Prevalence of rheumatoid arthritis in the French West Indies: Results of the EPPPRA study in Martinique.
OBJECTIVE
Studies suggest that rheumatoid arthritis (RA) is less frequent in African populations. However, no recent precise data exists for Afro-Caribbeans. The EPPPRA project is a prospective epidemiological survey to describe prevalence and clinical aspects of RA in the French West Indies (Martinique, Guadeloupe, French Guiana).


METHODS
EPPPRA involved all rheumatologists from the French West Indies who included all patients with a known clinical diagnosis of RA, during a one-year period. We outline here results for Martinique.


RESULTS
EPPPRA estimated an overall world age-standardized prevalence of RA at 0.10% [95% CI 0.09% to 0.11%] in Martinique, with a high female predominance (88.1%) and 93.1% of self-reported Afro-Caribbeans. Mean age at diagnosis was 49.6±16.0 years. A majority of subjects presented at least 4 criteria points from the 1987 American College of Rheumatology (ACR) classification (94.4%) and at least 6 points (78.2%) from the 2010 ACR/European League Against Rheumatism (EULAR) classification. A high immune seropositivity rate was highlighted (84.2%). Despite functional impact observed in 40.5% of patients, 71.4% presented a low disease activity level. Methotrexate was the most common ongoing treatment (73%), followed by biotherapies (24.4%). Numerous patients (68.6%) received a steroid regimen. Cardiovascular risk factors were very frequent, contrasting with a very low tobacco use (8.7%), CONCLUSION: This work outlines low standardized prevalence of RA in a French Afro-Caribbean population with specific characteristics (high female predominance, high immune seropositivity, low tobacco use). Despite easy access to care and biotherapies, approximately half of RA patients still present destructive disease with functional impact.
Department of Rheumatology, University Hospital of Martinique (Pierre Zobda-Quitman Hospital), Route de Chateauboeuf, 97200 Fort-de-France, French West Indies (FWI), Martinique.
Lauren
L
Brunier
Department of Rheumatology, University Hospital of Martinique (Pierre Zobda-Quitman Hospital), Route de Chateauboeuf, 97200 Fort-de-France, French West Indies (FWI), Martinique.
Marie
M
Bleterry
Methodology and Biostatistics Unit (DRCI), University Hospital of Martinique (Pierre Zobda-Quitman Hospital), Route de Chateauboeuf, 97200 Fort-de-France, French West Indies (FWI), Martinique.
Sylvie
S
Merle
Methodology and Biostatistics Unit (DRCI), University Hospital of Martinique (Pierre Zobda-Quitman Hospital), Route de Chateauboeuf, 97200 Fort-de-France, French West Indies (FWI), Martinique.
Christian
C
Derancourt
Department of Internal Medicine, University Hospital of Martinique (Pierre Zobda-Quitman Hospital), Route de Chateauboeuf, 97200 Fort-de-France, French West Indies (FWI), Martinique.
Katlyn
K
Polomat
Department of Rheumatology, University Hospital of Martinique (Pierre Zobda-Quitman Hospital), Route de Chateauboeuf, 97200 Fort-de-France, French West Indies (FWI), Martinique.
Véronique
V
Dehlinger
Department of Internal Medicine, University Hospital of Martinique (Pierre Zobda-Quitman Hospital), Route de Chateauboeuf, 97200 Fort-de-France, French West Indies (FWI), Martinique.
Christophe
C
Deligny
Department of Rheumatology, University Hospital of Martinique (Pierre Zobda-Quitman Hospital), Route de Chateauboeuf, 97200 Fort-de-France, French West Indies (FWI), Martinique.
Georges
G
Jean-Baptiste
Department of Internal Medicine, University Hospital of Martinique (Pierre Zobda-Quitman Hospital), Route de Chateauboeuf, 97200 Fort-de-France, French West Indies (FWI), Martinique.
Serge
S
Arfi
Methodology and Biostatistics Unit (DRCI), University Hospital of Martinique (Pierre Zobda-Quitman Hospital), Route de Chateauboeuf, 97200 Fort-de-France, French West Indies (FWI), Martinique.
Rishika
R
Banydeen
Department of Rheumatology, University Hospital of Martinique (Pierre Zobda-Quitman Hospital), Route de Chateauboeuf, 97200 Fort-de-France, French West Indies (FWI), Martinique. Electronic address: micheldebandt@gmail.com.
Michel
M
De Bandt
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008395:Martinique / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult
African ancestry; Epidemiology; French West Indies (Martinique); Rheumatoid arthritis; Standardized prevalence