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Gheitasi H, Kostov B, Solans R, Fraile G, Suárez-Cuervo C, Casanovas A, Rascón F, Qanneta R, Pérez-Alvarez R, Ripoll M, Akasbi M, Pinilla B, Bosch J, Nava-Mateos J, Díaz-López B, Morera-Morales M, Retamozo S, Ramos-Casals M, Brito-Zerón P. How are we treating our systemic patients with primary Sjögren syndrome? Analysis of 1120 patients. Int Immunopharmacol 2015; 27:194-9. [DOI: 10.1016/j.intimp.2015.03.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 03/21/2015] [Indexed: 12/22/2022]
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Fraile G, Brito Zeron P, Solans R, Caravia-Durán D, Maure B, Rascόn FJ, Lopez-Dupla M, Ripoll M, Lόpez-Berastegui O, Trapiella L, García-Sánchez I, Pérez-de-Lis M, Jiménez-Heredia I, de la Red G, Gato A, Martínez-Valle F, Nava J, Díaz-Lόpez B, Pallarés L, Gheitasi H, Ramos-Casals M. FRI0604 Antimitochondrial Antibodies and Antibodies Against Subunits of Pyruvate Dehydrogenase as Serological Markers of Primary Biliary Cirrhosis in Patients with Primary SjöGren Syndrome. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Brito Zeron P, Kostov B, Solans R, Fraile G, Caravia-Durán D, Maure B, Rascόn FJ, Villar-Navas B, Ripoll M, Pinilla B, Fonseca E, Akasbi M, Pérez-de-Lis M, Jiménez-Heredia I, de la Red G, Gato A, Ramentol M, Ruedas A, Díaz-Lόpez B, Pallarés L, Gheitasi H, Ramos-Casals M. OP0088 Categorization of Baseline Systemic Activity at Diagnosis Using the Essdai Disease Activity States (DAS) in Primary Sjögren Syndrome: Association with Poor Outcomes. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gheitasi H, Kostov B, Solans R, Fraile G, Suárez-Cuervo C, Casanovas A, Rascόn FJ, Qanneta R, Pérez-Alvarez R, Ripoll M, Akasbi M, Pinilla B, Bosch X, Nava-Mateos J, Díaz-Lόpez B, Morera-Morales L, Retamozo S, Ramos-Casals M, Brito Zeron P. THU0408 How we are Treating Our Systemic Patients with Primary Sjögren Syndrome? Analysis of 1120 Patients (GEAS-SS Spanish Registry). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Brito Zeron P, Sellarés J, Bosch X, Hernández F, Lopez-Casany C, Sanchez M, Ramírez J, Gheitasi H, Kostov B, Santos J, Sisό Almirall A, Agustí C, Ramos-Casals M. SAT0547 Sequential Diagnosis of Sarcoidosis and Malignancy: A close But Complex Association with Four Differential Clinical Scenarios. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Brito Zeron P, Sellarés J, Bosch X, Hernández F, Lopez-Casany C, Sanchez M, Ramírez J, Gheitasi H, Kostov B, Santos J, Sisό Almirall A, Agustí C, Ramos-Casals M. THU0564 Is Extrathoracic Disease Associated with Mortality in Sarcoidosis? Predicting Survival According to the Epidemiological and Clinical Features at Diagnosis in 170 Patients. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Brito Zeron P, Kostov B, Solans R, Fraile G, García-Pérez A, Maure B, Rascόn FJ, Lopez-Dupla M, Ripoll M, Lόpez González-Cobos C, Fonseca E, Akasbi M, Pérez-de-Lis M, Jiménez-Heredia I, de la Red G, Gato A, Ramentol M, Ruedas A, Díaz-Lόpez B, Pallarés L, Gheitasi H, Ramos-Casals M. SAT0417 Cancer and Primary SjÖgren Syndrome in 1216 Patients (GEAS-SS Registry): Systemic Activity Measured by the Essdai is Related to Hematological, but not Solid Neoplasia. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Brito-Zerón P, Kostov B, Solans R, Fraile G, Suárez-Cuervo C, Casanovas A, Rascón FJ, Qanneta R, Pérez-Alvarez R, Ripoll M, Akasbi M, Pinilla B, Bosch JA, Nava-Mateos J, Díaz-López B, Morera-Morales ML, Gheitasi H, Retamozo S, Ramos-Casals M. Systemic activity and mortality in primary Sjögren syndrome: predicting survival using the EULAR-SS Disease Activity Index (ESSDAI) in 1045 patients. Ann Rheum Dis 2014; 75:348-55. [PMID: 25433020 DOI: 10.1136/annrheumdis-2014-206418] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [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: 08/05/2014] [Accepted: 