454 results on '"Citera,Gustavo"'
Search Results
152. Drs. Schneeberger and Citera reply.
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Schneeberger, Emilce E. and Citera, Gustavo
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- 2023
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153. Anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis: relation with clinical features, cytokines and HLA-DRB1
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Correa, Paula A, Tobón, Gabriel J, Citera, Gustavo, Cadena, José, Schneeberger, Emilce, Camargo, José F, Maldonado-Cocco, José A, and Anaya, Juan Manuel
- Subjects
Anticuerpos antipéptidos citrulinados cíclicos ,Citocinas ,Rheumatoid factor ,Anti-cyclic citrullinated peptide antibodies ,espondilitis anquilosante ,Espondilitis anquilosante ,HLA-DRB1 ,Systemic lupus erythematosus ,Sjögren’s syndrome ,ankylosing spondylitis ,Lupus eritematoso sistémico ,factor reumatoideo ,Síndrome de Sjögren ,Cytokines ,Ankylosingspondylitis ,Artritis reumatoidea ,Rheumatoid arthritis ,Factorreumatoideo - Abstract
En el presente estudio se examinó la especificidad y la sensibilidad de los anticuerpos antipéptidos citrulinados cíclicos (CCP) en pacientes latinoamericanas con artritis reumatoidea (AR), así como su relación con la actividad de la enfermedad, manifestaciones extraarticulares (MEA), síntesis de citocinas (IL-4, IL-10, IL-12, TNF-µ e IFN-gamma ) y factor reumatoideo (FR) IgM e IgA, y con el polimorfismo del HLA-DRB1. Se examinaron 79 pacientes con AR (69 con AR establecida y 10 con AR temprana sin previo tratamiento), 56 pacientes con espondilitis anquilosante (EA), 25 con lupus eritematoso sistémico (LES), 50 con síndrome de Sjögren primario (SSp) y diez individuos sanos. De las 69 pacientes con AR establecida, 36 fueron reevaluadas 2 años después. La actividad de la AR se examinó según los criterios del Colegio Americano de Reumatología. Los anticuerpos anti-CCP2, el FR y los niveles de citocinas se determinaron mediante inmunoensayo, y la genotipificación del HLA se llevó a cabo por reacción en cadena de la polimerasa utilizando mezclas de iniciadores específicos. Los anticuerpos anti-CCP se observaron en 96% de los pacientes con AR en la primera evaluación y en 86% en la segunda ( p=0,12), sin modificación significativa en los valores (131±58,7 vs. 130,6±67,1 UI). Su sensibilidad y especificidad global fue de 94% y 92%, respectivamente, pero cuando sólo se consideraron los niveles altos (>60 UI) fueron de 84% y 95%, respectivamente. La razón de probabilidades (RP) positiva fue de 12 y la RP negativa de 0,06. El valor predictivo (VP) positivo fue de 87% y el VP negativo de 96%. Los anticuerpos anti-CCP se observaron en 12% de los pacientes con LES y con SSp, en 2% de los de EA y en 10% de los controles sanos. En los pacientes con AR no se asociaron con la actividad de la enfermedad, MEA y alelos del HLA-DRB1. Tampoco se observaron correlaciones significativas entre sus valores y los niveles de citocinas. En conclusión, los anticuerpos anti-CCP tienen un interés diagnóstico para la AR en nuestra población, pero su utilidad en el seguimiento clínico es limitada y su síntesis es independiente del HLA-DRB1 y no se correlacionan con niveles de citocinas Th1/Th2. The specificity and sensitivity of anti-cyclic citrullinated peptide antibodies (anti-CCP) was examined in Latin-American patients with rheumatoid arthritis (RA). The variables considered included: 1) relation with the activity of disease, 2) extra-articular manifestations (EAM), 3) synthesis of cytokines (IL-4, IL-10, IL-12, TNF-alpha , and IFN-gamma ) and IgM and IgA rheumatoid factor (RF), and 4) the association with HLA-DRB1 polymorphism. Seventy-nine RA patients were assessed (69 with established RA, and 10 with recent-onset RA not receiving any treatment), 56 with ankylosing spondylitis (AS), 25 with systemic lupus erythematosus (SLE), 50 with primary Sjögren’s syndrome (pSS), and 10 healthy individuals. Of the 69 patients with established RA, 36 were reexamined 2 years later. The activity of the RA was measured by criteria adopted by the American College of Rheumatology. Anti-CCP2, RF and cytokines levels were determined by ELISA. HLA genotypes were established by first, PCR sequence amplification using sequence-specific primers and then, complete sequencing of the product. Anti-CCP antibodies were observed in 96% of patients with RA during the first evaluation and in 86% at the second evaluation ( p=0.12). No significant change in antibody titre was observed between the two evaluations (131±58.7 and 130.6±67.1 IU, respectively). The overall sensitivity and specificity was 94% and 92%, respectively; however, at titres >60 IU, the values were 84% and 95%, respectively. The anti-CCP likelihood ratio positive test was 12 and the likelihood ratio negative test was 0.06. The positive predictive value was 87%, and the negative predictive value was 96%. Anti-CCP antibodies were observed in 12% of SLE and pSS patients, in 2% of AS patients, and in 10% of healthy controls. In RA patients, these antibodies were not associated with the activity of disease, EAM or HLA-DRB1 alleles; no significant correlation was observed between antibody titre and cytokines level. Although anti-CCP antibodies have potential as a diagnostic tool for RA, they are not useful for monitoring clinical activity or predicting the clinical course of disease. Antibody synthesis is HLA-DRB1 independent and not correlated with Th1/Th2 cytokines.
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- 2004
154. Construct validity and responsiveness of the simplified version of Ankylosing Spondylitis Disease Activity Score (SASDAS) for the evaluation of disease activity in axial spondyloarthritis
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Salaffi, Fausto, primary, Ciapetti, Alessandro, additional, Carotti, Marina, additional, Gasparini, Stefania, additional, Citera, Gustavo, additional, and Gutierrez, Marwin, additional
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- 2014
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155. Clinical and immunogenetic characterization in psoriatic arthritis patients
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Schneeberger, Emilce Edith, primary, Citera, Gustavo, additional, Rodríguez Gil, Gustavo, additional, Granel, Amelia, additional, Arturi, Alfredo, additional, Rosemffet, Gabriel Marcos, additional, Maldonado Cocco, José Antonio, additional, Berman, Alberto, additional, Spindler, Alberto, additional, and Morales, Victor Hugo, additional
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- 2014
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156. Work instability in rheumatoid arthritis patients from Argentina: prevalence and associated factors
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Tamborenea, Maria N., primary, Pisoni, Cecilia, additional, Toloza, Sergio, additional, Mysler, Eduardo, additional, Tate, Guillermo, additional, Pereira, Dora, additional, García Carrasco, M., additional, Quintero, J., additional, Cappuccio, A., additional, Granel, A., additional, Lazaro, M., additional, Arturi, Pablo, additional, Citera, Gustavo, additional, Velazco Zamora, J., additional, Saurit, Veronica, additional, Alvarellos, A., additional, Pons Estel, S. B., additional, Danielsen, C., additional, Graf, C., additional, Paira, Sergio, additional, Ceccatto, F., additional, Cavallasca, Javier, additional, Civit, E., additional, Moreno, J., additional, Estevez, A., additional, Diaz, M., additional, Verando, Marcela, additional, Catalan Pellet, Antonio, additional, Gomez, G., additional, Maid, Pablo, additional, Beron, Ana, additional, Salvatierra, Gabriela, additional, Mendez, Marcos, additional, Cusa, A., additional, Rillo, Oscar, additional, Paez, M., additional, Larraude, M., additional, Sohn, D., additional, Gallo, M., additional, Conforti, A., additional, Malah, Veronica, additional, Tate, Patricio, additional, and Baños, A., additional
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- 2014
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157. Certolizumab para el tratamiento de un paciente con artritis reumatoidea refractaria a múltiples agentes biológicos
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Landi, Margarita, primary and Citera, Gustavo, additional
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- 2014
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158. Fatigue assessment and its impact in the quality of life of patients with ankylosing spondylitis
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Schneeberger, Emilce Edith, primary, Marengo, María Florencia, additional, Dal Pra, Fernando, additional, Maldonado Cocco, José Antonio, additional, and Citera, Gustavo, additional
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- 2014
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159. 86. Head-to-Head Comparison of Subcutaneous Abatacept Versus Adalimumab on Background Methotrexate in Rheumatoid Arthritis: Blinded Two-Year Results from the Ample Study
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Weinblatt, Michael E., primary, Schiff, Michael H., additional, Valente, Robert, additional, van der Heijde, Désirée, additional, Citera, Gustavo, additional, Elegbe, Ayanbola, additional, Maldonado, Michael A., additional, and Fleischmann, Roy, additional
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- 2014
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160. The −308 G/A polymorphism in the tumor necrosis factor-α gene is not associated with development and progression of rheumatoid arthritis in Argentinean patients
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Aranda, Federico, primary, Perés Wingeyer, Silvia D., additional, Schneeberger, Emilce, additional, Valerio, María, additional, Saint Martin, Emilia, additional, Dal Pra, Fernando, additional, Correa, María de los Ángeles, additional, Citera, Gustavo, additional, Martínez, Liliana, additional, Mannucci, Pablo, additional, Remondino, Graciela, additional, and de Larrañaga, Gabriela F., additional
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- 2014
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161. Adherencia al tratamiento de pacientes con artritis reumatoidea que reciben medicamentos biológicos
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Chaparro del Moral, Rafael, Rillo, Oscar, Benegas, Mariana, Correa, María de los Angeles, Citera, Gustavo, A. Maldonado Cocco, José, Casado, Gustavo, Caputo, Víctor Daniel, Helling, Claudia, Tamborenea, Natalia, Myseler, Eduardo, Tate, Guillermo, Takashima, Lorena, Secco, Anastasia, Salcedo, Mariana, Baños, Andrea, Cowan, Patricia, Molina, María Josefina, Cavillon, Emilia, Exeni, Ida, Gobbi, Carla, Scublinsky, Darío, Diaz, Mónica, Chaparro del Moral, Rafael, Rillo, Oscar, Benegas, Mariana, Correa, María de los Angeles, Citera, Gustavo, A. Maldonado Cocco, José, Casado, Gustavo, Caputo, Víctor Daniel, Helling, Claudia, Tamborenea, Natalia, Myseler, Eduardo, Tate, Guillermo, Takashima, Lorena, Secco, Anastasia, Salcedo, Mariana, Baños, Andrea, Cowan, Patricia, Molina, María Josefina, Cavillon, Emilia, Exeni, Ida, Gobbi, Carla, Scublinsky, Darío, and Diaz, Mónica
