Consultation rates in general practice for symptoms related to inflammatory arthritis increase a few years prior to the diagnosis, researchers reported at the 2016 American College of Rheumatology/Association of Rheumatology Health Professionals Annual Meeting. The symptoms could be useful to develop methods of earlier detection of inflammatory arthritis.
Marian vans Beers-Tas, MD, from the Amsterdam Rheumatology & Immunology Center in the Netherlands, and colleagues conducted a nested case-control study using data from electronic medical records to measure the number and timing of visits to general practitioners for 192 symptoms and diseases up to 9 years before a diagnosis of inflammatory arthritis.
The study included medical records from 2,772 patients who were diagnosed with inflammatory arthritis between 2012 and 2014. The researchers also included a control group matched at a 1:2 ratio for age, gender, general practice, and retrospective duration of follow-up.
Among patients diagnosed with inflammatory arthritis, the consultation rate for musculoskeletal symptoms increased in the last 1.5 years before diagnosis, with an odds ratio (OR) of 1.8 at 6 months, an OR of 1.4 at 12 months, and an OR of 1.3 at 18 months prior to the diagnosis.
The consultation rate was significantly higher for infections 6 and 18 months prior to diagnosis (OR, 1.2 for both). The rates for diseases related to inflammatory arthritis and other chronic diseases significantly increased 3 months before diagnosis (OR, 1.2; OR, 1.3, respectively).
Patients who were diagnosed with inflammatory arthritis had higher rates of shoulder complaints compared with controls (16.1% vs 5.6%). Patients diagnosed with inflammatory arthritis also had higher rates of hand or finger complaints (12.2% vs 5.6%), carpal tunnel syndrome (5% vs 2.5%) and foot or toe complaints (15.2% vs 9.2%).
The researchers note that the increased consultation rates for musculoskeletal symptoms and infectious diseases began 4 to 6 years prior to diagnosis but become statistically significant about 1.5 years before the diagnosis.
- van Beers-Tas M, Nielen M, Korevaar JC, et al. Early detection of inflammatory arthritis: The role of musculoskeletal symptoms, infections, and rheumatoid arthritis-related comorbidities in primary care. Abstract 489. Presented at the 2016 ACR/ARHP Annual Meeting; November 11-14, 2016; Washington DC.