Health Disparities in DMARD Use in RA Save

A UK study shows biological and targeted synthetic DMARD (b/tsDMARDs) use in newly diagnosed rheumatoid arthritis (RA) varies markedly by ethnicity, age and setting - "one-size-fits-all approach" does not apply. 

 

Data derived from the National Early Inflammatory Arthritis Audit (NEIAA) included all RA patients (2018-2022) who had 12-month follow-up data available.  They sought to identify factors associated with the initiation of b/tsDMARDs.

 

Amongst 6098 RA patients (mean age 59 years; 64% women; 14% Non-White), 508 (8.3%) started b/tsDMARDs within 12 months.  b/tsDMARD initiators were more likely to be under age 40 years. Compared to Whites, Asians were less likely to receive b/tsDMARDS (OR 0·52; 0·36–0·76), regardless of socioeconomic status, comorbidities, baseline disease severity, and the initial response to csDMARDs. These differences were evident for Asian women but not Asian men. 

 

Conversely, Black patients were more likely to be initiated on b/tsDMARDs than Whites(1·54 [1·10–2·16]; p=0·012), which became non-significant after adjusting for baseline disease severity and autoantibody status.

 

Underserved patient groups may require more consideration in formulating an RA treatment plan, otherwise health disparities in care will be evident.