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Carvalho JS, dos Reis Neto ET, Kakehasi AM, Ribeiro SLE, Studart SAS, Martins FP, Cavalheiro do Espírito Santo R, Ranzolin A, Fernandino DC, Dinis VG, Sato EI, Resende GG, Marinho A, Mariz HA, Sacilotto NC, Ribeiro FM, Shinjo SK, Dias LH, Yazbek MA, Omura F, Rached THS, Gomides APM, Marques CDL, Pillegi GCS, Mota LMH, Pinheiro MM, Monticielo OA, Xavier RM, Ferreira GA. Factors associated with poor outcomes in SLE patients with COVID-19: Data from ReumaCoV-Brazil register. Lupus 2022; 32:42-53. [PMID: 36300790 PMCID: PMC9614598 DOI: 10.1177/09612033221135884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To evaluate factors associated with COVID-19 severity outcomes in patients with systemic lupus erythematosus (SLE). METHODS This was a cross-sectional analysis of baseline data of a prospective, multi-stage cohort study-"The ReumaCoV Brazil"-designed to monitor patients with immune-mediated rheumatologic disease (IMRD) during the SARS-CoV-2 pandemic. SLE adult patients with COVID-19 were compared with those without COVID-19. SLE activity was evaluated by the patient global assessment (PGA) and SLE Disease Activity Index 2000 (SLEDAI-2K). RESULTS 604 SLE patients were included, 317 (52.4%) with COVID-19 and 287 (47.6%) in the control group. SLE COVID-19 patients reported a lower frequency of social isolation and worked more frequently as health professionals. There was no difference in the mean SLEDAI-2K score between groups in the post-COVID-19 period (5.8 [8.6] vs. 4.5 [8.0]; p = 0.190). However, infected patients reported increased SLE activity according to the Patient Global Assessment (PGA) during this period (2.9 [2.9] vs. 2.3 [2.6]; p = 0.031. Arterial hypertension (OR 2.48 [CI 95% 1.04-5.91], p = 0.041), cyclophosphamide (OR 14.32 [CI 95% 2.12-96.77], p = 0.006), dyspnea (OR: 7.10 [CI 95% 3.10-16.23], p < 0.001) and discontinuation of SLE treatment medication during infection (5.38 [CI 95% 1.97-15.48], p = 0.002), were independently associated with a higher chance of hospitalization related to COVID-19. Patients who received telemedicine support presented a 67% lower chance of hospitalization (OR 0.33 [CI 95% 0.12-0.88], p = 0.02). CONCLUSION Hypertension and cyclophosphamide were associated with a severe outcome, and telemedicine can be a useful tool for SLE patients with COVID-19.
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Affiliation(s)
- Joana S Carvalho
- Programa de Pós-graduação em Ciências Aplicadas a Saúde do Adulto, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil,Joana S Carvalho, Programa de Pós-graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina, Universidade Federal de Minas Gerais, Alfredo Balena avenue, 190. Belo Horizonte-MG 13130-100, Brazil.
| | | | - Adriana M Kakehasi
- Programa de Pós-graduação em Ciências Aplicadas a Saúde do Adulto, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sandra LE Ribeiro
- Faculdade de Medicina da Universidade Federal do Amazonas, Manaus, Brazil
| | | | - Francielle P Martins
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil
| | - Rafaela Cavalheiro do Espírito Santo
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Universidade Federal do Rio Grande do Sul, Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Porto Alegre, Brazil
| | | | - Diana C Fernandino
- Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | | | - Emília I Sato
- Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gustavo G Resende
- Programa de Pós-graduação em Ciências Aplicadas a Saúde do Adulto, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Henrique A Mariz
- Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Nathália C Sacilotto
- Instituto de Assistência Médica ao Servidor Público Estadual de S. Paulo, São Paulo, Brazil
| | - Francinne M Ribeiro
- Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Samuel K Shinjo
- Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Laiza H Dias
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Michel A Yazbek
- Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, Brazil
| | - Felipe Omura
- Clínica Omura Medicina Diagnóstica, São Paulo, Brazil
| | - Thiago HS Rached
- Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil
| | | | - Claudia DL Marques
- Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | | | - Lícia MH Mota
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil
| | - Marcelo M Pinheiro
- Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Odirlei A Monticielo
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Universidade Federal do Rio Grande do Sul, Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Porto Alegre, Brazil
