Dr. Kim has received research support from Takeda Pharmaceuticals North America and Pfizer, and tuition support for the Pharmacoepidemiology Program at the Harvard School of Public Health, funded by Pfizer and Asisa. Dr. Solomon has received research support from Abbott Immunology, Amgen, and Lilly and from the Consortium of Rheumatology Researchers of North America, and serves in unpaid roles on two Pfizer sponsored trials.
Changes in Use of Disease-Modifying Antirheumatic Drugs for Rheumatoid Arthritis in the United States During 1983–2009
Article first published online: 26 AUG 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 9, pages 1529–1533, September 2013
How to Cite
Kim, S. C., Yelin, E., Tonner, C. and Solomon, D. H. (2013), Changes in Use of Disease-Modifying Antirheumatic Drugs for Rheumatoid Arthritis in the United States During 1983–2009. Arthritis Care Res, 65: 1529–1533. doi: 10.1002/acr.21997
- Issue published online: 26 AUG 2013
- Article first published online: 26 AUG 2013
- Accepted manuscript online: 5 MAR 2013 03:30PM EST
- Manuscript Accepted: 21 FEB 2013
- Manuscript Received: 27 NOV 2012
- NIH. Grant Numbers: K23-AR-059677, P60-AR-053308-06, K24-AR-055989, P60-AR-047782, R21-DE-018750, R01-AR-056215
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.
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.
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.
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.