Incidence Rate Of Rheumatoid Arthritis Research Articles

Rheumatoid arthritis epidemiology: a nationwide study in Poland

To assess the incidence and prevalence of rheumatoid arthritis (RA) in Poland for the period 2013–2021, total and dependent on gender, age, region and serological status. Information on reported National Health Fund (NHF) health services and reimbursed prescriptions were used, defining an RA patient as a person who had at least two visits in different quarters with ICD-10 code M05 or M06 and at the same time filled at least one reimbursed prescription for a drug whose active substance is methotrexate, sulfasalazine, leflunomide or was treated with biologic disease-modifying anti-rheumatic drugs (bDMRDs) or targeted synthetic DMARDs (tsDMARDs) as part of a drug program financed by the National Health Fund. The nationwide standardised incidence rate of RA in 2021 was 29 persons per 100,000 population (18 per 100,000 population of seropositive vs. 11 per 100,000 population of seronegative RA). The prevalence of RA in Poland in 2021 was 689.0 people per 100,000 population, a total of 0.7% (1.1% in women and 0.3% in men). The incidence of seronegative RA was approximately 38%. The majority of new RA diagnoses were in the sixth and seventh decades of life, irrespective of patients’ gender. The results allow RA to be classified as a disease with a significant social impact. A trend of later onset of RA has been observed, which requires special consideration of the needs of patients over 55 years of age.

Ferroptosis as an emerging target in rheumatoid arthritis.

Rheumatoid arthritis (RA) is an autoimmune disease of unknown etiology. Due to the rise in the incidence rate of RA and the limitations of existing therapies, the search for new treatment strategies for RA has become a global focus. Ferroptosis is a novel programmed cell death characterized by iron-dependent lipid peroxidation, with distinct differences from apoptosis, autophagy, and necrosis. Under the conditions of iron accumulation and the glutathione peroxidase 4 (GPX4) activity loss, the lethal accumulation of lipid peroxide is the direct cause of ferroptosis. Ferroptosis mediates inflammation, oxidative stress, and lipid oxidative damage processes, and also participates in the occurrence and pathological progression of inflammatory joint diseases including RA. This review provides insight into the role and mechanism of ferroptosis in RA and discusses the potential and challenges of ferroptosis as a new therapeutic strategy for RA, with an effort to provide new targets for RA prevention and treatment.

Influence of Helicobacter pylori infection on risk of rheumatoid arthritis: a nationwide population-based study

The relationship between Helicobacter pylori infection and rheumatoid arthritis has been investigated, but the results remain controversial. This study aims to determine the association between the two diseases via a 17-year retrospective cohort study. Using the National Health Insurance Research Database, a nationwide population based in Taiwan, we identified 97,533 individuals with H. pylori infection and matched controls between 2000 and 2017 using propensity score matching at a 1:1 ratio. The adjusted hazard ratio of rheumatoid arthritis was determined by multiple Cox regression. The incidence rate of rheumatoid arthritis was 1.28 per 10,000 person-months in the H. pylori cohort, with a higher risk compared to the control group. In the < 30 years old subgroup, the risk was highest, especially in women < 30 years old with H. pylori infection. Patients with < 1 year follow-up showed 1.58 times higher susceptibility to rheumatoid arthritis. Individuals with follow-ups of 1–5 years and over 5 years demonstrated 1.43 and 1.44 times higher risks of rheumatoid arthritis, respectively. Our study showed H. pylori infection was associated with the development of rheumatoid arthritis. Clinicians should note higher risk, especially < 30 years old. More research needed to understand underlying mechanism.

P103 The impact of the COVID-19 pandemic on primary care referrals and new diagnoses of inflammatory arthritis

Abstract Background/Aims The COVID-19 pandemic abruptly changed healthcare delivery. This study describes the impact the pandemic had on time to referral and diagnosis of inflammatory arthropathies (IA), including rheumatoid arthritis (RA) and juvenile inflammatory arthritis (JIA), in patients presenting in primary care with musculoskeletal problems. Methods Data from the Clinical Practice Research Datalink (CPRD) Aurum were analysed from 01/04/17 to 01/10/2021 to describe episodes of care for patients with musculoskeletal conditions for pre-COVID-19 (01/04/2017-31/03/2020), peri-COVID-19 (01/04/2020-31/07/2021), and post-COVID-19 lockdown (01/08/2020-31/10/2021) periods. Prevalent and incident musculoskeletal consultations were determined. Referrals were matched to these consultations. Trends in referrals to musculoskeletal services and further incident diagnoses of IA were described using Joinpoint Regression and comparisons made between time-periods. Negative binomial regression was used to compare incident rates between time-periods of: RA/JIA/IA diagnosis and referral from first musculoskeletal consultation; and RA/JIA/IA diagnosis from first referral. The number of consultations between first musculoskeletal consultation and referral/diagnosis were described. Results were adjusted for age and sex and further stratified by geographical region and deprivation. Results The incidence rate of RA and JIA reduced by average -13.32% (from 31.98 per 1,000,000 to 17.15 per 1,000,000) and -17.43% (from 1.77 per 1,000,000 to 0.97 per 1,000,000) per month respectively between January 2020 and April 2020, then increased by 1.9% (from 17.15 per 1,000,000 to 25.22 per 1,000,000) and 3.7% (from 0.97 per 1,000,000 to 1.28 per 1,000,000) per month respectively between April 2020 and October 2021. Referral incidence decreased between February 2020 and May 2020 by -16.8% per month in patients presenting with a musculoskeletal condition. After May 2020, referrals increased significantly (16.8% per month) July 2020. Time from first musculoskeletal consultation to RA diagnosis, and referral to RA diagnosis increased in the peri-COVID-19 period (IRR 1.11, 95%CI 1.07-1.15; IRR 1.23, 95%CI 1.17-1.30) and remained consistent in the post-COVID-19 (IRR 1.13, 95%CI 1.11-1.16; IRR 1.27, 95%CI 1.23-1.32) periods respectively, compared to the pre-COVID-19 period. Similarly, number of consultations between first musculoskeletal consultation and referral/RA diagnosis reduced significantly in the peri-COVID-19 (IRR 0.92, 95%CI 0.88-0.96) and post-COVID-19 (IRR 0.92, 95%CI 0.90-0.95) periods. No change was observed between first musculoskeletal consultation and first referral. Similar results were observed for IA but not for JIA. Conclusion Patients with RA/JIA onset during the pandemic may be yet to present or are currently transitioning through referral and diagnosis. Primary care clinicians should remain alert to possible IA diagnosis and consider fast-track referral pathways where indicated. Patients developing incident episodes of IA may display a prodrome of other musculoskeletal symptoms and conditions, which alone may not warrant referral but in combination require further investigation. Commissioners should be alert to these findings to allow for the appropriate planning and commissioning of services. Disclosure R. Bajpai: None. C. Burton: None. K.J. Mason: None. J. Bailey: None. M. Frisher: None. K.P. Jordan: None. C.D. Mallen: None. V. Welsh: None.

Global, regional and national burden of rheumatoid arthritis, and attributable risk factors from 1990 to 2019: update from the Global Burden of Disease 2019 study.

