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Effectiveness of Biologics in Australian Patients with Rheumatoid Arthritis: A Large Observational Study: REAL
Journal article   Peer reviewed

Effectiveness of Biologics in Australian Patients with Rheumatoid Arthritis: A Large Observational Study: REAL

Dave Nicholls, Rina Barrett, Peter Button, Matt Truman, Paul Bird, Lynden Roberts, Kathleen Tymms, Geoffrey Littlejohn and Hedley Griffiths
Internal Medicine Journal, Vol.48(10), pp.1185-1192
2018
DOI: https://doi.org/10.1111/imj.14028
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https://doi.org/10.1111/imj.14028View
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Abstract

Opal-qumi biologic DMARD monotherapy persistence rheumatoid arthritis
AIMS: To assess the effectiveness of biologic disease-modifying anti-rheumatic drugs (bDMARDs) as monotherapy or in combination with methotrexate and/or other conventional DMARDs (cDMARDs) for treatment of rheumatoid arthritis (RA). METHODS: A retrospective, non-interventional study which investigated the use of bDMARDs in adult patients with RA in routine clinical practice. Data was extracted from the OPAL-QUMI database. Real-world effectiveness was measured using the 28-joint disease activity score (DAS28) and clinical disease activity index (CDAI) by treatment group at baseline, week 12 and week 24. RESULTS: 2,970 patients were included with median (min-max) age of 60.0 (19.0-94.0) years and median (min-max) duration of RA before first bDMARD treatment of 6.0 (0.2-58.3) years. A total of 1,177 patients received more than one bDMARD during the analysis period 1 January 1997 to 15 August 2015. Patients had 4,922 treatment "episodes" (defined as a cycle of continuous individual bDMARD prescribing in a single patient). Patients received a mean (SD) of 1.7 (1.0) episodes of treatment with median (min-max) treatment duration 0.7 (0-11.8) years; median treatment duration was higher with the first treatment episode. bDMARDs were most commonly initiated in combination with methotrexate (73.9% of episodes) and least commonly as monotherapy (9.9% of episodes). Median (min-max) baseline DAS28 decreased from 5.3 (0-8.7) with the first bDMARD to 3.7 (0-8.8) with the second. Median baseline CDAI similarly decreased. CONCLUSIONS: Patients tended to persist longer on their first bDMARD treatment. bDMARDs as monotherapy or in combination appear to be accepted treatment strategies in the real world.

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