Suboptimal management of rheumatoid arthritis in France: a real-world study based on data from the French National Health Data System
Authors' conclusion
Despite a diverse therapeutic arsenal, there remains a medical need that is not covered by current RA management, which is frequently compensated for by overprescription of steroids.
Study context
- Population
- Patients with rheumatoid arthritis (RA) identified 2013–2017 in the French Permanent Representative Sample (Echantillon Généraliste des Bénéficiaires) claims database
- Participants
- 2,553 patients
- Outcome
- Real-world RA treatment patterns, persistence and adherence
Methodological detailslongitudinal, national claims database
- Longitudinal
- National claims database
Main finding
As reported in the abstract
RA treatment patterns
- Prescribed disease-modifying antirheumatic drugs (DMARDs)
- 1512 (59.2%)
- Of these, no discontinuation or treatment switch required
- 721 (47.6%)
- Treatment discontinuations
- 377 (24.9%)
- Switched to a targeted DMARD (biological and synthetic (JAKi) DMARDs)
- 114 (7.5%)
- Not treated with a DMARD, among 2315 patients with RA in 2017
- n=1102, 47.6%
- Symptomatic treatment
- 85.7%
- Analgesics
- 81.0%
- Steroids
- 49.2%
- NSAIDs
- 39.5%
- csDMARDs among 1142 treatment initiations
- 713 (62.4%)
- MTX (most frequent initiation)
- n=553, 48.45%
- 1-year persistence, TNFi
- 55.9% (49.2-62.0%)
- 1-year persistence, csDMARDs
- 63.4% (59.6-67.0%)
- Adherence (medication possession ratio; cut-off ≥80%), range
- 71.9% and 90.8%
- Almost half of DMARD initiations associated with long-term (>6 months), high-dose oral steroid use
- ≈7 mg/day prednisone equivalent
Observational data: associations, not effects.
Original publication
Suboptimal management of rheumatoid arthritis in France: a real-world study based on data from the French National Health Data System. RMD Open. Published 31 October 2023. doi:10.
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