UMass Chan Medical School, Worcester.
Stanford University, Palo Alto, California.
Arthritis Care Res (Hoboken). 2024 Aug;76(8):1149-1161. doi: 10.1002/acr.25332. Epub 2024 May 16.
We evaluated sex differences in time to initiation of receiving nonsteroidal anti-inflammatory drugs (NSAIDs) or biologic disease-modifying antirheumatic drugs (bDMARDs) among patients with axial spondyloarthritis (axSpA).
Using the 2013 to 2018 IBM MarketScan Database, we identified 174,632 patients with axSpA aged ≥18 years. We evaluated the time between axSpA diagnosis and the first prescription NSAID dispensing (among those with no baseline NSAIDs reception) or bDMARDs infusion/procedure claim (among those who were dispensed two or more different prescription NSAIDs in the baseline period). Adjusted hazard ratios (aHRs) for time to initiation of patients receiving NSAIDs or bDMARDs were computed using survival analyses. Cox proportional hazard models estimated associations between sex and predictors of treatment initiation.
Average age at diagnosis was 48.2 years, 65.7% were female, and 37.8% were dispensed one or more NSAIDs before axSpA diagnosis. Of those who did not receive two or more different prescription NSAIDs before diagnosis, NSAID reception was initiated earlier in female patients than in male patients (NSAID reception initiators: female patients (32.9%), male patients (29.3%); aHR 1.14, 95% confidence interval [CI] 1.11-1.16). Among those who received two or more different prescription NSAIDs in the baseline period, 4.2% received a bDMARD, whereas 77.9% continued receiving NSAIDs after diagnosis. Time to bDMARD reception initiation was longer for female patients than for male patients (aHR 0.61, 95% CI 0.52-0.72), but bDMARDs were received sooner among those who received NSAIDs in the baseline period.
Prescription NSAID reception was more common than initiation of receiving bDMARDs among patients newly diagnosed with axSpA. Female patients appeared more likely to continue receiving NSAIDs after diagnosis, and the time to initiation of receiving bDMARDs was longer for female patients than for male patients.
我们评估了性别对接受非甾体抗炎药（NSAIDs）或生物改善疾病抗风湿药（bDMARDs）的时间差异，这些患者患有轴性脊柱关节炎（axSpA）。
使用 2013 年至 2018 年 IBM MarketScan 数据库，我们确定了 174632 名年龄≥18 岁的 axSpA 患者。我们评估了 axSpA 诊断和首次开具 NSAIDs 处方（基线期无 NSAIDs 接受）或 bDMARDs 输注/程序的时间（在基线期接受两种或更多种不同处方 NSAIDs 的患者中）。使用生存分析计算了接受 NSAIDs 或 bDMARDs 的患者开始治疗的调整后的危险比（aHR）。Cox 比例风险模型估计了性别与治疗开始预测因素之间的关系。
诊断时的平均年龄为 48.2 岁，65.7%为女性，37.8%在 axSpA 诊断前开具了一种或多种 NSAIDs。在未在诊断前接受两种或更多种不同处方 NSAIDs 的患者中，女性患者比男性患者更早开始 NSAIDs 治疗（NSAIDs 治疗开始者：女性患者（32.9%），男性患者（29.3%）；aHR 1.14，95%置信区间[CI] 1.11-1.16）。在基线期接受两种或更多种不同处方 NSAIDs 的患者中，4.2%接受了 bDMARD，而诊断后 77.9%继续接受 NSAIDs。女性患者开始接受 bDMARD 治疗的时间长于男性患者（aHR 0.61，95%CI 0.52-0.72），但在基线期接受 NSAIDs 的患者中更早开始接受 bDMARD。
新诊断为 axSpA 的患者中，接受 NSAIDs 的处方比开始接受 bDMARDs 更常见。女性患者在诊断后似乎更有可能继续接受 NSAIDs，女性患者开始接受 bDMARD 的时间长于男性患者。
