Table 1.
Baseline characteristics of the cohort by DMARD use
| Variable | n (%) | ||||
|---|---|---|---|---|---|
| TNF-α inhibitorsa | Methotrexate | Hydroxychloroquine | Other non-biologic DMARDsa |
||
| Total patients | 1010 (5.89) | 7941 (46.32) | 6130 (35.75) | 2064 (12.04) | |
| Female | 703 (69.60) | 5810 (73.16) | 5153 (84.06) | 1387 (67.20) | |
| Age (mean±SD) | 45.08 ± 13.71 | 47.81 ± 12.08 | 45.45 ± 12.12 | 45.29 ± 12.07 | |
| Follow-up days (mean±SD) | 471.22 ± 455.57 | 290.9 ± 333.24 | 284.05 ± 326.17 | 218.7 ± 263.42 | |
| Cardiovascular risk factors and comorbidities | |||||
| Hypertension | 190 (18.81) | 1760 (22.16) | 1311 (21.39) | 418 (20.25) | |
| Obesity | 29 (2.87) | 389 (4.9) | 269 (4.39) | 87 (4.22) | |
| Diabetes | 62 (6.14) | 449 (5.65) | 318 (5.19) | 109 (5.28) | |
| Smoking | 74 (7.33) | 793 (9.99) | 637 (10.39) | 232 (11.24) | |
| Comorbidity scoreb (mean±SD) | 0.32 ± 0.94 | 0.23 ± 0.89 | 0.34 ± 1.01 | 0.38 ± 1.15 | |
| Cardiovascular drug use | |||||
| ACE inhibitors | 49 (4.85) | 586 (7.38) | 418 (6.82) | 145 (7.03) | |
| ARBs | 32 (3.17) | 342 (4.31) | 285 (4.65) | 80 (3.88) | |
| Beta blockers | 48 (4.75) | 568 (7.15) | 450 (7.34) | 152 (7.36) | |
| Calcium channel blockers | 43 (4.26) | 456 (5.74) | 389 (6.35) | 113 (5.47) | |
| Diuretics | 70 (6.93) | 977 (12.3) | 709 (11.57) | 213 (10.32) | |
| Pain medications | |||||
| COX-2 inhibitors | 107 (10.59) | 1022 (12.87) | 718 (11.71) | 296 (14.34) | |
| Nonselective NSAIDs | 420 (41.58) | 4686 (59.01) | 3394 (55.37) | 1204 (58.33) | |
| Steroids | 431 (42.67) | 4529 (57.03) | 3068 (50.05) | 1130 (54.75) | |
| Cumulative steroid dose in milligramsc (mean±SD) | 1025.13 ± 1360 | 725.01 ± 1251 | 584.84 ± 706.76 | 775.79 ± 1104 | |
| Healthcare use in prior year | |||||
| Hospitalization | 143 (14.16) | 993 (12.50) | 774 (12.63) | 305 (14.78) | |
| Emergency room visit | 186 (18.42) | 1801 (22.68) | 1344 (21.93) | 471 (22.82) | |
| Number of distinct prescriptions filled (mean±SD) | 6.43 ± 5.82 | 7.39 ± 5.41 | 8.22 ± 6.07 | 8.26 ± 6.22 | |
| Number of physician visits (mean±SD) | 9.03 ± 7.81 | 8.43 ± 6.11 | 9.58 ± 6.73 | 9.87 ± 7.5 | |
| Laboratory data | |||||
| CRP tests ordered | 548 (54.25) | 4548 (57.27) | 3622 (59.08) | 1216 (58.91) | |
| CRP test results available (% of tests ordered) | 169 (30.83) | 1214 (26.69) | 957 (26.42) | 305 (25.08) | |
| CRP levels (% of results available) | |||||
| Low (<1 mg/L) | 34 (20.11) | 245 (20.18) | 291 (30.40) | 70 (22.95) | |
| Moderate (1–3 mg/L) | 37 (21.89) | 233 (19.19) | 229 (23.93) | 68 (22.29) | |
| High (>3 mg/L) | 98 (58.00) | 736 (60.62) | 437 (45.67) | 167 (54.76) | |
Abbreviations: ACE- Angiotensin converting enzyme, ARB- Angiotensin receptor bloockers, COX- Cyclo oxygenase, DMARDs- Disease modifying anti-rheumatic drugs, CRP- C-reactive protein, NSAIDS- non steroidal anti-inflammatory drugs, SD- standard deviation, TNF- Tumor necrosis factor
TNF-α inhibitors include adalimumab, certolizumab, etanercept, infliximab, and golimumab. Other non-biologic DMARDs include auranofin, injectable gold, penicillamine, sulfasalazine, minocycline, azathioprine, leflunomide, cyclophosphamide, and cyclosporine.
This score was computed after weighting 20 comorbid conditions and can range from −2 to 26. The range observed in our cohort was −2 to 14.
Cumulative dose measured among patients who used any steroid in the 365-day baseline period.