Statistical data on the incidence, disability-adjusted life years (DALYs) and burden of rheumatoid arthritis (RA), and associated risk factors are essential for the development of effective treatment options. The Global Burden of Disease (GBD) study provides a unique opportunity to evaluate the aforementioned parameters. The RA incidence rate, age-standardised incidence rate (ASR), DALYs and estimated annual percentage change (EAPC) between 1990 and 2019 were evaluated, using data from 204 territories and countries from the GBD 2019. Risk factors associated with DALYs in patients with RA were estimated using the comparative risk assessment framework of the GBD study. The results of the present study demonstrated that the incidence of RA increased from 567,462.89 to 1,074,390.80 cases, with an ASR of 13/100,000 patients between 1990 and 2019. The number of RA cases and DALYs were increased in all socio-demographic index quintiles during the study period. A significant negative association was found between EAPCs and age-standardised DALYs per 100,000 (ρ= -0.60; p<0.001). Notably, females exhibited an increased ASRs and DALYs than males, at both global and regional levels during the study period. Globally, age-standardised DALYs increased in an age-dependent manner, with the highest rate in the 60-69 years age group. Moreover, smoking was the predominant contributor to RA-associated DALYs for males worldwide, and this trend decreased from 1990 to 2019. The incidence rate of RA and associated DALYs are increasing worldwide, particularly among female patients. This trend is expected to increase, due an ageing population. Notably, smoking remained the predominant risk factor for RA-associated DALYs in males. Therefore, further investigations into the impact of smoking, and improvements in early diagnosis and treatment strategies for RA are required to reduce the global burden of RA.

Association between Exposure to Ambient Air Pollution and the Risk of Rheumatoid Arthritis in Taiwan: A Population-Based Retrospective Cohort Study.

Background: The association between ambient air pollution (AAP) and the risk of Rheumatoid arthritis (RA) remains debatable. We conducted a population-based cohort study to investigate the association between exposure to AAP and the risk of RA in Taiwan. Methods: We analyzed and combined the longitudinal Health Insurance Database (LHID) and the Taiwan Air Quality-Monitoring Database (TAQMD), which were in line with the residential areas. We calculated the RA incidence rates per 10,000 person-years exposed to each quartile of PM2.5 or PM10 concentrations or RH. Hazards regression was conducted to analyze the associations between exposure to each quartile of PM2.5 and PM10 concentrations and the risk of developing RA. The hazard ratios of RA were analyzed between participants exposed to annual average concentrations of PM2.5 and PM10. All the hazard ratios of RA were stratified by gender and adjusted for age and relative humidity (RH). A p-value < 0.05 was considered statistically significant. Results: Among 722,885 subjects, 9338 RA cases were observed. The analyses adjusted for age, gender, and humidity suggested an increased risk of developing RA in the exposure to PM2.5 in the last quartile (Q4) with the adjusted hazard ratio (aHR) was 1.053 (95%CI: 1.043 to 1.063). Conclusion: Our study suggests that exposure to PM2.5 is associated with an increased risk of RA. The finding has implications for policymaking to develop coping strategies to confront AAP as a risk factor for RA.

Incidence and prevalence of rheumatoid arthritis in Denmark from 1998 to 2018: a nationwide register-based study

Objective To investigate the incidence and prevalence of rheumatoid arthritis (RA) in the adult Danish population. Method In this nationwide register-based cohort study, patients with incident RA between 1998 and the end of 2018 were identified using Danish administrative registries. The age- and sex-standardized incidence rate (IR), incidence proportion (IP), lifetime risk (LR), and point prevalence (PP) of RA were calculated. RA was defined as a first-time RA diagnosis registered in the Danish National Patient Registry combined with a redeemed prescription of a conventional synthetic disease-modifying anti-rheumatic drug in the following year. In addition, three different case definitions of RA were explored. Results The overall age- and sex-standardized IR of RA from 1998 to 2018 was 35.5 [95% confidence interval (CI) 35.1–35.9] per 100 000 person-years while the IP was 35.2 (95% CI 34.8–35.5) per 100 000 individuals. The IR was two-fold higher for women than for men. The LR of RA ranged from 2.3% to 3.4% for women and from 1.1% to 1.5% for men, depending on the RA case definition used. The overall PP of RA was 0.6% (95% CI 0.5–0.6%) in 2018: 0.8% (95% CI 0.7–0.8%) for women and 0.3% (95% CI 0.3–0.4%) for men. The prevalence increased about 1.5-fold from 2000 to 2018. Conclusion The IR and PP were approximately two-fold higher for women than for men. The prevalence of RA in Denmark increased significantly from 2000 to 2018. The RA case definition had more impact on the results than the choice of denominator.

