Factors associated with biological and targeted synthetic disease-modifying antirheumatic drug initiation for rheumatoid arthritis in underserved patient groups in England and Wales, UK: a national cohort study
Authors' conclusion
The initiation of biological and targeted synthetic DMARDs for patients with newly diagnosed rheumatoid arthritis varies markedly by ethnicity and age in the universal health-care system of England and Wales.
Study context
- Population
- Patients with newly diagnosed RA enrolled in National Early Inflammatory Arthritis Audit (NEIAA), England and Wales, May 8, 2018–April 30, 2022, with 12-month follow-up (mean age 59.2 years [SD 14.9]; 64.2% women)3,912 women · 2,186 men
- Participants
- 6,098 patients
- Exposure
- Factors associated with b/tsDMARD initiation
- Whiten = 5,215reference
- Blackn = 152
- Asiann = 478
- Mixed or othern = 202
- Outcome
- Initiation of b/tsDMARDs within 12 months of initial rheumatology assessment
- Follow-up
- 12 months
Methodological detailsnational, modified Poisson regression, People with lived experience of RA contributed to study design and interpretation of findings
- National
- Modified Poisson regression
- People with lived experience of RA contributed to study design and interpretation of findings
Main finding
As reported in the abstract
Initiation of b/tsDMARDs within 12 months
Multivariable-adjusted RR (95% CI)P value
<40 yearsvs >65 years
2.41(1.83–3.19)
P < 0.0001Asianvs Whitepersisted after adjustment for socioeconomic status, comorbidities, baseline disease severity and initial response to csDMARDs; evident for Asian women but not Asian men
0.52(0.36–0.76)
P = 0.0007Blackvs Whitebecame non-significant after adjusting for baseline disease severity and autoantibody status
1.54(1.10–2.16)
P = 0.012- Overall b/tsDMARD initiation within 12 months
- 508 (8.3%) of 6098
Observational data: associations, not effects.
Original publication
Factors associated with biological and targeted synthetic disease-modifying antirheumatic drug initiation for rheumatoid arthritis in underserved patient groups in England and Wales, UK: a national cohort study. Lancet Rheumatol. Published 16 October 2024. doi:10.
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