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Abstract Number: 2369

Treatment Patterns with Disease Modifying Anti-rheumatic Drugs in United States Veterans with Newly Diagnosed Rheumatoid Arthritis, Psoriatic Arthritis, or Ankylosing Spondylitis

Rebecca Overbury1, Shaobo Pei 2, Gopi Penmetsa 3, Brian Sauer 2, Vikas Patil 2, Jodi Walker 4, Jerry Clewell 4, Kevin Douglas 4, Daniel Clegg 5, Grant Cannon 6, Ahmad Halwani 7 and Jessica Walsh 8, 1Assisstant Professor, University of Utah, Salt Lake City, UT, 2Division of Epidemiology, Department of Internal Medicine, Salt Lake City Veteran Affairs and University of Utah Medical Centers, Salt Lake City, UT, 3Gopi K. Penmetsa, MD, Division of Rheumatology, Department of Internal Medicine, Salt Lake City Veteran Affairs and University of Utah Medical Centers, Salt Lake City, UT, 4AbbVie Inc., Salt Lake City, UT, 5University of Utah, Salt Lake City, UT, 6Salt Lake City VA Medical Center and Univeristy of Utah, Salt Lake City, UT, 7Division of Hematology, Department of Internal Medicine, Salt Lake City Veteran Affairs and University of Utah Medical Centers, Salt Lake City, UT, 8Division of Rheumatology, University of Utah, Salt Lake City, UT

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: DMARDs, Early Rheumatoid Arthritis, inflammatory arthritis, psoriatic arthritis and ankylosing spondylitis (AS)

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Session Information

Date: Tuesday, November 12, 2019

Title: RA – Treatments Poster III: Safety and Outcomes

Session Type: Poster Session (Tuesday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Delays in treatment for inflammatory arthritis (IA) are associated with unfavorable outcomes, including impaired quality of life, irreversible joint damage, and disability. Our objective of this study was to characterize treatment initiation patterns in Veterans with newly diagnosed rheumatoid arthritis (RA), psoriatic arthritis (PsA) or ankylosing spondylitis (AS).

Methods: International Classification of Diseases codes and natural language processing were used to identify incident cases of RA, PsA, or AS, between January 1, 2007 and December 31, 2015, in patients enrolled in the Veteran Health Administration. Patterns of treatment initiation and non-treatment with disease modifying anti-rheumatic drugs (DMARDs) were assessed in the 12-month follow-up period after the incident diagnosis (Figure 1). Confidence intervals were used to statistically evaluate differences between comparison groups.

Results: The population consisted of 12,118 IA patients (9,711 RA, 1,472 PsA, 935 AS), with 91.3% males and a mean age of 63.7 (Table 1). The percentage of Veterans treated with ≥1 DMARD during the 12-month follow-up period increased from 48.8% in 2007 to 66.4% in 2015. Amongst Veterans diagnosed with IA in 2015, DMARD treatment was more common for PsA patients (72.9%) and RA patients (68.6%) than AS patients (28.9%). The mean time to the initial DMARD after diagnosis did not change over the observation period (35.5 days for RA, 43.9 days for PsA, 59.5 days for AS). In Veterans diagnosed with IA in 2015, a DMARD was dispensed ≤30 days after diagnosis in 45.8%, 31-90 days in 10.1%, and 91- 365 days for 10.5%; the remaining 33.6% were not treated with a DMARD within the 365-day follow-up period (Figure 2). Rheumatology specialty care was accessed by 87.4% of Veterans treated with a non-biologic DMARD and 92.2% treated with a biologic DMARD, in patients diagnosed in 2015.

Conclusion: DMARD treatment rates during the initial 12 months after diagnosis increased between 2007 and 2015, but non-treatment remained common, particularly in Veterans with AS. Time to treatment after the initial IA diagnosis did not change throughout the study period, and DMARDs were dispensed within 30 days of diagnosis for most Veterans who were treated within the 1-year follow-up period. DMARD treatment was uncommon in patients without rheumatology specialty care.


Disclosure: R. Overbury, None; S. Pei, None; G. Penmetsa, None; B. Sauer, None; V. Patil, None; J. Walker, None; J. Clewell, None; K. Douglas, None; D. Clegg, None; G. Cannon, Amgen, 2; A. Halwani, BMS, 2, KHK, 2, Seattle Genetics, 2, Roche-Genentech, 2, Miragen, 2, Immunedesign, 2, Takeda, 2, Amgen, 2, Pharmacyclics, 2, Abbvie, 2; J. Walsh, AbbVie, 2, 5, ABBVIE, NOVARTIS, LILLY, AMGEN, UCB, 5, Amgen, 2, 5, Janssen Research & Development, LLC, 2, Lilly, 2, 5, Novartis, 2, 5, Pfizer, 2, 5, PFIZER, ABBVIE, 2, UCB, 5.

To cite this abstract in AMA style:

Overbury R, Pei S, Penmetsa G, Sauer B, Patil V, Walker J, Clewell J, Douglas K, Clegg D, Cannon G, Halwani A, Walsh J. Treatment Patterns with Disease Modifying Anti-rheumatic Drugs in United States Veterans with Newly Diagnosed Rheumatoid Arthritis, Psoriatic Arthritis, or Ankylosing Spondylitis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/treatment-patterns-with-disease-modifying-anti-rheumatic-drugs-in-united-states-veterans-with-newly-diagnosed-rheumatoid-arthritis-psoriatic-arthritis-or-ankylosing-spondylitis/. Accessed .
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