POS0025 INCIDENCE RATES AND POINT PREVALENCE OF SEROPOSITIVE AND SERONEGATIVE RHEUMATOID ARTHRITIS IN DENMARK: A NATIONWIDE REGISTER-BASED STUDY FROM 1998 TO 2018 USING FOUR DIFFERENT CASE CRITERIA

Background:Few previous studies have investigated the incidence rate (IR) and point prevalence (PP) of seropositive and seronegative rheumatoid arthritis (RA), and further, the estimates remain unknown in the Danish population.Objectives:To investigate the IR and PP of seropositive and seronegative RA in the adult Danish population from 1998 to 2018 using four register-based case definitions of RA.Methods:Nationwide register-based cohort study. Using the Danish administrative registers, patients with RA between 1998 and end of 2018 were identified. ICD-10 codes for RA were identified in the Danish National Patient Registry and information on DMARD prescriptions were obtained through the Danish National Prescription Registry using ATC codes. The used case definitions were1: Criteria A, first time M05/M06 RA diagnosis and redemption of a DMARD in the following year; Criteria B, two RA diagnoses within 90 days of each other, originating from department of rheumatology or general internal medicine, where the latest registered M05/M06 diagnosis defined the serologic status; Criteria C, a M05/M06 diagnosis recorded at any time preceded or followed by redemption of a DMARD prescription within one year, where the M05/M06 diagnosis recorded determined the serologic status; Criteria D, as Criteria A, but with the additional requirements that cases had no registration for other selected inflammatory diseases.In calculation of IRs the total Danish population from 1998 to 2018 was used as reference population for standardisation. The PP was calculated for years 2000, 2009, 2011 and 2018.Results:From 1998 to 2018 the overall IR was 18.0 (95%CI 17.7 to 18.3) per 100,000 person years (PY) for seropositive RA and 16.7 (95%CI 16.4 to 16.9) per 100,000 PY for seronegative RA using Criteria A. A higher IR for seropositive RA than for seronegative RA was found regardless of the case criteria used. Figure 1 shows the temporal IRs of seropositive and seronegative RA.Regardless of case criteria used, the PP increased from 2000 to 2018 for both seropositive and seronegative RA, and the estimates were higher for seropositive RA than for seronegative RA (Table 1).Table 1.Point prevalence of rheumatoid arthritis in Denmark in year 2000, 2009, 2011 and 2018 using four different case definitions2000200920112018SeropositiveSeronegativeSeropositiveSeronegativeSeropositiveSeronegativeSeropositiveSeronegativeCriteria AN3029274174747127871281211243711662Population3964040416629842028914269677PP, % (95%CI)0.08 (0.08 to 0.08)0.07 (0.07 to 0.07)0.18 (0.18 to 0.19)0.17 (0.17 to 0.18)0.21 (0.20 to 0.21)0.19 (0.19 to 0.20)0.27 (0.27 to 0.28)0.26 (0.25 to 0.26)Criteria BN7507489311565903312710100111633413340PP, % (95%CI)0.20 (0.19 to 0.20)0.13 (0.12 to 0.13)0.28 (0.28 to 0.29)0.22 (0.21 to 0.22)0.30 (0.30 to 0.31)0.24 (0.23 to 0.24)0.36 (0.35 to 0.36)0.29 (0.29 to 0.30)Criteria CN6701457011174912512417101491588113712PP, % (95%CI)0.18 (0.17 to 0.18)0.12 (0.12 to 0.12)0.27 (0.27 to 0.28)0.22 (0.22 to 0.23)0.29 (0.29 to 0.30)0.24 (0.24 to 0.25)0.35 (0.34 to 0.35)0.30 (0.30 to 0.31)Criteria DN272423906612598476956759108309452PP, % (95%CI)0.07 (0.07 to 0.07)0.06 (0.06 to 0.07)0.16 (0.16 to 0.16)0.15 (0.14 to 0.15)0.18 (0.18 to 0.19)0.16 (0.16 to 0.17)0.24 (0.23 to 0.24)0.21 (0.20 to 0.21)PP = Point prevalenceConclusion:In Denmark, the IR and PP estimates were higher for seropositive compared to seronegative RA during the study period. However, when applying stricter case criteria for RA (Criteria A and D) the differences in IR and PP estimates were smaller, than when using less strict criteria (Criteria B and C). The findings of such small differences between seropositive and seronegative IRs warrant further investigation.

