Details
| Translated title of the contribution | Methotrexate treatment before use of biologics in rheumatoid arthritis: Analysis of guideline compliance |
|---|---|
| Original language | German |
| Pages (from-to) | 573-579 |
| Number of pages | 7 |
| Journal | Zeitschrift für Rheumatologie |
| Volume | 82 |
| Issue number | 7 |
| Early online date | 20 Sept 2021 |
| Publication status | Published - Sept 2023 |
Abstract
Background: With the introduction of biologics the treatment landscape for patients with rheumatoid arthritis (RA) has rapidly expanded; however, according to German and European treatment guidelines the use of biologic disease-modifying antirheumatic drugs (bDMARD) is only indicated after insufficient response under methotrexate (MTX) doses of at least 20 mg/week (first-line treatment). The aim of the study was to analyze the guideline compliance of MTX prescription in the outpatient sector prior to treatment with biologics. Material and methods: Claims data from the AOK Lower Saxony from 2013 to 2016 were provided for all insured patients with a diagnosis of RA and bDMARD prescription during the study period. Within a patient-specific observational period of 180 days prior to the first bDMARD prescription, the maximum prescribed MTX dosage was examined. Results: Data from 90 incident and 315 prevalent RA patients were analyzed. A maximum MTX prescription of < 20 mg/week was observed in 60.0% of incident patients and in 67.0% of prevalent patients. Men had a higher mean MTX maximum dose (17.1 ± 4.8 mg) than women (14.9 ± 5.0 mg; p < 0.0001). Of the study population 29.6% received oral only prescriptions during the observational period. In 12.4% of patients a switch to parenteral administration was made. Discussion: Targeted use of the full spectrum of therapies provided prior to initiation of bDMARD treatment may contribute to cost-effective RA care. This study showed indications for potential deficits in outpatient MTX prescription practice and can raise awareness for efficient treatment.
ASJC Scopus subject areas
- Medicine(all)
- Rheumatology
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In: Zeitschrift für Rheumatologie, Vol. 82, No. 7, 09.2023, p. 573-579.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Methotrexat-Versorgung vor dem Einsatz von Biologika bei rheumatoider Arthritis
T2 - Eine Analyse der Leitliniengerechtigkeit
AU - Pardey, Nicolas
AU - Zeidler, Jan
AU - Nellenschulte, Tim Fritz
AU - Stahmeyer, Jona T.
AU - Hoeper, Kirsten
AU - Witte, Torsten
PY - 2023/9
Y1 - 2023/9
N2 - Background: With the introduction of biologics the treatment landscape for patients with rheumatoid arthritis (RA) has rapidly expanded; however, according to German and European treatment guidelines the use of biologic disease-modifying antirheumatic drugs (bDMARD) is only indicated after insufficient response under methotrexate (MTX) doses of at least 20 mg/week (first-line treatment). The aim of the study was to analyze the guideline compliance of MTX prescription in the outpatient sector prior to treatment with biologics. Material and methods: Claims data from the AOK Lower Saxony from 2013 to 2016 were provided for all insured patients with a diagnosis of RA and bDMARD prescription during the study period. Within a patient-specific observational period of 180 days prior to the first bDMARD prescription, the maximum prescribed MTX dosage was examined. Results: Data from 90 incident and 315 prevalent RA patients were analyzed. A maximum MTX prescription of < 20 mg/week was observed in 60.0% of incident patients and in 67.0% of prevalent patients. Men had a higher mean MTX maximum dose (17.1 ± 4.8 mg) than women (14.9 ± 5.0 mg; p < 0.0001). Of the study population 29.6% received oral only prescriptions during the observational period. In 12.4% of patients a switch to parenteral administration was made. Discussion: Targeted use of the full spectrum of therapies provided prior to initiation of bDMARD treatment may contribute to cost-effective RA care. This study showed indications for potential deficits in outpatient MTX prescription practice and can raise awareness for efficient treatment.
AB - Background: With the introduction of biologics the treatment landscape for patients with rheumatoid arthritis (RA) has rapidly expanded; however, according to German and European treatment guidelines the use of biologic disease-modifying antirheumatic drugs (bDMARD) is only indicated after insufficient response under methotrexate (MTX) doses of at least 20 mg/week (first-line treatment). The aim of the study was to analyze the guideline compliance of MTX prescription in the outpatient sector prior to treatment with biologics. Material and methods: Claims data from the AOK Lower Saxony from 2013 to 2016 were provided for all insured patients with a diagnosis of RA and bDMARD prescription during the study period. Within a patient-specific observational period of 180 days prior to the first bDMARD prescription, the maximum prescribed MTX dosage was examined. Results: Data from 90 incident and 315 prevalent RA patients were analyzed. A maximum MTX prescription of < 20 mg/week was observed in 60.0% of incident patients and in 67.0% of prevalent patients. Men had a higher mean MTX maximum dose (17.1 ± 4.8 mg) than women (14.9 ± 5.0 mg; p < 0.0001). Of the study population 29.6% received oral only prescriptions during the observational period. In 12.4% of patients a switch to parenteral administration was made. Discussion: Targeted use of the full spectrum of therapies provided prior to initiation of bDMARD treatment may contribute to cost-effective RA care. This study showed indications for potential deficits in outpatient MTX prescription practice and can raise awareness for efficient treatment.
KW - Exhaustion
KW - Health insurance claims data
KW - Prescription
KW - Underuse
KW - bDMARD
UR - http://www.scopus.com/inward/record.url?scp=85115177646&partnerID=8YFLogxK
U2 - 10.1007/s00393-021-01086-0
DO - 10.1007/s00393-021-01086-0
M3 - Artikel
VL - 82
SP - 573
EP - 579
JO - Zeitschrift für Rheumatologie
JF - Zeitschrift für Rheumatologie
SN - 0340-1855
IS - 7
ER -