Reumatologia clinica最新文献

{"title":"Cardiovascular event in a cohort of rheumatoid arthritis patients in Castilla-La Mancha: Utility of carotid ultrasound","authors":"Marco Aurelio Ramírez Huaranga ,&nbsp;David Velasco Sánchez ,&nbsp;Luis Ángel Calvo Pascual ,&nbsp;David Castro Corredor ,&nbsp;María Dolores Mínguez Sánchez ,&nbsp;Verónica Salas Manzanedo ,&nbsp;Eva Revuelta Evrard ,&nbsp;Rocío Arenal López ,&nbsp;Joaquín Anino Fernández ,&nbsp;Marina González Peñas ,&nbsp;Lourdes Martin de la Sierra López ,&nbsp;Laura María Jiménez Rodríguez ,&nbsp;Alberto López Menchero Mora ,&nbsp;Marcos Paulino Huertas","doi":"10.1016/j.reumae.2024.02.005","DOIUrl":"10.1016/j.reumae.2024.02.005","url":null,"abstract":"<div><p>Rheumatoid Arthritis (RA) has a mortality rate 1,3 to 3 times higher than the general population, with cardiovascular mortality accounting for 40–50% of cases. Currently, cardiovascular disease is considered an extraarticular manifestation of RA (OR: 1,5–4,0). Ultrasound measurement of the intima-media thickness (IMT) of the common carotid artery and the presence of atherosclerotic plaques (AP) is a non-invasive method and a surrogate marker of subclinical arteriosclerosis.</p></div><div><h3>Objective</h3><p>To determine if subclinical arteriosclerosis findings through carotid ultrasound can serve as a good predictor of cardiovascular events (CVE) development in a cohort of RA patients over a 10-year period.</p></div><div><h3>Methodology</h3><p>A cohort of RA patients seen in the Rheumatology outpatient clinic of a hospital in Castilla La Mancha in 2013 was evaluated. A prospective evaluation for the development of CVE over the following 10 years was conducted, and its correlation with previous ultrasound findings of IMT and AP was analyzed.</p></div><div><h3>Results</h3><p>Eight (24%) patients experienced a CVE. Three (9%) had heart failure, three (9%) had a stroke, and two (6%) experienced acute myocardial infarction. RA patients who developed a CVE had a higher IMT (0,97 +/− 0.08 mm) compared to the RA patients without CV complications (0,74 +/− 0.15 mm) (p = 0,003). The presence of IMT ≥ 0.9 mm and AP had a relative risk of 12,25 (p = 0,012) and 18,66 (p = 0,003), respectively, for the development of a CVE.</p></div><div><h3>Conclusions</h3><p>Carotid ultrasound in RA patients may allow for early detection of subclinical atherosclerosis before the development of CVE, with IMT ≥ 0.9 mm being the most closely associated finding with CVE, unaffected by age.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 150-154"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041219","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":"Elderly-onset rheumatoid arthritis receives less aggressive therapies than young-onset rheumatoid arthritis in an Argentinian cohort","authors":"Nicolás Pérez ,&nbsp;María de Los Ángeles Gargiulo ,&nbsp;Marina Khoury ,&nbsp;Lorena Suárez ,&nbsp;María de los Ángeles Correa ,&nbsp;Mariana Pera ,&nbsp;Natali Saravia ,&nbsp;Graciela Gómez","doi":"10.1016/j.reumae.2024.02.001","DOIUrl":"10.1016/j.reumae.2024.02.001","url":null,"abstract":"<div><h3>Objectives</h3><p>When rheumatoid arthritis (RA) starts after the age of 60 it is called elderly-onset rheumatoid arthritis (EORA) and when it starts earlier, young-onset rheumatoid arthritis. (YORA). There are few Latin American studies that compared both groups. The objective of the study was to evaluate differences in the clinical characteristics, evolution and treatment among patients with RA with onset before or after 60 years of age.</p></div><div><h3>Materials and methods</h3><p>Observational study of patients with RA attended consecutively in four centers in Argentina. Sociodemographic data, comorbidities, clinical manifestations at diagnosis, presence of rheumatoid factor and/or anti-CCP (cyclic citrullinated peptide) and treatments received were collected. At the last visit, swollen and tender joints, assessment of disease activity by the patient and physician, the presence of radiographic erosions, and functional status using the HAQ-DI were recorded.