Lifetime Risks, Life Expectancy, and Health Care Expenditures for Rheumatoid Arthritis: A Nationwide Cohort Followed Up From 2003 to 2016.

ObjectiveThis study was undertaken to estimate the cumulative incidence rate of rheumatoid arthritis (RA) in the Taiwanese population ages 16–84 years, and life expectancy, loss of life expectancy, and lifetime health care expenditures for incident RA in Taiwan after 2003, when biologics began to be prescribed.MethodsWe obtained all claims data for the period 1999 to 2016 from the National Health Insurance program of Taiwan, and validated the data against the Catastrophic Illness Registry to establish the study cohort. We estimated the survival function for RA and extrapolated to lifetime using a rolling‐over algorithm. For every RA case, we simulated sex‐, age‐, and calendar year–matched referents from vital statistics and estimated their life expectancy. The difference between the life expectancy of the referent and the life expectancy of the RA patient was the loss of life expectancy for the RA patient. Average monthly health care expenditures were multiplied by the corresponding survival rates and summed up throughout the lifetime to calculate the lifetime health care expenditures.ResultsA total of 29,352 new RA cases were identified during 2003–2016. There was a decreasing trend in cumulative incidence rate in those ages 16–84 for both sexes. Mean life expectancy after diagnosis of RA was 26.3 years, and mean lifetime cost was $72,953. RA patients had a mean loss of life expectancy of 4.97 years. Women with RA survived 1–2 years longer than men with RA of the same age, which resulted in higher lifetime expenditures for the former. Since the life expectancy for women in Taiwan was 6–7 years higher than that for men, the loss of life expectancy for women with RA was higher than that for men with RA. Annual health care expenditures were similar for both sexes.ConclusionOur findings indicate that since biologics became available, RA patients have lived longer and had higher lifetime expenditures, which should be monitored and evaluated for cost‐effectiveness.

Risk of Rheumatoid Arthritis in Patients with Endometriosis: A Nationwide Population-Based Cohort Study.

Background: Abnormalities in the immune system of endometriosis has been demonstrated and may reflect the chronic inflammatory response or the autoimmune reaction to the presence of ectopic endometrial tissue. Rheumatoid arthritis (RA) is a chronic inflammatory joint disease of an autoimmune nature. The study aimed to investigate the risk of incident RA in patients with endometriosis. Materials and Methods: A total of 17,913 patients with endometriosis and 17,913 unaffected controls matched by age, index year, and Charlson Comorbidity Index (CCI) score were enrolled between 2000 and 2012. Patients were followed until the end of 2013 using Taiwan's National Health Insurance Research Database, at which time participants who developed RA were identified. Cox regression analysis was used to calculate the hazard ratio (HR) with a 95% confidence interval (CI) of RA incidence rate between patients with endometriosis and unaffected controls. Results: Patients with endometriosis were associated with an increased risk of incident RA compared with unaffected controls after adjusting for age, CCI score, and hormonal and surgical treatments (3.56 vs. 1.30 per 10,000 person-years, HR: 3.71, 95% CI: 2.91-5.73). Among these adjusted variables, hormonal and surgical treatments were treated as time-dependent covariates. Stratification analyses also revealed similar risk associations linking endometriosis to subsequent RA in all stratified age and CCI score subgroups (adjusted HR all >1, although not all were significant) Conclusions: Patients with endometriosis was associated with an increased risk of incident RA. Additional prospective studies that take into account genetic vulnerability and environmental exposures are warranted to confirm this relationship.