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- 2013
162. Adherencia al tratamiento de pacientes con artritis reumatoidea que reciben medicamentos biológicos
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Chaparro del Moral, Rafael, primary, Rillo, Oscar Luis, additional, Benegas, Mariana, additional, Correa, María de los Angeles, additional, Citera, Gustavo, additional, Maldonado Cocco, José A., additional, Casado, Gustavo, additional, Caputo, Victor, additional, Helling, Claudia, additional, Tamborenea, Natalia, additional, Myseler, Eduardo, additional, Tate, Guillermo, additional, Takashima, Lorena, additional, Secco, Anastasia, additional, Salcedo, Mariana, additional, Baños, Andrea, additional, Cowan, Patricia, additional, Molina, Josefina, additional, Cavillon, Emilia, additional, Exeni, Ida, additional, Gobbi, Carla, additional, Scublinsky, Darío, additional, and Diaz, Mónica, additional
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- 2013
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163. Prevalence of periprosthetic osteolysis after total hip replacement in patients with rheumatic diseases
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Perez Alamino,Rodolfo, Casellini,Carolina, BaÅos,Andrea, Schneeberger,Emilce Edith, Gagliardi,Susana Alicia, Maldonado Cocco,José Antonio, Citera,Gustavo, Perez Alamino,Rodolfo, Casellini,Carolina, BaÅos,Andrea, Schneeberger,Emilce Edith, Gagliardi,Susana Alicia, Maldonado Cocco,José Antonio, and Citera,Gustavo
- Abstract
Rodolfo Perez Alamino, Carolina Casellini, Andrea Banos, Emilce Edith Schneeberger, Susana Alicia Gagliardi, José Antonio Maldonado Cocco, Gustavo CiteraSection of Rheumatology, Instituto de Rehabilitación Psicofísica, Buenos Aires, ArgentinaAbstract: Periprosthetic osteolysis (PO) is a frequent complication in patients with joint implants. There are no data regarding the prevalence of PO in patients with rheumatoid arthritis (RA), juvenile chronic arthritis (JCA), ankylosing spondylitis (AS), and osteoarthritis (OA).Objectives: To evaluate the prevalence of PO in patients with RA, JCA, AS, and OA, who have undergone total hip replacement (THR), and to identify factors associated with its development.Methods: The study included patients diagnosed with RA (ACR 1987), AS (modified New York criteria), JCA (European 1977 criteria), and osteoarthritis (OA) (ACR 1990 criteria) with unilateral or bilateral THR. Demographic, clinical, and therapeutic data were collected. Panoramic pelvic plain radiographs were performed, to determine the presence of PO at acetabular and femoral levels. Images were read by two independent observers.Results: One hundred twenty-two hip prostheses were analyzed (74 cemented, 30 cementless, and 18 hybrids). The average time from prosthesis implantation to pelvic radiograph was comparable among groups. PO was observed in 72 hips (59%). In 55% of cases, PO was detected on the femoral component, with a lower prevalence in RA (53%) vs AS (64.7%) and JCA (76.5%). Acetabular PO was more frequent in JCA patients (58.8%), compared with RA (11.6%) and OA (28.5%) patients (P = 0.0001 and P = 0.06, respectively). There was no significant association between the presence of PO and clinical, functional, or therapeutic features.Conclusion: The prevalence of PO was 59%, being more frequent at the femoral level. Larger studies must be carried out to determine the clinical significance of radiologic PO.Keywords: periprosthetic os
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- 2012
164. Head-to-head comparison of subcutaneous abatacept versus adalimumab for rheumatoid arthritis: two-year efficacy and safety findings from AMPLE trial
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Schiff, Michael, primary, Weinblatt, Michael E, additional, Valente, Robert, additional, van der Heijde, Désirée, additional, Citera, Gustavo, additional, Elegbe, Ayanbola, additional, Maldonado, Michael, additional, and Fleischmann, Roy, additional
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- 2013
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165. Clinical and MRI responses to etanercept in early non-radiographic axial spondyloarthritis: 48-week results from the EMBARK study.
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Maksymowych, Walter P., Dougados, Maxime, van der Heijde, Désirée, Sieper, Joachim, Braun, Jürgen, Citera, Gustavo, Van den Bosch, Filip, Logeart, Isabelle, Wajdula, Joseph, Jones, Heather, Marshall, Lisa, Bonin, Randi, Pedersen, Ron, Vlahos, Bonnie, Kotak, Sameer, and Bukowski, Jack F.
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SACROILIAC joint ,RESEARCH ,TIME ,RESEARCH methodology ,MAGNETIC resonance imaging ,EVALUATION research ,MEDICAL cooperation ,ANTIRHEUMATIC agents ,SEVERITY of illness index ,TREATMENT effectiveness ,SPONDYLOARTHROPATHIES ,COMPARATIVE studies ,RANDOMIZED controlled trials ,BLIND experiment ,QUESTIONNAIRES - Abstract
Objective: To evaluate the efficacy and safety of etanercept (ETN) after 48 weeks in patients with early active non-radiographic axial spondyloarthritis (nr-axSpA).Methods: Patients meeting Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axSpA, but not modified New York radiographic criteria, received double-blind ETN 50 mg/week or placebo (PBO) for 12 weeks, then open-label ETN (ETN/ETN or PBO/ETN). Clinical, health, productivity, MRI and safety outcomes were assessed and the 48-week data are presented here.Results: 208/225 patients (92%) entered the open-label phase at week 12 (ETN, n=102; PBO, n=106). The percentage of patients achieving ASAS40 increased from 33% to 52% between weeks 12 and 48 for ETN/ETN and from 15% to 53% for PBO/ETN (within-group p value <0.001 for both). For ETN/ETN and PBO/ETN, the EuroQol 5 Dimensions utility score improved by 0.14 and 0.08, respectively, between baseline and week 12 and by 0.23 and 0.22 between baseline and week 48. Between weeks 12 and 48, MRI Spondyloarthritis Research Consortium of Canada sacroiliac joint (SIJ) scores decreased by -1.1 for ETN/ETN and by -3.0 for PBO/ETN, p<0.001 for both. Decreases in MRI SIJ inflammation and C-reactive protein correlated with several clinical outcomes at weeks 12 and 48.Conclusions: Patients with early active nr-axSpA demonstrated improvement from week 12 in clinical, health, productivity and MRI outcomes that was sustained to 48 weeks.Trial Registration Number: NCT01258738. [ABSTRACT FROM AUTHOR]- Published
- 2016
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166. The -308 G/A polymorphism in the tumor necrosis factor-α gene is not associated with development and progression of rheumatoid arthritis in Argentinean patients.
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Aranda, Federico, Perés Wingeyer, Silvia D., Schneeberger, Emilce, Valerio, María, Saint Martin, Emilia, Dal Pra, Fernando, Correa, María de los Ángeles, Citera, Gustavo, Martínez, Liliana, Mannucci, Pablo, Remondino, Graciela, and Larrañaga, Gabriela F.
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RHEUMATOID arthritis ,TUMOR necrosis factors ,GENETIC polymorphisms ,DISEASE progression ,PUBLIC health ,DISEASE susceptibility - Abstract
Aim: A polymorphism in the tumor necrosis factor-alpha (TNF-α) promoter region has been associated with disease susceptibility and progression in rheumatoid arthritis (RA). The presence of an adenosine (TNF2 allele) instead of a guanine (TNF1 allele) at position -308 may be responsible for a general increase in the transcriptional activity of the TNF-α gene. Our aim was to evaluate the association of the TNF2 allele with the risk of disease development and/or progression of RA in an Argentine population cohort. Methods: Two hundred and twenty-three consecutive patients with RA according to the 1987 criteria of the American College of Rheumatology were included in the study. Clinical variables, Disease Activity Score 28, Health Assessment Questionnaire and Rheumatoid Arthritis Quality of Life were recorded. The radiographic erosions were determined by the method of Sharp/van der Heijde. A group of 111 healthy subjects matched by sex and age was used as a control. All samples were genotyped for the -308 G/A TNF-α polymorphism. Results: No significant differences were observed either in the frequency of the TNF2 allele or in the genotypic distributions of the -308 G/A TNF-α polymorphism (P > 0.05) between the control group and the RA patients. No association was found between the TNF2 allele and the variables related to the course and outcome of the disease (P > 0.05). Conclusion: In this cohort of Argentinean patients with RA, the TNF2 allele was neither associated with susceptibility to the disease nor was it associated with the variables related to the course and outcome of the disease. Key words: -308 G/A TNF-α, polymorphism, rheumatoid arthritis, tumor necrosis factor-alpha. [ABSTRACT FROM AUTHOR]
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- 2016
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167. Head‐to‐head comparison of subcutaneous abatacept versus adalimumab for rheumatoid arthritis: Findings of a phase IIIb, multinational, prospective, randomized study
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Weinblatt, Michael E., primary, Schiff, Michael, additional, Valente, Robert, additional, van der Heijde, Désirée, additional, Citera, Gustavo, additional, Zhao, Cathy, additional, Maldonado, Michael, additional, and Fleischmann, Roy, additional
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- 2012
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168. Work Productivity in Rheumatoid Arthritis: Relationship with Clinical and Radiological Features
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Chaparro del Moral, Rafael, primary, Rillo, Oscar Luis, additional, Casalla, Luciana, additional, Morón, Carolina Bru, additional, Citera, Gustavo, additional, Cocco, José A. Maldonado, additional, Correa, María de los Ángeles, additional, Buschiazzo, Emilio, additional, Tamborenea, Natalia, additional, Mysler, Eduardo, additional, Tate, Guillermo, additional, Baños, Andrea, additional, and Herscovich, Natalia, additional
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- 2012
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169. Anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis: relation with clinical features, cytokines and HLA-DRB1.
