The Sicilian Web plAtform for Rheumatology Network: complete regional implementation and first-year real-world drug...

In the evolving landscape of chronic disease management, digital platforms have emerged as tools to support care coordination, standardised prescribing and clinical governance. Building on the precedent of the HCV Sicily Network, the Sicilian Web plAtform for Rheumatology Network (SWaNetwork) was developed to provide a regional digital infrastructure for standardised rheumatologic prescribing, conceived as the foundation of a continuously evolving regional real-world data ecosystem. This report describes the complete regional implementation of the SWaNetwork across all authorised Sicilian rheumatology prescribing centres and presents the first-year real-world prescribing data generated by the platform.

SWaNetwork is a secure, web-based platform launched in October 2022, designed to manage the complete process of prescribing and dispensing rheumatologic therapies. Developed in collaboration with the CINECA Interuniversity Consortium, the system integrates data from 14 regional prescribing centres, providing real-time dashboards, automated alerts, and structured reports to support clinical governance. Descriptive analyses were performed using Stata 18. This is a descriptive implementation and drug-utilisation report; no comparator group or clinical-effectiveness outcomes were analysed.

In its first year, all 14 authorised regional prescribing centres were fully onboarded and 71 healthcare professionals registered 8,243 patients, with a platform-defined follow-up completion rate of 98%. A total of 1,426 initial prescriptions and 40,025 follow-up prescriptions were recorded (41,451 prescriptions overall), predominantly involving biologics such as Adalimumab (33.4%) and Etanercept (24.3%). These findings describe the scale and drug-utilisation pattern generated during the first year of regional implementation.

The SWaNetwork achieved complete regional implementation and generated a comprehensive first-year real-world prescribing dataset across Sicily. Rather than demonstrating clinical effectiveness, this foundational report describes a regional digital infrastructure for standardised prescribing governance, laying the foundation for a continuously evolving regional real-world data ecosystem, and provides the basis for future studies on treatment persistence, drug survival, switching, effectiveness, safety, healthcare utilisation and pharmacoeconomic outcomes.