133 results on '"Sara Manrique-Arija"'
Search Results
2. Interstitial Lung Disease Is Associated with Sleep Disorders in Rheumatoid Arthritis Patients
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Natalia Mena-Vázquez, Rocío Redondo-Rodriguez, Pablo Cabezudo-García, Aimara Garcia-Studer, Fernando Ortiz-Márquez, Paula Borregón-Garrido, Manuel Martín-Valverde, Inmaculada Ureña-Garnica, Sara Manrique-Arija, Laura Cano-García, and Antonio Fernández-Nebro
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interstitial lung disease ,rheumatoid arthritis ,sleep disorders ,insomnia ,sleep satisfaction ,Medicine - Abstract
Objective: To evaluate sleep disorders and associated factors in patients with rheumatoid-arthritis-associated interstitial lung disease (RA-ILD). Methods: We performed an observational study of 35 patients with RA-ILD (cases) and 35 age- and sex-matched RA patients without ILD (controls). We evaluated sleep disorders (Oviedo Sleep Questionnaire), positive psychological factors (resilience using the Wagnild and Young Resilience Scale, emotional intelligence using the 24-item Trait Meta-Mood Scale), anxiety and depression (Hospital Anxiety and Depression Scale), quality of life (36-item short-form survey), and fatigue (Functional Assessment of Chronic Illness Therapy Questionnaire). Other variables studied included the Charlson Comorbidity Index (CCI) and RA activity according to the DAS28-ESR. Results: Compared to the controls, the cases were characterized by poorer sleep quality with a higher prevalence of insomnia (42% vs. 20%; p = 0.039), greater severity of insomnia (p = 0.001), and lower sleep satisfaction (p = 0.033). They also had poorer resilience and emotional recovery and more severe anxiety and depression. A diagnosis of ILD was the only factor independently associated with the three dimensions of sleep quality. The predictors of poorer sleep satisfaction in patients with RA-ILD were age (β = −0.379), DAS28-ESR (β = −0.331), and usual interstitial pneumonia pattern (β = −0.438). The predictors of insomnia were DAS28-ESR (β = 0.294), resilience (β = −0.352), and CCI (β = 0.377). Conclusions: RA-ILD is associated with significant sleep disorders. RA-ILD seems to be an independent risk factor for sleep alterations, with a greater impact on insomnia. Age, disease activity, and comorbidity also play a role in sleep disorders in patients with RA-ILD.
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- 2023
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3. Intestinal Dysbiosis, Tight Junction Proteins, and Inflammation in Rheumatoid Arthritis Patients: A Cross-Sectional Study
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Arkaitz Mucientes, José Manuel Lisbona-Montañez, Natalia Mena-Vázquez, Patricia Ruiz-Limón, Sara Manrique-Arija, Aimara García-Studer, Fernando Ortiz-Márquez, and Antonio Fernández-Nebro
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tight junction proteins ,intestinal permeability ,gut microbiota ,rheumatoid arthritis ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Recent studies point to intestinal permeability as an important factor in the establishment and development of rheumatoid arthritis (RA). Tight junctions (TJs) play a major role in intestinal homeostasis. The alteration of this homeostasis is related to RA. Furthermore, RA patients present dysbiosis and a lower microbiota diversity compared to healthy individuals. A cross-sectional study including RA patients and sex- and age-matched healthy controls was performed. The quantification of TJ proteins was carried out by ELISA. Gut microbiota was evaluated by NGS platform Ion Torrent S. The inflammatory variables included were DAS28, CRP, inflammatory cytokines (IL-6, IL-1, TNF-α) and oxidised LDL. Claudin-1 levels showed significant differences between groups. Results evidenced a correlation between claudin-1 values and age (r: −0.293; p < 0.05), IL6 (r: −0.290; p < 0.05) and CRP (r: −0.327; p < 0.05), and between zonulin values and both age (r: 0.267; p < 0.05) and TNFα (r: 0.266; p < 0.05). Moreover, claudin-1 and CRP levels are related in RA patients (β: −0.619; p: 0.045), and in patients with high inflammatory activity, the abundance of the genus Veillonella is positively associated with claudin-1 levels (β: 39.000; p: 0.004).
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- 2024
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4. Severity and impact of digestive impairment perceived by patients with systemic sclerosis: a cross-sectional study
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Antonio Fernández-Nebro, Sara Manrique-Arija, Natalia Mena-Vazquez, Laura Cano-García, Rocío Redondo-Rodríguez, Aimara García-Studer, Fernando Ortiz-Marquez, and Paula Borregón-Garrido
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Medicine - Abstract
Objectives To describe the severity and impact of gastrointestinal involvement in patients with systemic sclerosis (SSc) and identify associated factors.Patients and methods Non-controlled cross-sectional study of patients with SSc (2013 American College of Rheumatology/European League Against Rheumatism criteria). The main variables were severity of gastrointestinal involvement according to the University of California, Los Angeles Scleroderma Clinical Trials Consortium Gastrointestinal Tract 2.0 instrument (UCLA SCTC GIT 2.0) and dysphagia according to the Eating Assessment Tool-10 (EAT-10). We evaluated reflux, distension, diarrhoea, faecal soilage, constipation, emotional well-being and social functioning, as well as dysphagia. Clinical and epidemiological data were collected using the Mini Nutritional Assessment Short Form (MNA-SF) and the EuroQol-5D-3L. The degree of skin fibrosis was assessed using the modified Rodnan skin score (mRSS). Multivariate models were constructed to analyse factors associated with gastrointestinal involvement and dysphagia.Results Of the 75 patients with SSc included, 58.7% had moderate, severe or very severe reflux, 57.4% had constipation according to UCLA SCTC GIT 2.0 and 49.7% had abdominal distension. Gastrointestinal symptoms interfered significantly with social functioning (42.7%) and emotional well-being (40.0%). Dysphagia (EAT-10≥3) was recorded in 52% of patients, and according to MNA-SF poor nutrition in 30.7%, and clear malnutrition requiring a nutritional intervention in 5.3%. Multivariate adjustment revealed an association between severity of gastrointestinal symptoms according to the mRSS (β=0.249; p=0.002) and Visual Analogue Scale 3-Level EuroQol-5D (VAS-EQ-5D-3L) (β=–0.302; p=0.001), whereas presence of dysphagia was associated with the mRSS (OR=2.794; p=0.015), VAS-EQ-5D-3L (OR=0.950; p=0.005) and malnutrition (MNA-SF≤7; OR=3.920; p=0.041).Conclusions Patients with SSc frequently present severe gastrointestinal symptoms. These are associated with poor quality of life, more severe skin involvement and malnutrition.
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- 2024
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5. Rate of severe and fatal infections in a cohort of patients with interstitial lung disease associated with rheumatoid arthritis: a multicenter prospective study
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Natalia Mena-Vázquez, Rocío Redondo-Rodriguez, Marta Rojas-Gimenez, Carmen María Romero-Barco, Clara Fuego-Varela, Nair Perez-Gómez, Isabel Añón-Oñate, Patricia Castro Pérez, Aimara García-Studer, Ana Hidalgo-Conde, Rocío Arnedo Díez de los Ríos, Eva Cabrera-César, Maria Luisa Velloso-Feijoo, Sara Manrique-Arija, Jerusalem Calvo-Gutiérrez, Myriam Gandía-Martínez, Pilar Morales-Garrido, Francisco Javier Godoy-Navarrete, Coral Mouriño-Rodriguez, Francisco Espildora, María Carmen Aguilar-Hurtado, and Antonio Fernández-Nebro
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rheumatoid arthritis ,interstitial lung disease ,infection ,fatal infections microorganisms ,inflammation ,Immunologic diseases. Allergy ,RC581-607 - Abstract
ObjectiveTo describe severe infection, foci of infection, microorganisms, associated factors, and impact on mortality in patients with rheumatoid arthritis–associated interstitial lung disease (RA-ILD).Patients and methodsThe study was based on a multicenter prospective cohort of patients with RA-ILD followed up from 2015 to 2023. The main outcome measures were incident severe infection and fatal infection. We evaluated infectious foci, etiologic agents, vaccination status, variables associated with lung function, and clinical-therapeutic variables in RA. The incidence rate (IR) for infection and mortality was calculated per 100 person-years, and 3 multivariate models were constructed to explore factors associated with infection.ResultsWe followed up 148 patients with RA-ILD for a median 56.7 months (699.3 person-years). During this period, 142 patients (96%) had at least 1 infection. A total of 368 infectious episodes were recorded, with an IR of 52.6 per 100 person-years. Of the 48 patients who died, 65% did so from infection. Respiratory infections were the most common first infection (74%), infection overall (74%), and fatal infection (80%) and were caused mostly by SARS CoV-2, Streptococcus pneumoniae, Pseudomonas aeruginosa, and influenza A virus. The factors associated with an increased risk of infection and death in patients with RA-ILD were age, inflammatory activity, and therapy with corticosteroids and immunosuppressants.ConclusionPatients with RA-ILD have a high risk of serious infection, especially respiratory infection. Infection develops early, is recurrent, and is frequently fatal. The presence of associated factors such as advanced age, joint inflammation, and treatment highlight the importance of integrated and preventive medical care.
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- 2024
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6. Exploring the influence of baseline rheumatoid factor levels on TNF inhibitor retention rate in patients with rheumatoid arthritis: a multicentre and retrospective study
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Cesar Díaz-Torné, Virginia Ruiz-Esquide, Clementina López-Medina, Alejandro Balsa, Alejandro Escudero-Contreras, Rafaela Ortega-Castro, Sara Manrique-Arija, Chamaida Plasencia-Rodríguez, Natalia Mena-Vazquez, Ana Martínez-Feito, Jerusalem Calvo-Gutiérrez, M Carmen Ábalos-Aguilera, Francisco Cepas, Regina Faré-García, Antoni Juan-Mas, Luis Sainz, Francisco Javier Godoy-Navarrete, Isabel Añón-Oñate, and Marina Soledad Moreno-García
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Medicine - Abstract
Objective To assess whether the retention rate of certolizumab pegol (CZP) was longer than that of other tumour necrosis factor inhibitors (TNFi) based on baseline rheumatoid factor (RF) levels.Methods Longitudinal, retrospective and multicentre study including patients with RA who were treated with any TNFi (monoclonal antibodies (mAB), etanercept (ETA) or CZP). Log-rank test and Cox regressions were conducted to evaluate the retention rate in the three groups according to the level of RF, with the third quartile of the baseline levels used as cut-off:
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- 2024
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7. Adiposity is associated with expansion of the genus Dialister in rheumatoid arthritis patients
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Natalia Mena-Vázquez, Patricia Ruiz-Limón, Isabel Moreno-Indias, Sara Manrique-Arija, Jose Manuel Lisbona-Montañez, José Rioja, Arkaitz Mucientes, Gracia María Martin-Núñez, Laura Cano-García, Francisco J. Tinahones, and Antonio Fernández-Nebro
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Rheumatoid arthritis ,Gut microbiota ,Obesity ,Adiposity ,Body composition ,Inflammation ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Objective: To analyze the intestinal microbiota of patients with rheumatoid arthritis (RA) and obesity and a higher percentage of fatty tissue. Methods: Nested case-control study of 80 RA patients and 80 age and sex-matched controls. Obesity was defined as a body mass index ≥ 30, and body composition using dual-energy x-ray absorptiometry. The gut microbiota was analyzed using 16 S rRNA gene sequencing; bioinformatics analysis was performed using QIIME2 and PICRUSt. Other variables included averaged 28-joint Disease Activity Score (DAS28-ESR), cytokines and adipokines. Two multivariate were constructed with obesity and fat mass index (FMI). Results: Obesity was more frequent in RA patients than in controls (36.3 % vs 25.1 %; p = 0.026), as was a higher FMI value (mean [SE]=11.6 [3.9] vs 10.2 [3.9]; p = 0.032). Alpha and beta diversity analysis revealed differences in gut microbiota between RA patients with and without obesity. Dialister and Odoribacter were more abundant in RA patients with obesity than in RA patients without obesity, while the genus Clostridium was more abundant in RA patients without obesity. The factors associated with obesity in RA patients were age (OR [95 % CI], 1.09 [1.02–1.17]), mean DAS28-ESR (OR [95 % CI], 1.46 [1.12–1.67]), leptin levels (OR [95 % CI], 1.06 [1.01–1.10]), the genus Dialister (OR [95 % CI], 1.03 [1.01–1.07]), and the genus Clostridium (OR [95 % CI], 0.013 [0.00–0.36]). The associations observed for FMI were similar. Conclusions: In patients with RA, obesity, and a higher percentage of fatty tissue, intestinal microbiota differed from that of controls and of the other patients. The genus Dialister was associated with obesity and FMI.
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- 2023
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8. Effects of COVID-19 vaccination on disease activity in patients with rheumatoid arthritis and psoriatic arthritis on targeted therapy in the COVIDSER study
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Carlos Sanchez-Piedra, Jose M Alvaro-Gracia, Isabel Castrejón, Sara Manrique-Arija, Carlos Rodríguez-Lozano, Federico Díaz-González, Rosa Roselló, Mercedes Freire-González, Dolores Ruiz-Montesinos, Cristina Bohorquez, Enrique González-Dávila, Dante Culqui, Alicia Garcia-Dorta, Cristina Campos, Inmaculada Ros-Vilamajo, Rafael Caliz, Lourdes Mateo Soria, Noemí Busquets, and Fernando Sánchez-Alonso
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Medicine - Abstract
Objective To investigate the influence of COVID-19 vaccination on disease activity in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients under targeted therapies.Patients and methods 1765 vaccinated patients COVID-19, 1178 (66.7%) with RA and 587 (33.3%) with PsA from the COVID-19 registry in patients with rheumatic diseases (COVIDSER) project, were included. Demographics, disease characteristics, Disease Activity Score in 28 joints (DAS28) and targeted treatments were collected. DAS28-based flare rates and categorised disease activity distribution prevaccination and post vaccination were analysed by log-linear regression and contingency analyses, respectively. The influence of vaccination on DAS28 variation as a continuous measure was evaluated using a random coefficient model.Results The distribution of categorised disease activity and flare rates was not significantly modified by vaccination. Log-linear regression showed no significant changes in the rate of flares in the 6-month period after vaccination compared with the same period prior to vaccination in neither patients with RA nor patients with PsA. When DAS28 variations were analysed using random coefficient models, no significant variations in disease activity were detected after vaccination for both groups of patients. However, patients with RA treated with Janus kinase inhibitors (JAK-i) (1) and interleukin-6 inhibitor (IL-6-i) experienced a worsening of disease activity (1.436±0.531, p=0.007, and 1.201±0.550, p=0.029, respectively) in comparison with those treated with tumour necrosis factor inhibitor (TNF-i). Similarly, patients with PsA treated with interleukin-12/23 inhibitor (IL-12/23-i) showed a worsening of disease activity (4.476±1.906, p=0.019) compared with those treated with TNF-i.Conclusion COVID-19 vaccination was not associated with increased rate of flares in patients with RA and PsA. However, a potential increase in disease activity in patients with RA treated with JAK-i and IL-6-i and in patients with PsA treated with IL-12/23-i warrants further investigation.
