Abstract
[Purpose] To determine the changes that have occurred over a 10-year period in the medical care of rheumatoid arthritis (RA) performed by orthopedic surgeons at outpatient clinic in the Osaka Prefecture.
[Methods] An anonymous questionnaire on the medical care of RA, mainly regarding drug therapy, was administered three times (in 2003, 2008, and 2013) among members of the Osaka Clinical Orthopedic Association. The responses received from the mail-back survey were tallied and recorded.
[Results] The collection rates for each survey were 34.7% (139/401) in 2003, 31.7% (145/459) in 2008, and 24.5% (115/469) in 2013. With regard to therapeutic drugs for treating RA, the use of methotrexate (MTX) increased as a first-line agent, salazosulfapyridine (SASP) tended to increase as a second-line agent, and steroid use decreased.
In addition, the induction rate of biopharmaceutical agents and the use of combination therapy with disease-modifying antirheumatic drugs (DMARDs) increased.
[Conclusion] From 2003–2013, bio agents have been launched one after another, and some clinics aggressively prescribe them. The rate of using subcutaneous injections was particularly high, and as a result of these changes in RA treatment, the relationship between hospitals/clinics and foundation hospitals and/or collagen disease specialists has been promoted. DMARDs include MTX, SASP, bucillamine, and tacrolimus, and the treatment cost has dramatically increased, resulting in an increased rate of concomitant use of each DMARD.
