 641 AS patients and 1312 PsA patients. AS patients were significantly younger at diagnosis and were predominantly male. The average time from presenting symptoms to diagnosis of AS and PsA was 7.9 (s.d. 5.5) and 9.3 (s.d. 5.5) years, respectively. The proportion of patients receiving biologic treatment was significantly higher in AS (46%) compared with PsA patients (28.8%); of these, 23.1% of AS and 22.2% of PsA patients stopped/switched a biologic. There was a significant reduction in primary care involvement, sick notes and disability living allowance for both AS and PsA patients following biologic initiation. This real-world descriptive study confirms that patients treated with biologics have reduced disability and time off work despite being initiated ∼13 years after the first symptoms and 6 years after diagnosis.