A Comparison of Rheumatoid Arthritis Patients in Kuwait with Other Populations: Results from the KRRD Registry

Adeeba Al-Herz; Adel Al-Awadhi; Khulood Saleh; Waleed Al-Kandari; Eman Hasan; Aqeel Ghanem; Fatemah Abutiban; Ahmad Alenizi; Mohammed Hussain; Yaser Ali; Ahmad Khadrawy; Ammad Fazal; Khaled Mokaddem; Beena Aftab; Najaf Haider; Ajaz Zaman; Ghada Mazloum; Youssef Bartella; Sally Hamed; Ahmed Al-Saber

Adeeba Al-Herz Amiri Hospital, Kuwait City, Kuwait.
Adel Al-Awadhi Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait.
Khulood Saleh Farwania Hospital, Farwaniya Governorate, Kuwait
Waleed Al-Kandari Farwania Hospital, Farwaniya Governorate, Kuwait.
Eman Hasan Amiri Hospital, Kuwait City, Kuwait.
Aqeel Ghanem Mubarak Al-Kabeer Hospital, Hawally Governorate, Kuwait.
Fatemah Abutiban Jahra Hospital, Jahra Governorate, Kuwait.
Ahmad Alenizi Jahra Hospital, Jahra Governorate, Kuwait.
Mohammed Hussain Amiri Hospital, Kuwait City, Kuwait.
Yaser Ali Mubarak Al-Kabeer Hospital, Hawally Governorate, Kuwait.
Ahmad Khadrawy Farwania Hospital, Farwaniya Governorate, Kuwait.
Ammad Fazal Farwania Hospital, Farwaniya Governorate, Kuwait.
Khaled Mokaddem Amiri Hospital, Kuwait City, Kuwait.
Beena Aftab Jahra Hospital, Jahra Governorate, Kuwait.
Najaf Haider Jahra Hospital, Jahra Governorate, Kuwait.
Ajaz Zaman Mubarak Al-Kabeer Hospital, Hawally Governorate, Kuwait.
Ghada Mazloum Mubarak Al-Kabeer Hospital, Hawally Governorate, Kuwait.
Youssef Bartella Amiri Hospital, Kuwait City, Kuwait.
Sally Hamed Amiri Hospital, Kuwait City, Kuwait.
Ahmed Al-Saber Department of Mathematics and Statistics, University of Strathclyde, Glasgow, Scotland.

Keywords: Rheumatoid arthritis, comorbidities, prevalence, registry, KRRD, Kuwait, Middle East, Arabs

Abstract

Objective: Data on rheumatoid arthritis (RA) in Kuwait and The Middle East is scarce. Available data from Western countries may not be representative of the region. We describe RA patients in Kuwait and compare them with other RA populations and with Kuwaiti general population.

Methods: Adult RA patients from Kuwait Registry for Rheumatic Diseases (KRRD), the first RA registry in The Middle East, were studied from February 2013 through February 2015. Demographic, clinical and serologic data were compared with other RA populations and with Kuwaiti general population.

Results: 835 patients were enrolled, 62.3% female. Mean age 50.612 years and disease duration 6.16 years. RA was diagnosed at a mean age of 44.912 years. 17.1% had family history of autoimmune rheumatic diseases. 3.1% had rheumatoid nodules. Rheumatoid factor (RF) and anti-citrullinated peptide (ACPA) were detected in 75.6% and 57.8%, respectively. Both were positive in 49% (r=0.287, p=0.001). ANA was positive in 19.1%. Both ACPA and a combination of positive RF and ACPA were more in males (p=0.017, 0.004 respectively), whereas ANA was more in females (p=0.01). One third of male patients were smokers versus 1.9% of females. Smoking was correlated to RF (p=0.009) and ACPA (p=0,002). Difference in ACPA between genders was statistically explained by the predominance of smoking in males. Comorbidities included diabetes mellitus (DM) (20.8%), hypertension (20.2%), hyperlipidemia (10.5%) and coronary artery disease (CAD) (3.1%). 4 cases of cancer were reported.

Conclusion: RA population in Kuwait includes less women than other RA populations but more than Kuwaiti general population. Family history is more common. A higher positive ACPA in males was explained by smoking difference. Hypertension and hyperlipidemia were less reported than in both Kuwaiti general population and other RA populations. CAD was similar to other RA populations. DM was more reported, reflecting its high background prevalence in Kuwait.