PMID- 27709444 OWN - NLM STAT- MEDLINE DCOM- 20170412 LR - 20181113 IS - 1434-9949 (Electronic) IS - 0770-3198 (Print) IS - 0770-3198 (Linking) VI - 36 IP - 1 DP - 2017 Jan TI - The usage of biological DMARDs and clinical remission of rheumatoid arthritis in China: a real-world large scale study. PG - 35-43 LID - 10.1007/s10067-016-3424-5 [doi] AB - The aims of this study are to characterize the biological disease-modifying antirheumatic drug (bDMARD) usage patterns in real-life and examine the remission rate of rheumatoid arthritis (RA) patients receiving bDMARDs in routine clinical practice in China. Consenting RA patients (>/=18 years) from 15 teaching hospitals and receiving marketed bDMARDs were included. In total, 802 patients (81.3 % women, 49.0 +/- 13.9 years) were included; 89.5 % were receiving a combination of bDMARDs and conventional synthetic DMARDs (csDMARDS), whereas 10.5 % were receiving bDMARD monotherapy. Etanercept (including Enbrel(R) and local brand Yi Sai Pu(R) and Qiangke(R)), tocilizumab, adalimumab, and infliximab were used by 66.6 %, 17.0 %, 7.5 %, and 6.6 % patients, respectively. Etanercept was used at a mean weekly dose of 38.2 +/- 15.6 mg for 25.5 +/- 47.0 weeks and tocilizumab at 94.5 +/- 21.9 mg for 4.7 +/- 7.5 weeks. Overall rate of remission was 12.6 %, 5.4 % , and 3.5 % based on DAS28, CDAI, and SDAI scores, respectively. Compared with patients receiving bDMARDs for <3 months, those receiving bDMARDs for >/=3 months exhibited significantly lower DAS28 scores (p < 0.0001), and a significantly higher proportion of patients who received bDMARDs for >/=12 months achieved the treatment goal (remission or low disease activity, 62.5 % vs. 18.3 %, p < 0.0001). Patients receiving combination therapy with csDMARDs exhibited lower DAS28 scores than patients receiving bDMARD monotherapy (4.3 vs. 4.8, p = 0.011). This large-scale real-world study showed that bDMARD usage patterns in routine clinical practice in China were in accordance with international guidelines for RA management despite the short treatment duration. Longer duration of bDMARD usage and combination therapy showed a favored outcome of RA. FAU - An, Yuan AU - An Y AD - Department of Rheumatology and Immunology, Peking University People's Hospital, 11 South Xi Zhi Men Street, Xicheng District, Beijing, 100044, People's Republic of China. FAU - Liu, Tian AU - Liu T AD - Department of Rheumatology and Immunology, Peking University People's Hospital, 11 South Xi Zhi Men Street, Xicheng District, Beijing, 100044, People's Republic of China. FAU - He, Dongyi AU - He D AD - Department of Rheumatology, Shanghai Guanghua Hospital, Shanghai, China. FAU - Wu, Lijun AU - Wu L AD - Department of Rheumatology, People's Hospital of Xinjiang Uygur Autonomous Region, Xingjiang, China. FAU - Li, Juan AU - Li J AD - Department of Rheumatology, Nanfang Hospital of Southern Medical University, Guangzhou, China. FAU - Liu, Yi AU - Liu Y AD - Department of Rheumatology and Immunology, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China. FAU - Bi, Liqi AU - Bi L AD - Department of Rheumatology, China-Japan Union Hospital of Jilin University, Changchun, China. FAU - Zhou, Bin AU - Zhou B AD - Department of Rheumatology, Sichuan Provincial People's Hospital, Sichuan, China. FAU - Lin, Changsong AU - Lin C AD - Department of Rheumatology, The First Affiliated Hospital of Guangzhou Traditional Chinese Medicine University, Guangzhou, China. FAU - He, Lan AU - He L AD - Department of Rheumatology, The First Affiliated Hospital of Xi'An Jiaotong University, Xi'an, China. FAU - Liu, Xiangyuan AU - Liu X AD - Department of Rheumatology, Peking University Third Hospital, Beijing, China. FAU - Li, Xiaofeng AU - Li X AD - Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, China. FAU - Yang, Niansheng AU - Yang N AD - Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. FAU - Zhang, Zhuoli AU - Zhang Z AD - Department of Rheumatology, Peking University First Hospital, Beijing, China. FAU - Song, Hui AU - Song H AD - Department of Rheumatology, Beijing Jishuitan Hospital, Beijing, China. FAU - Wei, Wei AU - Wei W AD - Department of Rheumatology, Tianjin Medical University General Hospital, Tianjin, China. FAU - Liu, Jing AU - Liu J AD - Shanghai Roche Pharmaceuticals Ltd, Shanghai, China. FAU - Bi, Yu AU - Bi Y AD - Shanghai Roche Pharmaceuticals Ltd, Shanghai, China. FAU - Li, Zhanguo AU - Li Z AD - Department of Rheumatology and Immunology, Peking University People's Hospital, 11 South Xi Zhi Men Street, Xicheng District, Beijing, 100044, People's Republic of China. zgli99@aliyun.com. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20161005 PL - Germany TA - Clin Rheumatol JT - Clinical rheumatology JID - 8211469 RN - 0 (Antibodies, Monoclonal, Humanized) RN - 0 (Antirheumatic Agents) RN - 0 (Biological Products) RN - B72HH48FLU (Infliximab) RN - FYS6T7F842 (Adalimumab) RN - I031V2H011 (tocilizumab) RN - OP401G7OJC (Etanercept) SB - IM MH - Adalimumab/administration & dosage MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Antibodies, Monoclonal, Humanized/administration & dosage MH - Antirheumatic Agents/*therapeutic use MH - Arthritis, Rheumatoid/*drug therapy MH - Biological Products/*therapeutic use MH - China MH - Cross-Sectional Studies MH - Etanercept/administration & dosage MH - Female MH - Humans MH - Infliximab/administration & dosage MH - Male MH - Middle Aged MH - Remission Induction MH - Sample Size MH - Surveys and Questionnaires MH - Treatment Outcome MH - Young Adult PMC - PMC5216094 OTO - NOTNLM OT - Biological OT - China OT - DMARD OT - Duration OT - Rheumatoid arthritis OT - Therapy COIS- Compliance with ethical standards The study was approved by the Institutional Review Board of Peking University and independent ethics committees responsible for each investigating site. The study was conducted in compliance with the Declaration of Helsinki and in accordance with Good Clinical Practice and relevant ethical guidelines. Written informed consent was obtained from each participant. Disclosures Jing Liu and Yu Bi are employees of Shanghai Roche Pharmaceutical Ltd., and funding for this study was provided by Shanghai Roche Pharmaceutical Ltd. EDAT- 2016/10/07 06:00 MHDA- 2017/04/13 06:00 PMCR- 2016/10/05 CRDT- 2016/10/07 06:00 PHST- 2016/03/23 00:00 [received] PHST- 2016/09/18 00:00 [accepted] PHST- 2016/08/08 00:00 [revised] PHST- 2016/10/07 06:00 [pubmed] PHST- 2017/04/13 06:00 [medline] PHST- 2016/10/07 06:00 [entrez] PHST- 2016/10/05 00:00 [pmc-release] AID - 10.1007/s10067-016-3424-5 [pii] AID - 3424 [pii] AID - 10.1007/s10067-016-3424-5 [doi] PST - ppublish SO - Clin Rheumatol. 2017 Jan;36(1):35-43. doi: 10.1007/s10067-016-3424-5. Epub 2016 Oct 5.