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- 2023
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9. Prevalence of Malnutrition and Associated Factors in Older Patients with Rheumatoid Arthritis: A Cross-Sectional Study
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Laura Cano-García, Rocío Redondo-Rodríguez, Sara Manrique-Arija, Carmen Domínguez-Quesada, Juan Crisóstomo Vacas, Pedro Armenteros-Ortiz, Desiree Ruiz-Vilchez, José María Martín-Martín, Aimara García-Studer, Fernando Ortiz-Márquez, Natalia Mena-Vázquez, and Antonio Fernández-Nebro
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rheumatoid arthritis ,elderly ,malnutrition ,inflammation ,quality of life ,physical function ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Objective: To describe the frequency of malnutrition in older patients with rheumatoid arthritis (RA) and investigate associated risk factors. Methods: This multicenter, cross-sectional study included participants aged ≥65 years who met the 2010 ACR/EULAR criteria for RA. Nutritional status was assessed using the Mini Nutritional Assessment Short Form (MNA-SF) and based on variables, such as albumin level, the Geriatric Nutritional Risk Index (GNRI), and vitamin D. Data were also collected on epidemiological variables, inflammatory disease activity, quality of life, physical function, and frailty. Multivariate models were used to study factors associated with nutritional status. Results: The study population comprised 76 RA patients aged ≥65 years, of whom 68.4% had a normal nutritional status, and 31.5% had an impaired nutritional status: 28.9% were at risk of malnutrition, and 2.6% were malnourished. Additionally, 10% had albumin levels p = 0.035), DAS28-ESR (1.8 [1.0–3.2]; p = 0.024), and EuroQoL-5D-5L (0.9 [0.9–0.9]; p = 0.040). Furthermore, the GNRI was associated with the MNA score (0.06 [0.0–0.1]; p = 0.014). Conclusions: Approximately one-third of older patients with RA have impaired nutritional status. Older age, higher inflammatory disease activity, and decreased quality of life are associated with impaired nutritional status. The MNA and GNRI are valuable tools for assessing the nutritional status of patients with RA.
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- 2023
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10. Analysis of comorbidity in rheumatoid arthritis–associated interstitial lung disease: a nested case-cohort study
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Natalia Mena-Vázquez, Marta Rojas-Gimenez, Carmen María Romero-Barco, Myriam Gandía-Martínez, Nair Perez-Gómez, Francisco Javier Godoy-Navarrete, Sara Manrique-Arija, Aimara Garcia-Studer, Jerusalem Calvo-Gutiérrez, Clara Fuego Varela, Pilar Morales-Garrido, Patricia Castro Pérez, Coral Mouriño-Rodriguez, Isabel Añón-Oñate, Francisco Espildora, María Carmen Aguilar-Hurtado, Rocío Redondo, Ana Hidalgo Conde, Rocío Arnedo Díez de los Ríos, Eva Cabrera César, Maria Luisa Velloso-Feijoo, and Antonio Fernández-Nebro
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Rheumatoid arthritis ,Interstitial lung disease ,Comorbidity ,Multimorbidity ,Inflammation ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Objectives: To describe comorbid conditions in patients with rheumatoid arthritis–associated interstitial lung disease (RA-ILD) and to analyze factors associated with multimorbidity. Methods: Nested case-cohort study of 2 prospective cohorts: one with RA-ILD (cases) and another with RA but not ILD (controls). The cohorts were matched for age, sex, and time since diagnosis. Multimorbidity was defined as the co-occurrence of 2 or more chronic diseases, in addition to RA and ILD. We evaluated the comorbid conditions included in the Charlson Comorbidity Index, cardiovascular risk factors, neuropsychiatric conditions, and other frequent conditions in RA. We also recorded clinical-laboratory variables, inflammatory activity according to the 28-joint Disease Activity Score, C-reactive protein (CRP), physical function, and pulmonary function. We performed 2 multivariate analyses to identify factors associated with multimorbidity in RA and RA-ILD. Results: The final study population comprised 110 cases and 104 controls. Multimorbidity was more frequent among cases than controls (80 [72.7] vs 60 [57.7]; p = 0.021). In both groups, multimorbidity was associated with ILD (OR [95% CI] 1.92 [1.03–3.59]; p = 0.039), age (OR [95% CI] 1.05 [1.01–1.08]; p = 0.004), CRP (OR [95% CI] 1.16 [1.05–1.29]; p = 0.003), and erosions (OR [95% CI] 1.05 [1.01–1.08]; p = 0.004); in the cases, it was associated with CRP (OR [95% CI] 1.17 [1.01–1.35]; p = 0.027), anti–citrullinated peptide antibody (OR [95% CI] 1.23 [1.14–13.02]; p = 0.049), and forced vital capacity (OR [95% CI] 0.79 [0.96–0.99]; p = 0.036). Conclusion: In patients with RA, multimorbidity was associated with ILD, systemic inflammation, and advanced age.
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- 2023
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11. Inflammatory profile of incident cases of late-onset compared with young-onset rheumatoid arthritis: A nested cohort study
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Natalia Mena-Vázquez, Jose Manuel Lisbona-Montañez, Rocío Redondo-Rodriguez, Arkaitz Mucientes, Sara Manrique-Arija, José Rioja, Aimara Garcia-Studer, Fernando Ortiz-Márquez, Laura Cano-García, and Antonio Fernández-Nebro
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late-onset rheumatoid arthritis ,young-onset rheumatoid arthritis ,aging ,inflammation ,early rheumatoid arthritis ,Medicine (General) ,R5-920 - Abstract
ObjectivesTo describe the characteristics of patients between late-onset rheumatoid arthritis (LORA) with young-onset (YORA), and analyze their association with cumulative inflammatory burden.MethodsWe performed a nested cohort study in a prospective cohort comprising 110 patients with rheumatoid arthritis (RA) and 110 age- and sex-matched controls. The main variable was cumulative inflammatory activity according to the 28-joint Disease Activity Score with erythrocyte sedimentation rate (DAS28-ESR). High activity was defined as DAS28 ≥ 3.2 and low activity as DAS28 < 3.2. The other variables recorded were inflammatory cytokines, physical function, and comorbid conditions. Two multivariate models were run to identify factors associated with cumulative inflammatory activity.ResultsA total of 22/110 patients (20%) met the criteria for LORA (≥ 60 years). Patients with LORA more frequently had comorbid conditions than patients with YORA and controls. Compared with YORA patients, more LORA patients had cumulative high inflammatory activity from onset [13 (59%) vs. 28 (31%); p = 0.018] and high values for CRP (p = 0.039) and IL-6 (p = 0.045). Cumulative high inflammatory activity in patients with RA was associated with LORA [OR (95% CI) 4.69 (1.49–10.71); p = 0.008], smoking [OR (95% CI) 2.07 (1.13–3.78); p = 0.017], anti–citrullinated peptide antibody [OR (95% CI) 3.24 (1.15–9.13); p = 0.025], average Health Assessment Questionnaire (HAQ) score [OR (95% CI) 2.09 (1.03–14.23); p = 0.034], and physical activity [OR (95% CI) 0.99 (0.99–0.99); p = 0.010]. The second model revealed similar associations with inflammatory activity in patients with LORA.ConclusionControl of inflammation after diagnosis is poorer and comorbidity more frequent in patients with LORA than in YORA patients and healthy controls.
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- 2022
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12. Collinsella is associated with cumulative inflammatory burden in an established rheumatoid arthritis cohort
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Patricia Ruiz-Limón, Natalia Mena-Vázquez, Isabel Moreno-Indias, Sara Manrique-Arija, Jose Manuel Lisbona-Montañez, Laura Cano-García, Francisco J. Tinahones, and Antonio Fernández-Nebro
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Gut microbiota ,Inflammation ,Rheumatoid arthritis ,Collinsella ,Cumulative inflammatory burden ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Objective: To analyze the gut microbiota of patients with rheumatoid arthritis (RA) according to disease activity. Methods: An observational cross-sectional study of 110 patients with RA and 110 age- and sex-matched controls was performed. Patients were classified according to the disease activity (DAS28 ≥3.2 or DAS28
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- 2022
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13. Sarcopenia and Nutrition in Elderly Rheumatoid Arthritis Patients: A Cross-Sectional Study to Determine Prevalence and Risk Factors
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Laura Cano-García, Sara Manrique-Arija, Carmen Domínguez-Quesada, Juan Crisóstomo Vacas-Pérez, Pedro J. Armenteros-Ortiz, Desiré Ruiz-Vilchez, José María Martín-Martín, Rocío Redondo-Rodríguez, Aimara García-Studer, Fernando Ortiz-Márquez, Natalia Mena-Vázquez, and Antonio Fernández-Nebro
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rheumatoid arthritis ,elderly ,obesity ,sarcopenia ,nutrition ,malnutrition ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Objective: To describe the prevalence of sarcopenia in rheumatoid arthritis (RA) patients aged ≥65 years and identify the risk factors associated with sarcopenia. Methods: This is a multicenter, controlled, cross-sectional study of 76 RA patients and 76 age- and sex-matched healthy controls. Sarcopenia was defined according to the revised criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Whole-body dual-energy X-ray absorptiometry (DXA) was performed. Binary regression was used to assess the relationship between sarcopenia and sex, age, duration of RA, Mini Nutritional Assessment (MNA) score, and Short Physical Performance Battery (SPPB) score in patients with RA. Results: Nearly 80% of participants were female, and the average age was >70 years. Patients with RA had lower muscle mass and greater adiposity (fat-to-muscle ratio mean [SD] 0.9 [0.2] vs. 0.8 [0.2]; p = 0.017) than controls, mainly in the central area (android/gynoid ratio, median [p25–p75]: 1.0 [0.9–1.2] vs. 0.9 [0.8–1.1]; p < 0.001). Twelve patients (15.8%) and three controls (3.9%) had confirmed sarcopenia (p = 0.014). Sarcopenic obesity was observed in 8/76 patients with RA (10.5%) and in 1/76 controls (1.3%) (p = 0.016). The factors associated with sarcopenia were male sex (OR [95% CI]: 9.3 [1.1–80.4]; p = 0.042), disease duration (OR [95% CI]: 1.1 [1.0–1.2]; p = 0.012), and nutritional status according to the MNA (OR [95% CI]: 0.7 [0.5–0.9]; p = 0.042). Conclusions: Our results suggest that patients with RA aged ≥65 years may be at increased risk for sarcopenia, adiposity, and malnutrition (especially male patients with long-standing disease) and have poor nutritional status.
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- 2023
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14. Inflammatory Biomarkers in the Diagnosis and Prognosis of Rheumatoid Arthritis–Associated Interstitial Lung Disease
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Natalia Mena-Vázquez, Francisco Javier Godoy-Navarrete, Jose Manuel Lisbona-Montañez, Rocío Redondo-Rodriguez, Sara Manrique-Arija, José Rioja, Arkaitz Mucientes, Patricia Ruiz-Limón, Aimara Garcia-Studer, Fernando Ortiz-Márquez, Begoña Oliver-Martos, Laura Cano-García, and Antonio Fernández-Nebro
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rheumatoid arthritis ,interstitial lung disease ,biomarkers ,cytokines ,morbidity ,inflammation ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
This study aimed to identify inflammatory factors and soluble cytokines that act as biomarkers in the diagnosis and prognosis of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). We performed a nested prospective observational case–control study of patients with RA-ILD matched by sex, age, and time since the diagnosis of RA. All participants underwent pulmonary function testing and high-resolution computed tomography. ILD was defined according to the criteria of the American Thoracic Society/European Respiratory Society; the progression of lung disease was defined as the worsening of FVC > 10% or DLCO > 15%. Inflammation-related variables included the inflammatory activity measured using the DAS28-ESR and a multiplex cytokine assay. Two Cox regression models were run to identify factors associated with ILD and the progression of ILD. The study population comprised 70 patients: 35 patients with RA-ILD (cases) and 35 RA patients without ILD (controls). A greater percentage of cases had higher DAS28-ESR (p = 0.032) and HAQ values (p = 0.003). The variables associated with RA-ILD in the Cox regression analysis were disease activity (DAS28) (HR [95% CI], 2.47 [1.17–5.22]; p = 0.017) and high levels of ACPA (HR [95% CI], 2.90 [1.24–6.78]; p = 0.014), IL-18 in pg/mL (HR [95% CI], 1.06 [1.00–1.12]; p = 0.044), MCP-1/CCL2 in pg/mL (HR [95% CI], 1.03 [1.00–1.06]; p = 0.049), and SDF-1 in pg/mL (HR [95% CI], 1.00 [1.00–1.00]; p = 0.010). The only variable associated with the progression of ILD was IL-18 in pg/mL (HR [95% CI], 1.25 [1.07–1.46]; p = 0.004). Our data support that the inflammatory activity was higher in patients with RA-ILD than RA patients without ILD. Some cytokines were associated with both diagnosis and poorer prognosis in patients with RA-ILD.
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- 2023
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15. miRNA-Mediated Epigenetic Regulation of Treatment Response in RA Patients—A Systematic Review
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Arkaitz Mucientes, Jose Manuel Lisbona, Natalia Mena-Vázquez, Patricia Ruiz-Limón, Sara Manrique-Arija, and Antonio Fernández-Nebro
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microRNA ,rheumatoid arthritis ,treatment ,biomarker ,disease-modifying antirheumatic drug ,systemic review ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
This study aimed to evaluate the role of microRNAs (miRNA) as biomarkers of treatment response in rheumatoid arthritis (RA) patients through a systematic review of the literature. The MEDLINE and Embase databases were searched for studies including RA-diagnosed patients treated with disease-modifying antirheumatic drugs (DMARDs) that identify miRNAs as response predictors. Review inclusion criteria were met by 10 studies. The main outcome of the study was the response to treatment, defined according to EULAR criteria. A total of 839 RA patients and 67 healthy donors were included in the selected studies. RA patients presented seropositivity for the rheumatoid factor of 74.7% and anti-citrullinated C-peptide antibodies of 63.6%. After revision, 15 miRNAs were described as treatment response biomarkers for methotrexate, anti-tumour necrosis factor (TNF), and rituximab. Among treatments, methotrexate presented the highest number of predictor miRNAs: miR-16, miR-22, miR-132, miR-146a and miR-155. The most polyvalent miRNAs were miR-146a, predicting response to methotrexate and anti-TNF, and miR-125b, which predicts response to infliximab and rituximab. Our data support the role of miRNAs as biomarkers of treatment response in RA and point to DMARDs modifying the miRNAs expression. Nevertheless, further studies are needed since a meta-analysis that allows definitive conclusions is not possible due to the lack of studies in this field.
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- 2022
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16. Longitudinal Study of Cognitive Functioning in Adults with Juvenile Idiopathic Arthritis
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Natalia Mena-Vázquez, Fernando Ortiz-Márquez, Pablo Cabezudo-García, Claudia Padilla-Leiva, Gisela Diaz-Cordovés Rego, Luis Muñoz-Becerra, Teresa Ramírez-García, Jose Manuel Lisbona-Montañez, Sara Manrique-Arija, Arkaitz Mucientes, Esmeralda Núñez-Cuadros, Rocío Galindo Zavala, Pedro Jesús Serrano-Castro, and Antonio Fernández-Nebro
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juvenile idiopathic arthritis ,cognitive functions ,inflammation ,biological therapy ,Biology (General) ,QH301-705.5 - Abstract
Objective: To prospectively evaluate possible decline of cognitive functions in adult patients with juvenile idiopathic arthritis (JIA) and identify associated factors. Patients and methods: We performed a 24-month prospective observational study of adults (≥16 years) with JIA. The primary outcome measure was decline in cognitive function defined as a worsening of ≥2 points on the scales of the subsets administered to evaluate the different cognitive areas using the Wechsler Adult Intelligence Scale (WAIS) after 24 months: attention/concentration (digit span); verbal function (vocabulary); visual-spatial organization (block design); working memory (letter-number sequencing); and problem solving (similarities). Other variables included average inflammatory activity using C-reactive protein and composite activity indexes, comorbidity, and treatment. Logistic regression was performed to identify factors associated with cognitive decline. Results: The study population comprised 52 patients with JIA. Of these, 15 (28.8%) had cognitive decline at V24. The most affected functions were working memory (17.3%), attention/concentration (9.6%), verbal function (7.7%), visual-spatial organization (7.7%), and problem solving (3.8%). There were no significant differences in the median direct or scale scores for the cognitive functions evaluated between V0 and V24 for the whole sample. The factors associated with cognitive decline in patients with JIA were average C-reactive protein (OR [95% CI], 1.377 [1.060–1.921]; p = 0.039), depression (OR [95% CI], 3.691 [1.294–10.534]; p = 0.015), and treatment with biologics (OR [95% CI], 0.188 [0.039–0.998]; p = 0.046). Conclusion: Cognitive decline was detected in almost one third of adults with JIA after 24 months of follow-up. Systemic inflammatory activity in JIA patients was related to cognitive decline. Patients treated with biologics had a lower risk of decline in cognitive functions.
