Publication:

Analysis of drug prescribing trends in treatment of rheumatoid arthritis at a tertiary care hospital, Karnataka, India

Background This study proposes compilation, analysis of pattern, trend, rationality and frequency of use of drugs in the treatment of rheumatoid arthritis with emphasis on available treatment regimens inclusive of primary and adjunctive therapy.

Methods The study records relevant data obtained from medical case records of patients suffering from RA above 15 years age excluding pregnancy and other arthritis, attending orthopedic OPD at KVGMC, Sullia (D.K), Karnataka, prospectively for a period of 15-18 months starting from December 2013 to June 2015.

Results 217 patients suffering from RA were analyzed and recorded. RA was more common among the age group of 45 to 50 with female predominance (64%). RF positivity was seen in 42% cases. Out of 11 classes of drugs prescribed DMARDs (249), corticosteroids (225) and analgesics (217) played major role in treatment outcome. Non-biological DMARDs (94%) were more commonly prescribed, of which methotrexate (120) & hydroxychloroquine (128) were frequently administered. Very few patients received biological DMARDs like etanercept and infliximab. Both oral and IV preparations of corticosteroids were administered. Among the adjuvant group of drugs NSAIDs (130), opioids (53), Muscle relaxants (33), pregabalin (26), sedative/hypnotics (102) nutritional supplements (214), anti-gastric (201), antiemetic’s (13), anti-histamines (4) were prescribed accordingly. Treatment outcome was assessed at the end of 15 months and 163 patients were relieved from symptoms but no remission but there was significant association between treatment outcome and duration of treatment with DMARDs.

Conclusions The treatment outcome and the duration of illness have significantly improved with rational use of DMARDs. Thus the study highlights and creates awareness on rational use of therapeutic agents available for treatment of RA and provides feedback to the prescriber.