Reumatologia clinica最新文献

{"title":"Clinical Practice Mexican Guidelines for the Treatment of Systemic Lupus Erythematosus: 2024 Update.","authors":"Lilia Andrade-Ortega, Daniel Xibillé-Friedmann, Dionicio A Galarza-Delgado, Miguel Ángel Saavedra, José Alvarez-Nemegyei, Mary-Carmen Amigo-Castañeda, Hilda Fragoso-Loyo, María Vanessa Gordillo-Huerta, Fedra Irazoque-Palazuelos, Luis Javier Jara-Quezada, Javier Merayo-Chalico, Margarita Portela-Hernández, Sandra Sicsik-Ayala, Carlos Abud-Mendoza, Deshire Alpizar-Rodriguez, José Luis Amaya-Estrada, Yaneth R Barragán-Navarro, Sandra M Carrillo-Vázquez, Zully Castro-Colín, Luis Javier Cruz-Álvarez, Sergio Durán-Barragán, Jorge A Esquivel-Valerio, Jorge Iván Gamez-Nava, Conrado García-García, Laura Gonzalez-Lopez, Jaime Hadid-Smeke, Alina Hernández-Bedolla, María Fernanda Hernández-Cabrera, David A Herrera-VanOostdam, Gabriel Horta-Baas, Alberto E Iturbide-Escamilla, Sandra Muñoz-Lopez, Cesar Pacheco-Tena, Mario Pérez-Cristóbal, Rafael R Pimentel-Leon, Mercedes Pinto-Ortiz, María Azucena Ramos-Sánchez, Diana V Sandoval-Cabrera, Karina Santana de Anda, Luis H Silveira, Leonor A Barile-Fabris","doi":"10.1016/j.reumae.2024.10.003","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.10.003","url":null,"abstract":"<p><p>Herein we present the update for the Mexican Guidelines for the Treatment of Systemic Lupus Erythematosus. It involves the participation of several experts along the country, following the GRADE system. We included aspects regarding vaccines, pregnancy and cardiovascular risk which were not presented in the previous guidelines in 2017.</p>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592352","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":"Evaluation of the efficacy and safety of gravitational therapy in a cohort of patients with systemic sclerosis.","authors":"Luisa Fernanda Servioli, Eugenia Isasi, Alejandra Pérez, Silvia Pouquette, María Eloísa Isasi","doi":"10.1016/j.reumae.2024.10.004","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.10.004","url":null,"abstract":"<p><strong>Background: </strong>The exposure to artificial gravity (AG) through human centrifugation is the basis of the treatment called gravity therapy (GT), in which the mechanical stimulation over the vessel wall, induces the synthesis and release of prostacyclin. It has been used for more than four decades in Uruguay in the treatment of different vascular-based pathologies. In patients with systemic sclerosis (SSc) it has shown good benefits and excellent safety profile over the years. However, there is a lack of knowledge in the scientific community about GT and its results.</p><p><strong>Objective: </strong>To evaluate the effectiveness of GT in cutaneous and vascular involvement, in the quality of life and functional capacity and its safety profile in patients with SSc.</p><p><strong>Methodology: </strong>It is a descriptive and retrospective study of patients with SSc assisted in an autoimmunity center in Montevideo, treated with GT in the last 10 years.</p><p><strong>Results: </strong>Fifty patients were included, 48 women (96%) and 2 men (4%) with a mean age of 62 ± 12 years. The mean time of evolution of SSc at the time of inclusion in the study at the beginning of GT was 6.8 ± 3.2 years and 2.8 ± 3.2 years respectively. After GT, a significant improvement in the modified Rodnan skin score (mRSS) was observed (pre-GT 19.2 ± 8.7 vs. post-GT 5.4 ± 5.0, p < 0.05), which was not related to the time of disease progression at the beginning of GT nor to the skin extension or immunological profile. The degree of improvement post-GT was related to a higher initial mRSS (R = 0.84, p < 0.05). Also, a significant improvement was observed in the number of patients with puffy fingers (pre-GT 50% vs. post-GT 20% patients, p < 0.05), but not in telangiectasias, pitting scars or sclerodactyly. The severity of Raynaud's phenomenon significantly decreased (pre-GT: grade 3-4, 43/48 (89.6%) patients vs. post-GT: grade ≤2, 42/47 (89.4%) patients, p < 0.05) as well as the vascular pain measured with VAS (0-10 scale) (pre-GT: 7.6 ± 2.2 vs. post-TG: 1.4 ± 1.2, p < 0.05). The healing of digital ulcers was also recorded. Regarding the results reported by patients, 97% reported improvement in the quality of life and 89.5% improvement in the ability to carry out activities of daily living. No significant adverse effects were recorded.</p><p><strong>Conclusions: </strong>GT improved cutaneous and vascular involvement, the quality of life and the functional capacity in patients with SSc with an excellent safety profile. Randomized, controlled clinical trials are needed to corroborate these observational results.