Features of Drug Therapy for Patients with Ankylosing Spondylitis in Moscow

Background. Systematic research work on the assessment of medicines consumption allows timely identification of effective and problematic aspects of the existing system of preferential medicines provision, allowing to regulate the optimality of its functioning. Aims — to identify regional epidemiological features and key aspects of drug provision for patients with ankylosing spondylitis (AS) in Moscow in dynamics for the period 2017–2020. To identify the trend of changes and their specifics in order to optimize further preferential drug provision (DLO) for patients with AS in Moscow. Materials and methods. The sources of the study were the data of LLO of patients with AS within the outpatient care, registered in Moscow in 2017–2020. The researchers analyzed the number of patients with AS who are entitled to free and preferential drug provision, who received drugs as an outpatient link in the period 2017–2020. The age structure of beneficiaries with AS and their ratio by gender has been determined. A tendency was revealed in the distribution of patients according to the main drug therapy regimens, according to the drugs they received during the reporting period. The structure of LLO of patients with AS was revealed by international non-proprietary names of drugs, their dosage form, quantities, cost minus payment by patients. Results. A retrospective analysis of real-world data showed that the population with AS in Moscow increased by 1.5 times from 2017 to 2020, as well as the cost of expenses for LLO of these patients, excluding patient payments, also increased by 1.5 times. The average age of patients was 50±14 years in 2017, and in 2018, 2019, and 2020. This indicator increased to 51±11 years. The ratio of patients by sex was 2:1 male and female, respectively, in all periods studied. The maximum proportion of patients fell on the age group — 40–59 years, which was about 50% of the entire population of patients with AS during the entire study period. The second place was occupied by the age group 60–79 years, which accounted for 28.10% of all patients with AS in 2017 and by 2020 decreased by 3.38%, already amounting to 24.72% of patients, the third place in the number of patients belongs to the age group 30–39 years, which accounted for about 17–18% of the entire population with AS during the entire study period. The analysis of the polypharmacy indicator indicates a low drug load of most patients since a small proportion of patients — from 1.54% (20 people) to 2.71% (49 people) — had more than 10 items for international nonproprietary names per year. The leading position was occupied by the therapeutic scheme of monotherapy “NSAIDs” in 2017, since 2018 the first place belongs to the scheme of therapy with one “iTNF-α”. Conclusions. The increase in costs for the relief of adverse reactions and the treatment of concomitant diseases indicates a shift in the approach to the treatment of diseases of the musculoskeletal system, as pathologies accompanied by a wide variety of comorbid and polymorbid conditions. Despite the positive changes in the regional system of LLO of Moscow, it is possible to improve the indicators of the provision of patients with AS when evaluating its effectiveness, taking into account clinical indicators and the results of the assessment of the quality of life reported by patients.