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Mena-Vázquez N, Redondo-Rodriguez R, Cabezudo-García P, Garcia-Studer A, Ortiz-Márquez F, Borregón-Garrido P, Martín-Valverde M, Ureña-Garnica I, Manrique-Arija S, Cano-García L, Fernández-Nebro A. Interstitial Lung Disease Is Associated with Sleep Disorders in Rheumatoid Arthritis Patients. Clocks Sleep 2023; 5:755-769. [PMID: 38131748 PMCID: PMC10742867 DOI: 10.3390/clockssleep5040049] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
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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Affiliation(s)
- Natalia Mena-Vázquez
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Rocío Redondo-Rodriguez
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga, 29010 Malaga, Spain;
| | - Pablo Cabezudo-García
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- UGC Neurociencia, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Aimara Garcia-Studer
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga, 29010 Malaga, Spain;
| | - Fernando Ortiz-Márquez
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga, 29010 Malaga, Spain;
| | - Paula Borregón-Garrido
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
| | | | - Inmaculada Ureña-Garnica
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Sara Manrique-Arija
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga, 29010 Malaga, Spain;
| | - Laura Cano-García
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
| | - Antonio Fernández-Nebro
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Malaga, Spain; (R.R.-R.); (P.C.-G.); (A.G.-S.); (F.O.-M.); (P.B.-G.); (I.U.-G.); (S.M.-A.); (L.C.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
- UGC Neurociencia, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain
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Mena-Vázquez N, García-Studer A, Rojas-Gimenez M, Romero-Barco CM, Manrique-Arija S, Mucientes A, Velloso-Feijoo ML, Godoy-Navarrete FJ, Morales-Garrido P, Redondo-Rodríguez R, Ordoñez-Cañizares MC, Ortega-Castro R, Lisbona-Montañez JM, Hidalgo Conde A, Arnedo Díez de los Ríos R, Cabrera César E, Espildora F, Aguilar-Hurtado MC, Añón-Oñate I, Ureña-Garnica I, Fernández-Nebro A. Importance of Vaccination against SARS-CoV-2 in Patients with Interstitial Lung Disease Associated with Systemic Autoimmune Disease. J Clin Med 2022; 11:jcm11092437. [PMID: 35566564 PMCID: PMC9106041 DOI: 10.3390/jcm11092437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/23/2022] [Accepted: 04/24/2022] [Indexed: 01/09/2023] Open
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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Affiliation(s)
- Natalia Mena-Vázquez
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Cordoba, Spain; (M.R.-G.); (R.O.-C.)
- Correspondence:
| | - Aimara García-Studer
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
| | - Marta Rojas-Gimenez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Cordoba, Spain; (M.R.-G.); (R.O.-C.)
- UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Cordoba, Spain
| | - Carmen María Romero-Barco
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Clínico Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Sara Manrique-Arija
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain
| | - Arkaitz Mucientes
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
| | | | | | | | - Rocío Redondo-Rodríguez
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
| | - MC Ordoñez-Cañizares
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Clínico Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Rafaela Ortega-Castro
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Cordoba, Spain; (M.R.-G.); (R.O.-C.)
- UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Cordoba, Spain
| | - Jose Manuel Lisbona-Montañez
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain
| | - Ana Hidalgo Conde
- Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain; (A.H.C.); (R.A.D.d.l.R.)
| | - Rocío Arnedo Díez de los Ríos
- Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain; (A.H.C.); (R.A.D.d.l.R.)
| | - Eva Cabrera César
- UGC Neumología, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain;
| | - Francisco Espildora
- UGC de Neumología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
| | | | - Isabel Añón-Oñate
- Hospital Universitario de Jaén, 23007 Jaén, Spain; (F.J.G.-N.); (I.A.-O.)
