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Trajectories of Adherence to Biologic Disease-Modifying Anti-Rheumatic Drugs in Tuscan Administrative Databases: The Pathfinder Study
Scanty information on clustering longitudinal real-world data is available in the medical literature about the adherence implementation phase in rheumatoid arthritis (RA). To identify and characterize trajectories by analyzing the implementation phase of adherence to biologic Disease-Modifying Anti-...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8708974/ https://www.ncbi.nlm.nih.gov/pubmed/34945038 http://dx.doi.org/10.3390/jcm10245743 |
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author | Convertino, Irma Giometto, Sabrina Gini, Rosa Cazzato, Massimiliano Fornili, Marco Valdiserra, Giulia Cappello, Emiliano Ferraro, Sara Bartolini, Claudia Paoletti, Olga Tillati, Silvia Baglietto, Laura Turchetti, Giuseppe Trieste, Leopoldo Lorenzoni, Valentina Blandizzi, Corrado Mosca, Marta Tuccori, Marco Lucenteforte, Ersilia |
author_facet | Convertino, Irma Giometto, Sabrina Gini, Rosa Cazzato, Massimiliano Fornili, Marco Valdiserra, Giulia Cappello, Emiliano Ferraro, Sara Bartolini, Claudia Paoletti, Olga Tillati, Silvia Baglietto, Laura Turchetti, Giuseppe Trieste, Leopoldo Lorenzoni, Valentina Blandizzi, Corrado Mosca, Marta Tuccori, Marco Lucenteforte, Ersilia |
author_sort | Convertino, Irma |
collection | PubMed |
description | Scanty information on clustering longitudinal real-world data is available in the medical literature about the adherence implementation phase in rheumatoid arthritis (RA). To identify and characterize trajectories by analyzing the implementation phase of adherence to biologic Disease-Modifying Anti-Rheumatic Drugs (DMARDs), we conducted a retrospective cohort drug-utilization study using Tuscan administrative databases. RA patients were identified by a validated algorithm, including the first biologic DMARD supply from 2010 to 2015, RA specialist visit in the year before or after the first supply date and RA diagnosis in the five years before or in the year after the first supply date. We observed users for three years or until death, neoplasia, or pregnancy. We evaluated adherence quarterly through the Medication Possession Ratio. Firstly, we identified adherence trajectories and described the baseline characteristics; then, we focused on the trajectory most populated to distinguish the related sub-trajectories. We identified 952 first ever-biologic DMARD users in RA (712 females, mean age 52.7 years old, standard deviation 18.8). The biologic DMARD mostly supplied was etanercept (387 users) followed by adalimumab (233). Among 935 users with at least 3 adherence values, we identified 49 fully-adherent users, 829 continuous users, and 57 early-discontinuing users. Significant differences were observed among the index drugs. After focusing on the continuous users, three sub-trajectories were identified: continuous-steady users (556), continuous-alternate users (207), and continuous-declining users (66). No relevant differences emerged at the baseline. The majority of first ever-biologic DMARD users showed a continuous adherence behavior in RA. The role of adherence potential predictors and the association with effectiveness and safety outcomes should be explored by further studies. |
format | Online Article Text |
id | pubmed-8708974 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-87089742021-12-25 Trajectories of Adherence to Biologic Disease-Modifying Anti-Rheumatic Drugs in Tuscan Administrative Databases: The Pathfinder Study Convertino, Irma Giometto, Sabrina Gini, Rosa Cazzato, Massimiliano Fornili, Marco Valdiserra, Giulia Cappello, Emiliano Ferraro, Sara Bartolini, Claudia Paoletti, Olga Tillati, Silvia Baglietto, Laura Turchetti, Giuseppe Trieste, Leopoldo Lorenzoni, Valentina Blandizzi, Corrado Mosca, Marta Tuccori, Marco Lucenteforte, Ersilia J Clin Med Article Scanty information on clustering longitudinal real-world data is available in the medical literature about the adherence implementation phase in rheumatoid arthritis (RA). To identify and characterize trajectories by analyzing the implementation phase of adherence to biologic Disease-Modifying Anti-Rheumatic Drugs (DMARDs), we conducted a retrospective cohort drug-utilization study using Tuscan administrative databases. RA patients were identified by a validated algorithm, including the first biologic DMARD supply from 2010 to 2015, RA specialist visit in the year before or after the first supply date and RA diagnosis in the five years before or in the year after the first supply date. We observed users for three years or until death, neoplasia, or pregnancy. We evaluated adherence quarterly through the Medication Possession Ratio. Firstly, we identified adherence trajectories and described the baseline characteristics; then, we focused on the trajectory most populated to distinguish the related sub-trajectories. We identified 952 first ever-biologic DMARD users in RA (712 females, mean age 52.7 years old, standard deviation 18.8). The biologic DMARD mostly supplied was etanercept (387 users) followed by adalimumab (233). Among 935 users with at least 3 adherence values, we identified 49 fully-adherent users, 829 continuous users, and 57 early-discontinuing users. Significant differences were observed among the index drugs. After focusing on the continuous users, three sub-trajectories were identified: continuous-steady users (556), continuous-alternate users (207), and continuous-declining users (66). No relevant differences emerged at the baseline. The majority of first ever-biologic DMARD users showed a continuous adherence behavior in RA. The role of adherence potential predictors and the association with effectiveness and safety outcomes should be explored by further studies. MDPI 2021-12-08 /pmc/articles/PMC8708974/ /pubmed/34945038 http://dx.doi.org/10.3390/jcm10245743 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Convertino, Irma Giometto, Sabrina Gini, Rosa Cazzato, Massimiliano Fornili, Marco Valdiserra, Giulia Cappello, Emiliano Ferraro, Sara Bartolini, Claudia Paoletti, Olga Tillati, Silvia Baglietto, Laura Turchetti, Giuseppe Trieste, Leopoldo Lorenzoni, Valentina Blandizzi, Corrado Mosca, Marta Tuccori, Marco Lucenteforte, Ersilia Trajectories of Adherence to Biologic Disease-Modifying Anti-Rheumatic Drugs in Tuscan Administrative Databases: The Pathfinder Study |
title | Trajectories of Adherence to Biologic Disease-Modifying Anti-Rheumatic Drugs in Tuscan Administrative Databases: The Pathfinder Study |
title_full | Trajectories of Adherence to Biologic Disease-Modifying Anti-Rheumatic Drugs in Tuscan Administrative Databases: The Pathfinder Study |
title_fullStr | Trajectories of Adherence to Biologic Disease-Modifying Anti-Rheumatic Drugs in Tuscan Administrative Databases: The Pathfinder Study |
title_full_unstemmed | Trajectories of Adherence to Biologic Disease-Modifying Anti-Rheumatic Drugs in Tuscan Administrative Databases: The Pathfinder Study |
title_short | Trajectories of Adherence to Biologic Disease-Modifying Anti-Rheumatic Drugs in Tuscan Administrative Databases: The Pathfinder Study |
title_sort | trajectories of adherence to biologic disease-modifying anti-rheumatic drugs in tuscan administrative databases: the pathfinder study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8708974/ https://www.ncbi.nlm.nih.gov/pubmed/34945038 http://dx.doi.org/10.3390/jcm10245743 |
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