Rheumatologists’ Disease-modifying Antirheumatic Drug Preferences for Rheumatoid Arthritis: Results from a Survey in Nigeria

Abstract

BACKGROUND: There are regional differences in rheumatoid arthritis (RA) disease-modifying antirheumatic drug (DMARD) use and availability. These stem from factors and peculiarities in population characteristics and socioeconomic indices. There is no published literature on the DMARD preferences or prescription patterns in Nigeria. The aim of this study was to document the prescription pattern of DMARD in Nigeria as well as factors affecting the choice of DMARD among Nigerian rheumatologists and establish a documentary evidence of what the real-life prescription pattern is in a low-middle income country for the treatment of RA. METHODS: Online survey using pretested structured questionnaire inputted on the SurveyMonkey App and its link sent to and answers received from practicing Nigeria consultant rheumatologists. Analysis of data was done using data exported to SPSS. RESULTS: A total of 26 (63.4%) responses from consultant rheumatologists in Nigeria were received. Most participants (84.62% [22]) had their place of practice at a teaching hospital. The initial choice of DMARD monotherapy was methotrexate (MTX) (88.5%), followed by sulphasalazine (11.5%). Cost of medications, need for rapid disease control, and presence of joint erosions were the most common reasons that influenced rheumatologists' choice of DMARDs. Prescription rate of biologic DMARDs (bDMARDs) was low. CONCLUSION: MTX remains the DMARD of first choice for RA among Nigerian rheumatologists. Conventional synthetic DMARDs are the commonly available, widely used, and still effective armamentarium for RA in resource-poor settings like Nigeria. bDMARDs prescription rate for RA remains low in Nigeria.