Kuwait association of rheumatology 2018 treatment recommendations for patients with rheumatoid arthritis

Alhajeri, Hebah; Abutiban, Fatemah; Al-Adsani, Wasl; Al-Awadhi, Adel; Aldei, Ali; Alenizi, Ahmad; Alhadhood, Naser; Al‐Herz, Adeeba; Al-Kandari, W.; Dehrab, Ahmad; Ghanem, A.; Hasan, Eman; Hayat, Sawsan; Saleh, Khulood; Tarakmeh, Hoda; Ali, Yousef

doi:10.1007/s00296-019-04372-y

Cited by 9 publications

(12 citation statements)

References 54 publications

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“…Few countries in Africa and the Middle East have established national treatment guidelines that take into account the specific contexts for that country. At the time of writing, most recent country-specific guidelines were published in Kuwait [59] while a number of other countries follow established international guidelines, e.g., those published by ACR or EULAR [60,61]. However, even in countries that have established recommendations, failure to update the guidelines (and healthcare policies based on them) to account for new therapies and clinical data can lead to delays in effective treatment [39,54].…”

Section: Region-specific Unmet Needsmentioning

confidence: 99%

A Review of the Prevalence and Unmet Needs in the Management of Rheumatoid Arthritis in Africa and the Middle East

et al. 2020

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Estimates of the global prevalence of rheumatoid arthritis (RA) range from 0.24 to 1%, but vary considerably around the globe. A variation in RA prevalence is also expected across Africa and the Middle East, due to ethnic, climate, and socioeconomic differences. To assess the prevalence of RA in Africa and the Middle East, we searched Medline (via PubMed) and databases of major rheumatology conferences. Seventeen journal articles and 0 abstracts met the inclusion criteria. Estimated prevalence ranged from 0.06 to 3.4%. Most studies reported values near or below 0.25%. Consistent with data from other regions, RA was more prevalent among urban than rural populations, and among women than men. The women:men prevalence ratio ranged from 1.3:1 to 12.5:1, which suggests notable differences from the global average of 2:1. Relative increases in prevalence were observed in North Africa and the Middle East (13% since 1990) and Western Sub-Saharan Africa (14%), whereas rates in Eastern, Central, and Southern Sub-Saharan Africa show decreases (4-12%). Low disease awareness, delays to visit rheumatologists, and socioeconomic factors appear to hinder early diagnosis and aggressive treatment. Few countries have developed RA-specific treatment guidelines, and many physicians and patients face limited access to even basic treatments. An improved understanding of the epidemiology and management of RA, and the related socioeconomic consequences is necessary, so that targeted attempts can be made to encourage early diagnosis and treatment.

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Section: Region-specific Unmet Needsmentioning

confidence: 99%

A Review of the Prevalence and Unmet Needs in the Management of Rheumatoid Arthritis in Africa and the Middle East

et al. 2020

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“…Rheumatoid arthritis (RA) is a chronic and systemic inflammatory autoimmune disease that mainly involves the joints [ 1 ], with an estimated prevalence between 0.3 and 1%. It is more commonly diagnosed in women [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of aerobic exercise for rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials

Weng

et al. 2022

BMC Sports Sci Med Rehabil

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Background Rheumatoid arthritis (RA) can cause severe physical impairment and a reduced quality of life, and there is limited evidence for any effective intervention. Aerobic exercise may be beneficial for improving symptoms. Therefore, the purpose of this meta-analysis was to evaluate the effectiveness and safety of aerobic exercise for rheumatoid arthritis patients. Methods PubMed, The Cochrane Library, Web of Science, EMBASE, CNKI, WanFang Data and VIP databases were searched. Randomized controlled trials of the effectiveness and safety of aerobic exercise for rheumatoid arthritis were included. Risks of bias were assessed by two independent reviewers using the methods described in the RevMan 5.3, GRADEpro and the Cochrane Handbook. Meta-analyses were performed to investigate the effects of aerobic exercise on rheumatoid arthritis. Results A total of 13 RCTs were included, including 967 rheumatoid arthritis patients. The Meta-analysis results showed that aerobic exercise can improve functional ability [MD = − 0.25, 95% CI (− 0.38, − 0.11), P = 0.0002], relieve pain [SMD = − 0.46, 95% CI (− 0.90, − 0.01), P = 0.04], increase aerobic capacity [MD = 2.41, 95% CI (1.36, 3.45), P < 0.00001] and improve the Sit to Stand test score[MD = 1.60, 95% CI (0.07, 3.13), P = 0.04] with statistically significant differences. Conclusion Generally, aerobic exercise is beneficial and safe for RA patients and has a certain alleviating effect on the disease, such as functional ability improvement, pain relief and aerobic capacity increase. Limited by the quantity and quality of the included studies, future research with higher-quality studies needs to be conducted to verify the above conclusions. Trial registration: PROPERO registration number: CRD42021242953.