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- 2022
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17. Safety and Effectiveness of Abatacept in a Prospective Cohort of Patients with Rheumatoid Arthritis–Associated Interstitial Lung Disease
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Natalia Mena-Vázquez, Marta Rojas-Gimenez, Clara Fuego-Varela, Aimara García-Studer, Nair Perez-Gómez, Carmen María Romero-Barco, Francisco Javier Godoy-Navarrete, Sara Manrique-Arija, Myriam Gandía-Martínez, Jerusalem Calvo-Gutiérrez, Pilar Morales-Garrido, Coral Mouriño-Rodriguez, Patricia Castro-Pérez, Isabel Añón-Oñate, Francisco Espildora, María Carmen Aguilar-Hurtado, Ana Hidalgo Conde, Rocío Arnedo Díez de los Ríos, Eva Cabrera César, Rocío Redondo-Rodriguez, María Luisa Velloso-Feijoo, and Antonio Fernández-Nebro
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rheumatoid arthritis ,interstitial lung disease ,biologics ,abatacept ,Biology (General) ,QH301-705.5 - Abstract
Objective: To prospectively evaluate the safety and efficacy profile of abatacept in patients with rheumatoid arthritis–associated interstitial lung disease (RA-ILD). Methods: We performed a prospective observational multicenter study of a cohort of patients with RA-ILD treated with abatacept between 2015 and 2021. Patients were evaluated using high-resolution computed tomography and pulmonary function tests at initiation, 12 months, and the end of follow-up. The effectiveness of abatacept was evaluated based on whether ILD improved, stabilized, progressed, or was fatal. We also evaluated factors such as infection, hospitalization, and inflammatory activity using the 28-joint Disease Activity Score with the erythrocyte sedimentation rate (DAS28-ESR). Cox regression analysis was performed to identify factors associated with progression of lung disease. Results: The study population comprised 57 patients with RA-ILD treated with abatacept for a median (IQR) of 27.3 (12.2–42.8) months. Lung disease had progressed before starting abatacept in 45.6% of patients. At the end of follow-up, lung disease had improved or stabilized in 41 patients (71.9%) and worsened in 13 (22.8%); 3 patients (5.3%) died. No significant decreases were observed in forced vital capacity (FVC) or in the diffusing capacity of the lung for carbon monoxide (DLCO).The factors associated with progression of RA-ILD were baseline DAS28-ESR (OR [95% CI], 2.52 [1.03–3.12]; p = 0.041), FVC (OR [95% CI], 0.82 [0.70–0.96]; p = 0.019), and DLCO (OR [95% CI], 0.83 [0.72–0.96]; p = 0.018). Only 10.5% of patients experienced severe adverse effects. Conclusion: Pulmonary function and joint inflammation stabilized in 71% of patients with RA-ILD treated with abatacept. Abatacept had a favorable safety profile.
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- 2022
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18. Postprandial Hyperlipidemia: Association with Inflammation and Subclinical Atherosclerosis in Patients with Rheumatoid Arthritis
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Natalia Mena-Vázquez, Rocío Redondo-Rodríguez, José Rioja, Francisco Gabriel Jimenez-Nuñez, Sara Manrique-Arija, Jose Manuel Lisbona-Montañez, Laura Cano-García, Marta Rojas-Gimenez, Inmaculada Ureña, Pedro Valdivielso, and Antonio Fernández-Nebro
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rheumatoid arthritis ,postprandial lipemia ,triglycerides ,apolipoprotein B48 ,inflammation ,subclinical atherosclerosis ,Biology (General) ,QH301-705.5 - Abstract
Objective: To describe postprandial lipidemia in patients with rheumatoid arthritis (RA) and to analyze its association with subclinical atherosclerosis and inflammatory activity. Methods: Observational study of 80 cases of RA and 80 sex- and age-matched controls. We excluded individuals with dyslipidemia. Postprandial hyperlipidemia (PPHL) was defined as postprandial triglycerides >220 mg/dL and/or postprandial ApoB48 levels >75th percentile (>p75). Plasma lipids, cholesterol, triglycerides, ApoB48, and total ApoB were evaluated at baseline and after a meal. Other variables analyzed included subclinical atherosclerosis (defined as presence of carotid atheromatous plaque), inflammatory activity (disease activity score (DAS28-ESR)), cytokines, apolipoproteins, and physical activity. A multivariate analysis was performed to identify factors associated with PPHL in patients with RA. Results: A total of 75 patients with RA and 67 healthy controls fulfilled the inclusion criteria. PPHL was more frequent in patients with RA than controls (No. (%), 29 (38.70) vs. 15 (22.40); p = 0.036), as was subclinical atherosclerosis (No. (%), 22 (30.10) vs. 10 (14.90); p = 0.032). PPHL in patients with RA was associated with subclinical atherosclerosis (OR (95% CI) 4.69 (1.09–12.11); p = 0.037), TNF-α (OR (95% CI) 2.00 (1.00–3.98); p = 0.048), high-sensitivity C-reactive protein (OR (95% CI) 1.10 (1.01–1.19); p = 0.027), and baseline triglycerides (OR (95% CI) 1.02 (1.00–1.04); p = 0.049). Conclusion: PPHL was more frequent in patients with RA than in controls. PPHL in patients with RA was associated with inflammation and subclinical atherosclerosis.
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- 2022
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19. Ability to Participate in Social Activities of Rheumatoid Arthritis Patients Compared with Other Rheumatic Diseases: A Cross-Sectional Observational Study
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Laura Cano-García, Natalia Mena-Vázquez, Sara Manrique-Arija, Rocío Redondo-Rodriguez, Carmen María Romero-Barco, and Antonio Fernández-Nebro
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rheumatic diseases ,rheumatoid arthritis ,spondyloarthritis ,systemic lupus erythematosus ,participate in social activities ,psychological factors ,Medicine (General) ,R5-920 - Abstract
Objectives: To compare the ability to participate in social activities among rheumatoid arthritis patients with other rheumatic disease patients and identify potentially implicated factors. Patients and methods: Between June and November 2019, we consecutively selected patients aged ≥18 years with RA (defined according to ACR/EULAR 2010), SpA (ASAS/EULAR 2010), and SLE (ACR 1997). Main outcome measures: Ability to participate in social roles and activities evaluated using the PROMIS score v2.0 short-form 8a (PROMIS-APS). Secondary outcomes: Participation in social activities according to a series of variables (mobility, depression, satisfaction with social relationships, social isolation, company, emotional support, instrumental support, and support via information). We evaluated the association between the ability to participate in social activities and associated variables using multivariable linear regression analysis. Results: The study population comprised 50 patients with RA (33.1%), 51 patients (33.8%) with SpA, and 50 patients (33.1%) with SLE. The mean PROMIS-APS scores were similar in the three groups. The multivariable analysis for the whole sample showed that the ability to participate in social activities was inversely associated with depression and directly with social satisfaction, mobility, company, and age. The stratified analysis revealed an inverse association between inflammatory activity and ability to participate in social activities in patients with RA and SpA, but not in those with SLE. Conclusion: All patients with RA, SpA, and SLE had a similar ability to participate in social activities. This was associated with other psychosocial factors (social satisfaction, mobility, company, depression) and clinical factors (age and inflammatory activity).
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- 2021
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20. Characteristics and Predictors of Progression Interstitial Lung Disease in Rheumatoid Arthritis Compared with Other Autoimmune Disease: A Retrospective Cohort Study
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Natalia Mena-Vázquez, Marta Rojas-Gimenez, Carmen María Romero-Barco, Sara Manrique-Arija, Ana Hidalgo Conde, Rocío Arnedo Díez de los Ríos, Eva Cabrera César, Rafaela Ortega-Castro, Francisco Espildora, María Carmen Aguilar-Hurtado, Isabel Añón-Oñate, Lorena Pérez-Albaladejo, Manuel Abarca-Costalago, Inmaculada Ureña-Garnica, Maria Luisa Velloso-Feijoo, Rocio Redondo-Rodriguez, and Antonio Fernández-Nebro
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rheumatoid arthritis ,systemic autoimmune disease ,interstitial lung disease ,prognosis ,Medicine (General) ,R5-920 - Abstract
Objectives: To describe the characteristics and progression of interstitial lung disease in patients with associated systemic autoimmune disease (ILD-SAI) and to identify factors associated with progression and mortality. Patients and methods: We performed a multicenter, retrospective, observational study of patients with ILD-SAI followed between 2015 and 2020. We collected clinical data and performed pulmonary function testing and high-resolution computed tomography at diagnosis and at the final visit. The main outcome measure at the end of follow-up was forced vital capacity (FVC) >10% or diffusing capacity of the lungs for carbon monoxide >15% and radiological progression or death. Cox regression analysis was performed to identify factors associated with worsening of ILD. Results: We included 204 patients with ILD-SAI: 123 (60.3%) had rheumatoid arthritis (RA), 58 had (28.4%) systemic sclerosis, and 23 (11.3%) had inflammatory myopathy. After a median (IQR) period of 56 (29.8–93.3) months, lung disease had stabilized in 98 patients (48%), improved in 33 (16.1%), and worsened in 44 (21.5%). A total of 29 patients (14.2%) died. Progression and hospitalization were more frequent in patients with RA (p = 0.010). The multivariate analysis showed the independent predictors for worsening of ILD-SAI to be RA (HR, 1.9 [95% CI, 1.3–2.7]), usual interstitial pneumonia pattern (HR, 1.7 [95% CI, 1.0–2.9]), FVC (%) (HR, 2.3 [95% CI, 1.4–3.9]), and smoking (HR, 2.7 [95%CI, 1.6–4.7]). Conclusion: Disease stabilizes or improves after a median of 5 years in more than half of patients with ILD-SAI, although more than one-third die. Data on subgroups and risk factors could help us to predict poorer outcomes.
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- 2021
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21. Evaluation of 12 GWAS-drawn SNPs as biomarkers of rheumatoid arthritis response to TNF inhibitors. A potential SNP association with response to etanercept.
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Aida Ferreiro-Iglesias, Ariana Montes, Eva Perez-Pampin, Juan D Cañete, Enrique Raya, Cesar Magro-Checa, Yiannis Vasilopoulos, Rafael Caliz, Miguel Angel Ferrer, Beatriz Joven, Patricia Carreira, Alejandro Balsa, Dora Pascual-Salcedo, Francisco J Blanco, Manuel J Moreno-Ramos, Sara Manrique-Arija, María Del Carmen Ordoñez, Juan Jose Alegre-Sancho, Javier Narvaez, Federico Navarro-Sarabia, Virginia Moreira, Lara Valor, Rosa Garcia-Portales, Ana Marquez, Juan J Gomez-Reino, Javier Martin, and Antonio Gonzalez
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Medicine ,Science - Abstract
Research in rheumatoid arthritis (RA) is increasingly focused on the discovery of biomarkers that could enable personalized treatments. The genetic biomarkers associated with the response to TNF inhibitors (TNFi) are among the most studied. They include 12 SNPs exhibiting promising results in the three largest genome-wide association studies (GWAS). However, they still require further validation. With this aim, we assessed their association with response to TNFi in a replication study, and a meta-analysis summarizing all non-redundant data. The replication involved 755 patients with RA that were treated for the first time with a biologic drug, which was either infliximab (n = 397), etanercept (n = 155) or adalimumab (n = 203). Their DNA samples were successfully genotyped with a single-base extension multiplex method. Lamentably, none of the 12 SNPs was associated with response to the TNFi in the replication study (p > 0.05). However, a drug-stratified exploratory analysis revealed a significant association of the NUBPL rs2378945 SNP with a poor response to etanercept (B = -0.50, 95% CI = -0.82, -0.17, p = 0.003). In addition, the meta-analysis reinforced the previous association of three SNPs: rs2378945, rs12142623, and rs4651370. In contrast, five of the remaining SNPs were less associated than before, and the other four SNPs were no longer associated with the response to treatment. In summary, our results highlight the complexity of the pharmacogenetics of TNFi in RA showing that it could involve a drug-specific component and clarifying the status of the 12 GWAS-drawn SNPs.
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- 2019
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22. Validation study of genetic biomarkers of response to TNF inhibitors in rheumatoid arthritis.
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Rosario Lopez-Rodriguez, Eva Perez-Pampin, Ana Marquez, Francisco J Blanco, Beatriz Joven, Patricia Carreira, Miguel Angel Ferrer, Rafael Caliz, Lara Valor, Javier Narvaez, Juan D Cañete, Maria Del Carmen Ordoñez, Sara Manrique-Arija, Yiannis Vasilopoulos, Alejandro Balsa, Dora Pascual-Salcedo, Manuel J Moreno-Ramos, Juan Jose Alegre-Sancho, Federico Navarro-Sarabia, Virginia Moreira, Rosa Garcia-Portales, Enrique Raya, Cesar Magro-Checa, Javier Martin, Juan J Gomez-Reino, and Antonio Gonzalez
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Medicine ,Science - Abstract
Genetic biomarkers are sought to personalize treatment of patients with rheumatoid arthritis (RA), given their variable response to TNF inhibitors (TNFi). However, no genetic biomaker is yet sufficiently validated. Here, we report a validation study of 18 previously reported genetic biomarkers, including 11 from GWAS of response to TNFi. The validation was attempted in 581 patients with RA that had not been treated with biologic antirheumatic drugs previously. Their response to TNFi was evaluated at 3, 6 and 12 months in two ways: change in the DAS28 measure of disease activity, and according to the EULAR criteria for response to antirheumatic drugs. Association of these parameters with the genotypes, obtained by PCR amplification followed by single-base extension, was tested with regression analysis. These analyses were adjusted for baseline DAS28, sex, and the specific TNFi. However, none of the proposed biomarkers was validated, as none showed association with response to TNFi in our study, even at the time of assessment and with the outcome that showed the most significant result in previous studies. These negative results are notable because this was the first independent validation study for 12 of the biomarkers, and because they indicate that prudence is needed in the interpretation of the proposed biomarkers of response to TNFi even when they are supported by very low p values. The results also emphasize the requirement of independent replication for validation, and the need to search protocols that could increase reproducibility of the biomarkers of response to TNFi.
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- 2018
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23. Human motion capture for movement limitation analysis using an RGB-D camera in spondyloarthritis: a validation study.
