A retrospective cohort study: 10-year trend of disease-modifying antirheumatic drugs and biological agents use in patients with rheumatoid arthritis at Veteran Affairs Medical Centers

Objectives To evaluate the trends in patterns of disease-modifying antirheumatic drugs (DMARDs) and biological agents use from 1999 to 2009 and to identify patient characteristics associated with different patterns of their use in a national sample of Veterans with rheumatoid arthritis (RA). Design A retrospective cohort study. Settings Administrative databases of the USA Department of Veterans Affairs. Participants An incident cohort of 13 254 patients with newly diagnosed RA was identified. Primary outcome measures Trends and choice of DMARDs and biological agents’ usage, and time intervals between RA diagnosis and treatment Results Methotrexate use as first-line agent increased from 39.9% to 57.2% over the study period (p