Factors influencing the use of biologic therapy and adoption of treat-to-target recommendations in current european rheumatology practice

Peter C. Taylor, Rieke Alten, Juan J. Gomez Reino, Roberto Caporali, Philippe Bertin, Emma Sullivan, Robert Wood, James Piercy, Radu Vasilescu, Dean Spurden, Jose Alvir, Miriam Tarallo

Research output: Contribution to journalArticle

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Abstract

Objective: The aim of this study was to identify factors that influence treatment adjustments and adoption of a treat-to-target (T2T) strategy in patients with rheumatoid arthritis (RA) in European practices. Methods: Cross-sectional data were drawn from the Adelphi 2014 RA Disease Specific Programme. Treatment patterns and clinical characteristics were investigated in patients treated with biologic disease-modifying antirheumatic drugs (bDMARDs) vs non-bDMARDs. For the T2T analysis, patients were subdivided into two subsets (RA diagnosis <2 or ≥2 years) and compared according to the approach used (no target = no T2T approach; pragmatic = target different from remission; and aspirational = target set as remission). Results: Data from 2,536 patients were analyzed (mean age: 52.76 years and mean time since RA diagnosis: 6.05 years). Of the 1,438 patients eligible to receive bDMARDs, 55% did not receive them. Initiation of bDMARDs in a bDMARD-naïve patient was prompted by worsening of the disease. In the RA diagnosis <2 years subset, a T2T approach was not adopted in 58% of the patients, whereas 8% and 34% adopted a pragmatic and aspirational approach, respectively. In the RA diagnosis ≥2 years subset, 45%, 19%, and 36% of the patients adopted a no target, pragmatic, and aspirational approach, respectively. Physician satisfaction with RA control was lower in the RA diagnosis <2 years subset than in the RA diagnosis ≥2 years subset (65% vs 77% satisfied, respectively; P<0.0001). Conclusion: This analysis shows that the use of bDMARDs remains suboptimal and that a T2T strategy is not universally adopted.

Original languageEnglish
Pages (from-to)2007-2014
Number of pages8
JournalPatient Preference and Adherence
Volume12
DOIs
Publication statusPublished - Jan 1 2018

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Biological Therapy
Rheumatology
Rheumatoid Arthritis
Antirheumatic Agents
Disease
drug
pragmatics
Social Adjustment
physician
Physicians

Keywords

  • Disease-modifying antirheumatic drugs
  • Rheumatoid arthritis
  • Treat-to-target

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Social Sciences (miscellaneous)
  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Health Policy

Cite this

Factors influencing the use of biologic therapy and adoption of treat-to-target recommendations in current european rheumatology practice. / Taylor, Peter C.; Alten, Rieke; Gomez Reino, Juan J.; Caporali, Roberto; Bertin, Philippe; Sullivan, Emma; Wood, Robert; Piercy, James; Vasilescu, Radu; Spurden, Dean; Alvir, Jose; Tarallo, Miriam.

In: Patient Preference and Adherence, Vol. 12, 01.01.2018, p. 2007-2014.

Research output: Contribution to journalArticle

Taylor, PC, Alten, R, Gomez Reino, JJ, Caporali, R, Bertin, P, Sullivan, E, Wood, R, Piercy, J, Vasilescu, R, Spurden, D, Alvir, J & Tarallo, M 2018, 'Factors influencing the use of biologic therapy and adoption of treat-to-target recommendations in current european rheumatology practice', Patient Preference and Adherence, vol. 12, pp. 2007-2014. https://doi.org/10.2147/PPA.S170054
Taylor, Peter C. ; Alten, Rieke ; Gomez Reino, Juan J. ; Caporali, Roberto ; Bertin, Philippe ; Sullivan, Emma ; Wood, Robert ; Piercy, James ; Vasilescu, Radu ; Spurden, Dean ; Alvir, Jose ; Tarallo, Miriam. / Factors influencing the use of biologic therapy and adoption of treat-to-target recommendations in current european rheumatology practice. In: Patient Preference and Adherence. 2018 ; Vol. 12. pp. 2007-2014.
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abstract = "Objective: The aim of this study was to identify factors that influence treatment adjustments and adoption of a treat-to-target (T2T) strategy in patients with rheumatoid arthritis (RA) in European practices. Methods: Cross-sectional data were drawn from the Adelphi 2014 RA Disease Specific Programme. Treatment patterns and clinical characteristics were investigated in patients treated with biologic disease-modifying antirheumatic drugs (bDMARDs) vs non-bDMARDs. For the T2T analysis, patients were subdivided into two subsets (RA diagnosis <2 or ≥2 years) and compared according to the approach used (no target = no T2T approach; pragmatic = target different from remission; and aspirational = target set as remission). Results: Data from 2,536 patients were analyzed (mean age: 52.76 years and mean time since RA diagnosis: 6.05 years). Of the 1,438 patients eligible to receive bDMARDs, 55{\%} did not receive them. Initiation of bDMARDs in a bDMARD-na{\"i}ve patient was prompted by worsening of the disease. In the RA diagnosis <2 years subset, a T2T approach was not adopted in 58{\%} of the patients, whereas 8{\%} and 34{\%} adopted a pragmatic and aspirational approach, respectively. In the RA diagnosis ≥2 years subset, 45{\%}, 19{\%}, and 36{\%} of the patients adopted a no target, pragmatic, and aspirational approach, respectively. Physician satisfaction with RA control was lower in the RA diagnosis <2 years subset than in the RA diagnosis ≥2 years subset (65{\%} vs 77{\%} satisfied, respectively; P<0.0001). Conclusion: This analysis shows that the use of bDMARDs remains suboptimal and that a T2T strategy is not universally adopted.",
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AU - Caporali, Roberto

AU - Bertin, Philippe

AU - Sullivan, Emma

AU - Wood, Robert

AU - Piercy, James

AU - Vasilescu, Radu

AU - Spurden, Dean

AU - Alvir, Jose

AU - Tarallo, Miriam

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AB - Objective: The aim of this study was to identify factors that influence treatment adjustments and adoption of a treat-to-target (T2T) strategy in patients with rheumatoid arthritis (RA) in European practices. Methods: Cross-sectional data were drawn from the Adelphi 2014 RA Disease Specific Programme. Treatment patterns and clinical characteristics were investigated in patients treated with biologic disease-modifying antirheumatic drugs (bDMARDs) vs non-bDMARDs. For the T2T analysis, patients were subdivided into two subsets (RA diagnosis <2 or ≥2 years) and compared according to the approach used (no target = no T2T approach; pragmatic = target different from remission; and aspirational = target set as remission). Results: Data from 2,536 patients were analyzed (mean age: 52.76 years and mean time since RA diagnosis: 6.05 years). Of the 1,438 patients eligible to receive bDMARDs, 55% did not receive them. Initiation of bDMARDs in a bDMARD-naïve patient was prompted by worsening of the disease. In the RA diagnosis <2 years subset, a T2T approach was not adopted in 58% of the patients, whereas 8% and 34% adopted a pragmatic and aspirational approach, respectively. In the RA diagnosis ≥2 years subset, 45%, 19%, and 36% of the patients adopted a no target, pragmatic, and aspirational approach, respectively. Physician satisfaction with RA control was lower in the RA diagnosis <2 years subset than in the RA diagnosis ≥2 years subset (65% vs 77% satisfied, respectively; P<0.0001). Conclusion: This analysis shows that the use of bDMARDs remains suboptimal and that a T2T strategy is not universally adopted.

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