Reumatologia clinica最新文献

{"title":"Do patients with axial spondyloarthritis with active disease suffer from greater disease burden and work impairment? Results from the International Map of Axial Spondyloarthritis (IMAS)","authors":"Marco Garrido-Cumbrera ,&nbsp;Denis Poddubnyy ,&nbsp;Fernando Sommerfleck ,&nbsp;Christine Bundy ,&nbsp;Souzi Makri ,&nbsp;José Correa-Fernández ,&nbsp;Shashank Akerkar ,&nbsp;Jo Lowe ,&nbsp;Elie Karam ,&nbsp;Victoria Navarro-Compán","doi":"10.1016/j.reumae.2024.11.009","DOIUrl":"10.1016/j.reumae.2024.11.009","url":null,"abstract":"<div><h3>Background</h3><div>To assess the prevalence of clinically active disease in axial spondyloarthritis (axSpA) and its associated factors in a large global sample of patients from the International Map of Axial Spondyloarthritis (IMAS) study.</div></div><div><h3>Methods</h3><div>IMAS is a cross-sectional online survey (2017–2022) of 5557 axSpA patients. Patients were divided between those with active disease (BASDAI ≥4) and without active disease (BASDAI &lt;4). The factors evaluated were sociodemographic, lifestyle, patient-reported outcomes, employment, disease characteristics, extra-musculoskeletal manifestations, and treatment. Logistic regression analysis stratified by gender were used to evaluate the relationship between investigated factors and active disease.</div></div><div><h3>Results</h3><div>In the present study, 5295 patients who had responded to the BASDAI scale were included in the present study: 3231 were from Europe, 770 from North America, 600 from Asia, 548 from Latin America, and 146 from Africa. The mean age was 43.8<!--> <!-->±<!--> <!-->12.9 years and 55.4% were females. Patients reported a mean BASDAI of 5.4 (±2.1) with 75% having active disease (BASDAI ≥4). In South Africa, 87.0% of patients reported having active disease, compared to 68.5% in Asia. Multivariable logistic regression showed an association of active disease with higher functional limitation, greater spinal stiffness, difficulty finding a job due to axSpA and worse mental health in both genders. For males, younger age and shorter diagnostic delay, and for females, no physical activity and presence of inflammatory bowel disease were associated with active disease.</div></div><div><h3>Conclusions</h3><div>Three quarters of patients with axSpA reported clinically active disease, with higher proportion of patients with active disease in South Africa and lower proportion in Asia. Our results underline the complexity of the clinical disease activity concept in axSpA and the need for a holistic approach in the patient management, care and treatment.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 547-554"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccination against human papillomavirus in patients with immune-mediate diseases","authors":"Marco Tobar-Marcillo ,&nbsp;Carlos Guerrero-Solís ,&nbsp;Daniel Goyes-Burbano ,&nbsp;Jorge Esteban Toro-Tobar","doi":"10.1016/j.reumae.2024.11.005","DOIUrl":"10.1016/j.reumae.2024.11.005","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Page 570"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in immature granulocyte levels and their association with disease activation following biologic therapy in patients with ankylosing spondylitis","authors":"Burak Okyar ,&nbsp;Servet Yüce ,&nbsp;İbrahim Halil Bilen ,&nbsp;Bekir Torun ,&nbsp;İlyas Öztürk ,&nbsp;Gözde Yıldırım Çetin","doi":"10.1016/j.reumae.2024.11.007","DOIUrl":"10.1016/j.reumae.2024.11.007","url":null,"abstract":"<div><h3>Introduction</h3><div>AS is a chronic disease with an inflammatory serum microenvironment characterized by increased oxidative stress (OS). Along with OS, reactive oxygen species (ROS) are elevated in patients with AS. Overexpression of ROS causes active inflammatory processes leading to the secretion of pro-inflammatory factors, including tumor necrosis factor-alpha (TNF-α). Immature granulocytes (IG) are essential to the chronic inflammatory process. This may mean that IG can be a parameter used in the follow-up of chronic inflammatory diseases such as AS.</div></div><div><h3>Objective</h3><div>We aimed to evaluate the change in IG in patients with AS who were on biologic medication for six months after diagnosis and to assess its relationship with disease activity, remission, and BASDAI score.