</p></div><div><h3>Results</h3><p>51 patients from each group were analyzed. The EORA group had a significantly higher proportion of smokers (58.8% vs. 35.3%, p = 0.029), cardiovascular history (54.9% vs. 21.6%, p = 0.001), abrupt onset (49% vs. 29.4%, p = 0.034) or with symptoms similar to PMR (19.6% vs. 0%, p = 0.001). Lower methotrexate doses were used in the EORA group: 19 mg (15–25) vs. 21.9 mg (20−25) (p = 0.0036) and more frequently did not receive bDMARDs or tsDMARDs.</p></div><div><h3>Discussion and conclusions</h3><p>The benefits of intensive treatment in patients with RA have been described. In this study, the use of DMARDs in the EORA group was less intensive, suggesting that advanced age constitutes a barrier in the therapeutic choice.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 136-141"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041220","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":"The impact of COVID-19 and other factors on the usage status of the biologic drug therapies for rheumatoid arthritis: A study from Vietnam","authors":"Hai-Binh Bui ,&nbsp;Hong-Thinh Lai ,&nbsp;Thanh-Lam Nguyen ,&nbsp;Thuy-Duong Vu ,&nbsp;Nhat-Le Bui ,&nbsp;Van-Hung Nguyen ,&nbsp;Thi-To-Chau Tran ,&nbsp;Thi-Phuong-Thuy Nguyen ,&nbsp;Thi-Ngoc-Lan Nguyen ,&nbsp;Jaffar A. Al-Tawfiq ,&nbsp;Dinh-Toi Chu","doi":"10.1016/j.reumae.2024.02.003","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.02.003","url":null,"abstract":"<div><h3>Objectives</h3><p>To describe the status of using biological Disease Modifying Anti Rheumatic Drugs (bDMARDs) to treat rheumatoid arthritis (RA) and related factors. In addition, the study determined the impact of COVID-19 on the usage of bDMARDs.</p></div><div><h3>Methods</h3><p>This is a cross-sectional study and included 219 RA patients over 18 years old. The Kaplan–Meier method and the log-rank test (<em>p</em> <!-->&lt;<!--> <!-->0.05) were used to estimate the retention time and compare between different times. Cox regression analysis was used to determine the factors affecting the retention time of biological drugs (<em>p</em> <!-->&lt;<!--> <!-->0.05).</p></div><div><h3>Results</h3><p>Out of 1967 courses of treatment, there were 149 (7.6%) drug discontinuations, 760 (38.6%) doses extensions and 64 (3.3%) drug switch. Moderate disease level and choosing tumor necrosis factor (TNF) inhibitors initially were associated with retention time of COVID-19. Drug discontinuations and dose extensions increased after COVID-19 emergence. The retention time during COVID-19 was significantly different from that of pre-COVID-19. Gender, type of first-used bDMARD, conventional synthetic DMARDs (csDMARDs) and corticoid usage status, disease activity levels were associated with retention time.</p></div><div><h3>Conclusion</h3><p>The presence of COVID-19 has a significant effect on usage status of the biologic drug. Further longitudinal studies are needed to clarify the relationship between COVID-19 and drug usage as well as related factors.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 128-135"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140138065","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":"Performance of adenosine deaminase in synovial fluid for the diagnosis of tuberculous arthritis: A systematic review and meta-analysis","authors":"Juan Carlos Cortes-Quiroz,&nbsp;Jose Bernal,&nbsp;Jose Rosas,&nbsp;Javier Ena","doi":"10.1016/j.reumae.2024.02.002","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.02.002","url":null,"abstract":"<div><h3>Objectives</h3><p>Adenosine deaminase (ADA) activity has shown good performance in diagnosing pleural, peritoneal, and meningeal tuberculosis. This meta-analysis aimed to evaluate the performance of measuring ADA activity in synovial fluid for the early diagnosis of joint tuberculosis.</p></div><div><h3>Methods</h3><p>We searched published information in MEDLINE, Embase, Cochrane Library, Web of Science, and MedRxiv databases, as well as unpublished information in the American College of Rheumatology and European League Against Rheumatism for conference abstracts (2012–2021). We also scanned the reference lists of articles. Two reviewers independently applied the criteria for selection, assessed quality, and extracted data (PROSPERO number CRD42021284472).</p></div><div><h3>Results</h3><p>Seven independent studies (<em>N</em> <!-->=<!--> <!