Comparison of glucocorticoids and painkiller prescribed days between rheumatoid arthritis patients receiving early and late treatment with a biological agent via a population-based cohort study.

Autor:	Lee ZM; Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan., Yang YH; Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.; Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan.; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Kuo HC; Kawasaki Disease Center and Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan., Shen YH; Biostatistics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan., Yu HR; Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan., Su YJ; Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.; Center for Mitochondrial Research and Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.; Institute of Biomedical Sciences, National Sun Yat Sen University, Kaohsiung, Taiwan.
Jazyk:	angličtina
Zdroj:	Medicine [Medicine (Baltimore)] 2022 Nov 25; Vol. 101 (47), pp. e31986.
DOI:	10.1097/MD.0000000000031986
Abstrakt:	Comparison between early biologics treatment and late biologics treatment of rheumatoid arthritis (RA) patients in decreasing prescription days of glucocorticoids and painkillers by using the Taiwan National Health Insurance Research database from January 1, 1997 to December 31, 2013. We defined early use of biologics as biologics prescribed within 2.24 years after the RA diagnosis, and the late use of biologics was defined as those prescribed after 2.24 years of the RA diagnosis. These definitions are based on previous studies defining early arthritis as arthritis within 2 years of diagnosis, while we needed another 3 months for application biologics here in Taiwan, which equals a total of 2.24 years. Among the 821 patients, 410 patients (50%) were classified in the Early group, and the other 411 patients (50%) were classified in the Late group. The use of any of these 3 types of medication, including steroids, disease modifying antirhuematic drugs, and nonsteroid anti-inflammatory drug (NSAID) was changed significantly after biologics treatment. Comparing between before and after biologics treatment, oral medication was significantly tapered (all P < .0001). The results show that men are 1.81 times more likely than women to taper oral glucocorticoids and NSAIDs. Younger age (<45) patients are 1.91 times more likely to taper steroids and NSAIDs than those aged over 65 years old. Both gender and age were found to be independent factors that could decrease days of prescription of both steroids and NSAIDs in early use of biologics agents. This study indicates that younger patients only need short-term (2.53 ± 1.92 years, P = .03) and early treatment with biologics (within 2.24 years of diagnosis of RA), just in order to taper steroids and NSAIDs to less than 50% compared to the steroids and NSAIDs doses before biologics treatment. Competing Interests: The authors have no conflicts of interest to disclose. (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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