ArticleZeitschrift fur Rheumatologie2017
[The first biologic for rheumatoid arthritis: factors influencing the therapeutic decision].
Article in Zeitschrift fur Rheumatologie, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- The first biological choice in patients with rheumatoid arthritis: data from the Moroccan register of biotherapies.The Pan African medical journal · 2021Article
- Reality of care for musculoskeletal diseases at the population level : Results of the PROCLAIR collaborative project.Zeitschrift fur Rheumatologie · 2019Review
- [Reality of care for musculoskeletal diseases at the population level : Results of the PROCLAIR collaborative project. German version].Zeitschrift fur Rheumatologie · 2019Review
- [ADAPTHERA-Statewide cross-sectoral care network for patients with early rheumatoid arthritis shows sustained remission in standard care].Zeitschrift fur Rheumatologie · 2019Article
- Observational
- [Outpatient care and disease burden of rheumatoid arthritis : Results of a linkage of claims data and a survey of insured persons].Zeitschrift fur Rheumatologie · 2018Article
- [How frequent are poor prognostic markers in rheumatoid arthritis? : An estimate based on three epidemiologic cohorts].Zeitschrift fur Rheumatologie · 2017Article
- An Update on Statistical Boosting in Biomedicine.Computational and mathematical methods in medicine · 2017Review
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsBiologics (disease modifying antirheumatic drugs, bDMARD) have been in use in Germany for the treatment of rheumatoid arthritis (RA) since 2001, usually after failure of at least one conventional synthetic (cs)DMARD. We analyzed temporal changes in factors that influence the decision for either a first bDMARD or a further csDMARD. MATERIAL AND
methodsWe analyzed data from 9513 bDMARD-naive RA patients in the German biologics register RABBIT who switched to a new therapy. For three recruitment periods (2001-2003, 2004-2006 and 2009-2015) factors influencing the therapeutic decision were analyzed by means of machine learning methods and logistic regression analysis.
resultsIn all recruitment periods the number of previous csDMARDs, high dosages of glucocorticoids (>7.5 mg/day) and a higher DAS28 (>5.1) were significantly associated with the decision for a first bDMARD. Over time, the chance of receiving a bDMARD increased in patients with moderate disease activity, moderate glucocorticoid dosages (5-7.5 mg/day) and those with comorbidities, such as congestive heart failure or prior malignancy. Men had a higher chance of receiving a bDMARD than women only in the first recruitment period. Private health insurance, high education and gainful employment were significantly associated with more frequent prescription of bDMARDs in all recruitment periods. DISCUSSION: The time-dependent changes in the impact of disease activity, concomitant drugs, gender and comorbidity on the prescription of bDMARDs mirror the increasing therapeutic options and the growing experience in the application of the new substances in patients at higher risk. The influence of demographic and social factors may reflect safety concerns in patients at increased risk of adverse events but also the need to economize drug costs..
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