Article Figures & Data
Tables
- Table 1.
Sociodemographic characteristics of older patients with inflammatory arthritis at the time of diagnosis, by patient sex.
Rheumatoid Arthritis Psoriatic Arthritis Male,
n = 4868Female,
n = 8745Std Diff Male,
n = 478Female,
n = 638Std Diff Age, yrs, mean (SD) 74.3 (6.2) 74.6 (6.5) 0.04 72.1 (5.3) 72.2 (5.6) 0.01 Residence, n (%) Rural 518 (10.6) 791 (9) 0.05 41 (8.6) 41 (6.4) 0.08 Urban 4296 (88.2) 7890 (90.2) 0.06 436 (91.2) 594 (93.1) 0.07 SES, n (%) Low 1726 (35.5) 3471 (39.7) 0.09 180 (37.7) 230 (36.1) 0.03 Middle 2046 (42) 3543 (40.5) 0.03 184 (38.5) 252 (39.5) 0.02 High 1084 (22.3) 1710 (19.6) 0.07 113 (23.6) 154 (24.1) 0.01 Marginalization, n (%) Least deprived 2136 (43.9) 3448 (39.4) 0.09 218 (45.6) 299 (46.9) 0.03 Moderately deprived 978 (20.1) 1850 (21.2) 0.03 94 (19.7) 122 (19.1) 0.01 Most deprived 1719 (35.3) 3407 (39) 0.08 165 (34.5) 214 (33.5) 0.02 Comorbidities (individual), n (%) Psoriasis 79 (1.6) 134 (1.5) 0.01 194 (40.6) 234 (36.7) 0.08 Uveitis 15 (0.3) 32 (0.4) 0.01 < 6 (< 1) < 6(< 1) 0.01 Inflammatory bowel disease 65 (1.3) 127 (1.5) 0.01 16 (3.3) 30 (4.7) 0.07 Hypertension 3572 (73.4) 6606 (75.5) 0.05 361 (75.5) 461 (72.3) 0.07 Diabetes mellitus 1661 (34.1) 2225 (25.4) 0.19 145 (30.3) 179 (28.1) 0.05 Cardiovascular disease 1337 (27.5) 1441(16.5) 0.27 103 (21.5) 99 (15.5) 0.16 Cerebrovascular disease 73 (1.5) 98 (1.1) 0.03 6 (1.3) 7 (1.1) 0.02 Cancer 959 (19.7) 1208 (13.8) 0.16 95 (19.9) 86 (13.5) 0.17 Depression 143 (2.9) 420 (4.8) 0.01 10 (2.1) 43 (6.7) 0.23 Pulmonary disease 1635 (33.6) 2981 (34.1) 0.01 152 (31.8) 234 (36.7) 0.10 Liver disease 83 (1.7) 131 (1.5) 0.02 8 (1.7) 13 (2) 0.03 Kidney disease 447 (9.2) 579 (6.6) 0.01 34 (7.1) 43 (6.7) 0.02 Osteoporosis 100 (2.1) 1018 (11.6) 0.39 8 (1.7) 64 (10.0) 0.36 Comorbidities (ADG categories), n (%) 0-5 164 (3.4) 301 (3.4) < 0.01 19 (4.0) 7 (1.1) 0.18 6-9 895 (18.4) 1396 (16) 0.06 85 (17.8) 69 (10.8) 0.20 10+ 3809 (78.2) 7048 (80.6) 0.06 374 (78.2) 562 (88.1) 0.27 Regional density of rheumatologists, n (%) Optimal 2966 (60.9) 5521 (63.1) 0.05 302 (63.2) 430 (67.4) 0.09 Suboptimal 1902 (39.1) 3224 (36.9) 0.05 176 (36.8) 208 (32.6) 0.09 Remote distance to rheumatologist, n (%) 217 (4.5) 346 (4) 0.03 16 (3.3) 17 (2.7) 0.04 Values in bold are statistically significant (std diff > 0.1). ADG: Aggregated Diagnosis Groups; SES: socioeconomic status; Std Diff: standardized difference.
- Table 2.
Dispensation of rheumatic medications in older patients with inflammatory arthritis, by patient sex.
Medication Class Rheumatoid Arthritisa Psoriatic Arthritisb Male,
n (%)Female,
n (%)aORc
(95% Cl)Male,
n (%)Female,
n (%)aORc
(95% Cl)csDMARDsd Year 1 3749 (79.4) 6769 (79.1) 1.00 (0.92-1.09) 317 (66.6) 426 (67.1) 1.05 (0.81-1.37) Year 2 3095 (68.2) 5618 (67.6) 1.00 (0.92-1.08) 275 (58.9) 351 (56.3) 0.94 (0.73-1.20) Year 3 2672 (62.0) 5019 (62.7) 1.05 (0.97-1.14) 250 (55.2) 304 (50.1) 0.85 (0.66-1.09) Advanced therapy (bDMARDs and tsDMARDs)e Year 1 116 (2.5) 208 (2.4) 0.99 (0.78-1.25) 39 (8.2) 42 (6.6) 0.75 (0.47-1.19) Year 2 210 (4.6) 448 (5.4) 1.17 (0.99-1.39) 48 (10.3) 62 (9.9) 0.91 (0.61-1.37) Year 3 238 (5.5) 538 (6.7) 1.23 (1.05-1.45) 54 (11.9) 68 (11.2) 0.88 (0.6-1.30) NSAIDs Year 1 865 (18.3) 1723 (20.1) 1.14 (1.04-1.25) 128 (26.9) 159 (25) 0.94 (0.71-1.24) Year 2 661 (14.6) 1294 (15.6) 1.10 (0.99-1.22) 100 (21.4) 130 (20.8) 0.98 (0.73-1.32) Year 3 536 (12.4) 1,115 (13.9) 1.16 (1.04-1.30) 80 (17.7) 106 (17.5) 1.02 (0.73-1.41) Opioid medications Year 1 367 (7.8) 913 (10.7) 1.39 (1.22-1.58) 41 (8.6) 74 (11.7) 1.32 (0.87-1.98) Year 2 337 (7.4) 915 (11) 1.51 (1.32-1.72) 39 (8.4) 64 (10.3) 1.14 (0.75-1.75) Year 3 315 (7.3) 836 (10.4) 1.46 (1.27-1.68) 36 (7.9) 72 (11.9) 1.45 (0.95-2.23) Oral CS Year 1 2080 (44.1) 3161 (36.9) 0.73 (0.68-0.79) 64 (13.4) 89 (14) 0.98 (0.69-1.40) Year 2 1043 (23) 1864 (22.4) 0.96 (0.88-1.05) 49 (10.5) 58 (9.3) 0.86 (0.57-1.30) Year 3 759 (17.6) 1493 (18.6) 1.06 (0.96-1.17) 39 (8.6) 48 (7.9) 0.89 (0.57-1.40) ↵a Sample size in RA cohort: year 1 after index date (M = 4721, F = 8556); year 2 after index date (M = 4537, F = 8308); year 3 after index date (M = 4313, F = 8006).
