Selection and persistence rate of biological agents under community cooperation clinical pathway for rheumatoid arthritis treatment with biological agents

Abstract

    “Community cooperation clinical pathway for rheumatoid arthritis treatment with biological agents”was constructed in the north Kawauchi district of Osaka. We are cooperating with 23 medical institutions as a key facility in this cooperation clinical pathway. A retrospective analysis for the selection and persistence rate of biological agents was performed. The mean age of the 306 patients with rheumatoid arthritis who were started on biological agents from 2006 to 2010 was 57.0 years. In the selection of biological products of IFX, ETN, TCZ, and ADA, late-started TCZ and ADA often became the second selections. There was no difference in the persistence rate in these four biological agents in the patient groups of the first selections. 25.1% of the patient group administered IFX had an increased dosage of IFX, and the persistence rate in these patients was higher than in the patients with the usual dosage. The administering period was extended in patients being administered ADA and ETN by 73.1% and 25.0%, respectively, and the persistence rate in these patients was higher than patients with “the usual administering period”. Aged patients tended to select the biological agents of subcutaneous injection formulation (ETN and ADA). Few cases reached remission in the coordinated patient group.
    However, the persistence rate of biological agents in this group was high. There is a possibility that biological agents can be selected for aged patients by this cooperation clinical pathway.