Oral Presentation ARA-NSW 2020 - 42nd Annual NSW Branch Meeting

Changes in b/tsDMARD prescribing for rheumatoid arthritis during the COVID-19 pandemic: An analysis of the OPAL dataset. (#25)

Kathleen Tymms 1 , Peter Youssef 2 , Geoffrey Littlejohn 3 4 , Tegan Smith 3 , Catherine OSullivan 3 , Hedley Griffiths 5 , Sabina Ciciriello 6 , David Mathers 7
  1. Rheumatology, Canberra Rheumatology, Canberra, ACT, Australia
  2. Royal Prince Alfred Hospital, Camperdown, NSW, Australia
  3. OPAL Rheumatology, Geelong, VICTORIA, Australia
  4. Monash Rheumatology, Clayton, VIC, Australia
  5. Barwon Rheumatology Service, Geelong, VIC, Australia
  6. Royal Melbourne Hospital, Melbourne, VIC, Australia
  7. Georgetown Arthritis, Newcastle, NSW, Australia

Aims: To investigate the impact of the COVID-19 pandemic on initiation and switching of b/tsDMARDs in patients with rheumatoid arthritis (RA) in real-world rheumatology practice in Australia.

Methods: Deidentified clinical data were sourced from the OPAL dataset, which is collected in a custom-built electronic medical record at the time of the consultation1 by 104 rheumatologists in Australia. Prescribing data for patients >18 years with RA treated with a b/tsDMARD between January 2020 and June 2020 was compared to prescribing data from the same time points in 2019. The software program Tableau® was used to display data on medication initiation and switching.

Results: The number of b/tsDMARD naïve patients with RA initiating a b/tsDMARD in April 2020 (n = 66) and May 2020 (n = 86) was lower than the number of initiations in the months prior to the pandemic (January; n = 124, February; n= 142 and March; n= 123). When compared to the same time period in 2019, first line initiations of b/tsDMARDs in patients with RA were reduced by 49% in April and 52% in May 2020. The number of patients with RA switching from a b/tsDMARD was reduced from n = 139 in January and n = 158 in February, to n = 106 and n = 89 in March and April 2020, respectively. When the number of patients switching therapy in 2020 was compared to the same time periods in 2019, a reduction of 37% and 39% was observed in March and April, respectively.

Conclusions: The disruption to routine clinical care due to the COVID-19 pandemic and the subsequent uptake of teleheatlh resulted in a reduced number of patients with RA initiating or switching b/tsDMARD therapy. The long-term impact of delays in escalating therapy on disease control and clinical outcomes remains to be seen

  1. Littlejohn GO, Tymms KE, Smith T, Griffiths HT. Using big data from real-world Australian rheumatology encounters to enhance clinical care and research. Clin Exp Rheum Nov 2019.