Characteristics of hand involvement in a comparative study of two early RA cohorts from the UK and China

Abstract

Aim: To compare the characteristics of early hand involvement in rheumatoid arthritis (RA) using two matched populations, from the UK and China.

Methods: A cohort comparison study was conducted. Sixty Chinese patients recruited from Shanghai, China were matched on gender and age with 60 patients from a prospective early RA cohort from the UK (SARAH trial). The procedures of data collection in China followed the standard operating procedures employed in the SARAH trial. Outcome measures including Michigan Hand Outcomes Questionnaire (MHQ), medication history and physical assessments were used to assess functional ability and hand impairment.

Results: UK patients reported significantly more hand pain (P = 0.015), less satisfaction with dominant hand performance (P = 0.040), more swollen and tender joints (P = 0.016 and P = 0.001) and greater dexterity of both dominant and non-dominant hands (P < 0.001 and P < 0.001), while Chinese patients had higher disease activity indicated by erythrocyte sedimentation rate and C-reactive protein, more rheumatoid factor, less satisfaction in both dominant and non-dominant hand appearances (P < 0.001 and P < 0.001, respectively) and greater dominant hand deformity (P = 0.003). No statistically significant differences were seen in range of movement and overall hand function as reported by the MHQ.

Conclusion: The severity of RA is not milder in China than in the UK and the characteristics of hand involvement tend to be different. Clinicians should consider country-specific differences in managing pain and delivering treatment. It would be helpful for a future study to investigate the RA impact characteristics on a wider range of patients both from within China and from other populations.

Keywords: cohort comparison; functional ability; hand involvement; impact; rheumatoid arthritis.