Bawazir Yasser Mohammed
Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Open Access Rheumatol. 2020 Nov 24;12:267-275. doi: 10.2147/OARRR.S277956. eCollection 2020.
Rheumatoid arthritis (RA), if left untreated, can lead to joint damage and deformity, disability, and even death. Hence, early diagnosis and management are essential to improve clinical and functional outcomes. This study aimed to identify the most common variables and risk factors related to RA activity among patients living in the Kingdom of Saudi Arabia (KSA).
This study was conducted between January 2018 and March 2019 on consecutive patients diagnosed with RA at a tertiary care hospital in KSA. Adult patients (≥18 years old) diagnosed with RA based on the American College of Rheumatology 2010 criteria were recruited. The Disease Activity Score-28 for Rheumatoid Arthritis with CRP (DAS28-CRP) and health assessment questionnaire disability index (HAQ-DI) were calculated for 75 patients attending the rheumatology clinic during the study period to evaluate the rate of remission and functional capacity, and to compare findings with other local studies after assessing the relationship of these factors with medication use and existing comorbidities.
The majority of the 75 patients were female (n=64), with a mean age of 49.7 years and average disease duration of 130 days. The median HAQ-DI was less than 0.5 (range 0-1.95). The DAS28-CRP scores revealed moderate disease activity in 45.3% and low disease or remission in 38.6% of the patients. Many patients (45.3%) were treated with methotrexate, and the most commonly used biological treatment was adalimumab in 14.6%. Comorbidities included hypertension (26.7%) and diabetes mellitus (18.7%). There was a strong association between cardiovascular diseases and a high DAS28-CRP score (p < 0.001).
A higher RA activity rate was observed. This may be related to difficultly accessing rheumatology clinics in our facility and financial difficulties accessing biological treatments.
类风湿关节炎(RA)若不治疗,可导致关节损伤、畸形、残疾甚至死亡。因此,早期诊断和管理对于改善临床和功能结局至关重要。本研究旨在确定沙特阿拉伯王国(KSA)患者中与RA活动相关的最常见变量和危险因素。
本研究于2018年1月至2019年3月在KSA一家三级护理医院对连续诊断为RA的患者进行。招募基于美国风湿病学会2010年标准诊断为RA的成年患者(≥18岁)。计算了研究期间在风湿病门诊就诊的75例患者的类风湿关节炎28关节疾病活动评分(DAS28-CRP)和健康评估问卷残疾指数(HAQ-DI),以评估缓解率和功能能力,并在评估这些因素与药物使用及现有合并症的关系后,将结果与其他本地研究进行比较。
75例患者中大多数为女性(n = 64),平均年龄49.7岁,平均病程130天。HAQ-DI中位数小于0.5(范围0 - 1.95)。DAS28-CRP评分显示,45.3%的患者疾病活动度为中度,38.6%的患者疾病活动度低或处于缓解期。许多患者(45.3%)接受甲氨蝶呤治疗,最常用的生物治疗药物是阿达木单抗,占14.6%。合并症包括高血压(26.7%)和糖尿病(18.7%)。心血管疾病与高DAS28-CRP评分之间存在强关联(p < 0.001)。
观察到较高的RA活动率。这可能与在我们机构难以获得风湿病门诊服务以及获取生物治疗的经济困难有关。