title: Racial and ethnic disparities in disease activity in patients with rheumatoid arthritis.
abstract: 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.
authors.affiliation: New York University Hospital for Joint Diseases, New York, NY. Electronic address: jeffrey.greenberg@nyumc.org.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Greenberg
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Spruill
authors.forename: Ying
authors.initials: Y
authors.lastname: Shan
authors.forename: George
authors.initials: G
authors.lastname: Reed
authors.forename: Joel M
authors.initials: JM
authors.lastname: Kremer
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Potter
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yazici
authors.forename: Gbenga
authors.initials: G
authors.lastname: Ogedegbe
authors.forename: Leslie R
authors.initials: LR
authors.lastname: Harrold
mesh_terms: D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000208:ethnology* / Q000473:pathology*; D015331:Cohort Studies; D005006:Ethnicity; D054624:Health Status Disparities; D006801:Humans; D016017:Odds Ratio; D044469:Racial Groups; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Disease activity; Disparities; Rheumatoid arthritis