ACR Open Rheumatology最新文献

{"title":"Real-World Evidence Assessing Psoriatic Arthritis by Disease Domain: An Evaluation of the CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry.","authors":"Philip J Mease,&nbsp;Jacqueline O'Brien,&nbsp;Nicole Middaugh,&nbsp;Gregory Kricorian,&nbsp;Scott Stryker,&nbsp;David H Collier,&nbsp;Alexis Ogdie","doi":"10.1002/acr2.11556","DOIUrl":"https://doi.org/10.1002/acr2.11556","url":null,"abstract":"<p><strong>Objective: </strong>Real-world studies assessing treatment response by psoriatic arthritis (PsA) domains are limited. This study aimed to describe the patient characteristics, frequency and combinations of disease domains, disease activity, and patient-reported outcomes (PROs) by PsA domains in patients who initiated treatment with a tumor necrosis factor inhibitor (TNFi) or interleukin-17 inhibitor (IL-17i).</p><p><strong>Methods: </strong>Adults with PsA who initiated treatment with a TNFi or an IL-17i between January 2013 and January 2021 and had a 6 (±3)-month follow-up were included. The prevalence of PsA domains, the most common domain combinations, treatment persistence, and unadjusted change in disease activity and PROs from baseline to 6 months for each PsA domain were summarized descriptively.</p><p><strong>Results: </strong>Of the 1005 eligible patients, 63% were receiving TNFi and 37% were receiving IL-17i. Forty percent of TNFi and 14% of IL-17i initiators received these treatments as first-line therapy. Peripheral arthritis and skin disease were the most common PsA domains identified in 86% and 82% of patients, respectively, and the triad of peripheral arthritis, skin disease, and nail psoriasis was the most common domain combination observed in 14% of patients. More than two thirds (68%) of patients remained on therapy at 6 months' follow-up. Improvements in disease activity and PROs were observed across all PsA domains in those receiving TNFi or IL-17i.</p><p><strong>Conclusion: </strong>This real-world analysis highlights the heterogeneity in domain presentation; therefore, assessing all PsA domains is important for optimal disease management. Improvements in outcomes across all PsA domains demonstrate the effectiveness of TNFi and IL-17i in diverse patient groups exhibiting different phenotypes of PsA.</p>","PeriodicalId":7084,"journal":{"name":"ACR Open Rheumatology","volume":"5 8","pages":"388-398"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/f7/ACR2-5-388.PMC10425582.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10065673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and Damage Accrual of Systemic Lupus Erythematosus in Central Sweden: A Single-Center Population-Based Cohort Study Over 14 Years From Östergötland County.","authors":"Elizabeth V Arkema,&nbsp;Muna Saleh,&nbsp;Julia F Simard,&nbsp;Christopher Sjöwall","doi":"10.1002/acr2.11585","DOIUrl":"https://doi.org/10.1002/acr2.11585","url":null,"abstract":"<p><strong>Objective: </strong>Variations in prevalence and incidence of systemic lupus erythematosus (SLE) within a geographically defined area of central Sweden over a time period of 14 years were examined. Longitudinal differences in disease activity, laboratory test results, and damage accrual were investigated.</p><p><strong>Methods: </strong>Adults (aged ≥18 years) residing in Östergötland County between 2008 and 2021 (mean adult population: 357,000 citizens) with confirmed SLE were identified and followed prospectively until death, December 31, 2021, or emigration. We estimated annual incidence per 100,000 inhabitants stratified by sex and age. Linear regression with year of diagnosis as the outcome assessed whether each clinical measurement at diagnosis varied over time.</p><p><strong>Results: </strong>Prevalence on December 31, 2021, was 71.5 of 100,000 (87% female). One hundred twenty-six new cases were identified during the study period, yielding a mean annual incidence of 3.0 of 100,000 inhabitants; this was higher in females (4.8/100,000) than in males (1.2/100,000). Mean age at diagnosis was 43.7 years (SD 17.3). Age at diagnosis and disease activity measures increased over the calendar year of diagnosis (P < 0.05) whereas disease manifestations, including lupus nephritis, did not vary significantly. Accrual of organ damage was demonstrated over time since diagnosis and stratified by sex, lupus nephritis, and corticosteroid-related damage. Approximately 40% developed damage within 5 years.