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Manuel Trinidad-Fernández, Antonio I. Cuesta-Vargas, Peter Vaes, David Beckwée, Francisco Angel Moreno, Javier González Jiménez 0001, Antonio Fernández-Nebro, Sara Manrique-Arija, Inmaculada Ureña-Garnica, and Manuel González-Sánchez
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- 2021
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24. Relación entre poliautoinmunidad y obesidad sarcopénica en pacientes con artritis reumatoide
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José Rioja Villodres, Francisco Javier Godoy-Navarrete, Francisco Gabriel Jimenez Nuñez, Rocio Redondo-Rodriguez, Gisela Diaz-Cordovés Rego, Sara Manrique-Arija, L. Cano-Garcia, Inmaculada Ureña Garnica, María Carmen Ordoñez-Cañizares, Antonio Fernández-Nebro, and Natalia Mena-Vázquez
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Rheumatology ,business.industry ,Medicine ,business - Published
- 2022
25. P182 Real-world persistence and treatment patterns in psoriatic arthritis patients treated with anti-IL17 therapy: the PERFIL-17 study
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Beatriz Joven Ibañez, Concepción Fito Manteca, Esteban Rubio, Enrique Raya, Alba Pérez-Linaza, Raquel Hernandez, Sara Manrique-Arija, Mercedes Núñez, Silvia Diaz, Luis Trancho, and Rosario García de Vicuña
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Rheumatology ,Pharmacology (medical) - Abstract
Background/Aims Interleukin-17 inhibitors (anti-IL-17) have provided an additional treatment option in psoriatic arthritis (PsA). This study aims to describe the patient profile, treatment patterns and persistence in PsA patients treated with ixekizumab and secukinumab in a real-life setting. Methods A multicentre, retrospective study was conducted at 8 Spanish hospitals. Three cohorts of adult PsA patients, newly initiating treatment with an anti-IL-17A (secukinumab 150mg [SECU150], secukinumab 300mg [SECU300], ixekizumab [IXE]), between January 2019 and March 2020 were included. Data of patients exposed to anti-IL-17 drugs with a follow-up visit were collected until March 2021. Demographic and clinical characteristics, treatment patterns, and persistence were analysed descriptively. Continuous data were presented as mean (standard deviation [SD]) and categorical variables as frequencies with percentage. Persistence rates at 3/6/12 months were calculated. Results A total of 221 PsA patients were analysed (SECU150: 103 [46.6%], SECU300: 38 [17.2%] and IXE: 80 [36.2%]). Treatment patterns differed by clinical characteristics: SECU150 patients presented more moderate PsA and less peripheral joint damage, while SECU300 patients included a higher rate of enthesitis and active psoriasis. IXE patients showed a longer time since PsA diagnosis, with more frequent co-morbidities, joint damage and psoriasis diagnosed. 77.8% of patients were previously treated with csDMARDs in monotherapy and 72.9% with bDMARDs/tsDMARDs (93.8% IXE, 68.4% SECU300 and 58.3% SECU150). Mean number of previous bDMARDS/tsDMARDS were 2.4 (1.5), 1.7 (0.9) and 1.6 (1.0), respectively. Overall, persistence to anti-IL-17 treatments was found in 97.2%, 88.4% and 81.0% of patients at 3, 6 and 12 months, respectively, being 83.1% for SECU150, 64.5% for SECU300 and 86.4% for IXE at one year. The most frequent reason for discontinuation was lack of effectiveness (13.8%). Conclusion Most PsA patients treated with anti-IL-17 in Spain had a moderate to severe disease, high peripheral joint damage and skin involvement and had received at least 1 previous bDMARD/tsDMARD. More than 80% of patients with one year follow-up were persistent to anti-IL-17 treatments, observing the highest rate with IXE, followed by SECU150 and SECU300. Disclosure B. Ibañez: Consultancies; B.J.I. has received consulting fees from UCB, AMGEN, JANSSEN. Honoraria; B.J.I. has received honoraria from ABBVIE, LILLY, JANSSEN, NOVARTIS. Other; B.J.I. has received support for attending meetings and/or travel from NOVARTIS, UCB. C. Manteca: Other; C.F.M. has received support for attending meetings and/or travel from Inscripcion on line Congreso SER, EULAR. E. Rubio: None. E. Raya: None. A. Pérez-Linaza: None. R. Hernandez: Honoraria; R.H. has received honoraria from Lilly, Novartis, Janssen, Pfizer, Abbie. Grants/research support; R.H. has received support for the present manuscript from Lilly. Other; R.H. has received fee for expert testimony from Novartis, R.H. has received support for attending meetings and/or travel from NOVARTIS, UCB, R.H. has received fee for participation on a Data Safety Monitoring Board or Advisory Board from Novartis. S. Manrique-Arija: None. M. Núñez: Shareholder/stock ownership; M.N. is an employee and minor shareholder in Lilly. Grants/research support; M.N. has received support for the present manuscript from Lilly. S. Diaz: Shareholder/stock ownership; S.D. is an employee and minor shareholder in Lilly. Grants/research support; S.D. has received support for the present manuscript from Lilly. L. Trancho: Shareholder/stock ownership; L.T. is an employee and minor shareholder in Lilly. Grants/research support; L.T. has received support for the present manuscript from Lilly. R. García de Vicuña: Consultancies; R.G.D.V. has received consulting fees from Abbvie, Pfizer, Biogen, MSD. Honoraria; R.G.D.V. has received honoraria from Pfizer, Novartis, Sandoz. Grants/research support; R.G.D.V. has received funding for research from from Lilly, Novartis, Abbvie, Janssen, MSD, UCB. Other; R.G.D.V. has received support for attending meetings and/or travel from Abbvie, Pfizer, Novartis, MSD, Janssen, Lilly, UCB. A. Kiprianos (Non-author Presenter): Shareholder/stock ownership; A.P. is an employee and minor shareholder in Eli Lilly and Company.
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- 2023
26. Effectiveness, safety and economic analysis of Benepali in clinical practice
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Natalia Mena-Vázquez, M. Rojas-Giménez, Antonio Fernández-Nebro, F. G. Jiménez-Núñez, Sara Manrique-Arija, C.M. Romero-Barco, Gisela Diaz-Cordovés, and Inmaculada Ureña-Garnica
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0301 basic medicine ,medicine.medical_specialty ,Etanercept ,Arthritis, Rheumatoid ,03 medical and health sciences ,Pharmacoeconomics ,Psoriatic arthritis ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Adverse effect ,Biosimilar Pharmaceuticals ,BASDAI ,030203 arthritis & rheumatology ,business.industry ,Arthritis, Psoriatic ,Biosimilar ,General Medicine ,medicine.disease ,Confidence interval ,030104 developmental biology ,Antirheumatic Agents ,Cost-minimization analysis ,business ,medicine.drug - Abstract
Objective To assess the effectiveness, safety and cost of Etanercept biosimilar in patients with rheumatoid arthritis (RA), spondyloarthritis (SpA) and psoriatic arthritis (PsA) compared to the standard drug in real clinical practice. Patients and methods Retrospective observational study. Case series of 138 patients with RA, SpA or PsA treated with at least one dose of Benepali® (n = 79) or Enbrel® (n = 59). Drug retention time was the primary efficacy endpoint compared to the biosimilar and the original. The proportion of patients achieving low disease activity or remission after 52 weeks was used as the secondary outcome. Safety was assessed by means of the adverse effects incidence rate. A cost minimization analysis was performed. Results No differences were observed regarding treatment retention time between drugs (median [95% confidence interval, 95% CI] at 12.0 months [10.2–12.0] for the biosimilar and 12.0 months [12.0–12.0] for the original). Similar improvements, in terms of inflammatory activity and physical function, were obtained after 52 weeks except for patients with SpA and PsA who, in general, experienced improvements of BASDAI and ASDAS with the original compared with the biosimilar. No significant differences were observed in the total number of adverse effects (.43 events/patient-years versus the biosimilar and .53 versus the original). Using the biosimilar in place of the original drug resulted in a net savings of 118,383.55 € (1,747.20 €/patient-years) for the hospital. Conclusion The biosimilar Benepali is as effective and safe as the original and much more cost-effective.
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- 2021
27. Efectividad, seguridad y análisis económico de Benepali en práctica clínica
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F. G. Jiménez-Núñez, C.M. Romero-Barco, M. Rojas-Giménez, Inmaculada Ureña-Garnica, Antonio Fernández-Nebro, Natalia Mena-Vázquez, Sara Manrique-Arija, and Gisela Diaz-Cordovés
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medicine.medical_specialty ,business.industry ,Biosimilar ,medicine.disease ,Confidence interval ,Etanercept ,Psoriatic arthritis ,Rheumatology ,Internal medicine ,Rheumatoid arthritis ,Cost-minimization analysis ,medicine ,business ,Adverse effect ,BASDAI ,medicine.drug - Abstract
Objective To assess the effectiveness, safety and cost of Etanercept biosimilar in patients with rheumatoid arthritis (RA), spondyloarthritis (SpA) and psoriatic arthritis (PsA) compared to the standard drug in real clinical practice. Patients and methods Retrospective observational study. Case series of 138 patients with RA, SpA or PsA treated with at least one dose of Benepali® (n = 79) or Enbrel® (n = 59). Drug retention time was the primary efficacy endpoint compared to the biosimilar and the original. The proportion of patients achieving low disease activity or remission after 52 weeks was used as the secondary outcome. Safety was assessed by means of the adverse effects incidence rate. A cost minimization analysis was performed. Results No differences were observed regarding treatment retention time between drugs (median [95% confidence interval, 95% CI] at 12.0 months [10.2-12.0] for the biosimilar and 12.0 months [12.0-12.0] for the original). Similar improvements, in terms of inflammatory activity and physical function, were obtained after 52 weeks except for patients with SpA and PsA who, in general, experienced improvements of BASDAI and ASDAS with the original compared with the biosimilar. No significant differences were observed in the total number of adverse effects (.43 events/patient-years versus the biosimilar and .53 versus the original). Using the biosimilar in place of the original drug resulted in a net savings of 118,383.55 € (1,747.20 €/patient-years) for the hospital. Conclusion The biosimilar Benepali is as effective and safe as the original and much more cost-effective.
- Published
- 2021
28. Human motion capture for movement limitation analysis using an RGB-D camera in spondyloarthritis: a validation study
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Javier Gonzalez-Jimenez, Manuel Trinidad-Fernández, Antonio Cuesta-Vargas, Peter Vaes, Manuel González-Sánchez, Sara Manrique-Arija, Antonio Fernández-Nebro, Inmaculada Ureña-Garnica, David Beckwée, Francisco-Angel Moreno, Rehabilitation Research, Physiotherapy, Human Physiology and Anatomy, Physical Medicine and Rehabilitation, Vriendenkring VUB, and Frailty in Ageing
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Computer science ,Movement ,Biomedical Engineering ,Validity ,Timed Up and Go test ,Kinematics ,Motion capture ,Spondyloarthritis ,Spondylarthritis ,Criterion validity ,Humans ,Computer vision ,Biology ,Postural Balance ,Reliability (statistics) ,Computer. Automation ,BASFI ,Angular displacement ,business.industry ,Cámaras fotográficas ,Reproducibility of Results ,Trunk ,Computer Science Applications ,Biomechanical Phenomena ,Cross-Sectional Studies ,Time and Motion Studies ,Original Article ,Human medicine ,Artificial intelligence ,Camera ,business ,Spinal mobility ,Mathematics - Abstract
A human motion capture system using an RGB-D camera could be a good option to understand the trunk limitations in spondyloarthritis. The aim of this study is to validate a human motion capture system using an RGB-D camera to analyse trunk movement limitations in spondyloarthritis patients. Cross-sectional study was performed where spondyloarthritis patients were diagnosed with a rheumatologist. The RGB-D camera analysed the kinematics of each participant during seven functional tasks based on rheumatologic assessment. The OpenNI2 library collected the depth data, the NiTE2 middleware detected a virtual skeleton and the MRPT library recorded the trunk positions. The gold standard was registered using an inertial measurement unit. The outcome variables were angular displacement, angular velocity and lineal acceleration of the trunk. Criterion validity and the reliability were calculated. Seventeen subjects (54.35 (11.75) years) were measured. The Bending task obtained moderate results in validity (r = 0.55–0.62) and successful results in reliability (ICC = 0.80–0.88) and validity and reliability of angular kinematic results in Chair task were moderate and (r = 0.60–0.74, ICC = 0.61–0.72). The kinematic results in Timed Up and Go test were less consistent. The RGB-D camera was documented to be a reliable tool to assess the movement limitations in spondyloarthritis depending on the functional tasks: Bending task. Chair task needs further research and the TUG analysis was not validated. Graphical abstract Comparation of both systems, required software for camera analysis, outcomes and final results of validity and reliability of each test.
- Published
- 2021
29. Systematic Review and Metaanalysis of Worldwide Incidence and Prevalence of Antineutrophil Cytoplasmic Antibody (ANCA) Associated Vasculitis
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Arkaitz Mucientes, Natalia Mena Vázquez, ROCIO REDONDO RODRIGUEZ, Alba María Cabezas-Lucena, Sara Manrique-Arija, and Antonio Fernandez-Nebro
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prevalence ,incidence ,ANCA-associated vasculitis ,General Medicine - Abstract
Objective: In this study, we aimed to evaluate the worldwide incidence and prevalence of ANCA-associated vasculitis (AAV). Methods: A systematic search of Medline and Embase was conducted until June 2020 for studies that analyzed the incidence and prevalence of patients aged >16 years diagnosed with AAV in different geographical areas. A meta-analysis was undertaken to estimate the pooled incidence per million person-years and prevalence per million persons in AAV overall and for each subtype of AAV: granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA). The 95% confidence interval (CI) and I2 for heterogeneity were calculated. Results: The meta-analysis included 25 studies that met the inclusion criteria and covered a total of 4547 patients with AAV. Frequency increased over time. The global pooled incidence (95% CI) was 17.2 per million person-years (13.3–21.6) and the global pooled prevalence (95% CI) was 198.0 per million persons (187.0–210.0). The pooled incidence per million person-years for each AAV subtype varied from highest to lowest, as follows: GPA, 9.0; MPA, 5.9; and EGPA, 1.7. The individual pooled prevalence per million persons was, as follows: GPA, 96.8; MPA, 39.2; and EGPA, 15.6. AAV was more predominant in the northern hemisphere. By continent, a higher incidence in America and pooled prevalence of AAV was observed in America and Europe. Conclusion: The pooled incidence and prevalence of AAV seem to be increasing over time and are higher in the case of GPA. AAV was generally more frequent (incidence and prevalence) in the northern hemisphere.
