Rheumatoid Arthritis: Patient Characteristics and Disease Activities at Tertiary Hospital in Saudi Arabia

Background: The systemic autoimmune disease rheumatoid arthritis (RA) is characterized by extra-articular disorders and persistent inflammation of the synovial joints. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) are autoantibodies that are important for diagnosis and prognosis. Treat-to-target guidelines place a strong emphasis on reaching remission or decreased disease activity but they ignore patient characteristics or potential future disease behavior. Aim: To evaluate comparison between RA patients' demographics, medication use and the disease activity at a tertiary hospital in Jeddah, Saudi Arabia. Materials and Methods: This retrospective study includes 259 patients with RA aged =18 who meet ACR/EULAR 2010 criteria. Data collected from electronic medical records at King Abdulaziz University hospital (KAUH) between December 2021 and December 2023. Demographics, clinical characteristics, medication history and laboratory data for RF, Anti-Nuclear Antibodies (ANA) and ACPA levels were recorded. Disease activity was assessed using clinical disease activity index (CDAI) or disease activity score in 28 joints (DAS28) -Erythrocyte sedimentation. Results: The study involved 259 participants, primarily female, married and college students. There were insignificant differences between disease activity, gender, education, job, marital status, having kids, body mass index (BMI), RF and ACPA. Biologic disease-modifying anti-rheumatic medicines (DMARDs) showed insignificant changes with disease severity but rituximab showed moderate disease severity and infliximab showed more patients with remission. Non-biologic DMARDs, including Leflunomide and Hydrochloroquine, showed low to moderate disease activity. Targeted synthetic DMARDs, notably baricitinib and upadacitinib, dramatically alter disease activity. Conclusion: The study revealed that infliximab showed higher remission rates and rituximab showed moderate activity. Leflunomide, hydrochloroquine, baricitinib and upadacitinib exhibited low to moderate disease activity. Medical professionals should evaluate infliximab's efficacy in achieving remission and consider positive ANA. Further research is needed to confirm these findings and investigate additional factors.