Societal Costs of Rheumatoid Arthritis in China: A Hospital‐Based Cross‐Sectional Study

Xu, Chong; Wang, Xiuru; Mu, Rong; Yang, Li; Zhang, Ye; Han, Shuling; Li, Xiaofeng; Wang, Yongfu; Wang, Guochun; Zhu, Ping; Jin, Hongtao; Sun, Lin; Chen, Haiying; Zhang, Zhuoli; Li, Zhenbin; Li, Junfang; Zhang, Fengxiao; Lin, Jianhao; Liu, Xiaomin; Hu, Shaoxian; Yang, Xia; Lai, Bei; Li, Xingfu; Wang, Xiaoyuan; Su, Yin; Li, Zhanguo

doi:10.1002/acr.22160

Cited by 35 publications

(38 citation statements)

References 23 publications

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“…Its etiology remains unclear. Approximately 0.3% and 0.5%–1% of the Chinese and global populations, respectively, are affected by RA [1–3]. Approximately 35% of patients with uncontrolled RA lose their ability to work within 10 years [4, 5].…”

Section: Introductionmentioning

confidence: 99%

Pharmacologic Effect of Miao Medicine Illicium simonsii Maxim. on Collagen-Induced Arthritis in Rats

Qing-zhong

Yao

et al. 2018

Evidence-Based Complementary and Alternative Medicine

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Objectives To study the pharmacologic effect and mechanism of action of Miao medicine Illicium simonsii Maxim. (ISM) in treating rheumatoid arthritis. Methods Sixty rats were randomly divided to six groups: normal control (normal), collagen-induced arthritis (CIA) model (model), CIA + tripterygium glycosides (TG), CIA + ISM high dose oral (ISM-H), CIA + ISM low-dose oral (ISM-L), and CIA + ISM topical application (ISM-T). The treatment doses were selected based on published reports and folk medicine practice. The outcome measurements included paw swelling, joint pathology, organ index, blood count, T helper 17 (Th17) cell count, and interleukin-6 (IL-6) level. Results Compared to the CIA model group, all treatment groups showed a significant reduction in paw swelling, blood vessel pathology, Th17 cell count, and IL-6 levels (p < 0.05 or p < 0.01). All treatment groups showed alleviated foot swelling and lower total number of white blood cells, and these effects were observed earlier with oral ISM than topical ISM. The effect of ISM was weaker than that of TG. In addition, less organ damage was observed with topical ISM than oral ISM but better than TG. Conclusions These results suggest that, by downregulating Th17 cells, ISM inhibits the production of Il-6, thereby alleviating the proliferation of endothelial and rheumatoid-like cells and leukocytosis in CIA rats, ultimately eliminating foot swelling.

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Section: Introductionmentioning

confidence: 99%

Pharmacologic Effect of Miao Medicine Illicium simonsii Maxim. on Collagen-Induced Arthritis in Rats

Qing-zhong

Yao

et al. 2018

Evidence-Based Complementary and Alternative Medicine

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“…The most common clinical symptoms include symmetrical arthralgia, mainly present in the hands and feet, stiffness, joint damage, and loss of physical function [2,3]. RA is a global health problem both in developed and developing countries and results in significant negative effects on quality of health life in terms of the persistent pain, fatigue, disability, as well as the heavy economic burden associated with disease progression [4][5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Moxibustion for treating rheumatoid arthritis: A systematic review and meta-analysis of randomized controlled trials

