Korean J Intern Med.
2017 Jul;32(4):738-746. 10.3904/kjim.2015.364.
Impact of early diagnosis on functional disability in rheumatoid arthritis
- Affiliations
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- 1Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea. scbae@hanyang.ac.kr
- 2Department of Rheumatology, Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, Korea.
- 3Department of Rheumatology, Hanyang University Guri Hospital, Guri, Korea.
- 4Department of Rheumatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 5Department of Rheumatology, Catholic University of Daegu School of Medicine, Daegu, Korea.
- 6Department of Rheumatology, Dong-A University Hospital, Busan, Korea.
- 7Department of Rheumatology, Kyung Hee University Medical Center, Seoul, Korea.
- 8Department of Rheumatology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
- 9Department of Rheumatology, Jeju National University Hospital, Jeju, Korea.
- 10Department of Rheumatology, Chonnam National University Hospital, Gwangju, Korea.
- 11Department of Rheumatology, Ewha Womans University Mokdong Hospital, Seoul, Korea.
- 12Department of Rheumatology, Konkuk University Medical Center, Seoul, Korea.
- 13Department of Rheumatology, Chungnam National University Hospital, Daejeon, Korea.
- 14Department of Rheumatology, Inje University Ilsan Paik Hospital, Goyang, Korea.
- KMID: 2387720
- DOI: http://doi.org/10.3904/kjim.2015.364
Abstract
- BACKGROUND/AIMS
To determine whether early diagnosis is beneficial for functional status of various disease durations in rheumatoid arthritis (RA) patients.
METHODS
A total of 4,540 RA patients were enrolled as part of the Korean Observational Study Network for Arthritis (KORONA). We defined early diagnosis as a lag time between symptom onset and RA diagnosis of ≤ 12 months, whereas patients with a longer lag time comprised the delayed diagnosis group. Demographic characteristics and outcomes were compared between early and delayed diagnosis groups. Logistic regression analyses were performed to identify the impact of early diagnosis on the development of functional disability in RA patients.
RESULTS
A total of 2,597 patients (57.2%) were included in the early diagnosis group. The average Health Assessment Questionnaire-Disability Index (HAQ-DI) score was higher in the delayed diagnosis group (0.64 ± 0.63 vs. 0.70 ± 0.66, p < 0.01), and the proportion of patients with no functional disability (HAQ = 0) was higher in the early diagnosis group (22.9% vs. 20.0%, p = 0.02). In multivariable analyses, early diagnosis was independently associated with no functional disability (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.01 to 1.40). In a subgroup analysis according to disease duration, early diagnosis was associated with no functional disability in patients with disease duration < 5 years (OR, 1.37; 95% CI, 1.09 to 1.72) but not in patients with longer disease duration (for 5 to 10 years: OR, 1.07; 95% CI, 0.75 to 1.52; for ≥ 10 years: OR, 0.92; 95% CI, 0.65 to 1.28).
CONCLUSIONS
Early diagnosis is associated with no functional disability, especially in patients with shorter disease duration.
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