Changes in Patterns of Use of Advanced Therapies Following Emerging Data About Adverse Events in Patients With Rheumatoid Arthritis From the Veterans Affairs Health System
Objective To determine whether prescribing practices for Janus kinase inhibitors (JAKi), tumor necrosis factor inhibitors (TNFi), and non‐TNFi biologic agents changed after the results of the Oral Rheumatoid Arthritis Trial (ORAL) Surveillance trial were released in January 2021. Methods This is a r...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-10-01
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| Series: | ACR Open Rheumatology |
| Online Access: | https://doi.org/10.1002/acr2.11602 |
| _version_ | 1797660675061841920 |
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| author | Stephanie Jeong Michael D. George Ted R. Mikuls Bryant R. England Brian Sauer Grant W. Cannon Joshua F. Baker |
| author_facet | Stephanie Jeong Michael D. George Ted R. Mikuls Bryant R. England Brian Sauer Grant W. Cannon Joshua F. Baker |
| author_sort | Stephanie Jeong |
| collection | DOAJ |
| description | Objective To determine whether prescribing practices for Janus kinase inhibitors (JAKi), tumor necrosis factor inhibitors (TNFi), and non‐TNFi biologic agents changed after the results of the Oral Rheumatoid Arthritis Trial (ORAL) Surveillance trial were released in January 2021. Methods This is a retrospective study in adult patients with rheumatoid arthritis (RA) receiving advanced therapies within the Veterans Affairs Health System from January 2012 through September 2022. Eligible patients were required to have at least one diagnosis code for RA and to have received a biologic disease‐modifying antirheumatic drug or JAKi. Treatment courses were defined from pharmacy dispensing data and the number of new courses of each advanced therapy was quantified over time. We assessed changes in the use of each therapy before and after the release of safety data (January 2021). Results A total of 88,253 individual drug courses (in 34,656 unique patients) were included in the study. There was a consistent increase in the number and proportion of new courses of JAKi leading up to January 2021, which was followed by a significant net decrease in JAKi use through September 2022. There was significantly less tofacitinib use after the release of safety data, with a significant difference in the slope of change in use with time. In contrast, whereas TNFi use declined leading up to 2021, its use significantly increased after January 2021. Conclusion Changes in prescribing in response to new evidence emphasize the impact that safety trials have on prescribing practices. Ongoing study in this area, with attention to specific patient characteristics and risk profiles, will help characterize these changes in practice. |
| first_indexed | 2024-03-11T18:34:20Z |
| format | Article |
| id | doaj.art-d20b4d599fdd44c4bc4bb628e0b9d5d7 |
| institution | Directory Open Access Journal |
| issn | 2578-5745 |
| language | English |
| last_indexed | 2024-03-11T18:34:20Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | ACR Open Rheumatology |
| spelling | doaj.art-d20b4d599fdd44c4bc4bb628e0b9d5d72023-10-13T07:11:07ZengWileyACR Open Rheumatology2578-57452023-10-0151056356710.1002/acr2.11602Changes in Patterns of Use of Advanced Therapies Following Emerging Data About Adverse Events in Patients With Rheumatoid Arthritis From the Veterans Affairs Health SystemStephanie Jeong0Michael D. George1Ted R. Mikuls2Bryant R. England3Brian Sauer4Grant W. Cannon5Joshua F. Baker6University of Pennsylvania School of Medicine PhiladelphiaUniversity of Pennsylvania School of Medicine and University of Pennsylvania Center for Clinical Epidemiology and Biostatistics Philadelphia PennsylvaniaUniversity of Nebraska Medical Center OmahaUniversity of Nebraska Medical Center OmahaSalt Lake City Veteran Affairs Medical Center and University of Utah Salt Lake City UtahSalt Lake City Veteran Affairs Medical Center and University of Utah Salt Lake City UtahUniversity of Pennsylvania School of Medicine, University of Pennsylvania Center for Clinical Epidemiology and Biostatistcs, and Corporal Michael J. Crescenz Veterans Affairs Medical Center Philadelphia PennsylvaniaObjective To determine whether prescribing practices for Janus kinase inhibitors (JAKi), tumor necrosis factor inhibitors (TNFi), and non‐TNFi biologic agents changed after the results of the Oral Rheumatoid Arthritis Trial (ORAL) Surveillance trial were released in January 2021. Methods This is a retrospective study in adult patients with rheumatoid arthritis (RA) receiving advanced therapies within the Veterans Affairs Health System from January 2012 through September 2022. Eligible patients were required to have at least one diagnosis code for RA and to have received a biologic disease‐modifying antirheumatic drug or JAKi. Treatment courses were defined from pharmacy dispensing data and the number of new courses of each advanced therapy was quantified over time. We assessed changes in the use of each therapy before and after the release of safety data (January 2021). Results A total of 88,253 individual drug courses (in 34,656 unique patients) were included in the study. There was a consistent increase in the number and proportion of new courses of JAKi leading up to January 2021, which was followed by a significant net decrease in JAKi use through September 2022. There was significantly less tofacitinib use after the release of safety data, with a significant difference in the slope of change in use with time. In contrast, whereas TNFi use declined leading up to 2021, its use significantly increased after January 2021. Conclusion Changes in prescribing in response to new evidence emphasize the impact that safety trials have on prescribing practices. Ongoing study in this area, with attention to specific patient characteristics and risk profiles, will help characterize these changes in practice.https://doi.org/10.1002/acr2.11602 |
| spellingShingle | Stephanie Jeong Michael D. George Ted R. Mikuls Bryant R. England Brian Sauer Grant W. Cannon Joshua F. Baker Changes in Patterns of Use of Advanced Therapies Following Emerging Data About Adverse Events in Patients With Rheumatoid Arthritis From the Veterans Affairs Health System ACR Open Rheumatology |
| title | Changes in Patterns of Use of Advanced Therapies Following Emerging Data About Adverse Events in Patients With Rheumatoid Arthritis From the Veterans Affairs Health System |
| title_full | Changes in Patterns of Use of Advanced Therapies Following Emerging Data About Adverse Events in Patients With Rheumatoid Arthritis From the Veterans Affairs Health System |
| title_fullStr | Changes in Patterns of Use of Advanced Therapies Following Emerging Data About Adverse Events in Patients With Rheumatoid Arthritis From the Veterans Affairs Health System |
| title_full_unstemmed | Changes in Patterns of Use of Advanced Therapies Following Emerging Data About Adverse Events in Patients With Rheumatoid Arthritis From the Veterans Affairs Health System |
| title_short | Changes in Patterns of Use of Advanced Therapies Following Emerging Data About Adverse Events in Patients With Rheumatoid Arthritis From the Veterans Affairs Health System |
| title_sort | changes in patterns of use of advanced therapies following emerging data about adverse events in patients with rheumatoid arthritis from the veterans affairs health system |
| url | https://doi.org/10.1002/acr2.11602 |
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