A nationwide cross-sectional overview of patients with rheumatoid arthritis followed in outpatient specialty clinics in Finland

Abstract

Objectives: We aimed to conduct a cross-sectional overview of patients with rheumatoid arthritis (RA) in outpatient specialized clinics in Finland.

Method: Consecutive patients were enrolled in the study. The data collected comprised demographic, disease- and treatment-related variables.

Results: Between November 2011 and May 2012, 890 patients with RA (77% female) were enrolled from 14 sites. The median age was 59.8 years and the time from diagnosis 7.2 years. Values for the Disease Activity Score using 28 joint counts (DAS28) ranged from 0.28 to 6.61 (median 2.55) with 52% and 70% of patients reaching remission and low disease activity, respectively. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies were evident in 70% and 63% of patients, respectively. Median Health Assessment Questionnaire (HAQ) scores with and without aids and devices were 0.75 [interquartile range (IQR) 0.13–1.38] and 0.63 (IQR 0.13–1.13), respectively. Conventional disease-modifying anti-rheumatic drugs (DMARDs) were used by 91% of patients. A triple therapy of methotrexate (MTX), hydroxychloroquine (HCQ), and sulfasalazine (SSZ) was used by 15%, other MTX-based combination by 30%, MTX alone by 20%, and other DMARDs alone or in combination by 26% of patients. In addition, glucocorticoids and biologics were taken by 58% and 21% of patients, respectively. Of the 184 biologics users, 18% were not using DMARDs concomitantly.

Conclusions: Our cross-sectional review of patients with RA revealed that > 50% of patients were in remission according to DAS28. Comparison with previous studies revealed a reduction in disease activity of prevalent RA cases, possibly resulting from increased use of aggressive anti-rheumatic treatments.

Supporting Information

Additional Supporting Information may be found in the online version of this article.

Appendix 1. Formulas for disease activity indices used in this study

Appendix 2. The distribution of patients among the included hospital 220 districts.

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Acknowledgements

We are grateful to E Kankaanpää, R Koivuniemi, S Kortelainen, M Mali, H Mäkinen, R Peltomaa, M Pertovaara, L Pirilä, M Puurtinen-Vilkki, V Rantalaiho, H Relas, M Romu, E Rouhe, M Savolainen, S Sihvonen, A Similä, T. Tiippana-Kinnunen, R Tuompo, T Uotila, K-L Vidqvist, K Vuori, and T Väliviita for their help with the data collection.

This study was supported by Roche. Additionally, K J Aaltonen has received personal grants from Finska Läkaresällskapet, the Scandinavian Society for Rheumatology, and the Finnish Cultural Foundation.