Impact of early diagnosis on functional disability in rheumatoid arthritis.
OBJECTIVE
To determine whether early diagnosis is beneficial for functional status of various disease durations in rheumatoid arthritis (RA) patients.


METHODS
A total of 4,540 RA patients were enrolled as part of the Korean Observational Study Network for Arthritis (KORONA). We defined early diagnosis as a lag time between symptom onset and RA diagnosis of ≤ 12 months, whereas patients with a longer lag time comprised the delayed diagnosis group. Demographic characteristics and outcomes were compared between early and delayed diagnosis groups. Logistic regression analyses were performed to identify the impact of early diagnosis on the development of functional disability in RA patients.


RESULTS
A total of 2,597 patients (57.2%) were included in the early diagnosis group. The average Health Assessment Questionnaire-Disability Index (HAQ-DI) score was higher in the delayed diagnosis group (0.64 ± 0.63 vs. 0.70 ± 0.66,p< 0.01), and the proportion of patients with no functional disability (HAQ = 0) was higher in the early diagnosis group (22.9% vs. 20.0%,p= 0.02). In multivariable analyses, early diagnosis was independently associated with no functional disability (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.01 to 1.40). In a subgroup analysis according to disease duration, early diagnosis was associated with no functional disability in patients with disease duration < 5 years (OR, 1.37; 95% CI, 1.09 to 1.72) but not in patients with longer disease duration (for 5 to 10 years: OR, 1.07; 95% CI, 0.75 to 1.52; for ≥ 10 years: OR, 0.92; 95% CI, 0.65 to 1.28).


CONCLUSIONS
Early diagnosis is associated with no functional disability, especially in patients with shorter disease duration.
Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea.|Department of Rheumatology, Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, Korea.
Dam
D
Kim
Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea.|Department of Rheumatology, Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, Korea.
Chan-Bum
CB
Choi
Department of Rheumatology, Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, Korea.
Jiyoung
J
Lee
Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea.|Department of Rheumatology, Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, Korea.
Soo-Kyung
SK
Cho
Department of Rheumatology, Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, Korea.
Soyoung
S
Won
Department of Rheumatology, Hanyang University Guri Hospital, Guri, Korea.
So-Young
SY
Bang
Department of Rheumatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Hoon-Suk
HS
Cha
Department of Rheumatology, Catholic University of Daegu School of Medicine, Daegu, Korea.
Jung-Yoon
JY
Choe
Department of Rheumatology, Dong-A University Hospital, Busan, Korea.
Won Tae
WT
Chung
Department of Rheumatology, Kyung Hee University Medical Center, Seoul, Korea.
Seung-Jae
SJ
Hong
Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea.
Jae-Bum
JB
Jun
Department of Rheumatology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
Young Ok
YO
Jung
Department of Rheumatology, Jeju National University Hospital, Jeju, Korea.
Jinseok
J
Kim
Department of Rheumatology, Catholic University of Daegu School of Medicine, Daegu, Korea.
Seong-Kyu
SK
Kim
Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea.
Tae-Hwan
TH
Kim
Department of Rheumatology, Chonnam National University Hospital, Gwangju, Korea.
Tae-Jong
TJ
Kim
Department of Rheumatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Eunmi
E
Koh
Department of Rheumatology, Hanyang University Guri Hospital, Guri, Korea.
Hye-Soon
HS
Lee
Department of Rheumatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jaejoon
J
Lee
Department of Rheumatology, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Jisoo
J
Lee
Department of Rheumatology, Konkuk University Medical Center, Seoul, Korea.
Sang-Heon
SH
Lee
Department of Rheumatology, Chonnam National University Hospital, Gwangju, Korea.
Shin-Seok
SS
Lee
Department of Rheumatology, Dong-A University Hospital, Busan, Korea.
Sung Won
SW
Lee
Department of Rheumatology, Chungnam National University Hospital, Daejeon, Korea.
Seung-Cheol
SC
Shim
Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea.
Dae-Hyun
DH
Yoo
Department of Rheumatology, Inje University Ilsan Paik Hospital, Goyang, Korea.
Bo Young
BY
Yoon
Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea.|Department of Rheumatology, Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, Korea.
Yoon-Kyoung
YK
Sung
Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea.|Department of Rheumatology, Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, Korea.
Sang-Cheol
SC
Bae
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid; D004185:Disability Evaluation; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
Arthritis, rheumatoid; Disability; Early diagnosis; Health assessment questionnaires