Older adults with rheumatoid arthritis (RA) are undermedicated with disease-modifying antirheumatic drugs (DMARDs), according to a study published in ACR Open Rheumatology. Jiha Lee, MD, and colleagues examined patterns and trends of DMARD use by provider specialty in ambulatory visits by older adults (aged 65 and older) seen by rheumatologists or primary care providers (PCPs) for a diagnosis of RA. During 12 years, 518 observations were identified, representing 7.8 million ambulatory RA visits by older adults; 74% were with rheumatologists. 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 rheumatologist and PCP visits, respectively, had two or more DMARDs. After adjustment for patient characteristics, nonDMARD polypharmacy, and multimorbidity, no statistical difference was noted in the trend of any or conventional synthetic DMARD use at visits by provider specialty during the 12-year study. For rheumatologist versus PCP visits, biologic DMARD use was more likely to increase incrementally.
