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Study highlights factors correlated with care consistent with ACR recommendations for RA treatment
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Although two visits for treatment acceleration for rheumatoid arthritis correlated with an increase in care consistent with recommendations from the American College of Rheumatology, time since the publishing of the recommendations was not associated with concordant care.
Researchers identified 36,036 biologic-naïve patients with rheumatoid arthritis (RA) from the Corrona registry database with visits to rheumatologists between December 2008 and February 2013. Patients had follow-up visits within 6 months of their initial visit with a rheumatologist (with a mean of 4 months) and a disease duration of more than 1 year. Patients did not have low disease activity and were not in remission. Data collected included disease duration, prognosis, disease severity and activity, medical comorbidities, use of disease-modifying antirheumatic dugs (DMARDs) and adverse events.
Investigators assessed treatment acceleration with regard to moderate to high disease activity, which was determined with the Clinical Disease Activity Index. Patients were categorized into two groups: the methotrexate (MTX)-only users; or the multiple non-biologic DMARDs users. Logistic regression was used to compare the characteristics of providers and patients with treatment consistent with American College of Rheumatology (ACR) recommendations and those with care not in alignment with these recommendations.
Findings showed 741 patients in the MTX monotherapy group and 995 patients in the multiple non-biologic DMARD group were cared for by 139 providers. After one visit, 36.2% of patients in the MTX monotherapy group and 39.6% of patients in the multiple non-biologic DMARD group received care consistent with the ACR recommendations. These figures increased to 78.3% and 76.2%, respectively, after two visits.
According to researchers, improved adherence to the recommendations did not correlate with increasing time after the recommendations were published. ‒ by Monica Jaramillo
Disclosure: The study was sponsored by Corrona LLC.
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