Department of Internal Medicine, Sanwa Hospital, Chiba, Japan.
Division of Medical Informatics and Management, Chiba University Hospital, Chiba, Japan.
Mod Rheumatol. 2022 Aug 20;32(5):857-865. doi: 10.1093/mr/roab126.
To describe the real-world prescription and treatment retention of molecular-targeted drugs for rheumatoid arthritis (RA) in Japan.
A total of 204,416 patients with RA were prescribed at least one of the eight molecular-targeted drugs in 7 years from the National Database of Health Insurance Claims and Specific Health Checkups of Japan covering 98.3% of the Japanese population. The retention rates of each drug as well as head-to-head comparisons were estimated by Kaplan-Meier method.
A total of 121,131 RA patients were prescribed any molecular-targeted drug for the first time, while 36,633 uses of molecular-targeted drug were switched from another (switch use). The overall retention rates of molecular-targeted drugs at 12, 36, and 60 months were 0.64, 0.42, and 0.32 for the naïve use and 0.59, 0.40, and 0.31 for the switch use, respectively. Non-tumour necrosis factor (TNF)-inhibitor molecular-targeted drugs, particularly tocilizumab and tofacitinib, had higher retention rates than TNF inhibitors for both naïve and switch uses regardless of the previous drug and showed higher retention rates in head-to-head comparisons between eight molecular-targeted drugs.
Our data reveal that the real-world drug retention is overall lower than previously reported and higher with non-TNF inhibitors than with TNF inhibitors.
描述日本类风湿关节炎（RA）患者在真实世界中使用分子靶向药物的处方和治疗保留情况。
从日本国民健康保险索赔和特定健康检查数据库中选取了 7 年内至少使用过八种分子靶向药物之一的 204416 例 RA 患者。采用 Kaplan-Meier 法估计每种药物的保留率以及头对头比较。
共有 121131 例 RA 患者首次使用任何分子靶向药物，有 36633 例患者（转换使用）从另一种药物转换为分子靶向药物。在 12、36 和 60 个月时，初治使用和转换使用的分子靶向药物的总体保留率分别为 0.64、0.42 和 0.32，0.59、0.40 和 0.31。对于初治和转换使用，非肿瘤坏死因子（TNF）-抑制剂分子靶向药物，特别是托珠单抗和托法替布，与 TNF 抑制剂相比保留率更高，无论之前使用的药物如何，并且在八种分子靶向药物的头对头比较中显示出更高的保留率。
我们的数据表明，真实世界中的药物保留率总体低于先前报道的水平，而非 TNF 抑制剂的保留率高于 TNF 抑制剂。
