MỘT SỐ YẾU TỐ LIÊN QUAN ĐẾN TÌNH TRẠNG GIẢM LIỀU THUỐC SINH HỌC TRONG ĐIỀU TRỊ BỆNH VIÊM KHỚP DẠNG THẤP TẠI TRUNG TÂM CƠ XƯƠNG KHỚP BỆNH VIỆN BẠCH MAI

Abstract

Objective: The study aims to evaluate factors associated with dose reduction of biological drugs in the treatment of rheumatoid arthritis (RA). Subjects and Methods: This retrospective and prospective longitudinal observational study was conducted on 64 patients diagnosed with RA according to the ACR 1987 or ACR/EULAR 2010 criteria. These patients were treated with biological disease-modifying antirheumatic drugs (bDMARDs), including infliximab, adalimumab, subcutaneous golimumab, and tocilizumab, at the Center for Rheumatology of Bach Mai Hospital from January 2017 to June 2024. Results: The rate of dose reduction in the study group was 76.6%, with reasons for reduction including therapeutic response (61.2%), adverse effects (53.1%), drug unavailability (44.9%), and COVID-19 (10.2%). All patients underwent dose reduction by extending the interval between doses. The number of conventional synthetic DMARDs (csDMARDs) used in the dose-reduction group was significantly higher than in the standard-dose group (1.7 vs. 1.2, p = 0.03). Patients who reduced doses earlier than recommended had a lower average age than those who followed the recommended dose reduction, with a statistically significant difference (42.9 vs. 56.8 years old, p = 0.01). The highest adherence to recommended dose reduction was observed with golimumab and tocilizumab (84.6% and 83.3%, respectively). Conclusion: Therapeutic response was the main reason for the dose reduction of biological drugs. All patients in the study reduced their doses by extending the interval between treatments. The number of csDMARDs used was factor influencing the likelihood of dose reduction, while patient age at the time of biological treatment initiation was associated with adherence to recommended dose reduction.