Factors Associated with Disease Severity in Rheumatoid Arthritis Patients at Phra Nakhon Si Ayutthaya Hospital
Keywords:Rheumatoid arthritis, Factor, DAS28, Disability
Background: Rheumatoid arthritis is the most common chronic arthritis. Effective treatment requires a timely and accurate diagnosis, and administration of anti-rheumatic drugs to modulate the disease. Therefore, it is important to validate associated factors in order to monitor the rapid progression and reduce the complications of the disease.
Methodology: This research is a cross-sectional study, based on data from medical records involving patients with rheumatoid arthritis in Phra Nakhon Si Ayutthaya hospital during 2018-2020. The outcomes were evaluated by the Disease Activity Score with 28 joint counts (DAS28) criteria to categorize patients into two groups as: (a) patients with extremely severe conditions which indicated a severe disease activity (b) patients with inactive, mildly or moderately severe disease which denotes a better disease activity and then analyze the factors influencing the severity of rheumatoid arthritis.
Result: 88 patients were enrolled in this study. There were 32 patients (36.36%) in severe disease activity and the remaining 56 patients (63.63%) were classified as having better disease activity. Baseline characteristics were not significantly different between two groups. The mean period of onset was less in the better disease activity group (3.3 months vs. 5.4 months). In the severe disease activity group, elbow inflammation was more common than another group. Extra-articular symptoms were more frequent in the severe disease activity group. Hematologic symptoms was more common in the severe disease activity group. Rheumatoid factor was positive, the joint erosion was detected more frequently and the mean ESR was higher in the severe disease activity group. In the multivariate analysis, patients with severe disease activity tended to have elbow inflammation, extra articular manifestation especially hematologic symptoms, positive rheumatoid factors, and erosive joint findings on diagnostic radiographs.
McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med 2011;365(23):2205-19.
England BR, Thiele GM, Anderson DR, Mikuls TR. Increased cardiovascular risk in rheumatoid arthritis: mechanisms and implications. BMJ 2018;361:k1036.
Fleming A, Crown JM, Corbett M. Early rheumatoid disease. I. Onset. Ann Rheum Dis 1976;35(4):357-60.
de Hair MJ, Lehmann KA, van de Sande MG, Maijer KI, Gerlag DM, Tak PP. The clinical picture of rheumatoid arthritis according to the 2010 American College of Rheumatology/European League Against Rheumatism criteria: is this still the same disease? Arthritis Rheum 2012;64(2):389-93.
Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet 2010;376(9746):1094-108.
Safiri S, Kolahi AA, Hoy D, Smith E, Bettampadi D, Mansournia MA, et al. Global, regional and national burden of rheumatoid arthritis 1990-2017: a systematic analysis of the Global Burden of Disease study 2017. Ann Rheum Dis 2019;78(11):1463-71.
Cross M, Smith E, Hoy D, Carmona L, Wolfe F, Vos T, et al. The global burden of rheumatoid arthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 2014;73(7):1316-22.
Katchamart W, Narongroeknawin P, Chanapai W, Thaweeratthakul P. Health-related quality of life in patients with rheumatoid arthritis. BMC Rheumatol 2019;3:34.
Haridoss M, Bagepally BS, Natarajan M. Health-related quality of life in rheumatoid arthritis: systematic review and meta-analysis of EuroQoL (EQ-5D) utility scores from Asia. Int J Rheum Dis 2021;24(3):314-26.
Toledano E, Candelas G, Rosales Z, Prada CM, León L, Abásolo L, et al. A meta-analysis of mortality in rheumatic diseases. Reumatol Clin 2012;8(6):334-41.
van der Heijde DM, van 't Hof MA, van Riel PL, Theunisse LA, Lubberts EW, van Leeuwen MA, et al. Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of a disease activity score. Ann Rheum Dis 1990;49(11):916-20.
Singh JA, Saag KG, Bridges SL, Jr., Akl EA, Bannuru RR, Sullivan MC, et al. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol 2016;68(1):1-26.
Katchamart W, Narongroeknawin P, Chevaisrakul P, Dechanuwong P, Mahakkanukrauh A, Kasitanon N, et al. Evidence-based recommendations for the diagnosis and management of rheumatoid arthritis for non-rheumatologists: Integrating systematic literature research and expert opinion of the Thai Rheumatism Association. Int J Rheum Dis 2017;20(9):1142-65.
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988;31(3):315-24.
Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 2010;62(9):2569-81.
Kaipiainen-Seppänen O, Aho K. Incidence of chronic inflammatory joint diseases in Finland in 1995. J Rheumatol 2000;27(1):94-100.
Ngian GS. Rheumatoid arthritis. Aust Fam Physician 2010;39(9):626-8.
Firestein GS BR, Gabriel SE, Mclnnes IB, O'Dell JR, editor. Treatment of Rheumatoid Arthritis. 10th ed. Philadelphia: Elsevier Inc; 2017.
How to Cite
Copyright (c) 2022 Journal of Preventive Medicine Association of Thailand
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ลงพิมพ์ในวารสารเวชศาสตร์ป้องกันแห่งประเทศไทย ถือเป็นผลงานวิชาการ งานวิจัย วิเคราะห์ วิจารณ์ ตลอดจนเป็นความเห็นส่วนตัวของผู้นิพนธ์ กองบรรณาธิการไม่จำเป็นต้องเห็นด้วยเสมอไปและผู้นิพนธ์จะต้องรับผิดชอบต่อบทความของตนเอง