Patients with rheumatoid arthritis (RA) who use corticosteroids can delay the initiation of biologic disease-modifying antirheumatic drugs (DMARDs), have higher incidence of adverse events (AEs), and have more healthcare costs before the initiation of biologic DMARDs than patients who do not use corticosteroids.
Patients with rheumatoid arthritis (RA) who use corticosteroids can delay the initiation of biologic disease-modifying antirheumatic drugs (DMARDs), have higher incidence of adverse events (AEs), and have more healthcare costs before the initiation of biologic DMARDs than patients who do not use corticosteroids, according to a study published in Rheumatology and Therapy.
Patients with RA often use corticosteroids to quickly relieve pain or swelling. The American College of Rheumatology recommends low doses as a short-term therapy (up to 3 months) until patients can feel the benefits of DMARDs, due to adverse events related to long-term corticosteroid use, including weight gain, worsened diabetes, and increased risk of infection.
The researchers in this study used a retrospective analysis to measure patterns of corticosteroid use, the duration of use, and the dosage amount. Utilizing the Cox proportional hazards models, the effects of corticosteroid use on the amount of time it took to initiate DMARDs was also evaluated. In addition, the researchers analyzed the probability of AEs due to corticosteroid use.
25,542 patients with RA were included in the analysis. The mean patient age was 53.55 years, and over 70% of patients were female. Nearly 10% of these patients used corticosteroids for a long period of time (over 3 months). Most of these patients were older, more likely to be female, lived in the US South, were treated by a rheumatologist, and most importantly, had more comorbidities.
Corticosteroid users compared to non-users had significantly higher incidence rates of cardiovascular events, gastrointestinal events, infections, skin events, lipodystrophy, metabolic and endocrinologic events, neuropsychiatric events, and ophthalmologic events. They also had higher average health care costs compared to nonusers. Patients who used corticosteroids for longer durations at lower dosages were less likely to initiate biologic DMARDs.
The authors found that health care providers who prescribe corticosteroids for a longer period of time may not want to disrupt treatment by waiting for DMARDs to have an effect. It is recommended that physicians limit patient use of corticosteroids, as they delay early initiation of biologic DMARDs, which are associated with improved outcomes and decreased hospitalization.
“This study thus provides evidence that corticosteroid utilization may have deleterious effects on RA patient health and may increase the cost burden associated with treatment,” the authors concluded. “Future studies should continue to examine the appropriate and optimal use of corticosteroids and biologic DMARDs in RA treatment.”
Reference
Spivery CA, Griffith J, Kaplan C, Postlethwaite A, Ganguli A, Wang J. Published December 4, 2017. Rheumatol Ther. doi: 10.1007/s40744-017-0089-8.
Biosimilars in America: Overcoming Barriers and Maximizing Impact
July 21st 2024Join us as we explore the complexities of the US biosimilars market, discussing legislative influences, payer and provider adoption factors, and strategies to overcome industry challenges with expert insights from Kyle Noonan, PharmD, MS, value & access strategy manager at Cencora.
Patient-Reported Outcomes Similar Between Adalimumab-adbm, Reference Product in VOLTAIRE-RA Study
September 28th 2024A summary of research written by Vibeke Strand, MD, clinical professor in division of immunology/rheumatology at Stanford University School of Medicine, gave an overview of patient-reported outcomes (PROs) in the VOLTAIRE-RA trial.
Breaking Barriers in Osteoporosis Care: New Denosumab Biosimilars Wyost, Jubbonti Approved
June 16th 2024In this episode, The Center for Biosimilars® delves into the FDA approval of the first denosumab biosimilars, Wyost and Jubbonti (denosumab-bbdz), and discuss their potential to revolutionize osteoporosis treatment with expert insights from 2 rheumatologists.
AAM Report: Despite Massive Savings, Patient OOP Costs on Biosimilars, Generics Remain High, Part 2
September 24th 2024Part 2 of our series diving into the Association for Accessible Medicines' (AAM) latest report discusses that while generics and biosimilars saved $445 billion in 2023, their potential is hindered by high patient costs, drug shortages, and ineffective policies, underscoring the need for reforms to fully realize their benefits.
AAM Report: Generics and Biosimilars Savings Reach $445 Billion in 2023, Part 1
September 18th 2024Savings from generic and biosimilar drugs totaled $445 billion in 2023, showing promise for the growth of both markets and highlighting the success of expansion policies for these products, according to a new report from the Association for Accessible Medicines (AAM).