PMID- 32978302
OWN - NLM
STAT- MEDLINE
DCOM- 20210831
LR  - 20210831
IS  - 2056-5933 (Electronic)
IS  - 2056-5933 (Linking)
VI  - 6
IP  - 3
DP  - 2020 Sep
TI  - Introduction and switching of biologic agents are associated with antidepressant 
      and anxiolytic medication use: data on 42 815 real-world patients with 
      inflammatory rheumatic disease.
LID - 10.1136/rmdopen-2020-001303 [doi]
LID - e001303
AB  - OBJECTIVES: Depression and anxiety are linked bi-directionally with inflammatory 
      rheumatic diseases (IRDs) activity, which in turn, depends on subjective patient 
      reported outcomes that can be distorted by comorbid mood disorders. We tested the 
      hypothesis that introduction and/or switching of biologic agents for IRDs are 
      associated with treatment for depression and/or anxiety, by analysing real-world 
      data. METHODS: Using a country-wide electronic prescription database (10 012 604 
      registered, 99% population coverage), we captured almost all patients with 
      rheumatoid arthritis (n=12 002), psoriatic arthritis (n=5465) and ankylosing 
      spondylitis (n=6423) who received biologic disease modifying anti-rheumatic drugs 
      (bDMARDs) during a 2-year period (8/2016-7/2018). Concomitant 
      antidepressant/anxiolytic medication use was documented in patients who started 
      or switched bDMARDs and compared with those who remained on conventional 
      synthetic (cs)DMARDs or the same bDMARD, respectively, by multivariate regression 
      analysis. RESULTS: Two-year data analysis on 42 815 patients revealed that bDMARD 
      introduction was associated with both antidepressant [OR: 1.248, 95% CI 1.153 to 
      1.350, p<0.0001] and anxiolytic medication use [OR: 1.178, 95% CI 1.099 to 1.263, 
      p<0.0001]. Moreover, bDMARD switching was also associated with antidepressant 
      [OR: 1.502, 95% CI 1.370 to 1.646, p<0.0001] and anxiolytic medication use [OR: 
      1.161, 95% CI 1.067 to 1.264, p=0.001]. Notably, all these associations were 
      independent of age, gender, underlying disease diagnosis and concomitant 
      glucocorticoid or csDMARD medication use. CONCLUSION: In real-world settings, 
      both introduction and switching of bDMARDs in patients with IRDs were associated 
      with the presence of mood disorders. Although a causal relationship is uncertain, 
      the impact of depression and anxiety should always be considered by physicians 
      facing the decision to introduce or switch bDMARDs in patients with active IRDs.
CI  - (c) Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Bournia, Vasiliki-Kalliopi
AU  - Bournia VK
AUID- ORCID: 0000-0002-2162-1362
AD  - Joint Rheumatology Program, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece lily_bournia@hotmail.com psfikakis@med.uoa.gr.
FAU - Tektonidou, Maria G
AU  - Tektonidou MG
AUID- ORCID: 0000-0003-2238-0975
AD  - Joint Rheumatology Program, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece.
FAU - Vassilopoulos, Dimitrios
AU  - Vassilopoulos D
AD  - Joint Rheumatology Program, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece.
FAU - Laskari, Katerina
AU  - Laskari K
AD  - Joint Rheumatology Program, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece.
FAU - Panopoulos, Stylianos
AU  - Panopoulos S
AD  - Joint Rheumatology Program, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece.
FAU - Fragiadaki, Kalliopi
AU  - Fragiadaki K
AD  - Joint Rheumatology Program, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece.
FAU - Mathioudakis, Konstantinos
AU  - Mathioudakis K
AD  - IDIKA SA - e-Government Center for Social Security Services, Athens, Greece.
FAU - Tsolakidis, Anastasios
AU  - Tsolakidis A
AD  - IDIKA SA - e-Government Center for Social Security Services, Athens, Greece.
FAU - Mitrou, Panagiota
AU  - Mitrou P
AD  - Hellenic Republic Ministry of Health, Athens, Greece.
FAU - Sfikakis, Petros P
AU  - Sfikakis PP
AD  - Joint Rheumatology Program, Medical School, National and Kapodistrian University 
      of Athens, Athens, Greece.
LA  - eng
PT  - Journal Article
PL  - England
TA  - RMD Open
JT  - RMD open
JID - 101662038
RN  - 0 (Anti-Anxiety Agents)
RN  - 0 (Antidepressive Agents)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Biological Factors)
RN  - 0 (Biological Products)
SB  - IM
MH  - *Anti-Anxiety Agents/therapeutic use
MH  - Antidepressive Agents/adverse effects
MH  - *Antirheumatic Agents/adverse effects
MH  - *Arthritis, Rheumatoid/drug therapy/epidemiology
MH  - Biological Factors/therapeutic use
MH  - *Biological Products/adverse effects
MH  - Humans
PMC - PMC7539856
OTO - NOTNLM
OT  - Ankylosing
OT  - Arthritis
OT  - Biological Therapy
OT  - Psoriatic
OT  - Rheumatoid
OT  - Spondylitis
COIS- Competing interests: None declared.
EDAT- 2020/09/27 06:00
MHDA- 2021/09/01 06:00
PMCR- 2020/09/25
CRDT- 2020/09/26 05:25
PHST- 2020/05/04 00:00 [received]
PHST- 2020/07/29 00:00 [revised]
PHST- 2020/09/05 00:00 [accepted]
PHST- 2020/09/26 05:25 [entrez]
PHST- 2020/09/27 06:00 [pubmed]
PHST- 2021/09/01 06:00 [medline]
PHST- 2020/09/25 00:00 [pmc-release]
AID - rmdopen-2020-001303 [pii]
AID - 10.1136/rmdopen-2020-001303 [doi]
PST - ppublish
SO  - RMD Open. 2020 Sep;6(3):e001303. doi: 10.1136/rmdopen-2020-001303.