2025 Volume 56 Issue 6 Pages 257-270
Objective: The treatment of rheumatoid arthritis (RA) in Japan has evolved significantly since the introduction of biologic disease-modifying antirheumatic drugs (bDMARDs) in 2003. This study aimed to identify the key factors associated with poor drug continuation among patients with RA.
Methods: Using the JMDC prescription database, we analyzed the utilization of biologic/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) in Japan. Patient characteristics were compared between those who continued treatment for 2 years and those who discontinued treatment to identify the factors contributing to poor continuation.
Results: A total of 1,890 patients (mean age: 49 years; female: 76.2%) were included in the study. The baseline corticosteroid co-administration rate was 47% (535/1,131) in the continuation group and 58% (444/759) in the discontinuation group (p<0.0001). Fracture history was higher among those who discontinued treatment (3.2% vs. 1.8%, p＝0.049). Independent factors for continuation included corticosteroid use (odds ratio [OR]: 0.63; 95% confidence interval [CI]: 0.52-0.76; p<0.0001), fracture history (OR: 0.53; 95% CI: 0.29-0.97, p＝0.039), and male sex (OR: 1.32; 95% CI: 1.06-1.64, p＝0.014).
Conclusion: This study identified corticosteroid use and male sex as independent factors contributing to poor continuation of b/tsDMARDs among Japanese patients with RA within 2 years of treatment initiation. The history of fracture was also associated with poor continuation; however, given its low prevalence and wide confidence interval, this finding should be regarded as exploratory.
