SAT0024 Use of Biologic Drugs and Clinical Effectiveness of Care of Early RA in Two Clinics with Different Treatment Tradition in Their T2T Approach
Background In early RA, EULAR recommends a conventional monotherapy (with MTX) as the 1st DMARD and an addition of a biologic drug in case of inefficacy. Due to high medication costs, these recommendations can be followed in very few countries. Most rheumatology clinics have to manage with the optim...
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Veröffentlicht in: | Annals of the rheumatic diseases 2013-06, Vol.72 (Suppl 3), p.A587-A588 |
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description | Background In early RA, EULAR recommends a conventional monotherapy (with MTX) as the 1st DMARD and an addition of a biologic drug in case of inefficacy. Due to high medication costs, these recommendations can be followed in very few countries. Most rheumatology clinics have to manage with the optimal use of inexpensive conventional DMARDs in their T2T approach. Objectives To compare the use of DMARDs, biologics and the clinical effectiveness of care of early RA in two rheumatology clinics with different traditions to use of biologics and DMARDs. Methods Patients with a new diagnosis of RA in 2007-11 were identified in databases of two rheum. clinics in two countries, and followed until end of 2012. Similarities between the clinics include the size of background population, T2T-approach in care with remission as the treatment target, multidisciplinary care with patient education of T2T, and an electronic monitoring at all visits. Clinical data were compared between the clinics; interval between diagnosis and initiation of a biologic drug was analyzed using Kaplan-Meier statistics. Results Included were 499 pts in Clinic1 and 519 in Clinic2 with comparable baseline values and demographics, better outcomes in Clinic2, and different treatment strategies (Table) with earlier use of biologics in Clinic1; Figure; thin line Clinic1, bold line Clinic2, p |
doi_str_mv | 10.1136/annrheumdis-2013-eular.1750 |
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J. ; Soldal, D. M. ; Asikainen, J. ; Hannonen, P.</creator><creatorcontrib>Sokka, T. ; Haugeberg, G. ; Rannio, T. ; Hansen, I. J. ; Soldal, D. M. ; Asikainen, J. ; Hannonen, P.</creatorcontrib><description>Background In early RA, EULAR recommends a conventional monotherapy (with MTX) as the 1st DMARD and an addition of a biologic drug in case of inefficacy. Due to high medication costs, these recommendations can be followed in very few countries. Most rheumatology clinics have to manage with the optimal use of inexpensive conventional DMARDs in their T2T approach. Objectives To compare the use of DMARDs, biologics and the clinical effectiveness of care of early RA in two rheumatology clinics with different traditions to use of biologics and DMARDs. Methods Patients with a new diagnosis of RA in 2007-11 were identified in databases of two rheum. clinics in two countries, and followed until end of 2012. Similarities between the clinics include the size of background population, T2T-approach in care with remission as the treatment target, multidisciplinary care with patient education of T2T, and an electronic monitoring at all visits. Clinical data were compared between the clinics; interval between diagnosis and initiation of a biologic drug was analyzed using Kaplan-Meier statistics. Results Included were 499 pts in Clinic1 and 519 in Clinic2 with comparable baseline values and demographics, better outcomes in Clinic2, and different treatment strategies (Table) with earlier use of biologics in Clinic1; Figure; thin line Clinic1, bold line Clinic2, p<0.001. Image/graph Conclusions The use of biologics vary between countries due to affordability, availability and acceptability. Our results confirm that good clinical results can be achieved in early RA applying T2T strategy in a real world setting using biologics in a minority of patients and that strategy is more important than the drugs used. Furthermore, these results, in line with those of recent clinical trials concerning an active use of conventional DMARDs suggest