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Rheumatoid arthritis in the United Arab Emirates

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Abstract

Studies have shown that patients with rheumatoid arthritis (RA) in the Middle East have delayed diagnosis and low disease-modifying anti-rheumatic drug (DMARD) utilization. We describe the characteristics and treatments of consecutive RA patients presenting to a new musculoskeletal clinic in Dubai, United Arab Emirates (UAE). Demographic and clinical data were collected over a 10-month period at the first visit to our clinic for patients meeting the American College of Rheumatology (ACR) criteria for RA. A total of 100 patients were seen: (average ± SD) age 42.2 ± 12.3 years; female 87%; Arabs 38%, Indian 36%, Caucasian and others 26%; 73% rheumatoid-factor positive; years since diagnosis: 3.9 ± 5.7; lag time between symptom onset to diagnosis 1.2 ± 1.3 years and lag time to first DMARD was 1.6 ± 2.0 years. Mean tender joint count was 8.9 ± 7.9, mean swollen joint count 9.0 ± 7.6, mean patient’s global assessment of disease activity 57.4 ± 25.0 mm, mean ESR 33 ± 25 mm/h, mean DAS28 5.2 ± 1.6, physician global assessment 55.0 ± 23.8. Only 43% were on DMARDs (25% MTX, 5% TNF blockers). Among the patients who were not on DMARD, only 28.1% had disease duration less than 1 year (p = <0.01). Erosions were present in 55.2% of patients with available X-rays, and deformities in 26% of patients. There were no racial differences in disease characteristics. The UAE has a unique population with many races residing in the country. Among the first 100 consecutive patients seen at our clinic, there were no significant differences in disease characteristics with the majority of the patients having very active disease, delayed diagnosis, and not being treated with DMARDs.

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References

  1. Al-Rawi ZS, Alazzawi AJ, Alajili FM, Alwakil R (1978) Rheumatoid arthritis in population samples in Iraq. Ann Rheum Dis 37(1):73–75, Feb 1978

    Article  PubMed  CAS  Google Scholar 

  2. Al-Salem IH, Al-Awadhi AM (2004) The expression of rheumatoid arthritis in Kuwaiti patients in an outpatient hospital-based practice. Med Princ Pract 13(1):47–50, Jan 2004

    Article  PubMed  CAS  Google Scholar 

  3. Al Attia HM, Gatee OB, George S, Masri MM (1993) Rheumatoid arthritis in a population sample in the Gulf: clinical observations. Clin Rheumatol 12(4):506–510, Dec 1993

    Article  PubMed  Google Scholar 

  4. Alballa SR (1995) The expression of rheumatoid arthritis in Saudi Arabia. Clin Rheumatol 14(6):641–645, Nov 1995

    Article  PubMed  CAS  Google Scholar 

  5. Badsha H, Kong KO, Tak PP (2007) Rheumatoid arthritis in Dubai-delayed diagnosis and low usage of disease modifying antirheumatic drugs. Ann Rheum Dis 66(6):835, Jun 2007

    Article  PubMed  Google Scholar 

  6. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31(3):315–324, Mar 1988

    Article  PubMed  CAS  Google Scholar 

  7. Smolen JS, Breedveld FC, Schiff MH, Kalden JR, Emery P, Eberl G et al (2003) A simplified disease activity index for rheumatoid arthritis for use in clinical practice. Rheumatology (Oxford) 42(2):244–257, Feb 2003

    Article  CAS  Google Scholar 

  8. Prevoo ML, van ’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL (1995) Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38(1):44–48, 1995 Jan

    Article  PubMed  CAS  Google Scholar 

  9. Sokka T, Kautiainen H, Toloza S, Makinen H, Verstappen SM, Hetland ML et al (2007) QUEST-RA: Quantitative clinical assessment of patients with rheumatoid arthritis seen in standard rheumatology care in 15 countries. Ann Rheum Dis 66:1491–1496, Apr 2007

    Article  PubMed  Google Scholar 

  10. Michaud K, Wolfe F (2006) Trends in mEdication Use by 10,982 Rheumatoid Arthritis patients in the United States from 1998–2005: Biological Use now at 40%. Ann Rheum Dis 65(Suppl II):311

