Keywords
b/sDMARDs
inflammatory arthritis
registry
How to Cite
Abstract
Introduction: Inflammatory arthritis is a chronic, systemic autoimmune disease characterized by inflammation, pain, and damage to joints and other organs. Over the years, various recommendations have been developed regarding the use of different medications for these diseases.
Objectives: To describe the patterns of initiation of biologic and synthetic disease-modifying antirheumatic drugs (b/sDMARDs) in patients with inflammatory arthritis in the BIOBADAGUAY registry and compare the situation between them.
Method: Data from the BIOBADAGUAY registry were analyzed, including patients with inflammatory arthritis who had started a b/tsDMARDs by the end of March 2025. The statistical analysis was descriptive.
Results: A total of 965 patients and 1298 treatments were analyzed. 75% were women, with a mean age at treatment initiation of 43.8 ± 16.9 years. Rheumatoid arthritis was the most frequent condition (69%). Original TNF inhibitors (anti-TNFo) were the first used, followed by the addition of original rituximab and IL-6 inhibitors. Biosimilar drugs were introduced in Paraguay in 2015. In 2020, Janus kinase inhibitors were introduced in Uruguay, and in 2022, they were introduced in Paraguay. Anti-TNFo were the most used, especially as first-line treatment. The frequency of anti-TNFo use decreased gradually with the introduction of new drugs in each country.
Conclusions: The availability of drugs in both countries was similar. The inclusion of new treatment targets has modified the pattern of use of these drugs.
References
(1) Pei W, Xu L, Zhong H, Wang Z, Yao R, Zhang L, et al. Clinical features of inflammatory arthritis in daily practice-China's perspective. Clin Rheumatol. 2025 Mar;44(3):969-978. doi: https://doi.org/10.1007/s10067-024-07262-2
(2) De Abreu P, Cabrera S, Cordovilla D, Román L, Brunengo C, Melgarejo P, et al. Seguridad de terapias biológicas y sintéticas dirigidas en pacientes con enfermedades inmunomediadas: datos del registro BIOBADAGUAY. Reumatol Clin. 2025;21: 101798. DOI: https://doi.org/10.1016/j.reuma.2024.09.008
(3) Brown P, Pratt AG, Hyrich KL. Therapeutic advances in rheumatoid arthritis. BMJ. 2024 Jan 17;384:e070856. doi: https://doi.org/10.1136/bmj-2022-070856.
(4) Fraenkel L, Bathon JM, England BR, St Clair EW, Arayssi T, Carandang K, et al. 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2021 Jul;73(7):924-939. doi: https://doi.org/10.1002/acr.24596.
(5) Smolen JS, Landewé RBM, Bergstra SA, Kerschbaumer A, Sepriano A, Aletaha D, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. Ann Rheum Dis. 2023 Jan;82(1):3-18. doi: https://doi.org/10.1136/ard-2022-223356.
(6) Nikitina V, Laurini GS, Montanaro N, Motola D. Comparative Safety Profiles of Biosimilars vs. Originators Used in Rheumatology: A Pharmacovigilance Analysis of the EudraVigilance Database. J Clin Med. 2025 Feb 28;14(5):1644. doi: https://doi.org/10.3390/jcm14051644.
(7) Swart J, Giancane G, Horneff G, Magnusson B, Hofer M, Alexeeva Е, et al. Pharmacovigilance in juvenile idiopathic arthritis patients treated with biologic or synthetic drugs: combined data of more than 15,000 patients from Pharmachild and national registries. Arthritis Res Ther. 2018 Dec 27;20(1):285. doi: https://doi.org/10.1186/s13075-018-1780-z.
(8) Rivera Terán V, Alpízar Rodríguez D, Isnardi C, De Abreu P, Laurindo I. Patterns of use of biological drugs and small molecules in patients with inflammation of the arthritis: combined data from five Latin American countries. Invest. Discapacidad [Internet]. 2025 Nov. 11 [cited 2025 Dec. 4];11(S1). Available from: https://dsm.inr.gob.mx/indiscap/index.php/INDISCAP/article/view/657
(9) Isnardi CA, Alfaro MA, Brigante JA, Peón C, Velozo E, Berbotto G, et al. Patrones de uso de inhibidores de JAK en pacientes con artritis reumatoidea en Argentina en función del tiempo: datos del registro nacional BIOBADASAR. Rev. Argent. Reumatol 2023; 34, suplemento: 34.
(10) Yalamanchili P, Lee LY, Bushnell G, Mannion ML, Dave CV, Horton DB. Trends in New Use of Disease-Modifying Antirheumatic Drugs for Juvenile Idiopathic Arthritis Among Commercially Insured Children in the United States from 2001 to 2022. Arthritis Rheumatol. 2025 Apr;77(4):468-476. doi: https://doi.org/10.1002/art.43041.
(11) Stajszczyk M, Obarska I, Jeka S, Batko B. Budget impact analysis and treatment availability with biosimilar TNF inhibitors in rheumatic diseases in Poland: real-world evidence using a nationwide database. Ann Rheum Dis. 2023 Sep;82(9):1171-1180. doi: https://doi.org/10.1136/ard-2022-223696.
(12) Yi S, Jang M, Kwon T. EE513 Assessing the Economic Impact of Biosimilars in the U.S.: A cost analysis of Infliximab, Trastuzumab, and Rituximab. Value in Health. 2025;28(6):S156.
(13) Hillhouse E, Mathurin K, Bibeau J, Parison D, Rahal Y, Lachaine J, Beauchemin C. The Economic Impact of Originator-to-Biosimilar Non-medical Switching in the Real-World Setting: A Systematic Literature Review. Adv Ther. 2022 Jan;39(1):455-487. doi: https://doi.org/10.1007/s12325-021-01951-z.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2025 Paloma de Abreu Trigueros, Sonia Cabrera Villalba, Angélica Amarilla Ortiz, Vannia Valinotti Cabrera, Teresa Chávez, Mariela Zarza Torres, Lourdes Róman Ruíz Díaz, Patricia Melgarejo Paniagua, Astrid Paats, Alexis Pineda, Evelyn Leiva Ríos, Zoilo Morel Ayala, Roger Rolón Campuzano, Sany Gómez González, Santiago Ferreira Maidana, Laura Martínez, Claudia Coronel, Raquel Aranda, Paola Pusineri, Paola Jara Gómez, Darwin Cordovilla, Clyde Parodi, Cynthia Vega Balbuena, Carolina Díaz, Sandra Consani, Pilar Garino, Sofia Rostan, Pamela Velázquez, Cristina Brunengo, Pedro Babak, Agustina Maidana, Yanira Yinde, Gabriela Ávila Pedretti