Patient's ethnicity does not influence utilization of effective therapies in rheumatoid arthritis.
OBJECTIVE
Biological agents have revolutionized the treatment of rheumatoid arthritis (RA). Given the previously documented ethnic disparity in the health service literature, we sought to determine if ethnic difference exists in the lag time between the diagnosis of RA and use of first biological agent.


METHODS
RADIUS 1 and 2 are observational studies designed to document how rheumatologists treat RA across the United States. The sample analyzed here included early patients with RA who entered RADIUS with the initiation of the first biological agent. Ethnic status was categorized as White (W), African American (AA), and Hispanic (H). Lag time (months from RA diagnosis to initiation of the first biological agent) was the principal outcome variable.


RESULTS
Compared to W (n=1616), AA (n=147) and H (n=116) were more likely to be female, younger, and have less than a high school education. Despite similar swollen and tender joint counts, AA and H had more active disease on the basis of Health Assessment Questionnaire and patient global assessments. Almost 97% of patients had some type of insurance coverage. On multivariable analysis, ethnic affiliation was not associated with lag time (14.5 months W vs 14.9 AA vs 14.3 H; p=NS). Similarly, there were also no significant ethnic differences in time to first DMARD (e.g., methotrexate) initiation.


CONCLUSIONS
In a national sample of patients with RA, most of whom were insured, the length of time from diagnosis of RA to initiation of the first biological agent was not significantly different among Whites, African Americans, and Hispanics.
Ang
Dennis C
DC
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202-5100, USA. Dang@iupui.edu
Paulus
Harold E
HE
Louie
James S
JS
D000328:Adult; D001741:Black or African American; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology* / Q000503:physiopathology; D005006:Ethnicity; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007354:Insurance, Major Medical; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010346:Patient Care Management / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D044465:White People
D018501:Antirheumatic Agents