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Characteristics of Patients With Early-Onset Arthritis in Latin America: Description of the REPANARC Cohort

Ramagli, Alicia MD*; Corbacho, Inés MD; Linhares, Fernanda MD*; de Abreu, Paloma MD; Teijeiro, Raquel MD*; Garau, Mariela MD§; Dapueto, Juan MD, PhDthe Pan-American League for Rheumatology Early Onset Arthritis (PANLAR-EOA) Study Group

JCR: Journal of Clinical Rheumatology: September 2015 - Volume 21 - Issue 6 - p 283–288
doi: 10.1097/RHU.0000000000000280
Original Articles
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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.

From 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.

PANLAR-EOA Study Group: Eduardo Kerzberg y Fabiana Montoya (Argentina); Dr María Luisa Gil (Bolivia); Geraldo Castelar (Brasil); Elena Jarpa y Sandra Pino (Chile); Ariel Herrera (Colombia); José Díaz y Cristian Arias (Costa Rica); Sara Vargas (Ecuador); Denise Yaresi Lazarin Valles Marvis Goycochea (México); Pedro Babac, Paloma de Abreu, María del Carmen Martínez Dr Yanira Yinde (Paraguay); Carlos Glave y Juan Angulo Solimano (Perú); Ángel Achurra y Edgardo Gonzalez (Panamá); Sol Villegas, Esther Chirinos y Elaudi del Valle Rodríguez (Venezuela); Juan Dapueto, Mariela Garau, Raquel Tejeiro, Inés Corbacho, Fernanda Linhares y Alicia Ramagli (Uruguay).

The authors declare no conflict of interest.

Correspondence: Alicia Ramagli, MD, Instituto Nacional de Reumatología del Uruguay, Av. Italia S/N esq. Las Heras, 11.600, Montevideo, Uruguay. E-mail: aramagli@gmail.com.

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