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首页> 外文期刊>Advances in Rheumatology >The REAL study: a nationwide prospective study of rheumatoid arthritis in Brazil
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The REAL study: a nationwide prospective study of rheumatoid arthritis in Brazil

机译：REAL研究：巴西类风湿关节炎的全国性前瞻性研究

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There are few data on the epidemiology, clinical manifestations and management of RA in Brazil, even with the recognition of the high direct, indirect and societal costs of this disease. Herein, we report the formation of the REAL - Rheumatoid Arthritis in Real Life, the first nationally representative multicenter prospective observational study in Brazil. The REAL study was designed to include a total of 1300 evaluable patients from 13 tertiary care public health centers specialized in RA management and representative of 5 regions of Brazil. Each center was expected to enroll ~ 100 consecutively seen patients and follow them prospectively in a systematic protocol-driven fashion with scheduled visits at baseline, 6 and 12 months. Core clinical, laboratory and patient-reported outcomes measures were required to be collected at each visit. A total of 1115 patients (89.4% female, mean age of 56.7 years and median disease duration of 12.7 years) were enrolled from 11 participating centers. Almost 80% of patients were of middle-low or low socioeconomic classes. The median educational time was 8 years, with 3.23% being below literacy level. The interval between symptoms and diagnosis varied from 1 to 457 months (median 12 months). Almost half of the patients were on glucocorticoids, 96.5% on DMARDs, with 35.7% on biologics. Median HAQ-DI was 0.875, ranging from 0 to 3. Median DAS28-ESR was 3.5, with 58.7% of patients presenting moderate or high disease activity. The first large cohort of Brazilian patients with RA in a real-life setting shows several striking differences from previously published cohorts from other countries. The long delay for diagnosis and start of DMARDs may partly explain the high frequency of erosive disease. An elevated percentage of patients on moderate or high disease activity was seen, despite of the high frequency of corticosteroid and biologics utilization. Data from this cohort may enable public health managers of developing countries better allocate the limited resources available for the care of RA patients.
机译：在巴西，关于RA的流行病学，临床表现和管理的数据很少，即使已经认识到这种疾病的直接，间接和社会成本很高。在此，我们报告了REAL-类风湿关节炎在现实生活中的形成，这是巴西第一个具有全国代表性的多中心前瞻性观察研究。 REAL研究的目的是包括来自13个专门针对RA管理的三级公共卫生中心以及巴西5个地区的代表的1300名可评估患者。预计每个中心将招募约100名连续看诊的患者，并以系统的方案驱动方式对他们进行前瞻性随访，并在基线，6和12个月进行计划就诊。每次访问都需要收集核心的临床，实验室和患者报告的结局指标。来自11个参与中心的总共1115名患者（女性89.4％，平均年龄56.7岁，疾病中位病程12.7年）入组。几乎80％的患者属于中低等社会经济阶层。中位教育时间为8年，低于识字率的比例为3.23％。症状和诊断之间的间隔从1到457个月不等（中位数为12个月）。几乎一半的患者使用糖皮质激素，DMARDs占96.5％，生物制剂占35.7％。 HAQ-DI的中位数为0.875，范围为0到3。DAS28-ESR的中位数为3.5，其中58.7％的患者表现出中度或高疾病活性。在现实生活中，巴西患有RA的第一批大型患者队列与其他国家先前发表的队列患者存在显着差异。 DMARDs诊断和启动的长期延迟可能部分解释了糜烂性疾病的高发率。尽管皮质类固醇和生物制剂的使用频率很高，但发现中度或高度疾病活动的患者百分比有所上升。该队列的数据可以使发展中国家的公共卫生管理人员更好地分配有限的资源来治疗RA患者。

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