Racial and ethnic differences in medication use among beneficiaries of social security disability insurance with rheumatoid arthritis

Navarro‐Millán, Iris; Rajan, Mangala; Lui, Geyanne; Kern, Lisa M.; Pinheiro, Laura C.; Safford, Monika M.; Sattui, Sebastian E.; Curtis, Jeffrey R.

doi:10.1016/j.semarthrit.2020.07.008

Cited by 15 publications

(11 citation statements)

References 36 publications

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“…Since inner-city areas would naturally be grouped in the same county as more wealthy areas in most cities, potential lack of access would be averaged out and not seen in this analysis. For example, previous literature assessed that amongst Social Security Disability Insurance beneficiaries, bDMARD use was lower among Black Americans than white Americans [ 30 ]. Given the county-level grouping utilized by this study, Black Americans were identified to have significantly higher populations in hotspots versus coldspots.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Access Disparities to Biologic Disease-Modifying Antirheumatic Drugs in Rural and Urban Communities

Peterman¹,

Vashi²,

Govan³

et al. 2022

Cureus

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The American College of Rheumatology guidelines provides a strong recommendation for the use of biologic disease-modifying antirheumatic drugs (bDMARDs) when conventional rheumatoid arthritis treatments fail to meet treatment targets. Although bDMARDs are an effective and important treatment component, access inequalities remain a challenge in many communities worldwide. The purpose of this analysis is to assess nationwide trends in bDMARD access in the United States, with a specific focus on rural and urban access gaps. This study combined multiple county-level databases to assess bDMARD prescriptions from 2015 to 2019. Using geospatial analysis and the Moran's I statistic, counties were classified according to prescription levels to assess for hotspots and coldspots. Analysis of variance (ANOVA) was used to compare significant counties across 49 socioeconomic variables of interest. The analysis identified statistically significant hotspot and coldspot prescription clusters within the United States. Coldspot (Low-Low) clusters with low access to bDMARDs are located predominantly in the rural west North Central region, extending down to Oklahoma and Arkansas. Hotspot (High-High) clusters are seen in urban and metro areas of Wisconsin,

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Section: Discussionmentioning

confidence: 99%

Evaluation of Access Disparities to Biologic Disease-Modifying Antirheumatic Drugs in Rural and Urban Communities

Peterman¹,

Vashi²,

Govan³

et al. 2022

Cureus

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“…Chronic opioids are prescribed to 17% to 67% of US patients with RA. The highest recent estimate is from a study of Social Security Disability Insurance beneficiaries less than 65 years of age (Table 1) [6 ▪ –8 ▪ ,9 ▪▪ ,10–14]. A cross-sectional study of the National Ambulatory Medical Care Survey examining data from 2011 to 2016 showed that one-fourth of US office visits for RA involved an opioid prescription; opioid prescribing for outpatient RA visits increased from 15% to 34% ( P < 0.0001) over the time frame; and primary care physicians were the most common prescribers [6 ▪ ].…”

Section: Rheumatoid Arthritismentioning

confidence: 99%

“…Disability has also been associated with long-term opioid use in multiple studies [7 ▪ ,8 ▪ ,14]. Baker and colleagues [8 ▪ ] reported results from the FORWARD databank between 1999 and 2019 showing that obese RA patients had greater comorbidities, pain, and disability.…”

Section: Rheumatoid Arthritismentioning

confidence: 99%

Review of publications evaluating opioid use in patients with inflammatory rheumatic disease

Anastasiou

Yazdany

2022

Current Opinion in Rheumatology

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Purpose of reviewThis article discusses publications assessing the prevalence, efficacy, and safety of opioid analgesics in patients with rheumatic diseases, including rheumatoid arthritis, systemic lupus erythematosus, psoriatic arthritis, ankylosing spondylitis, and systemic sclerosis. Recent findingsRecent studies show long-term opioid use is common in patients with inflammatory rheumatic disease. We did not find any studies demonstrating improved function or pain control with long-term opioid use in people with rheumatic diseases. Some data shows potential adverse effects including increased risk for fractures and opioid poisoning hospitalizations. There is evidence demonstrating an association of opioid use with mental health disorders, fibromyalgia, obesity, and disability, although causative links have not been established. Only minimal reductions in opioid use were observed after initiation of biologic disease modifying antirheumatic drugs (DMARDs). Studies have shown delayed DMARD initiation and reduced DMARD use in patients on opioids, raising concerns that these analgesics may delay care or initially mask symptoms of active disease.

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“…[2][3][4] Racial/ ethnic minority groups, like African American or Hispanic, may suffer from higher disease activities and worse global health scores and experience more pain. [2][3][4][5] To make it worse, race and ethnicity remain significant predictors of the quality of health care received. 6 The minority groups tend to wait longer before disease-modifying anti-rheumatic drug therapy starts.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of race/ethnicity in trials leading to anti‐rheumatic drug approval for inflammatory arthritis by the US Food and Drug Administration

Xie,

Liu,

Qin

et al. 2023

Int J of Rheum Dis

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ObjectivePresenting the racial/ethnic representation in clinical trials leading to new approvals of inflammatory arthritis (IA) by the US Food and Drug Administration (FDA) to determine the extent of racial/ethnic disparities.MethodsPivotal trials supporting the approval of new indications from July 2012 to June 2022 were collected from Drugs@FDA, the FDA‐approved drugs database. More details were then identified by searching Pubmed and the National Institutes of Health trials registry. General characteristics of the approved drugs and demographic data for each pivotal trial, especially the race/ethnicity data, were collected. The enrollment profiles of each race/ethnicity were analyzed and then compared with the 2020 US census data.ResultsFrom 2012 to 2022, 34 new approvals were identified based on 59 clinical trials. The Black was consistently underrepresented in all subtypes of IA and drugs, while the White was overrepresented compared to the 2020 US census data.For Asian and Hispanic participants, these pivotal trials presented relatively heterogeneities in enrollments. As for the trends over time, increased involvements of White were still observed in rheumatoid arthritis (RA), psoriatic arthritis, and spondyloarthritis, while increased involvements of Black and decreased enrollments of Asian and Hispanic were only observed in RA.ConclusionsDespite many efforts to eliminate racial/ethnic disparities, the Black was consistently underrepresented in pivotal clinical trials compared to the 2020 US national race/ethnicity distribution data. The White was consistently overrepresented, and the Hispanic presented heterogeneous results. No evident time trend was observed.

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Racial and ethnic differences in medication use among beneficiaries of social security disability insurance with rheumatoid arthritis

Cited by 15 publications

References 36 publications

Evaluation of Access Disparities to Biologic Disease-Modifying Antirheumatic Drugs in Rural and Urban Communities

Evaluation of Access Disparities to Biologic Disease-Modifying Antirheumatic Drugs in Rural and Urban Communities

Review of publications evaluating opioid use in patients with inflammatory rheumatic disease

Characteristics of race/ethnicity in trials leading to anti‐rheumatic drug approval for inflammatory arthritis by the US Food and Drug Administration

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