ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2025

Factors Associated with Time to Diagnosis from Symptom Onset in Early Rheumatoid Arthritis Patients

Yoon-Kyoung Sung1,2, Soo-Kyung Cho2,3, Dam Kim3, Soyoung Won3, Jiyoung Lee3, Jung-Yoon Choe4, Chan-Bum Choi1,2, Seung-Jae Hong5, Jae-Bum Jun2, Tae-Hwan Kim6, Eunmi Koh7, Hye-Soon Lee8, Jisoo Lee9, Dae-Hyun Yoo1, Bo Young Yoon10 and Sang-Cheol Bae1,3, 1Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea, 2Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea, 3Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, South Korea, 4Division of Rheumatology, Catholic University of Daegu School of Medicine, Daegu, South Korea, 5Division of Rheumatology, Department of Internal Medicine, Kyung Hee University, Seoul, South Korea, 6Division of Rheumatology, Department of Internal Medicine, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea, 7Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, 8Department of Rheumatology, Hanyang University Guri Hospital, Guri, South Korea, 9Ewha Womans University School of Medicine, Seoul, South Korea, 10Inje University Ilsan Paik Hospital, Goyang, South Korea

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Epidemiology and Public Health (ACR): Rheumatoid Arthritis Pathogenesis and Treatment

Session Type: Abstract Submissions (ACR)

Background/Purpose

Early diagnosis and treatment is an optimal target for better outcomes in rheumatoid arthritis (RA) in clinical practice. To make an early diagnosis, it would be helpful to know the sociodemographic or clinical factors for recognition of disease. On this study, we aimed to identify the factors associated with time to diagnosis after symptom onset in early RA patients

Methods .

Early RA patients with less than 1 year of disease duration in the KORean Observational study Network for Arthritis (KORONA) database were included in this analysis. The time to diagnosis was defined as the duration between symptom onset and the diagnosis of RA in each patient. Early RA patients were further divided into two groups according to the time to diagnosis: early diagnosis group (time to diagnosis <1year) and late diagnosis group (time to diagnosis°Ã1year). Using the multivariate regression model, we identified the factors associated with the early diagnosis. We also compared the disease status such as disease activity, hand radiographic change and functional disability on the point of RA diagnosis between early diagnosis group and late diagnosis group.

Results .

Among the 714 early RA patients, 401 patients (56.2%) and the other 313 patients (43.8%) were classified as early diagnosis group and late diagnosis group, respectively. In multivariate analysis, older onset age (OR 1.03, 95%CI 1.02-1.05), higher education level (OR 1.72, 95%CI 1.15-2.57) and higher income (OR 1.47, 95%CI 1.03-2.10) were identified as associating factors for early diagnosis (See table). Disease activity scores (DAS) 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) were not different between two groups. However, hand joint erosions on X-ray (37.8% vs. 25.6% p<0.01) was common in late diagnosis group than early diagnosis group.

Conclusion .

Old age at symptom onset, higher education level or income were the factors associated with short time to diagnosis in early RA patients. Hand joint erosion was more common in late diagnosis group when they diagnosed as RA.

Table. Factors associated with time to diagnosis in early RA patients

Crude OR (95% CI)

Multi-adjusted OR (95% CI)

Onset age

1.01 (1.00-1.03)*

1.03 (1.02-1.05)*

Male

0.92 (0.64-1.32)

0.78 (0.52-1.15)

Family history of RA

0.82 (0.52-1.31)

0.85 (0.52-1.38)

Body Mass Index

  <18.5 kg/m2

1

1

  °Ã18.5 and <23.0 kg/m2

1.36 (0.70-2.62)

1.13 (0.56-2.30)

  °Ã23.0 kg/m2

1.02 (0.53-1.97)

0.84 (0.41-1.73)

Education

  Middle school or less

1

1

  High school or more

1.32 (0.97-1.78)

1.72 (1.15-2.57)*

Income

  <2 million won

1

1

  °Ã2 million won

1.38 (1.02-1.86)*

1.47 (1.03-2.10)*

Exercise

1.32 (0.97-1.78)

1.19 (0.86-1.65)

First symptom in small joint

1.37 (0.99- 1.89)

1.31 (0.93-1.85)

Number of comorbidity

  =0

1

1

  =1

1.12 (0.80-1.57)

0.99 (0.69-1.43)

  °Ã2

1.11 (0.75-1.66)

0.94 (0.61-1.46)

Rheumatoid factor positivity

1.17 (0.73-1.89)

1.29 (0.77-2.15)

This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry of Health and Welfare, Republic of Korea.(HI10C2020).

Disclosure:

Y. K. Sung,
None;

S. K. Cho,
None;

D. Kim,
None;

S. Won,
None;

J. Lee,
None;

J. Y. Choe,
None;

C. B. Choi,
None;

S. J. Hong,
None;

J. B. Jun,
None;

T. H. Kim,
None;

E. Koh,
None;

H. S. Lee,
None;

J. Lee,

Basic Science Research Program through the National Research Foundation (NRF) funded by the ministry of Education and Technology 2010-0010589 ,

2;

D. H. Yoo,
None;

B. Y. Yoon,
None;

S. C. Bae,
None.

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/factors-associated-with-time-to-diagnosis-from-symptom-onset-in-early-rheumatoid-arthritis-patients/