{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:02:47Z","timestamp":1793318567509,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,9,27]],"date-time":"2016-09-27T00:00:00Z","timestamp":1474934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Open Access Fund of the Leibniz Association"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacology Res &amp; Perspec"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of this study was to analyze the population\u2010based frequency of classic (c\u2010) and biologic (b\u2010) disease\u2010modifying antirheumatic drug (DMARD) use over time, selected underlying indications and the specialty of the prescribing physicians in Germany. Based on the claims data of the German Pharmacoepidemiological Research Database (GePaRD), yearly cross\u2010sectional studies were conducted from 2004 to 2011. The prevalence of DMARD use was calculated as the number of persons with at least one dispensation per 1000 persons stratified by sex and age. In 2011, we also obtained the proportion of c\u2010 and b\u2010DMARDs users with diagnoses of selected indications and the proportion of dispensations by specialty of the physician. Between 2004 and 2011, the annual prevalence of b\u2010DMARD and c\u2010DMARD use increased from 0.35\u2030 to 1.54\u2030 and from 6.53\u2030 to 8.93\u2030, respectively. In 2011, the study population comprised 12.8 million insurants with a mean age of 44.0\u00a0years. During this year, among c\u2010DMARDs, methotrexate was prescribed most frequently (4.76\u2030), followed by azathioprine (1.72\u2030) and sulfasalazine (1.20\u2030). For b\u2010DMARDs, adalimumab (0.57\u2030), etanercept (0.46\u2030), and rituximab (0.23\u2030) were most frequently used. Notably, b\u2010DMARD users more often had a diagnosis of ankylosing spondylitis and psoriasis compared to c\u2010DMARD\u2010users (20.7% vs. 2.9% and 20.0% vs. 11.4%, respectively) and b\u2010DMARDs were more frequently prescribed by rheumatologists and other specialists. Our population\u2010based study highlights the increasing use of c\u2010 and b\u2010DMARDs in Germany. Compared to c\u2010DMARDs, b\u2010DMARDs were commonly used for indications besides rheumatoid arthritis. Future research should therefore also focus on their prescription patterns and safety aspects in indications other than RA.<\/jats:p>","DOI":"10.1002\/prp2.254","type":"journal-article","created":{"date-parts":[[2016,9,27]],"date-time":"2016-09-27T10:36:48Z","timestamp":1474972608000},"source":"Crossref","is-referenced-by-count":14,"title":["Frequency and trends of disease\u2010modifying antirheumatic drug (DMARD) use in Germany"],"prefix":"10.1002","volume":"4","author":[{"given":"Alexander M.","family":"Fassmer","sequence":"first","affiliation":[{"name":"Department of Clinical Epidemiology Leibniz Institute for Prevention Research and Epidemiology (BIPS) Achterstrasse 30 28359 Bremen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edeltraut","family":"Garbe","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Leibniz Institute for Prevention Research and Epidemiology (BIPS) Achterstrasse 30 28359 Bremen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"Schmedt","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Leibniz Institute for Prevention Research and Epidemiology (BIPS) Achterstrasse 30 28359 Bremen Germany"},{"name":"Health Risk Institute GmbH Spittelmarkt 12 10117 Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,9,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2009.133"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharep.2014.05.004"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21660"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12230"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-001603"},{"key":"e_1_2_9_7_1","unstructured":"FassmerA SchinkT(2014).Representativity of outpatient drug prescriptions in German Pharmacoepidemiological Research Database (GePaRD): Leibniz Institute for Prevention Research and Epidemiology \u2013 BIPS GmbH."},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2038"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00761-010-1973-9"},{"key":"e_1_2_9_10_1","first-page":"2156","article-title":"Effectiveness and drug adherence of biologic monotherapy in routine care of patients with rheumatoid arthritis: a cohort study of patients registered in the Danish biologics registry","volume":"54","author":"J\u00f8rgensen TS","year":"2015","journal-title":"Rheumatology (Oxford)"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-012-2371-5"},{"key":"e_1_2_9_12_1","unstructured":"Kassen\u00e4rztliche Bundesvereinigung & Arzneimittelkommission der Deutschen \u00c4rzteschaft [National Association of Statutory Health Insurance Physicians & Drug Commission of the German Medical Association](2010).Biologische DMARDs [Biologic DMARDs]. Wirkstoff AKTUELL [Pharmaceutical UP TO DATE]. Available athttp:\/\/www.akdae.de\/Arzneimitteltherapie\/WA\/Archiv\/Biologische-DMARDs.pdf(accessed July 21 2016)."},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-013-2482-1"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21997"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3111\/13696998.2014.893241"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1610-0387.2012.07919.x"},{"key":"e_1_2_9_17_1","volume-title":"Generalized linear models. Series: monographs on statistics and applied probability","author":"Nelder JA","year":"1992"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-002468"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-013-2828-7"},{"key":"e_1_2_9_20_1","article-title":"Assessment of the representativity of in\u2010patient hospital diagnoses in the German pharmacoepidemiological research database","author":"Schink T","year":"2010","journal-title":"26th International Conference on Pharmacoepidemiology & Therapeutic Risk Management (ICPE)"},{"key":"e_1_2_9_21_1","unstructured":"SchneiderM LelgemannM AbholzH\u2010H BlumenrothM Fl\u00fcggeC GerkenM et\u00a0al. (2011).Interdisziplin\u00e4re Leitlinie: management der fr\u00fchen rheumatoiden Arthritis: Deutsche Gesellschaft f\u00fcr Rheumatologie (DGRh). 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