</p>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565050","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":"Inclusion Body Myositis: A Late Diagnosis Case Report.","authors":"Deysi Andrea Hernández-Rivero, Lisette Bazán-Rodríguez, María Del Pilar Cruz-Domínguez, Gabriela Medina, Ana Lilia Peralta Amaro, Olga Vera-Lastra","doi":"10.1016/j.reumae.2024.10.002","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.10.002","url":null,"abstract":"<p><p>Inclusion body myositis is a idiopathic inflammatory myopathy characterized by muscle weakness and dysphagia, with muscle biopsy showing inflammation and rimmed vacuoles. We present the case of a patient who was diagnosed with polymyositis but due to lack of response to treatment, a new biopsy revealed inclusion body myositis.</p>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549884","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":"Prevalence of occipital enthesophyte in non-inflammatory and inflammatory rheumatic diseases.","authors":"Natalia de la Torre Rubio, Jose Campos Esteban, José Luis Andréu Sánchez, Jesús Sanz Sanz","doi":"10.1016/j.reumae.2024.06.002","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.06.002","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549885","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":"Fibromyalgia with elevated rheumatoid factor is associated with poor therapeutic response but not with progression to rheumatoid arthritis. Prospective cohort study.","authors":"Freddy Liñán Ponce, Juan Leiva Goicochea, David Sevilla Rodríguez, Elmer Hidalgo Bravo, Ginna Obregón Atanacio, Inés Loyola Macalapú, Paola Jáuregui Rojas, Jackeline Yampufe Canani","doi":"10.1016/j.reumae.2024.10.001","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.10.001","url":null,"abstract":"<p><strong>Objetive: </strong>Evaluate response to treatment and progression to rheumatoid arthritis (RA) in patients with fibromyalgia (FM) associated with elevated rheumatoid factor (RF).</p><p><strong>Material and methods: </strong>Prospective cohort study. The sample consisted of 124 patients with FM: 62 with high RF (>20 U/mL) and 62 with negative RF (0-20 U/mL). All patients were evaluated using FM treatment improvement score (FIQR) and progression to RA according to EULAR/ACR 2010 criteria at 6 and 12 months. Pearson's χ² test for homogeneity was used to relate variables of improvement to FM treatment and progression to RA.</p><p><strong>Results: </strong>The response to treatment was lower in the high RF group (24 and 20 patients improved at 6 and 12 months, respectively, compared to 45 and 38 patients in the negative RF group), with a significant difference. Progression to rheumatoid arthritis was similar in both groups (5 in the high RF group and 4 in the negative RF group), with a non-significant relationship.</p><p><strong>Conclusions: </strong>FM with elevated RF is associated with a poor therapeutic response but not with progression to RA.</p>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515627","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":"Gastrointestinal symptoms in patients using methotrexate: A cross-sectional study in a sample with rheumatoid arthritis","authors":"","doi":"10.1016/j.reumae.2024.09.004","DOIUrl":"10.1016/j.reumae.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Gastrointestinal intolerance is common in rheumatoid arthritis (RA) patients using methotrexate and may lead to treatment discontinuation.</div></div><div><h3>Aim</h3><div>To study the prevalence of gastrointestinal symptoms in a sample of RA methotrexate users as well as its possible association with clinical and epidemiological variables.</div></div><div><h3>Methods</h3><div>Cross-sectional study of 192 patients with gastrointestinal symptoms using the MISS (methotrexate intolerance severity score). Clinical and epidemiological variables were collected through chart review and direct questioning. Patients’ adherence to methotrexate was evaluated through Moriski–Green–Levin questionnaire.</div></div><div><h3>Results</h3><div>The prevalence of gastrointestinal complaints was high with 55.7% of the sample classified as intolerant. Nausea and pain after drug ingestion were the most common reported complaints. This intolerance was associated with afro-descendant background (<em>p</em> <!-->=<!--> <!-->0.02); presence of associated fibromyalgia (<em>p</em> <!-->=<!--> <!-->0.04), concomitant use of glucocorticoids (<em>p</em> <!-->=<!--> <!-->0.03) and Jak inhibitors (0.03). A tendency towards association with leflunomide use was observed (<em>p</em> <!-->=<!--> <!-->0.06). Logistic regression was used to test drug associations with methotrexate intolerance, and showed that glucocorticoid use was independently associated with methotrexate intolerance OR<!--> <!-->=<!--> <!-->1.85; 95% CI<!--> <!-->=<!--> <!-->1.01–3.44; <em>p</em> <!-->=<!--> <!-->0.04. Route of administration, presence of previous gastric complaints, age and methotrexate dose did not interfere with MISS. MISS results were associated with moderate adherence to the drug.