11/07/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To score systemic activity at diagnosis and correlate baseline activity with survival in a large cohort of patients with primary Sjögren syndrome (SS). PATIENTS AND METHODS We include 1045 consecutive patients who fulfilled the 2002 classification criteria for primary SS. The clinical and immunological characteristics and level of activity (EULAR-SS Disease Activity Index (ESSDAI) scores) were assessed at diagnosis as predictors of death using Cox proportional hazards regression analysis adjusted for age at diagnosis. The risk of death was calculated at diagnosis according to four different predictive models. RESULTS After a mean follow-up of 117 months, 115 (11%) patients died. The adjusted standardised mortality ratio for the total cohort was 4.66 (95% CI 3.85 to 5.60), and survival rates at 5, 10, 20 and 30 years were 96%, 90%, 81% and 60%, respectively. The main baseline factors associated with overall mortality in the multivariate analysis were male gender, cryoglobulins and low C4 levels. Baseline activity in the constitutional, pulmonary and biological domains was associated with a higher risk of death. High activity in at least one ESSDAI domain (HR 2.14), a baseline ESSDAI score ≥14 (HR 1.85) and more than one laboratory predictive marker (lymphopenia, anti-La, monoclonal gammopathy, low C3, low C4 and/or cryoglobulins) (HR 2.82) were associated with overall mortality; these HRs increased threefold to 10-fold when the analysis was restricted to mortality associated with systemic disease. CONCLUSIONS Patients with primary SS, who present at diagnosis with high systemic activity (ESSDAI ≥14) and/or predictive immunological markers (especially those with more than one), are at higher risk of death.
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Affiliation(s)
- P Brito-Zerón
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ICMiD, Hospital Clínic, Barcelona, Spain
| | - B Kostov
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ICMiD, Hospital Clínic, Barcelona, Spain Primary Care Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Primary Care Centre Les Corts, CAPSE, Barcelona, Spain
| | - R Solans
- Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Spain
| | - G Fraile
- Department of Internal Medicine, Hospital Ramón y Cajal, Madrid, Spain
| | - C Suárez-Cuervo
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A Casanovas
- Department of Internal Medicine, Hospital Parc Taulí, Sabadell, Spain
| | - F J Rascón
- Department of Internal Medicine, Hospital Son Espases, Palma de Mallorca, Spain
| | - R Qanneta
- Department of Internal Medicine, Hospital Joan XXIII, Tarragona, Spain
| | - R Pérez-Alvarez
- Department of Internal Medicine, Hospital do Meixoeiro, Vigo, Spain
| | - M Ripoll
- Department of Internal Medicine, Hospital Infanta Sofía, Madrid, Spain
| | - M Akasbi
- Department of Internal Medicine, Hospital Infanta Leonor, Madrid, Spain
| | - B Pinilla
- Department of Internal Medicine, Hospital Gregorio Marañón, Madrid, Spain
| | - J A Bosch
- Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Spain
| | - J Nava-Mateos
- Department of Internal Medicine, Hospital Ramón y Cajal, Madrid, Spain
| | - B Díaz-López
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - H Gheitasi
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ICMiD, Hospital Clínic, Barcelona, Spain
| | - S Retamozo
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ICMiD, Hospital Clínic, Barcelona, Spain
| | - M Ramos-Casals
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ICMiD, Hospital Clínic, Barcelona, Spain
