HealthDay News — Older adults with rheumatoid arthritis (RA) are undermedicated with disease-modifying antirheumatic drugs (DMARDs), according to a study published in the April issue of ACR Open Rheumatology.

Jiha Lee, MD, from the University of Michigan in Ann Arbor, and colleagues examined patterns and trends of DMARD use by provider specialty in ambulatory visits by older adults (aged 65 years or older) seen by rheumatologists or primary care providers (PCPs) for a diagnosis of RA. Over 12 years, 518 observations were identified, representing 7,873,246 ambulatory RA visits by older adults; 74% were with rheumatologists.

The researchers found that any DMARD use was recorded at 56 and 30% of rheumatologist and PCP visits, respectively. Among visits with any DMARD use, 20 and 6% of rheumatologists and PCP visits, respectively, had 2 or more DMARDs. After adjustment for patient characteristics, non-DMARD polypharmacy, and multimorbidity, there was no statistical difference noted in the trend of any or conventional synthetic DMARD use at visits by provider specialty during the 12-year study period. For rheumatologist vs PCP visits, biologic DMARD use was more likely to increase incrementally.

“Prescribing for older adults is challenging because polypharmacy and multimorbidity are common, and this population is more prone to the negative effects of disease-modifying drugs,” Lee said in a statement. “However, we should be cautious older adults do not experience more pain and deformities that really limit their functioning because of undertreatment.”

Abstract/Full Text