A retrospective review of dispensing of biologics prescribed for the treatment of rheumatoid arthritis in the australian population.

Aim: To investigate the persistence on biologic (b) DMARDS in the Australian landscape and identify factors that might influence biologic survival in rheumatoid arthritis (RA) patients. Method(s): RA patients aged >=18 for whom biologics were dispensed for their RA and who were in the Australian Medicare 10% sample database (dating from 01-August 2010 to 31-June 2014) provided by the Department of Health and Aging through an Australian healthcare consulting company were included. bDMARDS included: abatacept (ABA), adalimumab, certolizumab pegol, etanercept, golimumab, infliximab (INF) and tocilizumab (TCZ). Data were analysed using descriptive statistics for continuous variables and frequency counts for categorical variables. Time-to-endpoints were summarised using Kaplan-Meier (K-M) methodology. Individual subcutaneous (SC) anti-TNFs were equivalent in all analyses and therefore were combined for simplicity. Result(s): Data from 1230 patients were analysed; 27% were >= 65 years old and 73% were between 18-64 years old. The majority (73%) were females. For all patients, the percentage (based on K-M estimates) who continued on treatment (combination and monotherapy) at 6-months (mo) after commencement was 87%-TCZ, 78%-ABA, 72%-SC anti-TNFs and 40%- INF. At 6-months, 86%-TCZ of patients, 85%-ABA and 64%-Sc anti- TNFs continued treatment as first-line; and 91%-TCZ, 73%-ABA and 63% Sc anti-TNFs continued as second-line. Median time-to-stopping treatment was 40 mo-TCZ (95% CI:30-ND), 33 mo-ABA (95% CI:20- ND); 22 mo-SC anti-TNF (95% Cl:18-27), and 4 mo-for INF (95% CI:2- 13). Longer median treatment persistence was observed for concomitant SC anti-TNFs (27 mo vs 14 mo; p < 0.0001) and ABA (although not statistically significant, 33 mo versus 23 mo; p = 0.26) with MTX or other DMARDs than for monotherapy (but not TCZ). Age had no effect on persistence. Conclusion(s): Treatment persistence was longer onTCZ followed by ABA then SC anti-TNFs therapy. This real-world data hel