Date of Conferral

2021

Degree

Ph.D.

School

Public Health

Advisor

Gudeta Fufaa

Abstract

Rheumatoid arthritis (RA) is an autoimmune condition that causes chronic joint pain and destruction. The current standard regimen of monotherapy disease modifying anti-rheumatic drug (DMARD) treatments may not be as effective as that of combination therapy of a DMARD and a biologic agent in treating RA. The purpose of this study was to answer the question, is there a difference in the therapeutic efficacy of combination DMARD treatments with a biologic, compared to monotherapy DMARDs without a biologic, in U.S. Caucasian women between the ages of 30 and 60 that have been diagnosed with RA? Guided by the theoretical framework of integrated theory from evidence-based practices, this study used a cross sectional study design and data from AR-PoWER Patient Powered Research Network. Having adjusted for age, logistic regression was used to examine the association between the therapeutic effectiveness and treatment modality (DMARDs without a biological agent versus DMARDs with a biologic agent; OR = 1.15, 95% CI = 0.57-2.33). The result indicated that there was no significant association between treatment effectiveness and treatment modality. A positive social change implication of this finding is that the assessment of the efficacy of DMARDs with or without a biologic agent may warrant further investigation in which studies with large sample sizes that include various populations are used. In this study, there was no difference between the monotherapy and combination therapy treatments for Caucasian women aged 30 to 60 years. However, a future study with a larger sample size that compares diverse populations may produce a different outcome.

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