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Pattern of infliximab utilization in rheumatoid arthritis patients at an academic medical center
Objective To investigate the pattern of use of infliximab with an emphasis on treatment escalation and the durability of infliximab use in the management of rheumatoid arthritis (RA) in an academic setting. Methods We conducted a retrospective review of pharmacy and medical records of 183 patients w...
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| Published in: | Arthritis and rheumatism 2005-12, Vol.53 (6), p.872-878 |
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| Main Authors: | , , , , , , , , , |
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| container_title | Arthritis and rheumatism |
| container_volume | 53 |
| creator | Agarwal, Sandeep K. Maier, Agnes L. Chibnik, Lori B. Coblyn, Jonathan S. Fossel, Anne Lee, Ryan Fanikos, John Fiumara, Karen Lowry, Colleen Weinblatt, Michael E. |
| description | Objective
To investigate the pattern of use of infliximab with an emphasis on treatment escalation and the durability of infliximab use in the management of rheumatoid arthritis (RA) in an academic setting.
Methods
We conducted a retrospective review of pharmacy and medical records of 183 patients with RA who received at least 1 infliximab infusion at the infusion centers of the Brigham and Women's Hospital. Treatment escalation was defined as an increase in the dosage of infliximab to >3 mg/kg and/or a decrease in the dosing interval to |
| doi_str_mv | 10.1002/art.21582 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68890198</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>68890198</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3532-30c341095196d143ca7b3e20231e47b4006c1fdee9289039e0a25abf91cf57ce3</originalsourceid><addsrcrecordid>eNp1kEtLAzEUhYMotlYX_gHJRsHFtHnMo1mW4gsKitT1eCdzh0bmUZMMWn-9sS105Sok98u55xxCLjkbc8bEBKwfC55MxREZ8kSoiHHJj8mQMRZHMlF8QM6c-whXIRN5SgY8lbFgKhmS9xfwHm1Lu4qatqrNt2mgoL03tfkBb7o2PFO7wr4B35mShl0ra7xxdB3G2HpHwVNoKWgosTGaNlgaDTXVYYj2nJxUUDu82J8j8nZ_t5w_Rovnh6f5bBHpYElEkmkZ82CJq7TksdSQFRJFMMwxzoqYsVTzqkRUYqqYVMhAJFBUiusqyTTKEbnZ6a5t99mj83ljnMa6hha73uXpNPzjahrA2x2obeecxSpf25DZbnLO8r868xAx39YZ2Ku9aF-EWAdy318ArvcAuJC5stBq4w5clrIs2wpNdtyXqXHz_8Z89rrcrf4FCLyMSw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68890198</pqid></control><display><type>article</type><title>Pattern of infliximab utilization in rheumatoid arthritis patients at an academic medical center</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Agarwal, Sandeep K. ; Maier, Agnes L. ; Chibnik, Lori B. ; Coblyn, Jonathan S. ; Fossel, Anne ; Lee, Ryan ; Fanikos, John ; Fiumara, Karen ; Lowry, Colleen ; Weinblatt, Michael E.</creator><creatorcontrib>Agarwal, Sandeep K. ; Maier, Agnes L. ; Chibnik, Lori B. ; Coblyn, Jonathan S. ; Fossel, Anne ; Lee, Ryan ; Fanikos, John ; Fiumara, Karen ; Lowry, Colleen ; Weinblatt, Michael E.</creatorcontrib><description>Objective
To investigate the pattern of use of infliximab with an emphasis on treatment escalation and the durability of infliximab use in the management of rheumatoid arthritis (RA) in an academic setting.
Methods
We conducted a retrospective review of pharmacy and medical records of 183 patients with RA who received at least 1 infliximab infusion at the infusion centers of the Brigham and Women's Hospital. Treatment escalation was defined as an increase in the dosage of infliximab to >3 mg/kg and/or a decrease in the dosing interval to <7 weeks between infusions.
