Artikel
Treatment patterns of patients with rheumatoid arthritis in Germany
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Veröffentlicht: | 12. September 2014 |
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Background: The prevalence of Rheumatoid arthritis (RA) in Germany is 0.5%, with around 329,000 patients older than age 19 suffering from the disease. Part of the management of RA includes symptomatic treatments such as non-steroidal anti-inflammatory drugs (NSAID), analgesic agents, glucocorticoids, and conventional disease-modifying antirheumatic drugs (DMARD). For some patients failing to respond to conventional DMARDs, the initiation of a biologic DMARD could be considered, which may often lead to rapid clinical improvement and reduction in physical impairment.
Objective: To describe the demographic characteristics, co-morbidities and treatment patterns of prevalent patients with RA in Germany.
Methods: A retrospective case-control study was conducted using data from the Statutory Health Insurance sample AOK Hesse/KV Hesse. Prevalent patients with an RA diagnosis based on ICD-10 codes (M05/M06/M07/M08/M09) in 2011 were identified and compared to a matched control cohort (1:4, by age/gender/date of death). Descriptive analysis was used to summarise the data.
Results: 3,831 prevalent RA cases were identified (of which 237 were treated with biologics) with 15,324 matched controls. 70.6% of the entire sample were female , mean age was 66.7 (SD 14.1) years. 1,505 (39.3%) patients had cardiovascular disease, versus 4,719 (30.8%) among controls. 31.7% suffered from chronic obstructive pulmonary disease (vs. 19.9%), 25.1% suffered from cataracts (vs. 18.3%), 60.2% from osteoarthritis (vs. 34.0%), and 43.8% from opportunistic infections (vs. 32%). NSAIDs were the most frequently used medication (all patients 56.1% vs. 33.8% among controls, and 59.1% among patients treated with biologics), followed by proton pump inhibitors, used by 48.4% of RA patients compared to 26.6% of controls. Glucocorticoids were used by 37.2% of all patients and by 65% of patients treated with biologics, but by only 6.8% of controls. Conventional DMARDs were used by 27.2% of patients, by 62.5% of patients treated with biologics, and only 0.3% of controls.
Conclusion: RA has a substantial impact on general health and is often associated with considerable comorbidities that mostly require lifelong treatment. Further investigation of the health care resource utilization of patients with RA is warranted in order to estimate the overall burden of the disease and the impact of different treatment options.