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“…In line with international guidelines [7,8], the 2018 Kuwait Association of Rheumatology guidelines recommended the use of biologic therapy in (a) patients with early RA if they had persistent moderate to high disease activity despite conventional disease-modifying anti-rheumatic drugs (cDMARDs) and (b) patients with established RA, especially those with an inadequate response to cDMARDs or those with contraindications to cDMARDs, high disease activity, or poor prognostic factors. The guidelines further addressed the indications for TNFinhibitor (TNFi)-or non-TNFi-based biologic therapy [9].…”

Section: Introductionmentioning

confidence: 99%

“…This usually takes 6 to 12 months until the medication is available, depending on how fast the paperwork is processed and the schedule of meetings to study the case. The 2018 Kuwait Association of Rheumatology guidelines were released in part to address the inequalities among KP and NKP in terms of access to biologics, lower disease activity, and better physical function [9].…”

Section: Introductionmentioning

confidence: 99%

Accessibility to biologics and its impact on disease activity and quality of life in patients with rheumatoid arthritis in Kuwait

et al. 2020

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Objective Biologics are indicated in rheumatoid arthritis (RA) in case of persistent high disease activity despite conventional disease-modifying anti-rheumatic drugs (cDMARDs) or patients with contraindications to cDMARDs or poor prognostic factors. The purpose of this study was to compare the prescription rates of biologics in Kuwaiti and non-Kuwaiti patients and to assess whether this had an impact on disease activity and quality of life in RA patients. Methods Data were extracted from the Kuwait Registry for Rheumatic Diseases. Adult patients who satisfied the ACR classification criteria for RA from four major hospitals in Kuwait were evaluated from February 2013 through May 2018. The treatment agents, disease activity, and quality of life of Kuwaiti patients were compared with non-Kuwaiti patients. Results A total of 1651 RA patients were included; 806 (48.8%) were Kuwaiti patients. Among Kuwaiti patients, 62.5% were on biologic drugs in comparison with 14% of non-Kuwaiti patients. In comparison with non-Kuwaiti patients, Kuwaiti patients had significantly lower numbers of swollen joints (p < 0.001) and disease activity score-28 scores (p = 0.02) and less steroid use (p < 0.001) yet a significantly higher health assessment questionnaire-disability index (p < 0.001). Regression analysis showed that DAS-28 scores were significantly associated with the treatment type (p < 0.001) and that nationality was significantly predictive of the treatment type (p < 0.001). Conclusion In the setting of easy accessibility to treatment for Kuwaiti patients, biologics were prescribed by rheumatologists at a higher rate than for non-Kuwaitis. This may explain the lower disease activity and the lower rate of steroid use in Kuwaiti patients than non-Kuwaitis. Key points • Significant discrepancies in the rates of prescribing biologic therapies between KP and NKP in Kuwait were observed. • Several treatment outcomes were significantly better in the KP group than in the NKP group even after adjustment of confounding factors. • The poor access to biologic therapies was suggested to limit the effectiveness of RA treatments in the NKP group.

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Kuwait association of rheumatology 2018 treatment recommendations for patients with rheumatoid arthritis

Cited by 9 publications

References 54 publications

A Review of the Prevalence and Unmet Needs in the Management of Rheumatoid Arthritis in Africa and the Middle East

A Review of the Prevalence and Unmet Needs in the Management of Rheumatoid Arthritis in Africa and the Middle East

Effectiveness and safety of aerobic exercise for rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials

Accessibility to biologics and its impact on disease activity and quality of life in patients with rheumatoid arthritis in Kuwait

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