Incidence and clinico-immunological assessment of patients of rheumatoid arthritis in Gorakhpur district, Uttar Pradesh, India

Authors

  • Pawan Kumar Vishwakarma Department of Medicine, Government Medical College, Azamgarh, Uttar Pradesh, India
  • Umesh Saroj Department of Orthopaedics, Government Medical College, Azamgarh, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20183138

Keywords:

CRP, DAS, ESR, Rheumatoid arthritis

Abstract

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease manifesting itself in various extra-articular signs and progressive articular damage. The present study was designed to find out the incidence and clinico-immunological characteristics of patients with RA.

Methods: This one-year observational study involved 150 adult patients attending orthopaedics department at Nehru Hospital, B.R.D. Medical College, 2010.  Each patient was subjected to clinical, functional, radiological and laboratorial examination after taking informed consent. SPSS software was used for data analysis.

Results: Nearly 36% patients had some radiological changes in the form of surrounding osteopenia articular erosion, joint space narrowing and degenerative changes. All NSAIDs when used alone showed poor fall in values of acute phase reactant i.e. ESR and CRP. Maximum fall in acute phase reactant was obtained by treatment with combination therapy of NSAID + hydroxychloroquine + methotrexate + sulfasalazine. NSAIDs did not prevent radiological progression of disease and in more than 50% radiological progression continued however when NSAIDs used with any DMARDs show radiological regression. Maximum radiological regression was caused by combination therapy of NSAID + hydroxychloroquine + sulfasalazine + methotrexate.

Conclusions: All NSAIDs produced poor fall in values of acute phase reactants and radiological progression continued in majority of patients, when a DMARD or combination of DMARDs were used with NSAIDs response was much better and relief was obtained earlier, and remission was sustained for longer duration.

References

Kobak S. Demographic, clinical and serological features of Turkish patients with rheumatoid arthritis: evaluation of 165 patients. Clin Rheumatol. 2011;30:843-7.

Kumar BS, Suneetha P, Mohan A, Kumar DP, Sarma KV. Comparison of Disease Activity Score in 28 joints with ESR (DAS28), Clinical Disease Activity Index (CDAI), Health Assessment Questionnaire Disability Index (HAQ-DI) & Routine Assessment of Patient Index Data with 3 measures (RAPID3) for assessing disease activity in patients with rheumatoid arthritis at initial presentation. Indian J Med Res. 2017;146,Suppl S2:57-62.

Caruso I, Santandrea S, Sarzi Puttini P, Boccassini L, Montrone F, Cazzola M et al. Clinical, laboratory and radiographic features in early rheumatoid arthritis. J Rheumatol. 1990 Oct;17(10):1263-7.

Fallahi S, Rostamian A, Khalvat A, Khazaeipour Z, Shahbazi F. Depicting and comparing the time to normalize erythrocyte sedimentation rate following two combination therapies in rheumatoid arthritis patients: a randomized clinical trial. Caspian J Int Med. 2013;4(1):564-8.

Weinblatt ME, Kaplan H, Germain BF, Block S, Solomon SD, Merriman RC, et al. Methotrexate in rheumatoid arthritis- A five-year prospective multicenter study. Arthritis Rheum. 1994;37(10):1492-8.

Gossen N, Kostev K. Reduction in C-reactive protein with biologic drugs in rheumatoid arthritis and spondylitis patients in German rheumatologist practices. Value Health. 2015;18(7):A635.

Sanmarti R, Gomez A, Ercilla G, Gratacos J, Larrosa M, Suris X et al. Radiological progression in early rheumatoid arthritis after DMARDS: a one‐year follow‐up study in a clinical setting. Rheumatol. 2003; 42(9):1044-9.

Silva I, Mateus M, Branco JC. Assessment of erythrocyte sedimentation rate (ESR) and C- reactive protein (CRP) on rheumatoid arthritis activity prediction]. Acta Reumatol Port. 2010 Oct-Dec;35(5):456-62.

Fuchs HA, Brooks RH, Callahan LF, Pincus T. A simplified twenty-eight-joint quantitative articular index in rheumatoid arthritis. Arthritis Rheum. 1989;32:531-7.

Aletaha D, Smolen J. The Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI): a review of their usefulness and validity in rheumatoid arthritis. Clin Exp Rheumatol. 2005;23(5 Suppl 39):S100-8.

Anderson J, Caplan L, Yazdany J, Robbins ML, Neogi T, Michaud K, et al. Rheumatoid arthritis disease activity measures: American College of rheumatology recommendations for use in clinical practice. Arthritis Care Res (Hoboken). 2012;64:640-7.

Sokka T. Assessment of rheumatoid arthritis in clinical care. Turk J Rheumatol. 2010;25:1-11.

Downloads

Published

2018-07-23

Issue

Section

Original Research Articles