Faculty, Staff and Student Publications
Publication Date
6-1-2024
Journal
Arthritis Care & Research
DOI
10.1002/acr.25306
PMID
38268474
PMCID
PMC11328146
PubMedCentral® Posted Date
6-1-2025
PubMedCentral® Full Text Version
Author MSS
Abstract
Objective: Biologic disease-modifying antirheumatic drugs (bDMARDs) are immunosuppressants, and there have been concerns that they might impact tumor immunity in patients with cancer with rheumatoid arthritis (RA). The purpose of this study was to describe the utilization trends of bDMARD in patients with RA after breast cancer (BC) diagnosis.
Methods: We performed a retrospective cohort study of adults with RA and BC (2008 onward) from Optum's de-identified Clinformatics® Data Mart Database (CDM); the Surveillance, Epidemiology, and End Results Program (SEER) Medicare; and the Texas Cancer Registry (TCR) Medicare databases. We evaluated bDMARD utilization trends during the first three years after BC. We conducted multivariable logistic regression to evaluate the association of utilization with patient characteristics.
Results: A total 1,412 patients were identified in CDM and 1,439 patients in SEER/TCR-Medicare. During the three months before BC diagnosis, 28.2% (CDM) and 26.9% (SEER/TCR-Medicare) patients had received bDMARDs. Within the first three years after diagnosis, 24.1% (CDM) and 26.4% (SEER/TCR-Medicare) were receiving bDMARDs. About 70% of the patients in the two cohorts received glucocorticoids with no significant time trend increases. The largest predictor of bDMARD utilization was prior use before BC (CDM: odds ratio [OR] 27.15, 95% confidence interval [CI] 19.29-38.19; SEER/TCR: OR 18.98, 95% CI 13.72-26.26). Regional and distant BC compared to in situ or localized were also associated with lower bDMARDs utilization in SEER/TCR-Medicare (OR 0.54, 95% CI 0.36-0.82; OR 0.31, 95% CI 0.13-0.77, respectively).
Conclusion: The utilization of tumor necrosis factor inhibitors and other bDMARDs in patients with RA and recent BC has not increased since 2008. Glucocorticoids utilization remained high. The largest predictor of bDMARD utilization was prior use before BC.
Keywords
Humans, Arthritis, Rheumatoid, Female, Retrospective Studies, Breast Neoplasms, Aged, Antirheumatic Agents, Middle Aged, United States, Biological Products, SEER Program, Medicare, Aged, 80 and over, Databases, Factual
Published Open-Access
yes
Recommended Citation
Ruiz, Juan I; Lei, Xiudong; Wu, Chi-Fang; et al., "Utilization of Biologic Disease-Modifying Antirheumatic Therapy in Patients With Rheumatoid Arthritis and Recently Diagnosed Breast Cancer" (2024). Faculty, Staff and Student Publications. 4444.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/4444
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