Rheumatoid arthritis trials often fail to report health inequalities

August 29, 2022

2 minute read


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According to data published in Arthritis Care & To research.

“We know that rheumatoid arthritis affects people from different backgrounds and with different life circumstances,” Megan Thomas, MSc, a doctoral student at the University of British Columbia, and Mary DeVera, PhD, an associate professor at the University of British Columbia and researcher at Arthritis Research Canada, told Healio in a joint statement. “Given the importance of research to inform rheumatoid arthritis care, we investigated whether the diversity seen in real-world clinical settings was reflected in research settings.”

According to the data, randomized controlled trials of RA in Canada often fail to report on the determinants of health inequity among their participants.

To examine how health equity factors are reported in randomized clinical trials of RA interventions in Canada, Thomas, De Vera and colleagues conducted a scoping review. The researchers included English-language randomized controlled trials evaluating interventions for patients with RA conducted in Canada and published between 1990 and 2021. Studies were retrieved from the MEDLINE, Embase and CENTRAL databases.

Each potential study was manually reviewed in two stages. The first stage assessed the title and abstract, followed by a review of the full text. The authors indicated that they paid particular attention to the PROGRESS-Plus factors reported in the text. These factors included place of residence, race, culture, ethnicity, language, occupation, sex, gender, religion, education, socioeconomic status, social capital, characteristics associated with discrimination, relationship characteristics, and time-dependent relationships.

The search yielded 6,290 unique records, 42 of which could be included in the analysis. Participants in these studies were mostly “middle-aged,” female, and Caucasian, the authors wrote. Overall, sex and age were the most widely reported factors, appearing in 41 studies. Race was reported in 15 articles, education in 11 articles, socioeconomic status in seven studies and occupation in six studies, according to the researchers. Religion, relationship characteristics, and time-dependent relationships were not reported in any of the included studies.

“Although many rheumatologists recognize that a patient’s life circumstances play an important role in their health outcomes, patient characteristics are often not represented in Canadian rheumatoid arthritis RCTs, so this should be taken into account. consider carefully when making care recommendations,” Thomas and De Vera said. “There is still work to be done, but this was a first step in documenting how equity factors are currently reported for RCTs in patients with rheumatoid arthritis in Canada.

“We are currently conducting similar scoping reviews for other types of inflammatory arthritis, because the representation of different conditions is important in rheumatology research,” they added. “Ultimately, this work will guide our approach to rheumatology research to ensure representation and diversity.”

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