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Brito Zeron P, Kostov B, Solans R, de Luna G, Casanovas A, Díaz-Lόpez B, Rascόn F, Qanneta R, Pérez-Alvarez R, García-Sánchez I, Ripoll M, Pinilla B, Gheitasi H, Retamozo S, Ramos-Casals M. OP0211 Association between Systemic Activity and Lymphoma in Primary Sjogren Syndrome: Baseline Essdai Predictors in 921 Spanish Patients (GEAS-SS Registry). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Brito Zeron P, Retamozo S, Bové A, Kostov B, Gheitasi H, Ligero M, Sisό-Almirall A, Alόs L, Ramos-Casals M. SAT0206 Minimally-Invasive Technique for the Biopsy of Minor Salivary Glands: Searching for Systemic Infiltrative Diseases in Patients Presenting with SICCA Symptoms. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5132] [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: 11/03/2022]
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Brito Zeron P, Caminal-Montero L, Chamorro A, de la Hera Fernández J, Gato A, Marín-Ballvé A, Robles A, Rodríguez-Carballeira M, Salvador G, Saez L, Ruiz-Irastorza G, Gheitasi H, Retamozo S, Ramos-Casals M. AB0542 Blocking the Human B Lymphocyte Stimulator Molecule (BLYS) Using A Monoclonal Antibody (Belimumab) in Systemic Lupus Erythematosus: First Results in Real-Life Spanish Patients with Refractory Disease (Biogeas-Semi Registry). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5447] [Citation(s) in RCA: 4] [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: 11/04/2022]
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Brito Zeron P, Retamozo S, Solans R, Fraile G, Morera-Morales L, Suárez-Cuervo C, Rascόn F, Qanneta R, Pérez-de-Lis M, Akasbi M, Ripoll M, Pinilla B, Kostov B, Gheitasi H, Ramos-Casals M. OP0213 The Degree of Activity Measured with the EULAR-SS Disease Activity Index (ESSDAI) Strongly Correlated with Death in Patients with Primary Sjogren Syndrome (GEAS-SS REGISTRY). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4342] [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: 11/04/2022]
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Brito Zeron P, Mañá J, Pérez-Alvarez R, Retamozo S, Gheitasi H, Fernández-Martín J, Pérez-de-Lis M, Bosch X, Ramos-Casals M. THU0397 Clinical Presentation and Characterization of Neurosarcoidosis: Analysis in 719 Patients (Sarcogeas-Semi Registry). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Brito Zeron P, Retamozo S, Fraile G, Ruiz de Temino de la Pena A, Andres Calvo M, Fonseca E, Martinez Zapico A, Rodriguez Caballeira M, Caminal L, Larranaga J, Gheitasi H, Bosch X, Prieto Gonzalez S, Ramos Casals M. THU0398 Adult Hemophagocytic Syndrome: Analysis of 50 Cases (Spanish National Registry Geas-Semi). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.6017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Brito Zeron P, Cajamarca L, Perez-Alvarez R, Real de Asua D, Benito Conejero S, Beamud F, Martinez-Valle F, Bosch X, Villaverde I, Fonseca E, Acevedo L, Gonzalez Vazquez L, de la Red G, Santiago C, Gonzalez Vazquez E, Inglada L, Robles Marhuenda A, Castro Salomo A, Jordana R, Fernandez Martin J, Perez de Lis M, Retamozo S, Gheitasi H, Lopez Soto A, Ramos-Casals M. THU0399 Systemic Amyloidosis as A Multi-Organ, Life-Threatening Disease: Predictive Baseline Factors Associated to Mortality in 570 Patients (Ramyd-Geas-Semi Registry). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Brito Zeron P, Retamozo S, Gheitasi H, Bové A, Kostov B, Sisό-Almirall A, Ramos-Casals M, Stone J. THU0396 Igg4-Related Disease or Primary Sjogren Syndrome? Organ-Specific Involvement and Immunological Profile Are Clues in Differentiating Two Diseases with A Common Clinical Presentation. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Brito Zeron P, Kaveri S, Bové A, Retamozo S, Gheitasi H, Akasbi M, Gandía M, Soto-Cárdenas M, Pérez-de-Lis M, Pérez-Alvarez R, Kostov B, Sisό-Almirall A, Londoño M, Forns X, Ramos-Casals M. THU0298 Are Anti-La Antibodies A Potential Protection for Hepatitis C Virus Infection in SjÖGren Syndrome? Analysis in 663 Patients. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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