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AB0167 Effects of early diagnosis on disease activity and functional disability in rheumatoid arthritis
  1. D. Kim1,
  2. C.-B. Choi1,
  3. Y.-K. Sung1,
  4. S.-K. Cho1,
  5. S.-Y. Park1,
  6. J.-Y. Choi1,
  7. D.-H. Yoo1,
  8. S.-S. Lee2,
  9. J. Lee3,
  10. J. Kim4,
  11. H.-S. Lee5,
  12. T.-H. Kim1,
  13. B. Y. Yoon6,
  14. W.-H. Yoo7,
  15. J.-Y. Choe8,
  16. S.-H. Lee9,
  17. S.-C. Shim10,
  18. W. T. Chung11,
  19. S.-J. Hong12,
  20. C. K. Lee13,
  21. E. Koh14,
  22. J.-B. Jun1,
  23. S.-Y. Bang5,
  24. S.-K. Kim8,
  25. H.-S. Cha14,
  26. L. Lee15
  1. 1HANYANG UNIVERSITY HOSPITAL for Rheumatic Diseases, Seoul
  2. 2Chonnam National University Hospital, Gwangju
  3. 3Ewha Womans University Hospital, Seoul
  4. 4Jeju National University Hospital, Jeju
  5. 5Hanyang University Guri Hospital, Guri
  6. 6Inje University Ilsan Paik Hospital, Goyang
  7. 7Chonbuk National University Hospital, Jeonju
  8. 8Catholic University of Daegu School of Medicine, Daegu
  9. 9Konkuk University Medical Center, Seoul
  10. 10Chungnam National University Hospital, Daejeon
  11. 11Dong-A University Hospital, Busan
  12. 12Kyung Hee University Hospital, Seoul
  13. 13Yeungnam University Hospital, Daegu
  14. 14Sungkyunkwan University School of Medicine, Samsung Medical Center
  15. 15Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, Korea, Republic Of

Abstract

Background Early and aggressive treatment offers better outcomes in early rheumatoid arthritis (RA). The long-term effect of early treatment and effect of early treatment on functional disability have not been studied.

Objectives To determine whether early diagnosis and treatment have long-term benefits for disease activity and functional disability in patients with RA enrolled in the KORean Observational study Network for Arthritis (KORONA).

Methods A total of 4540 rheumatoid arthritis patients completed questionnaires to establish their demographic profile, medical history, disease-specific outcomes, and RA-related information. We defined early and delayed RA diagnoses as lag-times of shorter than and at least 1 year. Disease activity was measured with the DAS28–ESR, and it was dichotomized using a score of 2.6. Functional disability was measured with the Korean HAQ-DI, and was dichotomized using a score of 1. We used the chi-square test and t-test to identify differences between male and female patients, and crude and multiadjusted models to identify the impacts of early diagnosis on disease activity and functional disability.

Results In crude and multiadjusted models, early diagnosis was not associated with a higher remission rate (OR 1.10, CI 0.94-1.28 in crude model, OR 1.05, CI 0.83-1.32 in multiadjusted model). We performed subgroup analysis according to disease duration; there was no association between early diagnosis and remission rate. Early diagnosis was associated with functional disability in crude model (OR 0.79, CI 0.68-0.91) but not in multiadjusted model (OR 0.85, CI 0.72-1.002). In subgroup analysis according to disease duration and disease activity, early diagnosis was independently associated with functional disability for a shorter disease duration (OR 0.78, CI 0.63-0.96 in disease duration <10 years) and the presence of moderate-to-severe disease activity (OR 0.83, CI 0.69-0.99 in DAS28-ESR ≥3.2).

Conclusions Early diagnosis is associated with functional disability especially with a disease duration of less than 10 years and the presence of moderate-to-severe disease activity.

Disclosure of Interest None Declared

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