| | - Ricardo M Xavier
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Universidade Federal do Rio Grande do Sul, Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Porto Alegre, Brazil
| | - Gilda A Ferreira
- Programa de Pós-graduação em Ciências Aplicadas a Saúde do Adulto, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Marques CDL, Ribeiro SLE, Albuquerque CP, de Sousa Studart SA, Ranzolin A, de Andrade NPB, Dantas AT, Mota GD, Resende GG, Marinho AO, Angelieri D, Andrade D, Ribeiro FM, Omura F, Silva NA, Rocha Junior L, Brito DE, Fernandino DC, Yazbek MA, Souza MPG, Ximenes AC, Martins ASS, Castro GRW, Oliveira LC, Freitas ABSB, Kakehasi AM, Gomides APM, Reis Neto ET, Pileggi GS, Ferreira GA, Mota LMH, Xavier RM, de Medeiros Pinheiro M. COVID-19 was not associated or trigger disease activity in spondylarthritis patients: ReumaCoV-Brasil cross-sectional data. Adv Rheumatol 2022; 62:45. [PMID: 36419163 PMCID: PMC9685130 DOI: 10.1186/s42358-022-00268-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To evaluate the disease activity before and after COVID-19 and risk factors associated with outcomes, including hospitalization, intensive care unit (ICU) admission, mechanical ventilation (MV) and death in patients with spondylarthritis (SpA). METHODS ReumaCoV Brazil is a multicenter prospective cohort of immune-mediated rheumatic diseases (IMRD) patients with COVID-19 (case group), compared to a control group of IMRD patients without COVID-19. SpA patients enrolled were grouped as axial SpA (axSpA), psoriatic arthritis (PsA) and enteropathic arthritis, according to usual classification criteria. RESULTS 353 SpA patients were included, of whom 229 (64.9%) were axSpA, 118 (33.4%) PsA and 6 enteropathic arthritis (1.7%). No significant difference was observed in disease activity before the study inclusion comparing cases and controls, as well no worsening of disease activity after COVID-19. The risk factors associated with hospitalization were age over 60 years (OR = 3.71; 95% CI 1.62-8.47, p = 0.001); one or more comorbidities (OR = 2.28; 95% CI 1.02-5.08, p = 0.001) and leflunomide treatment (OR = 4.46; 95% CI 1.33-24.9, p = 0.008). Not having comorbidities (OR = 0.11; 95% CI 0.02-0.50, p = 0.001) played a protective role for hospitalization. In multivariate analysis, leflunomide treatment (OR = 8.69; CI = 95% 1.41-53.64; p = 0.023) was associated with hospitalization; teleconsultation (OR = 0.14; CI = 95% 0.03-0.71; p = 0.01) and no comorbidities (OR = 0.14; CI = 95% 0.02-0.76; p = 0.02) remained at final model as protective factor. CONCLUSIONS Our results showed no association between pre-COVID disease activity or that SARS-CoV-2 infection could trigger disease activity in patients with SpA. Teleconsultation and no comorbidities were associated with a lower hospitalization risk. Leflunomide remained significantly associated with higher risk of hospitalization after multiple adjustments.
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Affiliation(s)
| | | | | | | | | | - Nicole Pamplona Bueno de Andrade
- grid.8532.c0000 0001 2200 7498Hospital de Clínicas de Porto Alegre – Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andrea T. Dantas
- grid.411227.30000 0001 0670 7996Hospital das Clínicas – Universidade Federal de Pernambuco, Recife, Brazil
| | - Guilherme D. Mota
- grid.411249.b0000 0001 0514 7202Universidade Federal de São Paulo, Rua Borges Lagoa, 913/ 51-53, Vila Clementino, São Paulo, SP CEP: 04038-034 Brazil
| | - Gustavo G. Resende
- grid.8430.f0000 0001 2181 4888Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Danielle Angelieri
- grid.414644.70000 0004 0411 4654Hospital dos Servidores de São Paulo – IAMSPE, São Paulo, Brazil
| | - Danieli Andrade
- grid.11899.380000 0004 1937 0722Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil
| | - Francinne M. Ribeiro
- grid.412211.50000 0004 4687 5267Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Abraão, Brazil
| | - Felipe Omura
- Clínica Omura Medicina Diagnóstica, São Paulo, Brazil
| | - Nilzio A. Silva
- grid.411195.90000 0001 2192 5801Faculdade de Medicina da Universidade Federal de Goiás, Goiânia, Brazil
| | - Laurindo Rocha Junior
- grid.419095.00000 0004 0417 6556Instituto de Medicina Integral Professor Fernando Figueira -IMIP, Recife, Brazil
| | - Danielle E. Brito
- grid.411216.10000 0004 0397 5145Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Diana C. Fernandino
- grid.411198.40000 0001 2170 9332Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Michel A. Yazbek
- grid.411087.b0000 0001 0723 2494Hospital de Clínicas da Universidade Estadual de Campinas- UNICAMP, Campinas, Brazil
