Persistence with biological drugs in patients treated in rheumatology practices in Germany
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The goal of this study was to investigate the persistence with biological drugs in patients treated in rheumatology practices in Germany. This study included patients diagnosed with rheumatoid arthritis (RA), psoriatic arthritis (PA), or ankylosing spondylitis (AS) who received a first prescription of biological drugs between 2008 and 2016 (index date) in 21 rheumatology practices in Germany (n = 4925; Disease Analyzer database). The main outcome measure was the rate of persistence within 5 years of the index date. Kaplan–Meier analyses were performed to study treatment persistence as a function of diagnosis, gender and age. A Cox proportional hazards regression model was used to estimate the relationship between non-persistence and diagnosis, gender, age, and comorbidities. After 5 years of follow-up, the rate of persistence was 31.8% in patients with RA, 35.2% in those with AS, and 33.2% in those with PA (log-rank p value = 0.028). Furthermore, 33.8% of men and 31.9% of women were persistent (log-rank p value = 0.035). The rate of persistence was 20.8%, 27.9%, 33.0%, 36.6%, 35.2%, and 32.0% in people aged ≤ 30, 31–40, 41–50, 51–60, 61–70, and > 70 years, respectively (log-rank p value = 0.002). The risk of discontinuation was lower in participants diagnosed with AS than in those diagnosed with RA [hazard ratio (HR) = 0.87; 95% confidence interval (CI) 0.79–0.96]. In addition, patients aged ≤ 30 years were more likely to discontinue their biological therapy than those aged > 70 years (HR = 1.29; 95% CI 1.10–1.52). Persistence with biological drugs was low after 5 years of follow-up in rheumatology practices.
KeywordsPersistence Biological drugs Rheumatology practices Germany Retrospective study
LJ and TC contributed to the interpretation of the data, drafted the manuscript and gave the final approval of the version to be published. KK contributed to the conception and the design of the study, revised the manuscript critically for important content, and gave the final approval of the version to be published.
The authors have received no financial support for the research, authorship, and/or publication of this article.
Compliance with ethical standards
Conflict of interest
Karel Kostev is an employee of IQVIA. IQVIA (https://www.iqvia.com/) is a commercial research institute providing information, services and technology for the healthcare industry. The other authors declare that they have no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
German law allows the use of anonymous electronic medical records for research purposes under certain conditions. According to this legislation, it is not necessary to obtain informed consent from patients or approval from a medical ethics committee for this type of observational study that contains no directly identifiable data. Because patients were only queried as aggregates and no protected health information was available for queries, no IRB approval was required for the use of this database or the completion of this study.
- 4.Boonen A, Linden SM van der (2006) The burden of ankylosing spondylitis. J Rheumatol Suppl 78:4–11Google Scholar
- 5.Lee S, Mendelsohn A, Sarnes E (2010) The burden of psoriatic arthritis. Pharm Ther 35:680–689Google Scholar
- 7.Braun J, Bollow M, Remlinger G et al (1998) Prevalence of spondylarthropathies in HLA-B27 positive and negative blood donors. Arthritis Rheum 41:58–67Google Scholar
- 10.Reich K, Krüger K, Mössner R, Augustin M (2009) Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1511 patients with plaque-type psoriasis. Br J Dermatol 160:1040–1047. https://doi.org/10.1111/j.1365-2133.2008.09023.x Google Scholar
- 11.Braun J, Kellner H, Max R, Rihl M, Schmitz-Bortz E, Schulze-Koops H, Zinke S, Fan T, Ding Q, Lyu R (2013) Disease severity, quality of life, and productivity loss among patients with ankylosing spondylitis in Germany. 2013 ACR/ARHP Annual Meeting (Abstract Number: 1012) Google Scholar
- 13.Haase I, Pongratz G, Sander O et al (2018) SAT0698 Mortality of patients with diagnosed rheumatoid arthritis (RA) in germany 2012: analysis of claims data from 60 million people. Ann Rheum Dis 77:1196–1197. https://doi.org/10.1136/annrheumdis-2018-eular.1651 Google Scholar
- 33.Lee M-Y, Shin J-Y, Park S-Y et al (2018) Persistence of biologic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis: an analysis of the South Korean National Health Insurance Database. Semin Arthritis Rheum 47:485–491. https://doi.org/10.1016/j.semarthrit.2017.08.007 Google Scholar