{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T02:55:12Z","timestamp":1777085712372,"version":"3.51.4"},"reference-count":39,"publisher":"The Journal of Rheumatology","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2010,8]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>To describe differences in phenotype and outcomes in North American Native (NAN) patients with rheumatoid arthritis (RA) followed prospectively and compared to white patients with RA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>Patients from a single academic center were followed over 20 years using a custom database. Data included diagnoses, year of disease onset, ethnicity, modified Health Assessment Questionnaire (mHAQ) score, patient and physician global scores, tender and swollen joint counts, treatment, serology, and erythrocyte sedimentation rate (ESR). Records of all white (n = 1315) and NAN (n = 481) patients with RA were abstracted. Cumulative treatment data and clinical measures were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Disease duration was longer in white patients compared to NAN patients (16 \u00b1 11 vs 14 \u00b1 10 years, respectively; p = 0.03). Onset age was 34 years for NAN patients and 43 years for white patients (p &lt; 0.001). NAN patients were more frequently positive for rheumatoid factor (89% vs 74%; p &lt; 0.001) and antinuclear antibody (57% vs 21%; p &lt; 0.001). Although mean tender joint counts and swollen joint counts were similar, NAN patients had higher Lansbury scores (weighted joint count; 66.5 vs 49.7; p &lt; 0.001), mHAQ scores (1.1 vs 0.9; p = 0.001), and ESR (31 vs 25 mm\/h; p &lt; 0.012). NAN patients had more frequent knee (53% vs 34%; p &lt; 0.001) and elbow (62% vs 48%; p = 0.007) involvement. Compared to white patients, NAN patients took a higher lifetime number of disease-modifying antirheumatic drugs (3.2 \u00b1 1.9 vs 2.2 \u00b1 1.7; p &lt; 0.001), had more combination therapy (38% vs 29%; p = 0.002), and had more frequent prednisone use (55% vs 39%; p &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Compared to white patients, NAN patients with RA develop disease earlier, are more frequently seropositive, have greater large joint involvement, and greater disease burden, although treatment is more aggressive. These differences are present early and persist throughout the disease course.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.091452","type":"journal-article","created":{"date-parts":[[2010,6,16]],"date-time":"2010-06-16T00:55:52Z","timestamp":1276649752000},"page":"1589-1595","source":"Crossref","is-referenced-by-count":61,"title":["Rheumatoid Arthritis in a North American Native Population: Longitudinal Followup and Comparison with a White Population"],"prefix":"10.3899","volume":"37","author":[{"given":"CHRISTINE A.","family":"PESCHKEN","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CAROL A.","family":"HITCHON","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"DAVID B.","family":"ROBINSON","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"IRENE","family":"SMOLIK","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CHERYL R.","family":"BARNABE","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SURAJ","family":"PREMATILAKE","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"HANI S.","family":"EL-GABALAWY","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2262","published-online":{"date-parts":[[2010,6,15]]},"reference":[{"key":"2018112909233978000_37.8.1589.1","first-page":"684","article-title":"Rheumatic disease in the Nuu-Chah-Nulth native Indians of the Pacific Northwest","volume":"15","author":"Atkins","year":"1988","journal-title":"J Rheumatol"},{"key":"2018112909233978000_37.8.1589.2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780160607"},{"key":"2018112909233978000_37.8.1589.3","first-page":"1477","article-title":"Rheumatic diseases in Alaskan Indians of the southeast coast: high prevalence of rheumatoid arthritis and systemic lupus erythematosus","volume":"18","author":"Boyer","year":"1991","journal-title":"J Rheumatol"},{"key":"2018112909233978000_37.8.1589.4","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1093\/oxfordjournals.aje.a115238","article-title":"High incidence and prevalence of rheumatoid arthritis in Pima Indians","volume":"129","author":"Del Puente","year":"1989","journal-title":"Am J Epidemiol"},{"key":"2018112909233978000_37.8.1589.5","first-page":"224","article-title":"Arthritis in Indian country: determining the prevalence and effects","volume":"10","author":"Elliott","year":"2000","journal-title":"Ethn Dis"},{"key":"2018112909233978000_37.8.1589.6","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780240515"},{"key":"2018112909233978000_37.8.1589.7","first-page":"509","article-title":"Rheumatoid arthritis and ankylosing spondylitis in British Columbia Indians: their prevalence and the challenge of management","volume":"100","author":"Hill","year":"1969","journal-title":"Can Med Assoc J"},{"key":"2018112909233978000_37.8.1589.8","first-page":"9","article-title":"Studies of rheumatoid arthritis among a tribe of Northwest Indians","volume":"3","author":"Willkens","year":"1976","journal-title":"J Rheumatol"},{"key":"2018112909233978000_37.8.1589.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-0172(96)80009-6"},{"key":"2018112909233978000_37.8.1589.10","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-5-30"},{"key":"2018112909233978000_37.8.1589.11","first-page":"589","article-title":"Rheumatic diseases in Western Canadian Indian children","volume":"9","author":"Rosenberg","year":"1982","journal-title":"J Rheumatol"},{"key":"2018112909233978000_37.8.1589.12","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/0049-0172(76)90013-5","article-title":"Prospective study of the early course of rheumatoid arthritis in young adults: comparison of patients with and without rheumatoid factor positivity at entry and identification of variables correlating with outcome","volume":"4","author":"Masi","year":"1976","journal-title":"Semin Arthritis Rheum"},{"key":"2018112909233978000_37.8.1589.13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/03009748509104317","article-title":"Prognostic factors and diagnostic criteria in early rheumatoid arthritis","volume":"57","author":"Kaarela","year":"1985","journal-title":"Scand J Rheumatol Suppl"},{"key":"2018112909233978000_37.8.1589.14","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199808)41:8<1464::AID-ART17>3.0.CO;2-X"},{"key":"2018112909233978000_37.8.1589.15","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1002\/art.1780340107","article-title":"Association of HLA-Dw16 with rheumatoid arthritis in Yakima Indians. 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