RESEARCH - Changes in disease characteristics and response rates among patients with RA in the UK starting anti-TNF biologics between 2001 and 2008

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Rheumatology Advance Access published online on July 29, 2010

Rheumatology, doi:10.1093/rheumatology/keq209

Changes in disease characteristics and response rates among patients

in the United Kingdom starting anti-tumour necrosis factor therapy for

rheumatoid arthritis between 2001 and 2008

Kimme L. Hyrich1, Kath D. 1, Mark Lunt1, Deborah P. M. Symmons1

on behalf of the British Society for Rheumatology Biologics Register

(BSRBR)

1Arthritis Research UK Epidemiology Unit, University of Manchester,

Manchester Academic Health Sciences Centre, Manchester, UK.

Abstract

Objectives. Anti-TNF therapy has significantly improved outcomes for

patients with severe RA. In the UK, changing financial restrictions

and increasing experience with their use may have resulted in changes

to the way physicians use anti-TNF therapies. The aim of this analysis

was to examine changes in disease characteristics and response rates

among patients starting anti-TNF therapy for RA over an 8-year period.

Methods. A total of 11 216 RA patients registered between 2001 and

2008 with the British Society for Rheumatology Biologics Register were

included and stratified according to year of first anti-TNF

prescription. Baseline characteristics and treatment response were

compared year on year using logistic and linear regression models.

Results. Mean RA disease activity and severity of new anti-TNF-treated

patients decreased between 2001 and 2008. The mean disease duration

remained high (11 years in 2008) although the proportion of patients

having disease duration <5 years increased significantly (2001: 9%;

2008: 29%; P < 0.001). The majority of patients had failed three

DMARDs on average before the first anti-TNF prescription. There was an

increase in both the proportion of EULAR good responders at 1 year

(2001: 18%; 2008: 30%; P < 0.001) and in the number of patients

achieving remission (2001: 8%; 2008: 17%; P < 0.001). Drug survival

remained relatively stable over the study years.

Conclusions. There is a significant trend towards earlier use of

anti-TNF therapies in patients with less severe disease, although the

mean disease duration at first treatment remains high. This has

correlated with improvements in outcome. These results support the

earlier use of anti-TNF therapies in RA.

Full article here:

http://rheumatology.oxfordjournals.org/cgi/content/full/keq209v1?view=long & pmid=\

20671021

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