King's College London

The study, published today in The Lancet Rheumatology by researchers from the Faculty of Life Sciences & Medicine, looked at data from more than 6000 patients who had been newly diagnosed with rheumatoid arthritis in the National Early Inflammatory Arthritis Audit in England and Wales.

The researchers also found patients over 65 were 60% less likely to be given highly-effective biologic drugs to treat symptoms than patients under 40. Asian women were less likely to be prescribed biologic drugs than Asian men and White men, and differences were not explained by socioeconomic status, the presence of other health conditions, or the response to conventional treatments.

Rheumatoid arthritis affects half a million people in the UK and develops when the body’s immune system attacks itself, causing joint pain, swelling and significant disability. There is no cure. However, biologic drugs which are expensive, are effective at controlling symptoms and preventing irreversible damage. They work by blocking specific parts of the immune system involved in inflammation, can relieve symptoms and prevent irreversible damage. In the UK, biologics can be started when the symptoms of rheumatoid arthritis have not responded adequately to conventional drugs.

Each year, the quality of care for people with rheumatoid arthritis in England and Wales is benchmarked through a national audit. Researchers used data from the National Early Inflammatory Arthritis Audit to evaluate whether the use of biologic drugs varies by age, sex and ethnicity.

The study found that Black individuals were more likely to be started on biologic drugs than White individuals, which was at least partly explained by worse disease severity at diagnosis in Black individuals.

He added: “Access to these drugs in England and Wales is defined by need. Despite this, we found that Asian women and older adults were far less likely to be initiated on these treatments. Biologics are incredibly effective at improving quality of life and preventing complications from rheumatoid arthritis. It is therefore crucial to develop a better understanding of what underlies these disparities if we are to ensure all patient groups receive equitable access to the best available care.”