Document Detail


Patient's ethnicity does not influence utilization of effective therapies in rheumatoid arthritis.
MedLine Citation:
PMID:  16652419     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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. CONCLUSION: 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.
Authors:
Dennis C Ang; Harold E Paulus; James S Louie
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  33     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-02     Completed Date:  2006-08-09     Revised Date:  2007-03-06    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  870-8     Citation Subset:  IM    
Affiliation:
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202-5100, USA. Dang@iupui.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
African Americans
Antirheumatic Agents / therapeutic use*
Arthritis, Rheumatoid / diagnosis,  drug therapy*,  ethnology*,  physiopathology
Ethnic Groups*
European Continental Ancestry Group
Female
Hispanic Americans
Humans
Insurance, Major Medical
Male
Middle Aged
Multivariate Analysis
Patient Care Management / statistics & numerical data*
Questionnaires
Time Factors
United States
Chemical
Reg. No./Substance:
0/Antirheumatic Agents
Comments/Corrections
Comment In:
J Rheumatol. 2007 Jan;34(1):233; author reply 233-4   [PMID:  17216694 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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