| | - Mariana P. G. Souza
- grid.415169.e0000 0001 2198 9354Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
| | | | - Ana Silvia S. Martins
- grid.411284.a0000 0004 4647 6936Hospital de Clínicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Glaucio Ricardo W. Castro
- grid.413214.10000 0004 0504 2293Hospital Governador Celso Ramos – Santa Catarina, Florianópolis, Brazil
| | | | | | - Adriana M. Kakehasi
- grid.8430.f0000 0001 2181 4888Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Edgard Torres Reis Neto
- grid.411249.b0000 0001 0514 7202Universidade Federal de São Paulo, Rua Borges Lagoa, 913/ 51-53, Vila Clementino, São Paulo, SP CEP: 04038-034 Brazil
| | - Gecilmara S. Pileggi
- grid.411249.b0000 0001 0514 7202Universidade Federal de São Paulo, Rua Borges Lagoa, 913/ 51-53, Vila Clementino, São Paulo, SP CEP: 04038-034 Brazil
| | - Gilda A. Ferreira
- grid.8430.f0000 0001 2181 4888Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Licia Maria H. Mota
- grid.7632.00000 0001 2238 5157Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília (PPGCM-FM-UnB), Brazil, Brasília, DF Brazil ,grid.411215.2Hospital Universitário de Brasília (HUB-UnB-EBSERH), Brasília, DF Brazil
| | - Ricardo M. Xavier
- grid.8532.c0000 0001 2200 7498Hospital de Clínicas de Porto Alegre – Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marcelo de Medeiros Pinheiro
- grid.411249.b0000 0001 0514 7202Universidade Federal de São Paulo, Rua Borges Lagoa, 913/ 51-53, Vila Clementino, São Paulo, SP CEP: 04038-034 Brazil
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Dantas AE, Lanna CCD, Pedrosa MS, Resende GG. Dactylitis in psoriatic arthritis: a histologic description. Rheumatology (Oxford) 2021; 61:1737. [PMID: 34115834 DOI: 10.1093/rheumatology/keab476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 05/31/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Aurivan E Dantas
- Rheumatology Department, Hospital das Clínicas, Universidade Federal of Minas Gerais, Belo Horizonte, Minas Gerais State, Brazil
| | - Cristina C D Lanna
- Locomotor Apparatus Department, Medical School, Universidade Federal of Minas Gerais, Belo Horizonte, Minas Gerais State, Brazil
| | - Moises S Pedrosa
- Pathology Department, Hospital das Clínicas, Universidade Federal of Minas Gerais, Belo Horizonte, Minas Gerais State, Brazil
| | - Gustavo G Resende
- Rheumatology Department, Hospital das Clínicas, Universidade Federal of Minas Gerais, Belo Horizonte, Minas Gerais State, Brazil
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Gomides APM, Albuquerque CP, Santos ABV, Amorim RBC, Bértolo MB, Júnior PL, Santos IA, Giorgi RD, Sacilotto NC, Radominski SC, Borghi FM, Guimarães MFBR, Pinto MRC, Resende GG, Bonfiglioli KR, Carriço H, Sauma MFLC, Sauma ML, Medeiros JB, Pereira IA, Castro GRW, Brenol CV, Xavier RM, Mota LMH, Pinheiro GRC. High Levels of Polypharmacy in Rheumatoid Arthritis-A Challenge Not Covered by Current Management Recommendations: Data From a Large Real-Life Study. J Pharm Pract 2019; 34:365-371. [PMID: 31451091 DOI: 10.1177/0897190019869158] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is associated with high frequency of comorbidities and increased risk of polypharmacy. Although there is a great potential for complications, there is a gap in literature on polypharmacy in patients with rheumatic arthritis. OBJECTIVE To evaluate the prevalence and factors associated with polypharmacy in a population in a real-life setting. METHODS A cross-sectional multicenter study was conducted in Brazil. Patients underwent clinical evaluation and medical records analysis. Polypharmacy was considered as a dependent variable. To test independent variables, we used Poisson regression. RESULTS We evaluated 792 patients (89% female, median age 56.6 years). Median duration of disease was 12.7 years, 78.73% had a positive rheumatoid factor. The median of disease activity score-28 was 3.5 (disease with mild activity), median of the clinical disease activity index score was 9, and median of health assessment questionnaire-disability index was 0.875; 47% used corticosteroids, 9.1% used nonsteroidal anti-inflammatory drugs, 90.9% used synthetic disease-modifying antirheumatic drugs, 35.7% used biologic disease-modifying antirheumatic drugs (DMARDs). In total, 537 (67.9%) patients used 5 or more drugs. Polypharmacy showed a relationship with a number of comorbidities and use of specific drugs (corticosteroids, methotrexate, and biological DMARDs). CONCLUSION We found a high prevalence of polypharmacy (67.9%) in RA. Solutions to management this problem should be stimulated.
