Clinical Rheumatology

, Volume 27, Issue 1, pp 97–100 | Cite as

Clinical and radiological features of rheumatoid arthritis in British black Africans

  • Vinod Ravindran
  • May-ai Seah
  • David A. Elias
  • Ernest H. Choy
  • David L. Scott
  • Patrick A. Gordon
Brief Report
First Online:
Received:
Accepted:

Abstract

The objective of this study was to determine whether radiographic damage is different in British black African patients with rheumatoid arthritis compared to Caucasian patients. Data on demographics, disease- and disability-related variables were obtained from all black African patients and their age-, gender- and disease-duration-matched Caucasian controls. After all features identifying the patients were concealed, X-rays of hands and feet were scored by using the Sharp/van der Heijde method. Data were analysed using Mann–Whitney U test, t test and χ 2 test. Sixty-four patients (32 in each ethnic group) were studied. The median age was 52 years and median disease duration 6 years. Seventy-two percent of patients were female. Black Africans and Caucasians did not differ significantly in rheumatoid factor positivity, disease-modifying anti-rheumatic drugs and biological treatment use. British black African patients had significantly more tender joints and disability. Joint space narrowing was significantly greater in Caucasian patients [48 (27–85) vs 56 (34–107), p = 0.01]. Caucasian patients had more number of erosions (172 vs 220) and higher erosion score; however, the difference in the erosion scores was not statistically significant [2 (0–48) vs 4.5 (0–46), p = 0.17]. Radiographic damage was less severe in black African patients with rheumatoid arthritis compared to their age-, gender- and disease-duration-matched Caucasian controls. A large prospective study is required to confirm the findings of this study and to establish the factors which might be accountable for any differences in the expression of rheumatoid arthritis in this ethnic group.

Keywords

Black Africans Ethnicity Radiographic damage Rheumatoid arthritis 
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Notes

Acknowledgement

This study was a part of Dr. Vinod Ravindran’s project for MSc (Rheumatology) submitted to the King’s College London, University of London, London, UK.

References

  1. 1.
    Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324PubMedCrossRefGoogle Scholar
  2. 2.
    Prevoo ML, van’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL (1995) Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48PubMedCrossRefGoogle Scholar
  3. 3.
    Fries JF, Spitz P, Kraines G, Holman H (1980) Measurement of outcome in arthritis. Arthritis Rheum 23:137–45PubMedCrossRefGoogle Scholar
  4. 4.
    van der Heijde DMFM (1999) How to read radiographs according to the Sharp/van der Heijde method. J Rheumatol 26:743–745PubMedGoogle Scholar
  5. 5.
    Lopez-Mendez A, Paul WA, Alarcon GS (1989) Rheumatoid arthritis in American blacks: a clinical and radiological study. J Rheumatol 16:1197–1200PubMedGoogle Scholar
  6. 6.
    van der Heijde DM, van Riel PL, Van Leeuwen MA, van’t Hof MA, van Rijswijk MH, van de Putte LB (1992) Prognostic factors for radiographic damage and physical disability in early rheumatoid arthritis. A prospective follow-up study of 147 patients. Br J Rheumatol 31:519–525PubMedCrossRefGoogle Scholar
  7. 7.
    Meyer O, Labarre C, Dougados M, Goupille Ph, Cantagrel A, Dubois A, Nicaise-Roland P, Sibilia J, Combe B (2003) Anticitrullinated peptide/protein antibody assays in early rheumatoid arthritis for predicting five year radiographic damage. Ann Rheum Dis 62:120–126PubMedCrossRefGoogle Scholar
  8. 8.
    Kaltenhäuser S, Pierer M, Arnold S, Kamprad M, Baerwald C, Häntzschel H, Wagner U (2007) Antibodies against cyclic citrullinated peptide are associated with the DRB1 shared epitope and predict joint erosion in rheumatoid arthritis. Rheumatology 46:100–104PubMedCrossRefGoogle Scholar
  9. 9.
    McDaniel DO, Alarco’n GS, Pratt PW, Reveille JD (1995) Most African-American patients with rheumatoid arthritis do not have the rheumatoid antigenic determinant (epitope). Ann Intern Med 123:181–187PubMedGoogle Scholar
  10. 10.
    Iren UT, Mark S, Walker MS, Hochman E, Brasington R (2005) A pilot study to determine whether disability and disease activity are different in African-American and Caucasian patients with rheumatoid arthritis in St. Louis, Missouri, USA. . J Rheumatol 32:602–608PubMedGoogle Scholar
  11. 11.
    Jordan MS, Lumley MA, Leisen JC (1998) The relationships of cognitive coping and pain control beliefs to pain and adjustment among African-American and Caucasian women with rheumatoid arthritis. Arthritis Care Res 11:80PubMedCrossRefGoogle Scholar
  12. 12.
    Griffiths B, Situnayake RD, Clarke B, Tennant A, Salmon M, Emery P (2000) Racial origin and its effect on disease expression and HLA-DRB1 types in patients with rheumatoid arthritis: a matched cross-sectional study. Rheumatology 39:857–864PubMedCrossRefGoogle Scholar
  13. 13.
    Bates MS, Edwards WT, Anderson KO (1993) Ethnocultural influences on variation in chronic pain perception. Pain 52:101–112PubMedCrossRefGoogle Scholar
  14. 14.
    Bridges SL, Hughes LB, Mikuls RT et al (2003) Early rheumatoid arthritis in African-Americans: the CLEAR Registry. Clin Exp Rheumatol 21(Suppl 31):S138–S145PubMedGoogle Scholar

Copyright information

© Clinical Rheumatology 2007

Authors and Affiliations

  • Vinod Ravindran
    • 1
    • 3
  • May-ai Seah
    • 2
  • David A. Elias
    • 2
  • Ernest H. Choy
    • 1
  • David L. Scott
    • 1
  • Patrick A. Gordon
    • 1
  1. 1.Department of Clinical & Academic RheumatologyKing’s College HospitalLondonUK
  2. 2.Department of RadiologyKing’s College HospitalLondonUK
  3. 3.SurreyUK

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