RA Patients Waiting for Drug Treatment

Rheumatoid arthritis patients may not be getting early DMARD treatment

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Even in the first few years of rheumatoid arthritis, your joints can become badly damaged. So doctors often put patients on strong drug treatment early in the course of disease.

Yet, less than half of rheumatoid arthritis patients were treated with DMARDs (drugs that treat the underlying cause of rheumatoid arthritis) within the 6 months after symptoms started.

"Start arthritis drug treatment early to prevent permanent joint damage."

Studies have shown that early treatment of rheumatoid arthritis can prevent permanent damage down the road. DMARDs, or disease-modifying anti-rheumatic drugs, are generally the first drug of choice for early treatment.

In their recent study, Ruben Tavares, MSc, MBt, of McMaster University in Canada, and colleagues wanted to see how many patients were put on DMARD treatment within 6 months of symptoms starting. They also wanted to see what factors affected the time it took for patients to be put on DMARD treatment.

The researchers found that 41 percent of patients (about 139 out of 339) were treated with DMARDs within the first 6 months of symptoms.

As a whole, patients started DMARD treatment anytime from 3.8 months to 24 months after symptoms started.

The biggest predictors of delayed time to treatment were other musculoskeletal conditions. That is, rheumatoid arthritis patients with other conditions like osteoarthritis or fibromyalgia were more likely to wait longer for DMARD treatment.

The main reason for delayed DMARD treatment was the time it took for patients to be referred to a rheumatology specialist. More specifically, 78.1 percent of the time between the start of symptoms and DMARD treatment was time waiting to be referred to a rheumatology specialist.

According to the study's authors, these findings call for more research on this topic.

If early DMARD treatment can prevent permanent damage, researchers should try to better understand why some patients do not get early treatment.

This study was supported by unrestricted educational grants from Amgen Canada Inc., Wyeth Pharmaceuticals and Schering Canada Inc.

Dr. Tavares received scholarship support from the Canadian Arthritis Network, Edward Dunlop Foundation Ontario Graduate Scholarship in Science and Technology and the University of Toronto Institute of Medical Science.

Study co-author Claire Bombardier, MD, holds a Pfizer Chair and a Canada Research Chair in Knowledge Transfer for Musculoskeletal Care.

The research was published August 15 in the Journal of Rheumatology.

Reviewed by: 
Review Date: 
August 24, 2012
Last Updated:
August 27, 2012