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Affiliation(s)
| | | | - Ana B V Santos
- 28130Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Paulo L Júnior
- Faculdade de Medicina da Universidade de Ribeirao Preto, 28133Universidade de Sao Paulo, Ribeirão Preto, Brazil
| | - Isabela A Santos
- Faculdade de Medicina da Universidade de Ribeirao Preto, 28133Universidade de Sao Paulo, Ribeirão Preto, Brazil
| | - Rina D Giorgi
- 74357Instituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual de São Paulo, São Paulo, Brazil
| | - Nathália C Sacilotto
- 74357Instituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual de São Paulo, São Paulo, Brazil
| | | | | | | | - Maria R C Pinto
- 28114Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | | | | | | | - Ivânio A Pereira
- 28117Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Gláucio R W Castro
- 28131Universidade do Sul de Santa Catarina-Unisul, Florianópolis, Brazil
| | - Claiton V Brenol
- 28124Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ricardo M Xavier
- 28124Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Machado CRL, Resende GG, Macedo RBV, do Nascimento VC, Branco AS, Kakehasi AM, Andrade MV. Fibroblast-like synoviocytes from fluid and synovial membrane from primary osteoarthritis demonstrate similar production of interleukin 6, and metalloproteinases 1 and 3. Clin Exp Rheumatol 2019; 37:306-309. [PMID: 30620271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 09/03/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The objective of the study was to compare the production of metalloproteinases (MMP)-1, -3 and interleukin (IL)-6 by fibroblast-like synoviocytes (FLS) derived from synovial fluid (FD-FLS), and FLS derived from synovial tissue (TD-FLS) of patients with primary osteoarthritis (OA). The more accessible FD-FLS could facilitate the study of the role of these cells in OA pathophysiology. METHODS MMP-1, MMP-3, and IL-6 levels were measured in the supernatant culture at baseline and 22 hours after stimulation with TNF-α and IL-1 β. RESULTS There was no difference at baseline between MMP-1, MMP-3 and IL-6 production by FD-FLS and TDFLS. Analogous to baseline, stimulation of FD-FLS and TD-FLS with IL-1β and TNF-α did not result in difference on MMP-3 and IL-6 production. However, TD-FLS produced more MMP-1 than FD-FLS after stimulation with IL-1β (p=0.01). Additionally, there was a positive correlation for production of MMP-1, MMP-3 and IL-6 between FD-FLS and TD-FLS (r=0.40 and p<0.0008; r=0.66 and p<0.0001; r=0.76 and p<0.0001, respectively). Supporting this statistical significant positive correlation, the Bland-Altman plotting, showed a homogeneous distribution of the values and low mean disagreement rates between all results of FD-FLS and TD-FLS (23.1%, 56.8% and 48.1%, respectively). CONCLUSIONS Our data demonstrated functional similarity between FD-FLS and TD-FLS and support the use of a more accessible source of FLS for the study of the pathogenesis of joint destruction and therapeutic targets in primary OA.
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Affiliation(s)
- Camilla R L Machado
- Laboratory of Scientific Research #30 "Professor Lineu Freire-Maia", Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Brazil
| | - Gustavo G Resende
- Laboratory of Scientific Research #30 "Professor Lineu Freire-Maia", Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Brazil
| | - Rafaela B V Macedo
- Laboratory of Scientific Research #30 "Professor Lineu Freire-Maia", Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Brazil
| | - Vanuza C do Nascimento
- Laboratory of Scientific Research #30 "Professor Lineu Freire-Maia", Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Brazil
| | - Angela S Branco
- Laboratory of Scientific Research #30 "Professor Lineu Freire-Maia", Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Brazil
| | - Adriana M Kakehasi
- Laboratory of Scientific Research #30 "Professor Lineu Freire-Maia", Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Brazil
| | - Marcus Vinicius Andrade
- Laboratory of Scientific Research #30 "Professor Lineu Freire-Maia", Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Brazil.
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Ribeiro SL, Albuquerque EN, Bortoluzzo AB, Gonçalves CR, Silva JABD, Ximenes AC, Bértolo MB, Keiserman M, Menin R, Skare TL, Carneiro S, Azevedo VF, Vieira WP, Bianchi WA, Bonfiglioli R, Campanholo C, Carvalho HM, Costa IP, Duarte ALP, Kohem CL, Leite NH, Lima SA, Meirelles ES, Pereira IA, Pinheiro MM, Polito E, Resende GG, Rocha FAC, Santiago MB, Sauma MDFL, Valim V, Sampaio‐Barros PD. Qualidade de vida nas espondiloartrites: análise de uma grande coorte brasileira. Revista Brasileira de Reumatologia 2016. [DOI: 10.1016/j.rbr.2015.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Ribeiro SLE, Albuquerque EN, Bortoluzzo AB, Gonçalves CR, da Silva JAB, Ximenes AC, Bértolo MB, Keiserman M, Menin R, Skare TL, Carneiro S, Azevedo VF, Vieira WP, Bianchi WA, Bonfiglioli R, Campanholo C, Carvalho HMS, Costa IP, Duarte ALBP, Kohem CL, Leite NH, Lima SAL, Meirelles ES, Pereira IA, Pinheiro MM, Polito E, Resende GG, Rocha FAC, Santiago MB, Sauma MDFLC, Valim V, Sampaio-Barros PD. Quality of life in spondyloarthritis: analysis of a large Brazilian cohort. Rev Bras Reumatol Engl Ed 2015; 56:22-7. [PMID: 27267330 DOI: 10.1016/j.rbre.2015.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 03/01/2015] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To analyze quality of life and demographic and clinical variables associated to its impairment in a large Brazilian cohort of patients with spondyloarthritis (SpA). METHODS A common protocol of investigation was applied to 1465 Brazilian patients classified as SpA according to the European Spondyloarthropaties Study Group (ESSG) criteria, attended at 29 reference centers for Rheumatology in Brazil. Clinical and demographic variables were recorded. Quality of life was analyzed through the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire. RESULTS The mean ASQoL score was 7.74 (+5.39). When analyzing the specific diseases in the SpA group, the ASQoL scores did not present statistical significance. Demographic data showed worse scores of ASQoL associated with female gender (p=0.014) and African-Brazilian ethnicity (p<0.001). The analysis of the clinical symptoms showed that buttock pain (p=0.032), cervical pain (p<0.001) and hip pain (p=0.001) were statistically associated with worse scores of ASQoL. Continuous use of nonsteroidal anti-inflammatory drugs (p<0.001) and biologic agents (p=0.044) were associated with higher scores of ASQoL, while the other medications did not interfere with the ASQoL scores. CONCLUSION In this large series of patients with SpA, female gender and African-Brazilian ethnicity, as well as predominant axial symptoms, were associated with impaired quality of life.
