Initiation of Disease-Modifying Antirheumatic Drugs in Older Medicare Beneficiaries With New Diagnosis of Late-Onset Rheumatoid Arthritis
dc.contributor.author | Lee, J | |
dc.contributor.author | Martindale, J | |
dc.contributor.author | Makris, UE | |
dc.contributor.author | Singh, N | |
dc.contributor.author | Yung, R | |
dc.contributor.author | Bynum, JPW | |
dc.coverage.spatial | United States | |
dc.date.accessioned | 2024-05-02T12:17:24Z | |
dc.date.available | 2024-05-02T12:17:24Z | |
dc.date.issued | 2023-12-01 | |
dc.identifier.issn | 2578-5745 | |
dc.identifier.issn | 2578-5745 | |
dc.identifier.uri | https://www.ncbi.nlm.nih.gov/pubmed/37872884 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/192984 | en |
dc.description.abstract | Objective: Older adults with rheumatoid arthritis (RA) account for up to one-third of the RA population and are less likely to receive optimal treatment. For the subgroup of older adults with late-onset RA (LORA), who experience more symptomatic and progressive disease, suboptimal treatment could be more consequential than the general population who age with RA. We evaluated use of disease-modifying antirheumatic drugs (DMARDs) in older adults with a new diagnosis of LORA. Methods: In this retrospective observational study, we identified adults 66 years of age or older with a new diagnosis of LORA using Medicare data from 2008 to 2017. Information on baseline patient characteristics and DMARD initiation during the first 12 months after LORA diagnosis were collected. We also assessed concomitant use of glucocorticoids (GCs). Results: We identified 33,373 older adults with new diagnosis of LORA. Average age at LORA diagnosis was 76.7 (SD 7.6); 75.4% were female, 76.9% were White, and 35.6% had low-income subsidy (LIS). Less than one-third were initiated on a DMARD (28.9%). In multivariable analyses, DMARD initiation was associated with younger age, fewer comorbidities, and absence of LIS status. Concomitant long-term (>3 months) GC use was higher among those on any DMARD (44.3%) compared with those without (15.2%). Conclusions: DMARD initiation after new diagnosis of LORA is low despite current clinical practice guidelines recommending early aggressive initiation of treatment. Long-term GC use is common among those on any DMARDs, raising concern for suboptimal DMARD use. Further studies are needed to understand drivers of DMARD use in older adults. | |
dc.format.medium | Print-Electronic | |
dc.language | eng | |
dc.publisher | Wiley | |
dc.rights | Licence for published version: Creative Commons Attribution-NonCommercial 4.0 International | |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ | |
dc.subject | 32 Biomedical and Clinical Sciences | |
dc.subject | 3202 Clinical Sciences | |
dc.subject | Aging | |
dc.subject | Autoimmune Disease | |
dc.subject | Clinical Research | |
dc.subject | Arthritis | |
dc.subject | 6 Evaluation of treatments and therapeutic interventions | |
dc.subject | 6.1 Pharmaceuticals | |
dc.subject | Inflammatory and immune system | |
dc.title | Initiation of Disease-Modifying Antirheumatic Drugs in Older Medicare Beneficiaries With New Diagnosis of Late-Onset Rheumatoid Arthritis | |
dc.type | Article | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/192984/2/Initiation of Disease-Modifying Antirheumatic Drugs in Older Medicare Beneficiaries With New Diagnosis of Late-Onset Rheumat.pdf | |
dc.identifier.doi | 10.1002/acr2.11625 | |
dc.identifier.doi | https://dx.doi.org/10.7302/22629 | |
dc.identifier.source | ACR Open Rheumatology | |
dc.description.version | Published version | |
dc.date.updated | 2024-05-02T12:17:21Z | |
dc.identifier.orcid | 0000-0002-6402-6563 | |
dc.identifier.orcid | 0000-0002-8181-027X | |
dc.identifier.orcid | 0000-0003-1481-4462 | |
dc.identifier.volume | 5 | |
dc.identifier.issue | 12 | |
dc.identifier.startpage | 694 | |
dc.identifier.endpage | 700 | |
dc.identifier.name-orcid | Lee, J; 0000-0002-6402-6563 | |
dc.identifier.name-orcid | Martindale, J | |
dc.identifier.name-orcid | Makris, UE | |
dc.identifier.name-orcid | Singh, N | |
dc.identifier.name-orcid | Yung, R; 0000-0002-8181-027X | |
dc.identifier.name-orcid | Bynum, JPW; 0000-0003-1481-4462 | |
dc.working.doi | 10.7302/22629 | en |
dc.owningcollname | Internal Medicine, Department of |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.