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Objective: The aim of the present study is to describe the general characteristics of a cohort of patients with early arthritis in Argentina., Methods: CONAART (Consorcio Argentino de Artritis Temprana--Argentine Consortium for Early Arthritis) is an initiative of seven rheumatology centres across Argentina. Patients were included if they had at least one or more swollen joints and <2 years of disease duration. Social, demographic, familiar, hereditary, clinical and laboratory data were recollected. At first visit and every year, X-rays of hands and feet were performed and working characteristics and pharmaco-economic data were re-collected., Results: A total of 413 patients were included. Of them, 327 (79.2%) were women with a median age of 49 years and a median disease duration of 6 months. Of the total, 183 (44.3%) had RA (ACR 1987) and 167 (40.4%) undifferentiated arthritis (UA). Other diagnoses included: 12 crystalics, 11 PsA, 6 uSpA, 6 other CTD, 1 AS and 27 other diagnosis. As 85% of our population had RA and UA, we only compared these two groups of patients. Patients with RA had significantly worse activity parameters of the disease (DAS of 28 joints), functional capacity (HAQ) and quality of life (Rheumatoid Arthritis Quality of Life) than patients with UA. The frequency of RF and anti-CCP, and symmetrical distribution were also significantly higher in patients with RA compared with UA patients. All patients with RA initiated early specific treatment, in a period no longer than 6 months from the beginning of the disease., Conclusion: Early arthritis clinics are a useful tool to identify and treat patients with different forms of joint involvement.

• Higher disease activity and the presence of peripheral arthritis are independently and longitudinaly associated with a higher functional impairment. • These relationships are not modified by contextual factors, like age, gender, educational level or occupation. The aim of this study was to investigate whether peripheral arthritis together with disease activity independently contribute to functional impairment over time in patients with axSpA and to evaluate if there are contextual factors modifying this relationship. Patients with axial spondyloarthritis from the ESPAXIA cohort were followed-up annually over a mean of 3.7 years. Physical function was assessed by the self-reported questionnaire BASFI, disease activity by ASDAS and peripheral arthritis was also recorded. Generalized estimating equations (GEE) were used to investigate longitudinal association between peripheral arthritis, ASDAS and BASFI as the outcome. Autoregressive models (adjusted for BASFI 1 year earlier) were run to allow for a truly longitudinal interpretation. Interactions between each of ASDAS and peripheral arthritis with contextual factors (age, gender, educational level, smoking, job type) were tested. 185 patients (77 % male, mean (SD) age 42 (13) years old and mean disease duration (SD) of 9.4 (9.6) years) were included. ASDAS and peripheral arthritis independently contributed to explaning BASFI over time. Contextual factors did not modify either of the relationships. A true longitudinal relation was proven with the autoregressive GEE model, showing that, adjusted for age, gender, spinal mobility and use of NSAIDs, an increase of one ASDAS unit led to a BASFI 0.48 units higher (ß 0.48 [95%CI 0.39, 0.57]), and the presence of peripheral arthritis, to a BASFI 0.44 units higher (ß 0.44 [95%CI 0.08, 0.8]). Peripheral arthritis and higher disease activity independently lead to more functional impairment in axSpA over time. Contextual factors do not modify these relationships. [ABSTRACT FROM AUTHOR]

Patients with rheumatoid arthritis (RA) or undifferentiated arthritis (UA) in the CONAART database (Argentine Consortium for Early Arthritis) were assessed for genetic risk factors for RA, specifically for HLA-DRB1 alleles and the PTPN22 rs2476601 polymorphism associated with progression to RA. This is a case-control study. Blood samples were obtained to determine HLA-DRB1 genotypes by PCR-SSO Luminex and PTPN22 (rs2476601) polymorphism by allelic discrimination. A control group of individuals from the general Argentinian population were obtained from the national register of cadaveric organ donors. A total of 1859 individuals were included in this analysis: 399 patients from the CONAART database (347 patients with RA at study end and 52 patients with UA at study end, mean follow-up time 25 ± 18 months) and 1460 individuals from the general Argentinian population. Compared with the controls, the HLA-DRB1*04 and DRB1*09 alleles were more commonly detected in patients with RA diagnosis (OR (95% CI) 2.23 (1.74-2.85) and 1.89 (1.26-2.81)) respectively. Both patients with UA and the general population showed higher frequency of DRB1*07, DRB1*11 and DRB1*15 alleles than patients with RA. PTPN22 rs2476601 polymorphism frequency was higher in RA and UA vs the general population; however, this was significantly different only for RA vs control group (OR [95% CI] = 1.81 [1.10-3.02], P = 0.018. HLA-DRB1 typing and PTPN22 allelic discrimination could distinguish between patients with UA, patients with early RA, and the general population in Argentina. This is the first study of HLA-DRB1 alleles and PTPN22 polymorphism associations with progression to early RA in an Argentinian population. