Monitoring patients with rheumatoid arthritis in routine care: experiences from a treat-to-target strategy using the DANBIO registry

Merete Lund Hetland; Dorte Vendelbo  Jensen; Niels Steen Krogh

Monitoring patients with rheumatoid arthritis in routine care: experiences from a treat-to-target strategy using the DANBIO registry

Merete Lund Hetland, Dorte Vendelbo Jensen, Niels Steen Krogh

Department of Clinical Medicine

28 Citations (Scopus)

Abstract

Objective. Advances in aggressive use of conventional synthetic diseasemodifying anti-rheumatic drugs (csDMARDs) as well as biological DMARDs (bDMARDs) have improved the treatment armamentarium for rheumatologists, and modern treatment principles include a treat-to-target (T2T) strategy. However, little is known about the feasibility of a T2T strategy in patients with rheumatoid arthritis (RA) treated in routine care. The aim of the present study was to (i) present the annual number of patients included in DANBIO between 2006 and 2013 and their disease characteristics and (ii) estimate coverage of DANBIO by 2013. Methods. Patients who were registered with RA for the first time in the nationwide Danish DANBIO database between year 2006 and 2013 were included. Baseline characteristics were assessed in patients treated with bDMARDs and csDMARDs, respectively. The fraction of patients with low/ moderate/high disease activity (i.e. DAS28 (CRP-based, 4 variables) was calculated for each calendar year. Results. From 2006-2013 the number of patients increased from 2,395 to 14,249. By 2013, 29.8% of patients were receiving bDMARD. Patients in the csDMARD group were older, had shorter disease duration, lower disease activity, less disability and radiographic damage. By 2013, 19% of csDMARD (15% of bDMARD) patients were in ACR/Boolean remission. Coverage had increased to between 41% and 79% for patients with RA, for the bDMARD group it was 94%. Conclusion. Systematic monitoring of RA patients with real-time feedback to the physician is feasible, although the goal of treat-to-target is not achieved in a substantial proportion of patients in routine care.

Original language	English
Journal	Clinical and Experimental Rheumatology
Volume	32
Issue number	Suppl 85
Pages (from-to)	s-141 -s-146
Number of pages	6
ISSN	0392-856X
Publication status	Published - 2014

Keywords

Aged
Antirheumatic Agents
Arthritis, Rheumatoid
Denmark
Disability Evaluation
Disease Progression
Female
Guideline Adherence
Humans
Male
Middle Aged
Outcome and Process Assessment (Health Care)
Physician's Practice Patterns
Practice Guidelines as Topic
Predictive Value of Tests
Registries
Remission Induction
Severity of Illness Index
Standard of Care
Time Factors
Treatment Outcome

Cite this

Monitoring patients with rheumatoid arthritis in routine care : experiences from a treat-to-target strategy using the DANBIO registry . / Hetland, Merete Lund; Jensen, Dorte Vendelbo ; Krogh, Niels Steen.

In: Clinical and Experimental Rheumatology, Vol. 32, No. Suppl 85, 2014, p. s-141 -s-146.

Research output: Contribution to journal › Journal article › Research › peer-review

@article{ed973f228bc842daa22c763df45d62d1,

title = "Monitoring patients with rheumatoid arthritis in routine care: experiences from a treat-to-target strategy using the DANBIO registry ",

abstract = "Objective. Advances in aggressive use of conventional synthetic diseasemodifying anti-rheumatic drugs (csDMARDs) as well as biological DMARDs (bDMARDs) have improved the treatment armamentarium for rheumatologists, and modern treatment principles include a treat-to-target (T2T) strategy. However, little is known about the feasibility of a T2T strategy in patients with rheumatoid arthritis (RA) treated in routine care. The aim of the present study was to (i) present the annual number of patients included in DANBIO between 2006 and 2013 and their disease characteristics and (ii) estimate coverage of DANBIO by 2013. Methods. Patients who were registered with RA for the first time in the nationwide Danish DANBIO database between year 2006 and 2013 were included. Baseline characteristics were assessed in patients treated with bDMARDs and csDMARDs, respectively. The fraction of patients with low/ moderate/high disease activity (i.e. DAS28 (CRP-based, 4 variables) was calculated for each calendar year. Results. From 2006-2013 the number of patients increased from 2,395 to 14,249. By 2013, 29.8% of patients were receiving bDMARD. Patients in the csDMARD group were older, had shorter disease duration, lower disease activity, less disability and radiographic damage. By 2013, 19% of csDMARD (15% of bDMARD) patients were in ACR/Boolean remission. Coverage had increased to between 41% and 79% for patients with RA, for the bDMARD group it was 94%. Conclusion. Systematic monitoring of RA patients with real-time feedback to the physician is feasible, although the goal of treat-to-target is not achieved in a substantial proportion of patients in routine care.",

