Race Differences in Rheumatoid Arthritis Treatment
African Americans are more wary of the risks of rheumatoid arthritis (RA) treatment and whites are optimistic about their benefits, according to research funded in part by the Arthritis Foundation.
Research shows that African Americans and white Americans differ in their healthcare utilization. However, the reasons behind this difference are not apparent. To help clarify this observation, scientists at Yale University in New Haven, Conn., asked people with RA to complete a computer survey to examine how they make trade-offs between specific risks and benefits of RA treatments. The respondents evaluated the following 10 attributes: chance of remission, symptom improvement, radiographic progression, route of administration, injection reaction, nausea, lung or liver injury, tuberculosis, neurological disease and theoretical risk of cancer.
The research team found that African American study participants were most influenced by the risk of cancer, whereas white participants were most influenced by the likelihood of remission and slowing of radiographic progression.
“African American patients attach greater importance to the risks of toxicity and less importance to the likelihood of benefit than white patients,” said Liana Fraenkel, MD, MPH, lead scientist and Arthritis Foundation grant recipient. “Effective risk communication and improved understanding of expected benefits may help decrease unwanted variability in the care of RA.”
Constantinescu F. Understanding why RA treatment preferences differ by race. Abstract presented at American College of Rheumatology Annual Scientific Meeting. San Francisco, October 25-29, 2008.