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Characteristics of Patients With Early-Onset Arthritis in Latin America: Description of the REPANARC Cohort
Alicia Ramagli1, Inés Corbacho, Fernanda Linhares
1From the Departments of *Instituto Nacional de Reumatologia and †Faculty of Medicine, Universidad de la República, Montevideo, Uruguay; ‡Rheumatology and Internal Medicine, Centro Médico La Costa, Asunción, Paraguay; and §Quantitative Methods Department and ∥Medical Psychology Department, Faculty of Medicine, Universidad de la República, Montevideo Uruguay.
Insights
Early intervention in arthritis shows promise, but Latin American data is scarce. The Pan-American Registry of Early-Onset Arthritis (REPANARC) project offers valuable insights into patient outcomes in the region.
Area of Science:
- Rheumatology
- Clinical Research
- Epidemiology
Background:
- Limited studies exist on early intervention's impact on early-onset arthritis in Latin America.
- The Pan-American Registry of Early-Onset Arthritis (REPANARC) project addresses this gap.
- Understanding regional outcomes is crucial for improving patient care.
Purpose of the Study:
- To introduce the REPANARC project.
- To present preliminary outcomes from a diverse Latin American cohort of early-onset arthritis patients.
- To establish a foundation for future research in the region.
Main Methods:
- A multi-country cohort (6 Latin American nations) was established.
- Patients with recent-onset arthritis (≤1 year duration) were followed for 2 years.
- Comprehensive data collection included clinical, analytical, imaging, and patient-reported outcomes.
Main Results:
- 173 patients (83.8% female, mean age 41.9) were analyzed, predominantly with insidious, polyarticular, symmetrical onset.
- Rheumatoid arthritis (50.6%) and undifferentiated arthritis (40.5%) were common initial diagnoses.
- High disease activity (76.9%), moderate-to-severe disability (61.9%), significant psychological distress, and reduced quality of life were observed. Mean delay to rheumatologist visit was 126 days, with shorter delays correlating to better outcomes.
Conclusions:
- The REPANARC project is a valuable resource for understanding early-onset arthritis in Latin America.
- Preliminary findings highlight significant disease burden and psychological impact.
- Timely rheumatologist consultation is associated with improved outcomes, emphasizing the need for early intervention strategies.
Background:
While many studies have tried to show that early intervention improves the clinical outcomes of early-onset arthritis, only a few were carried out in Latin America.
Objectives:
The aim of this study was to describe the Pan-American Registry of Early-Onset Arthritis (REPANARC) project and report the preliminary outcomes of a cohort of patients.
Methods:
The REPANARC cohort consisted of a sample of patients from 6 Latin American countries. Patients with arthritis of 1 or more joints of 1-year duration or less were assessed by a rheumatologist during 6 consecutive clinical visits for a follow-up period of 2 years. The registry included clinical characteristics, medical history, physical examination, disease activity, analytical chemistries, imaging, current treatment, and a set of patient-reported outcome measures evaluating disability, psychological distress, and quality of life.
Results:
A total of 173 patients were included with mean age of 41.9 ± 13.2 years; 83.8% were women. The predominant presentations at onset were insidious, polyarticular, additive, bilateral, and symmetrical. The initial diagnoses were rheumatoid arthritis (50.6%), undifferentiated arthritis (40.5%), and other arthritis (8.9%). With Disease Activity Score in 28 Joints, 76.9% had moderate to high disease activity, and 61.9% had moderate to severe disability (Health Assessment Questionnaire). Considering undifferentiated arthritis, 60.3% persisted undifferentiated, 29.4% evolved as rheumatoid arthritis, 4.4% remained self-limited, and 5.9% to other forms. The frequencies of depression and anxiety were high as measured with the Hospital Anxiety and Depression Scale, and approximately 20% had significant decrements in quality of life measured with the Medical Outcomes Study Short-Form 36 Health Survey Version 2. Mean time from the first symptoms to the first visit to a rheumatologist was 126 days. Shorter delays were confirmed to be associated with better outcomes.
Conclusions:
The REPANARC project is a useful tool to provide valuable information regarding patients with early-onset arthritis attending rheumatology centers in Latin-America.
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