Results
A total of 183 patients with RA received infliximab infusions for a mean ± SD duration of 58.2 ± 56.6 weeks. Infliximab was discontinued in 48% of the patients during the first year of therapy and in 67% of the patients overall. A total of 126 patients had a treatment escalation, including 25 patients with a dose increase, 35 patients with a decrease in the interval, and 66 patients with both. Infliximab treatment was associated with a decrease in corticosteroid and methotrexate doses. Patients who had a treatment escalation were more likely to continue infliximab infusions compared with patients without a treatment escalation (odds ratio 2.0, 95% confidence interval 1.0–4.1).
Conclusion
The use of infliximab may be an effective treatment for RA; however, a substantial number of patients will discontinue its use. Treatment escalation is commonly used in the management of RA with infliximab and is associated with longer duration of infliximab use.</description><identifier>ISSN: 0004-3591</identifier><identifier>ISSN: 0893-7524</identifier><identifier>EISSN: 1529-0131</identifier><identifier>EISSN: 1529-0123</identifier><identifier>DOI: 10.1002/art.21582</identifier><identifier>PMID: 16342095</identifier><identifier>CODEN: ARCREG</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Antibodies, Monoclonal - therapeutic use ; Arthritis, Rheumatoid - drug therapy ; Biological and medical sciences ; Diseases of the osteoarticular system ; Dose ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drug Utilization - statistics & numerical data ; Female ; Hospitals, University ; Humans ; Immunologic Factors - therapeutic use ; Immunomodulators ; Inflammatory joint diseases ; Infliximab ; Interval ; Male ; Massachusetts ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Retrospective Studies ; Rheumatoid arthritis ; Treatment Refusal - statistics & numerical data</subject><ispartof>Arthritis and rheumatism, 2005-12, Vol.53 (6), p.872-878</ispartof><rights>Copyright © 2005 by the American College of Rheumatology</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3532-30c341095196d143ca7b3e20231e47b4006c1fdee9289039e0a25abf91cf57ce3</citedby><cites>FETCH-LOGICAL-c3532-30c341095196d143ca7b3e20231e47b4006c1fdee9289039e0a25abf91cf57ce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17607782$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16342095$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Agarwal, Sandeep K.</creatorcontrib><creatorcontrib>Maier, Agnes L.</creatorcontrib><creatorcontrib>Chibnik, Lori B.</creatorcontrib><creatorcontrib>Coblyn, Jonathan S.</creatorcontrib><creatorcontrib>Fossel, Anne</creatorcontrib><creatorcontrib>Lee, Ryan</creatorcontrib><creatorcontrib>Fanikos, John</creatorcontrib><creatorcontrib>Fiumara, Karen</creatorcontrib><creatorcontrib>Lowry, Colleen</creatorcontrib><creatorcontrib>Weinblatt, Michael E.</creatorcontrib><title>Pattern of infliximab utilization in rheumatoid arthritis patients at an academic medical center</title><title>Arthritis and rheumatism</title><addtitle>Arthritis Rheum</addtitle><description>Objective
To investigate the pattern of use of infliximab with an emphasis on treatment escalation and the durability of infliximab use in the management of rheumatoid arthritis (RA) in an academic setting.
Methods
We conducted a retrospective review of pharmacy and medical records of 183 patients with RA who received at least 1 infliximab infusion at the infusion centers of the Brigham and Women's Hospital. Treatment escalation was defined as an increase in the dosage of infliximab to >3 mg/kg and/or a decrease in the dosing interval to <7 weeks between infusions.
Results
A total of 183 patients with RA received infliximab infusions for a mean ± SD duration of 58.2 ± 56.6 weeks. Infliximab was discontinued in 48% of the patients during the first year of therapy and in 67% of the patients overall. A total of 126 patients had a treatment escalation, including 25 patients with a dose increase, 35 patients with a decrease in the interval, and 66 patients with both. Infliximab treatment was associated with a decrease in corticosteroid and methotrexate doses. Patients who had a treatment escalation were more likely to continue infliximab infusions compared with patients without a treatment escalation (odds ratio 2.0, 95% confidence interval 1.0–4.1).
