Treatment | 2008 (n = 106) | 2009 (n = 268) | 2010 (n = 318) | 2011 (n = 365) | 2012 (n = 377) | 2013 (n = 397) | 2014 (n = 412) | 2015 (n = 384) | 2016 (n = 340) | 2017 (n = 341) | Annual mean | P valuea2008–17 and 2013–17 |
---|---|---|---|---|---|---|---|---|---|---|---|---|
No treatmentb (%) | 29 (27.4) | 92 (34.3) | 96 (30.2) | 115 (31.5) | 115 (30.5) | 112 (28.2) | 113 (27.4) | 102 (26.6) | 72 (21.2) | 65 (19.1) | 27.5% | < 0.001 0.011 |
bDMARD (%) | 32 (30.2) | 63 (23.5) | 88 (27.7) | 99 (27.1) | 113 (30.0) | 120 (30.2) | 129 (31.3) | 125 (32.6) | 107 (31.5) | 112 (32.8) | 29.9% | 0.29 0.94 |
TNF inhibitor (%) | 31 (29.2) | 59 (22.0) | 83 (26.1) | 94 (25.8) | 110 (29.2) | 115 (29.0) | 121 (29.4) | 118 (30.7) | 99 (29.1) | 100 (29.3) | 28.1% | 0.43 0.99 |
Non-TNF inhibitors (%) | 1 (0.9) | 4 (1.5) | 5 (1.6) | 5 (1.4) | 3 (0.8) | 5 (1.3) | 8 (1.9) | 7 (1.8) | 8 (2.4) | 12 (3.5) | 1.8% | 0.32 0.30 |
sDMARD (%) | 59 (55.7) | 136 (50.7) | 168 (52.8) | 188 (51.5) | 192 (50.9) | 208 (52.4) | 215 (52.2) | 206 (53.6) | 188 (55.3) | 192 (56.3) | 53.0% | 0.89 0.75 |
One sDMARD (%) | 59 (55.7) | 136 (50.7) | 168 (52.8) | 188 (51.5) | 191 (50.7) | 208 (52.4) | 214 (51.9) | 205 (53.4) | 188 (55.3) | 191 (56.0) | 52.8% | 0.96 0.87 |
Two sDMARDs (%) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 1 (0.3) | 0 (0) | 1 (0.2) | 1 (0.3) | 0 (0) | 1 (0.3) | 0.1% | – |
bDMARD and sDMARD (%) | 20 (18.9) | 36 (13.4) | 51 (16.0) | 52 (14.2) | 61 (16.2) | 66 (16.6) | 68 (16.5) | 68 (17.7) | 52 (15.3) | 53 (15.5) | 15.9% | 0.91 0.91 |
TNF inhibitor and sDMARD (%) | 20 (18.9) | 35 (13.1) | 50 (15.7) | 52 (14.2) | 61 (16.2) | 64 (16.1) | 65 (15.8) | 64 (16.7) | 49 (14.4) | 47 (13.8) | 15.3% | 0.89 0.81 |
Prednisolone (%) | 24 (22.6) | 39 (14.6) | 49 (15.4) | 52 (14.2) | 49 (13.0) | 56 (14.1) | 52 (12.6) | 54 (14.1) | 59 (17.4) | 60 (17.6) | 14.9% | 0.22 0.23 |
Prednisolone and sDMARD (%) | 16 (15.1) | 23 (8.6) | 29 (9.1) | 32 (8.8) | 26 (6.9) | 28 (7.1) | 25 (6.1) | 28 (7.3) | 31 (9.1) | 31 (9.1) | 8.1% | 0.19 0.44 |
Prednisolone, sDMARD, and bDMARD (%) | 4 (3.8) | 8 (3.0) | 9 (2.8) | 7 (1.9) | 5 (1.3) | 9 (2.3) | 5 (1.2) | 5 (1.3) | 5 (1.5) | 5 (1.5) | 1.9% | 0.47 0.77 |
Biologic DMARDs | ||||||||||||
 Adalimumab (%) | 11 (10.4) | 31 (11.6) | 41 (12.9) | 44 (12.1) | 46 (12.2) | 48 (12.1) | 44 (10.7) | 41 (10.7) | 25 (7.4) | 28 (8.2) | 10.9% | 0.33 0.18 |
