Rheumatoid Arthritis treatment in Dubai UAE, Emirates

In a recent study published in the Annals of Rheumatic Diseases it was found that care of Rheumatoid Arthritis in the uAE has improved and is now comparable to other High GDP countries. The only disparity is low access and use of the newer Biological agents due to their expense and lack of coverage.

Disparities in rheumatoid arthritis disease activity according to gross domestic product in 25 countries in the QUEST–RA database

T Sokka,1 H Kautiainen,2 T Pincus,3 S Toloza,4 G da Rocha Castelar Pinheiro,5
J Lazovskis,6 M L Hetland,7 T Peets,8 K Immonen,9 J F Maillefert,10 A A Drosos,11
R Alten,12 C Pohl,12 B Rojkovich,13 B Bresnihan,14 P Minnock,15 M Cazzato,16
S Bombardieri,16 S Rexhepi,17 M Rexhepi,17 D Andersone,18 S Stropuviene,19
M Huisman,20 S Sierakowski,21 D Karateev,22 V Skakic,23 A Naranjo,24 E Baecklund,25
D Henrohn,25 F Gogus,26 H Badsha,27 A Mofti,28 P Taylor,29 C McClinton,29 Y Yazici3
For numbered affiliations see
end of article
Correspondence to:
Dr T Sokka, Arkisto/Tutkijat,
Jyva¨skyla¨ Central Hospital,
40620 Jyva¨skyla¨, Finland;
tuulikki.sokka@ksshp.fi
Accepted 19 May 2009
Published Online First
This paper is freely available
online under the BMJ Journals
unlocked scheme, see http://
ard.bmj.com/info/unlocked.dtl
ABSTRACT
Objective: To analyse associations between the clinical
status of patients with rheumatoid arthritis (RA) and the
gross domestic product (GDP) of their resident country.
Methods: The Quantitative Standard Monitoring of
Patients with Rheumatoid Arthritis (QUEST–RA) cohort
includes clinical and questionnaire data from 6004
patients who were seen in usual care at 70 rheumatology
clinics in 25 countries as of April 2008, including 18
European countries. Demographic variables, clinical
characteristics, RA disease activity measures, including
the disease activity score in 28 joints (DAS28), and
treatment-related variables were analysed according to
GDP per capita, including 14 ‘‘high GDP’’ countries with
GDP per capita greater than US$24 000 and 11 ‘‘low
GDP’’ countries with GDP per capita less than US$11 000.
Results: Disease activity DAS28 ranged between 3.1 and
6.0 among the 25 countries and was significantly
associated with GDP (r = 20.78, 95% CI 20.56 to
20.90, r2 = 61%). Disease activity levels differed
substantially between ‘‘high GDP’’ and ‘‘low GDP’’
countries at much greater levels than according to
whether patients were currently taking or not taking
methotrexate, prednisone and/or biological agents.
Conclusions: The clinical status of patients with RA was
correlated significantly with GDP among 25 mostly
European countries according to all disease measures,
associated only modestly with the current use of
antirheumatic medications. The burden of arthritis
appears substantially greater in ‘‘low GDP’’ than in ‘‘high
GDP’’ countries. These findings may alert healthcare
professionals and designers of health policy towards
improving the clinical status of patients with RA in all
countries.
Health disparities, including high mortality rates,
are associated with low socioeconomic status in
many specific diseases in many countries.1–6
Furthermore, differences in gross domestic product
(GDP) in different countries are associated significantly
with differences in mortality rates among
countries.7–9 Most reports of these observations are
based on surveys and national databases, with
relatively limited information from clinical settings
based on physical examination, laboratory tests,
medications and patient self-report information
concerning functional status, pain, psychosocial
distress, etc, to understand further the basis for
these disparities. Furthermore, little is known
concerning associations of GDP and clinical outcomes
of chronic disabling musculoskeletal conditions
such as rheumatoid arthritis (RA).
A multinational database Quantitative Standard
Monitoring of Patients with Rheumatoid Arthritis
(QUEST–RA)10 11 was established to assess 100
unselected consecutive patients with RA per clinic
and included 25 countries by April 2008.
Considerable variation was observed in clinical
status in different countries according to most
clinical measures, whether derived from the physician,
patient or laboratory, as well as the
composite RA disease activity score in 28 joints
(DAS28) index.12 In this report, we compare
demographic characteristics, RA disease activity
measures and treatment-related variables between
‘‘high GDP’’ and ‘‘low GDP’’ countries, and analyse
associations between DAS28 and GDP.