Epidemiology and Treatment of Patients with Rheumatoid Arthritis, Psoriatic Arthritis and Psoriasis in Germany: A Real-World Evidence Study

Abstract

Introduction: Rheumatoid arthritis (RA), psoriatic arthritis (PsA) and psoriasis (PSO) are chronic inflammatory diseases that have a substantial impact on patients' health. This retrospective database study aimed to assess the epidemiology, comorbidities, diagnosis and treatment patterns of RA, PsA and PSO in the German population. Methods: Data were extracted from the Deutsche Forschungsdatenbank für Abrechnungsinformationen der Krankenversicherung database from 2012 to 2016 for patients aged C 18 years holding full health coverage in the reporting year at least. Diagnoses were defined according to International Classification of Diseases (ICD)-10 codes. Reported outcomes included prevalence and incidence rates, pre-defined comorbidities, diagnosing and treating physicians, and treatment exposure. A subgroup analysis was performed for women of childbearing age (females aged 18-45 years). Results: The prevalence rates of RA, PsA and PSO in Germany were consistent over the study period; by 2016 they were 0.4%, 0.3% and 2.1%, respectively, and in women of childbearing age they were 0.2%, 0.2% and 1.5%, respectively. RA, PsA and PSO were predominantly observed among patients aged [ 45 years. RA and PsA were more prevalent in women, while PSO had an approximately equal gender distribution. Depressive episodes were the most frequently reported comorbidity in 2016 (RA: 25.7%; PsA: 25.1%; PSO: 17.8%), and this was similar in women of childbearing age (RA: 20.5%; PsA: 23.4%; PSO: 16.3%). Approximately 50% of patients with RA and PsA and 6% of patients with PSO were receiving systemic treatment in 2016, of which methotrexate (RA: 38.4%; PsA: 30.2%; PSO: 2.2%) was most common. Biologic therapies were the least frequently used treatment options (RA: 28.9%; PsA: 20.9%; PSO: 1.8%). Conclusions: This analysis provides key epidemiological information for patients with RA, PsA and PSO, including in women of childbearing age, in Germany and highlights common comorbidities and that patients were likely receiving insufficient treatment for these diagnoses.

Treatment Patterns and Pharmacoutilization in Patients Affected by Psoriasis: An Observational Study in an Italian Real-World Setting

“…Furthermore, the lower percentage of patients on biologic agents may be explained by limitations related to the prescription of these agents to patients with moderate-to-severe forms [ 16 ]. Indeed, similar proportions (0.25–2%) were observed in other studies based on claim databases [ 24 , 25 ], while a Belgian cross-sectional study that focused on moderate-to-severe PP reported that 29.5% of patients were receiving biologics [ 26 ].…”

Prescription Behaviour and Barriers to Prescription of Biologicals for Treatment of Chronic Inflammatory Skin Diseases in Dermatological Practice in Two German Federal States

“…Despite the high cost of this medication, a cost-effectiveness advantage of treatment with biologicals has been shown in several studies ( 24 , 25 ). Nevertheless, prescription rates of biologicals were found to be low compared with the number of eligible patients in several European countries ( 26 , 27 ). In a study from 2017, barriers to the prescription of biologicals included regulatory issues, high therapy costs, and low reimbursement for patient care for office-based dermatologists in Bavaria ( 28 ).…”

Systematisches Review zur Schätzung der Prävalenz entzündlich rheumatischer Erkrankungen in Deutschland

“…Für die rheumatoide Arthritis (RA) liegen 5 Routinedatenanalysen und patientenberichtete Angaben aus der NAKO-Gesundheitsstudie vor. Die Prävalenzangaben variieren je nach Falldefinition der RA von 0,4% (Grellmann et al [6]) bis 1,85 % (selbstberichtete ärztliche Diagnose aus der NAKO-Gesundheitsstudie [4]), s. . Abb.…”