Rheumatology Department A, El Ayachi Hospital, Ibn Sina University Hospital, Rabat-Sale, Morocco.
Laboratory of Epidemiology and Clinical Research, Faculty of Medicine and Pharmacy, Rabat, Morocco.
Pan Afr Med J. 2021 Feb 17;38:183. doi: 10.11604/pamj.2021.38.183.27081. eCollection 2021.
the aim of our study is to determine, from data of the Moroccan register of biotherapies, the factors influencing the choice of the first prescribed biological treatment.
cross-sectional multicenter study including rheumatoid arthritis patients who were initiated the first biological treatment either: Rituximab, an anti-TNF, or Tocilizumab. The determinants related to the patient and disease have been gathered. A univariate and then multivariate analysis to determine the factors associated with the choice of the first bDMARDs was realized.
a total of 225 rheumatoid arthritis patients were included in the Moroccan registry. The mean age was 52 ± 11 years, with female predominance 88% (n = 197). The first prescribed biological treatment was Rituximab 74% (n = 166), the second one was Tocilizumab, 13.6% (n = 31) then comes the anti-TNF in 3 position with 12.4% (n = 28). The factors associated with the choice of Rituximab as the first line bDMARDs prescribed in univariate analysis were: the insurance type, the positivity of the rheumatoid factor. In multivariate analysis, only the insurance type that remains associated with the choice of Rituximab as the first biological drugs. The Tocilizumab was associated with shorter disease duration and was more prescribed as mono-therapy compared to non Tocilizumab group. TNFi was associated with the insurance type.
our study suggests that Rituximab and TNFi are associated with the type of insurance and Tocilizumab is the most prescribed biologic mono-therapy in RA patients. Further studies are needed to confirm these results.
我们的研究目的是从摩洛哥生物疗法登记处的数据中确定影响首次规定的生物治疗选择的因素。
这是一项横断面多中心研究，包括接受首次生物治疗的类风湿关节炎患者，他们接受的治疗药物为：利妥昔单抗、抗 TNF 或托珠单抗。收集了与患者和疾病相关的决定因素。进行了单变量和多变量分析，以确定与首次选择生物改善病情抗风湿药相关的因素。
摩洛哥登记处共纳入 225 例类风湿关节炎患者。平均年龄为 52 ± 11 岁，女性占 88%（n = 197）。首次规定的生物治疗药物为利妥昔单抗 74%（n = 166），其次为托珠单抗，占 13.6%（n = 31），然后是抗 TNF 药物，占 12.4%（n = 28）。单变量分析中，与选择利妥昔单抗作为一线 bDMARDs 相关的因素包括：保险类型、类风湿因子阳性。多变量分析中，只有保险类型与选择利妥昔单抗作为一线生物药物相关。与非托珠单抗组相比，托珠单抗与较短的疾病病程有关，且更多地作为单药治疗。TNFi 与保险类型有关。
我们的研究表明，利妥昔单抗和 TNFi 与保险类型有关，而托珠单抗是 RA 患者最常开的单药生物制剂。需要进一步研究来证实这些结果。
