Treatment Of Rheumatoid Arthritis Patients With Chronic Hepatitis B: Analysis Of Korean National Health Insurance Claims Data

Background There are currently limited treatment options for rheumatoid arthritis (RA) patients with chronic hepatitis B (CHB). Numerous recommendations or consensus have been published for selecting conventional and biologic disease modifying anti-rheumatic agents (DMARDs) for these patients. However, there is limited data demonstrating what DMARDs are practically prescribed within the population of an endemic region of CHB. Objectives To study the prescription characteristics of conventional and biologic DMARDs, as well as the rate of combination of anti-viral agents in RA patients with CHB in Korea. Methods We analyzed the Korean National Health Insurance claims database (2007-2009) of RA patients through the co-work with Korean Health Insurance Review and Assessment Service. Patients with CHB were defined by an algorithm including prescription information, blood tests, and the ICD-10 code. Among biologic DMARDs, data of etanercept, adalimumab, infliximab, and rituximab data were only available during the study period. Results There were 8,677 CHB patients (3.8%) among 226,592 RA patients in the database. The age distribution or gender difference in CHB patients was comparable to the general RA population. Hydroxychloroquine was the most frequently (66.2%) prescribed DMARD. Thirty four percent of CHB patients had been prescribed with methotrexate (MTX) during the study period, only 7.6% with concomitant anti-viral treatment. About 3% of RA patients with CHB were prescribed with TNF inhibitors, which was significantly lower compared with the rate in the general RA population in Korea. Conclusions MTX is yet one of the DMARDs frequently prescribed to Korean RA patients with CHB. Our data also indicate that biologic DMARDs are indeed seldom prescribed in this particular subgroup of patients. Disclosure of Interest None Declared