Sun

et al. 2014

European Journal of Integrative Medicine

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Introduction: Moxibustion is widely used in China and other East Asian countries to manage the symptom of rheumatoid arthritis (RA) and to lessen the adverse effects of western medicine. The purpose of this systematic review was to evaluate the available evidence from randomized controlled trials (RCTs) of moxibustion for treating patients with rheumatoid arthritis (RA). Methods: Seven Chinese and English databases were searched to November 2013 from their inception. Eligible RCTs were included if moxibustion was used either alone or in combination with Western medicine for treating rheumatoid arthritis. Study selection, data extraction, and validation was performed independently by two reviewers. Cochrane criteria for risk of bias was used to assess the methodological quality of the trials. Results: Eight RCTs met the inclusion criteria, and most were of low methodological quality. Meta-analysis showed favorable effects of moxibustion on the response rate, either alone [RR = 1.18, 95%CI (1.03, 1.35), p = 0.02; heterogeneity: Chi 2 = 1.11, p = 0.77, I 2 = 0%] or the combination with Western medicine therapy [RR = 1.28, 95%CI (1.12, 1.47), p = 0.0004; heterogeneity: Chi 2 = 1.96, p = 0.58, I 2 = 0%]. When compared with Western medicine therapy, Western medicine plus moxibustion therapy showed a favorable statistically significant effect on a reduction on American College of Rheumatology (ACR) 50 [RR = 1.57, 95%CI (1.25, 1.99), p = 0.0001; heterogeneity: Chi 2 = 2.87, p = 0.58, I 2 = 0%], whereas it failed to do so on American College of Rheumatology (ACR) 20. Additionally, when compared with western medicine therapy alone, meta-analysis of three RCTs suggested favorable but no statistically significant effects of moxibustion plus western medicine on the control of disease activities of rheumatoid arthritis.Conclusions: It is difficult to draw firm conclusions on whether moxibustion is an effective intervention for treating RA due to the small sample size of eligible RCTs and the high risk of bias among the available RCTs. Further rigorous RCTs are warranted but need to overcome methodological shortcomings of the existing evidence.

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“…Instead, they visit specialists at tertiary hospitals often without referral. 2 Second, many hospitals do not have scheduled appointments. Patients queue in the morning to register to see a specific clinician later that day.…”

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confidence: 99%

“…Paying for 65% out of pocket would be difficult for many patients, 89% of whom made less than 36,006 RMB ($10,200) per year. 2 As of 2011, over 95% are insured, mean reimbursement has increased to 47%, and more people are utilizing the healthcare system. The government is continuing to work toward universal coverage by 2020.…”

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confidence: 99%

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Barriers to Reconstructive Hand Surgery for Rheumatoid Arthritis in China: A Multicenter Survey of Patients and Physicians

Franzblau

Liang

Wang

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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Background:China has a similar rheumatoid arthritis (RA) disease burden compared with other countries, yet RA patients rarely receive surgical treatment for hand deformities that limit function and impact appearance. We investigated potential barriers to rheumatoid hand surgery in China.Methods:Patients with RA, rheumatologists, and hand surgeons at 3 large tertiary hospitals in Beijing completed questionnaires that assess knowledge and attitudes surrounding RA hand surgery. We calculated descriptive statistics and compared responses among groups using chi-square and Fisher exact tests as appropriate.Results:One hundred RA patients with hand deformities and 94 physicians completed the surveys. No patients had received hand surgery, and just 13% were aware of this treatment option. Patients and physicians most frequently cited uncertain effectiveness of surgery, high cost, and risk of surgical complications as potential barriers to hand reconstruction. Rheumatologists reported low rates of referral to hand surgeons (39% referred <5% of the time and 31% never referred). Most hand surgeons (69%) had not performed metacarpophalangeal arthroplasty, a common procedure for RA hand deformities, within the past year. Some had never performed this operation.Conclusions:This survey revealed multiple barriers that support previous observations of infrequent reconstruction of RA hand deformities in China. These obstacles can be addressed through patient education, coordination between specialists, and more robust hand surgeon training in common RA procedures through the application of international plastic surgery collaborations.

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Societal Costs of Rheumatoid Arthritis in China: A Hospital‐Based Cross‐Sectional Study

Cited by 35 publications

References 23 publications

Pharmacologic Effect of Miao Medicine Illicium simonsii Maxim. on Collagen-Induced Arthritis in Rats

Pharmacologic Effect of Miao Medicine Illicium simonsii Maxim. on Collagen-Induced Arthritis in Rats

Moxibustion for treating rheumatoid arthritis: A systematic review and meta-analysis of randomized controlled trials

Barriers to Reconstructive Hand Surgery for Rheumatoid Arthritis in China: A Multicenter Survey of Patients and Physicians

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