Rheumatoid arthritis study of the Egyptian College of Rheumatology (ECR): nationwide presentation and worldwide stance

Abstract

To depict the spectrum of rheumatoid arthritis (RA) in Egypt in relation to other universal studies to provide broad-based characteristics to this particular population. This work included 10,364 adult RA patients from 26 specialized Egyptian rheumatology centers representing 22 major cities all over the country. The demographic and clinical features as well as therapeutic data were assessed. The mean age of the patients was 44.8 ± 11.7 years, disease duration 6.4 ± 6 years, and age at onset 38.4 ± 11.6 years; 209 (2%) were juvenile-onset. They were 8750 females and 1614 males (F:M 5.4:1). 8% were diabetic and 11.5% hypertensive. Their disease activity score (DAS28) was 4.4 ± 1.4 and health assessment questionnaire (HAQ) 0.95 ± 0.64. The rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) were positive in 73.7% and 66.7% respectively. Methotrexate was the most used treatment (78%) followed by hydroxychloroquine (73.7%) and steroids (71.3%). Biologic therapy was received by 11.6% with a significantly higher frequency by males vs females (15.7% vs 10.9%, p = 0.001). The least age at onset, F:M, RF and anti-CCP positivity were present in Upper Egypt (p < 0.0001), while the highest DAS28 was reported in Canal cities and Sinai (p < 0.0001). The HAQ was significantly increased in Upper Egypt with the least disability in Canal cities and Sinai (p = 0.001). Biologic therapy intake was higher in Lower Egypt followed by the Capital (p < 0.0001). The spectrum of RA phenotype in Egypt is variable across the country with an increasing shift in the F:M ratio. The age at onset was lower than in other countries.

Comorbidities and extra-articular manifestations of Rheumatoid arthritis in sub-Saharian Africa

“…The lifestyle of patients was characterized by smoking in 2-13.6%. The frequency of tobacco consumption was also reported by Lin et al [27] in China (15%), Uribe-Reina et al [28] in Colombia (6.14%), and Gheita et al [29] in Egypt (8.2%). This practice should be avoided by patients insofar as smoking is a cardiovascular risk factor but promotes the citrillination of proteins entering the etiopathogenic phenomena of rheumatoid arthritis [25].…”

Clinical implications of seropositive and seronegative autoantibody status in rheumatoid arthritis patients: A comparative multicentre observational study

“…This study is a multicentre observational study of the Egyptian College of Rheumatology-RA study group (ECR-RA) study, which has been described in detail elsewhere. [ 2 ] Adult patients with RA were recruited between September 2018 till December 2021. Data were extracted from the ECR-RA database for patients with diagnosis of RA ( N = 10, 364) confirmed using the 2010 ACR/EULAR classification criteria.…”

“…[ 1 ] The diverse spectrum of RA is associated with female predominance. [ 2 ] RA is characterized by the production of autoantibodies, rheumatoid factor (RF) and anti-cyclic citrullinated protein (anti-CCP), that provide clues to the underlying disease pathophysiology. RF, an autoantibody directed against the Fc part of IgG, is an important serological marker for the diagnosis of RA in everyday clinical practice.…”

Mechanistic role of quercetin as inhibitor for adenosine deaminase enzyme in rheumatoid arthritis: systematic review

“…RA is present worldwide, its prevalence varies among countries, regions, and ethnic groups [ 3 ]. The prevalence of RA is higher in Africa and the Middle East, usually ranging from 0.25% to 3.4% in most countries, according to Finckh et al.…”