Systematic review of rheumatic disease phenotypes and outcomes in the Indigenous populations of Canada, the USA, Australia and New Zealand
Open Access
- 17 December 2016
- journal article
- review article
- Published by Springer Science and Business Media LLC in Rheumatology International
- Vol. 37 (4), 503-521
- https://doi.org/10.1007/s00296-016-3623-z
Abstract
We performed a systematic review designed to characterize clinical phenotypes and outcomes in Indigenous populations with rheumatic disease to enhance the understanding of how rheumatic disease presents in Indigenous populations and allow for better projection of the healthcare needs of the communities affected. A systematic search was performed in medical (Medline, EMBASE, CINAHL), Indigenous and conference abstract databases (to June 2015). Search terms for Indigenous populations were combined with terms for inflammatory arthritis conditions, connective tissue disorders, crystal arthritis and osteoarthritis. Studies were included if they reported on disease features, disease activity measures, or patient-reported outcomes in Canadian, American, Australian or New Zealand Indigenous populations. Data were extracted in duplicate, and a narrative summary was prepared. A total of 5269 titles and abstracts were reviewed, of which 504 underwent full-text review and 85 met inclusion criteria. Nearly all the studies described outcomes in the North American populations (n = 77), with only four studies from Australia and four studies from New Zealand. The majority of studies were in rheumatoid arthritis (n = 31) and systemic lupus erythematosus (n = 19). Indigenous patients with rheumatoid arthritis had higher disease activity and reported more significant impact on patient-reported outcomes and quality of life than non-Indigenous patients. Spondyloarthropathy features were described in North American populations, with most patients having advanced manifestations. In systemic lupus erythematosus, nephritis was more frequent in Indigenous populations. Gout and osteoarthritis were more severe in New Zealand Maori populations. The existing literature supports differences in disease phenotype and severity in Indigenous populations of Canada, America, Australia and New Zealand. We encourage investigators in this area of research to undertake contemporary studies that disentangle differences between phenotype and severity that are biologic in etiology or merely reflecting differences in access to care and that provide a longitudinal assessment of outcomes in more diverse populations.Funding Information
- Canadian Institutes of Health Research
- Arthur JE Child Chair in Rheumatology
This publication has 87 references indexed in Scilit:
- Prevalence of Anti-Peptidylarginine Deiminase Type 4 Antibodies in Rheumatoid Arthritis and Unaffected First-degree Relatives in Indigenous North American PopulationsThe Journal of Rheumatology, 2013
- Diagnostic criteria for fibromyalgia: Comment on the article by Wolfe et alArthritis Care & Research, 2010
- Canadian Rheumatology Association (CRA) Meeting, Quebec City, Quebec, February 3-6, 2010The Journal of Rheumatology, 2010
- IntroductionThe Journal of Rheumatology, 2009
- Risk of tuberculosis is higher with anti–tumor necrosis factor monoclonal antibody therapy than with soluble tumor necrosis factor receptor therapy: The three‐year prospective french research axed on tolerance of biotherapies registryArthritis & Rheumatism, 2009
- Arthritis prevalence and associations in American Indian and Alaska native peopleArthritis Care & Research, 2008
- Rheumatic disease in the Australian Aborigine of Cape York Peninsula: a 1965 studyInternational Journal of Rheumatic Diseases, 2004
- Discrepancies between patient recall and the medical record. Potential impact on diagnosis and clinical assessment of chronic diseaseArchives of Internal Medicine, 1995
- Systemic lupus erythematosus in Australian Aborigines: high prevalence, morbidity and mortalityAustralian and New Zealand Journal of Medicine, 1993
- A Study of Rheumatic Disease in a Canadian Indian PopulationAnnals Of The Rheumatic Diseases, 1963