- Author
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Correa, Paula A., Tobón, Gabriel J., Citera, Gustavo, Cadena, José, Schneeberger, Emilce, Camargo, José F., Maldonado-Cocco, José A., Anaya, Juan Manuel, Correa, Paula A., Tobón, Gabriel J., Citera, Gustavo, Cadena, José, Schneeberger, Emilce, Camargo, José F., Maldonado-Cocco, José A., and Anaya, Juan Manuel
- Abstract
The specificity and sensitivity of anti-cyclic citrullinated peptide antibodies (anti-CCP) was examined in Latin-American patients with rheumatoid arthritis (RA). The variables considered included: 1) relation with the activity of disease, 2) extra-articular manifestations (EAM), 3) synthesis of cytokines (IL-4, IL-10, IL-12, TNF-alpha, and IFN-gamma) and IgM and IgA rheumatoid factor (RF), and 4) the association with HLA-DRB1 polymorphism. Seventy-nine RA patients were assessed (69 with established RA, and 10 with recent-onset RA not receiving any treatment), 56 with ankylosing spondylitis (AS), 25 with systemic lupus erythematosus (SLE), 50 with primary Sjögren's syndrome (pSS), and 10 healthy individuals. Of the 69 patients with established RA, 36 were reexamined 2 years later. The activity of the RA was measured by criteria adopted by the American College of Rheumatology. Anti-CCP2, RF and cytokines levels were determined by ELISA. HLA genotypes were established by first, PCR sequence amplification using sequence-specific primers and then, complete sequencing of the product. Anti-CCP antibodies were observed in 96% of patients with RA during the first evaluation and in 86% at the second evaluation (p = 0.12). No significant change in antibody titre was observed between the two evaluations (131 +/- 58.7 and 130.6 +/- 67.1 IU, respectively). The overall sensitivity and specificity was 94% and 92%, respectively; however, at titres > 60 IU, the values were 84% and 95%, respectively. The anti-CCP likelihood ratio positive test was 12 and the likelihood ratio negative test was 0.06. The positive predictive value was 87%, and the negative predictive value was 96%. Anti-CCP antibodies were observed in 12% of SLE and pSS patients, in 2% of AS patients, and in 10% of healthy controls. In RA patients, these antibodies were not associated with the activity of disease, EAM or HLA-DRB1 alleles; no significant correlation was observed between antibody titre and cytokines level, En el presente estudio se examinó la especificidad y la sensibilidad de los anticuerpos antipéptidos citrulinados cíclicos (CCP) en pacientes latinoamericanas con artritis reumatoidea (AR), así como su relación con la actividad de la enfermedad, manifestaciones extraarticulares (MEA), síntesis de citocinas (IL-4, IL-10, IL-12, TNF-? e IFN-?) y factor reumatoideo (FR) IgM e IgA, y con el polimorfismo del HLA-DRB1. Se examinaron 79 pacientes con AR (69 con AR establecida y 10 con AR temprana sin previo tratamiento), 56 pacientes con espondilitis anquilosante (EA), 25 con lupus eritematoso sistémico (LES), 50 con síndrome de Sjögren primario (SSp) y diez individuos sanos. De las 69 pacientes con AR establecida, 36 fueron reevaluadas 2 años después. La actividad de la AR se examinó según los criterios del Colegio Americano de Reumatología. Los anticuerpos anti-CCP2, el FR y los niveles de citocinas se determinaron mediante inmunoensayo, y la genotipificación del HLA se llevó a cabo por reacción en cadena de la polimerasa utilizando mezclas de iniciadores específicos. Los anticuerpos anti-CCP se observaron en 96% de los pacientes con AR en la primera evaluación y en 86% en la segunda (p=0,12), sin modificación significativa en los valores (131±58,7 vs. 130,6±67,1 UI). Su sensibilidad y especificidad global fue de 94% y 92%, respectivamente, pero cuando sólo se consideraron los niveles altos (>60 UI) fueron de 84% y 95%, respectivamente. La razón de probabilidades (RP) positiva fue de 12 y la RP negativa de 0,06. El valor predictivo (VP) positivo fue de 87% y el VP negativo de 96%. Los anticuerpos anti-CCP se observaron en 12% de los pacientes con LES y con SSp, en 2% de los de EA y en 10% de los controles sanos. En los pacientes con AR no se asociaron con la actividad de la enfermedad, MEA y alelos del HLA-DRB1. Tampoco se observaron correlaciones significativas entre sus valores y los niveles de citocinas. En conclusión, los anticuerpos anti-CCP tienen un interés diagnó
- Published
- 2004
170. Effects of Amerindian Genetic Ancestry on Clinical Variables and Therapy in Patients with Rheumatoid Arthritis
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Sánchez, Elena, García de la Torre, Ignacio, Sacnún, Mónica, Goñi, Mario, Berbotto, Guillermo, Paira, Sergio, Musuruana, Jorge Luis, Graf, César, Alvarellos, Alejandro, Messina, Osvaldo D., Babini, Alejandra, Strusberg, Ingrid, Marcos, Juan Carlos, Scherbarth, Hugo, Spindler, Alberto, Quinteros, Ana, Toloza, Sergio, Moreno, José Luis C., Catoggio, Luis J., Tate, Guillermo, Eimon, Alicia, Citera, Gustavo, Pellet, Antonio Catalán, Nasswetter, Gustavo, Cardiel, Mario H., Miranda, Pedro, Ballesteros, Francisco, Esquivel-Valerio, Jorge A., Maradiaga-Ceceña, Marco A., Acevedo-Vásquez, Eduardo M., García, Conrado García, Tusié-Luna, Teresa, Pons-Estel, Bernardo A., and Alarcón-Riquelme, Marta E.
- Abstract
Objective.To define whether Amerindian genetic ancestry correlates with clinical and therapeutic variables in admixed individuals with rheumatoid arthritis (RA) from Latin America.Methods.Patients with RA (n = 1347) and healthy controls (n = 1012) from Argentina, Mexico, Chile, and Peru were included. Samples were genotyped for the Immunochip v1 using the Illumina platform. Clinical data were obtained through interviews or the clinical history.Results.Percentage of Amerindian ancestry was comparable between cases and controls. Morning stiffness (p < 0.0001, OR 0.05), rheumatoid factor (RF; p < 0.0001, OR 0.22), radiographic changes (p < 0.0001, OR 0.05), and higher number of criteria were associated with lower Amerindian ancestry after Bonferroni correction. Higher Amerindian ancestry correlated only with weight loss (pBonferroni< 0.0001, OR 2.85). Increased Amerindian ancestry correlated with higher doses of azathioprine (p < 0.0001, OR 163.6) and sulfasalazine (p < 0.0001, OR 48.6), and inversely with methotrexate (p = 0.001, OR 0.35), leflunomide (p = 0.001, OR 0.16), and nonsteroidal antiinflammatory drugs (pBonferroni= 0.001, OR 0.37). Only the presence of RF and weight loss were modified after confounders adjustment.Conclusion.Amerindian ancestry protects against most major clinical criteria of RA, but regarding the association of RF with increased European ancestry, age, sex, and smoking are modifiers. Ancestry also correlates with the therapeutic profiles.
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- 2017
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171. Differential Features Between Primary Ankylosing Spondylitis and Spondylitis Associated with Psoriasis and Inflammatory Bowel Disease
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PÉREZ ALAMINO, RODOLFO, primary, MALDONADO COCCO, JOSÉ A., additional, CITERA, GUSTAVO, additional, ARTURI, PABLO, additional, VAZQUEZ-MELLADO, JANITZIA, additional, SAMPAIO-BARROS, PERCIVAL D., additional, FLORES, DIANA, additional, BURGOS-VARGAS, RUBÉN, additional, SANTOS, HELENA, additional, CHAVEZ-CORRALES, JOSÉ E., additional, PALLEIRO, DANIEL, additional, GUTIERREZ, MIGUEL A., additional, VIEIRA-SOUSA, ELSA, additional, PIMENTEL-SANTOS, FERNANDO M., additional, PAIRA, SERGIO, additional, BERMAN, ALBERTO, additional, MORENO-ALVAREZ, MARIO, additional, and COLLANTES-ESTEVEZ, EDUARDO, additional
- Published
- 2011
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172. Work instability in rheumatoid arthritis patients from Argentina: prevalence and associated factors.
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Tamborenea, Maria, Pisoni, Cecilia, Toloza, Sergio, Mysler, Eduardo, Tate, Guillermo, Pereira, Dora, García Carrasco, M., Quintero, J., Cappuccio, A., Granel, A., Lazaro, M., Arturi, Pablo, Citera, Gustavo, Velazco Zamora, J., Saurit, Veronica, Alvarellos, A., Pons Estel, S., Danielsen, C., Graf, C., and Paira, Sergio
- Subjects
RHEUMATOID arthritis risk factors ,DISABILITIES ,LOGISTIC regression analysis ,PHYSIOLOGY ,RHEUMATOID arthritis ,PATIENTS - Abstract
To determine the prevalence of and associated factors to work instability (WI) in rheumatoid arthritis (RA) Argentinean patients. Observational cross-sectional study that assessing employment status in currently working RA patients. They answered the validated version of RA work instability scale (RA-WIS). High-risk WI was considered when RA-WIS was ≥17. Factors associated with high-risk WI were examined by univariable and multivariable analysis. Four-hundred and fifty RA patients were enrolled; of these, 205 patients were currently employed, but only 172 have completed questionnaires required [RA-WIS and health assessment questionnaire (HAQ-A)]. Their mean age was 49.3 ± 10.8 years; 81.3 % were female; and their mean disease duration was 8.1 ± 7.2 years. Fifty-two percent of patients were doing manual work. The mean RA-WIS score was 11.4 ± 6.8, and 41 % of patients had a high-risk WI. High-risk WI was associated with radiographic erosions ( p < 0.001) and HAQ-A >0.87 ( p < 0.001) in the univariable analysis, whereas in the multivariable logistic regression analysis the variables associated with a high-risk WI were as follows: HAQ-A >0.87 [odds ratio (OR) 12.31; 95 % CI 5.38-28.18] and the presence of radiographic erosions (OR 4.848; 95 % CI 2.22-10.5). In this model, having a higher monthly income (OR 0.301; 95 % CI 0.096-0.943) and a better functional class (OR 0.151; 95 % CI 0.036-0.632) were protective. Forty-one percent of RA working patients had high-risk WI. The predictors of high RA-WIS were HAQ-A ≥0.87 and radiographic erosions, whereas having a better functional class and have higher incomes were protective. [ABSTRACT FROM AUTHOR]
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- 2015
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173. Anticuerpos anti-CCP en artritis reumatoidea: relación con características clínicas, citocinas Th1/Th2 y HLA-DRB1.
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Correa, Paula A., primary, Tobón, Gabriel J., additional, Citera, Gustavo, additional, Cadena, José, additional, Schneeberger, Emilce, additional, Camargo, José F., additional, Maldonado-Cocco, José A., additional, and Anaya, Juan Manuel, additional
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- 2004
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174. Prevalence of psoriatic arthritis in psoriasis patients according to newer classification criteria.
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Ficco, Hernán, Citera, Gustavo, and Cocco, José
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PSORIATIC arthritis , *DISEASE prevalence , *PSORIASIS , *SPONDYLOARTHROPATHIES , *X-ray imaging , *NAILS (Anatomy) , *CLASSIFICATION - Abstract
The aim of this study is to determine the prevalence of psoriatic arthritis (PsA) according to Classification of Psoriatic Arthritis (CASPAR) criteria, Assessment of Spondyloarthritis International Society (ASAS) peripheral and axial SpA criteria, and New York criteria for AS. The first 100 patients consecutively attending a psoriasis dermatology clinic were assessed. Demographic and clinical data were collected; all patients were questioned and examined for joint manifestations. Rheumatoid factor and radiographies of hands, feet, cervical spine, and pelvis for sacroiliac joints were obtained. X-rays were read independently by two experienced observers in blind fashion. Patients with objective joint manifestations, both axial and peripheral, were evaluated for fulfillment of CASPAR, ASAS peripheral and axial, and New York criteria. Median age 48 years; 93 % of patients had psoriasis vulgaris and 56 % had nail involvement. Seventeen patients had peripheral arthritis as follows: nine mono/oligoarticular and eight polyarthritis. Median arthritis duration was of 8 years. Seventeen percent of patients fulfilled CASPAR and ASAS peripheral criteria, 6 % New York, and 5 % ASAS axial criteria. Patients who met CASPAR criteria showed a significantly higher psoriasis duration compared to those without arthritis (M 16 vs 10 years, p = 0.02), and a higher frequency of nail involvement (88.2 vs 49.4 %, p = 0.003). Five patients (29.4 %) fulfilled ASAS axial criteria; all of them had peripheral involvement as follows: mono/oligoarticular in three patients and polyarticular in two. Patients with peripheral and axial involvement presented a significantly higher frequency of erythrodermic psoriasis compared to the other patients (35.3 vs 1.2 %, p = 0.0006 and 80 vs 16.7 %, p = 0.02). Prevalence of PsA, for CASPAR and ASAS peripheral criteria, was of 17 %. Five percent of patients met ASAS axial criteria, while 6 % met New York criteria. Worth noting, few patients without signs or symptoms of arthritis had radiological changes, both axial and peripheral, precluding a proper classification. [ABSTRACT FROM AUTHOR]
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- 2014
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175. SASDAS: a practical tool to measure disease activity in axSpa patients. Comments on "a prospective study of novel disease activity indices for ankylosing spondylitis".
