ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2244

Utilization Patterns of Subcutaneously Administered Biologic Medications within a Sample of Rheumatoid Arthritis Patients

Joseph Tkacz1, Brenna Brady2, Lorie A. Ellis3 and Roxanne Meyer4, 1Health Analytics, Columbia, MD, 2Health Analytics, LLC, Columbia, MD, 3Health Economics & Outcomes Research, Janssen Scientific Affairs, LLC, Horsham, PA, 4Janssen Scientific Affairs, Horsham, PA

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Biologic agents and rheumatoid arthritis (RA)

  • Tweet
  • Email
  • Print
Session Information

Date: Tuesday, November 15, 2016

Session Title: Health Services Research - Poster III

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

 

Background/Purpose:   Adherence to medication is crucial to the maximum therapeutic benefit of biologic treatment. The plethora of currently approved biologic agents makes comparison of the various medications more difficult, particularly when drug dosing and administration schedules vary. This study used administrative claims to investigate real world utilization and adherence patterns of subcutaneous (subQ) biologic treatment in a population of patients with RA.

Methods: The earliest incident adalimumab (ADA), certolizumab (CER), etanercept (ETA), and golimumab (GLM) biologic cycles of treatment were identified in the Truven MarketScan® and Optum Clinformatics™ research databases for adult patients with an RA diagnosis (ICD-9: 714.xx) between 2009 – 2013. Members were required to have ≥ two index biologic fills, and continuous eligibility for at least 6 months prior to biologic initiation. Members were followed until the end of their treatment, eligibility was lost, or the end of the data was reached. Utilization measures included biologic placement, treatment gaps measured as the number of days between expected refill dates, dose escalation, defined as any appearance of a twofold increase in dose from the starting dose, and medication adherence assessed by the proportion of days’ covered (PDC).  Members with 80% of the days in their treatment period covered by the index medication were categorized as adherent. One-way ANOVA and chi-square tests of equality of proportions were conducted to assess group differences.

 

Results: Modal monthly calculated dosages were in line with recommended prescribing guidelines for all four treatments (Table 1).  GLM and CER were significantly less likely to be administered as a first line biologic compared to ADA and ETA; however GLM members were more likely to be adherent (ps < 0.05).  ADA and GLM members displayed the greatest refill consistency within the Truven database as evidenced by lower gaps between refills (ps < 0.05).  Consistent with the label, ADA cycles were more likely to show a dose escalation (ps < 0.001).  Nearly two-thirds of all treatment cycles persisted for ≥ 6 months, with the greatest proportion from the ETA group across both databases. (p < 0.001).  

Conclusion:   Significant differences in biologic utilization patterns were observed among the four treatment groups. ADA and ETA were the most common first line biologics, though GLM cycles were associated with greater refill consistency and levels of adherence. These findings have implications for healthcare decision makers interested in quality improvement or optimization of adherence in patients treated with subcutaneous biologic therapies.  

Table 1. Biologic Utilization Descriptive Statistics: Results from Multiple Data Sources
 

ADA 

 

CER

 

ETA

 

GLM

 

 

 

Truven Database
Sample Size

11,425

1,471

12,965

2,043

Recommended Mo. Dose

80 mg1

400 mg

200 mg

50 mg

Modal Calculated Dose

80 mg

400 mg

196 mg

47 mg

f

%

f

%

f

%

f

%

p

post hoc2

% Adherent (PDC ≥ 0.80)

8,614

75.4%

980

66.6%

9,318

71.9%

1,619

79.2%

<0.001

a,b,c,d,e,f

% as 1st Line Therapy

8,678

76.0%

694

47.2%

10,686

82.4%

994

48.7%

<0.001

a,b,c,d

% Continuing for ≥ 6 Months

7,909

69.2%

960

65.3%

9,171

70.7%

1,393

68.2%

<0.001

a,b,d,f

% with a Dose Escalation

1,356

11.9%

76

5.2%

432

3.3%

78

3.8%

<0.001

a,b,c,d,f

Mean

SD

Mean

SD

Mean

SD

Mean

SD

Refill Interval Gap (days)

9.2

13.5

10.3

11.1

10.4

15.1

8.4

9.9

<0.001

a,b,e,f

Optum Database

ADA 

CER

ETA

GLM

Sample Size

3,202

731

4,811

956

Recommended Mo. Dose

80 mg1

400 mg

200 mg

50 mg

Modal Calculated Dose

80 mg

400 mg

196 mg

47 mg

f

%

f

%

f

%

f

%

p

post hoc

% Adherent (PDC ≥ 0.80)

2,275

71.0%

485

66.3%

3,329

69.2%

721

75.4%

<0.001

a,c,e,f

% as 1st Line Therapy

2,342

73.1%

377

51.6%

3,974

82.6%

516

54.0%

<0.001

a,b,c,d,f

% Surviving for 6 Months

2,104

65.7%

460

62.9%

3,312

68.8%

637

66.6%

<0.01

b,d

% with a Dose Escalation

358

11.2%

42

5.7%

91

1.9%

64

6.7%

<0.001

a,b,c,d,f

Mean

SD

Mean

SD

Mean

SD

Mean

SD

Refill Interval Gap (days)

9.1

12.6

8.4

8.4

9.6

13.2

8.3

10.9

<0.05

f

1 Dose may be adjusted to 40 mg weekly in patients not taking methotrexate.
2 post hoc comparisons: A: ADA ≠ CER; B: ADA ≠ ETA; C: ADA ≠ GLM; D: CER ≠ ETA; E: CER ≠ GLM; F: ETA ≠ GLM.

 


Disclosure: J. Tkacz, Janssen Scientific Affairs, LLC, 5; B. Brady, Janssen Scientific Affairs, LLC, 5; L. A. Ellis, Janssen Scientific Affairs, LLC, 3; R. Meyer, Janssen Scientific Affairs, LLC, 3.

To cite this abstract in AMA style:

Tkacz J, Brady B, Ellis LA, Meyer R. Utilization Patterns of Subcutaneously Administered Biologic Medications within a Sample of Rheumatoid Arthritis Patients [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/utilization-patterns-of-subcutaneously-administered-biologic-medications-within-a-sample-of-rheumatoid-arthritis-patients/. Accessed February 2, 2023.
  • Tweet
  • Email
  • Print

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/utilization-patterns-of-subcutaneously-administered-biologic-medications-within-a-sample-of-rheumatoid-arthritis-patients/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences