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  • Psoriatic arthritis treatment regimens, therapy duration and reasons for cessation in the biologics era: A multi-centre Australian study

    Author(s)
    Tymms, Kathleen
    Kelly, Ayano
    Bird, Paul
    Griffiths, Hedley
    de Jager, Julien
    Littlejohn, Geoff
    Louw, Sandra
    Roberts, Lynden
    Youssef, Peter
    Zochling, Jane
    Nichols, Dave
    Griffith University Author(s)
    de Jager, Julien P.
    Year published
    2018
    Metadata
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    Abstract
    Aim: To describe the treatment regimens, duration of therapy and reasons for disease-modifying antirheumatic drug (DMARD) cessation in a large psoriatic arthritis (PsA) cohort. Methods: A retrospective non-interventional multi-centre study using Audit4 electronic medical records, with de-identified, routinely collected clinical data from rheumatology practices in the OPAL consortium (Optimising Patient outcomes in Australian rheumatoLogy) during November 2015. Baseline characteristics, type and duration of conventional and biologic DMARDs (cDMARD and bDMARD, respectively), disease activity (Disease Activity Score of 28 joints ...
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    Aim: To describe the treatment regimens, duration of therapy and reasons for disease-modifying antirheumatic drug (DMARD) cessation in a large psoriatic arthritis (PsA) cohort. Methods: A retrospective non-interventional multi-centre study using Audit4 electronic medical records, with de-identified, routinely collected clinical data from rheumatology practices in the OPAL consortium (Optimising Patient outcomes in Australian rheumatoLogy) during November 2015. Baseline characteristics, type and duration of conventional and biologic DMARDs (cDMARD and bDMARD, respectively), disease activity (Disease Activity Score of 28 joints C-reactive protein [DAS28-CRP]), and reasons for treatment cessation were recorded. Results: A total of 3422 rheumatologist-diagnosed PsA patients were included: 60% female, mean age 54 years and disease duration 10 years. Of patients with treatment recorded (n = 2948), 46% were on cDMARD monotherapy, 19% bDMARD monotherapy, 13% combination bDMARD and cDMARDs, 11% combination cDMARDs and 10% no DMARDs. Of those with DAS28-CRP results (n = 494), the highest mean DAS28-CRP was 3.32 on combination cDMARDs, and the lowest was 2.19 on bDMARD monotherapy. Median duration on cDMARD monotherapy was 33.5 months (n = 2232), on bDMARD monotherapy 110.1 months (n = 751), on combination bDMARD and cDMARDs 68.5 months (n = 559). The most common reasons for cessation of cDMARD monotherapy was adverse reactions (41%), for bDMARD monotherapy lack of efficacy (26%), and for combination bDMARD and cDMARDs treatment completed or no longer required (37%). Conclusion: Most PsA patients were prescribed DMARD therapies with a large proportion receiving cDMARDs. Patients on combination cDMARD therapies had the highest DAS28-CRP results. Adverse reactions were the most common reason for cessation of cDMARD monotherapy, whereas for bDMARD monotherapy it was lack of efficacy.
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    Journal Title
    International Journal of Rheumatic Diseases
    Volume
    21
    Issue
    2
    DOI
    https://doi.org/10.1111/1756-185X.13127
    Subject
    Clinical sciences
    Immunology
    Medical microbiology
    Science & Technology
    Life Sciences & Biomedicine
    Rheumatology
    clinical aspects
    drug treatment
    Publication URI
    http://hdl.handle.net/10072/409948
    Collection
    • Journal articles

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