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Biological disease-modifying antirheumatic drugs (bDMARD) have constituted a major advance in the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA). In Norway, access to these therapies has been good since their introduction, with full reimbursement and no requirements of disease activity measures above certain cut-offs. With increasing focus on early and aggressive therapy, one could expect increasing prescription of bDMARDs, including use in patients with moderate disease activity. Our objectives were to examine if prescription rates of bDMARDs in RA, PsA and axSpA continue to increase or have reached a plateau, and whether disease activity at initiation of therapy has changed over the years.
Data for these analyses were provided by the NOR-DMARD register, which was established by three Norwegian rheumatology departments in 2000, with two more centres joining in 2002. The register has aimed for longitudinal follow-up of all patients with inflammatory joint diseases starting a new DMARD regimen.1 For the current analyses we included all prescriptions of bDMARDs in previously bDMARD-naive patients with …