Document Detail


Changes in use of disease-modifying antirheumatic drugs for rheumatoid arthritis in the United States during 1983-2009.
MedLine Citation:
PMID:  23463543     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Use of nonbiologic disease-modifying antirheumatic drugs (DMARDs) and/or biologic DMARDs is generally recommended to improve the prognosis of patients with rheumatoid arthritis (RA). The objective of this study was to describe the changing trends in DMARD use for RA over the past 2 decades.
METHODS: We analyzed data from an open longitudinal cohort of RA patients recruited from rheumatologists' practices in northern California. We examined baseline demographic and clinical characteristics of the participants and their long-term DMARD use through annual comprehensive structured telephone interviews.
RESULTS: A total of 1,507 established RA patients were recruited through 5 enrollment periods between 1983 and 2009. Between 1983 and 2009, the use of any DMARD increased from 71% of all patients to 83% (P for trend < 0.0001). In 2009, 43% received a biologic DMARD, 34% were on both nonbiologic and biologic DMARDs, and 40% were treated with only nonbiologic DMARDs. The 4 most commonly used nonbiologic DMARDs in 2009 were methotrexate (49%), hydroxychloroquine (30%), leflunomide (13%), and sulfasalazine (7%). Etanercept (20%) was the most commonly used biologic DMARD in 2009, followed by infliximab (10%), adalimumab (9%), and abatacept (6%). Use of oral steroids was common (40-50%) and remained similar throughout the study period.
CONCLUSION: There has been a significant increase in the use of DMARDs for RA over the past 2 decades. However, 15% of the individuals with a clinical diagnosis of RA were not receiving DMARDs in 2009. Future research should focus on sociodemographic and clinical factors associated with DMARD use for RA.
Authors:
Seoyoung C Kim; Ed Yelin; Chris Tonner; Daniel H Solomon
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis care & research     Volume:  65     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-09-16     Completed Date:  2013-11-19     Revised Date:  2014-09-02    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1529-33     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 by the American College of Rheumatology.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antirheumatic Agents / therapeutic use*
Arthritis, Rheumatoid / drug therapy*,  epidemiology*
Cohort Studies
Female
Humans
Longitudinal Studies
Male
Middle Aged
United States / epidemiology
Grant Support
ID/Acronym/Agency:
K23 AR059677/AR/NIAMS NIH HHS; K23-AR-059677/AR/NIAMS NIH HHS; K24-AR-055989/AR/NIAMS NIH HHS; P60 AR053308/AR/NIAMS NIH HHS; P60-AR-047782/AR/NIAMS NIH HHS; P60-AR-053308-06/AR/NIAMS NIH HHS; R01 AR056215/AR/NIAMS NIH HHS; R01-AR-056215/AR/NIAMS NIH HHS; R21-DE-018750/DE/NIDCR NIH HHS
Chemical
Reg. No./Substance:
0/Antirheumatic Agents
Comments/Corrections

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