Article Text

Download PDFPDF
Prescription practice of biological drugs in rheumatoid arthritis during the first 3 years of post-marketing use in Denmark and Norway: criteria are becoming less stringent
  1. E Hjardem1,
  2. M L Hetland2,
  3. M Østergaard2,
  4. N S Krogh3,
  5. T K Kvien4
  1. 1Department of Rheumatology, Copenhagen University Hospital at Hvidovre, Denmark
  2. 2Danish Database for Biological Therapies in Rheumatology (DANBIO), Hvidovre, Denmark
  3. 3Zitelab, Frederiksberg, Denmark
  4. 4Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  1. Correspondence to:
    Dr M L Hetland
    DANBIO, Copenhagen University Hospital at Hvidovre, Department of Rheumatology 232, Kettegård Alle 30, DK 2650 Hvidovre, Denmark;


Background: The study was based on the Danish DANBIO and the Norwegian NOR-DMARD databases.

Objective: To investigate changes in prescription practice during the first 3 years of post-marketing use of biological drugs, and to determine the proportion of patients who would not have received tumour necrosis factor (TNF) blocking agents if the prescription guidelines of the UK and the Netherlands had been applied.

Methods: Patients with rheumatoid arthritis (RA) receiving TNF blocking agents from Denmark (n = 823, median age 56.0, 72.2% women) and Norway (n = 371, median age 52.5, 75.4% women) were studied. Prescription guidelines in the UK and the Netherlands were applied to the data.

Results: Baseline disease activity and number of previous DMARDs declined significantly during the 3 years (median baseline DAS28 decreased from 5.8 to 5.2 in Denmark (p<0.001) and from 6.0 to 5.6 in Norway (p<0.01)). 47.9% and 41.3% of the Norwegian and Danish patients, respectively, did not meet the UK criteria for using TNF blocking agents, and 10.5% and 5.7% did not meet the Dutch criteria.

Conclusion: Danish and Norwegian prescription practices of biological treatments in RA were similar, and became less stringent from 2000 to 2003. Prescriptions agreed well with the Dutch guidelines, but almost half the patients did not meet the UK guidelines.

  • CRP, C reactive protein
  • DAS28, Disease Activity Score 28
  • DMARD, disease modifying antirheumatic drug
  • RA, rheumatoid arthritis
  • TNF, tumour necrosis factor
  • rheumatoid arthritis
  • tumour necrosis factor blocking agents
  • pharmacosurveillance
  • clinical databases

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.