Factors for starting biosimilar TNF inhibitors in patients with rheumatic diseases in the real world

Autoři: Yoon-Kyoung Sung aff001;  Sun-Young Jung aff002;  Hyoungyoung Kim aff001;  Seongmi Choi aff003;  Seul Gi Im aff003;  Yu Sang Lee aff003;  Eun Jin Jang aff004;  Soo-Kyung Cho aff001
Působiště autorů: Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea aff001;  College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea aff002;  Department of Statistics, Kyungpook National University, Buk-gu, Daegu, Republic of Korea aff003;  Department of Information Statistics, Andong National University, Andong, Republic of Korea aff004
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0227960



To identify factors for starting biosimilar TNF inhibitors (TNFI) in patients with rheumatic diseases.

Methods and finding

Using a national claims database, we identified patients with rheumatoid arthritis (RA) or ankylosing spondylitis (AS) who had used TNFIs since they were approved in Korea in 2004. We assessed changes in the proportion of each form of TNFI used between 2004 and 2017. We then selected patients starting on TNFIs between 2013 and 2017 to identify factors for starting biosimilars. In RA (n = 4,216), biosimilars were more likely to be initiated in clinics [odds ratio (OR) 2.54] and in the metropolitan area (OR, 2.02), but were less likely to be initiated in general hospitals (OR 0.40) or orthopedics (OR 0.44). In AS (n = 2,338), biosimilars were common at the hospital level (OR 2.20) and tended to increase over the years (OR 1.16), but were initiated less in orthopedics (OR 0.07). In addition, RA patients were more likely to initiate biosimilars in combination with methotrexate (OR 1.37), but biosimilars were not initiated frequently by patients with higher comorbidity scores (OR 0.97) or receiving glucocorticoids (OR 0.67). The patient factors favoring biosimilar in AS use were not clear.


In Korea, the proportion of biosimilar TNFIs has increased. Type of institution and physician specialty are more important than patient factors in affecting biosimilar use. In RA, biosimilar TNFIs tend to be initiated in combination with MTX, and are less likely to be initiated in patients taking glucocorticoids or in those with high comorbidities.

Klíčová slova:

Ankylosing spondylitis – Drug users – Gastroenterology and hepatology – Korea – NSAIDs – Physicians – Rheumatoid arthritis – Rheumatology


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2020 Číslo 1
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