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Current Use of Treatments for Rheumatoid Arthritis in Western European Countries: Presented at EULAR

By Chris Berrie

AMSTERDAM, THE NETHERLANDS -- June 30, 2006 -- The pattern of biologics and other disease-modifying antirheumatic drugs (DMARDs) in Western Europe appears to show a wide range of approaches being used in patients with rheumatoid arthritis (RA).

Principal investigator Tuulikki Sokka, MD, PhD, rheumatologist, Jyväskylä Central Hospital, Jyväskylä, Finland, presented results of a prospective cohort study here on June 24^th at the Annual European Congress of Rheumatology (EULAR).

"Just about everybody is interested in how patients with rheumatoid arthritis are treated, how they were treated in the past, how they are treated over the course of their rheumatoid arthritis, and how they are treated now that we have all these new fancy drugs available," Dr. Sokka said.

Dr. Sokka and colleagues determine past and current DMARDs usage profiles as recorded in an international cross-sectional database that includes patients with RA from 9 Western European countries. These data include clinical and patient self-report assessments and records of all DMARD use by these patients.

Data from January to December 2005 has been collected so far from 1 to 4 sites in 12 countries. For the present analysis, data from 9 Western European countries provide information on 1,579 patients.

Patient characteristics across the sample were a mean age of 59 years; female, 75%; rheumatoid factor positivity, 73%; Caucasian, 98%; mean disease duration, 11 years; and mean patient level of education, 11 years.

Current DMARDs used across this dataset includes: prednisolone, 10% to 15% of patients; methotrexate (MTX), 35% to 70%; (hydroxyl)chloroquinone (HCQ), 0% to 39%; sulfasalazine (SSZ), 2% to 33%; leflunomide, 2% to 18%; etanercept, 3% to 16%; adalimumab, 3% to 16%; infliximab, 1% to 9%; and intramuscular gold, 0% to 9%.

The analysis from this dataset also revealed that during the course of their RA: 18% to 82% of the patients had taken prednisolone; 80-98% had taken MTX; 9% to 75%, HCQ; 16% to 84%, SSZ; 3% to 19% intramuscular gold; 7% to 43%, leflunomide; 4% to 20%, etanercept; 3% to 19%, infliximab; and 7% to 22% adalimumab.

Dr. Sokka also outlined the trends in DMARD use from 1970 to 2000. Here, the most prevalent (about 60%) in the 1970's was intramuscular gold, which has more recently been completely replaced by MTX to the year 2000 (about 55%).

The researchers acknowledged that usage profiles depend upon different genetic or behavioral patterns of the patient populations studied, differences in national guidelines for use/availability of the newer biologic agents, local traditions, and specific marketing and clinical trials.

They stressed the necessity for further data to confirm these results, so that every patient with RA can be certain of the availability and use of the best therapies available.

This study was sponsored by Abbott.


[Presentation title: Current Use of Biologics and Other DMARDs in a Sample of 1579 Patients With Rheumatoid Arthritis Receiving Routine Clinical Care in 9 Western European Countries. Abstract SAT0172]

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