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Affiliation(s)
| | | | | | - Célio R Gonçalves
- Disciplina de Reumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | | | | | | | - Rita Menin
- Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil
| | | | - Sueli Carneiro
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | | | | | | | | | - Izaias P Costa
- Universidade Federal do Mato Grosso do Sul, Campo Grande, MS, Brazil
| | | | - Charles L Kohem
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Nocy H Leite
- Faculdade de Medicina Souza Marques, Rio de Janeiro, RJ, Brazil
| | - Sonia A L Lima
- Hospital do Servidor Público Estadual, São Paulo, SP, Brazil
| | - Eduardo S Meirelles
- Instituto de Ortopedia e Traumatologia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ivânio A Pereira
- Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | | | | | | | | | | | | | - Valéria Valim
- Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Percival D Sampaio-Barros
- Disciplina de Reumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
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Costa IPD, Bortoluzzo AB, Gonçalves CR, Silva JABD, Ximenes AC, Bértolo MB, Ribeiro SL, Keiserman M, Menin R, Skare TL, Carneiro S, Azevedo VF, Vieira WP, Albuquerque EN, Bianchi WA, Bonfiglioli R, Campanholo C, Carvalho HM, Duarte ALP, Kohem CL, Leite NH, Lima SA, Meirelles ES, Pereira IA, Pinheiro MM, Polito E, Resende GG, Rocha FAC, Santiago MB, Sauma MDFL, Valim V, Sampaio‐Barros PD. Avaliação do desempenho do BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) numa coorte brasileira de 1.492 pacientes com espondiloartrites: dados do Registro Brasileiro de Espondiloartrites (RBE). Revista Brasileira de Reumatologia 2015; 55:48-54. [DOI: 10.1016/j.rbr.2014.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 04/25/2014] [Accepted: 05/19/2014] [Indexed: 11/26/2022] Open
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Duarte AP, Marques CDL, Bortoluzzo AB, Gonçalves CR, da Silva JAB, Ximenes AC, Bértolo MB, Ribeiro SLE, Keiserman M, Skare TL, Carneiro S, Menin R, Azevedo VF, Vieira WP, Albuquerque EN, Bianchi WA, Bonfiglioli R, Campanholo C, Carvalho HMS, Costa IP, Kohem CL, Leite N, Lima SAL, Meirelles ES, Pereira IA, Pinheiro MM, Polito E, Resende GG, Rocha FAC, Santiago MB, Sauma MDFLC, Valim V, Sampaio-Barros PD, Barros PDS. [Epidemiologic profile of juvenile-onset compared to adult-onset spondyloarthritis in a large Brazilian cohort]. Rev Bras Reumatol 2014; 54:424-30. [PMID: 25458023 DOI: 10.1016/j.rbr.2014.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 05/07/2014] [Accepted: 06/02/2014] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To analyze the clinical and epidemiologic characteristics of juvenile-onset spondyloarthritis (SpA) (< 16 years) and compare them with a group of adult-onset (≥ 16 years) SpA patients. PATIENTS AND METHODS Prospective, observational and multicentric cohort with 1,424 patients with the diagnosis of SpA according to the European Spondyloarthropathy Study Group (ESSG) submitted to a common protocol of investigation and recruited in 29 reference centers participants of the Brazilian Registry of Spondyloarthritis (RBE - Registro Brasileiro de Espondiloartrites). Patients were divided in two groups: age at onset<16 years (JOSpA group) and age at onset ≥ 16 years (AOSpA group). RESULTS Among the 1,424 patients, 235 presented disease onset before 16 years (16.5%). The clinical and epidemiologic variables associated with JOSpA were male gender (p<0.001), lower limb arthritis (p=0.001), enthesitis (p=0.008), anterior uveitis (p=0.041) and positive HLA-B27 (p=0.017), associated with lower scores of disease activity (Bath Ankylosing Spondylitis Disease Activity Index - BASDAI; p=0.007) and functionality (Bath Ankylosing Spondylitis Functional Index - BASFI; p=0.036). Cutaneous psoriasis (p<0.001), inflammatory bowel disease (p=0.023), dactylitis (p=0.024) and nail involvement (p=0.004) were more frequent in patients with adult-onset SpA. CONCLUSIONS Patients with JOSpA in this large Brazilian cohort were characterized predominantly by male gender, peripheral involvement (arthritis and enthesitis), positive HLA-B27 and lower disease scores.
