J Rheum Dis.  2013 Dec;20(6):356-360. 10.4078/jrd.2013.20.6.356.

Clinical Characteristics of Korean Rheumatoid Arthritis Patients with Indications for TNF-alpha Blocker

• Son KM
• Jung YO
• Kim IJ
• Kim BJ
• Lee SY
• Mun SY
• Seo YI
• Kim HA

• KMID: 2222993
• DOI: http://doi.org/10.4078/jrd.2013.20.6.356

Abstract

OBJECTIVE
The aim of this study was to examine clinical characteristics of Korean rheumatoid arthritis (RA) patients with clinically indications for TNF-alpha blocker, and to compare their clinical parameters with the Korean National Health Insurance reimbursement criteria.
METHODS
Data were obtained from a registry of RA patients who visited rheumatology clinics of Hallym University affiliated hospitals. Among patients who were previously prescribed DMARDs for more than three months, rheumatologists selected patients clinically indicated for TNF-alpha blocker. The clinical characteristics at the time TNF-alpha blocker use was deemed indicated were examined. Radiographic damage was quantified by Modified Sharp van der Heijde score in hand and foot simple AP radiograph.
RESULTS
From August 2010 to January 2013, five rheumatologists in four hospitals selected 109 patients clinically indicated for TNF-alpha blocker. When TNF-alpha blocker was considered, mean DAS28 was 5.2 (range 2.1~8.05), mean swollen joint count was 6 (range 0~22), mean tender joint count was 10.6 (range 0~28), mean ESR was 43.2 mm/hr (range 1~140) and mean CRP was 2.5 mg/dL (range 0.1~18.3). The mean total modified Sharp van der Heijde score was 32.72 (range 0~240). Eighty one percent of subjects did not have enough active joints to satisfy the Korean National Health Insurance reimbursement standard.
CONCLUSION
Our results show that patients with clinically indications for TNF-alpha blocker had a broad range of disease activity and clinical parameters, and the majority did not meet the Korean National Health Insurance reimbursement criteria.

Keyword

Rheumatoid arthritis; TNF-alpha blocker; Korean National Health Insurance reimbursement criteria

MeSH Terms

Antirheumatic Agents
Arthritis, Rheumatoid*
Foot
Hand
Humans
Joints
National Health Programs
Rheumatology
Tumor Necrosis Factor-alpha*
Antirheumatic Agents
Tumor Necrosis Factor-alpha

Reference

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