Rheumatology International

, Volume 39, Issue 3, pp 525–531 | Cite as

Persistence with biological drugs in patients treated in rheumatology practices in Germany

  • Louis Jacob
  • Thomas Chevalier
  • Karel KostevEmail author


The goal of this study was to investigate the persistence with biological drugs in patients treated in rheumatology practices in Germany. This study included patients diagnosed with rheumatoid arthritis (RA), psoriatic arthritis (PA), or ankylosing spondylitis (AS) who received a first prescription of biological drugs between 2008 and 2016 (index date) in 21 rheumatology practices in Germany (n = 4925; Disease Analyzer database). The main outcome measure was the rate of persistence within 5 years of the index date. Kaplan–Meier analyses were performed to study treatment persistence as a function of diagnosis, gender and age. A Cox proportional hazards regression model was used to estimate the relationship between non-persistence and diagnosis, gender, age, and comorbidities. After 5 years of follow-up, the rate of persistence was 31.8% in patients with RA, 35.2% in those with AS, and 33.2% in those with PA (log-rank p value = 0.028). Furthermore, 33.8% of men and 31.9% of women were persistent (log-rank p value = 0.035). The rate of persistence was 20.8%, 27.9%, 33.0%, 36.6%, 35.2%, and 32.0% in people aged ≤ 30, 31–40, 41–50, 51–60, 61–70, and > 70 years, respectively (log-rank p value = 0.002). The risk of discontinuation was lower in participants diagnosed with AS than in those diagnosed with RA [hazard ratio (HR) = 0.87; 95% confidence interval (CI) 0.79–0.96]. In addition, patients aged ≤ 30 years were more likely to discontinue their biological therapy than those aged > 70 years (HR = 1.29; 95% CI 1.10–1.52). Persistence with biological drugs was low after 5 years of follow-up in rheumatology practices.


Persistence Biological drugs Rheumatology practices Germany Retrospective study 


Author contributions

LJ and TC contributed to the interpretation of the data, drafted the manuscript and gave the final approval of the version to be published. KK contributed to the conception and the design of the study, revised the manuscript critically for important content, and gave the final approval of the version to be published.


The authors have received no financial support for the research, authorship, and/or publication of this article.

Compliance with ethical standards

Conflict of interest

Karel Kostev is an employee of IQVIA. IQVIA ( is a commercial research institute providing information, services and technology for the healthcare industry. The other authors declare that they have no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

German law allows the use of anonymous electronic medical records for research purposes under certain conditions. According to this legislation, it is not necessary to obtain informed consent from patients or approval from a medical ethics committee for this type of observational study that contains no directly identifiable data. Because patients were only queried as aggregates and no protected health information was available for queries, no IRB approval was required for the use of this database or the completion of this study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Faculty of MedicineUniversity of Versailles Saint-Quentin-en-YvelinesMontigny-le-BretonneuxFrance
  2. 2.Hospital Saint-AntoineParisFrance
  3. 3.EpidemiologyIQVIA, Commercial GmbH & Co OHGFrankfurt am MainGermany

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