Gaitonde P, et al. - Here, researchers scrutinized the treatment patterns among adults with rheumatoid arthritis (RA) and identified factors impacting access to traditional and biological disease-modifying antirheumatic drugs (DMARDs). This study revealed that the visits with a specialist and Medicare beneficiaries were significantly connected with any/biological DMARD use. Additionally, contrary to prior evidence, race/ethnicity was not related to any/biological DMARD utilization, which may show the reduction in the disparity of treatment access.

Methods

• Authors investigated visits recorded in the National Ambulatory Medical Care Survey from 2005-2014 with an RA diagnosis.
• The primary outcome was DMARD use (traditional and/or biological).
• They included prescriptions of all RA-related treatments such as traditional and biological DMARDs, glucocorticoids, gold preparations, immunosuppressants, and non-steroidal anti-inflammatory drugs.
• Covariates in the logistic regression models included age, gender, race/ethnicity, type of healthcare coverage, provider type, geographic region, and the number of comorbidities.

Results

• In this study, they observed 60.4% (n=807) were prescribed DMARDs and 23.8% (n=334) biological DMARDs among 1405 visits with a RA diagnosis.
• In fully adjusted models, females have 1.57 times higher odds of any DMARD use (95% Confidence Interval (CI): 1.02-2.46).
• Also, Medicare beneficiaries as compared to privately insured have 2.31 times higher odds of receiving any DMARDs (95% CI: 1.40-3.82), while visits with specialist versus general physician are 2.38 times more connected with any DMARD use (95% CI: 1.37-4.14).
• For biological DMARDs, Medicare beneficiaries were at 2.58 times higher odds (95% CI: 1.42-4.70) than privately insured, while visits with specialist are at 3.37 times higher odds than general physician (95% CI: 1.40-8.23).