FRI0584 The Vicious Circle of Educational Level, Rheumatoid Arthritis, and Risk of Poverty - Results of A Cross-Sectional Multicenter Study in Germany

Background Compared to the general population, patients with rheumatoid arthritis (RA) are threatened by poverty due to treatment-related expenses, disability, and early retirement. Also, lower socio-economic state is associated with increased prevalence and severity of RA. The underlying mechanisms are still unclear. Objectives To evaluate the risk of poverty of RA-patients in an unselected community-based cohort in the German states of Brandenburg and Saarland, and to investigate interrelationship between educational level, socio-economic state and disease severity. Methods Cross-sectional multicenter study consecutively recruiting RA-patients in outpatient-clinics in Brandenburg and Saarland. Inclusion criteria were written consent and diagnosis of RA fulfilling ACR/EULAR-criteria. Using anonymised questionnaires, equivalised disposable income (EDI = total net income of a household divided by the number of equalised household members) was calculated. Risk of poverty was defined as Results Of all 910 returned questionnaires (return rate 88%), 882 (97%) were evaluable (666 from Brandenburg and 215 from Saarland). The mean±SD age of all patients was 61±12 years, 71% were female, mean functional capacity (FFbH) was 72±23%, rate of biologic treatment was 41%, and 21% were active smokers. Median monthly EDI of RA-patients was 1239€ (IQR 869–1654), 88% of the median EDI in Germany (1413€). The rate of RA-patients at risk of poverty was significantly higher compared to the population in Germany (27% vs. 16%, p Conclusions RA-patients in this study had an almost doubled risk of poverty compared to the general population. Poverty reduces compliance to treatment resulting in a vicious circle. Lower educational level is associated with more severe disease course of RA, but the underlying mechanisms need further elucidation. Disclosure of Interest None declared