Santoleri Fiorenzo, Lasala Ruggero, Abrate Paolo, Pestrin Laura, Pasut Enrico, Modesti Germana, Musicco Felice, Fulgenzio Chiara, Zuzolo Eva, Pieri Gabriella, Roperti Martina, Gazzola Pietro, Gambera Marco, Martignoni Isabella, Montresor Valentina, De Vita Francesco, Guarino Francesca, Grossi Laura, Di Fabio Letizia, Roberti Cristina, Spoltore Concetta, Tinari Gabriella, De Rosa Stefania, Giannini Romina, Langella Roberto, Mingolla Grazia, Piccoli Mariantonietta, Costantini Alberto
Pescara General Hospital, Pescara, Italy.
Hospital Pharmacy of Corato, Local Health Unit of Bari, Bari, Italy.
Curr Med Res Opin. 2023 Dec;39(12):1729-1735. doi: 10.1080/03007995.2023.2287600. Epub 2023 Dec 15.
The objective was to assess the adherence, persistence, and costs of bDMARDs through a multicentre study of nine Italian hospital pharmacies.
The drugs analysed were Abatacept, Adalimumab, Certolizumab, Etanercept, Golimumab and Tocilizumab.Adult subjects with Rheumatoid Arthritis were considered in the analysis.In this study, we calculated the following metrics: Adherence to treatment was evaluated as dose-intensity, which is the ratio between the amount of medication received and probably taken by the patient at home (Received Daily Dose, RDD) and the amount prescribed by the clinician (Prescribed Daily Dose, PDD). Persistence was calculated as the number of days between the first and last dispensing of the same drug. Lastly, costs were assessed based on persistence to treatment and normalized for adherence.
Adherence to treatment was found to be above 0.8 for all drugs studied. The median persistence for a 5-year treatment period was 1.4 years for Abatacept, 1.7 years for Adalimumab, 1.8 years for Certolizumab, 1.4 years for Etanercept, 1.3 years for Golimumab, and 1.6 years for Tocilizumab.
This multicentre retrospective observational study of bDMARDs used in the treatment of RA showed that, for all the drugs studied, there was no problem with adherence to treatment but rather a difficulty in maintaining treatment with the same drug over time.
通过对九家意大利医院药房进行的多中心研究，评估生物制剂改善病情抗风湿药（bDMARDs）的依从性、持续性和成本。
分析的药物有阿巴西普、阿达木单抗、赛妥珠单抗、依那西普、戈利木单抗和托珠单抗。分析纳入患有类风湿性关节炎的成年受试者。在本研究中，我们计算了以下指标：治疗依从性通过剂量强度来评估，即患者在家中实际服用的药物量（每日接收剂量，RDD）与临床医生开具的药物量（每日处方剂量，PDD）之比。持续性计算为同一药物首次和最后一次配药之间的天数。最后，根据治疗持续性评估成本，并对依从性进行标准化。
所有研究药物的治疗依从性均高于0.8。在5年治疗期内，阿巴西普的中位持续时间为1.4年，阿达木单抗为1.7年，赛妥珠单抗为1.8年，依那西普为1.4年，戈利木单抗为1.3年，托珠单抗为1.6年。
这项关于用于治疗类风湿性关节炎的bDMARDs的多中心回顾性观察研究表明，对于所有研究药物，治疗依从性不存在问题，而是随着时间推移维持使用同一药物存在困难。
