Evaluation of diagnostic and therapeutic delay in patients with rheumatoid arthritis and psoriatic arthritis
Objective. A monocentric cross-sectional study recruiting rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients residing in the Lazio region, Italy, to assess factors related to diagnostic delay and treatment accessibility. Methods. Clinical/serological data, including the time between...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2024-03-01
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| Series: | Reumatismo |
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| Online Access: | https://www.reumatismo.org/reuma/article/view/1607 |
| _version_ | 1797248654625472512 |
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| author | M. Iacovantuono S. Ferrigno P. Conigliaro P. Triggianese A. D’Antonio F.R. Spinelli A. Bergamini M.S. Chimenti |
| author_facet | M. Iacovantuono S. Ferrigno P. Conigliaro P. Triggianese A. D’Antonio F.R. Spinelli A. Bergamini M.S. Chimenti |
| author_sort | M. Iacovantuono |
| collection | DOAJ |
| description |
Objective. A monocentric cross-sectional study recruiting rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients residing in the Lazio region, Italy, to assess factors related to diagnostic delay and treatment accessibility.
Methods. Clinical/serological data, including the time between symptom onset, diagnosis, and the beginning of treatment, were collected. Residence, referral to a rheumatologic center, physician who made the diagnosis, and previous misdiagnosis were also evaluated.
Results. A higher diagnostic delay (p=0.003), and time between symptom onset and the start of I-line therapy (p=0.006) were observed in PsA compared to RA. A delayed start of II-line therapy was observed in RA compared to PsA (p=0.0007). Higher diagnostic delay (p=0.02), and time between symptom onset and the start of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) (p=0.02) were observed among residents of small-medium cities for both groups. Patients who have been diagnosed by another physician rather than a rheumatologist had a longer diagnostic delay (p=0.034) and a delayed start of I-line therapy (p=0.019). Patients who received a different previous diagnosis experienced greater diagnostic delay (p=0.03 and p=0.003) and time of start of csDMARDs (p=0.05 and p=0.01) compared with those receiving RA or PsA as the first diagnosis. PsA had a delay in starting targeted synthetic disease-modifying anti-rheumatic drugs (p=0.0004) compared to RA. Seronegative RA had delayed diagnosis (p=0.02) and beginning of therapies (p=0.03; p=0.04) compared to seropositive ones.
Conclusions. According to our results, greater diagnostic delay was found in PsA compared to RA, in patients living in small-medium cities, in those who did not receive the diagnosis from a rheumatologist, in those who were previously misdiagnosed, and in seronegative RA.
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| first_indexed | 2024-04-24T20:18:02Z |
| format | Article |
| id | doaj.art-02bf52ab935046a6ab2c4bef299b695b |
| institution | Directory Open Access Journal |
| issn | 0048-7449 2240-2683 |
| language | English |
| last_indexed | 2024-04-24T20:18:02Z |
| publishDate | 2024-03-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Reumatismo |
| spelling | doaj.art-02bf52ab935046a6ab2c4bef299b695b2024-03-22T13:03:52ZengPAGEPress PublicationsReumatismo0048-74492240-26832024-03-0176110.4081/reumatismo.2024.1607Evaluation of diagnostic and therapeutic delay in patients with rheumatoid arthritis and psoriatic arthritisM. Iacovantuono0S. Ferrigno1P. Conigliaro2P. Triggianese3A. D’Antonio4F.R. Spinelli5A. Bergamini6M.S. Chimenti7Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, RomeRheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, RomeRheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, RomeRheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, RomeRheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, RomeRheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University, RomeRheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, RomeRheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, Rome Objective. A monocentric cross-sectional study recruiting rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients residing in the Lazio region, Italy, to assess factors related to diagnostic delay and treatment accessibility. Methods. Clinical/serological data, including the time between symptom onset, diagnosis, and the beginning of treatment, were collected. Residence, referral to a rheumatologic center, physician who made the diagnosis, and previous misdiagnosis were also evaluated. Results. A higher diagnostic delay (p=0.003), and time between symptom onset and the start of I-line therapy (p=0.006) were observed in PsA compared to RA. A delayed start of II-line therapy was observed in RA compared to PsA (p=0.0007). Higher diagnostic delay (p=0.02), and time between symptom onset and the start of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) (p=0.02) were observed among residents of small-medium cities for both groups. Patients who have been diagnosed by another physician rather than a rheumatologist had a longer diagnostic delay (p=0.034) and a delayed start of I-line therapy (p=0.019). Patients who received a different previous diagnosis experienced greater diagnostic delay (p=0.03 and p=0.003) and time of start of csDMARDs (p=0.05 and p=0.01) compared with those receiving RA or PsA as the first diagnosis. PsA had a delay in starting targeted synthetic disease-modifying anti-rheumatic drugs (p=0.0004) compared to RA. Seronegative RA had delayed diagnosis (p=0.02) and beginning of therapies (p=0.03; p=0.04) compared to seropositive ones. Conclusions. According to our results, greater diagnostic delay was found in PsA compared to RA, in patients living in small-medium cities, in those who did not receive the diagnosis from a rheumatologist, in those who were previously misdiagnosed, and in seronegative RA. https://www.reumatismo.org/reuma/article/view/1607Rheumatoid arthritispsoriatic arthritisdiagnostic delayrheumatologic referral |
| spellingShingle | M. Iacovantuono S. Ferrigno P. Conigliaro P. Triggianese A. D’Antonio F.R. Spinelli A. Bergamini M.S. Chimenti Evaluation of diagnostic and therapeutic delay in patients with rheumatoid arthritis and psoriatic arthritis Reumatismo Rheumatoid arthritis psoriatic arthritis diagnostic delay rheumatologic referral |
| title | Evaluation of diagnostic and therapeutic delay in patients with rheumatoid arthritis and psoriatic arthritis |
| title_full | Evaluation of diagnostic and therapeutic delay in patients with rheumatoid arthritis and psoriatic arthritis |
| title_fullStr | Evaluation of diagnostic and therapeutic delay in patients with rheumatoid arthritis and psoriatic arthritis |
| title_full_unstemmed | Evaluation of diagnostic and therapeutic delay in patients with rheumatoid arthritis and psoriatic arthritis |
| title_short | Evaluation of diagnostic and therapeutic delay in patients with rheumatoid arthritis and psoriatic arthritis |
| title_sort | evaluation of diagnostic and therapeutic delay in patients with rheumatoid arthritis and psoriatic arthritis |
| topic | Rheumatoid arthritis psoriatic arthritis diagnostic delay rheumatologic referral |
| url | https://www.reumatismo.org/reuma/article/view/1607 |
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