Background Rheumatoid arthritis is a chronic systemic inflammatory disease that concerns, above all, the industrialised countries and it has a high rate of development. According to the World Health Organization, the rheumatoid arthritis prevalence in the world is between 0.3% and 1% and in Italy is equivalent to 0.33/100, that is about 2 00 000 patients.

Purpose The aim of this work consists in comparing prescriptions between an Italian district, including 6 00 000 citizens, and regional and national prescriptions, in order to make a pharmaceutilisation analysis.

Material and methods Immunosuppressive drugs have been analysed (Anatomical Therapeutic Chemical (ATC) classification: L04), employed in rheumatoid arthritis therapy, according to the defined daily dose (DDD), divided in the ATC classification, concerning the two-year period 2016/2017. Prescriptions concerning an Italian district, the region of belonging and the whole nation have been compared.

Results In an Italian north district, DDDs concerning immunosuppressive prescriptions for rheumatoid arthritis have been increased by 14.6% in 2017 compared with the previous year, however they are being on regional and national average. DDDs that have increased more concern secukinumab (+1135.3%) and, in, less quantity, tocilizumab (+59.6%). In 2017, every molecules considered DDDs are increased except etanercept and infliximab in the region, and mycophenolate in general in the nation, compared to 2016. Immunosuppressive drugs belonging to ATC L04 totals 2.2% of the whole DDD. In 2017, DDDs increased in this district (+14.6%) and also in the region and national territory.

Conclusion From this analysis, it can be said that in 2017 there has been a DDD increase in molecules belonging to ATC L04 prescribed for rheumatoid arthritis. The pharmaceutical market is booming thanks to the frequent introduction of new molecules and the updating of new therapeutic indications. It is necessary for continuous training of prescriptors and pharmacists to ensure prescriptive appropriateness in order to deliver suitable and effective therapy to patients, and economic sustainability.

References and/or acknowledgements Biosimilar position paper AIFA.

No conflict of interest.