that EULAR recommendations of the drug treatment of RA should be re-visited. Disclosure of Interest None Declared</description><identifier>ISSN: 0003-4967</identifier><identifier>EISSN: 1468-2060</identifier><identifier>DOI: 10.1136/annrheumdis-2013-eular.1750</identifier><identifier>CODEN: ARDIAO</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><ispartof>Annals of the rheumatic diseases, 2013-06, Vol.72 (Suppl 3), p.A587-A588</ispartof><rights>2013, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Copyright: 2013 (c) 2013, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://ard.bmj.com/content/72/Suppl_3/A587.2.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://ard.bmj.com/content/72/Suppl_3/A587.2.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3196,23571,27924,27925,77600,77631</link.rule.ids></links><search><creatorcontrib>Sokka, T.</creatorcontrib><creatorcontrib>Haugeberg, G.</creatorcontrib><creatorcontrib>Rannio, T.</creatorcontrib><creatorcontrib>Hansen, I. J.</creatorcontrib><creatorcontrib>Soldal, D. M.</creatorcontrib><creatorcontrib>Asikainen, J.</creatorcontrib><creatorcontrib>Hannonen, P.</creatorcontrib><title>SAT0024 Use of Biologic Drugs and Clinical Effectiveness of Care of Early RA in Two Clinics with Different Treatment Tradition in Their T2T Approach</title><title>Annals of the rheumatic diseases</title><addtitle>Ann Rheum Dis</addtitle><description>Background In early RA, EULAR recommends a conventional monotherapy (with MTX) as the 1st DMARD and an addition of a biologic drug in case of inefficacy. Due to high medication costs, these recommendations can be followed in very few countries. Most rheumatology clinics have to manage with the optimal use of inexpensive conventional DMARDs in their T2T approach. Objectives To compare the use of DMARDs, biologics and the clinical effectiveness of care of early RA in two rheumatology clinics with different traditions to use of biologics and DMARDs. Methods Patients with a new diagnosis of RA in 2007-11 were identified in databases of two rheum. clinics in two countries, and followed until end of 2012. Similarities between the clinics include the size of background population, T2T-approach in care with remission as the treatment target, multidisciplinary care with patient education of T2T, and an electronic monitoring at all visits. Clinical data were compared between the clinics; interval between diagnosis and initiation of a biologic drug was analyzed using Kaplan-Meier statistics. Results Included were 499 pts in Clinic1 and 519 in Clinic2 with comparable baseline values and demographics, better outcomes in Clinic2, and different treatment strategies (Table) with earlier use of biologics in Clinic1; Figure; thin line Clinic1, bold line Clinic2, p<0.001. Image/graph Conclusions The use of biologics vary between countries due to affordability, availability and acceptability. Our results confirm that good clinical results can be achieved in early RA applying T2T strategy in a real world setting using biologics in a minority of patients and that strategy is more important than the drugs used. Furthermore, these results, in line with those of recent clinical trials concerning an active use of conventional DMARDs suggest that EULAR recommendations of the drug treatment of RA should be re-visited. Disclosure of Interest None Declared</description><issn>0003-4967</issn><issn>1468-2060</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqVkcFu1DAQhi0EEkvhHSz1nOKJEzsWpyXdQqUCEqRwtJxk3PWSdRY7ofTWC6_AA_IkJJsKceXk8ej75j_8hJwCOwPg4qXxPmxx3LcuJikDnuDYmXAGMmePyAoyUUxrwR6TFWOMJ5kS8il5FuNu-rICihX59WldMZZmv-9_XkekvaWvXd_1N66h52G8idT4lpad864xHd1Yi83gvqPHGGe4NOEobUzo7ujHNXWeVrf9gxHprRu29NxNWkA_0CqgGfbLZFo3uN4fjS26QKu0ouvDIfSm2T4nT6zpIr54eE_I9cWmKt8mVx_eXJbrq6QGkbOkaAWHNkPGjYFaZLVVucp5KsAUiA3mXKU2txyUrVVrasgmAw1MkwSrGD8hp8vdKfbbiHHQu34MforUIKVUkGVspl4tVBP6GANafQhub8KdBqbnIvQ_Rei5CH0sQs9FTHay2C4O-OOvasJXLSSXuX7_udTvxBcphQI982Lh6_3uv4L-AD7ho9Q</recordid><startdate>201306</startdate><enddate>201306</enddate><creator>Sokka, T.</creator><creator>Haugeberg, G.</creator><creator>Rannio, T.</creator><creator>Hansen, I. J.</creator><creator>Soldal, D. M.