RT Journal Article SR Electronic T1 Time to Disease-modifying Antirheumatic Drug Treatment in Rheumatoid Arthritis and Its Predictors: A National, Multicenter, Retrospective Cohort JF The Journal of Rheumatology JO J Rheumatol FD The Journal of Rheumatology SP 2088 OP 2097 DO 10.3899/jrheum.120100 VO 39 IS 11 A1 RUBEN TAVARES A1 JANET E. POPE A1 JEAN-LUC TREMBLAY A1 CARTER THORNE A1 VIVIAN P. BYKERK A1 JURIS LAZOVSKIS A1 KENNETH L.N. BLOCKA A1 MARY J. BELL A1 DIANE LACAILLE A1 CAROL A. HITCHON A1 AVRIL A. FITZGERALD A1 WESLEY K. FIDLER A1 ARTHUR A.M. BOOKMAN A1 JAMES M. HENDERSON A1 DIANNE P. MOSHER A1 DALTON E. SHOLTER A1 MAJED KHRAISHI A1 BOULOS HARAOUI A1 HONG CHEN A1 XIUYING LI A1 ANDREAS LAUPACIS A1 GILLES BOIRE A1 GEORGE TOMLINSON A1 CLAIRE BOMBARDIER YR 2012 UL http://www.jrheum.org/content/39/11/2088.abstract AB Objective. To determine the proportion of patients with rheumatoid arthritis (RA) under rheumatologic care treated with disease-modifying antirheumatic drugs (DMARD) within 6 months from symptom onset and the components of time to treatment and its predictors. Methods. A historical inception cohort of 339 patients with RA randomly selected from 18 rheumatology practices was audited. The proportion that initiated DMARD treatment within 6 months from symptom onset was estimated using Kaplan-Meier analysis. Time to each component of the care pathway was estimated. Multivariable modeling was used to determine predictors of early treatment using 12 preselected variables available in the clinical charts. Bootstrapping was used to validate the model. Results. Within 6 months from symptom onset, 41% (95% CI 36%−46%) of patients were treated with DMARD. The median time to treatment was 8.4 (interquartile range 3.8−24) months. Events preceding rheumatology referral accounted for 78.1% of the time to treatment. The most prominent predictor of increased time to treatment was a concomitant musculoskeletal condition, such as osteoarthritis or fibromyalgia. The significance of other variables was less consistent across the models investigated. Included variables accounted for 0.69 ± 0.03 of the variability in the model. Conclusion. Fewer than 50% of patients with RA are treated with DMARD within 6 months from symptom onset. Time to referral to rheumatology represents the greatest component delay to treatment. Concomitant musculoskeletal condition was the most prominent predictor of delayed initiation of DMARD. Implications of these and other findings warrant further investigation.