(HealthDay News) — Patients with rheumatoid arthritis (RA) rarely use triple therapy (methotrexate, sulfasalazine, and hydroxychloroquine), according to a study published in the July issue of Arthritis & Rheumatology.

Jeffrey A. Sparks, M.D., from Brigham and Women’s Hospital in Boston, and colleagues used U.S. insurance claims data to examine use of triple therapy among patients with RA in 2009 to 2014. The frequency of intensification to triple therapy or a biologic disease-modifying antirheumatic drug (DMARD) and rates of intensification per six-month time period were evaluated. Factors associated with use of triple therapy were identified.

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Data were included for 24,576 patients (78 percent female). The researchers found that treatment was intensified to biologic DMARDs in 11.1 percent of patients and to triple therapy in 0.7 percent of patients during the study period. Across calendar years there was no significant change in triple therapy use. Patients whose treatment was intensified to triple therapy were more likely to receive glucocorticoids and nonsteroidal anti-inflammatory drugs (hazard ratios, 1.91 and 1.48, respectively). Factors significantly associated with triple therapy use included older age, U.S. region (highest odds for use in West and lowest in Northeast), glucocorticoid use, and lower number of outpatient visits.

“Despite reports published during the study period suggesting equivalent efficacy of triple therapy and biologic DMARDs for RA, the use of triple therapy was infrequent and did not increase over time in this large nationwide study,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry, including CVS Health, which provided funding for the study.

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