</p><p><strong>Conclusion: </strong>SLE prevalence and incidence estimates remained constant over 14 years, and disease phenotypes at SLE onset were similar. SLE was diagnosed also among older individuals with a smaller female-to-male ratio. Estimates of prevalence and incidence were comparable to previous Scandinavian reports but lower than observed in registry data from the US and the UK.</p>","PeriodicalId":7084,"journal":{"name":"ACR Open Rheumatology","volume":"5 8","pages":"426-432"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/49/2c/ACR2-5-426.PMC10425583.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10001971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Image: Erythema ab igne: a mimicker of rheumatoid vasculitis.","authors":"Akitsu Higuchi,&nbsp;Ryo Rokutanda","doi":"10.1002/acr2.11545","DOIUrl":"https://doi.org/10.1002/acr2.11545","url":null,"abstract":"The patient, a 34-year-old woman, presented with a 2-month history of livedo reticularis lesions on her lower extremities. Three years previously, she was diagnosed with seropositive rheumatoid arthritis, and her arthritis was in remission with a disease-modifying antirheumatic drug. She did not have fever, numbness, or other subjective symptoms. Her anti-nuclear antibodies were positive in a low titer, but she had negative results for anti – double-stranded DNA antibodies, anti-phospholipid antibodies, and anti-neutrophil cytoplasmic antibodies. Her serum complement levels remained within normal ranges. On further probing about the history of her present illness, she reported using an electric heater during the winter. A clinical diagnosis of erythema ab igne (EAI) was made. EAI is a pathognomonic cutaneous reaction caused by chronic heat exposure below the threshold for thermal burn (1). A biopsy is not necessary for EAI diagnosis. Because this is a clinical diagnosis, a thorough medical history and physical examination are essential. In this case, rheumatoid vasculitis was a differential diagnosis. The prognosis for EAI is good once the offending source is removed (2). The patient ’ s livedo reticularis completely disappeared after she stopped using the heater in the spring. Written informed consent for publication of this clinical image was obtained from the patient. Author disclosures are available at https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Facr2.11545& fi le=acr211545-sup-0001-Disclosureform","PeriodicalId":7084,"journal":{"name":"ACR Open Rheumatology","volume":"5 8","pages":"380"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/a1/ACR2-5-380.PMC10425580.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10385588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT, authorship, and medical publishing.","authors":"Amnuay Kleebayoon,&nbsp;Viroj Wiwanitkit","doi":"10.1002/acr2.11583","DOIUrl":"https://doi.org/10.1002/acr2.11583","url":null,"abstract":"","PeriodicalId":7084,"journal":{"name":"ACR Open Rheumatology","volume":"5 8","pages":"419"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/af/65/ACR2-5-419.PMC10425586.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10066178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Cost Sharing With Rheumatoid Arthritis Disease Burden.","authors":"Sharon Dowell,&nbsp;Christopher J Swearingen,&nbsp;Manuela Pedra-Nobre,&nbsp;Dianne Wollaston,&nbsp;Sawsan Najmey,&nbsp;Cynthia Lawrence Elliott,&nbsp;Theresa Lawrence Ford,&nbsp;Heather North,&nbsp;Robin Dore,&nbsp;Soha Dolatabadi,&nbsp;Thaila Ramanujam,&nbsp;Stacy Kennedy,&nbsp;Stephanie Ott,&nbsp;Ilona Jileaeva,&nbsp;Amina Richardson,&nbsp;Grace Wright,&nbsp;Gail S Kerr","doi":"10.1002/acr2.11575","DOIUrl":"https://doi.org/10.1002/acr2.11575","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the regional variation of cost sharing and associations with rheumatoid arthritis (RA) disease burden in the US.