Disease profile of rheumatoid arthritis and its complications in hispanic population
Original price was: $27.95.$2.99Current price is: $2.99.
- Title: Disease profile of rheumatoid arthritis and its complications in hispanic population
- Author: Anna Cawley, Shubhang Bhalla, Ryan Floresca, Luis Alvarado and Fatma Dihowm
- Publication: American Journal of the Medical Sciences
- Publisher: Elsevier Inc
- Year: 2023
- Language: English
- Pages: 8
- Format: PDF
- File size: 474 KB
- DOI: 10.1016/j.amjms.2022.12.029
- CBID: CBR136
Abstract
Background
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease that is associated with functional disability and reduced quality of life. The central pathology of RA is the inflammation of diarthrodial joints, but approximately 40% of patients experience extra-articular manifestations of RA. Extra-articular manifestations are complications of RA that constitute multisystem disorders, associated with genetic and environmental conditions, and increase mortality in RA patients. Observational studies of RA patients have suggested ethnic disparities exist for minority populations; however, less is known about the distribution and prevalence of RA complications and drug-related problems (DRPs). Our objective was to construct a disease profile of RA-related complications in the Hispanic Mexican-American population compared to the non-Hispanic population of El Paso, Texas.
Methods
A retrospective study was conducted in a Texas Tech University Health Science Center El Paso from 2009 to 2019 to assess the prevalence of RA-related complications in the Hispanic vs non-Hispanic population. The primary parameters were RA diagnosis, serological status, RA-treatment modalities, and history of associated complications. Data were extracted by chart review and correlated to disease-related and treatment-related complications. STATA was used to perform statistical analyses. A p-value of < 0.05 determined statistical significance.
Results
One thousand five hundred five (N=1505) patients, diagnosed with RA, were included in this study. Of the cohort, 82.52% of patients were females, 76.81% were Hispanic, and 64.12% had no smoking history. From the total cohort, seven hundred fifty-six (N=756) patients had documentation of serological markers (Rheumatoid factor (RF) and/or Anti-cyclic citrullinated peptide (Anti-CCP)); 78.44% of patients whose serological status was documented, were positive for RF and/or Anti-CCP. Multivariate regression analysis revealed Hispanics have 15% and 17% less risk of overall RA complications and drug-related side-effects, respectively, compared to non-Hispanics (p-value <0.0001). However, within the entire cohort, those with a family history of RA had a 44% more risk of complications compared to those without family history (p-value <0.0001). Additionally, modifiable risk factors, i.e., active smoking and alcohol use had a higher complication risk, 19% and 21%, respectively (p-value <0.0001). Significantly, all patients seropositive for RF, and/or anti-CCP had a lower prevalence of RA-related and drug-related complications. However, non-Hispanic patients seropositive for RF or anti-CCP had a higher prevalence of specific complications of RA and DRPs compared to Hispanic patients.
Conclusion
In our retrospective review, analysis of sociodemographic characteristics reveals that Hispanic patients paradoxically have less risk of disease-related and treatment-related complications compared to non-Hispanic populations in El Paso, Texas. Genetic predisposition, modifiable environment/lifestyle factors had a higher prevalence of RA complications, congruent with established studies. Further analysis reveals that seropositive RA-patients have decreased complication prevalence compared to seronegative cohorts.
Introduction
Rheumatoid Arthritis (RA) is a chronic, systemic autoimmune disease associated with long-term adverse outcomes.
The central pathology of RA involves the symmetrical inflammation of the synovium of diarthrodial joints; however, extra-articular RA manifestations, also known as multisystem disorder complications of RA, i.e. cardiovascular (pericarditis), respiratory (Caplan syndrome), and small vasculitis are frequent (18 to 41%) and are associated with increased morbidity and mortality. Multiple genetic and environmental factors are associated with increased risk for RA and disease sequela. , Of these, the strongest associations have been seen with female sex, individuals with comorbid conditions, smoking history, low socioeconomic status (SES), and family history. Autoantibodies play a critical role in the pathogenesis of RA. Rheumatoid factor (RF), IgM autoantibody to the Fc component of IgG, and IgG anti-cyclic citrullinated peptide (anti-CCP) are prognostic serological autoantibodies in RA patients. Approximately 70-80% of RA patients are ‘seropositive’ for autoantibodies. Seropositive patients have more pronounced joint destruction and a higher prevalence of RA complications than seronegative patients. Current literature suggests that higher titers of RF increase the incidence of rheumatoid nodules, vasculitis, and pleuropulmonary complications. , Anti-CCP seropositive patients show evidence of atherosclerotic damage and more active disease sequelae than seronegative patients. RA affects approximately 0.6% to 1% of the US adult population. While RA has been noted in all ethnic groups, conflicting evidence has emerged regarding whether RA-associated ethnic disparities in clinical outcomes exist. Some evidence shows that minority populations, i.e. Hispanic and African American, have worse functional outcomes than non-minority groups. However, other studies have shown that Hispanics have equal or lower mortality rates (among specific pathologies) compared to non-Hispanic populations, despite lower SES and higher rates of other co-morbidities. Thus, the extent to which RA ethnic disparities persist in minority populations has yet to be fully examined. Furthermore, little data exists regarding ethnic disparities in the development of RA complications and pattern of disease according to serological status. , , , Most studies of RA complications have typically examined homogenous patient populations.
Thus, accurately understanding the epidemiology of RA by RA complications and serological phenotype may provide insights into the pathophysiology of RA and implications for the course of disease management.
This study aims to examine a multiethnic cohort of patients with RA to determine the prevalence and manifestations of RA complications between different ethnic groups and to identify specific RA complications and DRPs differing between the Hispanic Mexican-American population and non-Hispanic populations in El Paso, Texas.
Be the first to review “Disease profile of rheumatoid arthritis and its complications in hispanic population”
Related products
Reviews
There are no reviews yet.