Scandinavian journal of rheumatology · 2025
Burden of disease and treatment patterns for psoriatic arthritis in Finland: a nationwide real-world evidence study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Ukkola-Vuoti L, Klåvus A, Toppila I, Elo P, Veijalainen L, Nordström D
Аннотация
OBJECTIVE: This study assessed the characteristics, concomitant medications, medication switches, sick leave, disability pensions, and healthcare resource utilization (HCRU) of patients with psoriatic arthritis (PsA) and biological disease-modifying anti-rheumatic drug (bDMARD) purchases in Finland using comprehensive follow-up data from four nationwide registry controllers.
METHOD: Electronic healthcare data covering adult patients with PsA and reimbursed bDMARD purchases between 2013 and 2021 in Finland were used. Patients were followed from the first bDMARD purchase (first biological cohort) or switch (switcher cohort) to 2022 or until death/loss of follow-up. Patients with bDMARD purchases before 2013 and no switches afterwards were not included.
RESULTS: The study investigated 2546 patients with PsA and bDMARD purchases, with 458 (18.0%) in the switcher cohort and 2088 (82.0%) in the first biological cohort. In the first biological cohort, 22.4% (95% confidence interval 20.6-24.2) switched bDMARD after 12 months. Work absences accumulated before bDMARD initiation and decreased afterwards in the first biological cohort, while switchers maintained a modest linear accumulation. The proportion of under-65-year-old patients on disability pensions was higher in switchers compared to the first biological cohort. HCRU decreased after bDMARD initiation in the first biological cohort (annual cost per patient €5093 vs €4610), while it increased for switchers (€5246 vs €5596).
CONCLUSION: Patients experienced increasing absenteeism before first bDMARD initiation, indicating an unmet need at treatment initiation. This suggests that earlier medication initiation could be beneficial, as a bDMARD switch with the bDMARD armamentarium available during the study period did not fully address growing absenteeism.
METHOD: Electronic healthcare data covering adult patients with PsA and reimbursed bDMARD purchases between 2013 and 2021 in Finland were used. Patients were followed from the first bDMARD purchase (first biological cohort) or switch (switcher cohort) to 2022 or until death/loss of follow-up. Patients with bDMARD purchases before 2013 and no switches afterwards were not included.
RESULTS: The study investigated 2546 patients with PsA and bDMARD purchases, with 458 (18.0%) in the switcher cohort and 2088 (82.0%) in the first biological cohort. In the first biological cohort, 22.4% (95% confidence interval 20.6-24.2) switched bDMARD after 12 months. Work absences accumulated before bDMARD initiation and decreased afterwards in the first biological cohort, while switchers maintained a modest linear accumulation. The proportion of under-65-year-old patients on disability pensions was higher in switchers compared to the first biological cohort. HCRU decreased after bDMARD initiation in the first biological cohort (annual cost per patient €5093 vs €4610), while it increased for switchers (€5246 vs €5596).
CONCLUSION: Patients experienced increasing absenteeism before first bDMARD initiation, indicating an unmet need at treatment initiation. This suggests that earlier medication initiation could be beneficial, as a bDMARD switch with the bDMARD armamentarium available during the study period did not fully address growing absenteeism.