Racial and ethnic differences in the pharmacologic management of osteoarthritis: rapid systematic review

Ernest R Vina; Philip H Tsoukas; Shahrzad Abdollahi; Nidhi Mody; Stephanie C Roth; Albert H Redford; C Kent Kwoh

doi:10.1177/1759720X221105011

Racial and ethnic differences in the pharmacologic management of osteoarthritis: rapid systematic review

Ther Adv Musculoskelet Dis. 2022 Jun 30:14:1759720X221105011. doi: 10.1177/1759720X221105011. eCollection 2022.

Authors

Ernest R Vina¹, Philip H Tsoukas², Shahrzad Abdollahi², Nidhi Mody², Stephanie C Roth³, Albert H Redford⁴, C Kent Kwoh⁴

Affiliations

¹ Section of Rheumatology, Lewis Katz School of Medicine, Temple University, 201 MOB, 3322 N. Broad Street, Philadelphia, PA 19140, USA.
² Section of Rheumatology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
³ Health Sciences Library, Temple University, Philadelphia, PA, USA.
⁴ The University of Arizona Arthritis Center and Division of Rheumatology, College of Medicine, University of Arizona, Tucson, AZ, USA.

Abstract

Background: Racial and ethnic disparities in osteoarthritis (OA) patients' disease experience may be related to marked differences in the utilization and prescription of pharmacologic treatments.

Objectives: The main objective of this rapid systematic review was to evaluate studies that examined race/ethnic differences in the use of pharmacologic treatments for OA.

Data sources and methods: A literature search (PubMed and Embase) was ran on 25 February 2022. Studies that evaluated race/ethnic differences in the use of OA pharmacologic treatments were included. Two reviewers independently screened titles and abstracts and abstracted data from full-text articles. Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.

Results: The search yielded 3880 titles, and 17 studies were included in this review. African Americans and Hispanics were more likely than non-Hispanic Whites to use prescription non-selective non-steroidal anti-inflammatory drugs (NSAIDs) for OA. However, compared to non-Hispanic Whites with OA, African Americans and Hispanics with OA were less likely to receive a prescription for cyclooxygenase-2-selective NSAIDs and less likely to report the use of joint health supplements (i.e. glucosamine and chondroitin sulfate). There were minimal/no significant race/ethnic differences in the patient-reported use of the following OA therapies: acetaminophen, opioids, and other complementary/alternative medicines (vitamins, minerals, and herbs). There were also no significant race differences in the receipt of intra-articular therapies (i.e. glucocorticoid or hyaluronic acid). However, there is limited evidence to suggest that African Americans may be less likely than Whites to receive opioids and intra-articular therapies in some OA patient populations.

Conclusion: This systematic review provides an overview of the current pharmacologic options for OA, with a focus on race and ethnic differences in the use of such medical therapies.

Keywords: African Americans; Hispanics; ethnicity; medications; osteoarthritis; race; utilization.

Publication types

Review