J Rheum Dis.  2013 Feb;20(1):24-29. 10.4078/jrd.2013.20.1.24.

Treatment of Rheumatoid Arthritis Patients with Chronic Hepatitis B: Analysis of Korean National Health Insurance Claims Data

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea. ysong@snu.ac.kr
  • 2Department of Health Policy Management, College of Medicine, Seoul National University, Seoul, Korea.
  • 3WCU Department of Molecular Medicine and Biopharmaceutical Sciences, Medical Research Center, College of Medicine, Seoul National University, Seoul, Korea.

Abstract


OBJECTIVE
There are currently limited treatment options for rheumatoid arthritis (RA) patients with chronic hepatitis B (CHB). In the process of pursuing further treatment strategies for this subgroup of patients, it is prudent to study what medications have been commonly prescribed, particularly for disease modifying anti-rheumatic agents (DMARDs) in Korea.
METHODS
We analyzed the Korean National Health Insurance claims database (2007~2009) of RA patients through co-working with the Clinical Research Center for RA (CRCRA). Patients with CHB were defined by an algorithm including prescription information, blood tests, and the ICD-10 code.
RESULTS
There were 8,677 CHB patients (3.8%) among 226,592 RA patients in the database. The age distribution or gender difference in CHB patients was comparable to the general RA population. Hydroxychloroquine was the most frequently (66.2%) prescribed DMARD. Thirty four percent of CHB patients had been prescribed with methotrexate (MTX) during the study period; most of them without concomitant anti-viral treatment. About 3% of RA patients with CHB were prescribed with TNF inhibitors.
CONCLUSION
Apart from the published expert recommendations, MTX still seems to be one of the main DMARDs prescribed to Korean RA patients with CHB. This is most likely due to the lack of evidence-based, effective treatment strategies for this subgroup of patients.

Keyword

Rheumatoid arthritis; Chronic hepatitis B; Methotrexate; Treatment

MeSH Terms

Age Distribution
Antirheumatic Agents
Arthritis, Rheumatoid
Hematologic Tests
Hepatitis B, Chronic
Hepatitis, Chronic
Humans
Hydroxychloroquine
International Classification of Diseases
Methotrexate
National Health Programs
Prescriptions
Antirheumatic Agents
Hydroxychloroquine
Methotrexate

Figure

  • Figure 1. Classifying RA patients with chronic hepatitis B. Patients were selected using prescription information, laboratory tests, and ICD-9 code. Patients were pooled (1+2+3+4) for further analysis (∗at least 2 incidents, † at least 1 incident of blood test). RA: rheumatoid arthritis, PEG-IFN: pegylated interferon, HBV: hepatitis B virus, AFP: alpha fetoprotein.


Cited by  1 articles

Disease Characteristics and Change in Arthritis Activity according to Treatment in Hepatitis B Surface Antigen-positive Rheumatoid Arthritis Patients: a Retrospective Chart Review Study
Yeonghee Eun, In Young Kim, Hyemin Jeong, Hyungjin Kim, Jaejoon Lee, Moon Seok Choi, Eunmi Koh, Hoon-Suk Cha
J Korean Med Sci. 2018;33(23):.    doi: 10.3346/jkms.2018.33.e168.


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