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Rheumatol Int. 2017 Oct;37(10):1719-1725. doi: 10.1007/s00296-017-3772-8. Epub 2017 Jul 10.

Real-world clinical experience of biological disease modifying anti-rheumatic drugs in Malaysia rheumatoid arthritis patients.

Author information

1
Rheumatology Unit, Department of Medicine, Hospital Pulau Pinang, Jalan Residensi, 10990, Georgetown, Penang, Malaysia. tbeeng3@yahoo.com.
2
Rheumatology Unit, Department of Medicine, Hospital Pulau Pinang, Jalan Residensi, 10990, Georgetown, Penang, Malaysia.
3
Rheumatology Unit, Department of Medicine, Hospital Selayang, Batu Caves, Selangor, Malaysia.
4
Rheumatology Unit, Department of Medicine, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia.
5
Rheumatology Unit, Department of Medicine, Hospital Putrajaya, Putrajaya, Wilayah Persekutuan, Malaysia.
6
Department of Medicine, Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia.
7
Rheumatology Unit, Department of Medicine, Hospital Umum Sarawak, Kuching, Sarawak, Malaysia.
8
Department of Medicine, Hospital Queen Elizabeth I, Kota Kinabalu, Sabah, Malaysia.
9
Department of Medicine, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.
10
Department of Medicine, Hospital Sultan Ismail, Johor Baharu, Johor Bahru, Malaysia.
11
Department of Medicine, Hospital Melaka, Malacca City, Melaka, Malaysia.
12
Department of Medicine, Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
13
Department of Medicine, Hospital Raja Perempuan Zainab II, Kota Baharu, Kelantan, Malaysia.
14
Outcome and Evidence, Health and Value, Pfizer Malaysia Sdn Bhd, Kuala Lumpur, Wilayah Persekutuan, Malaysia.

Abstract

The effect of biologic disease modifying anti-rheumatic drugs (bDMARDs) in treating rheumatoid arthritis (RA) in real-world clinical practice remains unknown in Southeast Asia. We aimed to assess the efficacy and safety of bDMARDs among Malaysian RA patients treated in routine clinical practice. A retrospective medical chart review of RA patients from 11 government hospitals were conducted from January 2003 to January 2014. A standardized questionnaire was used to abstract patient's demographic, clinical and treatment data. Level of disease activity was measured by DAS28 collected at baseline, 3, 6 and 12 months. Three hundred and one patients were available for analysis, mean age 41 (SD, 10.8) years, mean RA duration 12.3 (SD, 6.9) years and 98% had history of two or more conventional-synthetic DMARDs. There were 467 bDMARD courses prescribed with mean bDMARDs duration use of 12.9 months (SD 14.7). Tumour necrosis factor alpha inhibitors were the most common prescribed bDMARDs (77.1%), followed by Tocilizumab (14.6%) and Rituximab (8.4%). We observed significant improvement in mean DAS28 values from baseline to 3, 6 and 12 months (p < 0.001). Overall, 16.9% achieved DAS28 remission at 6 months. A third (35.6%) of patients reported adverse events, three commonest being infections (46.5%), allergy (22.9%) and laboratory abnormalities (12.9%). 3.7% of our patients had tuberculosis. Biologic DMARDs were effective in treating RA in real-world practice in Malaysia, despite a lower remission rate compared to developed countries. Except for higher rates of tuberculosis, the AEs were similar to the published reports.

KEYWORDS:

Biologics; Efficacy; Real world; Rheumatoid arthritis; Safety; Southeast Asia

PMID:
28695274
DOI:
10.1007/s00296-017-3772-8

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