Evidence map›Paper›PMID 37914177›Full record

ArticleRMD open2023

Suboptimal management of rheumatoid arthritis in France: a real-world study based on data from the French National Health Data System.

Cécile Gaujoux-Viala, Jean-Francois Bergmann, Mélanie Goguillot, Asma Mélaine, Marie Guérin, Alban Edouard, Stève Bénard, Bruno Fautrel

Open access · goldAbstract read
In one paragraph

Article in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.7field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Management strategies in rheumatoid arthritis.Nature reviews. Rheumatology · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Cécile Gaujoux-VialaDesbrest Institute of Epidemiology and Public Health, University of Montpellier, INSERM, Department of Rheumatology, CHU Nîmes, Montpellier, France cecile.GAUJOUX.VIALA@chu-nimes.fr.
Jean-Francois BergmannAPHP, Hôpital Lariboisière, Paris, France.
Mélanie Goguillotstève consultants, Oullins, France.
Asma Mélainestève consultants, Oullins, France.
Marie GuérinGalapagos, Puteaux, France.
Alban EdouardGalapagos, Puteaux, France.
Stève Bénardstève consultants, Oullins, France.
Bruno FautrelSorbonne Université - Assistance Publique Hôpitaux de Paris, INSERM UMRS 1136, Hôpital de La Pitié Salpêtrière, Paris, France.ORCID 0000-0001-8845-4274
Galapagos (France) · FRInserm · FRAssistance Publique – Hôpitaux de Paris · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe emergence of targeted therapy is changing rheumatoid arthritis (RA) management, but real-world data remain limited. This study aimed to describe real-world RA treatment patterns using data from a French national claims database.

methodsThis longitudinal study used the French Permanent Representative Sample (Echantillon Généraliste des Bénéficiaires) claims database. Patients with RA were identified between 2013 and 2017, with treatment patterns, persistence and adherence described.

resultsThe study population included 2553 patients with RA. Disease-modifying antirheumatic drugs (DMARDs) were prescribed for 1512 (59.2%) patients, of whom 721 (47.6%) did not require discontinuation or treatment switch. There were 377 (24.9%) treatment discontinuations and 114 patients (7.5%) switched to a targeted DMARD (biological and synthetic (Janus kinase inhibitor) DMARDs). Among the 2315 patients with RA in 2017, almost half (n=1102, 47.6%) were not treated with a DMARD. Most (85.7%) received symptomatic treatment (analgesics (81.0%), steroids (49.2%), non-steroidal anti-inflammatory drugs (39.5%)). Of the 1142 treatment initiations identified, 713 (62.4%) were conventional synthetic DMARDs (csDMARDs), with methotrexate being the most frequent (n=553, 48.45%). One-year persistence rates varied between 55.9% (49.2-62.0%) for tumour necrosis factor inhibitors, and 63.4% (59.6-67.0%) for csDMARDs. Treatment adherence, assessed through medication possession ratio, varied between 71.9% and 90.8%, with ≥80% being the adherence cut-off. Almost half of DMARD initiations were associated with long-term (>6 months), high-dose oral steroid use (~7 mg/day prednisone equivalent).

conclusionDespite a diverse therapeutic arsenal, there remains a medical need that is not covered by current RA management, which is frequently compensated for by overprescription of steroids.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidHumansLongitudinal StudiesPrednisoneRetrospective StudiesAntirheumatic AgentsPrednisonearthritis, rheumatoidepidemiologyhealth services researchoutcome assessment, health care

Identifiers

PMID37914177
PMCPMC10619049
OpenAlexW4388142581

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.