Role of DMARD Naïve Period in the Development of Severe Rheumatoid Arthritis.

Cross-sectional study DMARD naïve period Erosions India Rheumatoid arthritis

Journal

Indian journal of orthopaedics
ISSN: 0019-5413
Titre abrégé: Indian J Orthop
Pays: Switzerland
ID NLM: 0137736

Informations de publication

Date de publication:
Jul 2020
Historique:
received: 29 12 2019
accepted: 21 02 2020
entrez: 19 6 2020
pubmed: 19 6 2020
medline: 19 6 2020
Statut: epublish

Résumé

Rheumatoid arthritis (RA) is a symmetric poly-arthritis predominantly affecting the small synovial joints, although any synovial joint can be involved. The underlying cause is not known; however, predilection for the disease is impacted by genetic and environmental factors. Several factors predict disease severity in RA including development of erosions, female sex and duration of disease. This study evaluates the role of disease duration, early initiation of disease modifying anti-rheumatic drugs (DMARDs) and auto-antibodies like rheumatoid factor in predicting erosive disease in Indian patients with rheumatoid arthritis. A 2-year hospital-based cross-sectional observational study was conducted in the Department of Medicine in a tertiary care centre in Kumaon region of Uttarakhand in northern India. 260 patients diagnosed with RA on the basis of 2010 ACR/EULAR criteria were included. A total of 135 patients had erosive disease, with DMARD naive median period of 3 years compared to 125 patients with non-erosive disease, with DMARD naive median period of 2 years. On the basis of this data and after evaluation for radiographic erosions, it was found that a longer DMARD naive period predicts higher odds of developing erosive disease. Early diagnosis of rheumatoid arthritis and initiation of DMARDs is crucial in increasing quality of life and preventing severe disease with deformities, erosive changes and extra-articular manifestations.

Sections du résumé

BACKGROUND BACKGROUND
Rheumatoid arthritis (RA) is a symmetric poly-arthritis predominantly affecting the small synovial joints, although any synovial joint can be involved. The underlying cause is not known; however, predilection for the disease is impacted by genetic and environmental factors. Several factors predict disease severity in RA including development of erosions, female sex and duration of disease. This study evaluates the role of disease duration, early initiation of disease modifying anti-rheumatic drugs (DMARDs) and auto-antibodies like rheumatoid factor in predicting erosive disease in Indian patients with rheumatoid arthritis.
METHODS METHODS
A 2-year hospital-based cross-sectional observational study was conducted in the Department of Medicine in a tertiary care centre in Kumaon region of Uttarakhand in northern India. 260 patients diagnosed with RA on the basis of 2010 ACR/EULAR criteria were included.
RESULTS RESULTS
A total of 135 patients had erosive disease, with DMARD naive median period of 3 years compared to 125 patients with non-erosive disease, with DMARD naive median period of 2 years. On the basis of this data and after evaluation for radiographic erosions, it was found that a longer DMARD naive period predicts higher odds of developing erosive disease.
CONCLUSION CONCLUSIONS
Early diagnosis of rheumatoid arthritis and initiation of DMARDs is crucial in increasing quality of life and preventing severe disease with deformities, erosive changes and extra-articular manifestations.

Identifiants

pubmed: 32549967
doi: 10.1007/s43465-020-00077-8
pii: 77
pmc: PMC7270310
doi:

Types de publication

Journal Article

Langues

eng

Pagination

513-517

Informations de copyright

© Indian Orthopaedics Association 2020.

Déclaration de conflit d'intérêts

Conflict of interestMadhav Bahadur, Paramjeet Singh, Vivekanand Satyawali and Arun Joshi declare that they have no conflicts of interest.

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Auteurs

Madhav Bahadur (M)

Department of Medicine, Government Medical College, Haldwani, Uttarakhand 263139 India.

Paramjeet Singh (P)

Department of Medicine, Government Medical College, Haldwani, Uttarakhand 263139 India.

Vivekanand Satyawali (V)

Department of Medicine, Government Medical College, Haldwani, Uttarakhand 263139 India.

Arun Joshi (A)

Department of Medicine, Government Medical College, Haldwani, Uttarakhand 263139 India.

Classifications MeSH