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Introduction: the aim of our study is to determine, from data of the Moroccan register of biotherapies, the factors influencing the choice of the first prescribed biological treatment. Methods: cross- sectional multicenter study including rheumatoid arthritis patients who were initiated the first biological treatment either: Rituximab, an anti-TNF, or Tocilizumab. The determinants related to the patient and disease have been gathered. A univariate and then multivariate analysis to determine the factors associated with the choice of the first bDMARDs was realized. Results: a total of 225 rheumatoid arthritis patients were included in the Moroccan registry. The mean age was 52 ± 11 years, with female predominance 88% (n = 197). The first prescribed biological treatment was Rituximab 74% (n = 166), the second one was Tocilizumab, 13.6% (n = 31) then comes the anti- TNF in 3rd position with 12.4% (n = 28). The factors associated with the choice of Rituximab as the first line bDMARDs prescribed in univariate analysis were: the insurance type, the positivity of the rheumatoid factor. In multivariate analysis, only the insurance type that remains associated with the choice of Rituximab as the first biological drugs. The Tocilizumab was associated with shorter disease duration and was more prescribed as mono-therapy compared to non Tocilizumab group. TNFi was associated with the insurance type. Conclusion: our study suggests that Rituximab and TNFi are associated with the type of insurance and Tocilizumab is the most prescribed biologic mono- therapy in RA patients. Further studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

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Objective. We conducted a telephonic survey to determine the prevalence of chronic pain with neuropathic characteristics (NC) in the Moroccan general population. Design. We performed a large nationwide tele-phonic survey based upon a random sampling of households in the 16 administrative regions of Morocco to determine the prevalence of chronic pain with NC in the general population. We used a stratified sampling taking into account the number of residents in each region. A sample of house-holds was drawn for each of the 16 regions using systematic sampling. Outcome Measures. A questionnaire aimed at iden-tifying chronic pain (defined as daily pain for at least 3 months), evaluating its intensity, duration, and body locations was used. The Moroccan validated version of DN4 questionnaire was used to identify neuropathic characteristics. Results. A total of 5,328 respondents participated in the survey. 21% of the respondents (1,074) (95%CI: 19,9-22,2), reported chronic daily pain for more than 3 months. The point prevalence of chronic pain with NC, was 10.6% (95% CI: 9,75-11,45). The prevalence was higher in women and individuals older than 60. Chronic pain with NC was significantly more preva-lent in women, elderly, Illiterate respondents, and respondents from lower social class. It was more frequently located in the lower limbs, and its inten-sity and duration were higher in comparison with chronic pain without neuropathic characteristics. Conclusion. Chronic pain with neuropathic charac-teristics is probably more prevalent in the general population than was previously thought and is gen-erally more severe than other chronic pain. [ABSTRACT FROM AUTHOR]

La mono arthrite avec la présence de lésions lytiques intra-articulaires au cours des néoplasies solides sont peu fréquentes, non spécifiques, et exceptionnellement révélatrices. Le but de notre étude est d'en analyser les différentes présentations cliniques. Nous décrivons une série de 6 cas de néoplasie solide, dont le diagnostic a été posé à l'occasion d'une mono arthrite avec lésions lytiques intra-articulaires. Nous avons exclu les patients déjà diagnostiqués comme cancer solide. Nos rapportons six cas de néoplasie solide colligés au service de rhumatologie découverte par un tableau de monoarthrite avec des lésions lytiques intra-articulaires. Cinq cas étaient des hommes, l'âge moyen était de 64,57 ans, les circonstances de diagnostic de la néoplasie solide étaient : trois cas devant un bilan de mono arthrite du genou, trois cas devant un bilan d'une coxopathie avec tableau de spondylarthrite clinique et un cas devant une arthrite de la cheville gauche. Le diagnostic de cancer solide a été suspecté chez nos patients devant la présence de signes généraux, les douleurs osseuses accompagnant la symptomatologie articulaire, l'absence d'autres signes en faveur d'un rhumatisme inflammatoire ou une origine infectieuse et la présence de lésions lytiques sur les radiographies standards confirmées par une tomodensitométrie de l'articulation correspondante. Des métastases osseuses concomitantes étaient présentes chez trois malades. La sacroiliite était présente chez les trois malades présentant le tableau de coxopathie. La confirmation histologique de l'arthrite métastatique a été faite chez trois malades. La tumeur primitive était : trois cas d'adénocarcinome prostatique, un adénocarcinome vésiculaire de la thyroïde, un carcinome canalaire du sein, cancer bronchopulmonaire et un carcinome cutané squameux sur cicatrice d'une brûlure cutanée. Deux malades sont décédés après la découverte du cancer solide, les autres sont toujours en vie et en cours de traitement. Le recul moyen est de 2 ans. Bien que l'arthrite métastatique est une entité rare. Il faut y penser devant la présence de signes généraux, des douleurs osseuses associées ou en présence d'une arthrite inclassée. Plusieurs néoplasies solides ou lymphomes peuvent mimer une vraie spondylarthrite qui peut être un diagnostic de facilité. Ceci pour inciter sur l'importance des diagnostics différentiels même quand les critères de classification sont satisfaisants. [ABSTRACT FROM AUTHOR]