125 An Exploration of the Characteristics of Early Rheumatoid Arthritis Hand Involvement Among Different Gender, Age and Hand-Dominance in a Chinese Population

Abstract

Background: Rheumatoid arthritis (RA) is the most common inflammatory rheumatic disease across the globe causing symmetrical polyarthritis of large and small joints, including the hands and wrists. Understanding the disease presentation and impact across different global populations can add useful information to consider the impact of culture and different treatment regimes. Ethnicity, traditions, socioeconomic and lifestyles are assumed to have an impact on hand function and impairment, which Chinese population tends to experience less severe hand impairment. However, there are little data on the impact of RA on hand function in Chinese populations. The aim of this study was to use measurement protocols developed in the UK to explore and compare the characteristics of early hand RA among different sexes, ages, and hand-dominance in a Chinese population. Methods: A cohort comparison study was conducted in one Rheumatic centre in Shanghai, China. 60 Chinese patients with early hand RA were recruited from Shanghai, China. The procedures of data collection in China followed the standard operating procedures employed in the UK NIHR-funded “SARAH” trial. Participant questionnaires including the Michigan Hand Outcomes Questionnaire and Pain troublesomeness scales were used to measure patients’ reported functional ability. Medication history and indicators of all disease activities such as ESR, CRP and RF were recorded. Physical assessments including active range of hand and finger movement, deformity, tender and swollen joint counts and a dexterity test were conducted to report hand impairment and function. Results: There were no statistical significant differences (P?0.05) between Male (N=12) and Female (N=48) groups across all patient reported and objective outcome measures. Statistically significant differences (p?0.05) were found between two age groups (Age?60, N=28; Age ?60, N=32) in active wrist flexion of both dominant (z=-2.595, p=0.009) and non-dominant hands (z=-3.627, p?0.001) respectively. Dominant hand dexterity and combined finger flexion measurements were significantly better than the non-dominant measurements (t=2.232, p=0.029 and z=-2.085, p=0.037) in all participants. However, non-dominant hand composite finger extension was significantly greater than dominant hand extension (t=-2.463, p=0.017). Conclusion: In this exploratory analysis of a Chinese RA population, hand impairment and hand function were not significantly different between men and women. Hand impairment and function of the hand tended to be worse for the non-dominant hand. This is the first time that the characteristics of hand impairment and function for a Chinese population have been reported and there is a need to fully analyse the characteristics of RA hand involvement in a Chinese popul