Use of biologics for systemic sclerosis and systemic sclerosis-associated interstitial lung disease: Information from a Japanese hospital claims database

Abstract

Objectives Limited information is available on the use of biologics in patients with systemic sclerosis (SSc) or SSc-associated interstitial lung disease (SSc-ILD) in Japan. The types of biologics, treatment duration, treatment prior to biologics, concomitant treatment, and characteristics of patients receiving biologics were investigated. Method We used a Japanese hospital claims database provided by Medical Data Vision Co. (2008–2021). Results In the database, 1,186 of 34,207 SSc patients (3.5%) and 620 of 12,303 SSc-ILD patients (5.0%) received anti-interleukin-6 (anti-IL-6) drugs, anti-tumor necrosis factor (anti-TNF) drugs, abatacept, or rituximab. The most common were anti-IL-6 drugs (used in 35.5% of SSc patients and 38.5% of SSc-ILD patients [tocilizumab, 34.5% and 36.6%]), followed by anti-TNF drugs (31.3% and 26.5% [etanercept, 10.5% and 9.0%; others, <8%]), abatacept (17.5% and 20.6%), and rituximab (15.7% and 14.4%). Among SSc and SSc-ILD patients treated with anti-IL-6 drugs, anti-TNF drugs, or abatacept, the most common immunosuppressive drugs prior to initiation of biologics were methotrexate and tacrolimus. Approximately half of patients receiving anti-IL-6 drugs, anti-TNF drugs, or abatacept continued treatment beyond 1 year. Conclusions Our study indicates that off-label biologics have been used in a certain number of SSc or SSc-ILD patients in Japan, with tocilizumab the most common.

Correlation of High-Resolution Computed Tomography and Immunological Bronchoalveolar Lavage in Interstitial Lung Disease at the Onset of Inflammatory Rheumatic Diseases: Implications for Diagnosis and Therapeutic Strategies

“…This suggests a brotic component in addition to the in ammation. As a result, a combined anti-in ammatory and anti-brotic therapy should be initiated in these patients [24][25][26][27].…”