Drug Prescribing Trends in Adults with Rheumatoid Arthritis

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Drug Prescribing Trends in Adults with Rheumatoid Arthritis

The use of prescribed drugs has been steadily on the rise around the world, especially in Europe, UK, Canada and USA. According to the World Health Organization (WHO), the pharmaceutical market will grow by at least $100 billion USD or from 300 to 400 billion a year market in just next three years. However, 85% of the global market will be in Europe, Japan, North and South America.

Although limited data is available of the persons suffering from rheumatoid arthritis (RA), it is well known that these patients often take several drugs to relieve the symptoms and treat co-morbid conditions. For example, patients with RA are known to suffer the higher rates of cardiovascular disease, infections, depression and fibromyalgia than the general population.

Zamora-Legoff, J.A., et al conducted a study to examine the drug prescription trend for patients with RA over the recent years and compare them with non-RA peers. Data from retrospective prescription was examined from 2005 to 2014 in a population based incidence cohort of patients with RA and comparable non-RA peers.

The study included 497 RA (71% female) and 527 non-RA subjects (70% female). Drugs for treatment or related to the treatment of RA were excluded. Comparisons between cohorts of percentages of patients with at least one prescription in a specific drug category class were performed using Poisson regression models adjusted for age and sex. Overall, percentage of participants who were prescribed at least one drug over the 10-year period was higher among the RA compared to non-RA group (relative risk [RR], 1.04; 95 % confidence interval [CI], 0.99, 1.08).  At the end of the study, both RA and non-RA groups showed significant increases in the percentages of patients with at least one prescription.

Therefore, it can be concluded that drugs were more common among RA than non-RA groups. Drugs included gastro-intestinal drugs, antimicrobials, calcium metabolism modifiers, thyroid hormone replacement therapy, tricyclic antidepressants, anti-asthma/inhaled corticosteroids, proton pump inhibitors, contraceptives, anti-hypertensive and some others. Less commonly prescribed drugs in RA than non-RA included statins and other antilipemic drugs. Excluding drug prescriptions specifically for treatment of RA, there was a marked overall increase in prescription for drugs indicated for both RA and non-RA cohorts over the study period.

In drugs prescribed specifically or directly for the treatment of RA, a marked  increase in prescriptions for both RA and non-RA cohorts was reported. The overall prescriptions for cardiovascular, ophthalmic and CNS drug categories were similar among the RA and non-RA subjects with some different prescribing patterns among cohorts. Although patients with RA are at higher risk for cardiovascular events, they were consistently prescribed less statins and non-statin antilipemic than non-RA comparators. However, the patients who were suffering from RA were prescribed more proton pump inhibitors which may be associated with significant adverse effects over the long-term use.

It was also observed that prescription patterns could be a useful indicator to understand the burden of the diseases and gaps in the knowledge about the medical needs of RA patients. 

Clinical Rheumatology
Exploratory, Rheumatoid arthritis, Statins, Antilipemic drugs, Comparative study
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