Bernard Ng|Adeline Chu|Myrna M. Khan
A retrospective cohort study: 10-year trend of disease-modifying antirheumatic drugs and biological agents use in patients with rheumatoid arthritis at Veteran Affairs Medical Centers
Baylor College of Medicine|Michael E. DeBakey VA Medical Center|Health Services Research & Development|University of Houston - Victoria|Baylor College of Medicine|Michael E. DeBakey VA Medical Center|Health Services Research & Development
evaluate trends patterns diseasemodifying antirheumatic drugs dmards biological agents use 1999 2009 identify patient characteristics associated different patterns use national sample veterans rheumatoid arthritis raa retrospective cohort studyadministrative databases usa department veterans affairsan incident cohort 13 254 patients newly diagnosed ra identifiedtrends choice dmards biological agents usage time intervals ra diagnosis treatmentmethotrexate use firstline agent increased 399 572 study period p0001 although biological dispensations increased dmards biological agents 34 25 1999 2009 percentage ra patients diagnosed 1999 2007 biologics dispensations remained steady 233267 compared caucasian african americans less likely receive biologics hr 071 95 ci 063 081 patients aged 75 older less likely receive biologics younger 45 hr 029 95 ci 023 036 time interval ra diagnosis treatment dmards biological agents decreased significantly time median 51 days 19992001 28 days 20062007methotrexate use increased became preferred firstline agent traditional agents declined dispensation biologics increased significantly proportion ra patients eventually given biologics stabilised 30 significant shorter time ra diagnosis dmard biological agent initiation recent years suggests improvements quality care disproportionately lower use biologics certain age ethnic groups studies needed elucidate observations