Background Claims databases are useful tools to conduct epidemiological studies on representative samples in terms of patient’s profile, drug use and pattern of care.
Objectives To describe the characteristics and medical management of RA patients in France over the period 2009/2010 and compare to a control group in terms of comorbidity.
Methods The EGB database (total adult population around 380,000) is a national representative sample of individuals covered by the main French Public Sickness Fund. It collects all items of medical resource consumption in hospital and ambulatory setting. Beneficiaries of full coverage are identified due to the presence of any severe chronic diseases among a list of 30 defined by the Sickness Fund. RA patients were selected as benefiting from full coverage for the diagnosis ICD-10 M05-06 on January 1, 2009. A control group matched on sex, age and eligibility to “CMUc” (“Couverture Maladie Universelle complémentaire”, an indicator of precarious living conditions) was identified in the EGB to compare the frequency of comorbidities (n=3,888).
Results 1,296 individuals with RA were identified, corresponding to a crude prevalence rate of 3.47/1,000. The gender ratio M/F was 0.33, mean age 63.3±14.8 years, with a time since admission to full coverage for RA of 8.8±7.2 years (<2 years in 23.8% of patients). Table 1 presents the frequencies of comorbidity among RA patients and controls as defined through eligibility to the corresponding full coverage. Of identified RA patients, 214 (16.5%) received a biological agent: a TNF-inhibitor in 85% of cases (etanercept 51.3%, adalimumab 20.1%, infliximab 12.6%, rituximab 9.8%, abatacept 4.2%, tocilizumab 0.5%, anakinra 0.5%). Over the period 2009/2010, 79.4% of patients treated with biological agents received/took only one drug, 15% two, and 5.6% three drugs. Among 71 RA patients treated with first-line biological agents, a TNF-inhibitor was most frequently prescribed (71.9%), followed by rituximab (19.7%), abatacept (7%) and tocilizumab (1.4%).
Conclusions This analysis suggested that TNF-inhibitor adherence was similar in France to the results derived from other registries. Some differences were observed in frequencies of certain comorbidities between RA patients and controls (decrease in Alzheimer’s Disease, increase in hypertension and Ischemic Heart Disease) but further analysis should be performed to confirm this preliminary finding by taking into account more relevant clinical criteria for identifying comorbidities.
Acknowledgements The authors acknowledge Costello Medical Consulting for editorial assistance which was funded by UCB Pharma.
Disclosure of Interest B. Fautrel Consultant for: UCB Pharma, J.-M. Joubert Employee of: UCB Pharma, G. Cukierman Employee of: UCB Pharma, C. Laurendeau Consultant for: UCB Pharma, J. Gourmelen Grant/research support from: UCB Pharma, F. Fagnani Consultant for: UCB Pharma