Factors influencing remission in rheumatoid arthritis patients: results from Karnataka rheumatoid arthritis comorbidity (<scp>KRAC</scp>) study

Chandrashekara, S; Shobha, Vineeta; Dharmanand, BG; Jois, Ramesh; Kumar, Sharath; Mahendranath, Kurugodu M.; Haridas, Vikram; Prasad, Shiva; Singh, Yogesh Preet; Daware, Manisha; Swamy, Anupama; Subramanian, Ramaswamy; Somashekar, Srirama Attappa; Shanthappa, Arun Madhanaghatta; Anupama, K. R.

doi:10.1111/1756-185x.12908

Cited by 8 publications

(13 citation statements)

References 20 publications

(22 reference statements)

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“…With regard to country of origin from where the study population was drawn, 7 were from the UK,1–3 15–18 10 from the rest of Europe (3 the Netherlands, 3 Sweden, 1 Norway, 1 Germany, 1 Denmark),4 19–25 6 from USA and Canada,26–31 4 from South America (2 Chile, 1 Mexico, 1 Peru)32–35 and 3 from Asia (1 India, 1 China, 1 Singapore) 36–38. One study included multinational data 39.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of articles included educational achievement in their definition of SES, either alone or in combination with other factors. Educational attainment alone was used as a proxy for SES in eight (27%) of the included articles,4 23–25 33 38–40 while a further eight combined education with factors including employment status, occupation, income, race and area of residence 21 22 26–28 31 36 37. Finally, one article categorised SES according to the area of the city in which patients were resident,20 and another article used type of occupation 19…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Of the 30 articles, 25 (83%) reported a clear association between SES and disease activity, with lower SES predicting more active disease or worse clinical outcomes 1–4 15–18 20 21 24–33 35–39. Of these, 13 quantified the association as an OR 3 4 15 16 18 21 24–26 32 33 36 39. ORs for an association between SES and disease activity (ie, poorer SES associated with poorer disease outcomes) ranged from 1.06 to 3.15.…”

Section: Resultsmentioning

confidence: 99%

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Association between social deprivation and disease activity in rheumatoid arthritis: a systematic literature review

et al. 2022

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Physical and mental illnesses are driven by ethnicity, social, environmental and economic determinants. Novel theoretical frameworks in rheumatoid arthritis (RA) focus on links and adverse interactions between and within biological and social factors. This review aimed to summarise associations between socioeconomic status (SES) and RA disease activity, and implications for future research. Articles studying the association between SES and RA disease activity were identified, from 1946 until March 2021. The research question was: Is there an association between social deprivation and disease activity in people with RA? Articles meeting inclusion criteria were examined by one author, with 10% screened at abstract and full paper stage by a second author. Disagreements were resolved with input from a third reviewer. Information was extracted on definition/measure of SES, ethnicity, education, employment, comorbidities, disease activity and presence/absence of association between SES and disease activity. Initially, 1750 articles were identified, with 30 articles ultimately included. SES definition varied markedly—10 articles used a formal scale and most used educational attainment as a proxy. Most studies controlled for lifestyle factors including smoking and body mass index, and comorbidities. Twenty-five articles concluded an association between SES and RA disease activity; two were unclear; three found no association. We have demonstrated the association between low SES and worse RA outcomes. There is a need for further research into the mechanisms underpinning this, including application of mixed-methods methodology and consideration of syndemic frameworks to understand bio–bio and bio–social interactions, to examine disease drivers and outcomes holistically.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Association between social deprivation and disease activity in rheumatoid arthritis: a systematic literature review

et al. 2022

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“… [9] Other single-country studies have been conducted showing that clinical remission rate was low in the Asia-Pacific region, such as 14•6% in Thailand, 20•0% in India, and 29•5% in China for DAS28-ESR. [ 6 , 10 , 11 ] However, there is no data about RA remission rate of multinational study in the Asia-Pacific region. Herein, this study was performed to assess the remission rates in a large-scale multicentric study in the Asia-Pacific region, and analyze the factors related to remission according to various remission definitions.…”

