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Real - rheumatoid arthritis in real life - study cohort: a sociodemographic profile of rheumatoid arthritis in Brazil

Authors
  • Sacilotto, Nathália de Carvalho1
  • Giorgi, Rina Dalva Neubarth1
  • Vargas-Santos, Ana Beatriz2
  • de Albuquerque, Cleandro Pires3
  • Radominski, Sebastião Cezar4
  • Pereira, Ivânio Alves5
  • Guimarães, Maria Fernanda Brandão Resend...6
  • Bértolo, Manoel Barros7
  • Louzada, Paulo Jr8
  • Sauma, Maria de Fátima Lobato da Cunha9
  • Bonfiglioli, Karina Rossi10
  • Brenol, Claiton Viegas11
  • da Mota, Licia Maria Henrique3
  • Castelar-Pinheiro, Geraldo da Rocha2
  • 1 Hospital do ServidorPúblicoEstadual de São Paulo, Rua Pedro de Toledo, 1800, Vila Clementino, São Paulo, SP, 04039-000, Brazil , São Paulo (Brazil)
  • 2 Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil , Rio de Janeiro (Brazil)
  • 3 Universidade de Brasília, Federal District, Brazil , Federal District (Brazil)
  • 4 Universidade Federal do Paraná, Curitiba, Brazil , Curitiba (Brazil)
  • 5 Universidade Federal de Santa Catarina, Florianópolis, Brazil , Florianópolis (Brazil)
  • 6 Universidade Federal de Minas Gerais, Belo Horizonte, Brazil , Belo Horizonte (Brazil)
  • 7 UniversidadeEstadual de Campinas, Campinas, Brazil , Campinas (Brazil)
  • 8 Universidade de São Paulo, Ribeirão Preto, Brazil , Ribeirão Preto (Brazil)
  • 9 Universidade Federal do Pará, Belém, Brazil , Belém (Brazil)
  • 10 Universidade de São Paulo, São Paulo, Brazil , São Paulo (Brazil)
  • 11 Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil , Porto Alegre (Brazil)
Type
Published Article
Journal
Advances in Rheumatology
Publisher
BioMed Central
Publication Date
Mar 14, 2020
Volume
60
Issue
1
Identifiers
DOI: 10.1186/s42358-020-0121-5
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundIn Brazil, socioeconomic differences in the incidence of rheumatoid arthritis (RA) have been demonstrated, which are important in the formulation of hypotheses regarding the association between environmental factors, lifestyle and the risk of disease development. This study examines how the socioeconomic condition of the patient with RA in Brazil, assessed according to social class, educational level, employment situation and use of caregivers, affects the times between the beginning of symptoms and diagnosis and the beginning of the use of disease-modifying antirheumatic drugs, as well as the presence of erosive disease and functional status.MethodsThis work is part of a multicentric study called REAL - Rheumatoid Arthritis in Real Life in Brazil, which is a prospective observational cohort study.ResultsAs described in the REAL study, we included a total of 1115 patients. It was noted that patients with an educational classification of up to second grade incomplete presented with erosion percentages above those with a higher grade complete. Patients with caregivers presented a higher percentage of erosion than patients without caregivers. We verified that patients from economic classes above B2 presented fewer occurrences of erosion than those from classes C2, D-E. We also analyzed the average time differences from the beginning of symptoms and diagnosis and the beginning of treatment, according to academic level, erosion and economic classification. Patients with first grade complete showed an HAQ-DI averages higher than those with second grade complete. The patients who had employment showed lower HAQ-DI averages than patients who were not employed. The patients with erosion showed an HAQ-DI value higher than those without erosion. Patients with caregivers showed an HAQ-DI average higher than that of without caregivers.ConclusionThis study showed that the therapeutic window of RA is not being reached, and therefore we should have a policy to expand and ensure access to public health for all patients, especially those with lower levels of education and income.Trial registrationThis study was approved by the National Commission of Ethics in Research.

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