New Rheumatoid Arthritis Findings from J. Shafrin and Co-Researchers Reported (The Economic Burden of ACPA-Positive Status Among Patients with…

New Rheumatoid Arthritis Findings from J. Shafrin and Co-Researchers Reported (The Economic Burden of ACPA-Positive Status Among Patients with Rheumatoid Arthritis)

By a News Reporter-Staff News Editor at Health & Medicine Week -- Data detailed on Autoimmune Diseases and Conditions - Rheumatoid Arthritis have been presented. According to news reporting originating from Los Angeles, California, by NewsRx correspondents, research stated, "Anticitrullinated protein antibodies (ACPAs) are serological biomarkers associated with early, rapidly progressing rheumatoid arthritis (RA), including more severe disease and joint damage. ACPA testing has become a routine tool for RA diagnosis and prognosis."

Our news editors obtained a quote from the research, "Furthermore, treatment efficacy has been shown to vary by ACPA-positive status. However, it is not clear if the economic burden of patients with RA varies by ACPA status. To determine if the economic burden of RA varies by patient ACPA status. IMS PharMetrics Plus health insurance claims and electronic medical record (EMR) data from 2010-2015 were used to identify patients with incident RA. Patients were aged >= 18 years, had >= 1 inpatient or >= 2 outpatient claims reporting an RA diagnosis code (ICD-9-CM code 714.0), and had an anticyclic citrullinated peptide (anti-CCP; a surrogate of ACPA) antibody test within 6 months of diagnosis. Incident patients were defined as those who had no claims with an RA diagnosis code in the 6 months before the first observed RA diagnosis. The primary outcome of interest was RA-related medical expenditures, defined as the sum of payer-and patient-paid amounts for all claims with an RA diagnosis code. Secondary outcomes included health care utilization metrics such as treatment with a disease-modifying antirheumatic drug (DMARD) and physician visits. Generalized linear regression models were used for each outcome, controlling for ACPA-positive status (defined as anti-CCP >= 20 AU/mL), age, sex, and Charlson Comorbidity Index score as explanatory variables. Of 647,171 patients diagnosed with RA, 89,296 were incident cases, and 47% (n = 42,285) had an anti-CCP test. After restricting this sample to patients with a linked EMR and reported anti-CCP test result, 859 remained, with 24.7% (n = 212) being ACPA-positive. Compared with ACPA-negative patients, adjusted results showed that ACPA-positive patients were more likely to use either conventional (71.2% vs. 49.6%; P< 0.001) or biologic (20.3% vs. 11.8%; P< 0.001) DMARDs during the first year after diagnosis and had more physician visits (5.58 vs. 3.91 times per year; P< 0.001). Annual RA-associated total expenditures were $7,941 for ACPA-positive and $5,243 for ACPA-negative patients (Delta = $2,698; P = 0.002). RA-associated medical expenditures were $4,380 for ACP-Apositive and $3,427 for ACPA-negative patients (Delta = $954; P = 0.168), whereas DMARD expenditures were $3,560 and $1,817, respectively (Delta = $1,743; P = 0.001). RA-related economic burden is higher for patients who are ACPA-positive compared with those who are ACPA-negative."

According to the news editors, the research concluded: "Providers may wish to inform patients diagnosed with ACPA-positive RA about the likely future disease and economic burden in hopes that both stakeholders can be more proactive in addressing them."

For more information on this research see: The Economic Burden of ACPA-Positive Status Among Patients with Rheumatoid Arthritis. Journal of Managed Care & Specialty Pharmacy, 2018;24(1):4-11,14. Journal of Managed Care & Specialty Pharmacy can be contacted at: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA (see also Autoimmune Diseases and Conditions - Rheumatoid Arthritis).

The news editors report that additional information may be obtained by contacting J. Shafrin, Precis Hlth Econ, Los Angeles, CA 90025, United States. Additional authors for this research include M.G. Tebeka, K. Price, C. Patel and K. Michaud.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.18553/jmcp.2017.17129. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Keywords for this news article include: Los Angeles, California, United States, North and Central America, Musculoskeletal Diseases and Conditions, Autoimmune Diseases and Conditions, Joint Diseases and Conditions, Diagnostics and Screening, Rheumatoid Arthritis, Health and Medicine.

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