Section: Introductionmentioning

confidence: 99%

Clinical remission of rheumatoid arthritis in a multicenter real-world study in Asia-Pacific region

Sun

Cai

et al. 2021

The Lancet Regional Health - Western Pacific

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Background: Clinical remission is an attainable goal for Rheumatoid Arthritis (RA). However, data on RA remission rates from multinational studies in the Asia-Pacific region are limited. We conducted a crosssectional multicentric study to evaluate the clinical remission status and the related factors in RA patients in the Asia-Pacific region. Methods: RA patients receiving standard care were enrolled consecutively from 17 sites in 11 countries from APLAR RA SIG group. Data were collected on-site by rheumatologists with a standardized casereport form. Remission was analyzed by different definitions including disease activity score using 28 joints (DAS28) based on ESR and CRP, clinical disease activity index (CDAI), simplified disease activity index (SDAI), Boolean remission definition, and clinical deep remission (CliDR). Logistic regression was used to determine related factors of remission. Findings: A total of 2010 RA patients was included in the study, the overall remission rates were 62 • 3% (DAS28-CRP), 35 • 5% (DAS28-ESR), 30 • 8% (CDAI), 26 • 5% (SDAI), 24 • 7% (Boolean), and 17 • 1% (CliDR), respectively, and varied from countries to countries in the Asia-Pacific region. Biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) prescription rate was low (17 • 9%). Compared to patients in non-remission, patients in remission had higher rates of b/tsDMARDs usage and lower rates of

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Prevalence of comorbidities in Mexican mestizo patients with rheumatoid arthritis

et al. 2017

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Patients with rheumatoid arthritis (RA) have a high risk for comorbid conditions which increase mortality, hospital admissions, costs of care and inability. To evaluate the prevalence of comorbidities in Mexican mestizo patients with RA and determine the associated risk factors. Cross-sectional study in which RA patients admitted to our outpatient clinic were consecutively enrolled. We collected data regarding demographics, disease characteristics and comorbidities at the time of the patient's visit to the clinic. We analyzed 225 patients. Their mean age was 55.7 ± 8.3 years; disease duration, 9.5 (3.8-15.5) years; female gender, 93.8%; Disease Activity Score using 28 joints-C-reactive protein, 3 (2-4); methotrexate use, 84.9%; use of any other conventional disease modifying anti-rheumatic drug, 65.7%; use of biological agents, 8%. The most frequently associated diseases were: hypertension, 29.8%; dyslipidemia, 27.1%; osteoporosis, 19.1%; diabetes, 12.4%; hypothyroidism, 6.2%; solid malignancies 4.4%. Risk factors were also evaluated, the most prevalent was overweight in 101 (44.9%) of our patients. A total of 71 (31.6%) had obesity. We also detected high blood pressure in 12.4%, hyperglycemia in 27.1% and hyperlipidemia in 49.8%. Due to the high frequency of comorbidities among RA patients, it is important to follow existing recommendations for their timely detection and management. Cardiovascular diseases must be evaluated with priority. The initial evaluation should include a thorough examination to prevent the deleterious effect of comorbidities in RA.

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Factors influencing remission in rheumatoid arthritis patients: results from Karnataka rheumatoid arthritis comorbidity (KRAC) study

Abstract: The prevalence of remission noted was around 20%. Early treatment, escalating dose of DMARDs, and patient counseling are important contributing factors for attaining remission.

Cited by 8 publications

References 20 publications

Association between social deprivation and disease activity in rheumatoid arthritis: a systematic literature review

Association between social deprivation and disease activity in rheumatoid arthritis: a systematic literature review

Clinical remission of rheumatoid arthritis in a multicenter real-world study in Asia-Pacific region

Prevalence of comorbidities in Mexican mestizo patients with rheumatoid arthritis

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