Prescription rheumatology practices among Mexican specialists.

Arch Med Res

Unit of Clinical Epidemiology, Hospital General Regional No. 1 Gabriel Mancera, Instituto Mexicano del Seguro Social, D. F., and Unidad de Posgrado, Universidad Autónoma del Estado de México, México.

Published: April 2007

AI Article Synopsis

  • This study evaluated prescription practices and disease control in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) treated by rheumatologists in Mexico, involving 1208 patients who filled out questionnaires on their health and treatment.
  • The results showed that a high percentage of RA and AS patients were prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying anti-rheumatic drugs (DMARDs), with many RA patients also taking combinations of these medications, particularly methotrexate.
  • The findings indicate that the treatment approaches used by Mexican rheumatologists align with international guidelines, emphasizing the use of DMARDs along with other drugs to manage these conditions effectively.

Article Abstract

Background: We undertook this study to describe prescription practices and the degree of disease control in a large sample of patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) treated by rheumatologists in Mexico.

Methods: Board-certified Mexican rheumatologists across the country were asked to assess consecutive RA and AS patients; 1208 patients completed a self-administered questionnaire with information on demographics, disease duration, co-morbidity, treatment, pain, disability and a validated Spanish version of instruments to measure physical function and quality of life.

Results: Of the 1096 RA patients, 88.1% were treated with nonsteroidal anti-inflammatory drugs (NSAIDs), 1020 (93.3%) with disease-modifying anti-rheumatic drugs (DMARDs), 365 (33.4%) with steroids, and 70 (6.4%) with biological agents. Their mean Health Assessment Questionnaire Disability Index (HAQ-Di) score was 1.21+/-0.80, Disease Activity Index, 28 joint count (DAS 28) 3.9+/-1.29, and Rheumatoid Arthritis Disease Activity Index (RADAI), 3.94+/-2.01. Regarding the 112 AS patients, 110 (98.2%) received NSAIDs, 90 (80.4%) were on DMARDs, 11 (9.8%) took steroids, and 11 (9.8%) received biological agents, their functional status shown as Bath Ankylosing Spondylitis Functional Index (BASFI) score of 4.4+/-2.5. Among the 1110 DMARD users, only 64 received one drug, and a great proportion used two or more DMARDs; 81 subjects (16.2%) were on biological agents, in any combination. RA patients more commonly used methotrexate, 791 (72%) cases, and hydroxychloroquine. Taking into account their diagnosis, the combination most prescribed was NSAIDs plus DMARDs in 660 subjects (54.7%).

Conclusions: DMARDs in combination with other drug are the most frequently prescribed therapeutic scheme for RA and AS patients. These schemes used for both conditions by Mexican rheumatologists are in line with current international recommendations.

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http://dx.doi.org/10.1016/j.arcmed.2006.11.008DOI Listing

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