(001) Advancements in Rheumatoid Arthritis Management: An Analysis of Clinical Features and Treatment Outcomes in a Brazilian Cohort

Background: Rheumatoid arthritis (RA) is an inflammatory and systemic condition that affects around 1% of the adult population. The use of anti-inflammatories and synthetic disease-modifying antirheumatic drugs (DMARDs) is part of the first-line treatment. In Brazil, target-specific DMARDs, both biological and synthetic, are available in the public health system for individuals without disease control.

Objectives: This study aimed to describe the clinical characteristics, treatments employed, and therapeutic response of patients diagnosed with RA using target-specific DMARDs through the Brazilian Unified Health System (SUS).

Methods: Through a cohort study spanning from 2018 to 2023, 773 individuals with RA using target-specific DMARDs were monitored in Minas Gerais, Brazil, through SUS. Clinical data were collected through administrative processes associated with the request for a target-specific DMARD.

Results: A total of 773 individuals diagnosed with RA were monitored, with an average age of 58 years, of whom 85.1% (658) were female, and 32.9% self-identified as White. Approximately 97.2% (751) reported the presence of symmetrical polyarthritis, and 92.4% (714) reported experiencing morning stiffness. Rheumatoid factor was positive in 61.4% (475) of individuals. Regarding the treatment preceding the use of a target-specific DMARD, 97.4% of individuals used methotrexate, 77.2% leflunomide, 40.5% hydroxychloroquine, and 33.8% had previously used non-steroidal anti-inflammatories. Therapeutic failure and adverse reactions were the primary reasons for choosing a target-specific DMARD. Disease activity was measured using DAS28, with an average value of 5.81 points. Tofacitinib was the most prescribed among the target-specific DMARDs at 22.3% (172), followed by biological DMARDs golimumab at 21.1% (163), and adalimumab at 18.5% (145). Methotrexate was the most chosen synthetic DMARD as a combination therapy, followed by leflunomide.

Conclusions: In Brazil, RA treatment has undergone significant advancement. The availability of target-specific DMARDs in SUS may instill hope for disease regression and an improvement in the quality of life for these individuals. The use of administrative data proves to be a valuable tool for analyzing the clinical profile and medication usage within the public health system.