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Background: TNFα inhibitors are the first line biological treatment for patients suffering from rheumatic diseases (RD) and inflammatory bowel disease (IBD). Limited information is available about long-term treatment patterns of patients starting a TNFα inhibitor and whether these differ between patients suffering from RD and IBD. Objectives: To compare treatment patterns of patients with RD and IBD starting a TNFα inhibitor. Methods: Included were all patients starting (i.e. no prior use of a biological) with aTNFα inhibitor (ATC code: L04AB) between 1 July 2012 and 1 July 2017 at a Dutch general teaching hospital (the Spaarne Gasthuis, Haarlem/Hoofddorp) and with a RD or IBD diagnosis. All patients were followed for at least one year. Outcomes at one year of follow-up were: continuous use of the first TNFα inhibitor, switch to a different TNFα inhibitor or to a biological with another mode of action, or discontinuation. In addition, median duration of first TNFα inhibitor treatment were compared for patients with RD and IBD using the Kaplan Meier method. Data were analyzed by Pearson's chi square and Kruskal Wallis test. Results: 646 patients were included (median age 46 years, 84% female), of which 63.9% (n = 413) received a TNFα inhibitor for RD and 36.1% (n = 233) for IBD. After 1 year, 60.1% of patients continuously used their first TNFα inhibitor, 13.4% switched to another biological and 26.5% discontinued treatment. Significantly less RD patients continued their TNFα inhibitor compared to IBD patients (54.4% versus 70.0%, RR 0.78, 95% CI 0.69-0.88) and RD patients discontinued treatment more frequently than IBD patients (33.0% versus 15.0%, RR 2.19, 95% CI 1.57-3.06). 12.6% of RD patients and 15.0% of IBD patients had switched, most patients (71.1% of RD switchers and 91.4% of IBD switchers) to a second TNFα inhibitor. The median treatment duration of the first TNFα inhibitor was significantly (p

Background: Angiotensin converting enzyme inhibitors (ACEIs) are widely prescribed. While ACEIs are usually initiated for lifelong treatment, many patients stop or switch treatment. Exploration of such patterns is important because the discontinuation of these drugs is associated with poor clinical outcomes. Objectives: The aim of this study was to study usage patterns for different indications of ACEIs. Methods: We defined a cohort of patients older than 45 years who started ACEI treatment between 2007 and 2013 in the Clinical Practice Research Datalink (CPRD). Indications for ACEI treatment (hypertension (HTN), heart failure (HF), myocardial infarction (MI), renal failure (RF), or combinations of them (COT)) were retrieved from the medical records, and duration of ACEI treatment was calculated. We distinguished between continuous use, discontinued use, switch to an alternative drug, and restart, considering 6 months time interval between two prescription periods. Five-year persistence among the different indications was calculated using the Kaplan-Meier method, and times to discontinuation were compared using the log-rank test. Results: In total, 222058 patients initiating ACEIs were identified with the following indications: HTN (68.2%), MI (5.1%), RF (4.4%), HF (1.9%), and COT (20.4%). Five-year persistence rates were 62.4% for HF, 58% for HTN, 70.1% for MI, 45.5% for RF, and 55% for COT. Time to discontinuation was significantly different between indications (log-rank p-value