| | - Inmaculada Ureña-Garnica
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
| | - Antonio Fernández-Nebro
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; (A.G.-S.); (C.M.R.-B.); (S.M.-A.); (A.M.); (R.R.-R.); (M.O.-C.); (I.U.-G.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
- Departamento de Medicina, Universidad de Málaga, 29016 Malaga, Spain
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Ordoñez-Cañizares MC, Mena-Vázquez N, Redondo-Rodriguez R, Manrique-Arija S, Jimenez-Núñez FG, Ureña-Garnica I, Fernández-Nebro A. Frequency of Polyautoimmunity in Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus. J Clin Rheumatol 2022; 28:e38-e43. [PMID: 32956154 DOI: 10.1097/rhu.0000000000001574] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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 Sjögren syndrome (53.3%), followed by Hashimoto thyroiditis and psoriasis; the most frequent AIDs in SLE were Sjögren 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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Rojas-Giménez M, Mena-Vázquez N, Romero-Barco CM, Manrique-Arija S, Ureña-Garnica I, Diaz-Cordovés G, Jiménez-Núñez FG, Fernández-Nebro A. Effectiveness, safety and economic analysis of Benepali in clinical practice. Reumatol Clin (Engl Ed) 2021; 17:588-594. [PMID: 34823826 DOI: 10.1016/j.reumae.2020.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/29/2020] [Indexed: 06/13/2023]
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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Affiliation(s)
- Marta Rojas-Giménez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain; UGC de Reumatología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Natalia Mena-Vázquez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain.
| | - Carmen María Romero-Barco
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Virgen de la Victoria, Málaga, Spain
| | - Sara Manrique-Arija
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Inmaculada Ureña-Garnica
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Gisela Diaz-Cordovés
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Francisco Gabriel Jiménez-Núñez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Antonio Fernández-Nebro
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain; Departamento de Medicina, Universidad de Málaga, Málaga, Spain
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Trinidad-Fernández M, Cuesta-Vargas A, Vaes P, Beckwée D, Moreno FÁ, González-Jiménez J, Fernández-Nebro A, Manrique-Arija S, Ureña-Garnica I, González-Sánchez M. Human motion capture for movement limitation analysis using an RGB-D camera in spondyloarthritis: a validation study. Med Biol Eng Comput 2021; 59:2127-2137. [PMID: 34467447 PMCID: PMC8440303 DOI: 10.1007/s11517-021-02406-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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 07/01/2021] [Indexed: 11/30/2022]
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. Comparation of both systems, required software for camera analysis, outcomes and final results of validity and reliability of each test.
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Affiliation(s)
- Manuel Trinidad-Fernández
- Departamento de Fisioterapia, Instituto de Biomedicina de Málaga (IBIMA), Universidad de Málaga, Grupo de Clinimetría (F-14), Málaga, Spain
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Antonio Cuesta-Vargas
- Departamento de Fisioterapia, Instituto de Biomedicina de Málaga (IBIMA), Universidad de Málaga, Grupo de Clinimetría (F-14), Málaga, Spain.
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Peter Vaes
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - David Beckwée
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium
| | - Francisco-Ángel Moreno
- MAPIR-UMA Group, Department Ingeniería de Sistemas Y Automática, Instituto de Investigación Biomédico de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Javier González-Jiménez
- MAPIR-UMA Group, Department Ingeniería de Sistemas Y Automática, Instituto de Investigación Biomédico de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Antonio Fernández-Nebro
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA) Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Sara Manrique-Arija
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA) Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Inmaculada Ureña-Garnica
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA) Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Manuel González-Sánchez
- Departamento de Fisioterapia, Instituto de Biomedicina de Málaga (IBIMA), Universidad de Málaga, Grupo de Clinimetría (F-14), Málaga, Spain
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Mena-Vázquez N, Rojas-Gimenez M, Romero-Barco CM, Manrique-Arija S, Hidalgo Conde A, Arnedo Díez de los Ríos R, Cabrera César E, Ortega-Castro R, Espildora F, Aguilar-Hurtado MC, Añón-Oñate I, Pérez-Albaladejo L, Abarca-Costalago M, Ureña-Garnica I, Velloso-Feijoo ML, Redondo-Rodriguez R, Fernández-Nebro A. Characteristics and Predictors of Progression Interstitial Lung Disease in Rheumatoid Arthritis Compared with Other Autoimmune Disease: A Retrospective Cohort Study. Diagnostics (Basel) 2021; 11:diagnostics11101794. [PMID: 34679492 PMCID: PMC8534825 DOI: 10.3390/diagnostics11101794] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/14/2021] [Accepted: 09/27/2021] [Indexed: 12/22/2022] Open
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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Affiliation(s)
- Natalia Mena-Vázquez
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.M.R.-B.); (S.M.-A.); (I.U.-G.); (R.R.-R.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
- Correspondence: ; Tel.: +34-952290360
| | - Marta Rojas-Gimenez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (M.R.-G.); (R.O.-C.)
- UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
| | - Carmen María Romero-Barco
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.M.R.-B.); (S.M.-A.); (I.U.-G.); (R.R.-R.); (A.F.-N.)
- UGC de Reumatología, Hospital Clínico Universitario Virgen de la Victoria, 29010 Málaga, Spain
| | - Sara Manrique-Arija
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.M.R.-B.); (S.M.-A.); (I.U.-G.); (R.R.-R.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
| | - Ana Hidalgo Conde
- Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (A.H.C.); (R.A.D.d.l.R.); (M.A.-C.)
| | - Rocío Arnedo Díez de los Ríos
- Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (A.H.C.); (R.A.D.d.l.R.); (M.A.-C.)
| | - Eva Cabrera César
- UGC Neumología, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain;
| | - Rafaela Ortega-Castro
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (M.R.-G.); (R.O.-C.)
- UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
| | - Francisco Espildora
- UGC de Neumología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain;
| | | | | | | | - Manuel Abarca-Costalago
- Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (A.H.C.); (R.A.D.d.l.R.); (M.A.-C.)
| | - Inmaculada Ureña-Garnica
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.M.R.-B.); (S.M.-A.); (I.U.-G.); (R.R.-R.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
| | | | - Rocio Redondo-Rodriguez
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.M.R.-B.); (S.M.-A.); (I.U.-G.); (R.R.-R.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
| | - Antonio Fernández-Nebro
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.M.R.-B.); (S.M.-A.); (I.U.-G.); (R.R.-R.); (A.F.-N.)
- UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
- Departamento de Medicina, Universidad de Málaga, 29010 Málaga, Spain
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7
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Mena Vázquez N, Manrique-Arija S, Cabezudo-García P, Godoy-Navarrete FJ, Cabezas-Lucena AM, Morales-Águila M, Redondo-Rodríguez R, Sobrino B, Ureña-Garnica I, Ordoñez-Cañizares MC, Díaz Cordovés-Rego G, Fernández-Nebro A. Incidence and case fatality rate of COVID-19 in patients with inflammatory articular diseases. Int J Clin Pract 2021; 75:e13707. [PMID: 32931643 DOI: 10.1111/ijcp.13707] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/05/2020] [Accepted: 09/08/2020] [Indexed: 12/15/2022] Open
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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Affiliation(s)
- Natalia Mena Vázquez
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Sara Manrique-Arija
- Unidad de Gestión Clínica (UCG) de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Pablo Cabezudo-García
- Instituto de Investigación Biomédica de Málaga (IBIMA), Servicio de Neurología, UGC de Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Francisco Javier Godoy-Navarrete
- Unidad de Gestión Clínica (UCG) de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Alba María Cabezas-Lucena
- Unidad de Gestión Clínica (UCG) de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - M Morales-Águila
- Unidad de Gestión Clínica (UCG) de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Roció Redondo-Rodríguez
- Unidad de Gestión Clínica (UCG) de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Beatriz Sobrino
- Unidad de Gestión Clínica (UCG) de Enfermedades Infecciosas, Instituto de Investigación Biomédica de Málaga (IBIMA),, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Inmaculada Ureña-Garnica
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - M C Ordoñez-Cañizares
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Gisela Díaz Cordovés-Rego
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Antonio Fernández-Nebro
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
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8
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Mena-Vazquez N, Manrique-Arija S, Yunquera-Romero L, Ureña-Garnica I, Rojas-Gimenez M, Domic C, Jimenez-Nuñez FG, Fernandez-Nebro A. Adherence of rheumatoid arthritis patients to biologic disease-modifying antirheumatic drugs: a cross-sectional study. Rheumatol Int 2017. [PMID: 28631046 DOI: 10.1007/s00296-017-3758-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The aims of this study were to evaluate adherence of rheumatoid arthritis (RA) patients to biological disease-modifying antirheumatic drugs (bDMARDs), identify potential risk factors, and analyze the discriminative ability of the Morisky-Green test (MGT) to detect bDMARD nonadherence. One hundred and seventy-eight adult RA patients treated with bDMARDs were included. Adherence was measured using the medication possession ratio (MPR) of the previous 6 months. An MPR >80% was considered good adherence. Patient demographics, clinical characteristics, and MGT scores were assessed through a standardized clinical interview at the cross-sectional date. One-hundred and twelve patients (63%) were taking subcutaneous bDMARDs, while 66 (37%) were taking intravenous drugs. One-hundred fifty-eight (88.8%) showed good adherence to bDMARDs, while 79 (61.2%) also correctly took concomitant conventional synthetic DMARDs (csDMARDs). In logistic regression models, nonadherence to bDMARDs was associated with higher disease activity [odds ratio (OR) 1.45; 95% CI, 1.03-2.03; p = 0.032] and subcutaneous route (OR 3.70; 95% CI 1.02-13.48; p = 0.040). MGT accurately identified an MPR >80% of bDMARDs in 76.9% of the patients. A sensitivity of 78%, specificity of 70%, positive predictive value of 95.3%, negative predictive value of 28.5%, positive likelihood ratio (LR) of 2.6, and negative LR of 0.3% were obtained. Adherence may be good for bDMARDs but is low for csDMARDs. Low adherence for bDMARDs is associated with poorer disease control during the past 6 months and use of subcutaneous route. These findings should alert doctors to consider possible low adherence before declaring treatment failure.
