Missed opportunities for treatment of inflammatory arthritis and factors associated with non-treatment: An observational cohort study in United States Veterans with rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis
Authors' conclusion
A high proportion of Veterans with IA were not treated with a biologic or non-biologic DMARD within one year after their initial diagnosis.
Study context
- Population
- US Veterans with incident inflammatory arthritis (RA, PsA or AS) diagnosed in 2007–2019
- Participants
- 18,318 veterans
- Outcome
- Non-treatment with biologic or non-biologic disease modifying anti-rheumatic drugs (DMARDs) and associated factors
- Follow-up
- 12 months after initial IA diagnosis
Methodological detailsmultivariate Generalized Estimation Equation (GEE) log-Poisson, subgroup analyses by inflammatory arthritis (IA) subtype and diagnosis timeframe
- Multivariate GEE log-Poisson
- Subgroup analyses by IA subtype and diagnosis timeframe
Main finding
As reported in the abstract
No DMARD treatment within 12 months after diagnosis
- Proportion not treated within 12 months
- 40.7 %
- Black race (HR, 95% CI), non-treatment
- 1.13, 1.08-1.19
- Hispanic ethnicity (HR, 95% CI), non-treatment
- 1.14, 1.07-1.22
- Charlson Comorbidity Index ≥2 (HR, 95% CI), non-treatment
- 1.15, 1.11-1.20
- Opiate use (HR, 95% CI), non-treatment
- 1.09, 1.05-1.13
- Married status (HR, 95% CI), non-treatment
- 0.86, 0.81-0.91
- Erosion in joint imaging report (HR, 95% CI), non-treatment
- 0.86, 0.81-0.91
- Female diagnosing provider (HR, 95% CI), non-treatment
- 0.90, CI: 0.85-0.96
- Patient-provider gender concordance (HR, 95% CI), non-treatment
- 0.91, CI: 0.86-0.97
- Diagnosing provider specialty rheumatology (HR, 95% CI), non-treatment
- 0.53, CI: 0.49-0.56
Observational data: associations, not effects.
Original publication
Missed opportunities for treatment of inflammatory arthritis and factors associated with non-treatment: An observational cohort study in United States Veterans with rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis. Semin Arthritis Rheum. Published 28 March 2024. doi:10.
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