Background To date, there is no rheumatoid arthritis registry in Middle East. Rheumatoid arthritis registry in Qatar was established in 2013 with the aim of collecting data on RA patients seen in routine care at Hamad General Hospital, Qatar. It is observational study collecting data about demographic features of RA, RF and Anti CCP status, type of medication and their adverse reactions. CDAI, SDAI, DAS28, RAPID3 and HAQ questionnaire are also recorded.
Objectives To describe demographic, disease activity score and treatment pattern in rheumatoid arthritis patients in Qatar.
Methods All consecutive rheumatoid arthritis patients who were attending routine rheumatology outpatient clinic at Hamad General Hospital from period of June 2013 to September 2015 were included in this study.
Results Data of 496 patients were analyzed: 75.8% female, 54.2% Arabs, 45.8% non Arabs, 74.9% were positive for rheumatoid factor, 79.8% were positive for anti CCP and 31.3% have erosion at the time of data collection. One hundred thirty one patients (26.4%) were receiving biologic drugs: (9.3% etanercept, 6% rituximab, 5.6% tocilizumab, 4.4% adalimumab, 0.4% abatacept, 0.4% certolizumab, and 0.2% infliximab). Among patients who are receiving biologic therapy, 42 patients (32%) are on biologic monotherapy. (9.9% on rituximab monotherapy, 9.9% on tocilizumab, 6.9% on etanercept and 5.3% on adalimumab monotherapy). Similarly, 49.23% of those patients receiving biologic, are also using concurrent methotrexate.
Methotrexate (MTX) was the most commonly prescribed synthetic DMARD (65.3%); 27% MTX monotherapy, 9.9% combined MTX and hydroxychloroquine, 6% combined MTX and sulfasalazine, 4.8% combined MTX and leflunomide and 3.6% triple therapy. Hydroxychloroquine was used by 29.4% of patients (4.6% patients were only on hydroxycholoquine monotherapy). Sulfasalazine was used by 21.2% patients (3.2% were only on sulfasalazine monotherapy). Leflunomide was used by 13.7% of patients (3.4% were only on leflunomide monotherapy). Good number of patients (39.7%) was receiving corticosteroid in our cohort. Mean dose of methotrexate, sulfasalazine and prednisolone was 15.88 ± 4.98 mg per week, 1.64 ± 0.57 gram daily and 5.45 ± 1.81 mg per day respectively.
Different disease activity scores in our cohort were as follows: DAS28 (4) 3.2 ± 1.2, CDAI 8.5 ± 7.9 and SDAI 9.7 ± 9.1. Mean HAQ score was 0.9 ± 0.7. Disease activity categorized by these indices differs considerably; 18% and 17.5% patients were in remission according to CDAI and SDAI scores respectively while 30.3% patients were in DAS 28 remission. Similarly, 23.1% patients were in low disease activity according to DAS28 (4) score while 51.6% patients were in low disease activity according to CDAI and SDAI scores.
Conclusions This observational study describes a cohort of RA patients seen at Hamad General Hospital, Doha Qatar. Treatment pattern is somewhat similar to what is reported worldwide. One fourth of patients are receiving biological DMARD. Approximately two third of patients are categorized as having low disease activity or in remission. Disease activity categorized by various scores differs considerably.
Disclosure of Interest None declared