Racial and Ethnic Disparities in Disease Activity in Patients with Rheumatoid Arthritis - 19/11/13
, Tanya M. Spruill, PhD b, Ying Shan, MD, MPH c, George Reed, PhD c, Joel M. Kremer, MD d, Jeffrey Potter, MD a, Yusuf Yazici, MD a, Gbenga Ogedegbe, MD, MPH, MS b, Leslie R. Harrold, MD, MPH cAbstract |
Background |
Observational studies of patients with rheumatoid arthritis have suggested that racial and ethnic disparities exist for minority populations. We compared disease activity and clinical outcomes across racial and ethnic groups using data from a large, contemporary US registry.
Methods |
We analyzed data from 2 time periods (2005-2007 and 2010-2012). The Clinical Disease Activity Index was examined as both a continuous measure and a dichotomous measure of disease activity states. Outcomes were compared in a series of cross-sectional and longitudinal multivariable regression models.
Results |
For 2005-2007, significant differences of mean disease activity level (P < .001) were observed across racial and ethnic groups. Over the 5-year period, modest improvements in disease activity were observed across all groups, including whites (3.7; 95% confidence interval [CI], 3.2-4.1) compared with African Americans (4.3; 95% CI, 2.7-5.8) and Hispanics (2.7; 95% CI, 1.2-4.3). For 2010-2012, significant differences of mean disease activity level persisted (P < .046) across racial and ethnic groups, ranging from 11.6 (95% CI, 10.4-12.8) in Hispanics to 10.7 (95% CI, 9.6-11.7) in whites. Remission rates remained significantly different across racial/ethnic groups across all models for 2010-2012, ranging from 22.7 (95% CI, 19.5-25.8) in African Americans to 27.4 (95% CI, 24.9-29.8) in whites.
Conclusions |
Despite improvements in disease activity across racial and ethnic groups over a 5-year period, disparities persist in disease activity and clinical outcomes for minority groups versus white patients.
Le texte complet de cet article est disponible en PDF.Keywords : Disease activity, Disparities, Rheumatoid arthritis
Plan
| Funding: JDG was supported by grants from the National Institutes of Health (NIH)/National Institute of Arthritis and Musculoskeletal and Skin Diseases (K23 AR054412) and the NIH/National Center for Research Resources (5UL1RR029893). LRH has received support from the NIH (AR053856). |
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| Conflict of Interest: The Consortium of Rheumatology Researchers of North America (CORRONA) registry has received financial support unrelated to this study from Abbott, Amgen, AstraZeneca, Eli Lilly, Genentech, Pfizer, UCB, and Vertex. JDG receives consulting fees from AstraZeneca, CORRONA, Novartis, and Pfizer, and is a shareholder in CORRONA. YS, GR, and LRH have research contracts with CORRONA through the University of Massachusetts. JMK is an employee and stockholder of CORRONA; receives consulting fees from Amgen, Abbott, Genetech, and Pfizer; and has research grants from Bristol-Myers Squibb, Genentech, Pfizer, UCB, and HGS. YY has received consulting fees from Abbott, BMS, Celgene, Genentech, Merck, Pfizer, Horizon, and UCB, and research support from BMS, Celgene, Janssen (Centocor), and Genentech. |
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| Authorship: All authors had access to the data and played a role in writing this manuscript. |
Vol 126 - N° 12
P. 1089-1098 - décembre 2013 Retour au numéro
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