National registry of biological and targeted therapy of rheumatic diseases ATTRA – 20 years of experience
Authors:
K. Pavelka 1; Z. Křístková 2; L. Dušek 3
Authors‘ workplace:
Revmatologický ústav Praha
1; Institut biostatistiky a analýz, s. r. o., Brno
2; Ústav zdravotnických informací a statistiky ČR, Praha
3
Published in:
Čes. Revmatol., 28, 2020, No. 3, p. 120-131.
Category:
Original article
Overview
The national registry of biological therapy of rheumatic diseases ATTRA was established 20 years ago. A total of 5324 patients diagnosed with rheumatoid arthritis were entered into the registry. The median follow-up is 5 years and the total patient exposure is 27,358 patient-years. The number of patients is increasing and in recent years there has been an annual increase of 621 patients. Analysis of patients at the beginning of the study shows that these are patients with long disease duration, already with significant functional impairment and high activity (DAS 28 ESR 6.3 ± 0.9). At baseline, 63% of patients were using glucocorticoids, and 82% conventional synthetic DMARDs (csDMARD). Adherence to treatment with the first biological drug was 77.4% after 12 months and 63.8% after 24 months. The most common reasons for discontinuation were secondary failure 37.3%, primary failure 28.3%, and adverse events 25.8%. The mean DAS 28 decreased from 6.3 ± 0.9 to 3.1 ± 1.4 after 24 months. Fifty-five % of patients were in low activity or remission after 2 years of treatment. When assessing the quality of life, there was a significant improvement in all aspects assessed by the SF-36 questionnaire. The ability to work has improved significantly as the values of presenteeism and absenteeism assessed using the WPAI questionnaires have improved. The incidence of adverse reactions is in line with international experience. Tuberculosis occurred in only 19 patients.
Conclusion: The ATTRA registry documents the means of treating rheumatoid arthritis with biological drugs in biological treatment centers. The results are very good but show that the T2T principle could be used more intensively in routine clinical practice. The incidence of adverse reactions is lower than in comparable registries, which may be due to insufficient reporting.
Keywords:
rheumatoid arthritis – biological treatment – ATTRA registry
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