ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 881

Association of Comorbidities with DAS28 Disease Status and Remission in Race/Ethnic Groups with Rheumatoid Arthritis

Sharon Dowell1, Rodolfo Perez-Alamino2, Christopher J. Swearingen3, Gail S. Kerr4 and Yusuf Yazici5, 1Internal Medicine, Howard University, Washington, DC, 2Rheumatology Department, Hospital de Clínicas Pte. Dr. Nicolás Avellaneda, Tucumán, Argentina, 3Department of Medicine, Division of Rheumatology, New York University School of Medicine, New York, NY, 4Rheumatology, Washington DC VAMC and Georgetown and Howard University, Washington, DC, 5New York University School of Medicine, New York, NY

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Biologics, Comorbidity, race/ethnicity, remission and rheumatoid arthritis (RA)

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Sunday, October 21, 2018

Title: 3S086 ACR Abstract: RA–DX, Manifestations, & Outcomes I: Other Co-Morbidities (880–885)

Session Type: ACR Concurrent Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose: Racial/ethnic disparities in comorbidity (CM) in rheumatoid arthritis (RA) may confound treatment and outcomes. Rheumatic Disease Comorbidity Index (RDCI) is a validated tool predicting disability and mortality in RA patients. We evaluated the association between RDCI and clinical outcomes within racial/ethnic subsets of RA patients

Methods: Patients enrolled in the Ethnic Minority RA Consortium (EMRAC), with at least one follow-up (FU) visit were analysed. RDCI was compiled from enrolment data. Clinical outcomes: tender joint count (TJC), swollen joint count (SJC), RAPID3 and DAS28; medication use (recorded and aggregated as prednisone methotrexate, other DMARD, and biologic use), were recorded. Analysis of variance or chi-square tests were used to estimate enrolment differences between racial/ethnic groups. Generalized estimating equations and mixed model regression accounting for repeated measurements were used to estimate any differences between racial/ethnic groups during FU, and explore associations of RDCI on clinical outcomes and remission (DAS28<2.6), adjusting for enrolment age, gender, education, race/ethnicity and medication use.

Results: 1066 subjects with 3719 FU visits over 58 weeks were evaluated.  Racial/ethnic disparities were seen in formal education, RAPID3, DAS28, TJC, SJC as well as CM. Additionally, racial/ethnic disparities were seen in length of FU and medication use (Table). Increased RDCI scores were significantly associated with increased enrolment RAPID3 (P=0.022) and DAS28 (P<0.001), adjusting for age, education, gender and race/ethnicity. Enrolment DAS28 was also significantly higher in Blacks (0.49, 95% CI [0.21, 0.78], P=0.001) and Hispanics (0.70, 95% CI [0.37, 1.03], P=0.001) compared to Whites. While increased RDCI significantly reduced improvement in both RAPID3 (P<0.001) and DAS28 (P<0.001), RDCI was not significantly associated with reducing odds of DAS28 remission. Blacks, however, were significantly less likely to have DAS28 remission than all other race groups (Figure). Additionally, biologic use increased odds of DAS28 remission (OR=1.53, 95% CI [1.01, 2.33], P=0.45), but was less with advanced age (OR=0.80, 95% CI [0.68, 0.95], P=0.009).

Conclusion: CM was associated with higher disease activity regardless of race/ethnicity or medication, with black patients having more CM and less odds of remission.  Early access to care for management of comorbidities and disease in Black RA patients is necessary to improve outcomes

.


Table. Enrolment and Follow-up Data by Racial / Ethnicity Groups

White

Black

Hispanic

Other

Total

P

N

380

258

161

267

1066

Enrolment

Age (years)

55.53 (15.62)

56.66 (14.45)

54.48 (13.48)

54.01 (16.32)

55.27 (15.23)

0.214

Education (years)

15.07 (3.12)

13.42 (3.22)

12.61 (4.44)

15.23 (3.47)

14.25 (3.59)

<0.001

Female [N(%)]

296 (78.1%)

213 (82.6%)

129 (80.1%)

221 (86.0%)

859 (81.4%)

0.082

Tender Joints [0-28]

1.05 (3.62)

2.51 (5.02)

2.32 (4.91)

0.50 (2.37)

1.46 (4.06)

<0.001

Swollen Joints [0-28]

0.49 (2.04)

2.00 (3.82)

1.68 (3.85)

0.33 (1.76)

1.00 (2.92)

<0.001

RAPID3 [0-30]

11.33 (7.21)

13.07 (7.10)

12.68 (7.65)

10.83 (7.50)

11.95 (7.34)

<0.001

DAS28 [0-10]

2.32 (1.28)

3.11 (1.26)

3.09 (1.52)

2.41 (1.16)

2.28 (1.10)

<0.001

RDCI > 0 [N(%)]

95 (25.0%)

116 (45.0%)

48 (29.8%)

63 (23.6%)

322 (30.2%)

<0.001

Follow-up*

Number of Visits

1368

1033

514

804

3719

Length (weeks)

49.34 (46.59)

84.57 (71.77)

43.07 (46.58)

48.04 (50.25)

57.98 (57.87)

<0.001

Change RAPID3

1.54 (6.56)

0.71 (6.23)

2.37 (6.51)

1.06 (7.12)

1.29 (6.54)

<0.001

Change DAS28

0.34 (1.18)

0.03 (1.09)

0.80 (1.18)

0.37 (1.09)

0.34 (1.09)

<0.001

Prednisone Use [N(%)]

312 (22.8%)

216 (20.9%)

187 (36.4%)

225 (28.0%)

940 (25.3%)

0.030

Methotrexate Use [N(%)]

641 (46.9%)

342 (33.1%)

254 (49.4%)

456 (56.7%)

1693 (45.5%)

<0.001

Other DMARD Use [N(%)]

298 (21.8%)

213 (20.6%)

135 (26.3%)

215 (26.7%)

861 (23.2%)

<0.001

Biologic Use [N(%)]

572 (41.8%)

188 (18.2%)

136 (26.5%)

265 (33.0%)

1161 (31.2%)

<0.001

*All follow-up visit differences between racial/ethnic groups were estimated using generalized estimating equations.


Disclosure: S. Dowell, BMS, 2,Pfizer, Inc., 2,Genetech, 2,Horizon Pharma, 8,BMS, 2,Genetech, 2; R. Perez-Alamino, None; C. J. Swearingen, None; G. S. Kerr, Novartis, 2; Y. Yazici, Celgene Corporation, 2.

To cite this abstract in AMA style:

Dowell S, Perez-Alamino R, Swearingen CJ, Kerr GS, Yazici Y. Association of Comorbidities with DAS28 Disease Status and Remission in Race/Ethnic Groups with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/association-of-comorbidities-with-das28-disease-status-and-remission-in-race-ethnic-groups-with-rheumatoid-arthritis/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-of-comorbidities-with-das28-disease-status-and-remission-in-race-ethnic-groups-with-rheumatoid-arthritis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology