Prescription practice of biological drugs in rheumatoid arthritis during the first three years of postmarketing use in Denmark and Norway: criteria are becoming less stringent.

Elisabeth Hjardem, Merete Lund Hetland, Mikkel Østergaard, Niels Steen Krogh, Tore K Kvien

    Abstract

    OBJECTIVE: This study is based on the Danish DANBIO and the Norwegian NOR-DMARD databases. It was undertaken to investigate changes in prescription practice during the first three years of post-marketing use of biological drugs, and to find the proportion of patients who would not have received TNF-blocking agents if the prescription guidelines of the United Kingdom (UK) and Holland were applied. METHODS: Rheumatoid arthritis (RA) patients receiving TNF-blocking agents from Denmark (n= 823, age: 55.2 yrs, 72.2% women) and Norway (n= 371, age: 51.8 yrs, 75.4% women) were registered from 2000 to 2003 and each year was analysed separately. Prescription guidelines in the UK (minimum 2 previous Disease Modifying Anti-Rheumatic Drugs (DMARDs) and 28 joint Disease Activity Score (DAS28) >5.1) and Holland (minimum 1 previous DMARD and DAS28 >3.2) were applied to the data. RESULTS: Baseline disease activity and number of previous DMARDs declined significantly during the three years, e.g. baseline DAS28 decreased from 5.6 to 5.1 in both Denmark (p< 0.001) and Norway (p=0.004). 47.9 and 41.3% of the Norwegian and Danish patients, respectively, did not meet the UK-criteria for using TNF- blocking agents, and 10.5% and 5.7% did not meet the Dutch criteria. CONCLUSION: The Danish and Norwegian prescription practices of biological therapies in RA were similar, and became less stringent from 2000 to 2003. Prescriptions agreed well with the Dutch guidelines, while almost half of the patients did not meet the UK guidelines. This finding highlights that access to recent, effective therapies may vary across Europe.
    Translated title of the contributionPrescription practice of biological drugs in rheumatoid arthritis during the first three years of postmarketing use in Denmark and Norway: criteria are becoming less stringent.
    Original languageEnglish
    JournalAnnals of the Rheumatic Diseases
    Volume64
    Issue number8
    Pages (from-to)1220-3
    ISSN0003-4967
    Publication statusPublished - 2005

    Cite this