{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T21:13:10Z","timestamp":1775682790755,"version":"3.50.1"},"reference-count":9,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,10,4]],"date-time":"2018-10-04T00:00:00Z","timestamp":1538611200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Roche Products Pty Limited"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The comparative effectiveness of biologic treatment regimens in a real world Australian population is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the effectiveness of biological disease\u2010modifying anti\u2010rheumatic drugs (bDMARD) as monotherapy or in combination with methotrexate and\/or other conventional DMARD (cDMARD) for the treatment of rheumatoid arthritis (RA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective, non\u2010interventional study was conducted that investigated the use of bDMARD in adult patients with RA in routine clinical practice. Data were extracted from the Optimising Patient Outcomes in Australian Rheumatology \u2013 Quality Use of Medicines Initiative database. Real\u2010world effectiveness was measured using the 28\u2010joint disease activity score (DAS28) and clinical disease activity index (CDAI) by treatment group at baseline, weeks 12 and 24.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2970 patients was included with a median (min\u2013max) age of 60.0 (19.0\u201394.0) years and median (min\u2013max) duration of RA before first bDMARD treatment of 6.0 (0.2\u201358.3) years. A total of 1177 patients received more than one bDMARD during the analysis period of 1 January 1997 to 15 August 2015. Patients had 4922 treatment \u2018episodes\u2019 (defined as a cycle of continuous individual bDMARD prescribing in a single patient). Patients received a mean (SD) of 1.7 (1.0) episodes of treatment with median (min\u2013max) treatment duration of 0.7 (0\u201311.8) years; median treatment duration was higher with the first treatment episode. bDMARD were most commonly initiated in combination with methotrexate (73.9% of episodes) and least commonly as monotherapy (9.9% of episodes). Median (min\u2013max) baseline DAS28 decreased from 5.3 (0\u20138.7) with the first bDMARD to 3.7 (0\u20138.8) with the second. Median baseline CDAI similarly decreased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients tended to persist longer on their first bDMARD treatment. bDMARD as monotherapy or in combination appear to be accepted treatment strategies in the real world.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.14028","type":"journal-article","created":{"date-parts":[[2018,7,3]],"date-time":"2018-07-03T07:42:56Z","timestamp":1530603776000},"page":"1185-1192","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness of biologics in Australian patients with rheumatoid arthritis: a large observational study: REAL"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6192-2493","authenticated-orcid":false,"given":"Dave","family":"Nicholls","sequence":"first","affiliation":[{"name":"University of the Sunshine Coast and Coast Joint Care  Rheumatology Research Unit, Maroochydore Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rina","family":"Barrett","sequence":"additional","affiliation":[{"name":"Roche Products Pty Limited, Medical Affairs  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Button","sequence":"additional","affiliation":[{"name":"Roche Products Pty Limited, Medical Affairs  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matt","family":"Truman","sequence":"additional","affiliation":[{"name":"Roche Products Pty Limited, Medical Affairs  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Bird","sequence":"additional","affiliation":[{"name":"University of New South Wales and Combined Rheumatology Practice  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynden","family":"Roberts","sequence":"additional","affiliation":[{"name":"Monash University, Monash Rheumatology  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Tymms","sequence":"additional","affiliation":[{"name":"Canberra Rheumatology  Canberra Australian Capital Territory Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey","family":"Littlejohn","sequence":"additional","affiliation":[{"name":"Monash University, Monash Rheumatology  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hedley","family":"Griffiths","sequence":"additional","affiliation":[{"name":"Barwon Rheumatology Service  Geelong Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204573"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker300"},{"key":"e_1_2_7_4_1","first-page":"S\u2010150\u20102","article-title":"OPAL: a clinician driven point of care observational data management consortium","volume":"32","author":"Tymms K","year":"2014","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_5_1","unstructured":"Corrona LLC. Corrona Registries: Rheumatoid Arthritis;2016. [cited 2017 Dec]. Available from URL:https:\/\/www.corrona.org\/registries\/rheumatoid-arthritis"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-207760"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-016-3423-5"},{"key":"e_1_2_7_8_1","unstructured":"Australian Government Department of Human Services. Rheumatoid arthritis;2016. [cited 2017 Dec]. Available from URL:https:\/\/www.humanservices.gov.au\/health-professionals\/enablers\/rheumatoid-arthritis"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-015-3066-z"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-207524"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.14028","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.14028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T03:35:27Z","timestamp":1694835327000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.14028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10]]},"references-count":9,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1111\/imj.14028"],"URL":"https:\/\/doi.org\/10.1111\/imj.14028","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10]]},"assertion":[{"value":"2017-12-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-06-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}