Đặc điểm lâm sàng, cận lâm sàng và các yếu tố liên quan đến thời gian chẩn đoán ở người bệnh viêm khớp dạng thấp chưa điều trị DMARDs năm 2024 - 2025

Abstract

Early diagnosis of rheumatoid arthritis (RA) before initiation of disease-modifying antirheumatic drugs (DMARDs) is of great importance for both diagnosis and treatment.We conducted a study on 97 patients with rheumatoid arthritis diagnosed according to the 2010 ACR/EULAR criteria who had not yet received DMARD therapy. The aim was to describe the clinical and paraclinical characteristics and to identify factors associated with time to diagnosis of rheumatoid arthritis patients treated at the Center of Rheumatology - Bach Mai Hospital and the Department of Rheumatology - Hanoi Medical University Hospital from January 2024 to December 2025. The mean age of the study population was 54.2 ± 13.2 years old, with 49.48% of patients aged between 40 and 60 years old. The female-to-male ratio was 2.3:1. All patients presented with joint pain and swelling, with a median number of tender joints of 6 (IQR: 2-12) and a median number of swollen joints of 12 (IQR: 6 - 18). The positivity rates of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies were 91.8% and 83.5%, respectively. The mean C-reactive protein (CRP) level was 29.5 ± 42.4 mg/L, and the mean erythrocyte sedimentation rate (ESR) in the first hour was 47.8 ± 27.7 mm/h. The proportion of patients with high disease activity was 51.5% according to DAS28-CRP and 74.2% according to DAS28-ESR. The median time to diagnosis was 8 months and was associated with body mass index with, overweight patients experienced a longer time to diagnosis compared to underweight group.