Table 3.
Treatment patterns
| Pattern, n (%) | ABA (N = 583) | ADA (N = 6521) | CER (N = 415) | ETN (N = 9116) | GOL (N = 231) | INF (N = 1906) | RIT (N = 295) | TOC (N = 165) | TOF (N = 5) | UST (N = 922) |
|---|---|---|---|---|---|---|---|---|---|---|
| All patients | ||||||||||
| RA only, n | 583 | 2538 | 415 | 4326 | 135 | 1100 | 295 | 165 | 5 | NA |
| Persistent users | 333 (57.1) | 1313 (51.7) | 185 (44.6) | 2413 (55.8) | 26 (19.3) | 793 (72.1) | 133 (45.1) | 83 (50.3) | 1 (20.0) | |
| Restartersa | 72 (12.3) | 526 (20.7) | 86 (20.7) | 956 (22.1) | 7 (5.2) | 80 (7.3) | 61 (20.7) | 21 (12.7) | 1 (20.0) | |
| Discontinuersb | 74 (12.7) | 327 (12.9) | 71 (17.1) | 474 (11.0) | 6 (4.4) | 107 (9.7) | 81 (27.5) | 28 (17.0) | 1 (20.0) | |
| Switchersc | 104 (17.8) | 372 (14.7) | 73 (17.6) | 483 (11.2) | 96 (71.1) | 120 (10.9) | 20 (6.8) | 33 (20.0) | 2 (40.0) | |
| PsO only, n | NA | 1933 | NA | 2185 | NA | 42 | NA | NA | NA | 922 |
| Persistent users | 858 (44.4) | 902 (41.3) | 28 (66.7) | 399 (43.3) | ||||||
| Restartersa | 461 (23.8) | 606 (27.7) | 2 (4.8) | 312 (33.8) | ||||||
| Discontinuersb | 356 (18.4) | 357 (16.3) | 5 (11.9) | 148 (16.1) | ||||||
| Switchersc | 258 (13.3) | 320 (14.6) | 7 (16.7) | 63 (6.8) | ||||||
| PsA only, n | NA | 643 | NA | 850 | 53 | 214 | NA | NA | NA | NA |
| Persistent users | 327 (50.9) | 498 (58.6) | 6 (11.3) | 168 (78.5) | ||||||
| Restartersa | 162 (25.2) | 206 (24.2) | 2 (3.8) | 18 (8.4) | ||||||
| Discontinuersb | 84 (13.1) | 68 (8.0) | 5 (9.4) | 13 (6.1) | ||||||
| Switchersc | 70 (10.9) | 78 (9.2) | 40 (75.5) | 15 (7.0) | ||||||
| AS only, n | NA | 389 | NA | 532 | 20 | 147 | NA | NA | NA | NA |
| Persistent users | 204 (52.4) | 291 (54.7) | 4 (20.0) | 104 (70.7) | ||||||
| Restartersa | 88 (22.6) | 118 (22.2) | 6 (30.0) | 8 (5.4) | ||||||
| Discontinuersb | 53 (13.6) | 65 (12.2) | 0 (0.0) | 15 (10.2) | ||||||
| Switchersc | 44 (11.3) | 58 (10.9) | 10 (50.0) | 20 (13.6) | ||||||
| RA/PsA only, n | 0 | 117 | 0 | 153 | 15 | 89 | 0 | 0 | 0 | NA |
| Persistent users | 0 (0.0) | 51 (43.6) | 0 (0.0) | 74 (48.4) | 3 (20.0) | 59 (66.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Restartersa | 0 (0.0) | 29 (24.8) | 0 (0.0) | 34 (22.2) | 1 (6.7) | 15 (16.9) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Discontinuersb | 0 (0.0) | 20 (17.1) | 0 (0.0) | 25 (16.3) | 3 (20.0) | 8 (9.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Switchersc | 0 (0.0) | 17 (14.5) | 0 (0.0) | 20 (13.1) | 8 (53.3) | 7 (7.9) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| PsO/PsA only, n | NA | 682 | NA | 779 | 0 | 157 | NA | NA | NA | 0 |
| Persistent users | 327 (47.9) | 413 (53.0) | 0 | 116 (73.9) | 0 | |||||
| Restartersa | 151 (22.1) | 177 (22.7) | 0 | 14 (8.9) | 0 | |||||
| Discontinuersb | 103 (15.1) | 78 (10.0) | 0 | 8 (5.1) | 0 | |||||
| Switchersc | 101 (14.8) | 111 (14.2) | 0 | 19 (12.1) | 0 | |||||
| All other combinations, n | 0 | 219 | 0 | 291 | 8 | 157 | 0 | 0 | 0 | 0 |
| Persistent users | 0 (0.0) | 90 (41.1) | 0 (0.0) | 144 (49.5) | 2 (25.0) | 103 (65.6) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Restartersa | 0 (0.0) | 54 (24.7) | 0 (0.0) | 69 (23.7) | 1 (12.5) | 19 (12.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Discontinuersb | 0 (0.0) | 32 (14.6) | 0 (0.0) | 42 (14.4) | 1 (12.5) | 14 (8.9) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Switchersc | 0 (0.0) | 43 (19.6) | 0 (0.0) | 36 (12.4) | 4 (50.0) | 21 (13.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Patients new to biologics | ||||||||||
| RA only, n | 146 | 742 | 221 | 1429 | 47 | 225 | 208 | 63 | 5 | NA |
| Persistent users | 64 (43.8) | 285 (38.4) | 76 (34.4) | 598 (41.9) | 7 (14.9) | 120 (53.3) | 78 (37.5) | 22 (34.9) | 1 (20.0) | |
| Restartersa | 15 (10.3) | 151 (20.4) | 55 (24.9) | 331 (23.2) | 3 (6.4) | 18 (8.0) | 49 (23.6) | 13 (20.6) | 1 (20.0) | |
| Discontinuersb | 40 (27.4) | 146 (19.7) | 53 (24.0) | 255 (17.8) | 2 (4.3) | 52 (23.1) | 70 (33.6) | 17 (27.0) | 1 (20.0) | |
| Switchersc | 27 (18.5) | 160 (21.6) | 37 (16.7) | 245 (17.1) | 35 (74.5) | 35 (15.6) | 11 (5.3) | 11 (17.5) | 2 (40.0) | |
| PsO only, n | NA | 684 | NA | 889 | NA | 10 | NA | NA | NA | 419 |
| Persistent users | 236 (34.5) | 279 (31.4) | 3 (30.0) | 139 (33.2) | ||||||
| Restartersa | 154 (22.5) | 253 (28.5) | 0 (0.0) | 187 (44.6) | ||||||
| Discontinuersb | 190 (27.8) | 211 (23.7) | 3 (30.0) | 72 (17.2) | ||||||
| Switchersc | 104 (15.2) | 146 (16.4) | 4 (40.0) | 21 (5.0) | ||||||
| PsA only, n | NA | 173 | NA | 261 | 19 | 31 | NA | NA | NA | NA |
| Persistent users | 67 (38.7) | 118 (45.2) | 2 (10.5) | 15 (48.4) | ||||||
| Restartersa | 39 (22.5) | 62 (23.8) | 1 (5.3) | 2 (6.5) | ||||||
| Discontinuersb | 45 (26.0) | 44 (16.9) | 0 (0.0) | 9 (29.0) | ||||||
| Switchersc | 22 (12.7) | 37 (14.2) | 16 (84.2) | 5 (16.1) | ||||||
| AS only, n | NA | 140 | NA | 177 | 10 | 43 | NA | NA | NA | NA |
| Persistent users | 55 (39.3) | 62 (35.0) | 2 (20.0) | 20 (46.5) | ||||||
| Restartersa | 42 (30.0) | 48 (27.1) | 4 (40.0) | 2 (4.6) | ||||||
| Discontinuersb | 24 (17.1) | 38 (21.5) | 0 (0.0 | 11 (25.6) | ||||||
| Switchersc | 19 (13.6) | 29 (16.4) | 4 (40.0) | 10 (23.3) | ||||||