</p><p><strong>Methods: </strong>Patients with RA from rheumatology practices in Northeast, South, and West US regions were evaluated. Sociodemographics, RA disease status, and comorbidities were collected, and Rheumatic Disease Comorbidity Index (RDCI) score was calculated. Primary insurance types and copay for office visits (OVs) and medications were documented. Univariable pairwise differences between regions were conducted, and multivariable regression models were estimated to evaluate associations of RDCI with insurance, geographical region, and race.</p><p><strong>Results: </strong>In a cohort of 402 predominantly female, White patients with RA, most received government versus private sponsored primary insurance (40% vs. 27.9%). Disease activity and RDCI were highest for patients in the South region, where copays for OVs were more frequently more than $25. Copays for OVs and medications were less than $10 in 45% and 31.8% of observations, respectively, and more prevalent in the Northeast and West patient subsets than in the South subset. Overall, RDCI score was significantly higher for OV copays less than $10 as well as for medication copays less than $25, both independent of region or race. Additionally, RDCI was significantly lower for privately insured than Medicare individuals (RDCI -0.78, 95% CI [-0.41 to -1.15], P < 0.001) and Medicaid (RDCI -0.83, 95% CI [-0.13 to -1.54], P = 0.020), independent of region and race.</p><p><strong>Conclusion: </strong>Cost sharing may not facilitate optimum care for patients with RA, especially in the Southern regions. More support may be required of government insurance plans to accommodate patients with RA with a high disease burden.</p>","PeriodicalId":7084,"journal":{"name":"ACR Open Rheumatology","volume":"5 8","pages":"381-387"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/21/08/ACR2-5-381.PMC10425581.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10065662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Publication and Time-Lag Publication Bias for Randomized Trials on Connective Tissue Diseases.","authors":"Denis Mongin,&nbsp;Barbara Russo,&nbsp;Alejandro Brigante,&nbsp;Sami Capderou,&nbsp;Delphine S Courvoisier,&nbsp;Michele Iudici","doi":"10.1002/acr2.11582","DOIUrl":"https://doi.org/10.1002/acr2.11582","url":null,"abstract":"<p><strong>Objective: </strong>To assess the time from completion to publication of randomized controlled trials (RCTs) on connective tissue diseases (CTDs), investigate the factors associated with, and explore the influence of significance of study results on time to publication (time-lag publication bias).</p><p><strong>Methods: </strong>We included interventional, phase 2/3, 3, or 4 RCTs on CTDs registered in Clinicaltrials.gov from 2000 to 2016, whose results had been published in a peer-review journal less than 5 years after their completion. Main trial features, including the significance of primary outcome results, were collected. Time to publication was the time from study completion to the earliest publication date. Multivariable linear regression was used to identify factors associated with time to publication.</p><p><strong>Results: </strong>We included 62 studies, mostly phase 3 (61%) trials on pharmacologic treatments (94%); we recruited patients with systemic lupus (55%) or systemic sclerosis (23%) and planned to enroll a median of 131 (IQR [interquartile range]: 61-288) patients. Twenty-two (35%) reported at least a statistically significant primary outcome. Median time to publication was 28 months (IQR: 17-36). In a multivariable analysis, time to publication progressively improved over time (faster publication in recent years, with the average time to publication decreasing by 1.3 [95% CI: 0.3-2.3] months per year) and was not influenced by the significance of primary outcome results, funder, impact factor of the journal, number of recruiting countries, and comparator.</p><p><strong>Conclusion: </strong>A high proportion of CTDs-RCTs is published beyond 2 years from completion. We did not find evidence of time-lag publication bias, and time to publication improved over time.</p>","PeriodicalId":7084,"journal":{"name":"ACR Open Rheumatology","volume":"5 8","pages":"420-425"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/8a/ACR2-5-420.PMC10425588.