Association of Rheumatoid Arthritis with Dental Health - A Mini Review

Autoimmune disorders represent a cluster of diseases related to dysregulation of the immune system or misrecognition of self from non-self. Rheumatoid arthritis (RA) is a chronic inflammatory condition involving the joints. It is one of the most common forms of inflammatory arthritis reported globally. The incidence rate of RA is found to be the highest among middle-aged women. There happens to be a close relationship between RA and dental health. The inflammatory processes triggered by microbes and other endogenous factors affects the bone health resulting in the resorption of bones. This condition is observed in aggressive and chronic periodontitis. The main objective of the present literature review was to evaluate the association of rheumatoid arthritis with dental health such as gingivitis, tooth loss and periodontitis. Furthermore, the present literature review throws light on the common markers which might be associated with both the disease conditions. The current review identified novel markers that were associated with rheumatoid arthritis which were implicated in dental health also. Hence management of rheumatoid arthritis might as well reduce the damage caused by bone resorption and could aid in the prevention of premature tooth loss.

Active Surveillance of Adverse Events Following Human Papillomavirus Vaccination: Feasibility Pilot Study Based on the Regional Health Care Information Platform in the City of Ningbo, China.

BackgroundComprehensive safety data for vaccines from post-licensure surveillance, especially active surveillance, could guide administrations and individuals to make reasonable decisions on vaccination. Therefore, we designed a pilot study to assess the capability of a regional health care information platform to actively monitor the safety of a newly licensed vaccine.ObjectiveThis study aimed to conduct active surveillance of human papillomavirus (HPV) vaccine safety based on this information platform.MethodsIn 2017, one of China’s most mature information platforms with superior data linkage was selected. A structured questionnaire and open-ended interview guidelines were developed to investigate the feasibility of active surveillance following HPV vaccination using the regional health care information platform in Ningbo. The questionnaire was sent to participants via email, and a face-to-face interview was conducted to confirm details or resolve discrepancies.ResultsFive databases that could be considered essential to active surveillance of vaccine safety were integrated into the platform starting in 2015. Except for residents' health records, which had a coverage rate of 87%, the data sources covered more than 95% of the records that were documented in Ningbo. All the data could be inherently linked using the national identity card. There were 19,328 women who received the HPV vaccine, and 37,988 doses were administered in 2017 and 2018. Women aged 30-40 years accounted for the largest proportion. Quadrivalent vaccination accounted for 73.1% of total vaccination, a much higher proportion than that of bivalent vaccination. Of the first doses, 60 (60/19,328, 0.31%) occurred outside Ningbo. There were no missing data for vaccination-relevant variables, such as identity card, vaccine name, vaccination doses, vaccination date, and manufacturer. ICD-10 coding could be used to identify 9,180 cases using a predefined list of the outcomes of interest, and 1.88% of these cases were missing the identity card. During the 90 days following HPV vaccination, 4 incident cases were found through the linked vaccination history and electronic medical records. The combined incident rate of rheumatoid arthritis, optic neuritis, and Henoch-Schonlein purpura was 8.84/100,000 doses of bivalent HPV, and the incidence rate of rheumatoid arthritis was 3.75/100,000 doses of quadrivalent HPV.ConclusionsThis study presents an available approach to initiate an active surveillance system for adverse events following HPV vaccination, based on a regional health care information platform in China. An extended observation period or the inclusion of additional functional sites is warranted to conduct future hypothesis-generating and hypothesis-confirming studies for vaccine safety concerns.