</div></div><div><h3>Methods</h3><div>This single-center, retrospective study was conducted between January 2020 and January 2022. For the study, 68 patients were included in the patient group and 74 patients in the control group. Demographic and laboratory data were recorded and compared in the groups. Then, the patient group was divided into two groups: pre-biologic drug and post-biologic drug. Hemogram data, IG, ESR, CRP, and BASDAI data were recorded for both groups. Correlation analysis was performed between the results of IG data and hemogram and laboratory data.</div></div><div><h3>Conclusion</h3><div>In our study, WBC, neutrophil, IG, and IG% ratios were significantly higher in AS patients compared to the control group. Neutrophil, IG, and IG% levels were significantly decreased in the AS group compared to pretreatment and post-treatment comparisons. In addition, IG levels were correlated with WBC, neutrophil, CRP, and ESR levels. This study hypothesized that IG values may be a valuable parameter for monitoring AS disease severity, response to treatment, and disease activation after biological drug use.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 533-538"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of systemic lupus erythematosus in Latin America","authors":"Ivet Etchegaray-Morales ,&nbsp;Claudia Mendoza-Pinto ,&nbsp;Francisco Javier Arellano-Avendaño ,&nbsp;Sandra Ibañez-Ovando ,&nbsp;Pamela Munguía-Realpozo ,&nbsp;Jacsiry Guadalupe Orbe-Sosa ,&nbsp;Edith Ramírez-Lara ,&nbsp;Mario García-Carrasco","doi":"10.1016/j.reumae.2024.11.003","DOIUrl":"10.1016/j.reumae.2024.11.003","url":null,"abstract":"<div><div>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects several organs, causing significant morbidity and increased mortality. It’s more frequent in young, fertile women and can appear in all ethnic groups.</div><div>The worldwide prevalence report indicates that there are at least 5 million patients with SLE. Although this disease can be found in every geographic region, certain races are more affected, such as Afro-American, Hispanic, and Asian populations. Furthermore, most of the epidemiologic information comes from Europe or the USA. In Latin America, only a few countries have reported data, like Argentina, Colombia, or Mexico, and even in these countries, the numbers vary.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 560-566"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of virtual reality in medical training: Clinical management of a patient with knee monoarthritis","authors":"Javier de Toro Santos ,&nbsp;Ana Isabel Turrión ,&nbsp;Mariano Andrés Collado ,&nbsp;M. Carmen San José Méndez ,&nbsp;Roberto Rilo Antelo ,&nbsp;Juan Antonio Juanes Méndez","doi":"10.1016/j.reumae.2024.11.004","DOIUrl":"10.1016/j.reumae.2024.11.004","url":null,"abstract":"<div><div>The use of technological environments with virtual reality (VR) techniques for the practice of arthrocentesis offers an effective and safe way to learn and improve the necessary skills to carry out a medical procedure and patient care. This article presents an interactive simulator using immersive VR, in which the participant experiences practicing clinical management and decision-making in the face of a person presenting with monoarthritis in a medical consultation. The objective with this development is for the user to acquire the competence to perform, correctly and safely, a knee arthrocentesis and to differentiate the types of synovial fluids that can be found in a joint. In turn, it provides clinical guidance and assists with the user's medical decision-making. Therefore, the aim is to improve the quality of care and patient safety when practicing this technique previously through clinical simulation.