Factors associated with time to diagnosis from symptom onset in patients with early rheumatoid arthritis
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Background/Aims: To identify the factors associated with time to diagnosis after symptom onset in patients with early rheumatoid arthritis (RA). Methods: Early RA patients with ≤ 1 year of disease duration in the KORean Observational study Network for Arthritis (KORONA) database were included in this analysis. Patients were further divided into two groups according to the time to diagnosis from symptom onset: the early diagnosis group (time to diagnosis ≤ 1 year) and the late diagnosis group (time to diagnosis > 1 year). Using the multivariable regression model, we identified factors associated with early diagnosis. Results: Among 714 early RA patients, 401 patients (56.2%) and 313 patients (43.8%) were included in the early diagnosis and late diagnosis groups, respectively. The mean disease duration was 0.47 years in the early diagnosis group and 0.45 years in the late diagnosis group. In multivariable model analysis, greater age at onset (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02 to 1.05), high school education or higher (OR, 1.68; 95% CI, 1.14 to 2.47), higher income (OR, 1.48; 95% CI, 1.05 to 2.08), and initial small joint involvement (OR, 1.42; 95% CI, 1.02 to 1.98) were factors associated with early diagnosis. At diagnosis, disease activity scores using 28 joints on diagnosis (3.81 ± 1.44 vs. 3.82 ± 1.42, p = 0.92) and functional disability (0.65 ± 0.61 vs. 0.57 ± 0.62, p = 0.07) did not different between the two groups. However, hand joint erosion on X-ray (37.8% vs. 25.6%, p < 0.01) was more common in the late diagnosis group than the early diagnosis group. Conclusions: Older onset age, higher educational level and income, and initial small joint involvement were positive factors for early diagnosis of RA.
Abstract
Background/Aims: To identify the factors associated with time to diagnosis after symptom onset in patients with early rheumatoid arthritis (RA). Methods: Early RA patients with ≤ 1 year of disease duration in the KORean Observational study Network for Arthritis (KORONA) database were included in this analysis. Patients were further divided into two groups according to the time to diagnosis from symptom onset: the early diagnosis group (time to diagnosis ≤ 1 year) and the late diagnosis group (time to diagnosis > 1 year). Using the multivariable regression model, we identified factors associated with early diagnosis. Results: Among 714 early RA patients, 401 patients (56.2%) and 313 patients (43.8%) were included in the early diagnosis and late diagnosis groups, respectively. The mean disease duration was 0.47 years in the early diagnosis group and 0.45 years in the late diagnosis group. In multivariable model analysis, greater age at onset (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02 to 1.05), high school education or higher (OR, 1.68; 95% CI, 1.14 to 2.47), higher income (OR, 1.48; 95% CI, 1.05 to 2.08), and initial small joint involvement (OR, 1.42; 95% CI, 1.02 to 1.98) were factors associated with early diagnosis. At diagnosis, disease activity scores using 28 joints on diagnosis (3.81 ± 1.44 vs. 3.82 ± 1.42, p = 0.92) and functional disability (0.65 ± 0.61 vs. 0.57 ± 0.62, p = 0.07) did not different between the two groups. However, hand joint erosion on X-ray (37.8% vs. 25.6%, p < 0.01) was more common in the late diagnosis group than the early diagnosis group. Conclusions: Older onset age, higher educational level and income, and initial small joint involvement were positive factors for early diagnosis of RA.
참고문헌 (17)
- van der Linden MP, "Long-term impact of delay in assessment of patients with early arthritis", Arthritis Rheum, 62, pp.3537~3546 (2010)
- Combe B, "EULAR recommendations for the management of early arthritis : report of a task force of the European Standing Committee for International Clinical Studies Including Therapeutics(ESCISIT)", Ann Rheum Dis, 66, pp.34~45 (2007)
- Emery P, "Treatment of rheumatoid arthritis", BMJ, 332, pp.152~155 (2006)
- 김담, "Impact of early diagnosis on functional disability in rheumatoid arthritis", The Korean Journal of Internal Medicine, 32(4), pp.738~746 (2017), 대한내과학회[DOI]
- "Services for people with rheumatoid arthritis" (2011)[URL]
- Villeneuve E, "A systematic literature review of strategies promoting early referral and reducing delays in the diagnosis and management of inflammatory arthritis", Ann Rheum Dis, 72, pp.13~22 (2013)
- Raza K, "Delays in assessment of patients with rheumatoid arthritis : variations across Europe", Ann Rheum Dis, 70, pp.1822~1825 (2011)
- Kumar K, "Delay in presentation to primary care physicians is the main reason why patients with rheumatoid arthritis are seen late by rheumatologists", Rheumatology(Oxford), 46, pp.1438~1440 (2007)
- Pratt AG, "Components of treatment delay in rheumatoid arthritis differ according to autoantibody status : validation of a single-centre observation using national audit data", Rheumatology(Oxford), 55, pp.1843~1848 (2016)
- Sung YK, "Korean Observational Study Network for Arthritis(KORONA) : establishment of a prospective multicenter cohort for rheumatoid arthritis in South Korea", Semin Arthritis Rheum, 41, pp.745~751 (2012)
- Hussain W, "From symptoms to diagnosis : an observational study of the journey of rheumatoid arthritis patients in Saudi Arabia", Oman Med J, 31, pp.29~34 (2016)
- Song YJ, "The South Korean health care system", Japan Med Assoc J, 52, pp.206~209 (2009)
- Chan KW, "The lag time between onset of symptoms and diagnosis of rheumatoid arthritis", Arthritis Rheum, 37, pp.814~820 (1994)
- Hwang AS, "Evaluation of the internet for finding persons with undiagnosed rheumatoid arthritis and systemic lupus erythematosus", J Clin Rheumatol, 15, pp.218~222 (2009)
- Bell MJ, "Development of a self-administered early inflammatory arthritis detection tool", BMC Musculoskelet Disord, 11, pp.50~ (2010)
- Callahan LF, "A clue from a self-report questionnaire to distinguish rheumatoid arthritis from noninflammatory diffuse musculoskeletal pain : the P-VAS : DADL ratio", Arthritis Rheum, 33, pp.1317~1322 (1990)
- Kyburz D, "The long-term impact of early treatment of rheumatoid arthritis on radiographic progression : a population-based cohort study", Rheumatology(Oxford), 50, pp.1106~1110 (2011)
