New data reveals ethnic disparities in early rheumatoid arthritis treatment

Research has found that Asian patients are half as likely to be prescribed anti-rheumatic drugs as opposed to White patients, and Asian women less likely to be prescribed than Asian and White men, revealing major inequalities in the treatment of arthritis patients.

In a study published in the Lancet Rheumatology, a team of researchers have found marked ethnic and age-related disparities in newly diagnosed rheumatoid arthritis patients being initiated on biologic and targeted synthetic anti-rheumatic drugs.

The team involved in the study was made up of academics from the University of Birmingham, King’s College London, Oxford University Hospitals NHS Foundation Trust, Great Western Hospital NHS Foundation Trust, and the British Society for Rheumatology.

While studying data from over 6,000 newly diagnosed patients, the team found several variances depending on the patients’ ethnic and age groups, including:

• Asian patients were 50% less likely to be prescribed biologic drugs than White patients
• Patients over 65 were 60% less likely to be given highly-effective biologic drugs for their symptoms than patients under 40
• Asian women were less likely to be prescribed biologic drugs than Asian men and White men (the reasons for which were unclear)
• Black individuals were more likely to be started on biologic drugs than White individuals (partly due to Black individuals in the dataset having increased disease severity).

Dr Kanta Kumar, Associate Professor at the University of Birmingham, said: “These findings highlight the urgent need for tailored information and equitable access to high-quality care for people from minority ethnic backgrounds. A shift away from the one-size-fits-all model is essential if we are to address these disparities and improve outcomes for all.”

Dr Kumar, who has spent almost two decades on the foundations of this research at the University of Birmingham, has worked closely with researchers from Kings College and the collaborating institutions to investigate these disparities.

Autoimmune musculoskeletal conditions significantly impair physical activity, functional capacity, and well-being, with early treatment being key to preventing joint damage and improving quality of life. Rheumatoid arthritis, the most prevalent chronic inflammatory rheumatic disease, affects approximately 5 in 1000 people globally, with symptoms such as joint pain, swelling, and fatigue leading to diminished physical and emotional well-being.

Each year, the quality of care for people with rheumatoid arthritis in England and Wales is benchmarked through a national audit. Researchers used data from the National Early Inflammatory Arthritis Audit to evaluate whether the use of biologic drugs varies by age, sex and ethnicity.