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Capelunsik, Dafne, Schneeberger, Emilce E., and Citera, Gustavo
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ANKYLOSING spondylitis ,LONGITUDINAL method ,MEASURING instruments - Abstract
Dear Editor, We read with interest the article "A prospective study of novel disease activity indices for ankylosing spondylitis" by T. G. Sundaram, et al. [[1]] This was an observational prospective study which aimed to explore the utility of two disease activity indices for patients with Ankylosing Spondylitis: the Simplified Ankylosing Spondylitis Disease Activity Score (SASDAS) and the Juvenile Spondyloarthritis Disease Activity Score (JSpADA). SASDAS: a practical tool to measure disease activity in axSpa patients. To support this argument, results from the performance analysis of the four indices (SASDAS ESR/CRP and ASDAS ESR/CRP) were showed as well as the SASDAS-CRP development process, results and its cut-off values. [Extracted from the article]
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- 2021
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176. Pulmonary involvement in rheumatoid arthritis
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Anaya, Juan-Manuel, primary, Diethelm, Lisa, additional, Ortiz, Luis A., additional, Gutierrez, Miguel, additional, Citera, Gustavo, additional, Welsh, Ronaldld A., additional, and Espinoza, Luis R., additional
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- 1995
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177. Treatment of psoriatic arthritis
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Cuéllar, Marta Lucía, primary, Citera, Gustavo, additional, and Espinoza, Luis R., additional
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- 1994
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178. Ethnic and Geographic Perspectives in SLE
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Citera, Gustavo, primary and Wilson, Wendell A., additional
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- 1993
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179. CANDIDA ARTHRITIS
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Silveira, Luis H., primary, Cuellar, Marta Lucia, additional, Citera, Gustavo, additional, Cabrera, Gonzalo E., additional, Scopelitis, Evangeline, additional, and Espinoza, Luis R., additional
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- 1993
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180. CHLAMYDIA-INDUCED REACTIVE ARTHRITIS
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Silveira, Luis H., primary, Gutiérrez, Francisco, additional, Scopelitis, Evangeline, additional, Cuéllar, Marta Lucía, additional, Citera, Gustavo, additional, and Espinoza, Luis R., additional
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- 1993
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181. OTHER FUNGAL ARTHRITIDES
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Cuéllar, Marta Lucía, primary, Silveira, Luis H., additional, Citera, Gustavo, additional, Cabrera, Gonzalo E., additional, and Valle, Rafael, additional
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- 1993
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182. Quality of life of patients with rheumatoid arthritis in Argentina: reliability, validity, and sensitivity to change of a Spanish version of the Rheumatoid Arthritis Quality of Life questionnaire.
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Waimann, Christian, Dal Pra, Fernando, Marengo, Maria, Schneeberger, Emilce, Gagliardi, Susana, Cocco, Jose, Sanchez, Mónica, Garone, A., Moral, Rafael, Rillo, Oscar, Salcedo, Mariana, Rosa, Javier, Ceballos, F., Soriano, Enrique, and Citera, Gustavo
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QUALITY of life ,RHEUMATOID arthritis ,RELIABILITY (Personality trait) ,VALIDITY of statistics ,SENSITIVITY & specificity (Statistics) ,QUESTIONNAIRES - Abstract
The Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire is the first needs-based instrument specifically designed to measure quality of life (QoL) of patients with rheumatoid arthritis (RA). The aims of our study were to develop an Argentinean version of the RAQoL and to determine its reproducibility, validity, and sensitivity to change in patients with RA. Translation process was performed according to internationally accepted methodology. Internal consistency and test-retest reliability were calculated. Criterion and construct validity were assessed by comparing the RAQoL with parameters of disease activity, the Health Assessment Questionnaire (HAQ), and the Medical Outcomes Study 36-item health survey (SF-36) questionnaire. Sensitivity to change was measured at 6-12 months using standardized response mean (SRM). The minimal important change was defined as a change of 1 or 1.96 times the standard error of measurement. A total of 97 patients with RA were included. Cronbach's α was 0.93, and test-retest reliability was 0.95. The RAQoL showed moderate to strong correlation with parameters of disease activity, the HAQ, and the SF-36. Functional status was the main determinant of patients' level of QoL. The SRM of the RAQoL was 0.24. Agreement between 20 % improvement in RAQoL and ACR20 response was moderate. Minimal important change was 2.2 (1 SEM) or 4.3 (1.96 SEM). The Argentinean version of the RAQoL is the first Spanish translation of this questionnaire. Our findings show it to be valid, reliable, and sensitive to changes in RA clinical status. [ABSTRACT FROM AUTHOR]
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- 2012
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183. Work Productivity in Rheumatoid Arthritis: Relationship with Clinical and Radiological Features.
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del Moral, Rafael Chaparro, Rillo, Oscar Luis, Casalla, Luciana, Morón, Carolina Bru, Citera, Gustavo, Maldonado Cocco, José A., de los Ángeles Correa, María, Buschiazzo, Emilio, Tamborenea, Natalia, Mysler, Eduardo, Tate, Guillermo, Baños, Andrea, and Herscovich, Natalia
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Objective. To assess the relationship between work productivity with disease activity, functional capacity, life quality and radiological damage in patients with rheumatoid arthritis (RA). Methods. The study included consecutive employed patients with RA (ACR'87), aged over 18. Demographic, disease-related, and work-related variables were determined. The reduction of work productivity was assessed by WPAI-RA. Results. 90 patients were evaluated, 71% women. Age average is 50 years old, DAS28 4, and RAQoL 12. Median SENS is 18 and HAQ-A 0.87. Mean absenteeism was of 14%, presenting an average of 6.30 work hours wasted weekly. The reduction in performance at work or assistance was of 38.4% and the waste of productivity was of 45%. Assistance correlated with DAS28 (r = 0.446; P < 0.001), HAQ-A (r = 0.545; P < 0.001) and RAQoL (r = 0.475; P < 0.001). Lower total productivity was noticed in higher levels of activity and functional disability. Patients with SENS > 18 showed lower work productivity than those with SENS < 18 (50 versus 34; P = 0.04). In multiple regression analysis, variables associated with reduction of total work productivity were HAQ-A and RAQoL. Conclusion. RA patients with higher disease severity showed higher work productivity compromise. [ABSTRACT FROM AUTHOR]
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- 2012
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184. Differential Features Between Primary Ankylosing Spondylitis and Spondylitis Associated with Psoriasis and Inflammatory Bowel Disease.
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Alamino, Rodolfo Pérez, Cocco, José A. Maldonado, Citera, Gustavo, Arturi, Pablo, Vazquez-Mellado, Janitzia, Sampaio-Barros, Percival D., Flores, Diana, Burgos-Vargas, Rubén, Santos, Helena, Chavez-Corrales, José E., Palleiro, Daniel, Gutierrez, Miguel A., Vieira-Sousa, Elsa, Pimentel-Santos, Fernando M., Paira, Sergio, Berman, Alberto, Moreno-Alvarez, Mario, and Collantes-Estevez, Eduardo
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- 2011
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185. Anti-20S Proteasome Antibodies in Psoriatic Arthritis
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Colmegna, Inés, Sainz, Bruno, Citera, Gustavo, Maldonado-Cocco, Jose, Garry, Robert, and Espinoza, Luis
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OBJECTIVE :Proteasomes are targets of humoral autoimmune response in patients with connective tissue diseases and other organ-specific autoimmune diseases. The finding of circulating proteasomes in psoriasis, the multiplicity of mechanisms regulated by proteasomes that are also implicated in the pathogenesis of psoriatic arthritis (PsA), and the increasing evidence linking PsA and autoimmunity led us to evaluate whether the 20S proteasome represents an antibody target in PsA. METHODS: Serum samples from 36 patients with PsA and 30 age- and sex-matched healthy subjects were tested for the presence of anti-20S proteasome antibodies (anti-20S antibody). Additional controls included 24 patients with systemic lupus erythematosus (SLE) and 20 with rheumatoid arthritis (RA). The associations of anti-20S antibodies with clinical, laboratory, and therapeutic measures were evaluated. RESULTS: 27.8% of the PsA patients were positive for anti-20S antibody compared to 41.6% of the SLE group and 5% of the RA group. None of the healthy subjects were seropositive for anti-20S antibody. In PsA, anti-20S seropositivity was not associated with the presence of other autoantibodies or with a particular subgroup of articular involvement. CONCLUSION: Immunoreactivity against proteasomes occurs frequently in patients with PsA. This finding supports the concept of PsA as an autoimmune disease and opens new avenues for investigating its pathogenesis.
