title: Severity of rheumatoid arthritis: the SEVERA study.
abstract: This study aims to assess the severity of rheumatoid arthritis (RA) in rheumatology practice in our population. All outpatients and inpatients with RA seen by registered rheumatologists over a 1-year period were included. Severity was measured using the Larsen score for hands and wrists and the Modified Health Assessment Questionnaire (M-HAQ). Two hundred ninety-eight RA cases were included. Mean age was 51.5 years. Among them, 261 (87.6%) were females. Disease duration was less than a year in 26 subjects (8.7%) and 10 years and above in 108 (36.2%) with a mean of 8.9. There were 220 (73.8%) subjects who had M-HAQ score <1. In 61 (20.5%) subjects, M-HAQ score was > or =1 and <2, and 17 (5.7%) had M- HAQ score > or =2. In relation with disease duration, M-HAQ starts with an average (SD) value of 0.7 (0.6) during the first year, decreases to 0.4 (0.4) at 5-year disease duration and increases after 10 years of disease progression to an average of 0.9 (0.8). Mean (SD) Larsen score was 51.9 (29.5) and median was 45. A total of 25% had a Larsen score > or =50% of maximum. Larsen score increased significantly (p<0.0001) with disease duration, starting at an average (SD) of 36.1 (14.9) during the first year, rising to 42.5 (15.8) around 5 years and reaching 73.9 (36.9) after 10 years. RA severity in our practice is comparable to that reported in Western populations in terms of radiological damage; however, functional status differs, possibly reflecting cultural differences.
authors.affiliation: Rheumatology Department, Hotel-Dieu Hospital, St Joseph University, Beirut, Lebanon. rbaddoura@usj.edu.lb
authors.forename: Rafic
authors.initials: R
authors.lastname: Baddoura
authors.forename: Souha
authors.initials: S
authors.lastname: Haddad
authors.forename: Hassane
authors.initials: H
authors.lastname: Awada
authors.forename: Abdel Fattah
authors.initials: AF
authors.lastname: Al-Masri
authors.forename: Georges
authors.initials: G
authors.lastname: Merheb
authors.forename: Said
authors.initials: S
authors.lastname: Attoui
authors.forename: Jad
authors.initials: J
authors.lastname: Okais
authors.forename: Jamil
authors.initials: J
authors.lastname: Messayke
authors.forename: Fadi
authors.initials: F
authors.lastname: Ghandour
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000145:classification / Q000000981:diagnostic imaging / Q000503:physiopathology; D001175:Arthrography; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006801:Humans; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology