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Vol. 20. Issue 3.
Pages 128-135 (March 2024)
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Vol. 20. Issue 3.
Pages 128-135 (March 2024)
Original Article
The impact of COVID-19 and other factors on the usage status of the biologic drug therapies for rheumatoid arthritis: A study from Vietnam
El impacto de COVID-19 y otros factores en el estado de uso de las terapias farmacológicas biológicas para la artritis reumatoide: un estudio de Vietnam
Hai-Binh Buia,1, Hong-Thinh Laib,1, Thanh-Lam Nguyenc, Thuy-Duong Vuc, Nhat-Le Buic, Van-Hung Nguyena,d, Thi-To-Chau Trana, Thi-Phuong-Thuy Nguyena,d, Thi-Ngoc-Lan Nguyend, Jaffar A. Al-Tawfiqe,f,g, Dinh-Toi Chuc,h,
Corresponding author
a Department of Rheumatology, Bach Mai Hospital, Hanoi 100000, Viet Nam
b Department of Neurology and Rheumatology, Ha Nam Provincial General Hospital, Hanam, Viet Nam
c Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi 100000, Viet Nam
d Internal Medicine Department, Hanoi Medical University, Hanoi, Viet Nam
e Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
f Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
g Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
h Faculty of Applied Sciences, International School, Vietnam National University, Hanoi 100000, Viet Nam
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Figures (1)
Tables (6)
Table 1. Demographic characteristics of the study subjects.
Table 2. The impact of the COVID-19 pandemic on the retention time of biologic drugs.
Table 3. Impact of the COVID-19 pandemic on the study subjects’ use of biologic drugs.
Table 4. Factors associated with overall and first-used bDMARD retention time as determined by Cox multivariate regression analysis in pre-COVID-19 patients.
Table 5. Factors associated with overall and first-used bDMARD retention time as determined by Cox multivariate regression analysis in 23 during COVID-19 patients.
Table 6. Factors related to the overall and first-used bDMARD retention time determined by Cox regression analysis.
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To describe the status of using biological Disease Modifying Anti Rheumatic Drugs (bDMARDs) to treat rheumatoid arthritis (RA) and related factors. In addition, the study determined the impact of COVID-19 on the usage of bDMARDs.


This is a cross-sectional study and included 219 RA patients over 18 years old. The Kaplan–Meier method and the log-rank test (p<0.05) were used to estimate the retention time and compare between different times. Cox regression analysis was used to determine the factors affecting the retention time of biological drugs (p<0.05).


Out of 1967 courses of treatment, there were 149 (7.6%) drug discontinuations, 760 (38.6%) doses extensions and 64 (3.3%) drug switch. Moderate disease level and choosing tumor necrosis factor (TNF) inhibitors initially were associated with retention time of COVID-19. Drug discontinuations and dose extensions increased after COVID-19 emergence. The retention time during COVID-19 was significantly different from that of pre-COVID-19. Gender, type of first-used bDMARD, conventional synthetic DMARDs (csDMARDs) and corticoid usage status, disease activity levels were associated with retention time.


The presence of COVID-19 has a significant effect on usage status of the biologic drug. Further longitudinal studies are needed to clarify the relationship between COVID-19 and drug usage as well as related factors.

Usage status
Biologic drug therapies
Rheumatoid arthritis

Describir el estado del uso de fármacos antirreumáticos modificadores de la enfermedad biológica (bDMARD) para tratar la artritis reumatoide (AR) y los factores relacionados. Además, el estudio determinó el impacto de COVID-19 en el uso de bDMARD.


Este es un estudio transversal que incluyó a 219 pacientes con AR mayores de 18 años. El método Kaplan-Meier y la prueba Log-rank (p<0,05) se usaron para estimar el tiempo de retención y compararlo entre diferentes tiempos. El análisis de regresión de Cox se utilizó para determinar los factores que afectan el tiempo de retención de los medicamentos biológicos (p<0,05).


De 1.967 cursos de tratamiento, hubo 149 (7,6%) interrupciones del fármaco, 760 (38,6%) extensiones de dosis y 64 (3,3%) cambios de fármaco. Nivel de enfermedad moderado y elección del factor de necrosis tumoral (TNF) inhibidores inicialmente se asociaron con el tiempo de retención de COVID-19. Las discontinuaciones de los medicamentos y las extensiones de las dosis aumentaron después de la aparición de COVID-19. El tiempo de retención durante COVID-19 fue significativamente diferente del pre-COVID-19. Género, tipo de bDMARD de primer uso, convencional DMARD sintéticos (csDMARDs) y el estado de uso de corticoides, los niveles de actividad de la enfermedad se asociaron con el tiempo de retención.


La presencia de COVID-19 tiene un efecto significativo en el estado de uso del medicamento biológico. Se necesitan más estudios longitudinales para aclarar la relación entre COVID-19 y el uso de fármacos, así como los factores relacionados.

Palabras clave:
Estado de uso
Terapias farmacológicas biológicas
Artritis reumatoide


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