Background/Purpose:

Emerging data on exposure of infants to therapeutics through placental transfer and breastmilk could impact the management of women of childbearing age (WoCBA) with rheumatic diseases (RD; including rheumatoid arthritis [RA], psoriatic arthritis [PsA] and ankylosing spondylitis [AS]). This descriptive study assessed differences in treatment patterns of patients (pts) with RD between WoCBA and comparator groups.

Methods:

IMS PharMetrics claims were used to identify pts continuously enrolled between Jan 2014–Dec 2015 with: ≥2 RD diagnosis codes and ≥1 RD diagnosis or ≥1 RD medication claim between Jan–Dec 2015 (measurement period). Age/gender at the start of the measurement period were used to allocate pts to the following cohorts: WoCBA (aged 18–44 years), Women (45–65), Men (18–44), and Men (45–65). Outcomes assessed in the measurement period included % biologics utilization and treatment changes (discontinuation [≥60-day gap with no additional biologic claims]; switch [initiation of new biologic within 60 days]; re-initiation of the same or new biologic [after gap ≥60 days]).

Results:

Of the WoCBA pts analyzed, 15,999 had RA, 2,682 PsA and 1,153 AS. Biologic utilization among WoCBA pts with RD was lower compared with men in the same age group. Use of methotrexate was similar between genders for RA and PsA pts, but higher for WoCBA than for men with AS (Figure A). Across RD pt cohorts on biologic therapy, WoCBA had the highest proportion of new and reinitiating pts, and the lowest proportion of continuing pts (Figure B). Similarly, across RD indications, the WoCBA pt group on biologic therapy had one of the highest numbers of Switch, Reinitiate (new), and Discontinue events, compared to all other groups.

Conclusion:

Despite the importance of disease control prior to, during and after pregnancy, trends show lower rates of biologic use in WoCBA pts. Further exploration is needed to better understand how treatment patterns among WoCBA pts are impacting their disease outcome and how to best optimize care.

The study was funded by UCB Pharma, conducted by Charles River Associates, medical writing by Julia Bárdos, Costello Medical, UK. We thank the patients, their caregivers and the investigators who contributed.