Early RA Referral Clinics Work! Save
An outcomes study from the Leiden Early Arthritis Clinic (EAC) has shown substantially less diagnostic delay and better long-term outcomes when patients are referred to EAC compared to usual referrals.
Patients with symptoms less than 2 years referred through the early arthritis recognition clinic (between 2010 and 2020) were compared with similar patients referred outside of the EAC (2006 - 2009).
Between 2010 and 2020 there were 2081 patients seen via the EAC - 818 patients had clinical arthritis and 132 patients were diagnosed with rheumatoid arthritis (10 patients were lost to follow-up and 122 [59% female] were included in the study).
Between 2006 and 2009, 690 patients were referred via the regular referral pathway with clinical arthritis - 342 had rheumatoid arthritis (66% female) and 117 [34%] male.
By comparison, patients referred via the early arthritis clinic had:
- Lower disease activity (DAS-44) over 5 years (p=0·0003)
- Less functional disability (HAQ-DI) over 5 years (p=0·021)
- Higher rates of sustained DMARD-free remission (HR 2.1; p=0·0010)
- Lower median GP delay than regularly referred patients (median 5.14 vs 9 weeks; p<0·0001).
This study uniquely documents that accelerated referral and diagnosis yields signifcantly better long-term outcomes.
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