nationwide prevalence of ra and penetration of dmards in sweden

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NATIONWIDE PREVALENCE OF RA AND PENETRATION OF DMARDS IN SWEDEN Neovius M, Simard J & Askling J for the ARTIS Study Group Clinical Epidemiology Unit and Rheumatology Unit Dept of Medicine Karolinska Institutet Ann Rheum Dis, 2010

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Neovius M, Simard J & Askling J for the ARTIS Study Group. Nationwide Prevalence of RA and Penetration of Dmards in Sweden. Clinical Epidemiology Unit and Rheumatology Unit Dept of Medicine Karolinska Institutet. Ann Rheum Dis, 2010. Objective. - PowerPoint PPT Presentation

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Page 1: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

NATIONWIDE PREVALENCE OF RAAND PENETRATION OF DMARDS IN SWEDEN

Neovius M, Simard J & Askling J for the ARTIS Study Group

Clinical Epidemiology Unit and Rheumatology UnitDept of MedicineKarolinska Institutet

Ann Rheum Dis, 2010

Page 2: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

Objective

To provide nationwide data on the prevalence of RA(including variations by age, sex, geography, demography and education level)

and assess anti-rheumatic treatment penetration

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 3: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

Methods

• Patient Identification– Swedish Rheumatology Quality Register– National Patient Register (inpatient & specialist outpatient care)

• Treatment Exposure– Prescribed Drug Register– Swedish Biologics Register ARTIS

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 4: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

National Patient Register (NPR, 1964-2007; n=57,400)

Outpatient: n=48,644Inpatient: n=32,777

Prescribed Drug Register (PDR, 2005-2007; n=6,103)

Swedish Rheumatology Quality Register (SRQ, 1995-2007; n=18,201)

ARTIS (1999-2007; n=8,155)

ARTIS & SRQ: n=8,155ARTIS & PDR: n=5,750ARTIS & NPR: n=7,965

PDR & SRQ: n=5,801PDR & NPR: n=5,947

SRQ & NPR: n=17,499

Patient Identification

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 5: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

RESULTS

Page 6: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

Cases defined as ever having a visit in inpatient or outpatient specialist care with a diagnosis of rheumatoid arthritis, or a listing in the Swedish Rheumatology Quality Register

Prevalence of RA by Sex & AgeJan 1, 2008 (n=58,102)

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 7: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

Using Different Case Definitions

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 8: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

Using Different Case DefinitionsBy Sex

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 9: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

Prevalence by Place of Residence

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 10: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

Prevalence by Place of Residence

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 11: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

Prevalence by Place of Residence

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 12: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

Prevalence by County (n=58,102)

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 13: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

No population statistics on education level for persons ≥75y16-29y old persons excluded as many may not have completed their education

Prevalence by Education Level and Age (n=39,551)

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 14: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

Comparison of prevalence estimates in the current study (Sweden 2008) with a previous Swedish study by Simonsson et al (Sweden 1995)[3], a Norwegian study by Kvien et al (Norway 1994)[2], and an American study by Gabriel et al (Rochester

1985)[7] after applying the age-cutoffs used in the respective studies

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 15: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

PENETRATION OF BIOLOGIC AND NON-BIOLOGIC DMARDS

Page 16: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

Biologics Penetration by Age

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 17: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

Biologics Penetration by Age

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 18: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

DMARD Penetration by AgeNon-Biologic

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 19: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

DMARD Penetration by AgeNon-Biologic

Neovius, Simard & Askling for the ARTIS Study Group, ARD 2010

Page 20: Nationwide Prevalence of  RA and Penetration of  Dmards in Sweden

References1. Neovius M, Simard J, Askling J for the ARTIS Study Group

Nationwide Prevalence of Rheumatoid Arthritis and Penetration of Disease-Modifying Drugs in SwedenAnn Rheum Dis 2010

2. Neovius M, Simard J, Sundström A, Jacobsson L, Geborek P, Saxne T, Klareskog L & Askling J for the ARTIS Study GroupGeneralisability of Clinical Registers used for Drug Safety and Comparative Effectiveness Research: Coverage of the Swedish Biologics RegisterAnn Rheum Dis 2010

3. Simard J, Arkema E, Sundström A, Geborek P, Saxne T, Baecklund E, Coster L, Dackhammar C, Jacobsson L, Rütting M, Lindblad S, Rantapää-Dahlqvist S, Klareskog L, Van Vollenhoven RF, Neovius M & Askling JTen years with biologics: For whom do data on effectiveness and long-term safety apply? Rheumatology 2010

4. Askling J, Fored CM, Geborek P, Jacobsson LT, van Vollenhoven R, Feltelius N, Lindblad S & Klareskog LSwedish registers to examine drug safety and clinical issues in RA. Ann Rheum Dis 2006;65(6):707-12.

5. Neovius M, Sundstrom A, Simard J, Wettermark B, Cars T, Feltelius N, Askling J & Klareskog L for the ARTIS Study GroupSmall-area variations in sales of TNF inhibitors in Sweden between 2000 and 2009Scand J Rheumatol 2010