Public Awareness of Rheumatoid Arthritis and Ankylosing Spondylitis in Lebanon

Jeanine Menassa1, 2, *, Dima Bou Nassar3, Farah El Naboulsi4, Essam El Naggar5, Nancy Sunna6, Marcelle Ghoubar7
1 Department of Rheumatology, Lebanese University, Beirut, Lebanon
2 Department of Internal Medicine/Division of Rheumatology, Lebanese American University, Beirut, Lebanon
3 Patient Author, Rheumatoid Arthritis Patient Advocate, Beirut, Lebanon
4 Patient Author, Ankylosing Spondylitis Patient Advocate, Beirut, Lebanon
5 Pfizer, Cairo, Egypt
6 Pfizer, Amman, Jordan
7 Pfizer, Beirut, Lebanon

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© 2022 Menassa et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Faculty of Medical Sciences, Lebanese University, RGJF+3J9, Hadath, Lebanon; Tel: 009613060463; E-mail:



Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are associated with substantial disease burdens, including impaired quality of life, functional disability, and lost productivity. Early diagnosis and effective treatment are essential to reducing disease burden and improving long-term outcomes but remain difficult to achieve.


To better understand the deficiencies contributing to diagnostic and therapeutic delays in RA and AS in Lebanon, a computer-assisted survey of 1,200 Lebanese citizens was conducted about their awareness and knowledge of these diseases, including characteristics and management.


Approximately two-thirds and one-third of the survey participants had heard of RA and AS, respectively; two-thirds admitted they knew little about either disease after interviewers provided detailed descriptions. Most participants were aware of the major signs and symptoms of the disease, but most were unaware of serious related comorbidities and complications. While 63% identified rheumatologists as healthcare providers specializing in RA treatment, 89% indicated orthopedists were treating physicians for AS. More than three-quarters of participants understood that early treatment can be effective in RA and AS in preventing disease progression and joint damage, but two-thirds mistakenly considered treatment to be a cure. Among participants who had RA vs AS (57 [4.8%] vs 28 [2.3%]), 21.1% vs 7.1% visited a rheumatologist when initially experiencing symptoms; 64.9% vs 35.7% visited a rheumatologist for follow-up care after diagnosis.


To close gaps in knowledge and management of RA and AS, initiatives are needed to raise public awareness and educate patients and healthcare providers about the importance of early diagnosis and effective treatment.

Keywords: Ankylosing spondylitis, Awareness, Diagnosis, Education, Referral, Rheumatoid arthritis, Survey, Treatment.