A comparison of Gujarati Asian and Caucasian patients with rheumatoid arthritis

This study examined Gujarati and Caucasian patients with RA, with respect to disease activity, genetic factors, treatment, socioeconomic and psychological status.;61 Gujarati and 61 Caucasian subjects underwent a structured interview, including detailed social history, disease history, drug history, pain on VAS, HAQ, WHO Self Reporting Questionnaire, list of Threatening Life Events and an examination including a swollen joint count.;Caucasian patients had higher swollen joint counts (10.39 vs. 8.07, p=0.05), more nodulosis (46% vs. 16%, p=0.0005) and more sero-positivity for RF (66% vs. 45%, p=0.02). Gujaratis had longer EMS (1.36 hrs vs. 0.86 hrs, p=0.03), greater pain on VAS (5.1 vs. 3.7, p=0.0008) and greater disability on HAQ (1.9 vs. 1.2, p=0.0001). Gujaratis had an earlier age of onset (42.0 yrs vs. 46.3 years, p=0.01). There were no differences in DMARD therapy, but Gujaratis perceived their treatment to be less effective (p=0.0009). 76% of patients had tried complementary therapies.;Gujarati patients had a lower frequency of HLA DRB1 shared epitope (0.77 vs. 1.12 copies/patient, p=0.01). Caucasians expressed HLA DRB1*04 (37% vs. 12%, p=0.001) and DRB1*01 (15% vs. 1% p=0.0007). Gujaratis expressed HLA DRB1*10 (21% vs. 3%, p=0.0009).;59% Gujaratis were not working because of ill health, compared with 31% Caucasians. Gujaratis had a larger social network (3.15 vs. 1.89, p=0.0004) and more social services support (75% vs. 54%, p=0.01). 44% Gujarati patients were vegetarian, and few dark or smoked. Gujarati patients were significantly depressed (9.44 vs. 5.16 on SRQ, p<0.0001), and ethnicity was an independent risk factor for depression (p<0.0005) when other variables were adjusted for.;Ethnicity was an independent predictor for disability (p=0.001) despite adjusting for markers of disease severity and activity. Asian patients had an odds ratio of 8.20 (p=0.006) of having a HAQ >=2. Ethnicity was not a predictor for SJC.