SAT0145 Features of patients with rheumatoid arthritis whose debut joint is a foot or ankle joint: a 5,479 cases study from the iorra cohort
Authors: K. Yano, K. Ikari, K. Okazaki, A. Taniguchi, H. Yamanaka
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> Foot and ankle joint disorders are serious issues for patients with rheumatoid arthritis (RA). Rheumatoid foot is reported as the first symptom of the disease in 20–53% of RA patients<sup>1–3</sup>. However, there are few studies investigating the features of patients with RA whose debut joint is a foot or ankle joint. <h3>Objectives:</h3> The aim of this study is to compare the differences between RA patients whose first symptom was a foot or ankle joint (FOOT group) and was other joints (OTHER group) by using the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) cohort in our institute. <h3>Methods:</h3> In the IORRA survey conducted in April 2016, patients were asked about first symptom at RA onset. Disease activities, clinical laboratory variables, functional disability, quality of life, and the use and ratio of anti-inflammation and anti-rheumatic drugs were compared between the FOOT group and OTHER group. <h3>Results:</h3> Among 5,637 Japanese patients with RA who participated in the IORRA survey on April 2016, 5,479 patients (97.2%) responded to the questionnaire regarding debut joint. Of these 5,479 patients, 2,402 (43.8%) reported their first symptom of RA were a foot or ankle. Comparing the two groups, the FOOT group had higher disease activity, higher disabilities, lower quality of life, low activities of daily living, and poorer mental health and used higher dose and rate of anti-inflammatory drugs significantly than the OTHER group (all P&lt;0.01). On the other hand, medications to suppress the disease activity of RA have no statistical differences between the two groups (table 1). <h3>Conclusions:</h3> Patients whose debut joint was a foot or ankle had higher disease activity, higher dysfunction, lower quality of life, and used higher dose and rate of anti-inflammatory drugs than patients whose debut joint was the other joints on RA onset. Clinicians should have more attentions to foot and ankle joints in daily practice so as not to underestimate the disease activity of RA. <h3>References</h3> [1] Grondal L, Tengstrand B, Nordmark B, Wretenberg P, Stark A. The foot: still the most important reason for walking incapacity in rheumatoid arthritis: distribution of symptomatic joints in 1,000 RA patients. Acta Orthop2008;79:257–61. [2]Otter SJ, Lucas K, Springett K, Moore A, Davies K, Cheek L, et al. Foot pain in rheumatoid arthritis prevalence, risk factors and management: an epidemiological study. Clin Rheumatol2010;29:255–71. [3]Vainio K. The rheumatoid foot; a clinical study with pathological and roentgenological comments. Ann Chir Gynaecol Fenn Suppl1956;45:1–107. <h3>Disclosure of Interest:</h3> K. Yano Speakers bureau: Bristol-Meyers, Pfizer, Eisai, Tanabe-Mitsubishi, Chugai, AbbVie, Janssen Pharmaceutical, Asahi-Kasei and Takeda., K. Ikari Grant/research support from: Astellas, UCB, Bristol-Meyers, Pfizer, Eisai, Tanabe-Mitsubishi, Chugai, AbbVie, Janssen Pharmaceutical, Otsuka, Kaken, Asahi-Kasei, Hisamitsu and Takeda., Speakers bureau: Astellas, UCB, Bristol-Meyers, Pfizer, Eisai, Tanabe-Mitsubishi, Chugai, AbbVie, Janssen Pharmaceutical, Otsuka, Kaken, Asahi-Kasei, Hisamitsu and Takeda., K. Okazaki: None declared, A. Taniguchi Grant/research support from: AbbVie, Eisai, Takeda, Speakers bureau: AbbVie, Eisai, Takeda, Tanabe-Mitsubishi, Teijin Pharma and Pfizer., H. Yamanaka Grant/research support from: MSD, Ayumi, AbbVie, Eisai, Ono, Astellas, Daiichi-Sankyo, Taisyo-Toyama, Takeda, Tanabe-Mitsubishi, Chugai, Teijin Pharma, Torii, Nippon Shinyaku, Pfizer. UCB. Nippon Kayaku, YL biologics, Bayer and Bristol-Meyers., Consultant for: MSD, Ayumi, AbbVie, Eisai, Ono, Astellas, Daiichi-Sankyo, Taisyo-Toyama, Takeda, Tanabe-Mitsubishi, Chugai, Teijin Pharma, Torii, Nippon Shinyaku, Pfizer. UCB. Nippon Kayaku, YL biologics, Bayer and Bristol-Meyers., Speakers bureau: MSD, Ayumi, AbbVie, Eisai, Ono, Astellas, Daiichi-Sankyo, Taisyo-Toyama, Takeda, Tanabe-Mitsubishi, Chugai, Teijin Pharma, Torii, Nippon Shinyaku, Pfizer. UCB. Nippon Kayaku, YL biologics, Bayer and Bristol-Meyers.