title: Reduced incidence of extra-articular manifestations of RA through effective disease control: Karnataka Rheumatoid Arthritis Comorbidity (KRAC) study.
abstract: OBJECTIVE
  To estimate the prevalence of extra-articular manifestations (EAM) in rheumatoid arthritis (RA) patients and the impact of demographic, clinical and treatment factors.
  
  
  METHODS
  The study was carried out as a part of 'Karnataka Rheumatoid arthritis comorbidity (KRAC) study' conducted at 14 centers across Karnataka, India between September 2014 and July 2015. The data were collected by trained clinical research associates using a structured pro forma, under the supervision of the consulting rheumatologists. Based on the factors evaluated, the study participants were classified as follows: age, < 30 years, 30-39 years, 40-49 years, 50-59 years and ≥ 60 years; and duration of illness prior to visiting rheumatologist (DOIP), ≤ 6 months, > 6 months-2 years, 2-10 years and > 10 years. The Disease Activity Score of 28 joints-3 (erythrocyte sedimentation rate) score was calculated for each patient by three variable methods.
  
  
  RESULTS
  The total number of patients considered for the study after exclusion was 1716. The subjects had a mean (SD) age of 48.1 (12.71) years, the male-to-female ratio was 1 : 5, and median (range) of duration of RA was 48 (0.5-484) months. The prevalence of EAM noted was around 13%. EAM were more likely during the first 2 years of the disease (odds ratio [OR]: 1.465; P = 0.047) and increased with longer DOIP. The incidence was less in patients with low disease activity (OR: 0.657) and worse with the presence of deformities (OR: 2.1).
  
  
  CONCLUSIONS
  The study corroborates the current concept of effective disease control to reduce the incidence/likelihood of EAM in RA patients.
authors.affiliation: ChanRe Rheumatology and Immunology Center, Bangalore, Karnataka, India.
authors.forename: S
authors.initials: S
authors.lastname: Chandrashekara
authors.affiliation: St. John's Medical College Hospital, Bangalore, Karnataka, India.
authors.forename: Vineeta
authors.initials: V
authors.lastname: Shobha
authors.affiliation: Sakra Hospital, Bangalore, Karnataka, India.
authors.forename: B G
authors.initials: BG
authors.lastname: Dharmanand
authors.affiliation: Kanva Diagnostics Center, Bangalore, Karnataka, India.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Jois
authors.affiliation: Columbia Asia Hospital, Bangalore, Karnataka, India.
authors.forename: Sharath
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Samarpan Health Centre, Bangalore, Karnataka, India.
authors.forename: Kurugodu Mathada
authors.initials: KM
authors.lastname: Mahendranath
authors.affiliation: Arthritis Superspeciality Center, Hubli, Karnataka, India.
authors.forename: Vikram
authors.initials: V
authors.lastname: Haridas
authors.affiliation: Vikram Hospital Pty. Ltd., Mysore, Karnataka, India.
authors.forename: Shiva
authors.initials: S
authors.lastname: Prasad
authors.affiliation: Manipal Hospital, Mysore, Karnataka, India.
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Singh
authors.affiliation: Narayana Health City, Mysore, Karnataka, India.
authors.forename: Manisha Ashwin
authors.initials: MA
authors.lastname: Daware
authors.affiliation: Anurag Clinic, Mysore, Karnataka, India.
authors.forename: Anupama
authors.initials: A
authors.lastname: Swamy
authors.affiliation: JSS Medical College, Mysore, Karnataka, India.
authors.forename: R
authors.initials: R
authors.lastname: Subramanian
authors.affiliation: Bangalore Rheumatology Center, Bangalore, India.
authors.forename: Srirama Attappa
authors.initials: SA
authors.lastname: Somashekar
authors.affiliation: Arushi Rheumatology Center, Tumkur, India.
authors.forename: Arun Madhanaghatta
authors.initials: AM
authors.lastname: Shanthappa
authors.affiliation: ChanRe Rheumatology and Immunology Center, Bangalore, Karnataka, India.
authors.forename: K R
authors.initials: KR
authors.lastname: Anupama
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents
keywords: extra-articular manifestations; rheumatoid arthritis