Transcript Demographic and Clinical Characteristics of Rheumatoid Arthritis

Demographic and Clinical Characteristics of
Rheumatoid Arthritis patients in some Arab
States: Preliminary analysis
Mohammed Hammoudeh,M.D
Division of Rheumatology, Department of Medicine,
Hamad Medical Corporation, Doha, Qatar
Member of Middle East Rheumatoid Arthritis
Consortium (MERAC)
Saskia Mandey, Mohammed Hammoudeh, Ziyad Mahfoud, Wessam G. Elhaq, Marjonneke J
Mook-Kanamori , Rawan Shayboub, Samar Al Emadi, Humeira Badsha, Imad Uthman, Hussein
Halabi, Basel Masri, Layla Kazkaz, Robert M. Plenge, Cindy McKeon, Thurayya Arayssi
1
Disclaimer
Introduction
As faculty of Weill Cornell Medical College in Qatar
we are committed to providing transparency for any
and all external relationships prior to giving an
academic presentation.
Mohammed Hammoudeh M.D.
I DO NOT have a financial interest in commercial
products or service.
RA in the Middle East
Introduction
• There are few systemic large studies of RA in the ME
• 15 studies, largest 160 patients, single center
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RA is more common in females
High proportion of RF positivity
Association with SE
Conflicting results of severity
Delay in initiation of therapy 1,2
Low use of DMARDS 1,2
Current study: Genetic studies of Rheumatoid Arthritis in
some Arab States (GRAAS)
1.
2.
Badsha H et al. Ann Rheum Dis 66, 835 (2007)
Badsha H et al. Clin Rheumatol 27, 739-42 (2008)
Genetic studies of Rheumatoid Arthritis
in some Arab States
Introduction
Goal:
• Investigate the genetic basis of RA in the
Middle East by collecting at least 2000 RA
controls and 2000 RA controls from 5
Rheumatology Centers across 5 Arab States.
– Genome Wide Association Study (GWAS) that will
test for >30 identified risk alleles identified in
European and North American populations
Objective of this Presentation
Introduction
Describe the demographic and clinical
characteristics of the first 150 Rheumatoid
Arthritis patients from 5 countries in the Middle
East recruited to date
Inclusion Criteria
Introduction
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Self reported Arab ancestry
Age > 18
RA diagnosed per the ACR criteria
Ability to provide informed consent
Data Collection
Introduction
• Two sets of data were collected:
– Demographic and clinical data
– Ancestry data, based on self-reported ancestry
• All data entry is web-based and centralized at
WCMC-Q
Introduction
Results
Nationality
Introduction Nationality (%)
30
Nationality (regions)
North
Africa
14%
25
percentage (%)
20
Gulf
49%
Levant
37%
15
10
5
0
Gulf
Levant
North Africa
Analysis done on 150 patients in February 2013
Demographics/ Clinical
Introduction
Demographic/ clinical characteristics
Mean (SD)
Age in years
49.9 (12.2)
Age at diagnosis in years
38.9 (12.7)
Disease Duration in years
11.1 (9.5)
Demographics/Clinical characteristics
Number
Percentage
135
15
90
10
38
100
12
25.3
66.7
8
4
146
2.7
97.3
68
82
45.3
54.7
77
73
93
51.3
48.7
62.1
Gender
Female
Male
Family member with RA
Yes
No
I don't know
Extra-articular manifestation
Yes
no
Result of Anti CCP
Positive
Negative
Result of Rheumatoid Factor
Positive
Negative
Anti-CCP and/or RF positive
Analysis done on 150 patients in February 2013
Clinical history
Introduction
Clinical history characteristics
Number
Percentage
Yes
10
6.7
No
140
93.3
Yes
9
6
No
141
94
Yes type 1
2
1.3
Yes type 2
16
10.7
No
132
88
History of Autoimmune Disease
History of vascular disease
Diabetes
Analysis done on 150 patients in February 2013
Demographics
Introduction
Demographic characteristics
Number
Percentage
Married
120
80
Single
16
10.7
Divorced/ Separated/ Widowed
14
9.3
No formal education/ primary school
51
34
Middle/ Secondary School
49
32.7
University
50
33.3
Marital Status
Education
Analysis done on 150 patients in February 2013
Lifestyle
Introduction
Clinical characteristics
Number
Percentage
Current
24
16
Past
8
5.3
never
118
78.7
Cigarette smoking
Number of years smoking cigarettes
Mean (SD)
[range]
17.6 (13.1)
[1-45]
Shisha smoking
Current
16
10.7
Past
3
2
never
131
87.3
Number of years smoking shisha (in years)
Mean (SD)
[range]
7.8 (10.1)
[1-38]
Analysis done on 150 patients in February 2013
Medications
Introduction
% (percentage)
Medication Use (in percentage)
100
90
80
70
60
50
40
30
20
10
0
Yes
Never
86% of the patients are using Methotrexate; the use of biologics is low
Analysis done on 150 patients in February 2013
Conclusions
Introduction
• The patient population of this study is relatively young in
comparison to mean age (56.2 years) in the other large
databases
• RF positivity and CCP positivity are low
• Large percentage of patients are illiterate, which may impact
compliance and disease outcome
• Compared to the study done by Badsha et al, there is an
increase in the use of Methotrexate (36% vs. 86%) but use of
Biologics is still limited.
Future Plans
Introduction
• Analyze the demographic and clinical data on
a regular basis
• Encourage more centers to join MERAC
Acknowledgements
Introduction
Weill Cornell Medical College-Qatar
Saskia Mandey
Ziyad Mahfoud
Wessam G. Elhaq
Marjonneke Mook-Kanamori
Cindy McKeon
Rawan Shayboub
Thurayya Arayssi
Hamad Medical Corporation, Doha, Qatar
Samar Al Emadi
Al Biraa Arthritis and Bone Clinic, Dubai, UAE
Humeirah Badsha
American University of Beirut, Lebanon
Imad Uthman
King Faisal Specialist Hospital &
Research center, Jeddah, Kingdom of
Saudi Arabia
Hussein Halabi
Jordan Hospital, Amman, Jordan
Basel Masri
Tishreen Hospital, Damascus, Syria
Layla Kazkaz
Broad Institute, Cambridge, MA, USA
Robert Plenge