PMID- 29675622
OWN - NLM
STAT- MEDLINE
DCOM- 20190111
LR  - 20190111
IS  - 1434-9949 (Electronic)
IS  - 0770-3198 (Linking)
VI  - 37
IP  - 9
DP  - 2018 Sep
TI  - Rheumatoid arthritis in the indigenous qom population of Rosario, Argentina:
      aggressive and disabling disease with inadequate adherence to treatment in a
      community-based cohort study.
PG  - 2323-2330
LID - 10.1007/s10067-018-4103-5 [doi]
AB  - To describe the baseline and follow up epidemiological/clinical characteristics
      of rheumatoid arthritis (RA) in a community-based cohort of the qom population.
      RA (ACR criteria) patients identified (n = 40) or not (n = 25) in the previous
      study were included. Baseline and follow-up visits (3, 6, and 12 months) were
      performed. Treatment adherence and modification, disability (Health Assessment
      Questionnaire Disability Index-HAQ-DI), and Disease Activity [DAS-28 (ESR)] were 
      ascertained. At 12 months, complete and incomplete lost to follow-up patients
      were identified. The estimated RA prevalence was 3%. The patients' mean (SD)
      disease duration was 110.5 (17.9) and their median delay in diagnosis 30.4 (IQR
      52.8) months; mean (SD) age and years of formal education were 39.8 (1.6) and 5.3
      (SD 0.3); 58 (89.2%) were female, and 89.2% were seropositive. At baseline, their
      mean DAS-28 (ESR) was 4.8 (SD 0.9) with 67.7% having high disease activity and
      32.3% moderate; 76.9% reported HAQ-DI >/= 0.8. At 12 months, three patients have 
      died; 13 (20.9%) were "completely" and 19 (30.6%) "incompletely" lost to
      follow-up. There were favorable changes over time for disease activity (p <
      0.001), HAQ-DI (p < 0.001), and treatment modifications (p < 0.001) but no
      changes in treatment adherence (p = 0.260). The main cause of lost to follow-up
      was migration. This population has one of the highest RA prevalence rate
      reported. Patients had an aggressive and disabling disease, with poor adherence
      to treatment. Improvements of clinical parameters over time were observed.
FAU - Quintana, Rosana
AU  - Quintana R
AD  - Hospital Provincial de Rosario, Leandro N Alen 1450, Rosario, Santa Fe,
      Argentina. rosanaquintana@gmail.com.
AD  - Servicio Enfermedades Autoinmunes, Hospital Clinic, University of Barcelona,
      Barcelona, Catalonia, Spain. rosanaquintana@gmail.com.
AD  - Centro Regional de Enfermedades Autoinmunes y Reumaticas (CREAR), Grupo Orono,
      Rosario, Santa Fe, Argentina. rosanaquintana@gmail.com.
FAU - Goni, Mario
AU  - Goni M
AD  - Centro de Especialidades Medicas Ambulatorias de Rosario, Secretaria de Salud
      Publica, Municipalidad de Rosario, Santa Fe, Argentina.
FAU - Mathern, Nora
AU  - Mathern N
AD  - Ortopedia y Fisiatria, Instituto de Reumatologia, Rosario, Santa Fe, Argentina.
FAU - Jorfen, Marisa
AU  - Jorfen M
AD  - Centro de Especialidades Medicas Ambulatorias de Rosario, Secretaria de Salud
      Publica, Municipalidad de Rosario, Santa Fe, Argentina.
FAU - Conti, Silvana
AU  - Conti S
AD  - Hospital Provincial de Rosario, Leandro N Alen 1450, Rosario, Santa Fe,
      Argentina.
FAU - Nieto, Romina
AU  - Nieto R
AD  - Hospital Provincial de Rosario, Leandro N Alen 1450, Rosario, Santa Fe,
      Argentina.
FAU - Sanabria, Alvaro
AU  - Sanabria A
AD  - Hospital Provincial de Rosario, Leandro N Alen 1450, Rosario, Santa Fe,
      Argentina.
FAU - Prigione, Cristina
AU  - Prigione C
AD  - Hospital Provincial de Rosario, Leandro N Alen 1450, Rosario, Santa Fe,
      Argentina.
FAU - Silvestre, Adriana M R
AU  - Silvestre AMR
AD  - Ministerio de Salud, Gobierno de la Provincia de Santa Fe, Santa Fe, Argentina.
FAU - Garcia, Vanina
AU  - Garcia V
AD  - Ministerio de Salud, Gobierno de la Provincia de Santa Fe, Santa Fe, Argentina.
FAU - Pons-Estel, Guillermo
AU  - Pons-Estel G
AD  - Hospital Provincial de Rosario, Leandro N Alen 1450, Rosario, Santa Fe,
      Argentina.
AD  - Servicio Enfermedades Autoinmunes, Hospital Clinic, University of Barcelona,
      Barcelona, Catalonia, Spain.
AD  - Centro Regional de Enfermedades Autoinmunes y Reumaticas (CREAR), Grupo Orono,
      Rosario, Santa Fe, Argentina.
FAU - Cervera, Ricard
AU  - Cervera R
AD  - Servicio Enfermedades Autoinmunes, Hospital Clinic, University of Barcelona,
      Barcelona, Catalonia, Spain.
FAU - Garcia, Conrado
AU  - Garcia C
AD  - Hospital General de Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico.
FAU - Pelaez-Ballestas, Ingris
AU  - Pelaez-Ballestas I
AD  - Hospital General de Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico.
FAU - Alarcon, Graciela S
AU  - Alarcon GS
AD  - Department of Medicine, Division of Clinical Immunology and Rheumatology, School 
      of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
FAU - Pons-Estel, Bernardo A
AU  - Pons-Estel BA
AD  - Hospital Provincial de Rosario, Leandro N Alen 1450, Rosario, Santa Fe,
      Argentina.
AD  - Centro Regional de Enfermedades Autoinmunes y Reumaticas (CREAR), Grupo Orono,
      Rosario, Santa Fe, Argentina.
LA  - eng
PT  - Journal Article
DEP - 20180419
PL  - Germany
TA  - Clin Rheumatol
JT  - Clinical rheumatology
JID - 8211469
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Argentina/ethnology
MH  - Arthritis, Rheumatoid/diagnosis/drug therapy/*ethnology
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Compliance/*ethnology
MH  - Pilot Projects
MH  - Young Adult
OTO - NOTNLM
OT  - Community-based cohort
OT  - Indigenous community
OT  - Latin America
OT  - Rheumatoid arthritis
OT  - Treatment adherence
OT  - qom
EDAT- 2018/04/21 06:00
MHDA- 2019/01/12 06:00
CRDT- 2018/04/21 06:00
PHST- 2018/02/09 00:00 [received]
PHST- 2018/04/10 00:00 [accepted]
PHST- 2018/04/06 00:00 [revised]
PHST- 2018/04/21 06:00 [pubmed]
PHST- 2019/01/12 06:00 [medline]
PHST- 2018/04/21 06:00 [entrez]
AID - 10.1007/s10067-018-4103-5 [doi]
AID - 10.1007/s10067-018-4103-5 [pii]
PST - ppublish
SO  - Clin Rheumatol. 2018 Sep;37(9):2323-2330. doi: 10.1007/s10067-018-4103-5. Epub
      2018 Apr 19.