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- 2008
186. Sicca/Sjögren's syndrome triggered by PD-1/PD-L1 checkpoint inhibitors. Data from the International Immunocancer Registry (ICIR)
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Manuel Ramos-Casals, Maria, A., Suarez-Almazor, M. E., Lambotte, O., Fisher, B. A., Hernandez-Molina, G., Guilpain, P., Pundole, X., Flores-Chavez, A., Baldini, C., Bingham, C. O., Brito-Zeron, P., Gottenberg, J. -E, Kostine, M., Radstake, T. R. D., Schaeverbeke, T., Schulze-Koops, H., Calabrese, L., Khamashta, M. A., Mariette, X., Kostov, Belchin, Calabrese, Cassandra, Retamozo, Soledad, Ma Aguilar, Eva, Richter, Michael David, Lidar, Merav, Fisher, Ben, Michot, Jean Marie, Liew, David, Heiberg, Marte Schrumpf, Danda, Debashish, Olsson, Peter, Suzuki, Yasunori, Citera, Gustavo, Kawano, Mitsuhiro, Kilickap, Saadettin, Arrieta, Oscar, Moca Trevisani, Virginia Fernandes, Praprotnik, Sonja, Horvath, Ildiko Fanny, and Azuma, Naoto
187. Oral Abstracts 7: RA ClinicalO37. Long-Term Outcomes of Early RA Patients Initiated with Adalimumab Plus Methotrexate Compared with Methotrexate Alone Following a Targeted Treatment Approach
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Fleischmann, Roy, van Vollenhoven, Ronald F., Smolen, Josef, Emery, Paul, Florentinus, Stefan, Rathmann, Suchitrita, Kupper, Hartmut, Kavanaugh, Arthur, Taylor, Peter, Genovese, Mark, Keystone, Edward C., Drescher, Edit, Berclaz, Pierre-Yves, Lee, Chin, Fidelus-Gort, Rosalind, Schlichting, Douglas, Beattie, Scott, Luchi, Monica, Macias, William, Dikranian, Ara H., Alten, Rieke, Klearman, Micki, Musselman, David, Agarwal, Sunil, Green, Jennifer, Gabay, Cem, Weinblatt, Michael E., Schiff, Michael H., Valente, Robert, van der Heijde, Desiree, Citera, Gustavo, Zhao, Cathy, Maldonado, Michael A., Rakieh, Chadi, Nam, Jacqueline L., Hunt, Laura, Villeneuve, Edith, Bissell, Lesley-Anne, Das, Sudipto, Conaghan, Philip, McGonagle, Dennis, Wakefield, Richard J., Wright, Helen L., Thomas, Huw B., Moots, Robert, Edwards, Steven W., Hamann, Philip, Heward, James, McHugh, Neil, Lindsay, Mark A., Haroon, Muhammad, Giles, Jon T., Winchester, Robert, FitzGerald, Oliver, Karaderi, Tugce, Cohen, Carla J., Keidel, Sarah, Appleton, Louise H., Macfarlane, Gary J., Siebert, Stefan, Evans, David, Paul Wordsworth, B., Plant, Darren, Bowes, John, Orozco, Gisela, Morgan, Ann W., Wilson, Anthony G., Isaacs, John, Barton, Anne, Williams, Frances M., Livshits, Gregory, Spector, Tim, MacGregor, Alexander, Scollen, Serena, Cao, Dandan, Memari, Yasin, Hyde, Craig L., Zhang, Baohong, Sidders, Benjamin, Ziemek, Daniel, Shi, Yujian, Harris, Juliette, Harrow, Ian, Dougherty, Brian, Malarstig, Anders, McEwen, Robert, Stephens, Joel L., Patel, Ketan, Shin, So-Youn, Surdulescu, Gabriela, He, Wen, Jin, Xin, McMahon, Stephen B., Soranzo, Nicole, John, Sally, Wang, Jun, Spector, Tim D., Baker, Jonathan, Litherland, Gary J., Rowan, Andrew D., Kite, Kerry A., Bayley, Rachel, Yang, Peiming, Smith, Jacqueline P., Williams, Julie, Harper, Lorraine, Kitas, George D., Buckley, Christopher, Young, Stephen P., Fitzpatrick, Martin A., McGettrick, Helen M., Filer, Andrew, Raza, Karim, Nash, Gerard, Muthana, Munitta, Davies, Holly, Khetan, Sachin, Adeleke, Gbadebo, Hawtree, Sarah, Tazzyman, Simon, Morrow, Fiona, Ciani, Barbara, Wilson, Gerry, Quirke, Anne-Marie, Lugli, Elena, Wegner, Natalia, Charles, Peter, Hamilton, Bart, Chowdhury, Muslima, Ytterberg, Jimmy, Potempa, Jan, Fisher, Benjamin, Thiele, Geoffrey, Mikuls, Ted, Venables, Patrick, Adebajo, Adewale O., Mease, Philip, Gomez-Reino, Juan J., Wollenhaupt, Jurgen, Hu, ChiaChi, Stevens, Randall, Sieper, Joachim, Dougados, Maxime, Van den Bosch, Filip, Goupille, Philippe, Rathmann, Suchitrita S., Pangan, Aileen L., Maksymowych, Walter P., Brown, Matthew A., Elewaut, Dirk, Anderson, Jaclyn, Ramasamy, Pathma, O'Rourke, Michael, Murphy, Conor, Fitzgerald, Oliver, Jani, Meghna, Moore, Sarah, Mirjafari, Hoda, Macphie, Elizabeth, Chinoy, Hector, Rao, Chan, McLoughlin, Yokemei, Preeti, Shah, Fleischmann, Roy, van Vollenhoven, Ronald F., Smolen, Josef, Emery, Paul, Florentinus, Stefan, Rathmann, Suchitrita, Kupper, Hartmut, Kavanaugh, Arthur, Taylor, Peter, Genovese, Mark, Keystone, Edward C., Drescher, Edit, Berclaz, Pierre-Yves, Lee, Chin, Fidelus-Gort, Rosalind, Schlichting, Douglas, Beattie, Scott, Luchi, Monica, Macias, William, Dikranian, Ara H., Alten, Rieke, Klearman, Micki, Musselman, David, Agarwal, Sunil, Green, Jennifer, Gabay, Cem, Weinblatt, Michael E., Schiff, Michael H., Valente, Robert, van der Heijde, Desiree, Citera, Gustavo, Zhao, Cathy, Maldonado, Michael A., Rakieh, Chadi, Nam, Jacqueline L., Hunt, Laura, Villeneuve, Edith, Bissell, Lesley-Anne, Das, Sudipto, Conaghan, Philip, McGonagle, Dennis, Wakefield, Richard J., Wright, Helen L., Thomas, Huw B., Moots, Robert, Edwards, Steven W., Hamann, Philip, Heward, James, McHugh, Neil, Lindsay, Mark A., Haroon, Muhammad, Giles, Jon T., Winchester, Robert, FitzGerald, Oliver, Karaderi, Tugce, Cohen, Carla J., Keidel, Sarah, Appleton, Louise H., Macfarlane, Gary J., Siebert, Stefan, Evans, David, Paul Wordsworth, B., Plant, Darren, Bowes, John, Orozco, Gisela, Morgan, Ann W., Wilson, Anthony G., Isaacs, John, Barton, Anne, Williams, Frances M., Livshits, Gregory, Spector, Tim, MacGregor, Alexander, Scollen, Serena, Cao, Dandan, Memari, Yasin, Hyde, Craig L., Zhang, Baohong, Sidders, Benjamin, Ziemek, Daniel, Shi, Yujian, Harris, Juliette, Harrow, Ian, Dougherty, Brian, Malarstig, Anders, McEwen, Robert, Stephens, Joel L., Patel, Ketan, Shin, So-Youn, Surdulescu, Gabriela, He, Wen, Jin, Xin, McMahon, Stephen B., Soranzo, Nicole, John, Sally, Wang, Jun, Spector, Tim D., Baker, Jonathan, Litherland, Gary J., Rowan, Andrew D., Kite, Kerry A., Bayley, Rachel, Yang, Peiming, Smith, Jacqueline P., Williams, Julie, Harper, Lorraine, Kitas, George D., Buckley, Christopher, Young, Stephen P., Fitzpatrick, Martin A., McGettrick, Helen M., Filer, Andrew, Raza, Karim, Nash, Gerard, Muthana, Munitta, Davies, Holly, Khetan, Sachin, Adeleke, Gbadebo, Hawtree, Sarah, Tazzyman, Simon, Morrow, Fiona, Ciani, Barbara, Wilson, Gerry, Quirke, Anne-Marie, Lugli, Elena, Wegner, Natalia, Charles, Peter, Hamilton, Bart, Chowdhury, Muslima, Ytterberg, Jimmy, Potempa, Jan, Fisher, Benjamin, Thiele, Geoffrey, Mikuls, Ted, Venables, Patrick, Adebajo, Adewale O., Mease, Philip, Gomez-Reino, Juan J., Wollenhaupt, Jurgen, Hu, ChiaChi, Stevens, Randall, Sieper, Joachim, Dougados, Maxime, Van den Bosch, Filip, Goupille, Philippe, Rathmann, Suchitrita S., Pangan, Aileen L., Maksymowych, Walter P., Brown, Matthew A., Elewaut, Dirk, Anderson, Jaclyn, Ramasamy, Pathma, O'Rourke, Michael, Murphy, Conor, Fitzgerald, Oliver, Jani, Meghna, Moore, Sarah, Mirjafari, Hoda, Macphie, Elizabeth, Chinoy, Hector, Rao, Chan, McLoughlin, Yokemei, and Preeti, Shah
- Abstract
Background: This analysis assessed, on a group level, whether there is a long-term advantage for early RA patients treated with adalimumab (ADA) + MTX vs those initially treated with placebo (PBO) + MTX who either responded to therapy or added ADA following inadequate response (IR). Methods: OPTIMA was a 78- week, randomized, controlled trial of ADA + MTX vs PBO + MTX in MTX-naïve early (<1 year) RA patients. Therapy was adjusted at week 26: ADA + MTX-responders (R) who achieved DAS28 (CRP) <3.2 at weeks 22 and 26 (Period 1, P1) were re-randomized to withdraw or continue ADA and PBO + MTX-R continued randomized therapy for 52 weeks (P2); IR-patients received open-label (OL) ADA + MTX during P2. This post hoc analysis evaluated the proportion of patients at week 78 with DAS28 (CRP) <3.2, HAQ-DI <0.5, and/or ΔmTSS ≤0.5 by initial treatment. To account for patients who withdrew ADA during P2, an equivalent proportion of R was imputed from ADA + MTX-R patients. Results: At week 26, significantly more patients had low disease activity, normal function, and/or no radiographic progression with ADA + MTX vs PBO + MTX (Table 1). Differences in clinical and functional outcomes disappeared following additional treatment, when PBO + MTX-IR (n = 348/460) switched to OL ADA + MTX. Addition of OL ADA slowed radiographic progression, but more patients who received ADA + MTX from baseline had no radiographic progression at week 78 than patients who received initial PBO + MTX. Conclusions: Early RA patients treated with PBO + MTX achieved comparable long-term clinical and functional outcomes on a group level as those who began ADA + MTX, but only when therapy was optimized by the addition of ADA in PBO + MTX-IR. Still, ADA + MTX therapy conferred a radiographic benefit although the difference did not appear to translate to an additional functional benefit. Disclosures: P.E., AbbVie, Merck, Pfizer, UCB, Roche, BMS—Provided Expert Advice, Undertaken Trials, AbbVie—AbbVie sponsored the
188. Tasas de promoción, repitencia y abandono en la Carrera de Especialistas en Reumatología en la Ciudad de Buenos Aires.
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Cosentino, Vanesa Laura, Casado, Gustavo, Gobbi, Carla, Secco, Anastasia, Romanini, Félix, Citera, Gustavo, Rosemffet, Marcos, Papasidero, Silvia, Medina, María Alejandra, Bande, Juan Manuel, Roberts, Karen, Brigante, Alejandro, Pons Estel, Guillermo, de la Vega, María Celina, Sequeira, Gabriel, and Kerzberg, Eduardo Mario
- Abstract
To evaluate the trajectory of students enrolled in the specialty training in rheumatology. Retrospective analysis (2009-2016). Promotion, repetition, and dropout rates were determined. Analysis was performed to define variables associated with academic success. Out of 119 students, the actual promotion rate was 66.4%, 11.8% failed an exam (at least) and completed the course after the stipulated time, and the dropout rate was 7.6%. Among residents, the promotion rate was 82.5% vs. 48.2% among the rest (P <.001), the lagging students' repetition rate was 3.2% vs. 21.4% among the rest (P =.005), and the dropout rate was 3.2% vs. 12.5% among the rest (P =.06). A higher average score in medical school increased the chances of success in the postgraduate programme (OR: 3.41; 95% C I: 2.0-6.4; P <.001). The residency was associated with higher rates of academic success in postgraduate studies. The average score in medical school can help identify students at risk of failure. [ABSTRACT FROM AUTHOR]
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- 2024
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189. Hyposalivation and periodontal disease as oral non-articular characteristics in rheumatoid arthritis.