Secular trends in the incidence and prevalence of rheumatoid arthritis within members of an integrated health care delivery system.

The study objective was to estimate secular trends in the overall incidence rate (IR) and prevalence rate (PR) of rheumatoid arthritis (RA); and subgroup-specific IR and PR by race, ethnicity, and sex in a multi-ethnic population of a large integrated health care delivery system. An ecological study was conducted within the adult population of Kaiser Permanente Southern California health plan. From January 1995 up to and including December 2014, annual IR and PR were calculated separately by race, ethnicity, sex and pooled overall. Depending on the stationarity of each ecological series, annual percentage change in IR and PR was evaluated using auto-regressive integrated moving average models. Average overall IR was 53 [95% confidence interval (CI) 46, 61] per 100,000 person-years. The overall as well as subgroup-specific annual IR of RA were unchanged from 1995 to 2014. In 1995, the overall PR of RA was 59 (44, 74) per 100,000 person-years which increased by 14% (7%, 21%) annually thereafter. The increase in PR in Caucasians was lower as compared to African American, Asian and other race (13% vs 15%, 15%, and 18%, respectively). Compared to non-Hispanic ethnicity, the increase in PR among Hispanic was higher (17% vs 14%). Over the past 2 decades, while the incidence of RA was unchanged, the prevalence had increased significantly overall as well as within every subgroup of race, ethnicity, and sex.

The incidence rate and the early management of rheumatoid arthritis in Slovenia.

Epidemiological data for rheumatoid arthritis (RA) differ according to ethnicity and geographical region. Moreover, despite of clear RA management guidelines, the implementation of treat-to-target (T2T) strategy often remains incomplete. Our objectives were to determine the incidence rate of RA, the clinical characteristics, and the level of adherence to the T2T guidelines in Slovenia. We analyzed prospectively the collected data of adult patients diagnosed with RA from 2014 through 2016 at the Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia. The department provides rheumatology services to a well-defined region with a population of 704,000 adult residents. During the 3-year observation, we identified 341 incipient cases of RA (75% females, median (IQR) aged 64 (52.0-75.4) years), resulting in an annual incidence rate of 16.1 per 100,000 adults (95% CI 14.5-17.9). The incidence rate peaked in the 70-79-year age interval. The median time from the onset of symptoms suggestive of RA to rheumatology consultation was 12.9 (4.4-26.1) weeks, and the median time from referral to consultation was 1 (1-3) day. Within 12weeks of symptom onset, 161 (47.2%) incipient RA patients were examined by a rheumatologist, and 123 (36.1%) were started on DMARD therapy. The estimated incidence rate was in line with the available epidemiological data. Our early interventional clinic enabled us to identify and manage a substantial portion of RA patients within the recommended time frame.

Risk of rheumatoid arthritis in patients with hepatitis C virus infection receiving interferon-based therapy: a retrospective cohort study using the Taiwanese national claims database

ObjectivesTo illuminate the association between interferon-based therapy (IBT) and the risk of rheumatoid arthritis (RA) in patients infected with hepatitis C virus (HCV).Design, setting, participants and interventionsThis retrospective cohort study...

Analysis of Socioeconomic Status in the Patients with Rheumatoid Arthritis.

Rheumatoid arthritis (RA) is a systemic inflammatory disease with different etiologies in different areas. Our study focused on the prevalence of RA in Taiwan from 2001 to 2011. This study contained longitudinal enrollment files, claims data, catastrophic illness files, and treatment registries from Taiwan Longitudinal Health Insurance Research Database. We identified RA patients by ICD-9-CM code 714.0. The demographical variables including age, sex, income and area of registration were evaluated. The multivariate Poisson regression was applied to calculate relative risk for developing RA. In Taiwan, the ratio of female to male was about 5:1. From 2001 to 2011, significant increasing prevalence of RA, from 0.07% to 0.14%, was found in women. The prevalence of RA was increasing 6% per year in both sex groups. The annual incidence rate (per 10,000 person years) ranged from 1.62 to 2.02 (female: 2.30–3.14; male: 0.71–1.17) from 2003 to 2011. City area had lowest incidence rate of RA compared with suburban or rural area. Higher incidence of RA was observed among lower socioeconomic status. The prevalence of RA was rising from 0.07% in 2001 to 0.14% in 2011. Incidence was about 2/10,000 person-years and female to male ratio was 5:1. Lower socioeconomic status and living rural region might be a risk factor for developing RA.