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Affiliation(s)
| | | | | | - Célio R Gonçalves
- Divisão de Reumatologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | | | | | | | | | | | | | - Sueli Carneiro
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil; Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Rita Menin
- Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brasil
| | | | | | | | | | | | | | | | - Izaias P Costa
- Universidade Federal do Mato Grosso do Sul, Campo Grande, MS, Brasil
| | - Charles L Kohem
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Nocy Leite
- Faculdade de Medicina Souza Marques, Rio de Janeiro, RJ, Brasil
| | - Sonia A L Lima
- Hospital do Servidor Público Estadual, São Paulo, SP, Brasil
| | - Eduardo S Meirelles
- Instituto de Ortopedia e Traumatologia, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Ivânio A Pereira
- Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | | | | | | | | | | | | | - Valéria Valim
- Universidade Federal do Espírito Santo, Vitória, ES, Brasil
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Bianchi WA, Elias FR, Carneiro S, Bortoluzzo AB, Gonçalves CR, da Silva JAB, Ximenes AC, Bértolo MB, Ribeiro SLE, Keiserman M, Skare TL, Menin R, Azevedo VF, Vieira WP, Albuquerque EN, Bonfiglioli R, Campanholo C, Carvalho HMS, Costa IP, Duarte AP, Kohem CL, Leite NH, Lima SAL, Meirelles ES, Pereira IA, Pinheiro MM, Polito E, Resende GG, Rocha FAC, Santiago MB, Sauma MDFLC, Valim V, Sampaio-Barros PD. Assessment of fatigue in a large series of 1492 Brazilian patients with Spondyloarthritis. Mod Rheumatol 2014; 24:980-4. [DOI: 10.3109/14397595.2014.906049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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11
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Kohem CL, Bortoluzzo AB, Gonçalves CR, Braga da Silva JA, Ximenes AC, Bértolo MB, Ribeiro SLE, Keiserman M, Menin R, Skare TL, Carneiro S, Azevedo VF, Vieira WP, Albuquerque EN, Bianchi WA, Bonfiglioli R, Campanholo C, Carvalho HMS, da Costa IP, Duarte ALBP, Leite NH, Lima SAL, Meirelles ES, Pereira IA, Pinheiro MM, Polito E, Resende GG, Rocha FAC, Santiago MB, Sauma MDFLC, Valim V, Sampaio-Barros PD. Profile of the use of disease modifying drugs in the Brazilian Registry of Spondyloarthritides. Rev Bras Reumatol 2014; 54:33-37. [PMID: 24878789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 06/23/2013] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Few studies have evaluated the profile of use of disease modifying drugs (DMD) in Brazilian patients with spondyloarthritis (SpA). METHODS A common research protocol was applied prospectively in 1505 patients classified as SpA by criteria of the European Spondyloarthropathies Study Group (ESSG), followed at 29 referral centers in Rheumatology in Brazil. Demographic and clinical variables were obtained and evaluated, by analyzing their correlation with the use of DMDs methotrexate (MTX) and sulfasalazine (SSZ). RESULTS At least one DMD was used by 73.6% of patients: MTX by 29.2% and SSZ by 21.7%, while 22.7% used both drugs. The use of MTX was significantly associated with peripheral involvement, and SSZ was associated with axial involvement, and the two drugs were more administered, separately or in combination, in the mixed involvement (p < 0.001). The use of a DMD was significantly associated with Caucasian ethnicity (MTX , p = 0.014), inflammatory back pain (SSZ, p = 0.002) , buttock pain (SSZ, p = 0.030), neck pain (MTX, p = 0.042), arthritis of the lower limbs (MTX, p < 0.001), arthritis of the upper limbs (MTX, p < 0.001), enthesitis (p = 0.007), dactylitis (MTX, p < 0.001), inflammatory bowel disease (SSZ, p < 0.001) and nail involvement (MTX, p < 0.001). CONCLUSION The use of at least one DMD was reported by more than 70% of patients in a large cohort of Brazilian patients with SpA, with MTX use more associated with peripheral involvement and the use of SSZ more associated with axial involvement.