-->305 subjects) that compared ADA activity in synovial fluid with a composite reference diagnostic method for tuberculosis were included. Overall, the risk of bias was judged low. Studies were classified as high quality (<em>n</em> <!-->=<!--> <!-->3; 148 subjects) and low quality (<em>n</em> <!-->=<!--> <!-->4; 157 subjects). Pooled sensitivity and specificity of ADA activity was 94% (95% confidence interval [CI], 0.89–98; <em>I</em>² <!-->=<!--> <!-->23%) and 88% (95% CI, 83–92; <em>I</em>² <!-->=<!--> <!-->83%), respectively. The random-effects model for pooled diagnostic Odds ratio was 67.1 (95%CI, 20.3–222.2; <em>I</em>² <!-->=<!--> <!-->30%). The receiver operating characteristic curve area was 0.96 (95% CI, 0.92–0.99). Meta-regression did not identify the quality of the study, country of publication, or the type of assay as a source of heterogeneity.</p></div><div><h3>Conclusions</h3><p>Measuring ADA activity in synovial fluid demonstrates good performance for the early diagnosis of joint tuberculosis.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 117-122"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140138060","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":"Is the use of secukinumab after anti-TNF therapy greater than expected for the risk of developing inflammatory bowel disease?","authors":"Fatih Albayrak ,&nbsp;Mustafa Gür ,&nbsp;Ahmet Karataş ,&nbsp;Süleyman Serdar Koca ,&nbsp;Bünyamin Kısacık","doi":"10.1016/j.reumae.2023.11.002","DOIUrl":"https://doi.org/10.1016/j.reumae.2023.11.002","url":null,"abstract":"<div><h3>Objective</h3><p>In this study, our objective was to present real-life data on the incidence of inflammatory bowel disease (IBD) among patients receiving secukinumab treatment.</p></div><div><h3>Methods</h3><p>The study consisted of 209 patients who had prior exposure to anti-tumor necrosis factor (TNF) or were biologically naive. Patients with a pre-existing history of IBD were excluded from the study.</p></div><div><h3>Results</h3><p>Of the 209 patients in the study, 176 (84.3%) had ankylosing spondylitis, while 33 (15.7%) had psoriatic arthritis. 112 (53.6%) patients had prior exposure to at least one anti-TNF treatment before initiating secukinumab. IBD developed in 10 (4.8%) of the 209 patients. The incidence of IBD among patients who initiated secukinumab as their first biologic agent was 1%. For patients who had previously received any anti-TNF treatment and subsequently transitioned to secukinumab, the incidence of IBD was 8% (<em>p</em> <!-->=<!--> <!-->0.018, odds ratio (OR): 8.38, 95% CI: 1.04–67.45). A mean of 3.67 months (±4.3) after anti-TNF use, whereas IBD symptoms developed in the biologically naive patient after 15 months.</p></div><div><h3>Conclusion</h3><p>Our study observed IBD incidence in 4.8% of patients using secukinumab. Patients who initiated secukinumab after previous anti-TNF treatment exhibited a significantly higher rate and risk of developing IBD. The onset of IBD occurred earlier in these patients (mean 3.67 months), whereas a single case of IBD showed a longer duration (15 months). Further studies with larger patient numbers are warranted to provide a more comprehensive understanding of our findings.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 123-127"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140138064","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":"Evaluating the impact of the website campaign “A ti también te puede tocar” (“It could also be you”) to spread awareness of systemic autoimmune rheumatic diseases","authors":"Ana De las Heras-Alonso ,&nbsp;Daniel Seoane-Mato ,&nbsp;Mercedes Guerra ,&nbsp;Cristina Macía-Villa","doi":"10.1016/j.reumae.2023.09.006","DOIUrl":"https://doi.org/10.1016/j.reumae.2023.09.006","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 171-172"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140138530","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":"Ischiofemoral impingement syndrome: A five-case series report","authors":"Adrián Mayo-Juanatey ,&nbsp;Luís García-Ferrer ,&nbsp;Aránzazu Ballester-Suárez ,&nbsp;Elia Valls-Pascual ,&nbsp;Ignacio Vázquez-Gómez ,&nbsp;Juan José Alegre-Sancho","doi":"10.1016/j.reumae.2024.02.006","DOIUrl":"10.1016/j.reumae.2024.02.006","url":null,"abstract":"<div><p>Gluteal pain is