Global inequities in biologic and targeted DMARD use in rheumatoid arthritis: cross-sectional data from the international COVAD-2 cohort.

Publication date: May 13, 2026

Despite improvement in treatment, rheumatoid arthritis (RA) management remains inconsistent. To evaluate the worldwide disparities in the use of biological and targeted molecules (advanced) RA therapies, focusing on differences across continents and socioeconomic strata, and to identify factors associated with their utilisation. Cross-sectional analysis of the international COVAD-2 cohort, including demographics, socioeconomic factors, disease characteristics, patient-reported outcomes, and treatments. Primary outcomes assessed treatment distribution by continent, secondary outcomes evaluated distribution by Human Development Index (HDI), with predictors analysed using multivariable logistic regression. At the time of analysis, COVAD2 included 10,739 participants; 2007 had RA, 1997 with geographical data included in this study (mean age 50. 9 years, 88. 1% women). Most patients came from Europe (39. 4%) and Asia (24. 8%); 61. 3% and 23. 7% were from very high- and high-HDI countries, respectively. Overall, 29. 6% of patients used advanced therapies, with the highest rate in Europe (44. 0%), followed by North America and Oceania (33. 9%), South America (31. 1%), Asia (11. 7%), and Africa (5. 3%) (p 

Concepts Keywords
Arthritis Adult
Biologic Aged
Oceania Antirheumatic Agents
Socioeconomic Antirheumatic Agents
Antirheumatic agents
Arthritis, Rheumatoid
Arthritis, rheumatoid
Autoimmune diseases
Biological Products
Biological Products
Biological products
COVID-19
Cross-Sectional Studies
Female
Global Health
Global health
Health policy
Health services accessibility
Healthcare Disparities
Humans
Male
Middle Aged
SARS-CoV-2
Socioeconomic Factors

Semantics

Type Source Name
disease MESH rheumatoid arthritis
pathway KEGG Rheumatoid arthritis
disease MESH included
disease MESH Autoimmune diseases
disease MESH COVID-19

Original Article

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