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Effects of antirheumatic drug underutilization on rheumatoid arthritis disease activity

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Abstract

Background

Following the recommended guidelines is crucial for achieving patient remission in rheumatoid arthritis. The aim of this study was to assess the effect of proper drug utilization of antirheumatic drugs on disease activity and drug safety in Jordan.

Methods

In a retrospective cross-sectional study, patient’s demographics, clinical variables, drug regimens and side effects were recorded and the 28-joint disease activity scores were calculated. Patients were stratified into high, moderate, low disease activity or remission group.

Results

Around 80% of patients were using methotrexate which was under-dosed in 82% of them. Only 25% were using biologic drugs. Surprisingly, only 10% of patients had low disease activity and only 4% were in a remission state. Anaemia (32.3%) and mild renal impairment (27.6%) were the most common side effects.

Conclusions

The low frequency of well-controlled disease activity is interpreted by high occurrence of methotrexate underdosing and biologic agent underprescription. Implementing the role of a clinical pharmacist could have a real impact on tight control of such disease issues in Jordan.

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Abbreviations

RA:

Rheumatoid arthritis

DMARDs:

Disease-modifying antirheumatic drugs

DAS28:

The 28-joint disease activity score

ACR:

American College of Rheumatology

EULAR:

European League Against Rheumatism

MTX:

Methotrexate

CRP:

C-reactive protein

SC:

Subcutaneous

TNF:

Tumour-necrosis factor

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Authors and Affiliations

  1. Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan

    Mohammad A. Y. Alqudah, Sayer Al-azzam, Karem Alzoubi, Mohammad Alkhatatbeh, Ola Alazzeh & Bayan Ababneh

  2. Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan

    Khaldoon Alawneh

Authors
  1. Mohammad A. Y. Alqudah
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  2. Sayer Al-azzam
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  3. Karem Alzoubi
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  4. Mohammad Alkhatatbeh
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  5. Khaldoon Alawneh
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  6. Ola Alazzeh
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  7. Bayan Ababneh
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Corresponding author

Correspondence to Mohammad A. Y. Alqudah.

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The authors have declared that no competing interests exist.

Funding

This work was supported by the Deanship of Research at Jordan University of Science and Technology. The contents of this publication are solely the responsibility of the authors and the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Alqudah, M.A.Y., Al-azzam, S., Alzoubi, K. et al. Effects of antirheumatic drug underutilization on rheumatoid arthritis disease activity. Inflammopharmacol 25, 431–438 (2017). https://doi.org/10.1007/s10787-017-0315-6

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  • DOI: https://doi.org/10.1007/s10787-017-0315-6

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