| RA/PsA only, n | 0 | 37 | 0 | 57 | 5 | 9 | 0 | 0 | 0 | NA |
| Persistent users | 0 (0.0) | 8 (21.6) | 0 (0.0) | 22 (38.6) | 1 (20.0) | 4 (44.4) | 0 | 0 | 0 | |
| Restartersa | 0 (0.0) | 15 (40.5) | 0 (0.0) | 9 (15.8) | 0 (0.0) | 2 (22.2) | 0 | 0 | 0 | |
| Discontinuersb | 0 (0.0) | 10 (27.0) | 0 (0.0) | 17 (29.8) | 2 (40.0) | 2 (22.2) | 0 | 0 | 0 | |
| Switchersc | 0 (0.0) | 4 (10.8) | 0 (0.0) | 9 (15.8) | 2 (40.0) | 1 (11.1) | 0 | 0 | 0 | |
| PsO/PsA only, n | NA | 234 | NA | 340 | 0 | 37 | NA | NA | NA | 0 |
| Persistent users | 102 (43.6) | 151 (44.4) | 0 (0.0) | 22 (59.5) | 0 (0.0) | |||||
| Restartersa | 37 (15.8) | 70 (20.6) | 0 (0.0) | 5 (13.5) | 0 (0.0) | |||||
| Discontinuersb | 51 (21.8) | 52 (15.3) | 0 (0.0) | 3 (8.1) | 0 (0.0) | |||||
| Switchersc | 44 (18.8) | 67 (19.7) | 0 (0.0) | 7 (18.9) | 0 (0.0) | |||||
| All other combinations, n | 0 | 75 | 0 | 115 | 4 | 37 | 0 | 0 | 0 | 0 |
| Persistent users | 0 (0.0) | 20 (26.7) | 0 (0.0) | 41 (35.6) | 1 (25.0) | 15 (40.5) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Restartersa | 0 (0.0) | 17 (22.7) | 0 (0.0) | 30 (26.1) | 0 (0.0) | 4 (10.8) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Discontinuersb | 0 (0.0) | 16 (21.3) | 0 (0.0) | 28 (24.4) | 1 (25.0) | 6 (16.2) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Switchersc | 0 (0.0) | 22 (29.3) | 0 (0.0) | 16 (13.9) | 2 (50.0) | 12 (32.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Continuing users | ||||||||||
| RA only, n | 437 | 1796 | 194 | 2897 | 88 | 875 | 87 | 102 | 0 | NA |
| Persistent users | 269 (61.6) | 1028 (57.2) | 109 (56.2) | 1815 (62.6) | 19 (21.6) | 673 (76.9) | 55 (63.2) | 61 (59.8) | 0 (0.0) | |
| Restartersa | 57 (13.0) | 375 (20.9) | 31 (16.0) | 625 (21.6) | 4 (4.6) | 62 (7.1) | 12 (13.8) | 8 (7.8) | 0 (0.0) | |
| Discontinuersb | 34 (7.8) | 181 (10.1) | 18 (9.3) | 219 (7.6) | 4 (4.6) | 55 (6.3) | 11 (12.6) | 11 (10.8) | 0 (0.0) | |
| Switchersc | 77 (17.6) | 212 (11.8) | 36 (18.6) | 238 (8.2) | 61 (69.3) | 85 (9.7) | 9 (10.3) | 22 (21.6) | 0 (0.0) | |
| PsO only, n | NA | 1249 | NA | 1296 | NA | 32 | NA | NA | NA | 503 |
| Persistent users | 622 (49.8) | 623 (48.1) | 25 (78.1) | 260 (51.7) | ||||||
| Restartersa | 307 (24.6) | 353 (27.2) | 2 (6.2) | 125 (24.8) | ||||||
| Discontinuersb | 166 (13.3) | 146 (11.3) | 2 (6.2) | 76 (15.1) | ||||||
| Switchersc | 154 (12.3) | 174 (13.4) | 3 (9.4) | 42 (8.4) | ||||||
| PsA only, n | NA | 470 | NA | 589 | 34 | 183 | NA | NA | NA | NA |
| Persistent users | 260 (55.3) | 380 (64.5) | 4 (11.8) | 153 (83.6) | ||||||
| Restartersa | 123 (26.2) | 144 (24.4) | 1 (2.9) | 16 (8.7) | ||||||