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- 2022
30. Analysis of clinical–analytical characteristics in patients with rheumatoid arthritis and interstitial lung disease: Case–control study
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Carmen M. Romero Barco, Antonio Fernández-Nebro, Natalia Mena-Vázquez, Lorena Pérez Albaladejo, Carmen Gómez Cano, Inmaculada Ureña Garnica, and Sara Manrique-Arija
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musculoskeletal diseases ,030203 arthritis & rheumatology ,medicine.medical_specialty ,business.industry ,Interstitial lung disease ,Case-control study ,Arthritis ,General Medicine ,respiratory system ,medicine.disease ,behavioral disciplines and activities ,Rheumatology ,respiratory tract diseases ,body regions ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,DLCO ,Usual interstitial pneumonia ,Rheumatoid arthritis ,Internal medicine ,medicine ,business ,Serositis - Abstract
Objectives To study the differences between rheumatoid arthritis (RA)-interstitial lung disease (ILD) patients and RA patients without ILD in severity markers and disease activity and to identify factors associated with the presence of ILD in RA patients. Patients and methods Patients: RA-ILD patients selected from a multicentre cohort in Andalusia, Spain. Controls: RA-patients without ILD paired by sex, age and disease duration. Protocol: RA patients are reviewed every 3–6 months in rheumatology consultation. All patients are reviewed according to a predetermined protocol with systematic data collection. Outcomes: description of ILD type, differences in severity markers and disease activity in both groups. Other variables: ILD type by imaging technique (HRCT): nonspecific interstitial pneumonia (NSIP)/usual interstitial pneumonia (UIP). Lung function by PTF. Activity and severity markers of arthritis by DAS28-ESR, HAQ, RF, ACPA and erosions. Treatment with DMARD. Statistical analysis: descriptive and paired T-test or Chi-square test followed by binary logistic regression (DV: ILD in patients with RA). Results Eighty-two patients were included, 41 RA-ILD and 41 RA controls. RF and ACPA positivity, serositis and osteoporosis were more frequent in RA-ILD patients. No significant differences in DAS28 were observed (P = .145) between RA-ILD and RA control patients. RA-ILD patients presented worse HAQ scores (P = .006). All patients were treated with disease modifying antirheumatic drugs (DMARDs). The risk of developing ILD in RA patients is tripled by a history of smoking or the presence of erosive arthritis (R2 = .36). Conclusions The results of our study support the higher frequency of UIP and NSIP in RA patients. DLCO is the most sensitive parameter to detect ILD in RA patients. Our study showed that ILD in RA patients was associated with RA severity (presence of erosions and ACPA) and with a history of smoking.
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- 2021
31. Análisis de las características clínico-analíticas de pacientes con artritis reumatoide y enfermedad pulmonar intersticial: casos y controles
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Natalia Mena-Vázquez, Inmaculada Ureña Garnica, Lorena Pérez Albaladejo, Antonio Fernández-Nebro, Sara Manrique-Arija, Carmen Gómez Cano, and Carmen M. Romero Barco
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Rheumatology - Abstract
Resumen Objetivos Estudiar las diferencias en pacientes con artritis reumatoide (AR) y enfermedad pulmonar intersticial (EPID) y pacientes con AR sin EPID, e identificar factores asociados con la EPID en pacientes con AR. Pacientes y metodos Estudio observacional de casos y controles. Pacientes: se seleccionaron pacientes de una cohorte con AR y EPID de diferentes centros de Andalucia. Controles: pacientes con AR sin EPID pareados por edad, genero y tiempo de evolucion. Protocolo: los pacientes con AR se revisan cada 3-6 meses en consulta. Todos los pacientes son revisados de acuerdo con un protocolo predeterminado con recogida de datos sistematica. Desenlaces: descripcion del tipo radiologico de EPID, diferencias en los marcadores de gravedad en casos y controles y en la actividad de la enfermedad. Otras variables: descripcion del tipo de EPID por TACAR: neumonia intersticial usual (NIU), neumonia intersticial no especifica (NINE) y de la funcion pulmonar por PFR; marcadores de actividad y gravedad de artritis: DAS28, HAQ, FR, ACPA, erosiones. Tratamiento con FAME. Analisis: descriptivo, χ2 o t de Student, seguida de regresion logistica binaria (Vd:EPID en pacientes con AR). Resultados Se incluyeron 82 pacientes: 41 con AR y EPID y 41 controles AR sin EPID. Los pacientes con EPID presentaron un mayor porcentaje de pacientes con FR y ACPA positivos y una mayor frecuencia de serositis y osteoporosis. No hubo diferencias significativas en DAS28 en casos y controles(p = 0,145), pero los pacientes de AR con EPID presentaron peor HAQ (p = 0,006). Todos los pacientes estaban en tratamiento con FAME. El analisis multivariante mostro que los pacientes con AR exfumadores y con artritis erosiva triplicaron el riesgo de presentar EPID (R2 = 0,36). Conclusiones Los resultados de nuestro estudio apoyan la mayor frecuencia de NIU y NINE en pacientes con AR, asi como la alteracion de DLCO como el parametro mas importante. Los pacientes con AR y EPID se asociaron con una enfermedad mas grave (erosiones y ACPA) y con el tabaco.
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- 2021
32. Utility of pulmonary ultrasound to identify interstitial lung disease in patients with rheumatoid arthritis
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María Carmen Aguilar-Hurtado, Francisco Javier Godoy-Navarrete, Sara Manrique-Arija, Natalia Mena-Vázquez, F Espildora, F. G. Jiménez-Núñez, Antonio Fernández-Nebro, Inmaculada Ureña-Garnica, María Isabel Padin-Martín, and C.M. Romero-Barco
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medicine.medical_specialty ,Multivariate analysis ,business.industry ,Ultrasound ,Interstitial lung disease ,General Medicine ,respiratory system ,medicine.disease ,Logistic regression ,Rheumatology ,respiratory tract diseases ,Arthritis, Rheumatoid ,Cross-Sectional Studies ,Internal medicine ,Rheumatoid arthritis ,medicine ,Humans ,In patient ,Axillary space ,Lung Diseases, Interstitial ,Nuclear medicine ,business ,Lung ,Ultrasonography - Abstract
To analyze the diagnostic utility of lung ultrasound (US) to detect interstitial lung disease (ILD) in rheumatoid arthritis (RA) patients comparing with high-resolution computed tomography (HRCT) PATIENTS AND METHODS: We performed a cross-sectional, observational study in patients with RA-ILD (cases) controlled with a group of RA patients without ILD (controls) paired by sex, age, and time of disease evolution. Patients were assessed using HRCT, PFT, and US. The main variables were B-line number, evaluation of the lung-US score already described, pleural irregularities, and A pattern US lost. ROC curve analysis was performed to establish the cut-off point of the US B-lines number for detecting the presence of significant RA-ILD in relation to HRCT, and logistic regression analysis was performed to identify the intercostal spaces.Seventy-one patients were included, 35 (49.2%) with ILD-RA and 36 (50.8%) RA controls. Regarding US score, we found that the detection of 5.5 lines in a reduced score of 8 intercostal spaces had a sensitivity = 62.2%, specificity = 91.3%, PPV = 88.4%, and NPV = 69.5%. In multivariate analysis, the intercostal spaces which showed independent association with ILD were 3rd right anterior axillary space (OR [IC 95%] 19.0 [1.3-27.5]), 8th right posterior axillary space (OR [IC 95%] 0.04 [0.0-0.6]), 8th right subscapular space (OR [IC 95%] 16.5 [1.8-45.5]), 9th right paravertebral space (OR [IC 95%] 7.11 [1.0-37.1]), and 2nd left clavicular middle space (OR [IC 95%] 21.9 [1.26-37.8]).Lung ultrasound could be a useful tool for ILD diagnosis associated with rheumatoid arthritis. A 8-space reduced score showed a similar total predictive capacity than 72-space score. Key Points • Lung ultrasound could be a useful tool for ILD diagnosis associated with rheumatoid arthritis. • The 72-space evaluation is highly sensitive, whereas a simplified score enables a more specific and faster diagnosis. • The number of B lines is correlated with DLCO, ACPA, inflammatory activity, and physical function.
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- 2021
33. Psychological factors associated with sleep disorders in patients with axial spondyloarthritis or psoriatic arthritis: A multicenter cross‐sectional observational study
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Carmen Domínguez-Quesada, Natalia Mena-Vázquez, Sara Manrique Arija, Rocío Segura-Ruiz, María Dolores Hernández-Sánchez, L. Cano-Garcia, and Antonio Fernández-Nebro
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Adult ,Sleep Wake Disorders ,medicine.medical_specialty ,Adolescent ,Cross-sectional study ,Hospital Anxiety and Depression Scale ,03 medical and health sciences ,Psoriatic arthritis ,0302 clinical medicine ,Quality of life ,Spondylarthritis ,Insomnia ,Humans ,Medicine ,030212 general & internal medicine ,General Nursing ,030504 nursing ,business.industry ,Arthritis, Psoriatic ,General Medicine ,medicine.disease ,Cross-Sectional Studies ,Mood ,Mood disorders ,Quality of Life ,Physical therapy ,Anxiety ,medicine.symptom ,0305 other medical science ,business - Abstract
Background Studies in axial spondyloarthritis (AxSp) have shown that intensity of pain, anxiety, depression and inflammatory activity are associated with poor sleep quality. Aim To describe mood and sleep disorders and positive psychological factors in patients with AxSp and psoriatic arthritis (PsA) and to evaluate the psychological factors that are potentially involved in sleep disorders. Design Multicenter cross-sectional observational study based on a series of patients with AxSp and PsA. Participants Participants were selected consecutively from patients aged ≥18 years with AxSp or PsA followed at the rheumatology department of 4 Spanish hospitals. Inclusion criteria age ≥18 years, AxSp (ASAS criteria) or PsA (CASPAR criteria), ability to understand the study and prepared to complete the questionnaires. Methods Main outcomes: Oviedo Sleep Quality questionnaire result. Secondary outcomes psychological status evaluated using the Hospital Anxiety and Depression Scale (HADS) questionnaire, health-related quality of life evaluated using SF-36, perception of pain evaluated using the short questionnaire for assessment of pain (BDU) and fatigue evaluated using the Fatigue Scale (FACIT) questionnaire. We performed a descriptive multivariate linear regression analysis to study factors that were independently associated with sleep disorders. The STROBE guidelines were adopted. Results We included 301 patients (152 [50.5%] with AxSp and 149 [49.5%] with PsA). The multivariate linear regression analysis for the whole sample showed that insomnia was inversely associated with emotional recovery and biologic disease-modifying antirheumatic drugs and directly associated with depression in both groups. The analysis by disease (AxSp and PsA) showed that insomnia was independently associated with depression and emotional recovery. Conclusions Insomnia may be associated with other mood disorders, quality of life and inflammatory activity in the patients studied here. Relevance to clinical practice A nurse intervention can be carried out to prevent sleep disorders knowing the consequences and triggers of the problem.
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- 2020
34. Importance of Vaccination against SARS-CoV-2 in Patients with Interstitial Lung Disease Associated with Systemic Autoimmune Disease
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Natalia Mena-Vázquez, Aimara García-Studer, Marta Rojas-Gimenez, Carmen María Romero-Barco, Sara Manrique-Arija, Arkaitz Mucientes, María Luisa Velloso-Feijoo, Francisco Javier Godoy-Navarrete, Pilar Morales-Garrido, Rocío Redondo-Rodríguez, MC Ordoñez-Cañizares, Rafaela Ortega-Castro, Jose Manuel Lisbona-Montañez, Ana Hidalgo Conde, Rocío Arnedo Díez de los Ríos, Eva Cabrera César, Francisco Espildora, María Carmen Aguilar-Hurtado, Isabel Añón-Oñate, Inmaculada Ureña-Garnica, and Antonio Fernández-Nebro
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vaccination COVID-19 ,interstitial lung disease (ILD) ,systemic autoimmune disease (SAD) ,General Medicine ,SARS-CoV-2 infections - Abstract
Objectives: To describe the frequency of COVID-19 and the effect of vaccination in patients with interstitial lung disease and systemic autoimmune disease (ILD-SAD) and to identify factors associated with infection and severity of COVID-19. Methods: We performed a cross-sectional multicenter study of patients with ILD-SAD followed between June and October 2021. The main variable was COVID-19 infection confirmed by a positive polymerase chain reaction (PCR) result for SARS-CoV-2. The secondary variables included severity of COVID-19, if the patient had to be admitted to hospital or died of the disease, and vaccination status. Other variables included clinical and treatment characteristics, pulmonary function and high-resolution computed tomography. Two logistic regression was performed to explore factors associated with “COVID-19” and “severe COVID-19”. Results: We included 176 patients with ILD-SAD: 105 (59.7%) had rheumatoid arthritis, 49 (27.8%) systemic sclerosis, and 22 (12.54%) inflammatory myopathies. We recorded 22/179 (12.5%) SARS-CoV-2 infections, 7/22 (31.8%) of them were severe and 3/22 (13.22%) died. As to the vaccination, 163/176 (92.6%) patients received the complete doses. The factors associated with SARS-CoV-2 infection were FVC (OR (95% CI), 0.971 (0.946–0.989); p = 0.040), vaccination (OR (95% CI), 0.169 (0.030–0.570); p = 0.004), and rituximab (OR (95% CI), 3.490 (1.129–6.100); p = 0.029). The factors associated with severe COVID-19 were the protective effect of the vaccine (OR (95% CI), 0.024 (0.004–0.170); p < 0.001) and diabetes mellitus (OR (95% CI), 4.923 (1.508–19.097); p = 0.018). Conclusions: Around 13% of patients with ILD-SAD had SARS-CoV-2 infection, which was severe in approximately one-third. Most patients with severe infection were not fully vaccinated.
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- 2022
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35. Evaluation of cognitive function in adult patients with juvenile idiopathic arthritis
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Natalia Mena-Vázquez, Pablo Cabezudo-García, Luis Muñoz-Becerra, Antonio Fernández-Nebro, Fernando Ortiz-Márquez, Sara Manrique-Arija, and Gisela Diaz-Cordovés Rego
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Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Adolescent ,Inflammatory arthritis ,Neuropsychological Tests ,Logistic regression ,Risk Assessment ,Young Adult ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Rheumatology ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,medicine ,Humans ,Cognitive Dysfunction ,030212 general & internal medicine ,030203 arthritis & rheumatology ,business.industry ,Wechsler Adult Intelligence Scale ,Odds ratio ,medicine.disease ,Arthritis, Juvenile ,Cross-Sectional Studies ,Case-Control Studies ,Population study ,Female ,Block design test ,business - Abstract
OBJECTIVE To evaluate cognitive function in adult patients with juvenile idiopathic arthritis (JIA) and associated factors. PATIENTS AND METHODS We performed a cross-sectional observational study of adult patients with JIA and a healthy control group (no inflammatory diseases) matched for age, gender, and educational level. Cognitive function was assessed using Wechsler Adult Intelligence Scale-III. The cognitive domains measured were attention/concentration, verbal function, visuospatial organization, working memory, and problem solving (Similarities). Other measures included clinical-epidemiological characteristics, comorbid conditions, and treatment. We performed a descriptive bivariate analysis and logistic regression to identify factors associated with visuospatial involvement. RESULTS The study population comprised 104 subjects (52 with JIA and 52 healthy controls). Patients with JIA had poorer results for visuospatial function, with a lower median scaled score on the Block Design test (5.0 [4.0-8.0] vs 8.0 [5.0-10.0]; P = .014). The number of patients with scaled scores below the average range (
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- 2020
36. Frequency of Polyautoimmunity in Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus
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Sara Manrique-Arija, Natalia Mena-Vázquez, Inmaculada Ureña-Garnica, F. G. Jiménez-Núñez, M.C. Ordoñez-Cañizares, Antonio Fernández-Nebro, and Rocio Redondo-Rodriguez
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Autoimmune disease ,medicine.medical_specialty ,business.industry ,Hydroxychloroquine ,Odds ratio ,medicine.disease ,Rheumatology ,Autoimmune Diseases ,Arthritis, Rheumatoid ,Cross-Sectional Studies ,Sjogren's Syndrome ,immune system diseases ,Antiphospholipid syndrome ,Internal medicine ,Rheumatoid arthritis ,Psoriasis ,medicine ,Humans ,Lupus Erythematosus, Systemic ,skin and connective tissue diseases ,business ,Rheumatism ,medicine.drug - Abstract
Objective To describe the frequency of polyautoimmunity and multiple autoimmune syndrome in patients with rheumatoid arthritis (RA) and patients with systemic lupus erythematosus (SLE). Patients and methods This was a cross-sectional observational study of patients with RA, SLE, and controls without autoimmune rheumatic disease. Cases were those with RA according to the 2010 American College of Rheumatology/European League Against Rheumatism criteria and SLE according to the 2019 American College of Rheumatology/European League Against Rheumatism criteria, consecutively recruited in a rheumatology clinic. Controls were subjects with no rheumatic autoimmune disease (AIDs) recruited in the same area. Patients filled out a questionnaire on polyautoimmunity. Variables of interest were polyautoimmunity (RA or SLE with other AIDs), whereas secondary variables were rheumatic, skin, endocrine, digestive, and neurological AIDs. Multiple autoimmune syndrome is defined as the presence of 3 or more AIDs and a family history of AIDs. Statistical analyses performed were descriptive, bivariate, and multivariate (dependent variable: polyautoimmunity). Results The study population comprised 109 patients with RA, 105 patients with SLE, and 88 controls. Polyautoimmunity was recorded in 15 patients with RA (13.8%), 43 with SLE (41%), and 2 controls (2.2%). The most frequent AID in RA was Sjogren syndrome (53.3%), followed by Hashimoto thyroiditis and psoriasis; the most frequent AIDs in SLE were Sjogren syndrome (55.8%) and antiphospholipid syndrome (30.2%), followed by Hashimoto thyroiditis. Obesity was associated with polyautoimmunity in RA (odds ratio [OR], 3.362; p = 0.034). In SLE, joint damage (OR, 2.282; p = 0.038) and anti-RNP antibodies (OR, 5.095; p = 0.028) were risk factors for polyautoimmunity, and hydroxychloroquine was a protective factor (OR, 0.190; p = 0.004). Conclusions Polyautoimmunity is frequent in RA and even more frequent in SLE. It was associated with obesity in RA and with joint damage and anti-RNP in SLE. Hydroxychloroquine was a protector.
