Incidence and clinico-immunological assessment of patients of rheumatoid arthritis in Gorakhpur district, Uttar Pradesh, India

ABSTRACT

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease manifesting itself in various extra-articular signs and progressive articular damage. The present study was designed to find out the incidence and clinico-immunological characteristics of patients with RA.Methods: This one-year observational study involved 150 adult patients attending orthopaedics department at Nehru Hospital, B.R.D. Medical College, 2010. Each patient was subjected to clinical, functional, radiological and laboratorial examination after taking informed consent. SPSS software was used for data analysis.Results: Nearly 36% patients had some radiological changes in the form of surrounding osteopenia articular erosion, joint space narrowing and degenerative changes. All NSAIDs when used alone showed poor fall in values of acute phase reactant i.e. ESR and CRP. Maximum fall in acute phase reactant was obtained by treatment with combination therapy of NSAID + hydroxychloroquine + methotrexate + sulfasalazine. NSAIDs did not prevent radiological progression of disease and in more than 50% radiological progression continued however when NSAIDs used with any DMARDs show radiological regression. Maximum radiological regression was caused by combination therapy of NSAID + hydroxychloroquine + sulfasalazine + methotrexate.Conclusions: All NSAIDs produced poor fall in values of acute phase reactants and radiological progression continued in majority of patients, when a DMARD or combination of DMARDs were used with NSAIDs response was much better and relief was obtained earlier, and remission was sustained for longer duration.