MAPPING THE PRESCRIPTION TREND FOR RHEUMATOID ARTHRITIS IN MUMBAI, INDIA
Author(s)
Kulkarni AS, Kelkar RS, Majumdar AS
Bombay College of Pharmacy, Mumbai, India
OBJECTIVES: The drugs used for treatment of Rheumatoid Arthritis (RA) fall under one of the following categories: Disease Modifying Anti-Rheumatic Drugs (DMARDs), Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), Immunosuppressants, Steroids and Biologics. This research aims to explore and map the Prescribing Behavior of Medical Practitioners for disease management of RA. METHODS: A questionnaire based survey was employed to capture the demographics of RA and the prescription pattern covering General Physicians, Orthopedics and Rheumatologists in Mumbai, India. The survey featured questions to reveal: a) Gender predisposition to Rheumatoid Arthritis. b) Age of patients c) Drug preference in therapy (single or combination) including biologics. RESULTS: The survey revealed that women are more predisposed to RA than men and the ratio was approximately found to be 4:1. Amongst the patients diagnosed with RA, 86.36% were found to lie in the age group of 30-50. As a first line therapy, 31.81% of Medical Practitioners considered mono therapy with Methotrexate to be clinically most effective followed by combination therapy with Methotrexate + Hydroxychloroquine (27%). Doctors also preferred triple combination therapy of Methotrexate + Salfasalazine + Hydroxychloroquine as it had shown satisfactory clinical outcomes. 40% of Medical Practitioners were found to prescribe Leflunomide in conjunction with the first line therapy drugs. 45.45% of the Medical Practitioners recommended the use of Monoclonal Antibodies like Etanercept, Rituximab and Adalimumab as a therapy for patients who failed to respond to NSAIDs and DMARDs. CONCLUSIONS: No specific trend was observed in the prescriptions of NSAIDs as a choice of drug since a myriad of drugs are prescribed including Paracetamol, Indomethacin, Aceclofenac and Naproxen. A robust trend was observed in the prescriptions of Methotrexate either alone or as a combination with Hydroxychloroquine. Folinic acid was co prescribed by majority physicians to contain side effects. Amongst biologics, the most preferred was the TNF-alpha inhibitor-Etanercept.
Conference/Value in Health Info
2016-09, ISPOR Asia Pacific 2016, Singapore
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PMS21
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Prescribing Behavior
Disease
Musculoskeletal Disorders