Understanding the evolving treatment patterns in patients with rheumatoid arthritis (RA) is important for rheumatologists to make the best practice decisions and optimize treatment. Here, we describe treatment patterns among patients newly initiated on biologic and/or nonbiologic RA therapy over time after enrollment in the US Corrona RA registry. This was a retrospective, cohort study of adult patients with RA enrolled in the Corrona RA registry. Patients were included in this study if they initiated therapy with conventional synthetic disease-modifying antirheumatic drug (csDMARD) monotherapy, TNF inhibitor (TNFi) monotherapy, other (non-TNFi) biologic monotherapy, or combination therapy (index therapy); initiated therapy between January 1, 2004, and December 31, 2015 (index date), after enrollment in the Corrona RA registry; had at least 6 months of follow-up time after the index date; and had at least one follow-up visit. Time periods of interest were based on the year of index therapy initiation: 2004–2007, 2008–2011, and 2012–2015. This study included 8027 patients. csDMARD monotherapy and TNFi + csDMARD combination therapy were the most common index therapies in the registry (39.9% and 44.9%, respectively, in the 2004–2007 period; 38.6% and 38.2%, respectively, in the 2008–2011 period; and 35.2% for both in the 2012–2015 period). At therapy initiation, a higher proportion of patients who initiated other biologics, whether as monotherapies (54.0%) or in combination with csDMARD (49.9%), had high disease activity than those who initiated csDMARD monotherapy (28.4%). For 2012–2015 vs 2004–2007 and 2008–2011 periods, persistence on a given therapy appeared to decrease for the TNFi monotherapy cohort (48.2% vs 64.3% and 52.4%) and other biologic monotherapy cohort (52.3% vs 71.4% and 54.5%) over 12 months; switching from one therapy to another was common in the Corrona RA registry. Increased switching from one therapy to another and decreased time on a given therapy was observed in the Corrona RA registry in the 2012–2015 period. This observation is most likely due to the increased availability of additional treatment options and/or the change in clinical focus, particularly the emphasis on achievement of treat-to-target goals of remission or low disease activity along with more aggressive treatment.

中文翻译：

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类风湿性关节炎患者的治疗模式新开始使用生物和常规合成疾病缓解抗风湿药物治疗并在北美临床登记处登记

了解类风湿性关节炎 (RA) 患者不断变化的治疗模式对于风湿病学家做出最佳实践决策和优化治疗非常重要。在这里，我们描述了在美国 Corrona RA 注册登记后新开始接受生物和/或非生物 RA 治疗的患者的治疗模式。这是一项对在 Corrona RA 登记处登记的成年 RA 患者进行的回顾性队列研究。如果患者开始接受常规合成疾病缓解抗风湿药物 (csDMARD) 单药治疗、TNF 抑制剂 (TNFi) 单药治疗、其他（非 TNFi）生物单药治疗或联合治疗（指标治疗），则他们被纳入本研究；在 2004 年 1 月 1 日至 2015 年 12 月 31 日（索引日期）之间开始治疗，在 Corrona RA 注册登记后；在索引日期后至少有 6 个月的随访时间；并至少进行了一次随访。感兴趣的时间段基于开始治疗的年份：2004-2007、2008-2011 和 2012-2015。该研究包括 8027 名患者。csDMARD 单药疗法和 TNFi + csDMARD 联合疗法是注册研究中最常见的指标疗法（2004-2007 年期间分别为 39.9% 和 44.9%；2008-2011 年期间分别为 38.6% 和 38.2%；以及 35.2%） 2012-2015 年期间的百分比）。在治疗开始时，与开始 csDMARD 单药治疗的患者 (28.4%) 相比，无论是作为单一疗法 (54.0%) 还是与 csDMARD 联合治疗 (49.9%)，开始其他生物制剂的患者的疾病活动度更高。对于 2012-2015 与 2004-2007 和 2008-2011 期间，在 12 个月内，TNFi 单药治疗队列（48.2% 对 64.3% 和 52.4%）和其他生物单药治疗队列（52.3% 对 71.4% 和 54.5%）的给定治疗持续性似乎下降；从一种疗法转换到另一种疗法在 Corrona RA 注册中很常见。在 2012 年至 2015 年期间，Corrona RA 登记处观察到从一种疗法到另一种疗法的转换增加和给定疗法的时间减少。这一观察结果很可能是由于额外治疗方案的可用性增加和/或临床重点的变化，特别是强调实现缓解或低疾病活动的治疗目标以及更积极的治疗。从一种疗法转换到另一种疗法在 Corrona RA 注册中很常见。在 2012 年至 2015 年期间，Corrona RA 登记处观察到从一种疗法到另一种疗法的转换增加和给定疗法的时间减少。这一观察结果很可能是由于额外治疗方案的可用性增加和/或临床重点的变化，特别是强调实现缓解或低疾病活动的治疗目标以及更积极的治疗。从一种疗法转换到另一种疗法在 Corrona RA 注册中很常见。在 2012 年至 2015 年期间，Corrona RA 登记处观察到从一种疗法到另一种疗法的转换增加并减少了给定疗法的时间。这一观察结果很可能是由于额外治疗方案的可用性增加和/或临床重点的变化，特别是强调实现缓解或低疾病活动的治疗目标以及更积极的治疗。