Biologic drugs for SpA: does following recommendations affect patients’ cost and health?


Scientific Study Title:  Adherence to Anti-TNF Use Recommendations in Spondyloarthritis: Measurement and Impact in the DESIR Cohort


Principal Investigator: Stephanie Harvard, University of British Columbia School of Population and Public Health PhD student and Arthritis Research Canada Trainee supervised by Dr. Bruno Fautrel, Pierre and Marie Curie University, Paris, and Dr. Aslam Anis, University of British Columbia School of Population and Public Health


Study Start Date:  March 2015


Study End Date:  March 2017


What was done?

SpA (short for ‘spondyloarthritis’) is a type of inflammatory arthritis that affects the back, hips, and often other parts of the body. Biologic drugs (also called ‘anti-TNF’ therapies) are used to help stop inflammation from SpA. Doctors have made recommendations about who should use biologic drugs, as they are expensive and may have side effects. The DESIR cohort is a group of 708 French SpA patients who are responding to follow-up questions every six months about their costs and health. This study used information from DESIR to look at the effect of following doctors’ recommendations about who should use biologic drugs. To make sure this effect was understood in context, the study also looked at the effect of following other recommendations, such as using physiotherapy. Researchers looked at effects on patients’ costs as well as health.


What were the key findings?

Because information in the DESIR cohort is collected only every six months, researchers found that it was difficult to know for sure which patients would be recommended a biologic. Since this could affect the study findings, researchers decided to look at the information two different ways. The first way, the study showed that there were no differences in costs or in health between patients who received a biologic when recommended and those who did not. The second way, the study showed that patients who received a biologic when recommended had better health than those who did not, as well as reductions in certain types of costs. The study was important because it showed that researchers will need more information in order to know which SpA patients are being recommended a biologic. Future studies will be needed to know for sure how following recommendations about biologics affects patients’ costs and health.


Who was involved?

This study was led by a student researcher as part of a PhD thesis. A total of 7 researchers participated in the study.


Who funded this research?

To support her work with the DESIR Cohort, Stephanie Harvard received a Canadian Institutes of Health Research doctoral research award, two bursaries from the French Embassy in Canada, and a Michael Smith Foreign Study Travel award. For this study, Stephanie also received a bursary from Pfizer France.


Harvard S, Guh D, Bansback N, Richette P, Saraux A, Fautrel B, Anis AH. Adherence to Antitumor Necrosis Factor Use Recommendations in Spondyloarthritis:  Measurement and Effect in the DESIR Cohort. J Rheumatol. 2017 Oct;44(10):1436-1444.