↵b Sample size in PsA cohort: year 1 after index date (M = 476, F = 635); year 2 after index date (M = 467, F = 624); year 3 after index date (M = 453, F = 607).
↵c aOR: Female to male.
↵d Sample size of patients taking csDMARDs: RA (M = 3942, F = 7120), PsA (M = 337, F = 459).
↵e Sample size of patients on advanced therapy: RA (M = 296, F = 625), PsA (M = 60, F = 80). aOR: adjusted odds ratio; bDMARD: biologic disease-modifying antirheumatic drug; CS: corticosteroid; csDMARD: conventional synthetic DMARD; F: female; M: male; OR: odds ratio; tsDMARD: targeted synthetic DMARD.
- Table 3.
Dispensation patterns of rheumatic medications in older patients with inflammatory arthritis, odds ratios (ORs) for prescriptions in female patients compared to males, stratified by sex of the diagnosing specialists.
Medication Classa Rheumatoid Arthritis Psoriatic Arthritis Male Specialist,
OR (95% Cl)Female Specialist,
OR (95% Cl)Male Specialist,
OR (95% Cl)Female Specialist,
OR (95% Cl)csDMARDs Year 1 1.00 (0.89-1.12) 0.98 (0.85-1.14) 0.78 (0.56-1.09) 1.57 (1.03-2.39) Year 2 1.03 (0.93-1.13) 0.93 (0.82-1.06) 0.71 (0.51-0.99) 1.33 (0.89-1.98) Year 3 1.07 (0.97-1.18) 1.00 (0.88-1.14) 0.67 (0.48-0.93) 1.13 (0.76-1.68) Advanced therapy (bDMARDs and tsDMARDs) Year 1 1.02 (0.77-1.35) 0.98 (0.64-1.50) 0.84 (0.43-1.64) 0.65 (0.34-1.23) Year 2 1.04 (0.85-1.29) 1.52 (1.12-2.07) 0.98 (0.56-1.72) 0.81 (0.45-1.47) Year 3 1.10 (0.91-1.34) 1.59 (1.20-2.10) 0.88 (0.52-1.50) 0.86 (0.49-1.52) NSAIDs Year 1 1.17 (1.04-1.32) 1.14 (0.97-1.33) 0.91 (0.64-1.30) 1.01 (0.64-1.59) Year 2 1.13 (1.00-1.29) 1.10 (0.92-1.31) 0.94 (0.64-1.37) 1.08 (0.66-1.75) Year 3 1.22 (1.06-1.40) 1.10 (0.91-1.33) 1.10 (0.72-1.68) 0.93 (0.55-1.56) Opioid medications Year 1 1.47 (1.25-1.73) 1.26 (1.03-1.55) 1.48 (0.87-2.53) 1.08 (0.57-2.05) Year 2 1.68 (1.41-1.99) 1.26 (1.02-1.56) 1.30 (0.75-2.26) 0.91 (0.47-1.77) Year 3 1.59 (1.34-1.89) 1.28 (1.02-1.60) 1.67 (0.96-2.91) 1.16 (0.59-2.29) Oral CS Year 1 0.72 (0.66-0.79) 0.75 (0.67-0.85) 0.99 (0.62-1.58) 0.98 (0.57-1.69) Year 2 0.94 (0.84-1.05) 0.99 (0.86-1.14) 0.89 (0.52-1.52) 0.80 (0.42-1.53) Year 3 1.09 (0.96-1.23) 1.03 (0.87-1.20) 0.71 (0.40-1.26) 1.28 (0.60-2.74) Values in bold are statistically significant (P < 0.05). ORs in female patients (ref: male patients) adjusted for age, residence, SES, ADG of patients and regional density of rheumatologists.
↵a ORs of patients with dispensation of at least 1 csDMARD, at least 1 advanced therapy, at least 90 days’ supply of NSAIDs, at least 90 days’ supply of opioid medications, and at least 30 days’ supply of oral CS medications were estimated. ADG: Aggregated Diagnosis Groups; CS: corticosteroid; csDMARD: conventional synthetic disease-modifying antirheumatic drug; NSAID: nonsteroidal antiinflammatory drug; SES: socioeconomic status.
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