Objectives The use of concomitant medications, related to rheumatoid arthritis (RA) or to other chronic conditions, is frequent in RA patients. The purpose of this analysis is to determine the frequency and profiles of concomitant medications used in a routine clinical practice setting and to assess the impact of infliximab (IFX) treatment.
Methods The data for this analysis were obtained from BioTRAC, an observational prospective registry of adult RA patients initiated on treatment with Infliximab since 2002 and managed as per routine care. Patients enrolled were biologic-naïve or had initiated treatment with a biologic for a period of <6 months prior to enrolment. Analyses for RA-related medications was performed on the overall cohort (N=775). Since, non-RA related medications started being collected since 2007, a subgroup analysis was also performed in the 272 patients enrolled since then.
Results In the overall cohort, mean (SD) age was 55.9 (13.5) years, mean (SD) disease duration 10.3 (10.0) years. At baseline, the prevalence of RA-related concomitant medications was 90.1%, 56.0%, 39.6% and 19.9% for DMARDs, NSAIDS, corticosteroids and narcotic analgesics, respectively. Patients with higher disease duration and disease activity (CDAI) at baseline were being treated with an increased number of RA medications (P<0.001) and DMARDs (P<0.001) at baseline. Treatment with IFX for 12 months reduced the mean number of RA medications between baseline and 12 months (P<0.001). In the sub-group analysis, the baseline characteristics did not differ between patients with or without comorbidity-associated medications. The prevalence of medications associated with comorbidities was 31%. The most common comorbidity-associated medication was for anxiety/depression (17.6%), hypertension (7.0%), gastric disorders (6.3%), dyslipidemia (5.5%), and bone disorders (5.5%). The presence of comorbidities had no impact on the DAS-28 response following IFX treatment or the utilization of RA medication. However, patients with comorbidities experienced a higher number of non-serious adverse events (NSAEs) compared to patients without comorbidities (320.7 vs. 146.3 NSAEs/100 patient years (PY), respectively). The incidence of serious AEs (SAEs) was comparable between the two groups (6.4 vs. 6.4 SAEs/100 PY in patients with vs. without comorbidities).
Conclusions The results of this real-life observational study demonstrate that disease activity and duration seem to be associated with increased use of RA medications. Treatment with IFX slightly decreases the number of RA medications over time. NSAEs were reported by a greater number of patients with comorbidities compared to patients without comorbidities, however, the incidence of SAEs was comparable between the groups.
Disclosure of Interest None Declared
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