The journey of rheumatoid arthritis patients: a review of reported lag times from the onset of symptoms

Abstract

BackgroundEven after achieving tremendous advances in diagnosis and treatment of rheumatoid arthritis (RA), many of the patients undergo delays in diagnosis and initiation of treatment, which leads to worsening of the condition and poor prognosis.ObjectiveThe objective of this study was to perform a literature review to quantify the lag times in diagnosis and treatment of RA and study the reported factors associated with it.MethodsThe authors searched literature published until September 2016 in electronic full-text and abstract databases and hand-searched the suitable articles.ResultsThe weighted average of median lag time from symptom onset to therapy was 11.79 months (12 studies, 5,512 patients, range 3.6–24.0 months). Lag1 was 3.14 months (onset of symptoms to first physician consultant; 12 studies, 6,055 patients, range 0–5.7 months); lag2 was 2.13 months (physician visit to RA specialist referral; 13 studies, 34,767 patients, range 0.5–6.6 months); lag3 was 2.91 months (consultation with rheumatologist to diagnosis; 3 studies, 563 patients, range 0–5 months), lag4 was 2.14 months (diagnosis to initiation of disease-modifying antirheumatic drug therapy; 5 studies, 30,685 patients, range 0–2.2 months). Numerous patient-and physician-related factors like gender, ethnicity, primary care physician knowledge of the condition, availability of diagnostics, and so on were responsible for the delays.ConclusionThis review estimated the delay times and identified the main factors for delay in RA patients in diagnosis and initiation of treatment. A most plausible solution to this is coordinated effort by the rheumatology and primary care physicians.

LncRNA MEG3 inhibits rheumatoid arthritis through miR‐141 and inactivation of AKT/mTOR signalling pathway

“…Rheumatoid arthritis (RA) is a chronic disease mediated by autoimmune responses with manifestations like systemic inflammation . Various studies have shown that genetic and environmental risk factors together contribute to the development of RA .…”

“…Rheumatoid arthritis (RA) is a chronic disease mediated by autoimmune responses with manifestations like systemic inflammation. 1,2 Various studies have shown that genetic and environmental risk factors together contribute to the development of RA. [3][4][5][6] An increasing number of studies are identifying a correlation between the cytokine networks and the RA pathogenesis.…”

Disease burden and treatment challenges of psoriatic arthritis in Africa and the Middle East

“…Delays in the referral of patients with PsA to rheumatologists is a challenge in Africa and the Middle East which, similarly to RA, is likely to be a result of multiple patientrelated and physician-related factors [53]. One such factor may be primary care practitioners and dermatologists not recognizing the symptoms of PsA due to a lack of training in identifying the disease.…”

Synovial Fluid Cell Proteomic Analysis Identifies Upregulation of Alpha-Taxilin Proteins in Rheumatoid Arthritis: A Potential Prognostic Marker

“…However, these antigens are not specific whether they initiate autoimmune reactions, thus making the diagnosis critical [8,10]. As the early stage of RA is characterized by nonspecific clinical symptoms, a delayed diagnosis leads to irreversible joint damage [11,12]. Thus, there is an urgent and strong need for novel and more precise biomarkers with higher sensitivity and specificity for early diagnosis of disease.…”