<p>Achieving comprehensive remission or low disease activity in rheumatoid patients and its impact on workability &ndash; Saudi Rheumatoid Arthritis Registry</p>

Abstract

Purpose Ability to work is an important endpoint in rheumatoid arthritis (RA). It is not clear what outcome measures should be used to guide treatment in order to maximize workability. This study addressed the impact of RA on workability in a Saudi population and examined the correlation between objective measures of disease activity and reduced workability. This will allow better understanding of treatment targets that will translate into improved workability. Patients and methods Data were collected through a digital patient record keeper: The Rheumatoid Arthritis Saudi Database. Male and female patients, ≥18 years of age, that met the American College for Rheumatology criteria for diagnosis of RA, were recruited, regardless of treatment. Demographic and disease-specific data were collected. Disease Activity Score-28 (DAS-28) was used to define patients as low (DAS-28 ≤3.2) vs high (DAS-28 >3.2) disease activity. Health assessment questionnaire (HAQ) score, visual analog scale (VAS) score, and musculoskeletal ultrasound 7 joint score were documented also. The work productivity and activity impairment (WPAI) score was used to measure absenteeism, presenteeism, overall work impairment, and activity impairment. DAS-28 score was correlated with WPAI score and linear regression used to identify the demographic and measures of treatment response that predict improvement in WPAI score. Results Higher absenteeism and more activity impairment were seen for patients with persistent DAS-28 >3.2 (non-achievers). HAQ and VAS scores correlated with presenteeism, overall work impairment, and activity impairment. Conclusion Disease activity, as defined by DAS-28 score, correlates with absenteeism and work impairment in a Saudi population. However, on linear regression analysis, HAQ and VAS scores were the only measures predictive of work impairment. These scores should be used to monitor response to treatment regimens that aim to maximize work potential for Saudi individuals.

A Review of the Prevalence and Unmet Needs in the Management of Rheumatoid Arthritis in Africa and the Middle East

“…In Cameroon, this shortage of rheumatologists led to the centralization of diagnostic and therapeutic resources, which permits collection of data from a wide spectrum of patients but also increases pressure on tertiary centers to prescribe or monitor drugs in cases when primary and secondary care centers are unable to do so [ 33 , 34 ]. Multiple attempts have been made to establish RA patient registries in Saudi Arabia, the most recent being the Rheumatoid Arthritis Saudi Database (RASD), from which data are beginning to emerge [ 35 , 36 ]. Where available, registries such as the Kuwait Registry for Rheumatic Diseases [KRRD] and the Dubai Private Database, facilitate our understanding of patient characteristics, such as the mean age at diagnosis (49 years), prevalence of family history of rheumatic autoimmune disease (13%), the women:men ratio (3:1) [ 37 ], and main reasons for discontinuation of biologics (loss of efficacy and patient choice) [ 38 ].…”

“…RA-related loss of function can severely affect patients’ ability to work and to participate in social life. Employment rates decline most rapidly within 3 years of disease onset, with some patients experiencing reduced work ability within the first year of diagnosis, and up to 30% affected within 10 years of diagnosis [ 8 , 36 ]. The effects of disease on work function are seen both in reduced working hours (absenteeism, retirement) and reduced productivity while at work (presenteeism, activity impairment) [ 36 ].…”

Future Directions of Rheumatology Training According to Saudi Vision 2030: Recommendations From a Saudi Experts Meeting

“…37 There are successful examples of local efforts in building registries in SA like the efforts conducted by ZCRD to build the Rheumatoid Arthritis Saudi Database (RASD). 4 However, collaboration of efforts is greatly needed to expand the impact of these initiatives.…”

“…3 Almoallim et al have conducted a study on 197 Saudi patients to address the impact of rheumatoid arthritis (RA) on workability in a Saudi population and examined the correlation between objective measures of disease activity and reduced workability, highlighting that higher absenteeism and more activity impairment were seen for patients with persistent Disease Activity Score (DAS-28) >3.2 (non-achievers). 4 Albers and colleagues investigated the socio-economic consequences in a three-year period of patients with RA and found that work disability is more profound in rheumatoid patients than in general population. 5 Studies show wide global discrepancy between the prevalence of rheumatic diseases and the availability of competent and qualified rheumatologists.…”

Methodological and reporting quality evaluation of meta-analyses on the Chinese herbal preparation Zheng Qing Feng Tong Ning for the treatment of rheumatoid arthritis

“…Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease that may trouble patients as a result of morning stiffness, painful joints, chronic inflammation, synovitis, irrecoverable joint damage, and the presence of autoantibodies [1,2]. The prevalence of RA in adults worldwide is 0.04-1.6%, with significant national differences [3]. In China, RA has an estimated prevalence of 0.42% and affected more than 5 million patients in 2018 [4].…”