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- 2020
37. Non-anti-TNF biologic agents are associated with slower worsening of interstitial lung disease secondary to rheumatoid arthritis
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Carmen Gomez-Cano, Natalia Mena-Vázquez, Lorena Pérez-Albaladejo, María Isabel Padin-Martín, María Carmen Aguilar-Hurtado, C.M. Romero-Barco, Francisco Javier Godoy-Navarrete, Antonio Fernández-Nebro, F. G. Jiménez-Núñez, Inmaculada Ureña-Garnica, F Espildora, Isabel Añón-Oñate, and Sara Manrique-Arija
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musculoskeletal diseases ,medicine.medical_specialty ,Pulmonary function testing ,Arthritis, Rheumatoid ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Tocilizumab ,Rheumatology ,Internal medicine ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Adverse effect ,030203 arthritis & rheumatology ,Tumor Necrosis Factor-alpha ,business.industry ,Abatacept ,Interstitial lung disease ,General Medicine ,medicine.disease ,chemistry ,Antirheumatic Agents ,Rheumatoid arthritis ,Rituximab ,Lung Diseases, Interstitial ,business ,medicine.drug - Abstract
To analyze the effect of disease-modifying antirheumatic drugs (DMARDs) on the outcome of interstitial lung disease secondary to rheumatoid arthritis (RA-ILD).We performed a multicenter, prospective, observational study of patients with RA-ILD receiving DMARDs between 2015 and 2017. The patients were assessed using high-resolution computed tomography and pulmonary function tests at baseline and at 24 months. The radiological assessment was centralized. The main outcome measure at 24 months was changed in lung function (improvement, stabilization, worsening, or death). We recorded the 28-joint Disease Activity Score 28 (DAS28) and adverse events. A logistic regression analysis was performed to identify factors associated with worsening of ILD.After 24 months, lung disease was stabilized in 40 patients (57.1%), improved in 8 (11.4%), and worse in 21 (30.0%). One patient (1.4%) died. The factors associated with worsening of ILD in the multivariate analysis were treatment with abatacept, tocilizumab, or rituximab (OR, 0.102 [95%CI, 0.015-0.686]), DAS28 (OR, 1.969 [95%CI, 1.005-3.857]), and smoking (OR, 6.937 [95%CI, 1.378-4.900]). During follow-up, 30 patients (42.9%) experienced an adverse event, which was severe in 12 cases (17.1%).Lung function is stable and inflammatory activity well controlled in most patients with RA-ILD receiving treatment with DMARDs. Non-anti-TNF DMARDs reduce the risk of worsening of lung disease in 90% of patients. The inflammatory activity of RA and smoking, on the other hand, are associated with worsening. Key Points • We have performed prospectively evaluated lung and joint function in patients with RA-ILD receiving treatment with various DMARDs. • In our study, the lung function is stable and inflammatory activity well controlled in most patients with RA-ILD receiving treatment with DMARDs. • Neither csDMARDs nor anti-TNF agents were associated with a significant risk of worsening of lung disease, whereas non-anti-TNF bDMARDs could reduce the risk of worsening of lung disease. • Smoking and poor control of joint involvement were the main factors associated with worsening of lung disease.
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- 2020
38. Ability to Participate in Social Activities of Rheumatoid Arthritis Patients Compared with Other Rheumatic Diseases: A Cross-Sectional Observational Study
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Natalia Mena-Vázquez, Rocio Redondo-Rodriguez, C.M. Romero-Barco, Antonio Fernández-Nebro, Sara Manrique-Arija, and L. Cano-Garcia
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rheumatoid arthritis ,medicine.medical_specialty ,Medicine (General) ,Clinical Biochemistry ,psychological factors ,Article ,R5-920 ,systemic lupus erythematosus ,Internal medicine ,medicine ,In patient ,Social isolation ,Depression (differential diagnoses) ,rheumatic diseases ,spondyloarthritis ,participate in social activities ,mental health ,business.industry ,medicine.disease ,Mental health ,Rheumatoid arthritis ,Population study ,Observational study ,medicine.symptom ,business ,Psychosocial - Abstract
Objectives: To compare the ability to participate in social activities among rheumatoid arthritis patients with other rheumatic disease patients and identify potentially implicated factors. Patients and methods: Between June and November 2019, we consecutively selected patients aged ≥18 years with RA (defined according to ACR/EULAR 2010), SpA (ASAS/EULAR 2010), and SLE (ACR 1997). Main outcome measures: Ability to participate in social roles and activities evaluated using the PROMIS score v2.0 short-form 8a (PROMIS-APS). Secondary outcomes: Participation in social activities according to a series of variables (mobility, depression, satisfaction with social relationships, social isolation, company, emotional support, instrumental support, and support via information). We evaluated the association between the ability to participate in social activities and associated variables using multivariable linear regression analysis. Results: The study population comprised 50 patients with RA (33.1%), 51 patients (33.8%) with SpA, and 50 patients (33.1%) with SLE. The mean PROMIS-APS scores were similar in the three groups. The multivariable analysis for the whole sample showed that the ability to participate in social activities was inversely associated with depression and directly with social satisfaction, mobility, company, and age. The stratified analysis revealed an inverse association between inflammatory activity and ability to participate in social activities in patients with RA and SpA, but not in those with SLE. Conclusion: All patients with RA, SpA, and SLE had a similar ability to participate in social activities. This was associated with other psychosocial factors (social satisfaction, mobility, company, depression) and clinical factors (age and inflammatory activity).
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- 2021
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39. Characteristics and Predictors of Progression Interstitial Lung Disease in Rheumatoid Arthritis Compared with Other Autoimmune Disease: A Retrospective Cohort Study
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Rocio Redondo-Rodriguez, Francisco Espildora, Ana Hidalgo Conde, M. Rojas-Giménez, C.M. Romero-Barco, Natalia Mena-Vázquez, Rafaela Ortega-Castro, María Carmen Aguilar-Hurtado, Rocío Arnedo Díez de los Ríos, Inmaculada Ureña-Garnica, Manuel Abarca-Costalago, Eva Cabrera César, Sara Manrique-Arija, Isabel Añón-Oñate, Antonio Fernández-Nebro, Lorena Pérez-Albaladejo, María Luisa Velloso-Feijoó, [Mena-Vázquez,N, Romero-Barco,CM, Manrique-Arija,S, Ureña-Garnica,I, Redondo-Rodriguez,R, Fernández-Nebro,A] Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain. [Mena-Vázquez,N, Fernández-Nebro,A] UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain. [Rojas-Gimenez,M, Ortega-Castro,R] Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain. [Rojas-Gimenez,M, Ortega-Castro,R] UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain. [Romero-Barco,CM] UGC de Reumatología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain. [Hidalgo Conde,A, Arnedo Díez de Los Ríos,R, and Abarca-Costalago,M] Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Cabrera César,E] UGC Neumología, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Espildora,F] UGC de Neumología, Hospital Regional Universitario de Málaga, Málaga, Spain. [Aguilar-Hurtado,MC] UGC de Radiodiagnóstico, Hospital Regional Universitario de Málaga, Málaga, Spain. [Añón-Oñate,I] Hospital Universitario de Jaén, Jaén, Spain. [Pérez-Albaladejo,L] Hospital Universitario Virgen de las Nieves, Granada, Spain. [Velloso-Feijoo,ML] Hospital Universitario Virgen de Valme, Sevilla, Spain. [Fernández-Nebro,A] Departamento de Medicina, Universidad de Málaga, Málaga, Spain.
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rheumatoid arthritis ,Vital capacity ,Medicine (General) ,Clinical Biochemistry ,Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Tobacco Use::Smoking [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings] ,Pulmonary function testing ,Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Interstitial [Medical Subject Headings] ,Diseases::Skin and Connective Tissue Diseases::Connective Tissue Diseases::Scleroderma, Systemic [Medical Subject Headings] ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,Usual interstitial pneumonia ,Diffusing capacity ,Fumar ,interstitial lung disease ,Smoking ,Interstitial lung disease ,Pronóstico ,respiratory system ,Prognosis ,systemic autoimmune disease ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Hospitalization [Medical Subject Headings] ,Rheumatoid arthritis ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Tomography [Medical Subject Headings] ,Health Care::Health Services Administration::Quality of Health Care::Outcome and Process Assessment (Health Care)::Outcome Assessment (Health Care) [Medical Subject Headings] ,medicine.medical_specialty ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Analysis of Variance::Multivariate Analysis [Medical Subject Headings] ,Artritis reumatoide ,Article ,FEV1/FVC ratio ,R5-920 ,Enfermedades pulmonares intersticiales ,Internal medicine ,Enfermedades autoinmunes ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies [Medical Subject Headings] ,Diseases::Immune System Diseases::Autoimmune Diseases [Medical Subject Headings] ,medicine ,Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Interstitial::Idiopathic Interstitial Pneumonias::Idiopathic Pulmonary Fibrosis [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Regression Analysis [Medical Subject Headings] ,business.industry ,Retrospective cohort study ,Anatomy::Respiratory System::Lung [Medical Subject Headings] ,medicine.disease ,respiratory tract diseases ,Phenomena and Processes::Circulatory and Respiratory Physiological Phenomena::Respiratory Physiological Phenomena::Total Lung Capacity::Vital Capacity [Medical Subject Headings] ,Systemic autoimmune disease ,Diseases::Immune System Diseases::Autoimmune Diseases::Arthritis, Rheumatoid [Medical Subject Headings] ,prognosis ,business ,Chemicals and Drugs::Inorganic Chemicals::Carbon Compounds, Inorganic::Carbon Monoxide [Medical Subject Headings] - Abstract
Objectives: To describe the characteristics and progression of interstitial lung disease in patients with associated systemic autoimmune disease (ILD-SAI) and to identify factors associated with progression and mortality. Patients and methods: We performed a multicenter, retrospective, observational study of patients with ILD-SAI followed between 2015 and 2020. We collected clinical data and performed pulmonary function testing and high-resolution computed tomography at diagnosis and at the final visit. The main outcome measure at the end of follow-up was forced vital capacity (FVC) >, 10% or diffusing capacity of the lungs for carbon monoxide >, 15% and radiological progression or death. Cox regression analysis was performed to identify factors associated with worsening of ILD. Results: We included 204 patients with ILD-SAI: 123 (60.3%) had rheumatoid arthritis (RA), 58 had (28.4%) systemic sclerosis, and 23 (11.3%) had inflammatory myopathy. After a median (IQR) period of 56 (29.8–93.3) months, lung disease had stabilized in 98 patients (48%), improved in 33 (16.1%), and worsened in 44 (21.5%). A total of 29 patients (14.2%) died. Progression and hospitalization were more frequent in patients with RA (p = 0.010). The multivariate analysis showed the independent predictors for worsening of ILD-SAI to be RA (HR, 1.9 [95% CI, 1.3–2.7]), usual interstitial pneumonia pattern (HR, 1.7 [95% CI, 1.0–2.9]), FVC (%) (HR, 2.3 [95% CI, 1.4–3.9]), and smoking (HR, 2.7 [95%CI, 1.6–4.7]). Conclusion: Disease stabilizes or improves after a median of 5 years in more than half of patients with ILD-SAI, although more than one-third die. Data on subgroups and risk factors could help us to predict poorer outcomes.
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- 2021
40. Adiposity Is Related to Inflammatory Disease Activity in Juvenile Idiopathic Arthritis
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Rocio Redondo-Rodriguez, Francisco Javier Godoy-Navarrete, Rocío Galindo-Zavala, Antonio Fernández-Nebro, Sara Manrique-Arija, Soledad Aguado Henche, Gisela Diaz-Cordovés Rego, Esmeralda Núñez-Cuadros, Natalia Mena-Vázquez, Laura Martín-Pedraz, [Diaz-Cordovés Rego,G, Mena-Vázquez,N, Manrique-Arija,S, Redondo-Rodríguez,R, Godoy-Navarrete,FJ, Fernández-Nebro,A] Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain. [Diaz-Cordovés Rego,G, Fernández-Nebro,A] UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain. [Núñez-Cuadros,E, Galindo-Zavala,R, Martín-Pedraz,L] UGC de Pediatría, Hospital Regional Universitario de Málaga, Málaga, Spain. [Aguado Henche,S] Departamento de Anatomía y Embriología Humana, Facultad de Medicina, Universidad de Alcalá de Henares, Madrid, Spain. [Fernández-Nebro,A] Departamento de Medicina, Universidad de Málaga, Málaga, Spain., and This research was funded by a grant for medical researchers of the 'Sociedad Española de Reumatología Pediatrica'
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Obesidad ,Arthritis ,Adipose tissue ,Disease ,Dual-energy x-ray absorptiometry ,Overweight ,Índice de masa corporal ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Body Fat Distribution::Adiposity [Medical Subject Headings] ,Gastroenterology ,Body composition ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,Juvenile Arthritis Disease Activity Score ,Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight::Overweight [Medical Subject Headings] ,Phenomena and Processes::Metabolic Phenomena::Body Composition [Medical Subject Headings] ,Body mass index ,Adiposity ,adiposity ,General Medicine ,Anatomy::Tissues::Connective Tissue::Adipose Tissue [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cross-Sectional Studies [Medical Subject Headings] ,Adiposidad ,Medicine ,medicine.symptom ,medicine.medical_specialty ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Body Mass Index [Medical Subject Headings] ,Inflammatory disease activity ,Article ,Internal medicine ,medicine ,Obesity ,Composición corporal ,Absorciometría de fotón ,business.industry ,Juvenile idiopathic arthritis ,medicine.disease ,Trunk ,Diseases::Nutritional and Metabolic Diseases::Nutrition Disorders::Overnutrition::Obesity [Medical Subject Headings] ,Chemicals and Drugs::Complex Mixtures::Biological Products [Medical Subject Headings] ,inflammatory disease activity ,Artritis juvenil ,Anatomy::Body Regions::Extremities::Lower Extremity::Leg [Medical Subject Headings] ,Phenomena and Processes::Musculoskeletal and Neural Physiological Phenomena::Musculoskeletal Physiological Phenomena::Musculoskeletal Physiological Processes::Movement::Motor Activity::Exercise [Medical Subject Headings] ,Sobrepeso ,juvenile idiopathic arthritis ,Diseases::Musculoskeletal Diseases::Joint Diseases::Arthritis::Arthritis, Juvenile [Medical Subject Headings] ,business ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Radiography::Absorptiometry, Photon [Medical Subject Headings] - Abstract
Objective: To identify factors associated with the higher proportion of fatty tissue and overweight/obesity observed in patients with juvenile idiopathic arthritis (JIA). Patients and methods: We performed a cross-sectional study of 80 JIA patients aged 4–15 years with 80 age- and sex-matched healthy controls. Body composition was assessed using dual-energy x-ray absorptiometry. The 27-joint Juvenile Arthritis Disease Activity score (JADAS27) was calculated. Two multivariate models were constructed to identify factors associated with overweight/obesity and fat mass index (FMI). Results: No differences were found between cases and controls in body mass index (BMI) or body composition. However, compared with controls, patients with a high inflammatory activity (JADAS27 >, 4.2 for oligoarticular JIA or >, 8.5 for polyarticular disease) had higher values for BMI (p = 0.006), total fat mass (p = 0.003), FMI (p = 0.001), and fat in the legs (p = 0.001), trunk (p = 0.001), and arms (p = 0.002). The factors associated with overweight/obesity in patients were the duration of therapy with biological drugs, measured in months (OR [95% CI] = 1.12 [1.02–1.04], p = 0.037), and physical activity (OR [95% CI] = 0.214 [0.07–0.68], p = 0.010), while the factors associated with FMI were age (β [95% CI] = 0.30 [0.17–1.41], p = 0.014), JADAS27 (β [95% CI] = 0.45 [0.16–1.08], p = 0.009), and physical activity (β [95% CI] = −0.22 [−5.76 to 0.29], p = 0.031). Conclusion: Our study revealed no differences between JIA patients with well-controlled disease and low disability and the healthy population in BMI or body composition. Furthermore, the association observed between inflammatory activity and adiposity could be responsible for poorer clinical course.
