The REAL study: a nationwide prospective study of rheumatoid arthritis in Brazil

Advances in Rheumatology

Geraldo da Rocha Castelar-Pinheiro⁶  Maria Fernanda B. Resende Guimarã⁷  Maria de Fá⁹  Ivâ^1,12  Ana Beatriz Vargas-Santos^1,12  rtolo^1,12  Licia Maria Henrique da Mota^1,14  Evandro Silva Freire Coutinho^1,16  Karina Rossi Bonfiglioli^1,17  Rina Dalva Neubarth Giorgi^1,18  Sebastiã^1,19  o Cezar Radominski^2,20  Claiton Viegas Brenol^2,22  es^2,23  tima Lobato da Cunha Sauma^2,28  Cleandro Pires de Albuquerque^3,30  Paulo Louzada Jú^3,30  nio Alves Pereira^3,32  Manoel Barros Bé^3,34  nior^3,35 

[1] ã, Belé, Curitiba, Brazil;, Universidade Federal do ParanáDepartamento de Epidemiologia e MéDepartamento de Medicina Interna, Disciplina de Reumatologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil;Disciplina de Reumatologia, Faculdade de CiêDisciplina de Reumatologia, Faculdade de Medicina da Universidade Federal do ParanáDisciplina de Reumatologia, Faculdade de Medicina da Universidade de Ribeirao Preto, Universidade de Sao Paulo, RibeirãDisciplina de Reumatologia, Faculdade de Medicina, Universidade Federal do ParáDisciplina de Reumatologia, Faculdade de Medicina, Universidade de SãServiçblico Estadual de Sãblico Estadual, Hospital do Servidor Púde, Fundaçdica ao Servidor Púdicas, Universidade Estadual de Campinas, Campinas, Brazil;lia - Universidade de Brasília, Brasília, Brazil;m, Brazil;ncia Méncias Ménicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil;o Osvaldo Cruz, Rio de Janeiro, Brazil;o Paulo, Brazil;o Paulo, São Preto, Brazil;o de Reumatologia, Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil;o de Reumatologia, Hospital Universitáo de Reumatologia, Hospital das Clío de Reumatologia, Instituto de Assistêpolis, Brazil;rio Pedro Ernesto - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil;rio de Brasírio, Universidade Federal de Santa Catarina, Florianótodos Quantitativos em Saú

关键词: Rheumatoid arthritis;    Brazilian cohort;    Observational study;   

DOI  :  10.1186/s42358-018-0017-9

学科分类：过敏症与临床免疫学

来源: Springer

【 摘 要 】

There are few data on the epidemiology, clinical manifestations and management of RA in Brazil, even with the recognition of the high direct, indirect and societal costs of this disease. Herein, we report the formation of the REAL - Rheumatoid Arthritis in Real Life, the first nationally representative multicenter prospective observational study in Brazil. The REAL study was designed to include a total of 1300 evaluable patients from 13 tertiary care public health centers specialized in RA management and representative of 5 regions of Brazil. Each center was expected to enroll ~ 100 consecutively seen patients and follow them prospectively in a systematic protocol-driven fashion with scheduled visits at baseline, 6 and 12 months. Core clinical, laboratory and patient-reported outcomes measures were required to be collected at each visit. A total of 1115 patients (89.4% female, mean age of 56.7 years and median disease duration of 12.7 years) were enrolled from 11 participating centers. Almost 80% of patients were of middle-low or low socioeconomic classes. The median educational time was 8 years, with 3.23% being below literacy level. The interval between symptoms and diagnosis varied from 1 to 457 months (median 12 months). Almost half of the patients were on glucocorticoids, 96.5% on DMARDs, with 35.7% on biologics. Median HAQ-DI was 0.875, ranging from 0 to 3. Median DAS28-ESR was 3.5, with 58.7% of patients presenting moderate or high disease activity. The first large cohort of Brazilian patients with RA in a real-life setting shows several striking differences from previously published cohorts from other countries. The long delay for diagnosis and start of DMARDs may partly explain the high frequency of erosive disease. An elevated percentage of patients on moderate or high disease activity was seen, despite of the high frequency of corticosteroid and biologics utilization. Data from this cohort may enable public health managers of developing countries better allocate the limited resources available for the care of RA patients.

【 授权许可】

CC BY