The lag time from symptoms onset of rheumatoid arthritis to initiation of Methotrexate: data from the Moroccan register of biotherapies

Objective: The purpose of this study is to determine the time between the onset of rheumatoid arthritis (RA) symptoms and the introduction of methotrexate, as well as the associated factors. Methods: A multicenter cross-sectional study that included data from the Moroccan register of biologic patients with rheumatoid arthritis. Sociodemographic, economic patient data and disease data were collected. A logistic regression was performed to determine the factors that are associated with the change in the delay between the onset of symptoms and the initiation of cDMARD. Results: A total of 225 RA patients were included. The mean age was 51 ± 11 years, with a female predominance of 88% (n=197). The diagnosis lag time was 12 months (12-48). Seventy-three percent of the cases were housewives. Seventy-nine percent of patients received Methotrexate as the first CDMARDS. Salazopyrine was the second prescribed CDMARDS with 7%. Hydroxychloroquine was the third prescribed cDMARDs which 2.2%. The median lag time from symptoms onset to initiation of Methotrexate was 24 months (0.16-71). The factors, associated with the change in the delay between the onset of symptoms and the introduction of methotrexate in univariate analysis, were delay in diagnosis and corticosteroids Taking (p<0.05), only the delay of diagnosis in multivariate analysis persists p=0.0001. Conclusions: Our study suggests that there is a significant delay between diagnosis and the introduction of methotrexate as a first line cDMARDs. In multivariate analysis only the time to diagnosis was associated with the time to start methotrexate.