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10066194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Patient Experience of Gout Remission: A Qualitative Study.","authors":"Adwoa Dansoa Tabi-Amponsah,&nbsp;Sarah Stewart,&nbsp;Graham Hosie,&nbsp;Anne Horne,&nbsp;Nicola Dalbeth","doi":"10.1002/acr2.11579","DOIUrl":"https://doi.org/10.1002/acr2.11579","url":null,"abstract":"<p><strong>Objective: </strong>Preliminary remission criteria for gout have been developed. However, the patient experience of gout remission has not been described. This qualitative study aimed to understand the patient experience of gout remission and views about the preliminary gout remission criteria.</p><p><strong>Methods: </strong>Semistructured interviews were conducted. All participants had gout, had not had a gout flare in the preceding 6 months, and were on urate-lowering medication. Participants were asked to discuss their experience of gout remission and views about the preliminary remission criteria. Interviews were audio recorded and transcribed verbatim. Data were analyzed using a reflexive thematic approach.</p><p><strong>Results: </strong>Twenty participants with gout (17 male participants, median age 63 years) were interviewed. Four key themes of the patient experience of remission were identified: 1) minimal or no gout symptoms (absence of pain due to gout flares, good physical function, smaller or no tophi), 2) freedom from dietary restrictions, 3) gout is \"not on the mind\", and 4) multifaceted management strategies to maintain remission (regular urate-lowering therapy, exercise, healthy eating). Participants believed that the preliminary remission criteria contained all relevant domains but considered that the pain and patient global assessment domains overlapped with the gout flares domain. Participants regarded 12 months as a more suitable time frame than 6 months to measure remission.</p><p><strong>Conclusion: </strong>Patients experience gout remission as a return to normality with minimal or no gout symptoms, dietary freedom, and absence of mental load. Patients use a range of management strategies to maintain gout remission.</p>","PeriodicalId":7084,"journal":{"name":"ACR Open Rheumatology","volume":"5 8","pages":"399-406"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/33/39/ACR2-5-399.PMC10425584.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10386174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized, Double-Blind, Placebo-Controlled Multicenter Efficacy and Safety Study of Methotrexate to Increase Response Rates in Patients With Uncontrolled Gout Receiving Pegloticase: 12-Month Findings.","authors":"John K Botson,&nbsp;Kenneth Saag,&nbsp;Jeff Peterson,&nbsp;Katie Obermeyer,&nbsp;Yan Xin,&nbsp;Brian LaMoreaux,&nbsp;Lissa Padnick-Silver,&nbsp;Supra Verma,&nbsp;Suneet Grewal,&nbsp;Amar Majjhoo,&nbsp;John R P Tesser,&nbsp;Michael E Weinblatt","doi":"10.1002/acr2.11578","DOIUrl":"https://doi.org/10.1002/acr2.11578","url":null,"abstract":"<p><strong>Objective: </strong>To assess 12-month safety and efficacy of pegloticase + methotrexate (MTX) versus pegloticase + placebo (PBO) cotherapy in a PBO-controlled, double-blind trial (A randomized, double-blind, placebo-controlled, multicenter, efficacy and safety study of methotrexate to increase response rates in patients with uncontrolled gout receiving pegloticase [MIRROR RCT]).</p><p><strong>Methods: </strong>Patients with uncontrolled gout (serum urate level [SU] ≥7 mg/dl, oral urate-lowering therapy failure or intolerance, and presence of one or more gout symptoms [one or more tophi, two or more flares in 12 months, gouty arthropathy]) were randomized 2:1 to receive pegloticase (8-mg infusion every 2 weeks) with blinded MTX (oral 15 mg/week) or PBO for 52 weeks. Efficacy end points included proportion of responders (SU level <6 mg/dl for ≥80% of examined month) in the intent-to-treat population (ITT) (all randomized patients) during month 6 (primary end point), month 9, and month 12; proportion with resolution of one or more tophi (ITT); mean SU reduction (ITT); and time to SU-monitoring pegloticase discontinuation. Safety was evaluated via adverse event reporting and laboratory values.