In:
Advances in Rheumatology, Springer Science and Business Media LLC, Vol. 63, No. 1 ( 2023-07-26)
Abstract:
Although Rheumatoid Arthritis (RA) extra-articular manifestations (ExtRA) occurrence has been decreasing over time, they are still a major mortality risk factor for patients. Objective To determine the prevalence of ExtRA in a large cohort, and its association with demographic and clinical variables. Method Cross-sectional and observational study, based on a multi-centric database from a prospective cohort, in which 11 public rheumatology centres enrolled RA patients (1987 ARA or 2010 ACR-EULAR). Data collection began in 08-2015, using a single online electronic medical record. Continuous variables were compared using Mann–Whitney U -test, and Fisher’s exact test or chi-square test, as appropriate, were used for categorical variables. The level of significance was set at 5% ( p 〈 0.05). Results 1115 patients were included: 89% women, age [mean ± SD] 58.2 ± 11.5 years, disease duration 14.5 ± 12.2 years, positive Rheumatoid Factor (RF, n = 1108) in 77%, positive anti-cyclic citrullinated peptide (ACPA, n = 477) in 78%. Regarding ExtRA, 334 occurrences were registered in 261 patients, resulting in an overall prevalence of 23.4% in the cohort. The comparison among ExtRA and Non-ExtRA groups shows significant higher age ( p 〈 0.001 ), disease duration (p 〈 0.001 ), RF high titers ( p = 0.018 ), Clinical Disease Activity index (CDAI) ( p 〈 0.001 ), Disease Activity Index 28 (DAS 28) ( p 〈 0.001 ), and Health Assessment Questionnaire (HAQ) ( p 〈 0.001 ) in ExtRA group. Treatment with Azathioprine ( p = 0.002 ), Etanercept ( p = 0.049) Glucocorticoids (GC) (‘ p = 0.002 ), and non-steroidal anti-inflammatory drugs (NSAIDs) ( p 〈 0.001 ) were more frequent in ExtRA group. Conclusions ExtRA manifestations still show an expressive occurrence that should not be underestimated. Our findings reinforce that long-term seropositive disease, associated with significant disability and persistent inflammatory activity are the key factors related to ExtRA development.
Type of Medium:
Online Resource
ISSN:
2523-3106
DOI:
10.1186/s42358-023-00318-y
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2023
detail.hit.zdb_id:
2939120-9
Permalink