Retraso diagnóstico y terapéutico de la artritis reumatoide y su relación con dispositivos asistenciales en Catalunya. Estudio AUDIT

Corominas, Hèctor; Narváez, Javier; Díaz-Torné, Cèsar; Salvador, Georgina; Gómez-Caballero, Maria Eugenia; Fuente, Diana de la; Campoy, Ester; Roig-Vilaseca, Daniel; Clavaguera, Teresa; Morlà, Rosa; Torrente-Segarra, Vicenç; Arasa, X.; Gómez-Puerta, José A.; Möller, Ingrid; Alegre, Cayetano; Graell, Eduard; Ponce, Andrés; Pérez-García, Carolina; Fíguls, Ramon; Sirvent, Elena; Poca, V.; Sanmartí, Raimón

doi:10.1016/j.reuma.2015.08.002

Cited by 14 publications

(7 citation statements)

References 16 publications

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“…There is little data on the exact prevalence of PR before RA onset. Our results are very similar to those observed in a multicentre Catalan study that found a prevalence of 15.8% (14). In the Canadian CATCH early RA cohort study, the reported prevalence was 40%, although the definition of intermittent arthritis possibly reflecting PR was only analysed using a self-reported questionnaire (15).…”

Section: Discussionsupporting

confidence: 89%

Rheumatoid Arthritis Initiating as Palindromic Rheumatism: A Distinct Clinical Phenotype?

et al. 2019

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Objective.To analyze the prevalence of preexisting palindromic rheumatism (PR) in patients with established rheumatoid arthritis (RA) and to evaluate whether these patients have a distinctive clinical and serological phenotype.Methods.Cross-sectional study in patients with established RA. Preexisting PR was determined using a structured protocol and confirmed by retrospective review of medical records. Demographic, clinical, radiological, immunological, and therapeutic features were compared in patients with and without PR.Results.Included were 158 patients with established RA (78% female) with a mean disease duration since RA onset of 5.1 ± 2.7 years. Preexisting PR was recorded in 29 patients (18%). The median time from the onset of PR to progression to RA was 1.2 years. No between-group differences in demographic features, current disease activity, radiographic erosive disease, or disability were observed. Patients with PR had a higher prevalence of smoking (72% vs 40%). Positive rheumatoid factor, anticitrullinated peptide antibodies, and anticarbamylated protein antibodies were numerically higher in patients with PR. No differences in treatment were observed except for greater hydroxychloroquine (HCQ) use in patients with PR (38% vs 6%). Palindromic flares persisted in a significant proportion of patients during the RA course, including patients in clinical remission or receiving biological disease-modifying antirheumatic drugs.Conclusion.Eighteen percent of patients with RA had a history compatible with PR previous to RA onset. No specific clinical or serological phenotype was identified in these patients, although higher HCQ use and smoking prevalence were identified. Palindromic flares may persist during the RA disease course despite treatment.

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Section: Discussionsupporting

confidence: 89%

Rheumatoid Arthritis Initiating as Palindromic Rheumatism: A Distinct Clinical Phenotype?

et al. 2019

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“…Two recent studies found that 16-18 % of patients with established RA have a history compatible with PR [13,14].A recent survey found a prevalence of intermmitent joint episodes in the year before the…”

Section: Epidemiologymentioning

confidence: 99%

Palindromic rheumatism: a unique and enigmatic entity with a complex relationship with rheumatoid arthritis

Sanmartí

Haro

Cañete

2021

Expert Review of Clinical Immunology

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Introduction: Palindromic rheumatism (PR) is a form of relapsing/remitting arthritis that may evolve to chronic rheumatic disease, mainly rheumatoid arthritis (RA). The exact nature of PR is unclear, as it may be considered a disease in itself, an abortive form of RA or just a pre-RA stage. Areas covered:The authors review the most relevant epidemiological and clinical aspects of PR, especially the pathogenetic role of autoimmunity in PR, with most patients having a characteristic autoantibody profile similar to that observed in RA. The role of autoinflammation is also discussed. A literature review on the rate of RA progression and its prognostic factors was analyzed. Data on the efficacy of drug therapies used to treat PR is presented. PubMed was searched using the terms "palindromic rheumatism" OR "palindromic arthritis".Expert opinion: PR is a disease entity with a close but unclear relationship with RA. In PR there is an unmet need, which is to clarify the clinical spectrum and elucidate the risk factors for evolution to RA.The role of autoimmunity and the autoinflammatory component should be investigated. Since most patients evolve to RA, PR may display a unique therapeutic opportunity to avoid this evolution.

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“…In our study, the median time delay between symptom onset and rheumatologist evaluation was 28 months, in contrast with other authors who reported a median delay of 10 months. 3 Even though 82% of patients were treated at a rheumatology clinic before 12 weeks, the wait time between seeing a PCP and seeing a rheumatologist was 9.5 weeks on average. Although diagnostic concordance was low between physicians, we observed that the presence of pain in the upper limbs (including hands, elbows, and shoulders) and morning stiffness were associated with a final diagnosis of RA (odds ratio = 10.5, 95% confidence interval = 1.3-81.4; and odds ratio = 3.04, 95% confidence interval = 1.69-5.45, respectively).…”

Section: Letter To the Editormentioning

confidence: 99%

Time Delay to Rheumatology Consultation

Vega‐Morales¹,

Covarrubias-Castañeda²,

Arana-Guajardo³

et al. 2016

Am J Med Qual

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Retraso diagnóstico y terapéutico de la artritis reumatoide y su relación con dispositivos asistenciales en Catalunya. Estudio AUDIT

Cited by 14 publications

References 16 publications

Rheumatoid Arthritis Initiating as Palindromic Rheumatism: A Distinct Clinical Phenotype?

Rheumatoid Arthritis Initiating as Palindromic Rheumatism: A Distinct Clinical Phenotype?

Palindromic rheumatism: a unique and enigmatic entity with a complex relationship with rheumatoid arthritis

Time Delay to Rheumatology Consultation

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