Factors associated with time to diagnosis in early rheumatoid arthritis

Early diagnosis and treatment yield optimal outcomes in rheumatoid arthritis (RA); thus, barriers to disease recognition must be identified and addressed. We determined the impact of sociodemographic factors, medical comorbidities, family history, and disease severity at onset on the time to diagnosis in early RA. The Canadian early ArThritis CoHort study data on 1,142 early RA patients were analyzed for predictors of time to diagnosis using regression analysis. Sociodemographic factors (age, sex, income strata, education, ethnicity), measures of disease activity (joint counts, DAS28 score, acute-phase reactants, patient global evaluation, function), family history, serology, chronic musculoskeletal and mental health conditions, and obesity at diagnosis were considered. In multivariate linear regression analysis, more swollen joints ( β = −0.047 per joint, 95 % CI −0.085, −0.010, p = 0.014), higher erythrocyte sedimentation rate (ESR) ( β = −0.012 per 1 mm/h, 95 % CI −0.022, −0.002, p = 0.0018), and worse patient global scores ( β = −0.082 per 1 unit on a visual analogue scale, 95 % CI −0.158, −0.006, p = 0.034) at baseline predicted a shorter time to diagnosis. Anti-cyclic citrullinated peptide (anti-CCP) antibody positivity ( β = 0.688, 95 % CI 0.261, 1.115, p = 0.002) and low income (annual