Conclusion
The use of infliximab may be an effective treatment for RA; however, a substantial number of patients will discontinue its use. Treatment escalation is commonly used in the management of RA with infliximab and is associated with longer duration of infliximab use.</description><subject>Antibodies, Monoclonal - therapeutic use</subject><subject>Arthritis, Rheumatoid - drug therapy</subject><subject>Biological and medical sciences</subject><subject>Diseases of the osteoarticular system</subject><subject>Dose</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Administration Schedule</subject><subject>Drug Utilization - statistics & numerical data</subject><subject>Female</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Immunologic Factors - therapeutic use</subject><subject>Immunomodulators</subject><subject>Inflammatory joint diseases</subject><subject>Infliximab</subject><subject>Interval</subject><subject>Male</subject><subject>Massachusetts</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Retrospective Studies</subject><subject>Rheumatoid arthritis</subject><subject>Treatment Refusal - statistics & numerical data</subject><issn>0004-3591</issn><issn>0893-7524</issn><issn>1529-0131</issn><issn>1529-0123</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNp1kEtLAzEUhYMotlYX_gHJRsHFtHnMo1mW4gsKitT1eCdzh0bmUZMMWn-9sS105Sok98u55xxCLjkbc8bEBKwfC55MxREZ8kSoiHHJj8mQMRZHMlF8QM6c-whXIRN5SgY8lbFgKhmS9xfwHm1Lu4qatqrNt2mgoL03tfkBb7o2PFO7wr4B35mShl0ra7xxdB3G2HpHwVNoKWgosTGaNlgaDTXVYYj2nJxUUDu82J8j8nZ_t5w_Rovnh6f5bBHpYElEkmkZ82CJq7TksdSQFRJFMMwxzoqYsVTzqkRUYqqYVMhAJFBUiusqyTTKEbnZ6a5t99mj83ljnMa6hha73uXpNPzjahrA2x2obeecxSpf25DZbnLO8r868xAx39YZ2Ku9aF-EWAdy318ArvcAuJC5stBq4w5clrIs2wpNdtyXqXHz_8Z89rrcrf4FCLyMSw</recordid><startdate>20051215</startdate><enddate>20051215</enddate><creator>Agarwal, Sandeep K.</creator><creator>Maier, Agnes L.</creator><creator>Chibnik, Lori B.</creator><creator>Coblyn, Jonathan S.</creator><creator>Fossel, Anne</creator><creator>Lee, Ryan</creator><creator>Fanikos, John</creator><creator>Fiumara, Karen</creator><creator>Lowry, Colleen</creator><creator>Weinblatt, Michael E.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Lippincott Williams and Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20051215</creationdate><title>Pattern of infliximab utilization in rheumatoid arthritis patients at an academic medical center</title><author>Agarwal, Sandeep K. ; Maier, Agnes L. ; Chibnik, Lori B. ; Coblyn, Jonathan S. ; Fossel, Anne ; Lee, Ryan ; Fanikos, John ; Fiumara, Karen ; Lowry, Colleen ; Weinblatt, Michael E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3532-30c341095196d143ca7b3e20231e47b4006c1fdee9289039e0a25abf91cf57ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Antibodies, Monoclonal - therapeutic use</topic><topic>Arthritis, Rheumatoid - drug therapy</topic><topic>Biological and medical sciences</topic><topic>Diseases of the osteoarticular system</topic><topic>Dose</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug Administration Schedule</topic><topic>Drug Utilization - statistics & numerical data</topic><topic>Female</topic><topic>Hospitals, University</topic><topic>Humans</topic><topic>Immunologic Factors - therapeutic use</topic><topic>Immunomodulators</topic><topic>Inflammatory joint diseases</topic><topic>Infliximab</topic><topic>Interval</topic><topic>Male</topic><topic>Massachusetts</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Retrospective Studies</topic><topic>Rheumatoid arthritis</topic><topic>Treatment Refusal - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Agarwal, Sandeep K.</creatorcontrib><creatorcontrib>Maier, Agnes L.</creatorcontrib><creatorcontrib>Chibnik, Lori B.</creatorcontrib><creatorcontrib>Coblyn, Jonathan S.