Medicina Clinica最新文献

Impact of belimumab on glucocorticoid intake in newly diagnosed systemic lupus erythematosus

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-02-08 DOI: 10.1016/j.medcli.2024.09.033

Yin Zhao , Fumin Qi , Na Zhang , Tong Yang , Wenwen Sun , Xin Li , Yongjie Chen , Wei Wei

{"title":"Impact of belimumab on glucocorticoid intake in newly diagnosed systemic lupus erythematosus","authors":"Yin Zhao , Fumin Qi , Na Zhang , Tong Yang , Wenwen Sun , Xin Li , Yongjie Chen , Wei Wei","doi":"10.1016/j.medcli.2024.09.033","DOIUrl":"10.1016/j.medcli.2024.09.033","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Systemic lupus erythematosus (SLE) is an autoimmune disease with unknown etiology. For newly diagnosed SLE, there are few studies analyzing whether the use of belimumab can reduce the dose of glucocorticoids while maintaining disease remission. To explore this, we conducted this single-center, real-world setting study, based on a prospective cohort.</div></div><div><h3>Methods</h3><div>Newly diagnosed SLE taking Belimumab and standard-of-care (SoC) treatment were consecutively enrolled from July 2021 to December 2023 in a prospective manner. Disease assessments (SLE Responder Index 4 (SRI-4) response (a composite indicator to evaluate the efficacy of belimumab in RCTs), SLEDAI-2K) were conducted regularly. Patients were followed up for at least 12 months. Matched patients with SoC alone were enrolled after propensity score matching. Difference examination and generalized estimated equations were conducted.</div></div><div><h3>Results</h3><div>A total of 31 patients were enrolled in Belimumab group. SRI-4 response rate was 87.10% at 12 months. Serological parameters (anti-dsDNA and C3/C4), SLEDAI-2K and daily prednisone intake were improved overall. Compared with SoC group, SRI-4 rate and the trends of complement C4, SLEDAI-2K during follow up was similar in two groups. Trends of complement C3 (13.16 (4.14–22.18), <em>P</em>  =0.007) and prednisone intake (−18.59 (−26.88 to −10.30), <em>P</em>  <!-->0.000) were more significantly in Belimumab group. Belimumab group had significantly lower cumulative prednisone intake with overall well-tolerance.</div></div><div><h3>Conclusion</h3><div>Our data supported that prompt initiation of add-on Belimumab should be considered to control the disease and facilitate GC tapering/discontinuation, without prior failure to one or more conventional drugs.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 6","pages":"Pages 271-276"},"PeriodicalIF":2.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Independent predictors of functional loss and refractures in patients with femur fracture: Follow-up at 6 and 18 months in a Fracture Liaison Service.

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-02-07 DOI: 10.1016/j.medcli.2024.11.006

Teresa Casanova Querol, Dacia Cerdà Gabaroi, José María Santiago Bautista, Joan Girós Torres, Ramon Miralles Basseda, Montse Martín-Baranera

{"title":"Independent predictors of functional loss and refractures in patients with femur fracture: Follow-up at 6 and 18 months in a Fracture Liaison Service.","authors":"Teresa Casanova Querol, Dacia Cerdà Gabaroi, José María Santiago Bautista, Joan Girós Torres, Ramon Miralles Basseda, Montse Martín-Baranera","doi":"10.1016/j.medcli.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.medcli.2024.11.006","url":null,"abstract":"<p><strong>Background: </strong>In elderly patients hospitalized for a femur fracture, this study aimed to evaluate the functional evolution, and to estimate the incidence of second fractures at 6 and 18 months after hospital discharge.</p><p><strong>Patients and methods: </strong>A longitudinal prospective study was designed at an Orthogeriatric Unit after implementing a Fracture Liaison Service (FLS). The variables collected included the baseline demographic and clinical characteristics of the patients, and the outcome variables on discharge, at 6 and 18 months of follow-up. Logistic regressions models were applied to identify independent predictors of functional evolution.</p><p><strong>Results: </strong>478 patients were admitted. Independent predictors of functional loss at follow-up were institutionalisation, severe dependence either prior to and on discharge, delirium, protein malnutrition, prior acute myocardial infarction, GFR<30ml/min/1.73m<sup>2</sup> and not receiving treatment for osteoporosis on discharge. Patients attending follow-up appointments presented improved compliance with osteoporosis treatment both at 6 and 18 months. A lower number of 2nd fractures were recorded at 18 months for patients who attended their appointments (4.8% vs 12.1%, p=0.01). At 6 and 18 months follow-up, a lower rate of readmission was recorded (7% vs 15.3%, p=0.006), (9.6% vs 25.6%, p<0.0001), respectively.</p><p><strong>Conclusions: </strong>The independent predictors of functional loss at 6 and 18 months were institutionalisation, severe dependence either prior to and on discharge, delirium, protein malnutrition, prior acute myocardial infarct, GFR<30ml/min/1.73m<sup>2</sup> and not receiving treatment for osteoporosis on discharge. A lower incidence of refractures, a lower readmission rate and a better treatment compliance were observed in patients attending follow-up visits.</p>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Harm reduction of tobacco: Mith or reality?

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-02-07 DOI: 10.1016/j.medcli.2024.12.009

Rodrigo Córdoba, Vidal Barchilón, Francisco Pascual, Joan B Soriano

引用次数: 0

Deep dermatophytosis caused by Trichophyton rubrum.

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-02-06 DOI: 10.1016/j.medcli.2024.11.019

Borja González Rodríguez, Christian Gutiérrez Collar, An Wang, Lorena Calderón Lozano, Alba Calleja Algarra

引用次数: 0

Respiratory syncytial virus infections in adults.