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- 2021
41. Clinical and therapeutic management of rheumatoid arthritis with biological disease-modifying antirheumatic drugs: RADAR study
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Antonio Gómez-Centeno, Santiago Muñoz-Fernández, Ceferino Barbazán-Álvarez, Sagrario Bustabad, Sara Manrique-Arija, Esteban Rubio-Romero, Juan Amarelo-Ramos, Juan Ovalles, Javier del Pino-Montes, and Sara Marsal-Barril
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Adult ,Male ,medicine.medical_specialty ,Immunology ,Disease ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Quality of life ,Internal medicine ,Humans ,Immunology and Allergy ,Medicine ,Registries ,030212 general & internal medicine ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,Biological Products ,business.industry ,Medical record ,Middle Aged ,medicine.disease ,Methotrexate ,Treatment Outcome ,Antirheumatic Agents ,Rheumatoid arthritis ,Concomitant ,Cohort ,Quality of Life ,Drug Therapy, Combination ,Female ,Observational study ,business - Abstract
To describe the clinical and therapeutic management of rheumatoid arthritis (RA) patients with biological disease-modifying antirheumatic drugs (bDMARDs), alone or in combination with conventional synthetic DMARDs (csDMARDs), as well as analysing changes over time in bDMARD use. An observational, retrospective, multicentre study was conducted in the rheumatology departments of 10 public Spanish hospitals. Patients with RA treated with bDMARDs at baseline who had medical records available in the data collection period 2013-2016 were included. All visits to rheumatology departments recording any type of bDMARD modification (dose, etc.) were collected. Clinical characteristics, concomitant treatment, resource use, work productivity and quality of life (QoL) were recorded. 128 patients were included: 81 received first-line bDMARD treatment, 28 second-line bDMARD treatment and 19 received third or later lines. Mean study follow-up was 4.1 years. Assessment of DAS28 was available in 54.6% of visits. At baseline, 48.7% of patients had moderate-high disease activity. At final observation, 69.5% of patients continued with the first bDMARD. Tumour necrosis factor blockers were administered to 85.2% of patients in first line, 45.7% in second line and 18.1% in third or later lines. At final observation, 80.2% of patients still felt pain/discomfort. As expected, those with higher disease activity had higher loss of work productivity and lower QoL, as assessed by DAS28, than patients with lower disease activity. Drugs represented 82.6% of the total cost. In this Spanish cohort of 128 patients, most patients remained on the first prescribed bDMARD, despite remaining signs and symptoms.
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- 2019
42. Eficacia y seguridad de rituximab en neuropatía vasculítica: revisión sistemática
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Natalia Mena-Vázquez, Clara Fuego Varela, Pablo Cabezudo-García, Sara Manrique-Arija, and Antonio Fernández-Nebro
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Gynecology ,medicine.medical_specialty ,Rheumatology ,business.industry ,medicine ,Context (language use) ,Rituximab ,business ,medicine.disease ,Vasculitis ,Cryoglobulinemic vasculitis ,Vasculitic neuropathy ,medicine.drug - Abstract
espanolObjetivo Revisar la eficacia y seguridad del rituximab en neuropatia vasculitica (NV). Metodos Se realizo una busqueda en la literatura de Medline y Embase hasta 2017. Los terminos incluidos guardaron relacion con «vasculitis», «neuropatia vasculitica» y «rituximab». Dicha busqueda fue realizada por 2 revisores. El resultado principal fue la eficacia del rituximab. Resultados Tras seleccionar inicialmente 702 articulos, 5 de ellos permanecieron con un nivel de evidencia de entre 1+ y 3, y un grado de recomendacion variable. En el unico ensayo clinico incluido, el rituximab fue superior a la terapia convencional para vasculitis crioglobulinemica, mostrando NV un incremento en la tasa de retencion farmacologica (64,3 vs. 3,5%; p Conclusiones Rituximab parece ser un tratamiento eficaz y seguro para NV, en el contexto de vasculitis crioglobulinemica. Se carece de evidencia sobre la eficacia especifica de NV en el contexto de otras vasculitis. EnglishObjective To review the efficacy and safety of rituximab in vasculitic neuropathy (VN). Methods A literature search was performed on Medline and Embase up until 2017. It included terms related to “vasculitis”,“vasculitic neuropathy” and “Rituximab”. Research was carried out by two reviewers. The main outcome was rituximab efficacy. Results Of an initial selection of 702 articles, 5 remained with a level of evidence between 1+ and 3 and variable recommendation degree. In the only clinical trial included, rituximab was superior to conventional therapy for cryoglobulinemic vasculitis with VN showing an increase in drug retention rate (64.3% vs. 3.5%; P Conclusions Rituximab seems an effective and safe treatment for VN in the context of cryoglobulinemic vasculitis. Evidence for specific efficacy in VN in the context of other types of vasculitis is lacking.
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- 2019
43. Análisis de la efectividad, seguridad y optimización de tocilizumab en una cohorte de pacientes con artritis reumatoide en práctica clínica
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Inmaculada Ureña-Garnica, Antonio Fernández-Nebro, Natalia Mena-Vázquez, M. Rojas-Giménez, Sara Manrique-Arija, and F. G. Jiménez-Núñez
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Gynecology ,Disease activity ,Clinical Practice ,medicine.medical_specialty ,Secondary outcome ,Rheumatology ,business.industry ,medicine ,In patient ,Physical function ,business ,Retention time ,Surgery - Abstract
Resumen Objetivo Evaluar la efectividad y la seguridad de tocilizumab (TCZ) en pacientes con artritis reumatoide (AR) en practica clinica; la optimizacion de dosis y el cambio de formulacion intravenosa (iv) a subcutanea (sc). Material y metodos Estudio observacional retrospectivo. Se incluyo a 53 pacientes con AR tratados con TCZ. El desenlace principal fue efectividad de TCZ en la semana 24. Variables de desenlace secundarias incluyeron: efectividad en la semana 52, tiempo de retencion del tratamiento, funcion fisica y seguridad. Tambien se midio efectividad de la optimizacion de dosis y del cambio de formulacion iv a sc a los 3 y 6 meses. La efectividad se midio con el indice de actividad segun el Disease activity score-28. Se uso la prueba T pareada o prueba de rangos con signos de Wilcoxon para evaluar efectividad y el tiempo de supervivencia mediante curvas de Kaplan-Meier. Resultados La proporcion de pacientes que alcanzaron la remision o baja actividad de la enfermedad en las semanas 24 y 52 fue del 75,5 y el 87,3%, respectivamente. La media de tiempo de retencion (intervalo de confianza del 95% [IC del 95%]) fue de 81,7 meses (76,6-86,7). Veintiuno de 53 pacientes (39,6%) optimizaron la dosis de TCZ y 35 pacientes cambiaron a TCZ sc desde iv, sin cambios en resultados de efectividad. La tasa de efectos adversos fue 13,6 eventos/100 pacientes-ano. Conclusiones Tocilizumab parece efectivo y seguro en AR en practica clinica. La reduccion de dosis parece efectiva en la mayoria de los pacientes en remision, incluso cuando cambian de iv a sc. Objective To evaluate the effectiveness and safety of tocilizumab (TCZ) in patients with rheumatoid arthritis (RA) in clinical practice, establishing the optimized regimen and switching from intravenous (IV) to subcutaneous (SC) therapy. Material and methods Retrospective observational study. We included 53 RA patients treated with TCZ. The main outcome was TCZ effectiveness at week 24. Secondary outcome variables included effectiveness at week 52, therapeutic maintenance, physical function and safety. The effectiveness of optimization and the switch from IV to SC was evaluated at 3 and 6 months. The efficacy was measured with the Disease Activity Score. Paired t-tests or Wilcoxon were used to evaluate effectiveness and survival time using Kaplan-Meier. Results The proportion of patients who achieved remission or low disease activity at weeks 24 and 52 was 75.5% and 87.3%, respectively. The mean retention time (95% confidence interval [95% CI] was 81.7 months [76.6-86.7]). Twenty-one of 53 patients (39.6%) optimized the TCZ dose and 35 patients switched from IV TCZ to SC, with no changes in effectiveness. The adverse event rate was 13.6 events/100 patient-years. Conclusions Tocilizumab appears to be effective and safe in RA in clinical practice. The optimized regimen appears to be effective in most patients in remission, even when they change from IV to SC.
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- 2019
44. Analysis of Effectiveness, Safety and Optimization of Tocilizumab in a Cohort of Patients With Rheumatoid Arthritis in Clinical Practice
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M. Rojas-Giménez, Natalia Mena-Vázquez, Antonio Fernández-Nebro, Sara Manrique-Arija, Inmaculada Ureña-Garnica, and F. G. Jiménez-Núñez
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Adult ,Male ,medicine.medical_specialty ,Injections, Subcutaneous ,Antibodies, Monoclonal, Humanized ,Drug Administration Schedule ,Arthritis, Rheumatoid ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Tocilizumab ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Adverse effect ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,business.industry ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Confidence interval ,Clinical Practice ,Regimen ,Treatment Outcome ,chemistry ,Antirheumatic Agents ,Rheumatoid arthritis ,Cohort ,Female ,business ,Follow-Up Studies - Abstract
Objective To evaluate the effectiveness and safety of tocilizumab (TCZ) in patients with rheumatoid arthritis (RA) in clinical practice, establishing the optimised regimen and switching from intravenous (IV) to subcutaneous (SC) therapy. Material and methods Retrospective observational study. We included 53 RA patients treated with TCZ. The main outcome was TCZ effectiveness at week 24. Secondary outcome variables included effectiveness at week 52, therapeutic maintenance, physical function and safety. The effectiveness of optimization and the switch from IV to SC was evaluated at 3 and 6 months. The efficacy was measured with the Disease Activity Score. Paired t-tests or Wilcoxon were used to evaluate effectiveness and survival time using Kaplan–Meier. Results The proportion of patients who achieved remission or low disease activity at weeks 24 and 52 was 75.5% and 87.3%, respectively. The mean retention time (95% confidence interval [95% CI] was 81.7 months [76.6–86.7]). Twenty-one of 53 patients (39.6%) optimised the TCZ dose and 35 patients switched from IV TCZ to SC, with no changes in effectiveness. The adverse event rate was 13.6 events/100 patient-years. Conclusions Tocilizumab appears to be effective and safe in RA in clinical practice. The optimised regimen appears to be effective in most patients in remission, even when they change from IV to SC.