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González, Débora A., Bianchi, María L., Armada, Mariana, Escalante, Angélica Castro, Salgado, Pablo A., Seni, Sabrina, Citera, Gustavo, Ferrary, Teresita, and Orman, Betina
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PERIODONTAL disease , *RHEUMATOID arthritis , *ORAL diseases , *XEROSTOMIA , *DYSAUTONOMIA - Abstract
Objective: To investigate the association among rheumatoid arthritis (RA), saliva production, and periodontal status. Methods: An observational study was carried out on 103 subjects with RA and 103 without RA matched by sex and age. Rheumatologic evaluation included serological and clinical variables. A full mouth periodontal examination was performed according to the American Academy of Periodontology (1999). Resting and stimulated whole salivary flows were determined after spiting during 5 min. Results: RA was associated with a higher prevalence of severe periodontitis (12% vs. 4%), with a marked reduction in resting and stimulated saliva production, and with a higher prevalence of resting (19% vs. 0%) and also stimulated hyposalivation (54% vs. 10%), compared with the control group. The differences in mean resting and stimulated salivary flows between RA and control groups persisted after the exclusion of people with hyposalivation. Saliva production was not associated with the presence or the severity of periodontal disease, or with the rheumatic clinical characteristics of the patients. Conclusions: More than 50% of people with RA have some degree of reduction in their salivary flows, an affection not associated with the periodontal status or rheumatic activity, which are the expression of the two related inflammatory diseases. The influence of autonomic dysfunction on hyposalivation can be considered. While periodontitis would be a disease-associated comorbidity of RA, poor saliva production should be included among the extra-articular manifestations. Key Points • Rheumatoid arthritis patients are more prone to suffer from periodontitis and/or hyposalivation. • Periodontal disease is more prevalent in people with rheumatoid arthritis and also an association was found between the severities of both pathologies. • More than 50% of people with RA would have some degree of reduction in their salivary flows, an affection not associated with the periodontal status or rheumatic activity. • Reduced saliva production in rheumatoid arthritis patients should be included among the extra-articular manifestations. [ABSTRACT FROM AUTHOR]
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- 2024
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190. Sustained Remission and Outcomes with Abatacept plus Methotrexate Following Stepwise Dose De-escalation in Patients with Early Rheumatoid Arthritis.
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Emery, Paul, Tanaka, Yoshiya, Bykerk, Vivian P., Huizinga, Thomas W. J., Citera, Gustavo, Bingham 3rd, Clifton O., Banerjee, Subhashis, Soule, Benjamin P., Nys, Marleen, Connolly, Sean E., Lozenski, Karissa L., Zhuo, Joe, Wong, Robert, Huang, Kuan-Hsiang Gary, and Fleischmann, Roy
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ABATACEPT , *DISEASE remission , *RHEUMATOID arthritis , *AUTOIMMUNE diseases , *METHOTREXATE , *PATIENT reported outcome measures - Abstract
Introduction: One target of rheumatoid arthritis (RA) treatment is to achieve early sustained remission; over the long term, patients in sustained remission have less structural joint damage and physical disability. We evaluated Simplified Disease Activity Index (SDAI) remission with abatacept + methotrexate versus abatacept placebo + methotrexate and impact of de-escalation (DE) in anti-citrullinated protein antibody (ACPA)-positive patients with early RA. Methods: The phase IIIb, randomized, AVERT-2 two-stage study (NCT02504268) evaluated weekly abatacept + methotrexate versus abatacept placebo + methotrexate. Primary endpoint: SDAI remission (≤ 3.3) at week 24. Pre-planned exploratory endpoint: maintenance of remission in patients with sustained remission (weeks 40 and 52) who, from week 56 for 48 weeks (DE period), (1) continued combination abatacept + methotrexate, (2) tapered abatacept to every other week (EOW) + methotrexate for 24 weeks with subsequent abatacept withdrawal (abatacept placebo + methotrexate), or (3) withdrew methotrexate (abatacept monotherapy). Results: Primary study endpoint was not met: 21.3% (48/225) of patients in the combination and 16.0% (24/150) in the abatacept placebo + methotrexate arm achieved SDAI remission at week 24 (p = 0.2359). There were numerical differences favoring combination therapy in clinical assessments, patient-reported outcomes (PROs) and week 52 radiographic non-progression. After week 56, 147 patients in sustained remission with abatacept + methotrexate were randomized (combination, n = 50; DE/withdrawal, n = 50; abatacept monotherapy, n = 47) and entered DE. At DE week 48, SDAI remission (74%) and PRO improvements were mostly maintained with continued combination therapy; lower remission rates were observed with abatacept placebo + methotrexate (48.0%) and with abatacept monotherapy (57.4%). Before withdrawal, de-escalating to abatacept EOW + methotrexate preserved remission. Conclusions: The stringent primary endpoint was not met. However, in patients achieving sustained SDAI remission, numerically more maintained remission with continued abatacept + methotrexate versus abatacept monotherapy or withdrawal. Trial Registration: ClinicalTrials.gov identifier, NCT02504268. 6DHXqidsCNRrz-f8FYdsgJ Video abstract (MP4 62241 KB) Plain Language Summary: Patients with rheumatoid arthritis (RA) experience inflamed and damaged joints. RA is an autoimmune disease in which proteins called autoantibodies, particularly anti-citrullinated protein autoantibodies, target the patient's own joint tissue and organs by mistake, leading to symptomatic inflammation. Successful treatment can decrease the disease's activity to a state known as remission. Patients in remission may experience little or no symptoms and it may be possible for some to then be able to decrease their treatment. Here, we report the results of a large, international study that looked at two treatments, abatacept and methotrexate, in patients with RA and anti-citrullinated protein autoantibodies. The study had two parts. Firstly, to see how many patients had success (remission) with weekly abatacept and/or methotrexate treatment, and secondly, to see if remission was maintained when treatment was either continued or decreased and stopped. The study showed that the number of patients in remission 6 months after treatment started was not greatly different between patients treated with both abatacept and methotrexate and those treated with just methotrexate. Those taking abatacept and methotrexate together had better remission rates 1 year later. More patients also stayed in remission when they continued to receive both abatacept and methotrexate compared with those who were just treated with abatacept or when their abatacept treatment was decreased and stopped. More patients stayed in remission when abatacept was decreased than when it was stopped. The results from this study may help determine possible future treatment reduction and/or withdrawal plans for some patients with RA. [ABSTRACT FROM AUTHOR]
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- 2023
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191. Tofacitinib, an oral Janus kinase inhibitor, for the treatment of Latin American patients with rheumatoid arthritis: Pooled efficacy and safety analyses of Phase 3 and long-term extension studies.
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Radominski, Sebastião Cezar, Cardiel, Mario Humberto, Citera, Gustavo, Goecke, Annelise, Jaller, Juan Jose, Vannucci Lomonte, Andrea Barranjard, Miranda, Pedro, Velez, Patricia, Xibillé, Daniel, Kwok, Kenneth, Rojo, Ricardo, and García, Erika Gabriela
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JANUS kinases , *PROTEIN-tyrosine kinases , *AUTOIMMUNE diseases , *RHEUMATISM , *NILOTINIB - Abstract
Objective: Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We assessed tofacitinib efficacy and safety in the Latin American (LA) subpopulation of global Phase 3 and long-term extension (LTE) studies. Materials and methods: Data from LA patients with RA and inadequate response to disease-modifying antirheumatic drugs (DMARDs) were pooled across five Phase 3 studies. Phase 3 patients received tofacitinib 5 or 10mg twice daily (BID), adalimumab or placebo; patients in the single LTE study received tofacitinib 5 or 10mg BID; treatments were administered alone or with conventional synthetic DMARDs. Efficacy was reported up to 12 months (Phase 3) and 36 months (LTE) by American College of Rheumatology (ACR) 20/50/70 response rates, Disease Activity Score (DAS)28-4(erythrocyte sedimentation rate [ESR]) and Health Assessment Questionnaire-Disability Index (HAQ-DI). Incidence rates (IRs; patients with event/100 patient-years) of adverse events (AEs) of special interest were reported. Results: The Phase 3 studies randomized 496 LA patients; the LTE study enrolled 756 LA patients from Phase 2 and Phase 3. In the Phase 3 studies, patients who received tofacitinib 5 and 10mg BID showed improvements vs placebo at Month 3 in ACR20 (68.9% and 75.7% vs 35.6%), ACR50 (45.8% and 49.7% vs 20.7%) and ACR70 (17.5% and 23.1% vs 6.9%) responses, mean change from baseline in HAQ-DI (-0.6 and -0.8 vs -0.3) and DAS28-4(ESR) score (-2.3 and -2.4 vs -1.4). The improvements were sustained up to Month 36 in the LTE study. In the Phase 3 studies, IRs with tofacitinib 5 and 10mg BID and placebo were 7.99, 6.57 and 9.84, respectively, for SAEs, and 3.87, 5.28 and 3.26 for discontinuation due to AEs. IRs of AEs of special interest in tofacitinib-treated LA patients were similar to the global population. Conclusion: In Phase 3 and LTE studies in LA patients with RA, tofacitinib demonstrated efficacy up to 36 months with a manageable safety profile up to 60 months, consistent with the overall tofacitinib study population. [ABSTRACT FROM AUTHOR]
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- 2017
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192. Routine Assessment of Patient Index Data 3 (RAPID3) in Patients with Rheumatoid Arthritis Treated with Long-Term Upadacitinib Therapy in Five Randomized Controlled Trials.
