Canadian Variation by Province in Rheumatoid Arthritis Initiating Anti–Tumor Necrosis Factor Therapy: Results from the Optimization of Adalimumab Trial

Abstract

In Quebec, where access to anti-TNF is less restrictive, patients had lower SJC and TJC. ON used more DMARD, especially leflunomide, as mandated by the provincial government. Both provincial funding criteria and prescribing habits may contribute to differences. Canadian rheumatologists may vary in treatment decisions, but patients generally have similar DAS28 when initiating anti-TNF therapy.