# Clinical Characteristics, Medication Use, and Short-Term Outcomes in Patients With Rheumatoid Arthritis: A Prospective Observational Study at a Tertiary Care Centre in Central India

## TL;DR

This study describes RA patient characteristics, treatment patterns, and outcomes in Central India, highlighting gender and age trends, common symptoms, and drug use.

## Contribution

Provides new insights into RA clinical profiles and treatment outcomes specific to Central India's population.

## Key findings

- RA predominantly affects middle-aged females with common symptoms like arthralgia and morning stiffness.
- Methotrexate-hydroxychloroquine combination therapy was most commonly used and effective in reducing disease activity.
- Anemia was the most frequent extra-articular manifestation, and obesity was the most common comorbidity.

## Abstract

Background

Rheumatoid arthritis (RA) is a chronic inflammatory arthritis associated with articular and extraarticular manifestations. Clinical profile, treatment patterns, and treatment outcome of RA patients vary based on geographic location, both globally and among certain ethnic groups within a country.

Objectives

We aim in this study to describe the demographic and clinical characteristics, treatment patterns, and short-term treatment outcomes by DAS-28 CRP score (disease activity score) in patients with RA in Central India.

Methods

This prospective observational study was conducted from September 2023 to September 2024 at a tertiary care hospital in central India. A total of 121 RA patients aged over 18 years, diagnosed as per the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria or already receiving treatment for RA, were enrolled. Data on demographics, clinical profiles, drug usage patterns, comorbidities, and treatment outcomes were collected using a structured case record form over a follow-up period of three months.

Results

Out of 121 total participants, 101 (83.5%) were females. The female-to-male ratio was 5:1. The participants' mean age was 46.99±12.84 years. Of the 121 patients, 75 (61.9%) were previously diagnosed with RA, with 32 (42.7%) of them having disease duration between 1 and 5 years (mean duration: 4.1 years). Common symptoms included arthralgia (118 [97.5%]), early morning stiffness (102 [84.3%]), and weight loss (45 [37.2%]). Polyarticular involvement was seen in 105 (86.8%) of patients, most commonly affecting the hand joints. Boutonniere and Swan neck deformities were present in 18 (14.9%) and 16 (13.2%) of cases, respectively. Anemia (65 [53.7%]) was the most frequent extra-articular manifestation. Common comorbidities included obesity in 38 (31.4%), hypertension in 27 (22.3%), and ILD/COPD in 18 (14.9%) of the patients. Methotrexate and folic acid were each used in 103 (85.1%) patients, with hydroxychloroquine in 86 (71.1%); while 75 (61.9%) received steroids.

Conclusions

RA is predominant among the middle-aged population and females. Arthralgia and early morning stiffness in hand joints were the most common articular symptoms, while anemia was the most common extraarticular feature. Obesity followed by hypertension was the most common comorbidity reported in our study. Dual DMARDs (disease-modifying antirheumatic drugs) therapy, particularly the methotrexate-hydroxychloroquine combination, was most preferred. Treatment with DMARDs led to a significant reduction in disease activity over three months. These findings highlight RA characteristics and treatment patterns in Central India.