keywords = "Aged, Antirheumatic Agents, Arthritis, Rheumatoid, Denmark, Disability Evaluation, Disease Progression, Female, Guideline Adherence, Humans, Male, Middle Aged, Outcome and Process Assessment (Health Care), Physician's Practice Patterns, Practice Guidelines as Topic, Predictive Value of Tests, Registries, Remission Induction, Severity of Illness Index, Standard of Care, Time Factors, Treatment Outcome",

author = "Hetland, {Merete Lund} and Jensen, {Dorte Vendelbo} and Krogh, {Niels Steen}",

year = "2014",

language = "English",

volume = "32",

pages = "s--141 --s--146",

journal = "Clinical and Experimental Rheumatology",

issn = "0392-856X",

publisher = "Pacini Editore SpA",

number = "Suppl 85",

}

TY - JOUR

T1 - Monitoring patients with rheumatoid arthritis in routine care

T2 - experiences from a treat-to-target strategy using the DANBIO registry

AU - Hetland, Merete Lund

AU - Jensen, Dorte Vendelbo

AU - Krogh, Niels Steen

PY - 2014

Y1 - 2014

N2 - Objective. Advances in aggressive use of conventional synthetic diseasemodifying anti-rheumatic drugs (csDMARDs) as well as biological DMARDs (bDMARDs) have improved the treatment armamentarium for rheumatologists, and modern treatment principles include a treat-to-target (T2T) strategy. However, little is known about the feasibility of a T2T strategy in patients with rheumatoid arthritis (RA) treated in routine care. The aim of the present study was to (i) present the annual number of patients included in DANBIO between 2006 and 2013 and their disease characteristics and (ii) estimate coverage of DANBIO by 2013. Methods. Patients who were registered with RA for the first time in the nationwide Danish DANBIO database between year 2006 and 2013 were included. Baseline characteristics were assessed in patients treated with bDMARDs and csDMARDs, respectively. The fraction of patients with low/ moderate/high disease activity (i.e. DAS28 (CRP-based, 4 variables) was calculated for each calendar year. Results. From 2006-2013 the number of patients increased from 2,395 to 14,249. By 2013, 29.8% of patients were receiving bDMARD. Patients in the csDMARD group were older, had shorter disease duration, lower disease activity, less disability and radiographic damage. By 2013, 19% of csDMARD (15% of bDMARD) patients were in ACR/Boolean remission. Coverage had increased to between 41% and 79% for patients with RA, for the bDMARD group it was 94%. Conclusion. Systematic monitoring of RA patients with real-time feedback to the physician is feasible, although the goal of treat-to-target is not achieved in a substantial proportion of patients in routine care.

AB - Objective. Advances in aggressive use of conventional synthetic diseasemodifying anti-rheumatic drugs (csDMARDs) as well as biological DMARDs (bDMARDs) have improved the treatment armamentarium for rheumatologists, and modern treatment principles include a treat-to-target (T2T) strategy. However, little is known about the feasibility of a T2T strategy in patients with rheumatoid arthritis (RA) treated in routine care. The aim of the present study was to (i) present the annual number of patients included in DANBIO between 2006 and 2013 and their disease characteristics and (ii) estimate coverage of DANBIO by 2013. Methods. Patients who were registered with RA for the first time in the nationwide Danish DANBIO database between year 2006 and 2013 were included. Baseline characteristics were assessed in patients treated with bDMARDs and csDMARDs, respectively. The fraction of patients with low/ moderate/high disease activity (i.e. DAS28 (CRP-based, 4 variables) was calculated for each calendar year. Results. From 2006-2013 the number of patients increased from 2,395 to 14,249. By 2013, 29.8% of patients were receiving bDMARD. Patients in the csDMARD group were older, had shorter disease duration, lower disease activity, less disability and radiographic damage. By 2013, 19% of csDMARD (15% of bDMARD) patients were in ACR/Boolean remission. Coverage had increased to between 41% and 79% for patients with RA, for the bDMARD group it was 94%. Conclusion. Systematic monitoring of RA patients with real-time feedback to the physician is feasible, although the goal of treat-to-target is not achieved in a substantial proportion of patients in routine care.

KW - Aged

KW - Antirheumatic Agents

KW - Arthritis, Rheumatoid

KW - Denmark

KW - Disability Evaluation

KW - Disease Progression

KW - Female

KW - Guideline Adherence

KW - Humans

KW - Male

KW - Middle Aged

KW - Outcome and Process Assessment (Health Care)

KW - Physician's Practice Patterns

KW - Practice Guidelines as Topic

KW - Predictive Value of Tests

KW - Registries

KW - Remission Induction

KW - Severity of Illness Index

KW - Standard of Care

KW - Time Factors

KW - Treatment Outcome

M3 - Journal article

C2 - 25365104

SN - 0392-856X

VL - 32

SP - s-141 -s-146

JO - Clinical and Experimental Rheumatology

JF - Clinical and Experimental Rheumatology

IS - Suppl 85

ER -

Monitoring patients with rheumatoid arthritis in routine care: experiences from a treat-to-target strategy using the DANBIO registry

Abstract

Keywords

Fingerprint

Cite this