ORIGINAL ARTICLE Factors associated with time to diagnosis in early rheumatoid arthritis Cheryl Barnabe • Juan Xiong • Janet E. Pope • Gilles Boire • Carol Hitchon • Boulos Haraoui • J. Carter Thorne • Diane Tin • Edward C. Keystone • Vivian P. Bykerk • Canadian early ArThritis CoHort (CATCH) Study Investigators Received: 10 May 2013 / Accepted: 3 August 2013 / Published online: 30 August 2013 Ó Springer-Verlag Berlin Heidelberg 2013 Abstract 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, med- ical 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 dis- ease activity (joint counts, DAS28 score, acute-phase reactants, patient global evaluation, function), family his- tory, serology, chronic musculoskeletal and mental health conditions, and obesity at diagnosis were considered. In multivariate linear regression analysis, more swollen joints (b =-0.047 per joint, 95 % CI -0.085, -0.010, p = 0.014), higher erythrocyte sedimentation rate (ESR) (b =-0.012 per 1 mm/h, 95 % CI -0.022, -0.002, p = 0.0018), and worse patient global scores (b =-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 (b = 0.688, 95 % CI 0.261, 1.115, p = 0.002) and low income (annual \ $20,000 b = 1.185, 95 % CI 0.227, 2.143, p = 0.015; annual $20,000–50,000 b = 0.933, 95 % CI 0.069, 1.798, p = 0.034) increased time to diagnosis. In the logistic regression models, the odds of being diagnosed within 6 months of symptom onset were increased for each swollen joint present [odds ratio (OR) 1.04, 95 % CI 1.02–1.06 per joint], each The members of the Canadian early ArThritis CoHort (CATCH) study Investigators are given in ‘‘Appendix.’’ C. Barnabe (&) Departments of Medicine and Community Health Sciences, University of Calgary, 3330 Hospital Dr NW, Calgary, AB T2N 4N1, Canada e-mail: ccbarnab@ucalgary.ca J. Xiong Á V. P. Bykerk Rheumatology, Mount Sinai Hospital, University of Toronto, Toronto, Canada J. E. Pope Department of Medicine, University of Western Ontario, London, Canada G. Boire De ´partement de Me ´decine, Universite ´ de Sherbrooke, Sherbrooke, Canada C. Hitchon Department of Medicine, University of Manitoba, Winnipeg, Canada B. Haraoui Department of Rheumatology, Centre Hospitalier de l’Universite de Montreal, Montreal, Canada J. Carter Thorne Á D. Tin Southlake Regional Health Centre, Newmarket, Canada E. C. Keystone Department of Medicine, University of Toronto, Toronto, Canada V. P. Bykerk Hospital for Special Surgery, Weill Cornell Medical College, New York, NY, USA 123 Rheumatol Int (2014) 34:85–92 DOI 10.1007/s00296-013-2846-5