Mapping rheumatoid arthritis — first multinational review of RA shows

In the first international ‘map of rheumatoid arthritis’ (RA), spanning Europe and beyond, significant national differences in RA severity can be directly traced to national economics, most notably health expenditure, as exposed today by data from the QUEST-RA Study presented at EULAR 2007, the Annual Congress of the European League Against Rheumatism, Barcelona, Spain.

Lead author of the study, Dr Tuulikki Sokka of the Jyvaskyla Central Hospital, Finland, comments, “Most medical literature on RA is based on randomised clinical trials but many RA patients do not meet trial inclusion criteria and not all European countries are sufficiently involved in such trials. QUEST-RA was put together as a collaborative international cross-sectional study of RA. Consequently, it sheds light on the true international variations and related economic factors that affect the progression of the disease.”

QUEST-RA is the first multi-national database in RA in this scale. The study reviewed data from 100 consecutive RA patients in three or more centres in each of the 21 participating countries, including clinical status records and patient self-report outcomes. Between January 2005 to June 2007 QUEST-RA includes patients from Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Netherlands, Poland, Serbia, Spain, Sweden, Turkey, UK, Argentina, Canada, and USA.

Measurements of patients’ disease states were taken using the Disease Activity Scale 28, (DAS28) which assesses the activity of disease across the 28 joints most commonly affected by RA.

Each participating country’s Gross Domestic Product (GDP) and health expenditure per capita were logged and analysis revealed a negative correlation between disease severity and national GDP / health expenditure – showing disease severity to be higher in poorer countries with less health spending.

Professor Tore K Kvien, EULAR President, based at Diakonhjemmet Hospital, Oslo, Norway, says, “Now that we have such a clear picture of the disparity of disease severity relative to health spending across Europe, we must work to level off such inequalities. EULAR is a partnership organisation of people with arthritis and rheumatism in Europe and clinicians/researchers/health professional and will continue to work for equal access to effective treatments across Europe.”