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Longer DMARD use linked with delayed joint replacement surgery in older patients with RA
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Results of this population-based study indicated that after rheumatoid arthritis diagnosis, longer exposure to disease-modifying antirheumatic drugs correlated with delayed joint replacement surgery among patients in Ontario and Quebec, Canada.
Researchers used the Ontario Health Insurance Plan Clams History database and the Quebec Health Insurance Program database to identify 20,918 patients in Ontario and 6,754 patients in Quebec with rheumatoid arthritis who were at least 66 years old. Patients were followed for a median of 4.5 years. Investigators used Cox proportional hazards regression with time-dependent variables to determine cumulative drug use for methotrexate (MTX) and other disease-modifying antirheumatic drugs (DMARDs) which was adjusted for baseline demographics, clinical factors and other potential drug exposures.
Results showed 2,201 patients in Ontario and 494 patients in Quebec underwent joint replacement surgery for crude events rates of 2 per 100 person-years and 1.4 per 100 person-years, respectively. Investigators noted in the first year of diagnosis, greater cumulative exposure to MTX and DMARDs correlated with longer time to joint replacement surgery in both Ontario and Quebec, noting a 2% to 3% decrease in the hazard for surgery with each month of early medication use. ‒ by Monica Jaramillo
Disclosure: The study was supported by the Canadian Network for Advanced Interdisciplinary Methods for Comparative Effectiveness Research group, which is funded by the Canadian Institutes of Health Research, through the Drug Safety and Effectiveness Network. The study was also supported by the Institute for Clinical Evaluative Sciences.