Clinical evaluation of shiva guggulu and simhnad guggulu in the management of amavata

Amavata is one of the dreadful disorders and included under the vata vyadhis in Ayurveda. The annual incidence rate of rheumatoid arthritis is low however the prevalence rate of the same is very high. Of all the rheumatic disorders, rheumatoid arthritis still remains a formidable disease, as it causes severe crippling deformities and functional disabilities. The disease can undergo spontaneous remission and it is difficult to forecast the outcome of the disease and it makes the evaluation of new drug is also difficult. If proper attention has not been paid the condition turns to its worse. The severe pain and crippling deformities with functional abnormalities make the patient seek doctor’s advice. Even in the modern system of medicine the drug therapy for rheumatoid arthritis is empirical and is focused on 3 issues-1. Relieving the pain along with control of inflammation,2. Improving and maintaining the function and3. Prevention of the deformity.However, none of the medicine available at present can give everlasting benefit thereby permanent remission from the symptoms. The drugs which are available as on today are only of value in achieving the symptomatic relief. But their use is restricted because of the number of adverse effects attached to their usage. It is because of this reason the people are looking towards a safe and effective drug.

The association between gastro-oesophageal reflux disease and subsequent rheumatoid arthritis occurrence: a nested case–control study from Taiwan

ObjectiveGastro-oesophageal reflux disease (GORD) is a common comorbidity among patients with rheumatoid arthritis (RA). While GORD has been attributed to the antirheumatic medications, no studies of human cohorts have investigated...

Increased risk of rheumatoid arthritis in patients with migraine: a population-based, propensity score-matched cohort study.

Previous cross-sectional studies have suggested an association between migraine and rheumatoid arthritis (RA), but no longitudinal study has been performed to evaluate the temporal relationship between the two conditions. The purpose of the present population-based, propensity score-matched cohort study was to investigate whether migraineurs are at a higher risk of developing RA. A total of 58,749 subjects aged between 20 and 90years with at least two ambulatory visits with a diagnosis of migraine were recruited in the migraine group. We fit a logistic regression model that included age, sex, comorbid conditions, and socioeconomic status as covariates to compute the propensity score. The non-migraine group consisted of 58,749 propensity score-matched, randomly sampled subjects without migraine. The RA-free survival curves were generated using the Kaplan-Meier method. Stratified Cox proportional hazard regression was used to estimate the effect of migraine on the risk of RA. During follow-up, 461 subjects in the migraine group and 220 in the non-migraine group developed RA. The incidence rate of RA was 3.18 (95% confidence interval [CI] 2.90-3.49) per 1000 person-years in the migraine group and 1.54 (95% CI 1.34-1.76) per 1000 person-years in the non-migraine group. Compared to the non-migraine group, the crude hazard ratio of RA for the migraine group was 2.15 (95% CI 1.82-2.56, P<0.0001), and the multivariable-adjusted hazard ratio was 1.91 (95% CI 1.58-2.31, P<0.0001). This study showed that patients with migraine had an increased risk of developing RA.

Do solar cycles influence giant cell arteritis and rheumatoid arthritis incidence?

ObjectiveTo examine the influence of solar cycle and geomagnetic effects on the incidence of giant cell arteritis (GCA) and rheumatoid arthritis (RA).MethodsWe used data from patients with GCA (1950–2004) and...