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 555-559"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophilic granulomatosis with poliangiitis: Successful treatment with methotrexate and low-dose of mepolizumab","authors":"Luis Francisco Valdés-Corona ,&nbsp;Patricia Aguilar-Dominguez ,&nbsp;Ariel Jasqui-Bucay ,&nbsp;Mariana Arroyo-Machiavelo","doi":"10.1016/j.reumae.2024.11.001","DOIUrl":"10.1016/j.reumae.2024.11.001","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 571-572"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosis as a manifestation in systemic lupus erythematosus: treatment and long-term results. Number of cases","authors":"Maria Joselin Rodarte-Gallegos,&nbsp;Ma. Azucena Ramos-Sánchez,&nbsp;Yadhira Mejia-Holguin,&nbsp;Ariana Maia Becerra-Márquez,&nbsp;Luciano Ortiz-Treviño","doi":"10.1016/j.reumae.2024.11.002","DOIUrl":"10.1016/j.reumae.2024.11.002","url":null,"abstract":"<div><div>We present a case series of 5 patients with psychosis associated with SLE according to the ACR 1999 criteria. It presented as an initial clinical manifestation, clinically they had visual and auditory hallucinations, all the patients were women, average age 25 years, the accompanying manifestations were mostly mucocutaneous, articular and renal. Two patients presented antiphospholipid syndromes. The remission induction treatment was based on pulses of steroids and cyclophosphamide with a complete response in 4/5 patients, maintenance was left with mycophenolic acid and azathioprine.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 567-569"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical course and flare predictors in patients with rheumatoid arthritis in low disease activity and ultrasound remission monitored by ultrasound yearly and on-demand: A prospective 2-year observation study","authors":"Takeo Abe ,&nbsp;Masao Tamura ,&nbsp;Kazuyuki Tsuboi ,&nbsp;Yuko Minagawa ,&nbsp;Kazuteru Noguchi ,&nbsp;Chie Ogita ,&nbsp;Teppei Hashimoto ,&nbsp;Naoto Azuma ,&nbsp;Kiyoshi Matsui","doi":"10.1016/j.reumae.2024.08.001","DOIUrl":"10.1016/j.reumae.2024.08.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Ultrasound (US) remission in rheumatoid arthritis (RA) targets synovitis absence. Tenosynovitis triggers flares. Despite increased ultrasound use, flare patterns among patients with low disease activity (LDA) and ultrasound remission, especially in real-world settings, are poorly understood. This study examined flare rates and predictors of US remission in patients without synovitis or tenosynovitis.</div></div><div><h3>Materials and methods</h3><div>In a study of 88 patients achieving US remission and LDA, the focus was on the time to the first flare over a 2-year follow-up. US remission, indicated by the absence of active synovitis and tenosynovitis based on a power Doppler (US-PD) score of 0, was assessed on various joints. Flares are defined by the need for additional medication or encountering a US-PD flare. They were monitored at the baseline, 1-year, and 2-year visits with further US evaluation at clinical flare-ups. Baseline factors linked to a shorter time to flare were analyzed.</div></div><div><h3>Results</h3><div>At 1 year, LDA and US remission rates were 75% and 92%, respectively, and at 2 years, 73% and 87% respectively. Over the 2 years, 40% experienced flare, occurring on average at 11.7<!--> <!-->±<!--> <!-->7.0 months. Notably, 5.7% have US-PD flares without clinical signs. Analysis revealed Stage III disease and CRP as factors linked to a shorter time to flare.</div></div><div><h3>Discussion and conclusions</h3><div>In patients with RA achieving LDA and US remission, frequent flares were observed with US remission over 2 years, but most maintained sustained remission. Baseline factors are essential for predicting flares, emphasizing continuous monitoring and personalized treatment to sustain remission and minimize flare risks in RA management.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 517-525"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with patient-reported outcome measures in knee osteoarthritis: A cross-sectional community-based study","authors":"Rudy Hidayat ,&nbsp;Faisal Parlindungan ,&nbsp;Sumariyono Sumariyono ,&nbsp;Suryo Anggoro Kusumo Wibowo ,&nbsp;Anna Ariane ,&nbsp;Johanda Damanik ,&nbsp;Abirianty Priandani Araminta ,&nbsp;Jessica Audrey ,&nbsp;Mitra Alparisa","doi":"10.1016/j.reumae.2024.11.006","DOIUrl":"10.1016/j.reumae.2024.11.006","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Knee pain resulting from osteoarthritis (OA) often leads to functional limitations and disabilities, significantly affecting an individual's quality of life. This study aimed to explore the factors associated with patient-reported outcome measures in knee OA.