Initiation of glucocorticoids before entering rheumatology care associates with long-term glucocorticoid use in older adults with early rheumatoid arthritis: A joint analysis of Medicare and the Rheumatology Informatics System for Effectiveness (RISE) data
Main finding · Duration of GC useResult — go to the resultHazard ratio 0.61 95% CI 0.51–0.74Authors' conclusion
GCs are regularly used in eRA and most often initiated before patients enter rheumatology care. Long-term, low-dose GC use is common and associated with initiation before rheumatology care.
Study context
- Population
- Older adults with early RA in the U.S.; RISE registry linked with Medicare (2016–2018), ≥2 RA ICD codes in RISE67 % female
- Participants
- 1,733 adults
- Exposure
- Glucocorticoid (GC) initiation before vs after entering rheumatology care
- Outcome
- Duration of continuous GC use
- Follow-up
- Up to 12 months after the index date
Methodological detailslinked RISE registry and Medicare data, Cox proportional hazards models adjusted for confounders
- Linked RISE registry and Medicare data
- Cox proportional hazards models adjusted for confounders
Main finding
Duration of GC use · up to 12 months after index date
Hazard ratio
0.61
95% CI 0.51–0.74
Before rheumatologic carevs After rheumatologic care
HR 0.61 (95% CI 0.51–0.74)
As reported in the abstract
- Mean duration of GC use (all GC initiators)
- 157 days (95% CI 143 to 170)
Observational data: associations, not effects.
Further findings
GC initiation
- Proportion initiating GCs
- 41 %
- Mean timing of initiation, days before entering rheumatologic care
- 16 ± 58
Mean duration of GC use
- Mean duration of GC use, days
- 157 (95%-CI 143 to 170)
Average daily GC dose in patients using GCs for ≥3 months
- Average daily dose, mg/d prednisone equivalent
- <5
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Initiation of glucocorticoids before entering rheumatology care associates with long-term glucocorticoid use in older adults with early rheumatoid arthritis: A joint analysis of Medicare and the Rheumatology Informatics System for Effectiveness (RISE) data. Semin Arthritis Rheum. Published 22 August 2024. doi:10.
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