Early management of newly diagnosed rheumatoid arthritis by Canadian rheumatologists: a national, multicenter, retrospective cohort

J Rheumatol. 2011 Nov;38(11):2342-5. doi: 10.3899/jrheum.110249. Epub 2011 Sep 1.

Abstract

Objective: To describe early rheumatologic management for newly diagnosed rheumatoid arthritis (RA) in Canada.

Methods: A retrospective cohort of 339 randomly selected patients with RA diagnosed from 2001-2003 from 18 rheumatology practices was audited between 2005-2007.

Results: The most frequent initial disease-modifying antirheumatic drugs (DMARD) included hydroxychloroquine (55.5%) and methotrexate (40.1%). Initial therapy with multiple DMARD (15.6%) or single DMARD and corticosteroid combinations (30.7%) was infrequent. Formal assessment measures were noted infrequently, including the Health Assessment Questionnaire (34.6%) and Disease Activity Score for 28 joints (8.9%).

Conclusion: Initial pharmacotherapy is consistent with guidelines from the period. The infrequent reporting of multiple DMARD combinations and formal assessment measures has implications for current clinical management and warrants contemporary reassessment.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antirheumatic Agents / therapeutic use*
  • Canada / epidemiology
  • Cohort Studies
  • Disability Evaluation
  • Disease Management*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Practice Patterns, Physicians'*
  • Retrospective Studies
  • Rheumatic Fever / diagnosis
  • Rheumatic Fever / drug therapy*
  • Rheumatic Fever / epidemiology
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antirheumatic Agents