국내 류마티스 관절염의 처방 현황 분석

Analysis of Prescription Patterns for Rheumatoid Arthritis in Korea

This study was conducted to analyze the prescription patterns of glucocorticoids and disease-modifying antirheumatic drugs (DMARDs) in the management of rheumatoid arthritis. A cross-sectional study was conducted using the claims data of the Health Insurance Review and Assessment Service-National Patient Samples-2016. A total of 4,147 patients were analyzed. About 38, 28, and 6% received triamcinolone, methylprednisolone, and hydrocortisone, whereas 65, 45, 30, and 20% received methotrexate, hydroxychloroquine, leflunomide, and sulfasalazine. A total of 369 patients received biological DMARDs and approximately 47% received tocilizumab or adalimumab. Most of the biological DMARDs were concurrently prescribed with synthetic DMARD, especially methotrexate. In case of injectable glucocorticoids, 84% of the repeated injections were given within 12 weeks after the previous injections. As for oral glucocorticoid cases, 48% were “low dose” and stopped within 3 months. Furthermore, 15% continued for more than 6 months and 20% were prescribed at high doses. This study found that the prescription patterns of DMARDs met with the guidelines of American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR). However, in many cases of glucocorticoid uses, the dose was higher and the duration was longer than the recommendations of the guidelines. High doses and longterm use of glucocorticoids should be restrained to prevent serious side effects.