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Bergman, Martin, Buch, Maya H., Tanaka, Yoshiya, Citera, Gustavo, Bahlas, Sami, Wong, Ernest, Song, Yanna, Zueger, Patrick, Ali, Mira, and Strand, Vibeke
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RHEUMATOID arthritis , *ANTIRHEUMATIC agents , *C-reactive protein , *RANK correlation (Statistics) , *DISABILITIES - Abstract
Introduction: The Routine Assessment of Patient Index Data 3 (RAPID3) is a patient-reported outcome tool recommended for the assessment of disease activity in patients with rheumatoid arthritis (RA) in clinical practice. This analysis evaluated the long-term effect of upadacitinib vs. comparators on RAPID3 scores in patients with RA in the phase 3 SELECT clinical trial program. Methods: This post hoc analysis included data from five randomized controlled trials (RCTs) in patients receiving upadacitinib 15 mg or 30 mg once daily (QD) as monotherapy or in combination with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). The proportions of patients reporting RAPID3 remission (scores ≤ 3) were assessed at week 60. Correlations between absolute scores for RAPID3 and Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI), and 28-joint Disease Activity Score with C-reactive protein (DAS28[CRP]) at week 60 were assessed using Spearman correlation coefficients. Results: A total of 3117 patients were included from the SELECT-NEXT, -BEYOND, -MONOTHERAPY, -COMPARE, and -EARLY trials. By week 60, 32–52% of methotrexate-naïve and csDMARD inadequate responder (IR) patients treated with either upadacitinib 15 mg QD or upadacitinib 30 mg QD reported RAPID3 scores consistent with remission. The proportions were slightly lower in the biologic DMARD-IR SELECT-BEYOND population (19–28%). RAPID3 scores highly correlated (Spearman correlation values ≥ 0.58) with CDAI, SDAI, and DAS28(CRP) scores through week 60 (all p < 0.001). Conclusions: Upadacitinib, as monotherapy or in combination with csDMARDs, was associated with patient-reported remission assessed by RAPID3 over 60 weeks across the SELECT RCTs in patients with RA. Trial registration: SELECT-BEYOND (NCT02706847); SELECT-NEXT (NCT02675426); SELECT-MONOTHERAPY (NCT02706951); SELECT-EARLY (NCT02706873); SELECT-COMPARE (NCT02629159). Plain Language Summary: Rheumatoid arthritis (RA) is a disease that causes inflammation of the joints. Doctors have several ways of assessing how bad a patient's disease is, and these often use a combination of signs and symptoms to develop a 'score'. One method is called RAPID3, which is a score based on an overall assessment of the disease by the patient, the level of pain, and the amount of physical disability. An advantage of RAPID3 is that it is quick and easy to use, and since it uses only patient-reported symptoms, it can be measured easily via telemedicine, without the need for an in-person consultation. In this study, we decided to look into the effect of upadacitinib, a drug used for the treatment of RA, on RAPID3 score in patients with RA. We also investigated whether RAPID3 correlates with other ways of measuring RA severity, including scores that use physician-measured factors such as number of affected joints, as this can help show whether RAPID3 is a valid and useful tool. We found that upadacitinib led to long-term improvements in RAPID3 score, and that results were the same in different studies and patient groups, including patients who had not responded well to other treatments. We also found that RAPID3 correlated well with other measures, i.e., improvements in RAPID3 happened in parallel with improvements in other scores. Overall, these results suggest that RAPID3 can be a useful tool in patients with RA. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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193. Disease activity and subcutaneous nodules are associated to severe periodontitis in patients with rheumatoid arthritis.
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González, Débora A., Bianchi, María L., Salgado, Pablo A., Armada, Mariana, Seni, Sabrina, Isnardi, Carolina A., Citera, Gustavo, Ferrary, Teresita, and Orman, Betina
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PERIODONTITIS , *RHEUMATOID arthritis , *BLOOD sedimentation , *DISEASE duration , *RHEUMATOID factor , *PERIODONTAL disease - Abstract
Rheumatoid arthritis (RA) was significantly associated with increased overall risk of periodontitis, both chronic, inflammatory pathologies leading to connective tissue breakdown and bone destruction. To identify clinical and/or serological variables routinely evaluated during follow-up of people with RA which are associated with the severity of their periodontal disease. An observational, cross-sectional study was carried out, which included RA patients according to ACR/EULAR 2010 criteria having chronic periodontal disease. RA clinical parameters (disease duration, erythrocyte sedimentation rate, serum C-reactive protein, disease activity (DAS28) and rheumatoid factor, presence of bone erosions and rheumatic nodules) and also corticosteroid therapy were considered. Periodontitis was evaluated according to the American Academy of Periodontology (1999) and chronic periodontitis was assessed by full mouth periapical radiographic examination, periodontal probing depth, clinical attachment level and bleeding index. A total of 110 subjects with RA and chronic periodontitis were included. The female/male relation was 5.1, and no significant differences between genres were found in rheumatic or oral variables. RA patients with longer disease duration, higher disease activity and with rheumatic nodules had significantly greater periodontitis severity. Multivariate analysis confirmed that severe periodontitis was associated with DAS283 4.1 (OR 51.4, CI 95% 9.4–281.5) and the presence of rheumatic nodules (OR 6.4, CI 95% 1.3–31.6). Disease activity and rheumatic nodules were strongly associated with severe periodontitis. Based on these findings it would be desirable to include interdisciplinary management at an early stage of RA to ensure comprehensive treatment of both pathologies [ABSTRACT FROM AUTHOR]
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- 2022
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194. Adherencia al tratamiento con tofacitinib en pacientes con artritis reumatoide en la práctica clínica diaria.
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Barbich, Tatiana, Cerda, Osvaldo Luis, Schneeberger, Emilce Edith, and Citera, Gustavo
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PATIENT compliance , *FISHER exact test , *DISEASE duration , *MULTIVARIATE analysis , *DESCRIPTIVE statistics - Abstract
Evaluar la adherencia al tratamiento con tofacitinib en pacientes con artritis reumatoide (AR) mediante las dos versiones del autocuestionario Compliance Questionnaire Rheumatology , CQR19 y CQR5, determinar las variables asociadas a la adherencia a tofacitinib y comparar el rendimiento de ambos cuestionarios. Estudio de corte transversal. Se incluyeron pacientes ≥ 18 años de edad con AR (ACR/EULAR 2010) en tratamiento con tofacitinib. Se consignaron datos sociodemográficos, características clínicas de la enfermedad, tratamientos y datos sobre la evaluación de los pacientes. Todos los pacientes completaron los autocuestionarios CQR19 y CQR5. Análisis estadístico : Estadística descriptiva. T-test o Mann Whitney para variables continuas y test de chi cuadrado o test exacto de Fisher para las categóricas. Índice de concordancia kappa. Regresión logística múltiple. Se incluyeron 52 pacientes, 82,7% mujeres, con una edad mediana (m) de 57,7 años, tiempo de evolución de la enfermedad m 16 años. El 63,5% presentaban comorbilidades. El 86,5% de los pacientes estaban tratados con tofacitinib (5 mg dos veces/día) y el 48% recibía tofacitinib en monoterapia. El tiempo m de tratamiento con tofacitinib fue de 13 meses. El 42,3% suspendieron el tratamiento y un solo paciente suspendió definitivamente por falta de provisión. La m de CQR19 fue del 89,5%, y el 84,6% de los pacientes presentaron una adherencia ≥ 80%. Las variables significativamente asociadas con adherencia ≥ 80% fueron la presencia de comorbilidades (p = 0,014) y mayor edad (p = 0,033). Considerando el CQR5, un porcentaje similar de pacientes (82,7%) fueron adherentes al tratamiento, aunque la concordancia con CQR19 fue baja (ƙ: 0,227). En el análisis multivariado, mayor edad fue la única variable independientemente asociada a buena adherencia al tratamiento (p = 0,037). La adherencia al tratamiento con tofacitinib, en ambas formulaciones, fue muy buena. Mayor edad se asoció con mejor adherencia al tratamiento. La concordancia entre los cuestionarios CQR19 y CQR5 fue baja. To evaluate the adherence to treatment with tofacitinib in patients with rheumatoid arthritis (RA) using two versions of the self-questionnaire Compliance Questionnaire Rheumatology, CQR19 and CQR5, to determine the variables associated with adherence to tofacitinib and to compare the performance of both questionnaires. A cross-sectional study was carried out. We included patients ≥ 18 years old, with RA (ACR/EULAR criteria 2010) under treatment with tofacitinib. Sociodemographic data, clinical characteristics, treatment and data on patient evaluation. All the patients completed self-questionnaires CQR19 and CQR5. Statistical analysis: Descriptive statistics. T-test or Mann Whitney to compare the continuous variables, chi2 test or Fisher's exact test for the categorical ones. Kappa concordance index. Multiple logistic regression. We included 52 patients, 82.7% women, with a median (m) age of 57.7 years, disease duration m 16 years, 63.5% had comorbidities. Of the patients, 86.5% were treated with tofacitinib (5 mg BID) and 48% received tofacitinib as monotherapy. The median time of tofacitinib treatment was 13 months, 42.3% suspended treatment, and only one patient permanently stopped treatment due to lack of provision. Median CQR19 was 89.5%, and 84.6% had an adherence ≥ 80%. The variables significantly associated with adherence ≥ 80% were the presence of comorbidities (P =.014) and older age (P =.033). Considering the CQR5, a similar percentage of patients (82.7%) were adherents to treatment, however, the concordance with CQR19 was low. In the multivariate analysis, older age was the only variable independently associated with good adherence to treatment. Treatment adherence to tofacitinib was very good for both presentations. Older age was associated with higher adherence. The agreement between the questionnaires CQR19 and CQR5 was low. [ABSTRACT FROM AUTHOR]
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- 2022
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195. Effect of Tocilizumab on LDL and HDL Characteristics in Patients with Rheumatoid Arthritis. An Observational Study.
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Pierini, Florencia S., Botta, Eliana, Soriano, Enrique R., Martin, Maximiliano, Boero, Laura, Meroño, Tomás, Saez, María Soledad, Lozano Chiappe, Ezequiel, Cerda, Osvaldo, Citera, Gustavo, Gandino, Ignacio, Rosa, Javier, Sorroche, Patricia, Kontush, Anatol, and Brites, Fernando
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RHEUMATOID arthritis , *LOW density lipoproteins , *TOCILIZUMAB , *HIGH density lipoproteins , *DYSLIPIDEMIA , *LDL cholesterol - Abstract
Background: In patients with rheumatoid arthritis (RA), qualitative alterations of low and high-density lipoproteins (LDL and HDL, respectively) might partially explain their increased cardiovascular risk. Tocilizumab has been associated with an increase in lipids, including triglyceride (TG) and cholesterol levels. The aim of this study is to evaluate the effect of tocilizumab on certain LDL and HDL characteristics (oxidized LDL levels, HDL-associated enzymes, chemical composition of both total HDL and HDL3c subpopulation, and their capacity to promote cellular cholesterol efflux) at baseline and 3 months after the start of treatment in patients with RA. Methods: Twenty-eight RA patients (ACR/EULAR 2010 criteria) with indication of treatment with tocilizumab were included in the present study. Clinical assessment [Health assessment questionnaire (HAQ)], disease activity score 28 (DAS28), high-sensitivity C reactive protein (hsCRP) concentration, lipid profile, and lipoprotein (a) [Lp(a)] levels were evaluated in all patients at baseline and after 3 months of treatment with tocilizumab. Lipoprotein characteristics were evaluated through the levels of oxidized LDL (OxLDL), the activity of paraoxonase (PON) 1, the composition of total HDL and small, dense HDL3c subpopulation, and their ability to promote cellular cholesterol efflux. Results: After 3 months of treatment with tocilizumab, HAQ (− 23%, p < 0.05), DAS28 (− 49%, p < 0.001), and hsCRP (− 94%, p < 0.01) levels decreased significantly. Total cholesterol (TC), LDL-C, non-HDL-C, and apo B levels showed a significant increase after treatment (TC: + 7.0%, p < 0.01; LDL-C: + 10%, p < 0.01; non-HDL-C: + 9.9%, p < 0.01; and apo B: + 9.6%, p < 0.05). Decreases in Lp(a) and OxLDL levels were also observed after treatment [Lp(a): − 50%, p < 0.01; and oxLDL: − 5.4%, p < 0.05]. The latter was in accordance with the increment detected in PON activity. No changes were observed in HDL capacity to promote cholesterol efflux (p > 0.05) in the whole group. Conclusions: Treatment with tocilizumab reduced hsCRP levels and displayed positive effects on certain lipoprotein-related parameters, such as a potent decrease inLp(a) and a reduction in OxLDL levels. Moreover, HDL capacity to promote cellular cholesterol efflux was maintained after 3 months of treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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196. A useful tool to assess quality of LIFE in rheumatoid arthritis patients that does not require a license: QOL-RA II.