 Certolizumab (%) | 0 (0) | 0 (0) | 0 (0) | 1 (0.3) | 1 (0.3) | 1 (0.3) | 12 (2.9) | 16 (4.2) | 18 (5.3) | 15 (4.4) | 1.9% | < 0.001 0.001 |
 Etanercept (%)c | 8 (7.5) | 20 (7.5) | 26 (8.2) | 37 (10.1) | 44 (11.7) | 33 (8.3) | 34 (8.3) | 31 (8.1) | 30 (8.8) | 34 (10.0) | 9.0% | 0.69 0.90 |
 Golimumab (%) | 0 (0) | 0 (0) | 9 (2.8) | 5 (1.4) | 7 (1.9) | 23 (5.8) | 19 (4.6) | 12 (3.1) | 11 (3.2) | 8 (2.3) | 2.8% | < 0.001 0.11 |
 Infliximab (%)d | 12 (11.3) | 8 (3.0) | 7 (2.2) | 7 (1.9) | 12 (3.2) | 10 (2.5) | 12 (2.9) | 19 (4.9) | 15 (4.4) | 15 (4.4) | 3.5% | 0.001 0.31 |
 Abatacept (%) | 1 (0.9) | 4 (1.5) | 4 (1.3) | 2 (0.5) | 2 (0.5) | 4 (1.0) | 2 (0.5) | 2 (0.5) | 1 (0.3) | 1 (0.3) | 0.7% | 0.65 0.66 |
 Ustekinumab (%) | 0 (0) | 0 (0) | 0 (0) | 1 (0.3) | 0 (0) | 1 (0.3) | 6 (1.5) | 4 (1.0) | 5 (1.5) | 2 (0.6) | 0.6% | 0.022 0.33 |
 Sekukinumab (%) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 2 (0.6) | 9 (2.6) | 0.3% | < 0.001< 0.001 |
Other biologics (%) | 0 (0) | 0 (0) | 1 (0.3) | 2 (0.5) | 1 (0.3) | 0 (0) | 0 (0) | 1 (0.3) | 0 (0) | 0 (0) | 0.2% | 0.55 0.42 |
Synthetic DMARDs (%) | ||||||||||||
 Leflunomide | 6 (5.7) | 19 (7.1) | 27 (8.5) | 37 (10.1) | 48 (12.7) | 53 (13.4) | 58 (14.1) | 49 (12.8) | 36 (10.6) | 37 (10.9) | 11.2% | 0.037 0.52 |
 Methotrexate | 48 (45.3) | 106 (39.6) | 124 (39.0) | 134 (36.7) | 130 (34.5) | 144 (36.3) | 151 (36.7) | 147 (38.3) | 141 (41.5) | 149 (43.7) | 38.5% | 0.22 0.18 |
 Sulfasalazine | 4 (3.8) | 8 (3.0) | 13 (4.1) | 13 (3.6) | 11 (2.9) | 7 (1.8) | 4 (1.0) | 8 (2.1) | 8 (2.4) | 5 (1.5) | 2.4% | 0.16 0.62 |
 Other synthetic DMARDse | 1 (0.9) | 3 (1.1) | 4 (1.3) | 4 (1.1) | 4 (1.1) | 4 (1.0) | 3 (0.7) | 3 (0.8) | 3 (0.9) | 2 (0.6) | 0.9% | 1.00 0.98 |
Ever users | ||||||||||||
 Biologic DMARDs (%) | 41 (38.7) | 74 (27.6) | 106 (33.3) | 123 (33.7) | 138 (36.6) | 152 (38.3) | 165 (40.0) | 171 (44.5) | 150 (44.1) | 157 (46.0) | 38.6% | < 0.001 0.16 |
 TNF inhibitor (%) | 41 (38.7) | 74 (27.6) | 105 (33.0) | 122 (33.4) | 137 (36.3) | 150 (37.8) | 164 (39.8) | 168 (43.8) | 147 (43.2) | 156 (45.7) | 38.2% | < 0.001 0.17 |
 Non-TNF inhibitors (%) | 2 (1.9) | 5 (1.9) | 8 (2.5) | 7 (1.9) | 7 (1.9) | 11 (2.8) | 16 (3.9) | 17 (4.4) | 21 (6.2) | 20 (5.9) | 3.4% | 0.004 0.15 |