Allowing 2 visits for rheumatoid arthritis (RA) treatment acceleration was associated with an increase in care concordant with the recommendations of the American College of Rheumatology (ACR), a recent study found. Researchers identified a national cohort of biologic-naïve patients with RA with visits between December 2008 and February 2013. Treatment acceleration (initiation or dose escalation of biologic and nonbiologic disease-modifying antirheumatic drugs (DMARDs)) in response to moderate to high disease activity was assessed, using the Clinical Disease Activity Index. The study included 741 methotrexate (MTX) monotherapy and 995 multiple nonbiologic DMARD users cared for by 139 providers. In both groups, researchers compared the characteristics of patients who received care consistent with ACR recommendations with the characteristics of those who did not at the conclusion of 1 visit and over 2 visits. They found:

• Only 36.2% of MTX monotherapy users and 39.6% of multiple nonbiologic DMARD users received care consistent with the recommendations after 1 visit.

• Those percentages increased to 78.3% and 76.2%, respectively, after 2 visits.

• 25 to 30% achieved low disease activity by the second visit with DMARD acceleration.

• Increasing time since the ACR publication on RA treatment recommendations was not associated with improved adherence.

Citation: Harrold LR, Reed GW, Kremer JM, Curtis JR, et al. Identifying factors associated with concordance with the American College of Rheumatology rheumatoid arthritis treatment recommendations. [Published online ahead of print April 26, 2016]. Arthritis Res Ther. doi:10.1186/s13075-016-0992-3.