OBJECTIVES

Examine treatment patterns among patients with RA in Japan over time.

METHODS

This retrospective study used claims data from the JMDC Inc. database between 1/1/2005-5/31/2018. Adult (≥18 years) patients were required to have received treatment for RA with biologic therapies, methotrexate (MTX), other DMARDs or glucocorticoids between 1/1/2006 and 5/31/2017 (index date), have ≥1 RA diagnosis during one-year pre or 60 days post index date and have continuous enrollment during this period. Patients were excluded if they had received RA treatment during one year prior to the index date. The main outcomes of interest were the medications used during the first and second lines of therapy (LOT). Combination therapy was defined as use of additional RA medications within 60 days of index date. Discontinuation was defined by either the addition of new medication(s) after 60 days or gap of ≥ 90 days. Switch was defined by initiation of therapy after discontinuation. Results were stratified by year of index date, defined as period-1 (P1) 2006-2011, period-2 (P2) 2012-2014 and period-3 (P3) 2015-2017.

RESULTS

Of 17,894 patients meeting the inclusion criteria (mean[±SD] age=48.8[±11.9] years, 59.9% female), 16.0% were identified in P1, 34.3% in P2, and 49.7% in P3. Likelihood of the first LOT containing biologic (P1 vs P2 vs P3: 0.8% vs 1.2% vs 1.3%; p-value for trend=0.05) and MTX (6.3% vs 7.8% vs 8.9%; p-value<0.001) increased over time while that of other DMARD (8.3% vs 7.0% vs 7.1%; p-value=0.05) decreased. Similarly, the likelihood of second LOT containing biologic (2.3% vs 3.3% vs 5.1%; p-value<0.001), MTX (12.3% vs 14.1% vs 20.9%; p-value<0.001), or other DMARD (10.3% vs 11.6% vs 15.7%; p-value<0.001) increased over time, however that of glucocorticoids (88.9% vs 87.7% vs 83.1%; p-value=<0.001) decreased.

CONCLUSIONS

These results suggest that RA patients in Japan over time are receiving more aggressive treatment.