ABSTRACT

Background: The aim of this study is to assess treatment patterns and pharmaco-utilization in patients with psoriatic arthritis (PsA) in Italy.

Methods: A retrospective analysis using administrative databases of six Local Health Units was performed. All adult patients with PsA diagnosis and ≥1 prescription for biologic/targeted-synthetic (b/ts) disease-modifying antirheumatic drugs (DMARDs) from January 2010 to March 2017 were included. The date of first b/tsDMARD prescription was defined index-date. Follow-up lasted 1-year post index-date. Patients without b/tsDMARDs prescription pre index-date were defined bionaïve.

Results: Of the 1,056 patients included, 33% received adalimumab, 30% etanercept, 10% golimumab, 9% secukinumab, 7% infliximab, 6% ustekinumab, 4% certolizumab, and 1% apremilast. During follow-up, persistence with b/tsDMARDs was observed in 79.8% of patients, 10.8% switched therapies, dose change occurred in 15.8% of patients, 47.4% received an add-on. Among bionaïve patients (n = 591), 67.0% were persistent with b/tsDMARDs, 10.1% switched therapy, 14.5% required a dose change and 45.8% an add-on. Discontinuation was observed in 10.6% of total PsA population and in 24.8% of bionaïve patients.

Conclusion: This analysis provided insights on drug utilization patterns for PsA in an Italian real-world setting. Our results show that treatment regimen changes occur in a high proportion of PsA patients.

摘要

背景：本研究的目的是评估意大利银屑病关节炎 (PsA) 患者的治疗模式和药物使用情况。

方法：使用六个地方卫生单位的行政数据库进行回顾性分析。包括 2010 年 1 月至 2017 年 3 月所有 PsA 诊断和≥1 张生物/靶向合成 (b/ts) 疾病缓解抗风湿药物 (DMARDs) 处方的成年患者。第一个 b/tsDMARD 处方的日期被定义为索引日期。随访持续了索引日期后 1 年。在索引日期之前没有 b/tsDMARDs 处方的患者被定义为 bionaïve。

结果：在纳入的 1,056 名患者中，33% 接受阿达木单抗、30% 依那西普、10% 戈利木单抗、9% 苏金单抗、7% 英夫利昔单抗、6% 优特克单抗、4% 赛妥珠单抗和 1% 阿普司特。在随访期间，79.8% 的患者观察到 b/tsDMARDs 的持续存在，10.8% 的患者转换了治疗，15.8% 的患者发生了剂量变化，47.4% 的患者接受了附加治疗。在 bionaïve 患者（n = 591）中，67.0% 的患者持续使用 b/tsDMARDs，10.1% 的患者转换治疗，14.5% 的患者需要改变剂量，45.8% 的患者需要附加治疗。在 10.6% 的 PsA 总人群和 24.8% 的 bionaïve 患者中观察到停药。

结论：该分析提供了有关意大利现实环境中 PsA 药物利用模式的见解。我们的结果表明，很大一部分 PsA 患者发生了治疗方案的改变。