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to compare the frequency of comorbidities among patients with ax-SpA in the general population and to evaluate the impact of these comorbidities on the functional status and quality of life. Methods: Patients with ax-SpA fulfilling the modified New York 1984 criteria for Ankylosing Spondylitis (AS) and/or Assessment of SpondyloArthritis International Society (ASAS) 2009 criteria for patients with ax-SpA belonging to the ESPAXIA cohort ("Estudio de eSPondiloartritis Axial Irep Argentina") were included. Data regarding sociodemographics, comorbidities, and disease characteristics were recorded. Statistical analysis included descriptive statistics using the student t-test, Chi-square, and Fisher's exact test. Multiple logistic regression analysis was performed. A p value <0.05 was considered significant. Results: In total, 86 patients were included, 80% were males with a median age of 46 years (interquartile range [IQR]: 32-58) and a median disease duration of 19 years (IQR: 13-31). The most frequent comorbidities reported were hypertension (26.7%), gastritis (25.6%), dyslipidemia (24.4%), gallstone (12.8%), nephrolithiasis (11.6%), anemia (10.5%), hypothyroidism (7%), and type 2 diabetes (6%). The prevalence of these comorbidities in patients with ax-SpA was similar to that observed in the general population, with the exception of a higher frequency of nephrolithiasis among patients with ax-SpA (11.6% in ax-SpA vs 3.96% in the general population). We further categorized the study population into three groups: patients with no comorbidities, those with 1 or 2 comorbidities, and those with =3 comorbidities. The presence of =3 comorbidities was associated with older age, longer disease duration, worse disease activity, functional status, and quality of life as compared with the patients without comorbidities. In multivariate analysis, older age was the only variable independently associated with the presence of comorbidities. Conclusion: The frequency of comorbidities in the ax-SpA cohort was high, and the only variable associated with a higher prevalence of comorbidities was older age. Nephrolithiasis was more frequent in the patients with ax-SpA than that reported in the general population. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To assess patients’ preferences for rheumatoid-arthritis treatments with biologic agents using a discrete-choice experiment. Methods: A discrete-choice experiment was conducted with adult rheumatoid-arthritis patients who had never been treated with biological agents from two university hospitals—public and private—in Buenos Aires, Argentina. We evaluated preferences for seven treatment attributes (with two to three levels each): effectiveness, mode of administration, frequency of administration, local and systemic adverse events, severe infections, and out-of-pocket costs.A probit regression model was used to analyze the relative importance of rheumatoid-arthritis treatment attributes. We estimated attributes’ relative importance and their 95% confidence intervals. Results: Survey responses from 240 patients with rheumatoid arthritis receiving conventional disease-modifying antirheumatic drugs were included in the study. All tested biological agents’ attributes significantly affected the choice of treatment. Attributes’ relative importance in decreasing order was the following (mean, confidence interval 95%): cost, 0.81 (0.69–0.92); systemic adverse events, 0.66 (0.57–0.76); frequency of administration, 0.61 (0.52–0.71); efficacy, 0.42 (0.32–0.51); route of administration, 0.41 (0.30–0.52); local adverse events, 0.40 (0.31–0.49); and serious infections, 0.29 (0.22–0.37). Conclusions: Different treatment attributes had a significant and different influence in rheumatoid-arthritis patients’ choice of biological agents. This type of study can not only inform about patients’ preferences but also about the trade-offs among different possible treatments or process-related attributes. [Copyright &y& Elsevier]