Background Since 2005 the very early arthritis clinic (VEAC) at East Tallinn Central Hospital, serving approx. 700,000 inhabitants, have included patients (pts) between 18-75 years of age with arthritis of at least one peripheral joint with duration of joint swelling less than 16 weeks. The protocol was adopted from a multi-centre early arthritis study in Eastern Norway.
Objectives To characterise the 1-year disease courses of pts recruited to a VEAC in Tallinn, Estonia between 2005 and 2011, and to compare them to pts in a VEAC in Oslo, Norway who were included and followed by the same protocol.
Methods Pts from Diakonhjemmet Hospital in Oslo, serving approx. 600,000 inhabitants, were included as a comparator cohort for the current analyses. Both centres requested general practitioners to refer pts with recent onset arthritis, and pts were received with a maximum delay of 4 weeks. Pts with joint swelling due to osteoarthritis, gout, trauma and septic arthritis were excluded. Examinations at baseline and after 3, 6, 12 and 24 months included 66-swollen joint count (SJC) and 28-tender joint count (TJC), laboratory investigations and patient reported outcomes (PROs). Baseline characteristics and 6- and 12-month changes were compared between EAC pts in Tallinn and Oslo, and chi-square, two-samples t and Mann-Whitney U tests were applied as appropriate.
Results The cohort in Tallinn included 206 pts, and the Oslo comparator cohort included 391 pts. Mean(SD) baseline age was 43.6(15.6) vs. 45.0(15.2) yrs and duration of joint swelling 6.7(6.2) vs. 5.4(4.9) weeks (p=0.004) (median duration 5.6 vs. 3.6 weeks, p=0.001). 75% vs. 53% were female (p<0.001), 27% vs. 12% RF pos (p<0.001) and 24% vs. 15% ACPA pos (p=0.01). The baseline distributions of mono-, oligo- and polyarthritis were 22%/40%/38% in Tallinn and 39%/37%/34% in Oslo. At 6 months 74% in Tallinn vs. 57% in Oslo had no swollen joints, 14% vs. 14% had 1 swollen joint, 10% vs. 14% had 2-4 swollen joints, and 1.5% vs. 14% had >4 swollen joints. Baseline values and changes for various disease activity and HRQoL measures are shown in the table. Pts with available 6- and 12-month data were more often RF/ACPA pos, had longer disease duration, and a somewhat higher baseline SJC than pts without the available data.
Conclusions Overall, baseline characteristics were similar in patients in Tallinn and Oslo, except serology, proportions of monoarthritis and some HRQoL items. Outcome was at least as good in Tallinn as in Oslo. These data contribute to the generalisability of the concept of VEAC.
Disclosure of Interest None Declared