Blacks with rheumatoid arthritis are only half as likely to be prescribed more effective drugs that may prevent further joint damage and disability, according to a new study published in the journal Arthritis Care & Research.
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For the study, researchers surveyed 5,385 rheumatoid arthritis Medicaid patients between ages 50 and 70 in California who were being treated with at least one anti-rheumatic drug between 1998 and 2005. Scientists reviewed participants’ records to identify any differences in the way patients from different racial and ethnic groups were being prescribed anti-arthritis medication, despite similar income level and arthritis severity.
In addition, researchers determined if patients were prescribed the more potent, biologic disease-modifying anti-rheumatic drugs (DMARDs), or the less powerful standard DMARDs.
Study findings revealed only 9 percent of African-American patients (compared with 16 percent of white patients) were prescribed the more powerful biologic DMARDs, marketed as Enbrel and Humira. What’s more, 20 percent of Latino patients were prescribed biologics, but this group typically had more severe joint pain and inactivity than whites.
Why were doctors less likely to prescribe the stronger anti-arthritis drugs to black patients? Well, researchers point to several possible reasons: African-American patients may lack access to specialists well versed in rheumatoid arthritis management; ethnic and cultural beliefs may stop minorities from immediately seeking care; black people know few in their community who take biologic DMARDs; and doctors may be unaware of how severe the arthritis is in certain people.
“If cultural beliefs inhibit a [rheumatoid arthritis] patient from seeking care immediately, the window of opportunity for treatment may be lost,” said Aniket A. Kawatkar, PhD, a researcher at the Southern California Permanente Medical Group in Pasadena.
Researchers also emphasized that, ideally, a rheumatologist would assess each person’s condition and then prescribe the appropriate med.