</creatorcontrib><creatorcontrib>Fossel, Anne</creatorcontrib><creatorcontrib>Lee, Ryan</creatorcontrib><creatorcontrib>Fanikos, John</creatorcontrib><creatorcontrib>Fiumara, Karen</creatorcontrib><creatorcontrib>Lowry, Colleen</creatorcontrib><creatorcontrib>Weinblatt, Michael E.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Arthritis and rheumatism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Agarwal, Sandeep K.</au><au>Maier, Agnes L.</au><au>Chibnik, Lori B.</au><au>Coblyn, Jonathan S.</au><au>Fossel, Anne</au><au>Lee, Ryan</au><au>Fanikos, John</au><au>Fiumara, Karen</au><au>Lowry, Colleen</au><au>Weinblatt, Michael E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pattern of infliximab utilization in rheumatoid arthritis patients at an academic medical center</atitle><jtitle>Arthritis and rheumatism</jtitle><addtitle>Arthritis Rheum</addtitle><date>2005-12-15</date><risdate>2005</risdate><volume>53</volume><issue>6</issue><spage>872</spage><epage>878</epage><pages>872-878</pages><issn>0004-3591</issn><issn>0893-7524</issn><eissn>1529-0131</eissn><eissn>1529-0123</eissn><coden>ARCREG</coden><abstract>Objective
To investigate the pattern of use of infliximab with an emphasis on treatment escalation and the durability of infliximab use in the management of rheumatoid arthritis (RA) in an academic setting.
Methods
We conducted a retrospective review of pharmacy and medical records of 183 patients with RA who received at least 1 infliximab infusion at the infusion centers of the Brigham and Women's Hospital. Treatment escalation was defined as an increase in the dosage of infliximab to >3 mg/kg and/or a decrease in the dosing interval to <7 weeks between infusions.
Results
A total of 183 patients with RA received infliximab infusions for a mean ± SD duration of 58.2 ± 56.6 weeks. Infliximab was discontinued in 48% of the patients during the first year of therapy and in 67% of the patients overall. A total of 126 patients had a treatment escalation, including 25 patients with a dose increase, 35 patients with a decrease in the interval, and 66 patients with both. Infliximab treatment was associated with a decrease in corticosteroid and methotrexate doses. Patients who had a treatment escalation were more likely to continue infliximab infusions compared with patients without a treatment escalation (odds ratio 2.0, 95% confidence interval 1.0–4.1).
Conclusion
The use of infliximab may be an effective treatment for RA; however, a substantial number of patients will discontinue its use. Treatment escalation is commonly used in the management of RA with infliximab and is associated with longer duration of infliximab use.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>16342095</pmid><doi>10.1002/art.21582</doi><tpages>7</tpages></addata></record> |
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| ispartof | Arthritis and rheumatism, 2005-12, Vol.53 (6), p.872-878 |
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| language | eng |
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| subjects | Antibodies, Monoclonal - therapeutic use Arthritis, Rheumatoid - drug therapy Biological and medical sciences Diseases of the osteoarticular system Dose Dose-Response Relationship, Drug Drug Administration Schedule Drug Utilization - statistics & numerical data Female Hospitals, University Humans Immunologic Factors - therapeutic use Immunomodulators Inflammatory joint diseases Infliximab Interval Male Massachusetts Medical sciences Middle Aged Pharmacology. Drug treatments Retrospective Studies Rheumatoid arthritis Treatment Refusal - statistics & numerical data |
| title | Pattern of infliximab utilization in rheumatoid arthritis patients at an academic medical center |
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