Prescription Rheumatology Practices Among Mexican Specialists

• Published in: Archives of medical research Vol. 38; no. 3; pp. 354 - 359
• Main Authors: Goycochea-Robles, María Victoria, Arce-Salinas, César Alejandro, Guzmán-Vázquez, Silvia, Cardiel-Ríos, Mario H
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2007
• Subjects: Adult; Ankylosing spondylitis; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - drug therapy; Cross-Sectional Studies; Disability Evaluation; Disease-modifying anti-rheumatic drugs; Drug Prescriptions; Drug therapy; Drug Therapy, Combination; Drug Utilization; Female; Humans; Internal Medicine; Mexico; Middle Aged; Physicians; Practice Patterns, Physicians; Quality of Life; Rheumatoid arthritis; Rheumatology; Severity of Illness Index; Spondylitis, Ankylosing - drug therapy; Surveys and Questionnaires; Mexico; Disease-modifying anti-rheumatic drugs; Drug therapy; Rheumatoid arthritis; Ankylosing spondylitis; Quality of life
• ISSN: 0188-4409; 1873-5487
• DOI: 10.1016/j.arcmed.2006.11.008

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.