Müller S, et al. – The objective of this research was to evaluate the level of nonpersistence (NP) and nonadherence (NA) to methotrexate (MTX) therapy in German patients with rheumatoid arthritis (RA). In one–fourth of German patients with RA, NP to MTX treatment appeared to be common. At least 6.5% patients were also affected by NA. Moreover, a considerable percentage of RA patients who discontinued MTX therapy do not receive any follow–up disease–modifying antirheumatic drug (DMARD) therapy.

Methods

• RA patients who received a MTX therapy (subgroup: treatment–naive patients) were analyzed, based on German claims data.
• NP was defined as treatment gap >12 weeks. 
• Regarding NA, it is the overall medication possession ratio (MPR) during an observational period of 12 or 24 months after therapy.
• The MPR was calculated only for the periods of therapy continuation.
• NA was defined as MPR <80%.

Results

• A total of 7,146 RA patients who received at least one MTX prescription (subgroup: 1,211 treatment–naive patients) could be observed (mean age: 64.4 years, 73.6% female).
• As per the outcomes, percentage of NP patients among MTX–naive patients after 6, 12 and 18 months was 16.7%, 34.0% and 36.7%, respectively. 
• After MTX therapy discontinuation, 39.9% had restarted their MTX therapy, 13.8% had received another non–MTX synthetic disease–modifying antirheumatic drug (sDMARD), 8.1% had biological DMARD (bDMARD) and 49.2% had not received any DMARD prescription at all.
• Overall, 12– and 24–month MPRs for MTX therapy were 83.0% and 76.5% with a percentage of NA patients of 25.8% and 33.8%, respectively. 
• The percentage of patients with an MPR <80% was 6.5%, during periods of general treatment continuation.