a frequent cause of medical attention in the daily clinical practice. It can be caused by multiple pathologies, being ischiofemoral impingement syndrome among those included in its differential diagnosis. Encompassed within the deep gluteal syndromes, this entity occurs as a consequence of the entrapment of the neuromuscular structures between the lesser femoral trochanter and the ischial tuberosity, causing pain in the root of the lower limb, with irradiation towards the thigh or the gluteal region and poor tolerance to deambulation and sedestation. The magnetic resonance imaging of the hip is fundamental for its diagnosis, and its management consists on medical treatment at onset. Despite not being a frequent diagnosis in the clinical practice in Rheumatology, keeping it in mind helps improving its prognosis by establishing an early and adequate treatment.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 162-165"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041221","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":"Usefulness of ultrasound in clinical decision-making in rheumatology clinical practice: A single-center longitudinal study","authors":"Marta Serrano-Warleta ,&nbsp;Aliuska Palomeque-Vargas ,&nbsp;Rosa Manzo ,&nbsp;Boris Blanco-Cáceres ,&nbsp;Mónica Vazquez-Díaz ,&nbsp;Carlos Guillen-Astete","doi":"10.1016/j.reumae.2024.02.004","DOIUrl":"10.1016/j.reumae.2024.02.004","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of the present study is to identify the extent to which it affects clinical decisions in a single-centre observational retrospective study.</p></div><div><h3>Method</h3><p>The results of 801 requests and 1174 consecutive individual ultrasound examinations performed over 10 months were analysed.</p></div><div><h3>Results</h3><p>The most frequent indication was diagnostic assistance (39%) followed by assessment of inflammatory activity (34%). By topography, the hand was the most frequently studied region (51%), followed by the foot (18.1%). Of all requests, 67% had an impact on decision-making. The impact on clinical decision-making was associated with a shorter waiting time for the evaluation of the results, being the greatest in those ultrasound scans performed on demand on the same day of the request. In 73% of bilateral ultrasound studies, findings in one of the joints exemplified the overall result reported.</p></div><div><h3>Conclusions</h3><p>Rheumatological musculoskeletal ultrasound has proven to be a useful decision-making technique, the greater the impact of which is seen the shorter the waiting time before it is performed.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 147-149"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023847","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":"Neurological manifestations of rheumatoid arthritis – Nearly 50 years of experience","authors":"Beatriz Samões ,&nbsp;Ana Paula Sousa ,&nbsp;Raquel Samões ,&nbsp;Ernestina Santos","doi":"10.1016/j.reumae.2024.02.008","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.02.008","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 169-171"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140138529","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":"Pseudoseptic arthritis as a complication of intra-articular infiltration of hyaluronic acid in a patient with rheumatoid arthritis","authors":"Chafik Chacur,&nbsp;Anastasia Mocritcaia,&nbsp;Raimon Sanmartí","doi":"10.1016/j.reumae.2024.02.007","DOIUrl":"10.1016/j.reumae.2024.02.007","url":null,"abstract":"<div><p>Pseudoseptic arthritis is a rare complication of hyaluronic acid (HA) injections that often is difficult to differentiate from septic arthritis. Patients present acute pain, swelling and joint effusion normally around 24<!--> <!-->h after the second or third HA infiltration. We describe a female patient with seropositive rheumatoid arthritis and flare-ups of knee arthritis with pseudoseptic features in the past, who develops pseudoseptic arthritis of the knee following her first injection of hyaluronic acid.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 3","pages":"Pages 166-168"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041246","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}