</p><p><strong>Results: </strong>Month 12 response rate was significantly higher in patients cotreated with MTX (60.0% [60 of 100] vs. 30.8% [16 of 52]; difference: 29.1% [95% confidence interval (CI): 13.2%-44.9%], P = 0.0003), with fewer SU discontinuations (22.9% [22 of 96] vs. 63.3% [31 of 49]). Complete resolution of one or more tophi occurred in 53.8% (28 of 52) versus 31.0% (9 of 29) of MTX versus PBO patients at week 52 (difference: 22.8% [95% CI: 1.2%-44.4%], P = 0.048), more than at week 24 (34.6% [18 of 52] vs. 13.8% [4 of 29]). Consistent with observations through month 6, pharmacokinetic and immunogenicity findings showed increased exposure and lower immunogenicity of pegloticase when administered with MTX, with an otherwise similar safety profile. No infusion reactions occurred after 24 weeks.</p><p><strong>Conclusion: </strong>Twelve-month MIRROR RCT data further support MTX cotherapy with pegloticase. Tophi resolution continued to increase through week 52, suggesting continued therapeutic benefit beyond month 6 for a favorable treatment effect.</p>","PeriodicalId":7084,"journal":{"name":"ACR Open Rheumatology","volume":"5 8","pages":"407-418"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/1c/ACR2-5-407.PMC10425585.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10010870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Images: Multicentric reticulohistiocytosis.","authors":"Michael Lucke","doi":"10.1002/acr2.11569","DOIUrl":"https://doi.org/10.1002/acr2.11569","url":null,"abstract":"","PeriodicalId":7084,"journal":{"name":"ACR Open Rheumatology","volume":"5 8","pages":"379"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/5c/ACR2-5-379.PMC10425587.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10065158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologics Initiation in Rheumatoid Arthritis by Race and Ethnicity: Results From a Randomized Survey Study.","authors":"Julia F Simard,&nbsp;Rong Lu,&nbsp;Titilola O Falasinnu,&nbsp;Matthew C Baker,&nbsp;Saadiya Hawa,&nbsp;Mariani D Deluna,&nbsp;Audra Horomanski,&nbsp;Robert M Fairchild","doi":"10.1002/acr2.11573","DOIUrl":"https://doi.org/10.1002/acr2.11573","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether the race and ethnicity of a patient with rheumatoid arthritis (RA) influences rheumatologists' likelihood of choosing to initiate biologic disease-modifying antirheumatic drug (bDMARD) treatment.</p><p><strong>Methods: </strong>We conducted a randomized survey experiment in which identical brief case vignettes of hypothetical patients with RA were sent to US rheumatologists (respondents). Three of the four cases included some level of treatment decision ambiguity whereas the fourth case strongly favored bDMARD initiation. Each respondent was shown the four case vignettes, with the race and ethnicity (Black, Hispanic, White) randomly assigned for each case. Each vignette offered multiple choices for next therapeutic step, which we summarized using frequencies and proportions by race and ethnicity version.</p><p><strong>Results: </strong>Among 159 US rheumatologists, we found that for the three cases with some level of treatment decision ambiguity, there was little to no variability in the proportions of respondents who chose to start a biologic for the Black and Hispanic variants (cases 1, 2, and 3). For case 4, respondents generally agreed to start a biologic with some minimal variability across the variants (92.6% for the Black version, 98.1% for the Hispanic version, and 96.2% for the White version).</p><p><strong>Conclusion: </strong>There are conflicting data regarding bDMARD use and initiation in patients with RA based on the sex and race of the patient. This work adds to this conversation by examining how the next therapeutic step chosen by rheumatologists varied by the race and ethnicity of the hypothetical patient.</p>","PeriodicalId":7084,"journal":{"name":"ACR Open Rheumatology","volume":"5 7","pages":"371-375"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/80/ACR2-5-371.PMC10349254.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9800218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}