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Affiliation(s)
- Natalia Mena-Vazquez
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Pabellón C: "Hospital Civil", Plaza del Hospital Civil s/n, 29009, Málaga, Spain
| | - Sara Manrique-Arija
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Pabellón C: "Hospital Civil", Plaza del Hospital Civil s/n, 29009, Málaga, Spain
| | | | - Inmaculada Ureña-Garnica
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Pabellón C: "Hospital Civil", Plaza del Hospital Civil s/n, 29009, Málaga, Spain
| | - Marta Rojas-Gimenez
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Pabellón C: "Hospital Civil", Plaza del Hospital Civil s/n, 29009, Málaga, Spain
| | - Carla Domic
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Pabellón C: "Hospital Civil", Plaza del Hospital Civil s/n, 29009, Málaga, Spain
| | - Francisco Gabriel Jimenez-Nuñez
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Pabellón C: "Hospital Civil", Plaza del Hospital Civil s/n, 29009, Málaga, Spain
| | - Antonio Fernandez-Nebro
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Pabellón C: "Hospital Civil", Plaza del Hospital Civil s/n, 29009, Málaga, Spain.
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9
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Gómez-Moyano E, Ureña-Garnica I, Manrique-Arija S, Perez-Belmonte LM. Erythematous patches with keratotic annular borders on the glans penis. Cleve Clin J Med 2017; 84:23-24. [PMID: 28084979 DOI: 10.3949/ccjm.84a.15145] [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] [Indexed: 11/14/2022]
Affiliation(s)
- Elisabeth Gómez-Moyano
- Department of Dermatology. Hospital Regional Universitario de Málaga, Plaza Hospital Civil, Málaga, Spain.
| | | | - Sara Manrique-Arija
- Department of Rheumatology. Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Luis Miguel Perez-Belmonte
- UGC Corazón, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Red de Investigación Cardiovascular, Málaga, Spain
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10
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Cano-Garcia L, Manrique-Arija S, Mena-Vázquez N, Ordόñez-Cañizares M, Romero-Barco C, Domic-Bueno C, Rojas-Giménez M, Fuego-Valera C, Jiménez-Núñez F, Ureña-Garnica I, Irigoyen-Oyarzábal M, Coret-Cagigal V, Belmonte-Lόpez Ά, Fernández-Nebro A. SAT0630-HPR Variables Predictive of The Sleep Disorders in Patients with Psoriatic Arthritis and Spondylarthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2543] [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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11
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Mena-Vázquez N, Manrique-Arija S, Ureña-Garnica I, Romero-Barco CM, Jiménez-Núñez FG, Coret V, Irigoyen-Oyarzábal MV, Fernández-Nebro A. Eficiency of different doses of rituximab in rheumatoid arthritis. ACTA ACUST UNITED AC 2015; 12:139-45. [PMID: 26458761 DOI: 10.1016/j.reuma.2015.07.003] [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: 04/04/2015] [Revised: 06/15/2015] [Accepted: 07/03/2015] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Evaluate the effectiveness, cost and safety of rituximab in patients with rheumatoid arthritis (RA) depending on the dose used. MATERIAL AND METHODS Retrospective observational study conducted on 52 patients with RA treated with at least one dose of rituximab for 135.3 patient-years were included. Three treatment groups were obtained: (G1) First course and following two 1g infusions separated