AB0640 IMPACT OF SOCIOECONOMIC CLASS ON MANAGEMENT OUTCOMES OF RHEUMATOID ARTHRITIS UNDER REAL LIFE CONDITIONS
Authors: N. De Carvalho Sacilotto, C. Albuquerque, R. D. Neubarth Giorgi, A. B. Vargas-Santos, S. Radominski, I. Pereira, M. F. B. De Resende Guimarães, M. Bertolo, P. Louzada, M. D. F. Sauma, K. Bonfiglioli, C. V. Brenol, L. Mota, G. Da Rocha Castelar Pinheiro
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects the quality of life for those diagnosed and not adequately treated, impairing the ability to perform daily activities. The impact of RA extends beyond physical discomfort, influencing various aspects of a person's life. Routine tasks become challenging, and the overall well-being of individuals is compromised. Patients from diverse socioeconomic backgrounds may face distinct challenges in adhering to treatment plans, accessing specialized medical care and affording necessary medications. These disparities can impact the overall response to therapy, disease progression and the quality of life experienced by individuals with RA. <h3>Objectives:</h3> To assess the impact of socioeconomic factors on therapeutic outcomes in RA patients. <h3>Methods:</h3> We evaluated data from the REAL study, which is a prospective observational cohort study of patients with RA from 11 public healthcare centers in different geographic regions of Brazil, that described clinical, laboratory, radiographic, therapeutic and quality of life characteristics. For this analysis, patients were divided into 2 groups based on their socioeconomic status, as determined by the Brazilian Economic Classification Criterion, that is a scoring system that takes into account variables such as the number of household electrical appliances, the education level of the householder and access to public services. The score range is stratified from A to E. The first group comprises socioeconomic classes A and B, while the second group comprises socioeconomic classes C, D and E. <h3>Results:</h3> We analyzed a total of 1101 patients, with 89.4% being female, 56.9% identified as white, 54% had erosive disease, 47.3% were using corticosteroids, 35.7% were on biologic DMARD therapy and 66.2% were using methotrexate (MTX). Regarding socioeconomic status, 1.4% belonged to class A, 22% to class B, 58% to class C, and 17.9% to class D/E. In terms of rheumatoid factor (RF) status, 20.9% were RF negative, 22.1% and 55.4% had low and high-titer positive RF, respectively. Regarding the SDAI, 16% were in remission, 27.6% had low disease activity, 27.8% had moderate disease activity and 13% had high disease activity. Additionally, 12.4% and 15.8% achieved the Boolean criteria for remission 1.0 and 2.0, respectively. The differences across upper (A/B) vs lower (C/D/E) socioeconomic classes is shown in Table 1. <h3>Conclusion:</h3> A higher prevalence of erosive disease and a delayed onset of treatment were observed in patients classified under lower socioeconomic classes. Patients from socioeconomic classes A and B showed lower prescription rates of MTX and higher prescription rates of biologics. Furthermore, individuals from higher socioeconomic classes demonstrated better outcomes in the SDAI, with a greater frequency of achieved the Boolean remission criteria 1.0 and 2.0. These findings highlight the complex interplay between socioeconomic factors, disease characteristics and treatment outcomes in the studied population, emphasizing the need for a comprehensive approach to address disparities in RA management across different socioeconomic strata. <b>Table 1.</b> The differences across upper vs lower socioeconomic classes <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>