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Affiliation(s)
- Charles L Kohem
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | | | | | | | | | | | | | - Mauro Keiserman
- Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brasil
| | - Rita Menin
- Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brasil
| | | | - Sueli Carneiro
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | | | | | | | | | | | | | | | | | - Nocy H Leite
- Faculdade de Medicina Souza Marques, Rio de Janeiro, RJ, Brasil
| | - Sonia A L Lima
- Hospital do Servidor Público Estadual, São Paulo, SP, Brasil
| | - Eduardo S Meirelles
- Instituto de Ortopedia e Traumatologia, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Ivânio A Pereira
- Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | | | | | | | | | | | | | - Valéria Valim
- Universidade Federal do Espírito Santo, Vitória, ES, Brasil
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Kohem CL, Bortoluzzo AB, Gonçalves CR, Silva JABD, Ximenes AC, Bértolo MB, Ribeiro SL, Keiserman M, Menin R, Skare TL, Carneiro S, Azevedo VF, Vieira WP, Albuquerque EN, Bianchi WA, Bonfiglioli R, Campanholo C, Carvalho HM, Costa IPD, Duarte ALP, Leite NH, Lima SA, Meirelles ES, Pereira IA, Pinheiro MM, Polito E, Resende GG, Rocha FAC, Santiago MB, Sauma MDFL, Valim V, Sampaio-Barros PD. Perfil do uso de drogas modificadoras de doença no Registro Brasileiro de Espondiloartrites. Revista Brasileira de Reumatologia 2014. [DOI: 10.1016/j.rbr.2013.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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13
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Resende GG, Lanna CC, Bortoluzzo AB, Gonçalves CR, Sampaio-Barros PD, Silva JABD, Ximenes AC, Bértolo MB, Ribeiro SL, Keiserman M, Menin R, Skare TL, Carneiro S, Azevedo VF, Vieira WP, Albuquerque EN, Bianchi WA, Bonfiglioli R, Campanholo C, Carvalho HM, Costa IP, Duarte AP, Kohem CL, Leite N, Lima SA, Meirelles ES, Pereira IA, Pinheiro MM, Polito E, Rocha FAC, Santiago MB, Sauma MDFL, Valim V. Artrite enteropática no Brasil: dados do registro brasileiro de espondiloartrites. Revista Brasileira de Reumatologia 2013; 53:452-9. [DOI: 10.1016/j.rbr.2013.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Accepted: 04/04/2013] [Indexed: 02/07/2023] Open
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Carneiro S, Bortoluzzo A, Gonçalves C, Braga da Silva JA, Ximenes AC, Bértolo M, Ribeiro SL, Keiserman M, Skare T, Menin R, Azevedo V, Vieira W, Albuquerque E, Bianchi W, Bonfiglioli R, Campanholo C, de Carvalho HM, da Costa I, Duarte Á, Kohem C, Leite N, Lima SA, Meirelles ES, Pereira IA, Pinheiro MM, Polito E, Resende GG, Rocha FAC, Santiago MB, Sauma MDFL, Valim V, Sampaio-Barros PD. Effect of Enthesitis on 1505 Brazilian Patients with Spondyloarthritis. J Rheumatol 2013; 40:1719-25. [DOI: 10.3899/jrheum.121145] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective.To analyze the clinical effect of enthesitis in a large Brazilian cohort of patients with spondyloarthritis (SpA).Methods.A common protocol of investigation was prospectively applied to 1505 patients with SpA in 29 centers in Brazil. Clinical and demographic variables and disease indexes were investigated. The Maastricht Ankylosing Spondylitis Enthesitis Score was used to investigate the enthesitis component. Ankylosing spondylitis was the most frequent disease in the group (65.4%). Others were psoriatic arthritis (18.4%), undifferentiated SpA (6.7%), reactive arthritis (3.3%), and enteropathic arthritis (3.2%).Results.At least 1 affected enthesis was observed in 54% of the patients with SpA, with a mean of 2.12 ± 2.98 entheses affected. According to the clinical presentation, enthesitis was significantly more frequent in patients with axial + peripheral joint involvement compared to isolated axial or peripheral involvement (p < 0.001). There was a statistical association between the presence of enthesites and axial symptoms (buttock pain, cervical pain, and hip pain), and peripheral symptoms (lower limb arthritis, number of painful and swollen joints; p < 0.05). Patients with enthesitis also presented higher mean scores of Bath Ankylosing Spondylitis Functional Index (BASFI; p < 0.001), Bath Ankylosing Spondylitis Disease Activity Index (p < 0.001), and Ankylosing Spondylitis Quality of Life (ASQoL; p < 0.001). Multivariate logistic regression showed that BASFI (p < 0.0001; OR 74.839), ASQoL (p = 0.0001; OR 14.645), and Achilles tendonitis (p = 0.0059; OR 7.593) were associated with work incapacity.Conclusion.The clinical presence of enthesitis in this large cohort of patients with SpA was frequent and was associated with a significant increase in disease activity and decline in functional capacity and quality of life.
