Avaliação epidemiológica e econômica do tratamento em primeira linha com medicamentos modificadores do curso da doença sintéticos convencionais para artrite psoriásica
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Data
2022-11-09
Autores
Faria, Ronaldo José
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Universidade Federal do Espírito Santo
Resumo
Conventional synthetic disease course modifying drugs are the first-line treatment to inhibit the progression of psoriatic arthritis. Despite their wide clinical use, few studies have been conducted to compare these drugs for the treatment of psoriatic arthritis. In this regard, an observational study was conducted to identify the profile of use and expenditures with these drugs in a real-life setting. A longitudinal study was conducted from a national centralized patient database in Brazil. Patients with psoriatic arthritis who obtained their first synthetic disease-modifying drug through SUS were included. The market share of the drugs, persistence in treatment, drug costs, and cost per response, considered as the cost per persistent patient were evaluated. Results: a total of 1,999 individuals with psoriatic arthritis were included. Methotrexate was the most commonly used drug (44.4%), followed by leflunomide (40.6%), cyclosporine (8.2%), and sulfasalazine (6.8%). Methotrexate and leflunomide had a higher market share compared to cyclosporine and sulfasalazine over the years. Treatment persistence was highest for leflunomide (58.9% and 28.2%), followed by methotrexate (51.6% and 25.4%) at six and 12 months, respectively. Leflunomide was found to be the most expensive drug, with an average annual cost of R$ 749.67, followed by sulfasalazine (R$ 251.58), cyclosporine (R$ 230.73), and methotrexate (R$ 95.06). Methotrexate was the drug with the lowest cost per response. Methotrexate had the best cost-perresponse ratio due to its lower cost and a slightly lower proportion of persistent patients when compared with leflunomide, which supports its current use as a first drug indicated in the treatment of psoriatic arthritis. Leflunomide showed greater treatment persistence, however, it was the most expensive drug.
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Artrite psoriásica , Farmacoepidemiologia , Agentes antirreumáticos , Persistência no tratamento , Custos dos medicamentos