Determination of recombinant biological agents requirement for patients with rheumatoid arthritis: development of standardized indications for prescription
https://doi.org/10.14412/1995-4484-2009-675
Abstract
60 Recombinant biological agents (RBA) are perspective medications for treatment of rheu- matoid arthritis (RA) but their wide administration is hampered by high cost. State paysfor treatment with RBA in Russia. Information about number of pts requiring biological therapy is necessary for planning and optimization of treatment. Objective. To develop methodology of determination of RBA requirement for treatment of pts with RA. Material and methods. 126 consecutive pts (mean age 53,5 years, male/female ratio1/5) with proved RA diagnosis (according to ACR 1987 criteria) admitted to Institute of Rheumatology of RAMS were included. After determination of clinical stage, activity, radiological stage, extra-articular features and pharmacological history each pt was assigned by a highly qualified expert to one of the following groups:1 (27 pts – 21%) – treatment with RBA is absolutely indicated, 2 (29 pts – 23%) – therapy with RBA is more likely indicated, 3 (54 pts – 43%) – the therapy is more likely not indicated, 4 (16 pts –13%) – treatment with RBA is absolutely not indicated. Results. Cluster analysis revealed following factors influencing expert opinion about advisability of administration of RBA to the pt: disease activity, clinical stage of RA, extra-articular features, rapidly progressing course of the disease, previous therapy with DMARDs including methotrexate dose till 15 mg/week, administration of full doses of methotrexate (15-25 mg/week). Scale for determination of treatment with RBA advisability score for the present pt was developed. Conclusion. The scale developed in the present study provides the possibility of objective determination of treatment with RBA requirement for RA pts in clinical practice.
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For citations:
Telnyh M.Y., Erdes S.F., Galushko E.A. Determination of recombinant biological agents requirement for patients with rheumatoid arthritis: development of standardized indications for prescription. Rheumatology Science and Practice. 2009;47(6):52-60. (In Russ.) https://doi.org/10.14412/1995-4484-2009-675
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