Tình trạng tuân thủ giãn liều thuốc sinh học ở bệnh nhân viêm khớp dạng thấp tại trung tâm cơ xương khớp Bệnh viện Bạch Mai

Abstract

Biologic disease-modifying anti-rheumatic drugs (bDMARDs) represent a pivotal therapeutic option for rheumatoid arthritis (RA). However, in Vietnam, the high cost and potential side effects associated with long-term use necessitate the consideration of dose tapering or spacing once clinical targets are achieved. The study evaluated the adherence to bDMARD dose-tapering regimens and to identify factors influencing adherence among RA patients at Bach Mai Hospital. Methods: A hybrid retrospective and prospective longitudinal follow-up study was conducted on 75 patients diagnosed with RA who were prescribed bDMARDs. The study was performed at the Center for Rheumatology of Bach Mai Hospital, with a minimum follow-up period of 6 months between January 2017 and December 2025. Among 62 patients undergoing dose tapering, 32.3% adhered strictly to recommended guidelines, 29% tapered due to good therapeutic response but did not follow recommendations, and 38.7% tapered for other reasons. The overall medication adherence rate and the adherence rate per clinical visit were 93.3% and 88.5%, respectively. Adherence was lowest for infliximab and highest for adalimumab. Although adalimumab was associated with the highest number of follow-up visits, no statistically significant difference was observed between the drug groups (p > 0.05). The most frequent objective barrier to follow-up adherence was the disruption of the hospital's drug supply. The medication adherence and visit adherence rates were 93.3% and 88.5%, respectively. Age < 65 years old and being bDMARD-naïve were identified as factors significantly associated with better adherence.