</creator><creator>Asikainen, J.</creator><creator>Hannonen, P.</creator><general>BMJ Publishing Group Ltd and European League Against Rheumatism</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope></search><sort><creationdate>201306</creationdate><title>SAT0024 Use of Biologic Drugs and Clinical Effectiveness of Care of Early RA in Two Clinics with Different Treatment Tradition in Their T2T Approach</title><author>Sokka, T. ; Haugeberg, G. ; Rannio, T. ; Hansen, I. J. ; Soldal, D. M. ; Asikainen, J. ; Hannonen, P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b1650-8d631d4e03aa1b64bf95953261a8eece5392f5f319fb9dab148d6ea1ab171f903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sokka, T.</creatorcontrib><creatorcontrib>Haugeberg, G.</creatorcontrib><creatorcontrib>Rannio, T.</creatorcontrib><creatorcontrib>Hansen, I. J.</creatorcontrib><creatorcontrib>Soldal, D. M.</creatorcontrib><creatorcontrib>Asikainen, J.</creatorcontrib><creatorcontrib>Hannonen, P.</creatorcontrib><collection>Istex</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><jtitle>Annals of the rheumatic diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sokka, T.</au><au>Haugeberg, G.</au><au>Rannio, T.</au><au>Hansen, I. J.</au><au>Soldal, D. M.</au><au>Asikainen, J.</au><au>Hannonen, P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>SAT0024 Use of Biologic Drugs and Clinical Effectiveness of Care of Early RA in Two Clinics with Different Treatment Tradition in Their T2T Approach</atitle><jtitle>Annals of the rheumatic diseases</jtitle><addtitle>Ann Rheum Dis</addtitle><date>2013-06</date><risdate>2013</risdate><volume>72</volume><issue>Suppl 3</issue><spage>A587</spage><epage>A588</epage><pages>A587-A588</pages><issn>0003-4967</issn><eissn>1468-2060</eissn><coden>ARDIAO</coden><abstract>Background In early RA, EULAR recommends a conventional monotherapy (with MTX) as the 1st DMARD and an addition of a biologic drug in case of inefficacy. Due to high medication costs, these recommendations can be followed in very few countries. Most rheumatology clinics have to manage with the optimal use of inexpensive conventional DMARDs in their T2T approach. Objectives To compare the use of DMARDs, biologics and the clinical effectiveness of care of early RA in two rheumatology clinics with different traditions to use of biologics and DMARDs. Methods Patients with a new diagnosis of RA in 2007-11 were identified in databases of two rheum. clinics in two countries, and followed until end of 2012. Similarities between the clinics include the size of background population, T2T-approach in care with remission as the treatment target, multidisciplinary care with patient education of T2T, and an electronic monitoring at all visits. Clinical data were compared between the clinics; interval between diagnosis and initiation of a biologic drug was analyzed using Kaplan-Meier statistics. Results Included were 499 pts in Clinic1 and 519 in Clinic2 with comparable baseline values and demographics, better outcomes in Clinic2, and different treatment strategies (Table) with earlier use of biologics in Clinic1; Figure; thin line Clinic1, bold line Clinic2, p<0.001. Image/graph Conclusions The use of biologics vary between countries due to affordability, availability and acceptability. Our results confirm that good clinical results can be achieved in early RA applying T2T strategy in a real world setting using biologics in a minority of patients and that strategy is more important than the drugs used. Furthermore, these results, in line with those of recent clinical trials concerning an active use of conventional DMARDs suggest that EULAR recommendations of the drug treatment of RA should be re-visited. Disclosure of Interest None Declared</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and European League Against Rheumatism</pub><doi>10.1136/annrheumdis-2013-eular.1750</doi></addata></record> |
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title | SAT0024 Use of Biologic Drugs and Clinical Effectiveness of Care of Early RA in Two Clinics with Different Treatment Tradition in Their T2T Approach |
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