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Isnardi, Carolina Ayelen, Schneeberger, Emilce Edith, Capelusnik, Dafne, de los Ángeles Correa, María, Lim, Romina, Hu, María, Tapia, María Janina, Kerzberg, Eduardo, Blanco, Eliana, Benavidez, Federico Luján, Gonzales Lucero, Luciana, Barbaglia, Ana Lucía, Bazzarelli, Marcela, Ficco, Hernán Maldonado, Pérez, Silvana, Hartvig, Claudia, Salcedo, Mariana, and Citera, Gustavo
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QUALITY of life , *RHEUMATOID arthritis , *CRONBACH'S alpha , *DISEASE duration , *PHYSICAL activity - Abstract
To validate the Quality of Life-Rheumatoid Arthritis Scale II (QOL-RA II) in an Argentinean cohort of patients with rheumatoid arthritis (RA). Patients ≥ 18 years old, with a diagnosis of RA according to ACR-EULAR 2010 criteria, were included in a cross-sectional study. Sociodemographic data, comorbidities, RA characteristics, disease activity, and current treatment were registered. Questionnaires were administered, including EQ-5D-3 L, QOL-RA II, HAQ-A, and PHQ-9. The QOL-RA II was re-administered in 20 patients to evaluate reproducibility. Four hundred and thirty patients were included. Median QOL-RA was 6.6 (IQR 5.3–8). Mean time to complete it was 1.7 ± 0.57 min and to calculate it was 12 ± 1.7 s. It showed very good reliability (Cronbach's alpha 0.97), reproducibility (ICC, 0.96), and good correlation between the different items and the total questionnaire, without evidence of redundancy. Besides, QOL-RA II presented good correlation with EQ-5D-3L (Rho, 0.6) and moderate with DAS28 (Rho, 0.38), and CDAI (Rho, 0.46). Worse quality of life was observed in patients not doing physical activity, unemployed, and current smokers. Patients with higher disease activity had a significant poorer quality of life. Adjusting by age, sex and disease duration, unemployment, higher disease activity, disability, and the presence of depression were independently associated to worse quality of life. QOL-RA II demonstrated good construct validity, reproducibility, and reliability. It was easy to complete and calculate and does not require a license for its use, thus making it the optimal tool for assessing the quality of life in Spanish-speaking patients with RA. Key Points • The evaluation of quality of life is very important in patients with Rheumatoid Arthritis. • Most of the questionnaires used to assess the quality of life require a license to use. • QOL-RA II is a valid and simple questionnaire to evaluate the quality of life of patients with RA and does not require a license for its use. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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197. Validation and cultural adaptation of the qualisex questionnaire in patients with axial spondyloarthritis in Argentina.
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Sommerfleck, Fernando Andres, Schneeberger, Emilce Edith, Orozco, Maria Celeste, Zamora, Natalia, Landi, Margarita, and Citera, Gustavo
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SPONDYLOARTHROPATHIES , *HUMAN sexuality , *BIOLOGICALS , *ANKYLOSING spondylitis , *REPRODUCIBLE research - Abstract
The Qualisex questionnaire was developed and validated to assess sexuality in patients with rheumatoid arthritis. To the best of our knowledge, there is no instrument to evaluate sexuality in axial spondyloarthritis (axSpA). For this reason, the objective of this study was to validate and adapt the Qualisex questionnaire in axSpA and evaluate the impact of the disease on patients’ sexuality. Cross sectional study. Consecutive patients, with ≥ 21 years of age, diagnosed with axSpA according to ASAS’09 criteria were included. Sexual health was assessed using the Qualisex questionnaire. The original version was translated to Spanish and adapted to axSpA. Internal consistency, and test re-test reliability was calculated. Criterion and construct validity were assessed by comparing the Qualisex with parameters of disease activity functional capacity and quality of life. 61 patients were invited to participate in the study, 11 of whom refused. 50 patients were included; 40 (80%) were males, with a median age of 47 years (IQR 21-72) and a median disease duration of 13 years (IQR 1-46). Reproducibility was excellent with an ICC of 0.99 (95% CI 0.65-1). The Qualisex had a good correlation with different disease evaluation parameters. The Qualisex was significantly higher among women (5.4 in women vs. 2.5 in men, p = 0.02), unemployed (4.7 in unemployed vs. 2.3 in employed, p = 0.01), in patients with higher disease activity (4.2 in active patients vs. 1.6 in inactive patients, p = 0.01), and it was lower in patients receiving biologic therapy (BT) (1.9 with BT vs. 3.8 without BT, p = 0.01). Multivariable analysis showed that female sex, longer disease duration and higher disease activity were independently associated with a greater impact on sexuality. The Qualisex adapted to axSpA is a valid and reliable questionnaire. Female axSpA patients, those with longer disease duration and higher disease activity presented a worse sexual life. [ABSTRACT FROM AUTHOR]
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- 2018
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198. The −2518 A/G polymorphism in the monocyte chemoattractant protein 1 gene (MCP-1) is associated with an increased risk of rheumatoid arthritis in Argentine patients.
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Martin, Emilia, Schneeberger, Emilce, Aranda, Federico, Peres, Silvia, Carmen Valerio, María, los Angeles Correa, Maria, Pra, Fernando, Martinez, Liliana, Remondino, Graciela, Larrañaga, Gabriela, and Citera, Gustavo
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GENETIC polymorphisms , *MONOCYTE chemotactic factor , *RHEUMATOID arthritis risk factors , *ARGENTINES , *DISEASE susceptibility , *HEALTH - Abstract
The aim of this study was to analyze the influence of nucleotide transition (G/A) in position −2518 of the MCP-1 gene related to the susceptibility of developing RA. Two hundred twenty-three consecutive RA patients according to 2010 ACR/EULAR criteria were included; 120 healthy subjects were used as controls. MCP-1 −2518 A/G polymorphism (AG + GG) was present in 162 (72.6 %) RA patients and in 63 (52.5 %) healthy subjects [OR 2.44 (IC95% 1.53-3.88, p = 0.0002)]; associations for heterozygotes and homozygotes were OR 1.92 (IC95% 1.19-3.15, p = 0.001) and OR 5.19 (IC95% 2.34-11.51, p = 0.001), respectively. In Argentine patients, MCP-1 gene polymorphism confers susceptibility for developing RA. [ABSTRACT FROM AUTHOR]
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- 2016
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199. Mortality in patients with ankylosing spondylitis in Argentina.
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Buschiazzo, Emilio, Schneeberger, Emilce, Sommerfleck, Fernando, Ledesma, Cesar, and Citera, Gustavo
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ANKYLOSING spondylitis , *MORTALITY prevention , *CARDIOVASCULAR diseases , *MEDICAL records - Abstract
Some reports describe an increased mortality in patients with ankylosing spondylitis (AS) compared to the general population. The aims of this study were to evaluate the cumulative survival in patients with AS and to establish possible factors associated with mortality. In cross-sectional retrospective study, AS patients were included according to 1984 modified NY criteria, in the 2000-2010 period, the prevalence of mortality was determined by review of medical records, telephone contact, family reports, and death certificates, and it was compared with mortality in Argentina's general population. One hundred twenty-seven patients were studied, 96 (75.6 %) were male, median age 49 years (interquartile range (IQR) 34-60) and median disease duration 8 years (IQR 4-17). During the follow-up period, 9 patients died (7.1 %). The median estimated survival from diagnosis of AS was 39 years (IQR 34-50) and median cumulative survival was 76 years (IQR 74-85). Cardiovascular disease was the most frequent cause of death (5/9 patients). Deceased patients had a mean age and a mean AS disease duration significantly higher than living patients (68.1 ± 12.4 years vs 46.4 ± 15.09 years, p = 0.0001 and 33 ± 13.7 years vs 12 ± 10.7 years, p = 0.001, respectively), higher frequency of total surgeries [3/5 (60 %) vs 5/105 (4.76 %), p = 0.002] and cauda equina syndrome [3/6 (50 %) vs 2/116 (1.72 %), p = 0.001], respectively. Frequency of mortality in AS patients was higher than the crude mortality rate of Argentina's general population in the same period, with cardiovascular cause being the most frequent one. [ABSTRACT FROM AUTHOR]
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- 2016
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200. Effects of cigarette smoking on early arthritis: a cross-sectional study-data from the Argentine Consortium for Early Arthritis (CONAART).
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Haye Salinas, María, Retamozo, Soledad, Alvarez, Ana, Maldonado Ficco, Hernán, Dal Pra, Fernando, Citera, Gustavo, Benegas, Mariana, Chaparro del Moral, Rafael, Rillo, Oscar, Secco, Anastasia, Marino Claverie, Lucila, Catalan Pellet, Antonio, Marcos, Josefina, García, Mercedes, Marcos, Juan, Barbaglia, Ana, Bellomio, Verónica, Berman, Alberto, Quiroz, Cristian, and Soriano, Enrique
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SMOKING , *RHEUMATOID arthritis risk factors , *SOCIODEMOGRAPHIC factors , *PHYSIOLOGY ,HEALTH of cigarette smokers - Abstract
Our objective was to analyze the effects of cigarette smoking on disease activity, functional capacity, radiographic damage, serology and presence of extraarticular manifestations in patients with rheumatoid arthritis and undifferentiated arthritis. This is a cross-sectional study of 1,305 patients (729 with rheumatoid arthritis and 576 with undifferentiated arthritis) from CONAART, the Argentine Consortium for Early Arthritis that includes patients older than 16 years with <2 years of disease. Sociodemographic data, clinical characteristics of the disease and smoking history were collected. In patients with rheumatoid arthritis the disease activity score of 28 joints was 5.4 ± 1.3 in current smokers, 5.2 ± 1.4 in former smokers and 5.1 ± 1.4 in never smokers ( p = 0.011). The simple erosion narrowing score was higher in current smokers and former smokers than in never smokers ( M 14.0, R 6.0-21.0; M 15.0, R 7.0-24.0; M 10.0, R 5.0-17.0; p = 0.006). Current smokers had higher rheumatoid factor titer ( M 160.0, R 80.0-341.0) than former smokers ( M 146.8, R 6.03-255.5) and never smokers ( M 15.0, R 9.0-80.0) ( p = 0.004). The variable independently associated with tobacco exposure was simple erosion narrowing score (OR = 1.03, 95 % CI 1.00-1.05; p = 0.012). In patients with undifferentiated arthritis, an association between smoking status and parameters of activity or radiographic damage was not observed. Neither was tobacco exposure related to the presence of extraarticular manifestations or to the degree of disability in any of the two groups of patients. No relation was found between disease activity and severity, and number of packs smoked per year. Tobacco. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
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