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Mediterr J Rheumatol 2018;29(1):27-37
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Multicenter Cross-sectional Study of Patients with Rheumatoid Arthritis in Greece: Results from a cohort of 2.491 patients
Konstantinos Thomas1, Argiro Lazarini1, Evripidis Kaltsonoudis2, Alexandros Drosos2, Ioannis Papalopoulos3, Prodromos Sidiropoulos3, Pelagia Katsimbri1, Dimitrios Boumpas1, Panagiota Tsatsani4, Sousana Gazi4, Kalliopi Fragkiadaki1, Maria Tektonidou1, Petros P. Sfikakis1, Lina Pantazi5, Kyriaki A. Boki5, Eleftheria P. Grika1, Panagiotis G. Vlachoyiannopoulos1, Konstantina Karagianni6, Lazaros I. Sakkas6, Theodoros Dimitroulas7, Alexandros Garyfallos7, Dimitrios Kassimos8, Gerasimos Evangelatos9, Alexios Iliopoulos9, Maria Areti10, Constantinos Georganas10, Konstantinos Melissaropoulos11, Panagiotis Georgiou11, Periklis Vounotrypidis10, Konstantinos Ntelis10, Clio P. Mavragani1, Ilias Bournazos10, Gikas Katsifis12, Christos Mavrommatis10, George D. Kitas1,13, Dimitrios Vassilopoulos1
Authors Information

1: Joint Rheumatology Program, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

2: Rheumatology Clinic, University of Ioannina, Ioannina, Greece

3: Clinical Immunology and Allergy Department, University of Crete, Heraklion, Greece

4: Rheumatology Unit, KAT Hospital, Athens, Greece

5: Rheumatology Unit, Sismanoglio Hospital, Athens, Greece

6: Department of Rheumatology, University of Thessaly, Larissa, Greece

7: 4th Department of Medicine, Aristotle University, Thessaloniki, Greece

8: 401 General Military Hospital, Athens, Greece

9: Rheumatology Unit, NIMTS Hospital, Athens, Greece

10: Private Practice, Greece

11: Rheumatology Unit, Agios Andreas Hospital, Patras, Greece

12: Rheumatology Unit, Navy Hospital, Athens, Greece

13: Hygeia Hospital, Athens, Greece
Abstract

Aim of the study: To evaluate the current disease characteristics, treatment and comorbidities of rheumatoid arthritis (RA) in Greece. Methods: Multicenter, cross-sectional study with a 9-month recruitment period between 2015 and 2016. Demographics, disease characteristics, treatment and comorbidities were collected via a web-based platform. Results: 2.491 RA patients were recruited: 96% from tertiary referral centers, 79% were females with a mean age of 63.1 years and disease duration of 9.9 years. Fifty-two percent were rheumatoid factor and/or anti-CCP positive, while 41% had erosive disease. Regarding treatment, 82% were on conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs), 42% on biologic DMARDs (TNFi: 22%, non-TNFi: 20%) and 40% on corticosteroids (mean daily dose: 5.2 mg). Despite therapy, 36% of patients had moderate and 12% high disease activity. The most frequent comorbidities were hypertension (42%), hyperlipidemia (33%), osteoporosis (29%), diabetes mellitus (15%) and depression (12%). Latent tuberculosis infection (positive tuberculin skin test or interferon gamma release assay) was diagnosed in 13 and 15.3% of patients, respectively. Regarding chronic viral infections, 6.2% had history of herpes zoster while 2% and 0.7% had chronic hepatitis B and C virus infection, respectively. A history of serious infection was documented in 9.6%. Only 36% and 52% of the participants had ever been vaccinated against pneumococcus and influenza virus, respectively. Conclusion: This is one of the largest epidemiologic studies providing valuable data regarding the current RA characteristics in Greece. Half of patients were seropositive but despite therapy, half displayed residual disease activity, while preventive vaccination was limited.

https://doi.org/10.31138/mjr.29.1.27

Keywords: rheumatoid arthritis, comorbidities, biologics, methotrexate, vaccination, infections, tuberculosis, hepatitis, cardiovascular diseases