10.1016/0967-0653(96)80119-0

Vollständiger Abstract

Worum geht es in dieser Arbeit?

<h4>Background</h4>Despite guideline recommendations, long-term glucocorticoid (GC) use is common in rheumatoid arthritis (RA). We conducted a clinician survey nested within a large registry to identify patient and clinician factors associated with GC use.<h4>Methods</h4>Clinicians contributing patients to the CorEvitas Rheumatoid Arthritis registry were surveyed between 2023 and 2024, capturing demographics, medication safety concerns, and a range of other attitudes. We then identified patients with RA initiating a new biologic or Janus kinase inhibitor. Patient factors associated with GC use 6 months after treatment initiation were assessed with a mixed effects logistic regression model. Similar models assessed clinician factors associated with GC use at 6 months, adjusting for patient factors.<h4>Results</h4>Among 256 active clinicians, 92 (36%) responded to the survey of which 81 had 3966 qualifying patients, while 164 non-responders had 3196 qualifying patients. Higher disease activity, age ≤45 or >75, longer disease duration, more previous biologics/janus kinase inhibitor (JAKi), lung disease, and earlier calendar year were associated with greater GC use at 6 months. Clinicians with less concern about prednisone ≤5mg/day were more likely to prescribe GCs at 6 months [adjusted OR 1.98 (1.17-3.36)], but similar or stronger associations were seen for clinicians with less concern about biologics [aOR 2.47 (1.33-4.49)] or JAKi [aOR 2.35 (1.31-4.22)].<h4>Conclusion</h4>Lower clinician concerns about glucocorticoid, biologic, and JAKi safety were associated with greater GC prescribing, suggesting that broad attitudes towards prioritizing treatment benefits vs risks (rather than just specific GC concerns) may drive GC prescribing, with important implications for clinician education.

Abstract: PubMed · Datensatz