Introduction Some patients with rheumatoid arthritis (RA) using tumor necrosis factor inhibitors (TNFi) experience inefficacy or lack of tolerability and hence switch to another TNFi (cycling) or to a therapy with another mode of action (switching). This study examined patient characteristics, prescribing patterns and treatment practice for RA in the United States. Methods Data were from the Adelphi Disease Specific Programme (Q2-Q3 2016). Rheumatologists completed a survey and patient record forms for adult patients with RA who had received >= 1 targeted therapy. Patients were grouped by class of first-used targeted therapy, and monotherapy vs. combination therapy. TNFi patients who received >= 1 targeted therapy were classified as cyclers or switchers. Univariate analyses compared patient characteristics and physician factors across the analysis groups. Results Overall, 631 patients received >= 1 targeted therapy; 535 were prescribed a TNFi as first targeted therapy, 53 a nonTNFi biologic disease-modifying antirheumatic drug (bDMARD), and 43 tofacitinib. Of 577 patients with known conventional synthetic (cs) DMARD status, 18.7% were prescribed monotherapy and 81.3% combination therapy. Combination therapy patients received significantly more concomitant medications prior to initiation of first targeted therapy than monotherapy patients (P < 0.05). The top reason for physicians to prescribe first use targeted therapy was strong overall efficacy (79.9%). Of 163 patients who progressed to second targeted therapy, 60.7% were cyclers. A lower proportion of cyclers persisted on their first use targeted therapy versus switchers (P = 0.03). The main reason physicians gave for switching patients at this stage was worsening condition (46.6%). Conclusions Most patients were prescribed a TNFi as their first targeted therapy; over half then cycled to another TNFi. This suggests other factors may influence second use targeted treatment choice and highlights the need for greater understanding of outcomes associated with subsequent treatment choices and potential benefits of switching.
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Anderson P, 2008, CURR MED RES OPIN, V24, P3063, DOI [10.1185/03007990802457040, 10.1185/03007990802457040 ]
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Univ Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, AustraliaUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Cross, Marita
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Smith, Emma
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Univ Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, AustraliaUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Smith, Emma
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Hoy, Damian
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Univ Queensland, Sch Populat Hlth, Herston, Qld, AustraliaUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Hoy, Damian
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Carmona, Loreto
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Inst Salud Musculoesquelet InMusc, Madrid, SpainUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Carmona, Loreto
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Wolfe, Frederick
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Natl Data Bank Rheumat Dis, Wichita, KS USAUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Wolfe, Frederick
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Vos, Theo
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Univ Queensland, Sch Populat Hlth, Herston, Qld, Australia
Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USAUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Vos, Theo
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Williams, Benjamin
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Univ New S Wales, St George Clin Sch, Fac Med, Kogarah, NSW, AustraliaUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Williams, Benjamin
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Gabriel, Sherine
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Mayo Fdn, Dept Hlth Sci Res, Rochester, MN USAUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Gabriel, Sherine
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Lassere, Marissa
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Univ NSW, Fac Med, Sydney, NSW, Australia
St George Hosp, Dept Rheumatol, Sydney, NSW, AustraliaUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Lassere, Marissa
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Johns, Nicole
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Buchbinder, Rachelle
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Cabrini Inst, Monash Dept Clin Epidemiol, Melbourne, Vic, Australia
Monash Univ, Sch Publ Hlth & Prevent Med, Dept Epidemiol & Prevent Med, Melbourne, Vic 3004, AustraliaUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Buchbinder, Rachelle
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Woolf, Anthony
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Royal Cornwall Hosp, Dept Rheumatol, Truro, EnglandUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
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Univ Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, AustraliaUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Cross, Marita
;
Smith, Emma
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Univ Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, AustraliaUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Smith, Emma
;
Hoy, Damian
论文数: 0引用数: 0
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Univ Queensland, Sch Populat Hlth, Herston, Qld, AustraliaUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Hoy, Damian
;
Carmona, Loreto
论文数: 0引用数: 0
h-index: 0
机构:
Inst Salud Musculoesquelet InMusc, Madrid, SpainUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Carmona, Loreto
;
Wolfe, Frederick
论文数: 0引用数: 0
h-index: 0
机构:
Natl Data Bank Rheumat Dis, Wichita, KS USAUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Wolfe, Frederick
;
Vos, Theo
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Univ Queensland, Sch Populat Hlth, Herston, Qld, Australia
Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USAUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Vos, Theo
;
Williams, Benjamin
论文数: 0引用数: 0
h-index: 0
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Univ New S Wales, St George Clin Sch, Fac Med, Kogarah, NSW, AustraliaUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Williams, Benjamin
;
Gabriel, Sherine
论文数: 0引用数: 0
h-index: 0
机构:
Mayo Fdn, Dept Hlth Sci Res, Rochester, MN USAUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Gabriel, Sherine
;
Lassere, Marissa
论文数: 0引用数: 0
h-index: 0
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Univ NSW, Fac Med, Sydney, NSW, Australia
St George Hosp, Dept Rheumatol, Sydney, NSW, AustraliaUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Lassere, Marissa
;
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Johns, Nicole
;
Buchbinder, Rachelle
论文数: 0引用数: 0
h-index: 0
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Cabrini Inst, Monash Dept Clin Epidemiol, Melbourne, Vic, Australia
Monash Univ, Sch Publ Hlth & Prevent Med, Dept Epidemiol & Prevent Med, Melbourne, Vic 3004, AustraliaUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
Buchbinder, Rachelle
;
Woolf, Anthony
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h-index: 0
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Royal Cornwall Hosp, Dept Rheumatol, Truro, EnglandUniv Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia