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Disease-Modifying Medications in Patients with Rheumatoid Arthritis in the USA: Trends from 2016 to 2021
Samuel K Peasah1,2, Elizabeth C S Swart3, Yan Huang3
1Value-based Pharmacy Initiatives, Center for High-Value Health Care, UPMC Health Plan, US Steel Tower, 40th Floor. 600 Grant Street, Pittsburgh, PA, 15219, USA. Peasahsk@upmc.edu.
Drugs - Real World Outcomes
|February 18, 2024
Summary
Disease-modifying anti-rheumatic drugs (DMARDs) remain the cornerstone of rheumatoid arthritis (RA) treatment, with conventional synthetic DMARDs (csDMARDs) consistently most prescribed. The pandemic era saw increased hydroxychloroquine use and a rise in Janus kinase inhibitors (JAKs).
Area of Science:
- Rheumatology
- Pharmacology
- Epidemiology
Background:
- Disease-modifying anti-rheumatic drugs (DMARDs) have transformed rheumatoid arthritis (RA) management since 1990.
- Recent approvals of novel DMARDs have impacted treatment guidelines and patterns.
Purpose of the Study:
- To analyze current prescribing trends of DMARDs for rheumatoid arthritis (RA).
- To incorporate data from the COVID-19 pandemic era into prescribing pattern analysis.
Main Methods:
- Retrospective, cross-sectional, multi-year study utilizing the Optum Clinformatics® Data Mart Database (2016-2021).
- Analysis of DMARD utilization trends by type, class (csDMARDs, biologics, JAK inhibitors), and triple therapy in adult RA patients.
Main Results:
- Conventional synthetic DMARDs (csDMARDs) were consistently the most prescribed (77.2-79.2%).
- Janus kinase inhibitor (JAK) use more than doubled (1.5% to 4%), while methotrexate (MTX) use declined (40% to 34%).
- Hydroxychloroquine (HCQ) use increased during the pandemic (< 25% to 30%), and triple therapy remained low (~1%).
Conclusions:
- Approximately half of RA patients utilize DMARDs, with csDMARDs remaining dominant.
- The COVID-19 pandemic may have influenced hydroxychloroquine (HCQ) and infusion DMARD usage.
- Triple therapy for RA demonstrates consistently low prescription rates.
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