SPECIFIC ASPECTS OF THE EVOLUTION AND PROGNOSIS OF RHEUMATOID ARTRITIS

COORDINATOR: Prof. Dr. GEORGESCU LIA, Dr. SZASZ SIMONA

FIRST AUTHOR: OPRIȘ IULIA-CRISTINAAUTHOR: ANGHEL (BUJOR) VALENTINA

INTRODUCTION

-systemic autoimmune disease→ chronic evolution

-unknown etiology

-produce an inflammatory response

-afffect –joints cartilage

-epiphyses

-ligaments

-tendons

-causes - pain,

- swelling,

- stiffness

-loss of function

OBJECTIVE AND METHODS

Follow: - the evolution -the prognosis

A -retrospective -observational -analytical study

In the Rheumatology Clinic of Targu Mures

On a number of 100 patients - 85 woman - 15 men

The evolution and the prognosis according to :1 sex

 

15%

85%

sex masculinsex feminin

-common in woman with a privalence of 4-5:1

2 age

21-29 ani 30-39 ani 40-49 ani 50-59 ani >60 ani0%5%

10%15%20%25%30%35%40%45%50%

1%4%

8%

38%

49%

increased disease prevalence in patients aged over 60 years is explained by the fact that this disease started with 10 to 15 years before carrying out this study

3 According to the environment

43%57% Rural areasUrban areas

-the patients form the rural areas - lower access to health services -distrust of pharmacotherapy provided by hospitals -lower awareness of the disease

Analyzing the age when the first symptoms appeared and when they were diagnosed

0-9 10 - 19

20-29 30-39 40-49 50-59 60-69 70-790

10

20

30

40

50

60

70

0 1

913

33

1912

20 2

710

26

30

12

2

Num

ăr d

e pa

cienț

i

0-9 10 - 19

20-29

30-39

40-49

50-59

60-69

70-79

0

1

2

3

4

5

6

7

8

0 0

1

0

4

2 2

00 0

1

1

3

2 2

0

The age of diagnosis

The age when the first symp-toms apeared

Num

ăr d

e pa

cienț

i

- woman - men ↓ ↓ 2,2 years 0,8 years

Analyzing the differences between the first symptoms and the age of diagnosis

93,33%

6,67%

Men

52.94%47.06%

Woman

< 1 an

> 1 an

-from15 patients : -14 (93,33%) early diagnosis (0-1 year) -1 patient (6,67%) over this period

-from 85 patients : -45 (52,94%) early diagnosis - 40 (47,06%) over 1 year

p=0,0024

3 The association between a delayed diagnosis and the social environment of female patients

30.76%

69,24%

Rural area

76.08%

23.92%

Urban area

≤ 1year

> 1year

-from 39 pratients from the rural areas -12 patients(30,76%)-early diagnisis (< 1 year)-27 patients 69,24%) over this period.

-from 46 patients from the urban area -35 (76,08%)- early diagnosis (<1year) -11 (23,92%) over this period

4.The association between a delayed diagnosis and the social enronment of male patients

25.00%

75.00%

Rural area

90.90%

9.10%

Urban area

≤ 1year

> 1year

This difference was not noticed to the male patients

5.The association between a delayed diagnosis and the evolution of the disease

Studying the relationship between delay in diagnosis and the anatomical stage, statistics obtained a p value=0,0035

3

5

The anatomical stage III-IV

≤2years>2years

25

2

The anatomical stage I-II

The distribution of the pacients depending the rheumatoid factor presence or absence

89.41%

10.59%

woman

73.33%

26.67%

pacienți de sex masculin

The presence of the rheumatoid factor

The absence of the rheumatoid factor

-The rheumatoid factor was positive at - 76 (89,41%) woman - 11 (73,33%) men

Staging of patients in the study

30.58%

69.42%

Woman

26.66%

73.34%

Men

Anatomical stage I-II

Anatomical stage III-IV

-anatomical stage I și II -26 ( 30,58%) woman -4 ( 26,66%) mal-anatomical stage III-IV - 59 (69,41%) woman -11 (73,34%) men

CONCLUSIONS• The prevalence of the disease is higher in

females than males • The incidence of rheumatoid arthritis in

rural versus urban areas is similar• The time interval between symptom onset

and diagnosis is higher in women (2.2 years)

• Early diagnosis of rheumatoid arthritis is associated with a less aggressive evolution both anatomically and clinically.

Thank you!