Real-world utilization of DMARDs and biologics in rheumatoid arthritis: the RADIUS (Rheumatoid Arthritis Disease-Modifying Anti-Rheumatic Drug Intervention and Utilization Study) study

Gibofsky, Allan; Palmer, William; Goldman, John A.; Lautzenheiser, Richard L; Markenson, Joseph A.; Weaver, Arthur L.; Schiff, Michael; Keystone, Edward; Paulus, Harold E.; Harrison, Melanie; Whitmore, James B.; Leff, Jonathan A.

doi:10.1185/030079906x80341

Cited by 44 publications

(16 citation statements)

References 17 publications

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“…Data from the anti-rheumatic drug intervention and utilization study (RADIUS) study, a real-world prospective observational program of rheumatoid arthritis patients aimed at assessing prescribing patterns, safety and effectiveness of disease modifying anti-rheumatic drugs (DMARDs) and biologics, showed similar rates of biologic prescribing for the older (≥ 65 years) and younger (<65 years) patients. 31 Extrapolations from rheumatoid arthritis-based studies focusing on the older population indicate an increased risk of serious infection and hospitalization with immunosuppression, but the safety signals are greater with corticosteroids and non-biologic DMARDs compared to anti-TNF based therapies. 32, 33 …”

Section: Discussionmentioning

confidence: 99%

Medication Utilization and the Impact of Continued Corticosteroid Use on Patient-reported Outcomes in Older Patients with Inflammatory Bowel Disease

Geisz

Kappelman

et al. 2016

Inflammatory Bowel Diseases

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Background Older individuals with inflammatory bowel disease (IBD) require ongoing medications. We aimed to describe 1) medication use in older and younger IBD patients and 2) medication associations with patient reported outcomes (PRO’s) in older patients. Methods We conducted cross-sectional and longitudinal analyses within CCFA Partners internet-based cohort of patients with self-reported IBD. We assessed medication use by disease sub-type and age. We used bivariate analyses to 1) compare medication use in older and younger patients and 2) determine associations between continued steroid use and PRO’s in older patients. Results We included 5382 participants with IBD; 1004 were older (≥ age 60). Older patients with Crohn’s disease (CD) had lower anti-tumor necrosis factor alpha (anti-TNF) use at baseline (29.1% vs 44.3%, p<0.001), comparable steroid use (16.0% vs. 16.5%, p=0.77), and higher aminosalicylate use (40.3% vs. 33.9%, p=0.003) versus younger patients. Older ulcerative colitis (UC) patients had similar anti-TNF use (16.0% vs. 19.2%, p=0.16), lower steroid use (9.6% vs. 15.4%, p=0.004) and higher aminosalicylate use (73.8% vs. 68.2%, p=0.04) at baseline. In longitudinal analyses, older CD patients had higher continued steroid use (11.6% vs. 7.8%, p=0.002); which was associated with worsened anxiety (p=0.02), sleep (p=0.01), and fatigue (p=0.001) versus non-use. Older CD patients on steroids, versus anti-TNF or immunomodulators, had increased depression (p=0.04) and anxiety (p=0.03). Conclusions Medication utilization differs in older patients with IBD. Older CD patients have higher continued steroid use; associated with worsened PRO’s. As in younger IBD populations; continued steroid use should be limited in older patients.

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Section: Discussionmentioning

confidence: 99%

Medication Utilization and the Impact of Continued Corticosteroid Use on Patient-reported Outcomes in Older Patients with Inflammatory Bowel Disease

Geisz

Kappelman

et al. 2016

Inflammatory Bowel Diseases

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“…Prior studies have shown that older age has little effect on differential DMARD selection for treatment of RA. [1,13,14,26] Based on these factors, we do not believe that dual use will substantially affect our estimates of impact of specific DMARDs on HFI risk.…”

Section: Discussionmentioning

confidence: 99%

TNF-α Antagonist Use and Risk of Hospitalization for Infection in a National Cohort of Veterans With Rheumatoid Arthritis

et al. 2011

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Medications used to treat rheumatoid arthritis (RA) may confer an increased risk of infection. We conducted a retrospective cohort study of veterans with RA followed in the United States Department of Veterans Affairs health care system from October 1998 through June 2005. Risk of hospitalization for infection associated with tumor necrosis factor (TNF)-α antagonists therapy was measured using an extension of Cox proportional hazards regression, adjusting for demographic characteristics, comorbid illnesses, and other medications used to treat RA.

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“…Real-world efficacy data were also reported from the Rheumatoid Arthritis DMARD Intervention and Utilization Study (RADIUS), a 5-year, multicenter, observational registry of patients treated with etanercept and other RA therapies in the United States ( N = 10,061 in 2 cohorts) [26, 27]. Although safety data have not yet been reported, patients treated with etanercept, with ( p < 0.01) or without ( p < 0.05) methotrexate, were significantly more likely to have a modified ACR 20% response at 12 months compared with those receiving only methotrexate.…”

Section: Discussionmentioning

confidence: 99%

Postmarketing surveillance of safety and effectiveness of etanercept in Japanese patients with rheumatoid arthritis

Koike¹,

Harigai²,

Inokuma³

et al. 2011

Modern Rheumatology

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Our aim was to evaluate real-world safety and effectiveness in a 6-month postmarketing surveillance study covering all Japanese patients with rheumatoid arthritis (RA) who received etanercept during a 2-year period. Data for 13,894 patients (1334 sites) enrolled between March 2005 and April 2007 were collected. Adverse events (AEs) and serious adverse events (SAEs) were reported in 4336 (31.2%) and 857 (6.2%) patients, respectively. The most frequent AEs were injection site reactions (n = 610, 4.4%) and rash (n = 339, 2.4%), whereas pneumonia (n = 116, 0.8%) and interstitial lung disease (n = 77, 0.6%) were the most frequent SAEs. Significant improvement in the proportion of patients with a good European League Against Rheumatism (EULAR) response was observed from week 4 (17.6%) to week 24 (31.6%) (p \ 0.001); 84.3% of patients had good or moderate EULAR responses at week 24. The percentage of patients achieving remission increased significantly from week 4 (9.3%) to week 24 (18.9%) (p \ 0.001). Patients with early moderate RA were less likely to experience SAEs and were more likely to achieve remission compared with patients with more severe disease. The safety and effectiveness of etanercept was demonstrated in Japanese patients in one of the largest observational trials conducted thus far in RA patients treated with biologics.

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Real-world utilization of DMARDs and biologics in rheumatoid arthritis: the RADIUS (Rheumatoid Arthritis Disease-Modifying Anti-Rheumatic Drug Intervention and Utilization Study) study

Cited by 44 publications

References 17 publications

Medication Utilization and the Impact of Continued Corticosteroid Use on Patient-reported Outcomes in Older Patients with Inflammatory Bowel Disease

Medication Utilization and the Impact of Continued Corticosteroid Use on Patient-reported Outcomes in Older Patients with Inflammatory Bowel Disease

TNF-α Antagonist Use and Risk of Hospitalization for Infection in a National Cohort of Veterans With Rheumatoid Arthritis

Postmarketing surveillance of safety and effectiveness of etanercept in Japanese patients with rheumatoid arthritis

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