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Der Einsatz dieser biologischen \u201edisease-modifying antirheumatic drugs\u201c (bDMARDs) ist gem\u00e4\u00df deutscher und europ\u00e4ischer Behandlungsleitlinien jedoch erst bei Aussch\u00f6pfung der Methotrexat (MTX)-Erstlinientherapie von mindestens 20\u202fmg\/Woche indiziert. Ziel der Studie ist es, die Leitliniengerechtigkeit der MTX-Verordnung im ambulanten Sektor vor der Biologikatherapie zu \u00fcberpr\u00fcfen.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methodik<\/jats:title>\n                <jats:p>Es wurden Routinedaten der AOK-Niedersachsen der Jahre 2013 bis 2016 f\u00fcr alle Versicherten zur Verf\u00fcgung gestellt, die im Studienzeitraum eine RA-Diagnose sowie eine bDMARD-Verordnung aufweisen. Innerhalb eines patientenindividuellen Beobachtungszeitraums von 180\u00a0Tagen vor der ersten bDMARD-Verordnung wurde die maximal verordnete MTX-Dosierung untersucht.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ergebnisse<\/jats:title>\n                <jats:p>Die Studienpopulation umfasst 405\u00a0Patienten (90\u00a0inzident, 315 pr\u00e4valent). Bei 60,0\u202f% der inzidenten Patienten und 67,0\u202f% der pr\u00e4valenten Patienten wurde eine maximale MTX-Verordnung von &lt;\u202f20\u202fmg\/Woche beobachtet. M\u00e4nner weisen im Mittel mit 17,1\u202f\u00b1\u20094,8\u202fmg eine h\u00f6here MTX-Maximaldosierung als Frauen auf (14,9\u202f\u00b1\u20095,0\u202fmg; <jats:italic>p<\/jats:italic>\u202f&lt;\u20090,0001); 29,6\u202f% der Studienpopulation erhielten im Beobachtungszeitraum ausschlie\u00dflich orale Verordnungen. Umstellungen auf eine parenterale Applikationsform wurden bei 12,4\u202f% der Patienten festgestellt.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Diskussion<\/jats:title>\n                <jats:p>Ein gezielter Einsatz des gesamten vorgesehenen Therapiespektrums vor der Initiierung einer bDMARD-Therapie kann zu einer kosteneffizienten Versorgung der RA beitragen. Die Studie zeigt Indizien f\u00fcr m\u00f6gliche Defizite in der ambulanten MTX-Verordnungspraxis auf und kann f\u00fcr eine effiziente Therapie sensibilisieren.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00393-021-01086-0","type":"journal-article","created":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T20:08:28Z","timestamp":1632168508000},"page":"573-579","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Methotrexat-Versorgung vor dem Einsatz von Biologika bei rheumatoider Arthritis","Methotrexate treatment before use of biologics in rheumatoid arthritis"],"prefix":"10.1007","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3090-0651","authenticated-orcid":false,"given":"Nicolas","family":"Pardey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Zeidler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim Fritz","family":"Nellenschulte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jona T.","family":"Stahmeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Hoeper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Witte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,20]]},"reference":[{"issue":"1","key":"1086_CR1","doi-asserted-by":"publisher","first-page":"8","DOI":"10.7326\/M16-0713","volume":"167","author":"N Bansback","year":"2017","unstructured":"Bansback\u00a0N, Phibbs\u00a0CS, Sun\u00a0H et al (2017) Triple therapy versus biologic therapy for active rheumatoid arthritis: a cost-effectiveness analysis. 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