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- 2019
45. Hospitalizaciones y mortalidad por COVID-19 de pacientes con enfermedades inflamatorias reumáticas en Andalucía
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Enrique Raya-Álvarez, Marta Rojas-Giménez, María Luisa Velloso-Feijoó, C.M. Romero-Barco, Natalia Mena-Vázquez, Rocio Redondo-Rodriguez, Sara Manrique Arija, C López-Medina, Consuelo Ramos-Giraldez, Francisco Javier Godoy-Navarrete, M. Morales-Águila, Alba María Cabezas-Lucena, and Antonio Fernández-Nebro
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medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Population ,Disease ,Comorbidity ,Logistic regression ,rheumatic inflammatory diseases ,Article ,Enfermedad inflamatoria reumática ,Outcome variable ,Rheumatology ,Risk Factors ,Internal medicine ,Rheumatic Diseases ,medicine ,Humans ,hospitalización ,Statistical analysis ,In patient ,education ,Gynecology ,education.field_of_study ,SARS-CoV-2 ,business.industry ,COVID-19 ,General Medicine ,mortality ,Case-Control Studies ,Hypertension ,Hospital admission ,mortalidad ,Observational study ,Original Article ,Rheumatic inflammatory disease ,business ,human activities ,hospitalization - Abstract
Resumen OBJETIVO: Describir si las enfermedades inflamatorias reumaticas (EIR) se asocian con mayor riesgo de hospitalizacion y/o mortalidad por COVID-19 e identificar los factores asociados a la hospitalizacion y mortalidad en EIR y COVID-19 en diferentes Hospitales de Andalucia METODOS: Diseno: Estudio multicentrico observacional de casos y controles Pacientes: Casos: EIR y COVID-19 de diferentes centros de Andalucia Controles: pacientes sin EIR pareados por sexo, edad y PCR-COVID Protocolo: se solicito al servicio de microbiologia un listado de pacientes con PCR para COVID-19 desde 14 de marzo al 14 de abril de 2020 Se identificaron los pacientes que tuvieran EIR y luego consecutivamente un control pareado para cada caso Variables: La variable de desenlace principal fue ingreso hospitalario y mortalidad por COVID-19 Analisis estadistico: bivariante seguida de modelos de regresion logistica binaria (Vd : mortalidad/ingreso hospitalario) RESULTADOS: Se incluyeron 156 pacientes con COVID-19, 78 con EIR y 78 sin EIR Los pacientes con EIR no presentaron caracteristicas de la enfermedad COVID-19 diferentes a la poblacion general, tampoco mayor ingreso hospitalario ni mortalidad El factor asociado con mortalidad en los pacientes con EIR fue edad (OR [IC 95%], 1,1 [1,0-1,2];p=0,025), mientras que los factores asociados a ingreso hospitalario fueron edad (OR [IC 95%], 1,1 [1,1-1,2];p=0,007) e hipertension arterial (OR [IC 95%], 3,9 [1,5-6,7];p=0,003) CONCLUSION: La mortalidad y el ingreso hospitalario por COVID-19 no parecen aumentados en las EIR La edad se asocio con mortalidad en EIR y, ademas, la hipertension arterial se asocio con ingreso hospitalario ABSTRACT OBJECTIVE: To describe whether rheumatic inflammatory diseases (RID) are associated with a higher risk of hospitalization and / or mortality from COVID-19 and identify the factors associated with hospitalization and mortality in RID and COVID-19 in different Hospitals in Andalusia METHODS: Design: Multicentre observational case-control study Patients: RID and COVID-19 from different centres in Andalusia Controls: patients without RIS matched by sex, age and CRP-COVID Protocol: a list of patients with PCR for COVID-19 was requested from the microbiology service from March 14 to April 14, 2020 The patients who had RID were identified and then consecutively a paired control for each case Variables: The main outcome variable was hospital admission and mortality from COVID-19 Statistical analysis: bivariate followed by binary logistic regression models (DV: mortality / hospital admission) RESULTS: One hundred and fifty-six patients were included, 78 with RID and COVID-19 and 78 without RID with COVID-19 The patients did not present characteristics of COVID-19 disease different from the general population, nor did they present higher hospital admission or mortality The factor associated with mortality in patients with RID was advanced age (OR [95% CI], 1 1 [1 0-1 2];p = 025), while the factors associated with hospitalization were advanced age (OR [95% CI], 1 1 [1 0-1 1];p = 007) and hypertension (OR [95% CI], 3 9 [1 5-6 7] ;p = 003) CONCLUSION: Mortality and hospital admission due to COVID-19 do not seem to increase in RID Advanced age was associated with mortality in RID and, in addition, HTN was associated with hospital admission
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- 2021
46. Cumulative inflammatory burden and obesity as determinants of insulin resistance in patients with established rheumatoid arthritis: cross-sectional study
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Natalia Mena-Vázquez, I. Ureña, F. G. Jiménez-Núñez, Begoña Oliver-Martos, José Rioja, Antonio Fernández-Nebro, Pedro Valdivielso, Salomé Abad-Sánchez, Leovigildo Ginel-Mendoza, and Sara Manrique-Arija
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medicine.medical_specialty ,Cross-sectional study ,rheumatology ,diabetes & endocrinology ,030204 cardiovascular system & hematology ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,Insulin resistance ,Rheumatology ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Obesity ,030203 arthritis & rheumatology ,biology ,business.industry ,Quantitative insulin sensitivity check index ,C-reactive protein ,General Medicine ,medicine.disease ,Cross-Sectional Studies ,Spain ,Rheumatoid arthritis ,biology.protein ,Medicine ,Insulin Resistance ,business ,Body mass index - Abstract
ObjectivesTo describe the prevalence of insulin resistance (IR) in patients with established rheumatoid arthritis (RA) and to analyse the contribution of cumulative inflammatory burden and other factors to its development.DesignObservational cross-sectional study.ParticipantsPatients with RA and controls matched for age, sex and Body Mass Index. We excluded patients with diabetes.SettingsPatients from an RA inception cohort at Hospital Regional Universitario de Málaga, Spain, were recruited between September 2016 and May 2018.Primary and secondary outcome measuresIR was evaluated using the homeostasis model assessment for IR and beta-cell function and the quantitative insulin sensitivity check index. Other variables included the cumulative 28-Joint Disease Activity Score (DAS28) with C reactive protein (CRP) body composition and cytokines. Two logistic regression models were constructed to identify factors associated with IR in patients with RA.ResultsEighty-nine patients with RA and 80 controls were included. The prevalence of IR was similar in both cases and controls. Inflammatory activity was controlled appropriately in patients during follow-up (mean DAS28 3.1 (0.8)). The presence of IR in patients with RA was associated with obesity (OR 6.01, 95% CI 1.9 to 8.7), higher cumulative DAS28-CRP values during follow-up (OR 2.8, 95% CI 1.3 to 6.0), and higher interleukin-1β levels (OR 1.6, 95% CI 1.1 to 2.4). The second model showed that the risk of IR increased by 10% for each kilogram of excess body fat.ConclusionIn patients with well-controlled, established RA, IR is associated mainly with poorer control of inflammation from diagnosis and with obesity, specifically total fat mass.
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- 2021
47. Correction to: Utility of pulmonary ultrasound to identify interstitial lung disease in patients with rheumatoid arthritis
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Francisco Javier Godoy-Navarrete, Natalia Mena-Vázquez, Antonio Fernández-Nebro, María Isabel Padin-Martín, F. G. Jiménez-Núñez, C.M. Romero-Barco, F Espildora, María Carmen Aguilar-Hurtado, Sara Manrique-Arija, and Inmaculada Ureña-Garnica
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medicine.medical_specialty ,business.industry ,Ultrasound ,Interstitial lung disease ,MEDLINE ,General Medicine ,medicine.disease ,Rheumatology ,Text mining ,Internal medicine ,Rheumatoid arthritis ,medicine ,In patient ,business - Published
- 2021
48. Efficacy and Safety of Rituximab in Autoimmune Disease—Associated Interstitial Lung Disease: A Prospective Cohort Study
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Natalia Mena-Vázquez, Rocío Redondo-Rodríguez, Marta Rojas-Gimenez, Carmen María Romero-Barco, Sara Manrique-Arija, Rafaela Ortega-Castro, Ana Hidalgo Conde, Rocío Arnedo Díez de los Ríos, Eva Cabrera César, Francisco Espildora, María Carmen Aguilar-Hurtado, Isabel Añón-Oñate, Lorena Pérez-Albaladejo, Manuel Abarca-Costalago, Inmaculada Ureña-Garnica, Maria Luisa Velloso-Feijoo, Maria Victoria Irigoyen-Oyarzábal, and Antonio Fernández-Nebro
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autoimmune disease ,interstitial lung disease ,rituximab ,General Medicine ,respiratory system - Abstract
Objectives: To analyze the efficacy and safety of rituximab (RTX) in connective tissue disease associated with interstitial lung disease (CTD-ILD). Methods: We performed a multicenter, prospective, observational study of patients with CTD-ILD receiving rituximab between 2015 and 2020. The patients were assessed using high-resolution computed tomography and pulmonary function tests at baseline, at 12 months, and at the end of follow-up. The main outcome measure at the end of follow-up was forced vital capacity (FVC) > 10% or diffusing capacity of the lungs for carbon monoxide (DLCO) > 15% and radiological progression or death. We recorded clinical characteristics, time to initiation of RTX, concomitant treatment, infections, and hospitalization. A Cox regression analysis was performed to identify factors associated with worsening ILD. Results: We included 37 patients with CTD-ILD treated with RTX for a median (IQR) of 38.2 (17.7–69.0) months. At the end of the follow-up, disease had improved or stabilized in 23 patients (62.1%) and worsened in seven (18.9%); seven patients (18.9%) died. No significant decline was observed in median FVC (72.2 vs. 70.8; p = 0.530) or DLCO (55.9 vs. 52.2; p = 0.100). The multivariate analysis showed the independent predictors for worsening of CTD-ILD to be baseline DLCO (OR (95% CI), 0.904 (0.8–0.9); p = 0.015), time to initiation of RTX (1.01 (1.001–1.02); p = 0.029), and mycophenolate (0.202 (0.04–0.8); p = 0.034). Only 28 of the 37 patients (75.6%) were still undergoing treatment with RTX: two patients (5.4%) stopped treatment due to adverse events and seven patients (18.9%) died owing to progression of ILD and superinfection. Conclusion: Lung function improved or stabilized in more than half of patients with CTD-ILD treated with RTX. Early treatment and combination with mycophenolate could reduce the risk of progression of ILD.
- Published
- 2022
49. Incidence and case fatality rate of COVID-19 in patients with inflammatory articular diseases
- Author
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Natalia Mena Vázquez, Gisela Díaz Cordovés-Rego, Sara Manrique-Arija, Rocio Redondo-Rodriguez, Beatriz Sobrino, M.C. Ordoñez-Cañizares, Pablo Cabezudo-García, Inmaculada Ureña-Garnica, Antonio Fernández-Nebro, Francisco Javier Godoy-Navarrete, Alba María Cabezas-Lucena, and M. Morales-Águila
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medicine.medical_specialty ,Multivariate analysis ,Cross-sectional study ,Population ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Psoriatic arthritis ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Case fatality rate ,medicine ,Humans ,Cumulative incidence ,030212 general & internal medicine ,education ,Aged ,education.field_of_study ,business.industry ,SARS-CoV-2 ,Incidence (epidemiology) ,Incidence ,COVID-19 ,General Medicine ,medicine.disease ,Cross-Sectional Studies ,Rheumatoid arthritis ,Joint Diseases ,business - Abstract
Objective To describe the incidence and fatality of coronavirus disease 2019 (COVID-19) and identify risk factors to fatality in patients with inflammatory articular diseases (IAD). Methods This is a cross-sectional observational study of IAD patients and COVID-19 with controls matched for age, sex, and RT-PCR. A control group was used to compare the cumulative incidence (CI) and case fatality rate (CFR). The main outcomes of the study were CI and CFR. Other variables included comorbidities, treatments, and characteristics of the COVID-19. Multiple logistic regression analysis was performed to investigate risk factors for fatality in patients with IAD. Results Of the 1537 patients who fulfilled the inclusion criteria, 23/1537 (1.49%) had IAD 13 (0.8%) had rheumatoid arthritis (RA), 5 psoriatic arthritis (PsA) (0.3%) and 5 axial spondyloarthritis (0.3%). There were no significant differences in CI of COVID-19 and CFR in patients with IAD compared with COVID-19 patients without IAD. In RT-PCR positive patients, the CI of COVID-19 in PsA and AS was higher. Of the 23 IAD patients, 2 RA patients (8.6%) died. The patients did no show characteristics of the COVID-19 disease different from the population. In multivariate analysis, the factor associated with fatality in patients with IAD was older age (OR [95% CI], 1.1 [1.0-1.2]). Conclusion COVID-19 CI, fatality rate and other features do not seem to be increased in IAD patients. Older age was associated with fatality in patients with IAD.
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- 2020
50. Postprandial Apolipoprotein B48 is Associated with Subclinical Atherosclerosis in Patients with Rheumatoid Arthritis
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Manuel Castro-Cabezas, Francisco Gabriel Jimenez Nuñez, I. Ureña, Pedro Valdivielso, Antonio Fernández-Nebro, M. Rojas-Giménez, Sara Manrique-Arija, Natalia Mena-Vázquez, José Rioja, Patricia Ruiz-Limón, [Mena-Vázquez,N, Jimenez Nuñez,FG, Manrique-Arija,S, Rioja,J, Ruiz-Limón,P, Ureña,I, Valdivielso,P, Fernández-Nebro,A] The Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain. [Mena-Vázquez,N, Fernández-Nebro,A] UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain. [Rojas-Gimenez,M] UGC de Reumatología, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofia, Córdoba, Spain. [Rioja,J, Fernández-Nebro,A] Departamento de Medicina y Dermatología, Universidad de Málaga, Málaga, Spain. [Ruiz-Limón,P] Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Clínico Virgen de la Victoria, Málaga, Spain. [Castro-Cabezas,M] Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands. [Valdivielso,P] UGC de Medicina Interna, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain., and Grant for Medical Researchers from 'Fundación Española de Reumatología' 2019. Grant from 'Fundación Española de Reumatología' 2018 for non-funded projects.
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rheumatoid arthritis ,Apolipoprotein B ,Postprandial lipemia ,Estudios transversales ,lcsh:Medicine ,Apolipoproteína B-48 ,Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Feeding Behavior::Fasting [Medical Subject Headings] ,030204 cardiovascular system & hematology ,Gastroenterology ,Apolipoprotein B48 ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,chemistry.chemical_compound ,0302 clinical medicine ,Chemicals and Drugs::Organic Chemicals::Carboxylic Acids::Acids, Carbocyclic::Benzoates::Hydroxybenzoates::Salicylates::Aminosalicylic Acids [Medical Subject Headings] ,Aterosclerosis ,Chemicals and Drugs::Lipids::Glycerides::Triglycerides [Medical Subject Headings] ,Framingham Risk Score ,biology ,Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Lipid Metabolism Disorders::Dyslipidemias [Medical Subject Headings] ,Chemicals and Drugs::Polycyclic Compounds::Steroids::Cholestanes::Cholestenes::Cholesterol [Medical Subject Headings] ,General Medicine ,Diseases::Musculoskeletal Diseases::Rheumatic Diseases::Arthritis, Rheumatoid [Medical Subject Headings] ,Postprandial ,medicine.anatomical_structure ,Diseases::Cardiovascular Diseases::Vascular Diseases::Arterial Occlusive Diseases::Arteriosclerosis::Atherosclerosis [Medical Subject Headings] ,Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Lipid Metabolism Disorders::Dyslipidemias::Hyperlipidemias [Medical Subject Headings] ,Rheumatoid arthritis ,Cross-sectional studies ,cardiovascular system ,medicine.medical_specialty ,Endothelium ,subclinical atherosclerosis ,Chemicals and Drugs::Lipids::Lipoproteins::Apolipoproteins::Apolipoproteins B::Apolipoprotein B-48 [Medical Subject Headings] ,Artritis reumatoide ,Article ,03 medical and health sciences ,Internal medicine ,medicine ,Subclinical atherosclerosis ,cardiovascular diseases ,apolipoprotein B48 ,Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings] ,030203 arthritis & rheumatology ,postprandial lipemia ,Cholesterol ,business.industry ,lcsh:R ,Andalucía ,medicine.disease ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Ultrasonography::Carotid Intima-Media Thickness [Medical Subject Headings] ,chemistry ,Anatomy::Tissues::Epithelium::Endothelium [Medical Subject Headings] ,biology.protein ,business ,Dyslipidemia - Abstract
Objective: To describe postprandial lipemia in patients with rheumatoid arthritis (RA) and to analyze its association with subclinical atherosclerosis measured as carotid intima-media thickness (cIMT). Methods: We performed an observational study of 40 patients with RA and 40 sex and age-matched controls. Patients with dyslipidemia were excluded. Pathologically increased cIMT was defined as a carotid thickness greater than the 90th percentile (>, p90) for age and sex. Fasting and postprandial plasma lipids, cholesterol, triglycerides, apolipoprotein B48 (ApoB48), and total ApoB were evaluated. The other variables included were clinical and laboratory values, Framingham score, and the 28-joint Disease Activity Score (DAS28). Two multivariate models were constructed to identify factors associated with pathologic cIMT in patients with RA. Results: Fasting lipid values were similar in patients with RA and controls, although those of postprandial ApoB48 were higher (median (IQR), 14.4 (10.8&ndash, 12.1) vs. 12.1 (2.3&ndash, 9,8), p = 0.042). Pathologic cIMT was recorded in 10 patients with RA (25%) and nine controls (22.5%). In patients with RA, pathologic cIMT was associated with postprandial ApoB48 (OR (95% CI), 1.15 (1.0&ndash, 1.3)) and total ApoB (OR [95% CI], 1.12 [1.1&ndash, 1.2]). The second model revealed a mean increase of 0.256 mm for cIMT in patients with elevated anticitrullinated protein antibodies (ACPAs). Conclusion: Postprandial ApoB48 levels in patients with RA are higher than in controls. Postprandial ApoB48 and total ApoB levels and markers of severity, such as ACPAs, are associated with pathologic cIMT in patients with RA. Our findings could indicate that these atherogenic particles have a negative effect on the endothelium.
- Published
- 2020
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