Arthritis symptoms worse in African Americans

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African Americans with Rheumatoid Arthritis report more severe disease and more disability than whites with the disease, a new study shows.

“Clinicians have to recognize that the severity of disease with rheumatoid arthritis in our culture in 2005 tends to be worse in African Americans. First of all we need to recognize that, and second we need to think about what we can do to improve that,” Dr. Richard Brasington of the Washington University School of Medicine in St. Louis, the study’s lead author.

Given the lower scores on a self sufficiency test among African American study participants compared with whites, Brasington and his colleagues note, strategies to improve physical function, such as the Arthritis Foundation’s Arthritis Self Help Course, could be particularly beneficial for these patients.

Studies have shown that disease activity in patients with lupus and Scleroderma is more severe in African Americans, the researches note in their report, published in the Journal of Rheumatology. To investigate whether race might play a role in rheumatoid arthritis severity, they looked at 100 outpatients with the disease. Thirty-three of the study participants were African-American and the rest were Caucasian.

The average Health Assessment Questionnaire score for the African Americans was 1.5, compared to 0.9 for the Caucasians. Mean Disease Activity Scores were 5.5 for blacks and 4.3 for whites. And pain perception scores and number of tender joints were nearly double for blacks compared with whites.

The study also found African Americans had more other illnesses than whites did, were less likely to be taking, or to have taken, disease-modifying antirheumatic drugs, and had significantly lower self-sufficiency scores.

After adjusting the data for the possible effects of socioeconomic factors, the researchers found that race was no longer independently associated with Rheumatoid Arthritis disease severity.

“The Arthritis Self Help Course is a well-established tool for improving the outcome of people with arthritis—it’s something that doctors probably don’t emphasize enough because we tend to think about medications and surgery,” Brasington said.

“We may be able to make a bigger effort to encourage people to engage in this self-help type of activity, which in arthritis has been shown to be effective.”

SOURCE: Journal of Rheumatology, April 2005.

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