by 15 days; (G2) First course 2 infusions of 1g followed by 2 infusions of 500mg; (G3) First course and followed by 2 infusions of 500mg separated by 15 days. Re-treatments were administered on-demand according to the clinical activity. The retention time (Log-Rank), retreats and adverse events rates (incidence rate ratio) and treatment costs per patient-month of rituximab were analysed by groups. RESULTS Group 2 showed a better cost-effectiveness ratio than group 1, as it was associated with a longer retention of rituximab (mean [95% CI] 65.7 [60.8 to 70.7] months vs 33.5 [22.7 to 44.3]; P<.001) and a lower rate of severe adverse events with only a slight increase in the rate of retreatment (courses/patient-year [95% CI] 1.66 [1.39 to 1.93] vs. 1.01 [0.69 to 1.34]; P=.005), and in the costs (median/patient-month, €484.89 vs. €473.45). Although group 3 was €41.20/patient-month cheaper than group 2, it was associated with a higher rate of re-treatments and shorter retention of rituximab (P<.001). CONCLUSIONS The use of full-dose rituximab at onset, followed by reduced doses in successive courses administered on-demand retreatment may be the most cost-effective option.
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Key Words
- Adult
- Adulto
- Agentes antirreumáticos/administración y dosis
- Agentes antirreumáticos/efectos adversos
- Agentes antirreumáticos/uso terapéutico
- Antibodies, monoclonal, murine-derived
- Antibodies, monoclonal/administration and dosage
- Antibodies, monoclonal/adverse effects
- Antibodies, monoclonal/therapeutic use
- Anticuerpos, monoclonal, derivado-murino
- Anticuerpos, monoclonal/administración y dosis
- Anticuerpos, monoclonal/efectos adversos
- Anticuerpos, monoclonal/uso terapéutico
- Antirheumatic agents/administration and dosage
- Antirheumatic agents/adverse effects
- Antirheumatic agents/therapeutic use
- Arthritis, rheumatoid/drug therapy
- Arthritis, rheumatoid/immunology
- Artritis, reumatoide/inmunología
- Artritis, reumatoide/terapia farmacológica
- Dose-response relationship, drug
- Drug administration schedule
- Humanos
- Humans
- Pauta administración fármaco
- Relación dosis-respuesta, fármaco
- Rituximab
- Tratamiento desenlace
- Treatment outcome
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Affiliation(s)
- Natalia Mena-Vázquez
- Unidad de Gestión Clínica de Reumatología, Instituto de investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, España
| | - Sara Manrique-Arija
- Unidad de Gestión Clínica de Reumatología, Instituto de investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, España
| | - Inmaculada Ureña-Garnica
- Unidad de Gestión Clínica de Reumatología, Instituto de investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, España
| | - Carmen M Romero-Barco
- Unidad de Gestión Clínica de Reumatología, Instituto de investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, España
| | - Francisco G Jiménez-Núñez
- Unidad de Gestión Clínica de Reumatología, Instituto de investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, España
| | - Virginia Coret
- Unidad de Gestión Clínica de Reumatología, Instituto de investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, España
| | - María Victoria Irigoyen-Oyarzábal
- Unidad de Gestión Clínica de Reumatología, Instituto de investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, España
| | - Antonio Fernández-Nebro
- Unidad de Gestión Clínica de Reumatología, Instituto de investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, España.