    Google Scholar 

  11. Nurmohamed MT, Dijkmans BA (2005) Efficacy, tolerability and cost effectiveness of disease-modifying antirheumatic drugs and biologic agents in rheumatoid arthritis. Drug 65(5):661–694

    Article  CAS  Google Scholar 

  12. Verstappen SM, Jacobs JW, Bijlsma JW, Heurkens AH, van Booma-Frankfort C, Borg EJ et al (2003) Five-year followup of rheumatoid arthritis patients after early treatment with disease-modifying antirheumatic drugs versus treatment according to the pyramid approach in the first year. Arthritis Rheum 48(7):1797–1807, Jul 2003

    Article  PubMed  Google Scholar 

  13. Breedveld FC, Weisman MH, Kavanaugh AF, Cohen SB, Pavelka K, van Vollenhoven R et al (2006) The PREMIER study: A multicenter, randomized, double-blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early, aggressive rheumatoid arthritis who had not had previous methotrexate treatment. Arthritis Rheum 54(1):26–37, Jan 2006

    Article  PubMed  CAS  Google Scholar 

  14. Michaud K, Wolfe F (2005) Reduced Mortality among RA Patients Treated with Anti-TNF Therapy and Methotrexate. Ann Rheum Dis 64(Suppl III):87, 2006

    Google Scholar 

  15. St Clair EW, Van der Heijde DM, Smolen JS, Maini RN, Bathon JM, Emery P et al (2004) Combination of infliximab and methotrexate therapy for early rheumatoid arthritis: a randomized, controlled trial. Arthritis Rheum 50(11):3432–3443, Nov 2004

    Article  PubMed  CAS  Google Scholar 

  16. Anderson JJ, Wells G, Verhoeven AC, Felson DT (2000) Factors predicting response to treatment in rheumatoid arthritis: the importance of disease duration. Arthritis Rheum 43(1):22–29, Jan 2000

    Article  PubMed  CAS  Google Scholar 

  17. Pountain G (1991) The prevalence of rheumatoid arthritis in the Sultanate of Oman. Br J Rheumatol 30(1):24–28, Feb 1991

    Article  PubMed  CAS  Google Scholar 

  18. Malaviya AN, Kapoor SK, Singh RR, Kumar A, Pande I (1993) Prevalence of rheumatoid arthritis in the adult Indian population. Rheumatol Int 13(4):131–134

    Article  PubMed  CAS  Google Scholar 

  19. Lacaille D, Anis AH, Guh DP, Esdaile JM (2005) Gaps in care for rheumatoid arthritis: a population study. Arthritis Rheum 3(2):241–248, Apr 15, 2005

    Article  Google Scholar 

  20. Stucki G (1997) Specialist management: needs and benefits. Baillieres Clin Rheumatol 11(1):97–107, Feb 1997

    Article  PubMed  CAS  Google Scholar 

  21. Chandrashekara S, Anilkumar T, Jamuna S (2002) Complementary and alternative drug therapy in arthritis. J Assoc Physicians India 50:225–227, Feb 2002

    PubMed  CAS  Google Scholar 

  22. Abdel-Nasser AM, Rasker JJ, Valkenburg HA (1997) Epidemiological and clinical aspects relating to the variability of rheumatoid arthritis. Semin Arthritis Rheum 27(2):123–140, Oct 1997

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Dubai Bone & Joint Center LLC, Level 50, Emirates Towers, P.O. Box 118855, Dubai, United Arab Emirates

    Humeira Badsha & Paul P. Tak

  2. Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore

    Kok Ooi Kong

  3. Division of Clinical Immunology & Rheumatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Paul P. Tak

Authors
  1. Humeira Badsha
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  2. Kok Ooi Kong
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  3. Paul P. Tak
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Correspondence to Humeira Badsha.

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Footline: RA in the United Arab Emirates

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Badsha, H., Kong, K.O. & Tak, P.P. Rheumatoid arthritis in the United Arab Emirates. Clin Rheumatol 27, 739–742 (2008). https://doi.org/10.1007/s10067-007-0782-z

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  • DOI: https://doi.org/10.1007/s10067-007-0782-z

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