| Discontinuersb | 39 (8.3) | 24 (4.1) | 5 (14.7) | 4 (2.2) | ||||||
| Switchersc | 48 (10.2) | 41 (7.0) | 24 (70.6) | 10 (5.5) | ||||||
| AS only, n | NA | 249 | NA | 355 | 10 | 104 | NA | NA | NA | NA |
| Persistent users | 149 (59.8) | 229 (64.5) | 2 (20.0) | 84 (80.8) | ||||||
| Restartersa | 46 (18.5) | 70 (19.7) | 2 (20.0) | 6 (5.8) | ||||||
| Discontinuersb | 29 (11.7) | 27 (7.6) | 0 (0.0) | 4 (3.9) | ||||||
| Switchersc | 25 (10.0) | 29 (8.2) | 6 (60.0) | 10 (9.6) | ||||||
| RA/PsA only, n | 0 | 80 | 0 | 96 | 10 | 80 | 0 | 0 | 0 | NA |
| Persistent users | 0 (0.0) | 43 (53.8) | 0 (0.0) | 52 (54.2) | 2 (20.0) | 55 (68.8) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Restartersa | 0 (0.0) | 14 (17.5) | 0 (0.0) | 25 (26.0) | 1 (10.0) | 13 (16.2) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Discontinuersb | 0 (0.0) | 10 (12.5) | 0 (0.0) | 8 (8.3) | 1 (10.0) | 6 (7.5) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Switchersc | 0 (0.0) | 13 (16.2) | 0 (0.0) | 11 (11.5) | 6 (60.0) | 6 (7.5) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| PsO/PsA only, n | NA | 448 | NA | 439 | 0 | 120 | NA | NA | NA | 0 |
| Persistent users | 225 (50.2) | 262 (59.7) | 0 (0.0) | 94 (78.3) | 0 (0.0) | |||||
| Restartersa | 114 (25.5) | 107 (24.4) | 0 (0.0) | 9 (7.5) | 0 (0.0) | |||||
| Discontinuersb | 52 (11.6) | 26 (5.9) | 0 (0.0) | 5 (4.2) | 0 (0.0) | |||||
| Switchersc | 57 (12.7) | 44 (10.0) | 0 (0.0) | 12 (10.0) | 0 (0.0) | |||||
| All other combinations, n | 0 | 144 | 0 | 176 | 4 | 120 | 0 | 0 | 0 | 0 |
| Persistent users | 0 (0.0) | 70 (48.6) | 0 (0.0) | 103 (58.5) | 1 (25.0) | 88 (73.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Restartersa | 0 (0.0) | 37 (25.7) | 0 (0.0) | 39 (22.2) | 1 (25.0) | 15 (12.5) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Discontinuersb | 0 (0.0) | 16 (11.1) | 0 (0.0) | 14 (8.0) | 0 (0.) | 8 (6.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Switchersc | 0 (0.0) | 21 (14.6) | 0 (0.0) | 20 (11.4) | 2 (50.0) | 9 (7.5) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
ABA abatacept, ADA adalimumab, AS ankylosing spondylitis, CER certolizumab pegol, ETN etanercept, GOL golimumab, INF infliximab, NA not approved, PsA psoriatic arthritis, PsO psoriasis, RA rheumatoid arthritis, RIT rituximab, TOC tocilizumab, TOF tofacitinib, UST ustekinumab
aPatients who restarted on their index biologic medication after a gap of ≥45 days
bPatients who did not use any of the study medications after a gap of ≥45 days
cPatients who switched to another biologic medication