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Abstract Number: 1478

The Prevalence Of Biological Monotherapy Among Rheumatoid Arthritis Patients In Denmark: Results From The Danish Nationwide Danbio Registry

Tanja Schjoedt Joergensen1, Lars-Erik Kristensen2, Tove Lorenzen3, Jørgen Jensen4, Lida Zanjani5, Toke Laursen6, Sheraz Butt7, Mette Y. Dam8, Hanne M. Lindegaard9, Jakob Espesen10, Oliver Hendricks11, Prabhat Kumar12, Anita Kincses13, Line H. Larsen14, Marlene Andersen15, Esben K. Næser16, Dorte V. Jensen17, Jolanta Grydehøj18, Barbara Unger19, Ninna Dufour20, Vibeke N. Sørensen21, Sara Vildhøj22, Inger Marie J. Hansen23, Johnny Raun24 and Merete Lund Hetland25, 1The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark, 2Dept of Clinical Sciences, Lund, Section for Rheumatology, Lund University, Faculty of Medicine, Malmö, Sweden, 3Department of Rheumatology, Region Hospital Silkeborg, Silkeborg, Denmark, 4Department of Rheumatology, Køge, Denmark, 5Department of Rheumatology, Glostrup, Denmark, 6Department of Rheumatology, Gentofte, Denmark, 7Department of Rheumatology, Frederiksberg, Denmark, 8Department of Rheumatology, Aarhus, Denmark, 9Department of Rheumatology, Odense University Hospital, Odense, Denmark, 10Department of Rheumatology, Vejle, Denmark, 11Department of Rheumatology, Gråsten, Denmark, 12Department of Rheumatology, Esbjerg, Denmark, 13Department of Rheumatology, Copenhagen, Denmark, 14Department of Rheumatology, Aalborg, Denmark, 15Department of Rheumatology, Aalborg University, Hjørring, Denmark, 16Department of Rheumatology, Silkeborg, Denmark, 17Department of Rheumatology, Rønne, Denmark, 18Department of Rheumatology, Viborg, Denmark, 19Department of Rheumatology, Horsens, Denmark, 20Department of Rheumatology, Helsingør, Denmark, 21Department of Rheumatology, Randers, Denmark, 22Department of Rheumatology, Holstebro, Denmark, 23Department of Rheumatology, Svendborg, Denmark, 24Department of Rheumatology, Fredericia, Denmark, 25Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, The Danish Rheumatologic Database (DANBIO), Glostrup Hospital., Copenhagen, Denmark

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Biologic agents, biologic drugs and rheumatoid arthritis (RA)

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Session Information

Session Title: Rheumatoid Arthritis Treatment - Small Molecules, Biologics and Gene Therapy II

Session Type: Abstract Submissions (ACR)

Background/Purpose:

It is estimated that between 10 and 30% of rheumatoid arthritis (RA) patients are methotrexate (MTX)-intolerant and discontinuation is common in clinical practice. For RA patients’ requiring biological treatment and not tolerating MTX, the options are either combination therapy with other disease-modifying antirheumatic drugs (DMARDs) or biological monotherapy. In Denmark it is mandatory to register the patients in the national database, DANBIO. The objective of the present study was to elucidate the prevalence of Danish RA patients currently on biological monotherapy.

Methods:

All RA patients, treated with biologics, that were registered in DANBIO, as receiving biological treatment as monotherapy during the period May 1st 2011 to April 30th 2013 were eligible for inclusion. All files of individual patients were reviewed for inconsistence with the treatment registration in DANBIO. Results are presented as descriptive statistics, with no adjustments or statistical models applied.

Results:

Twenty-one of 25 Danish rheumatology departments participated in the study. In total 4,744 RA patients were registered in DANBIO as being in biological treatment, of which 4,151 (87.5%, Figure) were treated in the participating departments. Of these, 1,000 (24.1%) were registered as receiving biological monotherapy. 225 (22.5%) of the 1000 were excluded after file review due to use of concomitant conventional DMARDs not registered in DANBIO, leaving 775 (18.7%) in verified currently biological monotherapy. Etanercept, adalimumab, tocilizumab and rituximab were the biological drugs that most often were given in monotherapy (Table).

Conclusion:

In Denmark, 18.7% of biological treatments for RA are prescribed as monotherapy, i.e. without concomitant DMARDS. Monotherapy is prevalent across all biologics, while with a preponderance with adalimumab, etanercept, and tocilizumab, all three having the indication monotherapy.

 

Acknowledgement:

This study was supported by the Oak Foundation and Roche Denmark

Figure: Flow diagram

 

 

 

 

 

 

 

 

 

 

 

Table: The distribution of various biologics.

 

Numbers treated

(N=775)

% of total

Abatacept

17

2.2

Adalimumab

165

21.3

Anakinra

3

0.4

Certolizumab

26

3.4

Etanercept

284

36.6

Golimumab

21

2.7

Infliximab

48

6.2

Rituximab

92

11.9

Tocilizumab

119

15.3

 

 

 


Disclosure:

T. S. Joergensen,

Roche Pharmaceuticals,

2;

L. E. Kristensen,

Pfizer, Wyeth, Abbott, BMS, MSD and Schering-Plough.,

5;

T. Lorenzen,

Advisory Board member of Roche and Pfizer,

6;

J. Jensen,
None;

L. Zanjani,
None;

T. Laursen,
None;

S. Butt,
None;

M. Y. Dam,
None;

H. M. Lindegaard,

Lilly, MSD, Nordpharma and Roche,

5;

J. Espesen,
None;

O. Hendricks,
None;

P. Kumar,
None;

A. Kincses,
None;

L. H. Larsen,
None;

M. Andersen,
None;

E. K. Næser,
None;

D. V. Jensen,
None;

J. Grydehøj,
None;

B. Unger,
None;

N. Dufour,
None;

V. N. Sørensen,
None;

S. Vildhøj,
None;

I. M. J. Hansen,
None;

J. Raun,
None;

M. L. Hetland,

Pfizer, ROche og MSD.,

5.

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