The Early Arthritis Clinic of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán was established in February 2004. Patients with RA of less than a year of disease duration at first evaluation attend the Clinic.
Patients receive “treat-to-target” oriented treatment (T2T). Traditional disease-modifying anti-rheumatic drugs (DMARDs) are used in 99% of our population.
At baseline, a complete medical history and sociodemographic characteristics are obtained.
Standard baseline and consecutive rheumatic evaluations include at least extended joint counts, acute reactant phase determinations, RF and ACCP, physician and patient-reported outcomes, the disease activity score (28 joints evaluated), adverse events evaluations and comorbidity established by record review. Patients are evaluated every 2 months during the first two years of follow-up and thereafter, every 2, 4 or 6 (fixed and scheduled for all the patients) months. At fixed six months-intervals, serum lipid profiles, glucose, uric acid, creatinin, cytology, urine analysis are scheduled.
Yearly, hand and foot radiographs are schedule.
Comorbid conditions are assessed by record review and the Charlson score applied at fixed intervals.
Treatment records include previous treatment (defined as prescribed during the month prior to the baseline evaluation) and current treatment (at baseline and consecutive evaluations) which includes names, doses, schedule, order start and stop dates of DMARDs, of corticosteroids and of any other drug. Adherence to treatment is evaluated a fixed intervals.
All the information is recorded using standardized formats.
Up to March 2014, 162 consecutive patients with early RA are attending the Clinic.