</div></div><div><h3>Conclusions</h3><div>There is a high rate of methotrexate intolerance that is more common in afro-descendants, those with associated fibromyalgia, glucocorticoid and Jak inhibitors users.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421122","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":"Adalimumab treatment of resistant chondrocalcinosis","authors":"","doi":"10.1016/j.reumae.2024.09.007","DOIUrl":"10.1016/j.reumae.2024.09.007","url":null,"abstract":"<div><div>In this article, we present a case of resistant chondrocalcinosis who had a good response with 40<!--> <!-->mg subcutaneous adalimumab. To our knowledge, this is the first report using adalimumab successfully in severe CPDD. Anti-TNF therapy can be a good therapeutic option for second line therapy in CPPD.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421118","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":"Update of the Consensus Statement of the Spanish Society of Rheumatology on the use of biological and synthetic targeted therapies in rheumatoid arthritis","authors":"","doi":"10.1016/j.reumae.2024.09.002","DOIUrl":"10.1016/j.reumae.2024.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>To update the consensus document of the Spanish Society of Rheumatology (SER) regarding the use of targeted biological and synthetic therapies in rheumatoid arthritis (RA) with the aim of assisting clinicians in their therapeutic decisions.</div></div><div><h3>Methods</h3><div>A panel of 13 experts was assembled through an open call by SER. We employed a mixed adaptation-elaboration-update methodology starting from the 2015 Consensus Document of the Spanish Society of Rheumatology on the use of biological therapies in RA. Starting with systematic reviews (SR) of recommendations from EULAR 2019, American College of Rheumatology 2021, and GUIPCAR 2017, we updated the search strategies for the PICO questions of GUIPCAR. An additional SR was conducted on demyelinating disease in relation to targeted biological and synthetic therapies. Following the analysis of evidence by different panelists, consensus on the wording and level of agreement for each recommendation was reached in a face-to-face meeting.</div></div><div><h3>Results</h3><div>The panel established 5 general principles and 15 recommendations on the management of RA. These encompassed crucial aspects such as the importance of early treatment, therapeutic goals in RA, monitoring frequency, the use of glucocorticoids, the application of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), biological DMARDs (bDMARDs), and targeted synthetic DMARDs. Additionally, recommendations on dose reduction of these drugs in stable patients were included. This update also features recommendations on the use of bDMARDs and Janus Kinase inhibitors in some specific clinical situations, such as patients with lung disease, a history of cancer, heart failure, or demyelinating disease.</div></div><div><h3>Conclusions</h3><div>This update provides recommendations on key aspects in the management of RA using targeted biological and synthetic therapies.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335477","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":"Multicentric reticulohistiocytosis: A 20-year diagnosis beneath the surface","authors":"","doi":"10.1016/j.reumae.2024.09.008","DOIUrl":"10.1016/j.reumae.2024.09.008","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421146","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":"Efficacy of psychological interventions to reduce anxiety and depression in patients with lupus. A systematic review and meta-analysis","authors":"","doi":"10.1016/j.reumae.2024.09.006","DOIUrl":"10.1016/j.reumae.2024.09.006","url":null,"abstract":"<div><div>The presence of anxiety and depression symptoms in patients with lupus is common, and some research reports that psychological interventions can reduce them, therefore we conducted a systematic review and meta-analysis of the efficacy of psychological interventions in adults with systemic lupus erythematosus. Randomized and non-randomized clinical trials with adult population diagnosed with lupus, treated with psychological intervention, and compared with similar groups were selected. Several databases were searched in July 2023. Fourteen studies were included in the meta-analysis, with moderate effect sizes for anxiety and depression in group intervention modalities. Factors such as percentage of sample with lupus, gender, medication, and interventions with relaxation components influenced the results. Group psychological intervention programs are effective in reducing symptoms in patients with lupus, although further research on treatment modulating variables is needed.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421144","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}