title: [Medical treatment of rheumatoid arthritis in 2014 : Current data from the German Collaborative Arthritis Centers].
abstract: BACKGROUND
  Since the introduction of biologic treatment in rheumatoid arthritis (RA), disease activity and treatment modalities have changed substantially. The current provision and developments in recent years are analyzed with annual data from the National Database of the Collaborative Arthritis Centers in Germany.
  
  
  METHODS
  To analyze disease activity, diagnostics and treatment in RA patients in 2014 with regard to seropositivity and disease duration. Time trends from 2007-2014 are reported for disease activity (DAS28) distribution and biologic treatment.
  
  
  RESULTS
  In 2014, a total of 8,084 RA patients were analyzed: 72 % were rheumatoid factor and/or ACPA positive, the mean age was 62 years and the mean disease duration 12 years. According to DAS28, 35.9 % were in remission, 19.2 % had low, 37.1 % moderate and 7.8 % high disease activity. An increase since 2007 was only observed in patients with a disease duration >2 years. Synthetic DMARDS were used for treatment in 78 %. Biologic treatment increased from 16 % (2007) to 27 % (2014). Especially those patients with a disease duration >5 years were treated more frequently with biologics. Seronegative patients had slightly less severe mean disease activity parameters. They were treated equally frequent with DMARDS but only half as often with biologics compared to seropositive patients.
  
  
  CONCLUSIONS
  The use of biologics in RA patients has increased since 2007; however this was not observed in patients with short disease duration. Early intensive treatment adaption seems justified to improve disease activity in the large portion of patients who do not reach low disease activity under conventional DMARDs.
authors.affiliation: Deutsches Rheuma Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. albrecht@drfz.de.
authors.forename: K
authors.initials: K
authors.lastname: Albrecht
authors.affiliation: Deutsches Rheuma Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Huscher
authors.affiliation: Klinik für Innere Medizin III, Rheumatologie & Osteologie, Universitätsklinikum Jena, Jena, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Eidner
authors.affiliation: Rheumatologische Schwerpunktpraxis, Praxisgemeinschaft Rheumatologie - Nephrologie, Erlangen, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Kleinert
authors.affiliation: Rheumapraxis, München, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Späthling-Mestekemper
authors.affiliation: Deutsches Rheuma Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Bischoff
authors.affiliation: Deutsches Rheuma Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Zink
mesh_terms: D017677:Age Distribution; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D001688:Biological Products / Q000627:therapeutic use*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D012217:Rheumatoid Factor / Q000097:blood*; D012720:Severity of Illness Index; D017678:Sex Distribution; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D012217:Rheumatoid Factor
keywords: Biologics; Diagnostics; Disease activity; Rheumatoid arthritis; Vaccination