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted using data from the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) study in Jakarta. A home-to-home survey using multistage stratified random sampling was conducted involving subjects who met the clinical criteria for knee OA. Data collected included demographic information, body height and weight, history of injury, degree of work activities, presence of body aches and joint pain, and comorbidities. Patient-reported knee outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Bivariate and multivariate analyses were performed to identify factors associated with KOOS and its subscales.</div></div><div><h3>Results</h3><div>A total of 71 subjects meeting the clinical criteria for knee OA were included in the analysis, with a mean age of 54.54<!--> <!-->±<!--> <!-->9.97 years. Cardiovascular disease was significantly associated with overall KOOS scores and all five subscales. Additionally, OA subjects with a history of knee injury scored worse specifically on the KOOS quality of life subscale.</div></div><div><h3>Conclusion</h3><div>Cardiovascular disease and a history of knee injury were significantly associated with worse patient-reported knee outcomes among knee OA subjects. Future studies involving more cities are recommended to confirm these findings and provide more robust results for the Indonesian population.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 526-532"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TNFα-inhibitors cycling with golimumab as second drug in inflammatory arthritis patients: Data from the multicenter GO-REAL registry","authors":"Carolina Ayelen Isnardi ,&nbsp;Emma Estela Civit De Garignani ,&nbsp;Agustín García Ciccarelli ,&nbsp;Jimena Sanchez Alcover ,&nbsp;Ingrid Strusberg ,&nbsp;Marcos Baravalle ,&nbsp;Sol Castaños ,&nbsp;Liliana Morales ,&nbsp;Matias Palombo ,&nbsp;Eduardo Albiero ,&nbsp;Carla Gobbi ,&nbsp;Rodrigo Garcia Salinas ,&nbsp;Sebastian Magri ,&nbsp;Edson Velozo ,&nbsp;Enrique R. Soriano ,&nbsp;Alfredo Vargas Caselles ,&nbsp;Luis Carlos Palomino Romero ,&nbsp;Sergio Paira ,&nbsp;Romina Calvo ,&nbsp;Alberto Ortiz ,&nbsp;Gustavo Citera","doi":"10.1016/j.reumae.2024.11.008","DOIUrl":"10.1016/j.reumae.2024.11.008","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>There are still controversies about the efficacy of cycling to a second tumor necrosis factor inhibitor (TNFi) in patients with inflammatory arthritis. The aim of this study was to evaluate survival, persistence and effectiveness of golimumab (GLM) in patients with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) with previous experience with other TNFi and to compare these results with TNFi naive patients.</div></div><div><h3>Methods</h3><div>Observational cohort of consecutive patients with RA, PsA and axSpA who had started treatment with GLM according to medical indication. bDMARD naive and TNFi experienced patients were selected.</div></div><div><h3>Results</h3><div>A total of 147 (62.3%) bDMARD naive and 45 (19.1%) TNFi experienced patients were included. Patients were followed up for a total of 441.5 patients/year, 55 (28.6%) discontinued GLM, 42 (28.6%) and 13 (28.9%) in each group, respectively (<em>p</em> <!-->=<!--> <!-->0.967). The majority (63.6%) suspended due to inefficacy, followed by lack of access (23.6%) and adverse events (9.1%). Median GLM survival was 74.0 months (95% CI 57.0, 91.0) and 71.0 months (95% CI 37.0, 105.0), in the bDMARD naive and TNFi experienced patients, respectively (<em>p</em> <!-->=<!--> <!-->0.695). Drug persistence at 6, 12, 24 and 36 months was 92.8%, 88.1%, 76.1%, 65.4% and 93.1%, 77.4%, 74.2%, 68.5%, respectively. In the multivariable analysis, having public health insurance was associated with higher risk of drug discontinuation (HR 2.56, 95% CI 1.28–5.00, <em>p</em> <!-->=<!--> <!-->0.008). TNFi experienced patients did not show significantly higher risk of GLM suspension (HR 1.35, 95% CI 0.70–2.57, <em>p</em> <!-->=<!--> <!-->0.370).</div></div><div><h3>Conclusion</h3><div>In this cohort, TNFi experienced patients had comparable survival and persistence of treatment with GLM. Having public health insurance was associated with lower drug retention rates.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 10","pages":"Pages 539-546"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}