RT Journal Article
SR Electronic
T1 Rheumatoid Arthritis: Trends in Antirheumatic Drug Use, C-reactive Protein Levels, and Surgical Burden
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 2247
OP 2254
DO 10.3899/jrheum.141297
VO 42
IS 12
A1 Alma B. Pedersen
A1 Anil Mor
A1 Frank Mehnert
A1 Reimar W. Thomsen
A1 Søren P. Johnsen
A1 Mette Nørgaard
YR 2015
UL http://www.jrheum.org/content/42/12/2247.abstract
AB Objective. Over the past decade, the therapeutic approach used to treat patients with rheumatoid arthritis (RA) has considerably changed. It remains unclear whether these changes have been accompanied by decreased disease severity and surgical treatment burden at the population level. Therefore, we investigated time trends in antirheumatic drug consumption, C-reactive protein (CRP) levels, and use of orthopedic surgery among Danish patients with RA.Methods. Using medical databases, we identified all patients with RA living in Northern Denmark during 1996–2012. For each calendar year, we computed the annual rate of antirheumatic drug use (1996–2010), the median CRP value in mg/l (1996–2011), and the proportions of patients who underwent hip replacement and other orthopedic procedures (1996–2012).Results. Antirheumatic drug consumption per patient increased 5-fold, from 145.0 defined daily doses (DDD) in 1996 to 695.4 DDD in 2010. Median CRP declined from 20.5 mg/l [interquartile range (IQR), 10.0 to 43.5 mg/l] in 1996 to 10.0 mg/l (IQR, 4.2–17.8 mg/l) in 2011. From 1996 to 2012, declining proportions of patients with RA underwent hip replacement (14.9% to 10.1%) and other joint operations (29.1% to 23.4%), while the annual proportion of patients who underwent soft tissue procedures increased from 20.7% to 23.4%.Conclusion. Antirheumatic drug consumption has substantially increased among patients with RA since 1996, in association with reduced disease activity (i.e., lower CRP levels), fewer joint procedures (including hip replacements), and more soft tissue procedures.