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Rodrigues CEM, Vieira WP, Bortoluzzo AB, Gonçalves CR, Silva JABD, Ximenes AC, Bértolo MB, Ribeiro SLE, Keiserman M, Menin R, Skare TL, Carneiro S, Azevedo VF, Albuquerque EN, Bianchi WA, Bonfiglioli R, Campanholo C, Carvalho HMS, Costa IP, Duarte AP, Kohem CL, Leite NH, Lima SAL, Meirelles ES, Pereira IA, Pinheiro MM, Polito E, Resende GG, Rocha FAC, Santiago MB, Sauma MDFLC, Valim V, Sampaio-Barros PD. Baixa prevalência das manifestações extra-articulares renais, cardíacas, pulmonares e neurológicas nas espondiloartrites: análise do Registro Brasileiro de Espondiloartrites. Rev Bras Reumatol 2012. [DOI: 10.1590/s0482-50042012000300008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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16
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Skare TL, Leite N, Bortoluzzo AB, Gonçalves CR, da Silva JAB, Ximenes AC, Bértolo MB, Ribeiro SLE, Keiserman M, Menin R, Carneiro S, Azevedo VF, Vieira WP, Albuquerque EDN, Bianchi WA, Bonfiglioli R, Campanholo C, Carvalho HMS, Costa IP, Duarte AP, Gavi MBO, Kohem CL, Lima SAL, Meirelles ES, Pereira IA, Pinheiro MM, Polito E, Resende GG, Rocha FAC, Santiago MB, Sauma MDFLC, Sampaio-Barros PD. Effect of age at disease onset in the clinical profile of spondyloarthritis: a study of 1424 Brazilian patients. Clin Exp Rheumatol 2012; 30:351-357. [PMID: 22510473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 10/25/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To analyse demographic and clinical variables in patients with disease onset before and after 40, 45 and 50 years in a large series of Brazilian SpA patients. METHODS A common protocol of investigation was prospectively applied to 1424 SpA patients in 29 centres distributed through the main geographical regions in Brazil. The mean age at disease onset was 28.56 ± 12.34 years, with 259 patients (18.2%) referring disease onset after 40 years, 151 (10.6%) after 45 years and 81 (5.8%) after 50 years. Clinical and demographic variables and disease indices (BASDAI, BASFI, BASRI, MASES, ASQoL) were investigated. Ankylosing spondylitis was the most frequent disease (66.3%), followed by psoriatic arthritis (18%), undifferentiated SpA (6.7%), reactive arthritis (5.5%), and enteropathic arthritis (3.5%). RESULTS Comparing the groups according to age of disease onset, those patients with later onset presented statistical association with female gender, peripheral arthritis, dactylitis, nail involvement and psoriasis, as well as negative statistical association with inflammatory low back pain, alternating buttock pain, radiographic sacroiliitis, hip involvement, positive familial history, HLA-B27 and uveitis. BASDAI, BASFI and quality of life, as well as physicians and patient's global assessment, were similar in all the groups. Radiographic indices showed worse results in the younger age groups. CONCLUSIONS There are two different clinical patterns in SpA defined by age at disease onset: one with predominance of axial symptoms in the group with disease onset ≤ 40 years and another favouring the peripheral manifestations in those with later disease onset.
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Affiliation(s)
- T L Skare
- Hospital Evangélico de Curitiba, Brazil.
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Rodrigues CEM, Vieira WP, Bortoluzzo AB, Gonçalves CR, da Silva JAB, Ximenes AC, Bértolo MB, Ribeiro SLE, Keiserman M, Menin R, Skare TL, Carneiro S, Azevedo VF, Albuquerque EN, Bianchi WA, Bonfiglioli R, Campanholo C, Carvalho HMS, Costa IP, Duarte AP, Kohem CL, Leite NH, Lima SAL, Meirelles ES, Pereira IA, Pinheiro MM, Polito E, Resende GG, Rocha FAC, Santiago MB, Sauma MDFLC, Valim V, Sampaio-Barros PD. Low prevalence of renal, cardiac, pulmonary, and neurological extra-articular clinical manifestations in spondyloarthritis: analysis of the Brazilian Registry of Spondyloarthritis. Rev Bras Reumatol 2012; 52:375-383. [PMID: 22641592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 03/05/2012] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE To describe the extra-articular manifestations (cardiac, renal, pulmonary, and neurological), usually not related to spondyloarthritis (SpA), in a large cohort of Brazilian patients. MATERIALS AND METHODS This retrospective study analyzed 1,472 patients diagnosed with SpA and cared for at 29 health care centers distributed in the five major geographic regions in the country, participating in the Brazilian Registry of Spondyloarthritis (BRS). All patients were assessed for the prevalence of major extra-articular manifestations (cardiac, renal, pulmonary, and neurological), classified according to the diagnosis [ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis (ReA), arthritis associated with inflammatory bowel disease (IBD), undifferentiated spondyloarthritis (uSpA), and juvenile SpA], and according to the clinical presentation (axial, peripheral, mixed, and enthesitis). RESULTS Of the patients with SpA assessed, 963 had AS, 271 PsA, 49 ReA, 48 arthritis associated with IBD, 98 uSpA, and 43 juvenile SpA. Cardiac involvement was reported in 44 patients (3.0%), pulmonary involvement in 19 (1.3%), renal involvement in 17 (1.2%), and neurological involvement in 13 patients (0.9%). Most patients with visceral involvement had AS or PsA, and the mixed (axial + peripheral) and/or predominantly axial clinical form. CONCLUSION Cardiac, renal, pulmonary, and neurological extra-articular manifestations are quite infrequent in SpA, ranging from 0.9% to 3% in this large Brazilian cohort, and affected predominantly patients with AS and PsA.
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