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Lopez-Lasanta M, Julià A, Maymó J, Fernández-Gutierrez B, Ureña-Garnica I, Blanco FJ, Cañete JD, Alperi-López M, Olivè A, Corominas H, Tornero J, Erra A, Almirall M, Palau N, Ortiz A, Avila G, Rodriguez-Rodriguez L, Alonso A, Tortosa R, Gonzalez-Alvaro I, Marsal S. Variation at interleukin-6 receptor gene is associated to joint damage in rheumatoid arthritis. Arthritis Res Ther 2015; 17:242. [PMID: 26336855 PMCID: PMC4560075 DOI: 10.1186/s13075-015-0737-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 08/03/2015] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Interleukin-6 (IL-6) cytokine signaling is key in Rheumatoid Arthritis (RA) pathophysiology. Blocking IL-6 receptor (IL6R) has proven to be a highly effective treatment to prevent joint damage. This study was performed to investigate the association between the genetic variation at IL6R gene and the severity of joint damage in RA. METHODS IL6R gene tagging SNPs (n = 5) were genotyped in a discovery group of 527 RA patients from 5 different university hospitals from Spain. For each marker, a linear regression analysis was performed using an additive model and adjusting for the years of evolution of the disease, autoantibody status, gender and age. Haplotypes combining the SNPs were also estimated and tested for association with the level of joint destruction. Using an independent cohort of 705 RA patients from 6 university hospitals we performed a validation study of the SNPs associated in the discovery phase. RESULTS In the discovery group we found a highly significant association between IL6R SNP rs4845618 and the level of joint destruction in RA (P = 0.0058, P corrected = 0.026), and a moderate association with SNP rs4453032 (P = 0.02, P corrected = 0.05). The resulting haplotype from both SNPs was more significantly associated with joint damage (P = 0.0037, P corrected = 0.011). Using the validation cohort, we replicated the association between the two IL-6R SNPs with the degree of joint destruction in RA (P = 0.007 and P = 0.04, meta-analysis P = 0.00011 and P = 0.0021, respectively), and the haplotype association (P = 0.0058, meta-analysis P = 6.64 e-5). CONCLUSIONS Genetic variation at IL6R gene is associated with joint damage in RA.
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Affiliation(s)
- Maria Lopez-Lasanta
- Vall d'Hebron Hospital Research Institute, Rheumatology Research Group, Pg Vall Hebron 119-129, 08035, Barcelona, Spain.
| | - Antonio Julià
- Vall d'Hebron Hospital Research Institute, Rheumatology Research Group, Pg Vall Hebron 119-129, 08035, Barcelona, Spain.
| | - Joan Maymó
- Rheumatology Department, Hospital del Mar, Pg Marítim, 25-29, 08003, Barcelona, Spain.
| | | | - Inmaculada Ureña-Garnica
- UGC Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya, S/N, 29010, Málaga, Spain.
| | - Francisco J Blanco
- Rheumatology Department, INIBIC-Hospital Universitario A Coruña, C. As Xubias, 84, 15006, A Coruña, Spain.
| | - Juan D Cañete
- Rheumatology Department, Hospital Clínic de Barcelona, C. Villaroel, 170, 08036, Barcelona, Spain.
| | - Mercedes Alperi-López
- Rheumatology Department, Hospital Universitario Central de Asturias, Avda. De Roma, S/N, 33011, Oviedo, Spain.
| | - Alex Olivè
- Rheumatology Department, Hospital Universitari Germans Trias i Pujol, Crta. Can Ruti-Camí Escoles, S/N, 08916, Barcelona, Spain.
| | - Héctor Corominas
- Rheumatology Department, Hospital Moisès Broggi, C. Jacint Verdaguer, 90, 08906, L´Hospitalet de Llobregat, Barcelona, Spain.
| | - Jesus Tornero
- Rheumatology Department, Hospital Universitario De Guadalajara, C. Donantes de sangre, S/N, 19002, Guadalajara, Spain.
| | - Alba Erra
- Rheumatology Department, Hospital Sant Rafael, Pg Vall Hebron, 107, 08035, Barcelona, Spain.
| | - Miriam Almirall
- Rheumatology Department, Hospital del Mar, Pg Marítim, 25-29, 08003, Barcelona, Spain.
| | - Nuria Palau
- Vall d'Hebron Hospital Research Institute, Rheumatology Research Group, Pg Vall Hebron 119-129, 08035, Barcelona, Spain.
| | - Ana Ortiz
- Rheumatology Department, Hospital Universitario La Princesa, IIS La Princesa, C. Diego Leon, 62, 28006, Madrid, Spain.
| | - Gabriela Avila
- Vall d'Hebron Hospital Research Institute, Rheumatology Research Group, Pg Vall Hebron 119-129, 08035, Barcelona, Spain.
| | - Luis Rodriguez-Rodriguez
- Rheumatology Department, Hospital Clínico San Carlos, C. Prof. Martin Lagos, S/N, 28040, Madrid, Spain.
| | - Arnald Alonso
- Vall d'Hebron Hospital Research Institute, Rheumatology Research Group, Pg Vall Hebron 119-129, 08035, Barcelona, Spain.
| | - Raül Tortosa
- Vall d'Hebron Hospital Research Institute, Rheumatology Research Group, Pg Vall Hebron 119-129, 08035, Barcelona, Spain.
| | - Isidoro Gonzalez-Alvaro
- Rheumatology Department, Hospital Universitario La Princesa, IIS La Princesa, C. Diego Leon, 62, 28006, Madrid, Spain.
| | - Sara Marsal
- Vall d'Hebron Hospital Research Institute, Rheumatology Research Group, Pg Vall Hebron 119-129, 08035, Barcelona, Spain.
