In an analysis of California Medicaid data, use of newer rheumatoid arthritis (RA) drugs known as biologic disease-modifying antirheumatic drugs was more common among white and Hispanic RA patients than among black RA patients. These results were published in Arthritis Care & Research.
Rheumatoid arthritis affects an estimated 1.3 million adults in the United States. Important advances have been made in the management of RA, and use of more effective drugs earlier in the course of RA has improved outcomes for many patients.
Treatment of RA often begins with methotrexate or another standard disease-modifying antirheumatic drug (DMARD). If this initial treatment does not adequately control the RA, patients may move on to treatment with a newer and more potent type of drug known as a biologic DMARD. These drugs include Remicade® (infliximab), Humira® (adalimumab), Cimzia® (certolizumab), Simponi® (golimumab), Enbrel® (etanercept), Actemra® (tocilizumab), Kineret® (anakinra), Orencia® (abatacept), and Rituxan® (rituximab).
To explore whether use of biologics varies by race, researchers evaluated information about RA patients enrolled in California’s Medicaid program. The study was limited to people who had sought care for RA: all of the people had a diagnosis of RA and had received at least one prescription for a DMARD. Information was available about more than 5,300 patients.
In the analysis, the researchers accounted for factors such as age, gender, and other health conditions.
- Compared with white patients, black patients were 53% less likely to receive a biologic DMARD. Hispanic patients, in contrast, were 36% more likely than white patients to receive a biologic DMARD.
Given the importance of optimal RA management to long-term health, it will be important to better understand and address the reasons for this variability in treatment. In the current study, treatment varied by race in spite of patients having similar economic status and healthcare benefits.
Reference: Chu LH, Portugal C, Kawatkar AA, Stohl W, Nichol MB. Racial/ethnic differences in receiving biologic DMARD treatment among California Medicaid rheumatoid arthritis patients. Arthritis Care & Research. Early online publication July 17, 2012.