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Adherence to biological therapies in patients with rheumatoid arthritis: a retrospective cohort study

  • Observational Research
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Abstract

The advent of biologic disease-modifying antirheumatic drugs has dramatically changed the comprehensions of treatment and long-term prognosis in patients with rheumatoid arthritis. The potent therapeutic results can only be achieved if the patients adhere to prescribed medications. The objective of this study was to estimate the impact of age, gender, duration of the disease, concomitant Methotrexate therapy, prior exposure to biologic agents, disease activity, functional capacity, and health-related quality of life on adherence to biologic treatment among Bulgarian population with rheumatoid arthritis. This was a retrospective observational cohort study that included 179 patients. At the baseline visit and subsequent follow-up assessments at 6, 12, 24 and 36 months, patients were interviewed by a physician and underwent physical examinations. We monitored the changes in disease activity, functional capacity and health-related quality of life on each time point. Univariate and multivariate binary logistic regression was used to determine the prognostic value of possible predictors of treatment adherence. Our findings showed that only DAS28 score [odd ratio (OR) = 1.174; 95% CI 1.74–2.362] and HAQ score (OR 2.803; 95% CI 1.428–5.503) remained significant for the treatment adherence throughout the study period. The adherence to the biologic disease-modifying anti-rheumatic drugs among Bulgarian patients with rheumatoid arthritis is suboptimal. A multifaceted and comprehensive knowledge of the influencing factors can be useful for the development of different strategies that can improve treatment adherence.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank Dr. B. Oparanov, head of the Department of Rheumatology, Military Medical Academy-MHAT, Sofia, Bulgaria for their contribution to the data collection, for providing and caring for the study patients, for the support; Prof. Dr. Z. Kolarov, UMHAT “St. Ivan Rilski”, Clinic of Rheumatology, Sofia, Bulgaria for the critical comments and proofreading.

Funding

A therapeutic approach with bDMARD in adults is financed by the Bulgarian national health insurance organization. All authors declare no competing financial or non-financial interests.

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Authors and Affiliations

  1. Department of Rheumatology, Military Medical Academy, MHAT-Sofia, 3 Sveti Georgi Sofiyski Str., 1606, Sofia, Bulgaria

    Stefka Neycheva

  2. Faculty of Public Health “Prof. Tsekomir Vodenicharov, MD, DSc”, Medical University of Sofia, 8 Byalo More Str., 1527, Sofia, Bulgaria

    Emilia Naseva

  3. Clinic of Rheumatology, UMHAT “Kaspela”, Medical University of Plovdiv, 64 Sofia Str., 4000, Plovdiv, Bulgaria

    Zguro Batalov, Rositsa Karalilova & Anastas Batalov

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  1. Stefka Neycheva
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  2. Emilia Naseva
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Contributions

AB, SN, RK and ZB conceived the study conception and design, provided and cared for study patients, contributed to the acquisition and interpretation of the data. E.N. designed and carried out the data analysis and contributed to the interpretation of the data. SN, EN, RK, AB and ZB co-wrote the paper. All authors revised the paper critically for important intellectual content; approved the version to be published. The authors agree to take full responsibility for the integrity and accuracy of all aspects of the work. The authors retained full control of the content of the manuscript. All authors had full access to all the data in this study.

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Correspondence to Stefka Neycheva.

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Neycheva, S., Naseva, E., Batalov, Z. et al. Adherence to biological therapies in patients with rheumatoid arthritis: a retrospective cohort study. Rheumatol Int 43, 1287–1296 (2023). https://doi.org/10.1007/s00296-023-05327-0

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