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Polypharmacy in Early Rheumatoid Arthritis: Impact on Treatment Response and Adverse Event Risk in a multicenter
Soraya Benamar1, Cédric Lukas1, Claire Daien1
1Département de Rhumatologie, Centre Hospitalier Régional Universitaire de Montpellier and University of Montpellier, PhyMedExp, INSERM, CNRS UMR, Montpellier, France.
ACR Open Rheumatology
|July 29, 2025
Summary
Polypharmacy (PP) in early rheumatoid arthritis (RA) is linked to worse treatment response and higher serious adverse events (SAEs). PP may indicate comorbidities, impacting RA management.
Area of Science:
- Rheumatology
- Clinical Pharmacology
- Epidemiology
Background:
- Polypharmacy (PP) is common in rheumatoid arthritis (RA) patients.
- The impact of PP on RA treatment outcomes and safety is not fully understood.
Purpose of the Study:
- To evaluate the association between PP and treatment response in early RA.
- To assess the relationship between PP and serious adverse events (SAEs) in early RA.
- To determine if PP can act as a surrogate marker for comorbidities.
Main Methods:
- Analysis of data from the prospective French ESPOIR cohort of early RA patients.
- PP defined categorically based on medication count.
- Logistic regression used to assess treatment response (DAS 28 remission) and SAEs over 10 years.
Main Results:
- Patients with PP had significantly lower rates of achieving DAS 28 remission at 5 and 10 years.
- PP was associated with a 40-43% lower likelihood of remission.
- The incidence of SAEs was higher in the PP group (86.4%) compared to the non-PP group (49.8%).
Conclusions:
- PP is associated with poorer treatment response in early RA.
- PP increases the risk of serious adverse events.
- PP may serve as a useful surrogate marker for comorbidities in epidemiological studies of RA.
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