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Mena-Vazquez N, Manrique-Arija S, Yunquera L, Ureña-Garnica I, Cano-García L, Ordoñez-Cañizares M, Domic C, Rojas-Giménez M, Fuego C, Jiménez Núñez F, Romero-Barco C, Irigoyen-Oyarzábal M, Coret V, Belmonte-Lόpez Ά, Fernández-Nebro A. SAT0201 Treatment Adherence in Rheumatoid Arthritis (RA) Patients Followed in a Specific Biological Therapy Unit. a Pilot Study: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3588] [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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Mena-Vazquez N, Manrique-Arija S, Ordoñez-Cañizares M, Domic C, Ureña-Garnica I, Romero Barco C, Jiménez-Núñez F, Rojas-Giménez M, Fuego C, Cano-García L, Irigoyen-Oyarzábal M, Coret V, Belmonte-Lόpez Ά, Fernández-Nebro A. FRI0177 Analysis of Effectiveness, Safety and Cost of Different Doses of Rituximab in a Cohort of Patients with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4033] [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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Mena-Vazquez N, Rojas-Giménez M, Romero-Barco C, Manrique-Arija S, Ordόñez-Cañizares M, Domic C, Fuego C, Rodríguez-García V, Jiménez-Núñez F, Ureña-Garnica I, Cano-García L, Irigoyen-Oyarzabal M, Rodríguez-Pérez M, Fernández-Nebro A. SAT0295 Measuring Microarchitecture Bone in Patients with Systemic Lupus Erythematosus. Pilot Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4435] [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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Cano-Garcia L, Romero-Barco C, Manrique-Arija S, Ureña-Garnica I, Jimenez Nuñez F, Ordoñez-Cañizares M, Nieves-Martín L, Mena-Vázquez N, Irigoyen-Oyarzabal M, Fernández-Nebro A. AB1143-HPR A Pilot Study of A Standardized Educational Programme for the Improvement of Chronic Pain and Fatigue in Systemic Lupus Erythematosus (SLE). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4668] [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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Cano-Garcia L, Manrique-Arija S, Romero-Barco C, Nieves-Martín L, Mena-Vázquez N, Rodríguez-Pérez M, Irigoyen-Óyarzabal M, Jiménez-Nuñez F, Ureña-Garnica I, Ordόñez-Cañizares M, Fernández-Nebro A. AB1144-HPR Case Management on Frail Patients in the Rheumatology Department at the Regional University Hospital in Malaga. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4555] [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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Jiménez-Núñez FG, Manrique-Arija S, Ureña-Garnica I, Romero-Barco CM, Panero-Lamothe B, Descalzo MA, Carmona L, Rodríguez-Pérez M, Fernández-Nebro A. Reducing the need for central dual-energy X-ray absorptiometry in postmenopausal women: efficacy of a clinical algorithm including peripheral densitometry. Calcif Tissue Int 2013; 93:62-8. [PMID: 23608922 DOI: 10.1007/s00223-013-9728-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Accepted: 03/06/2013] [Indexed: 11/24/2022]
Abstract
We evaluated the efficacy of a triage approach based on a combination of osteoporosis risk-assessment tools plus peripheral densitometry to identify low bone density accurately enough to be useful for clinical decision making in postmenopausal women. We conducted a cross-sectional diagnostic study in postmenopausal Caucasian women from primary and tertiary care. All women underwent dual-energy X-ray absorptiometric (DXA) measurement at the hip and lumbar spine and were categorized as osteoporotic or not. Additionally, patients had a nondominant heel densitometry performed with a PIXI densitometer. Four osteoporosis risk scores were tested: SCORE, ORAI, OST, and OSIRIS. All measurements were cross-blinded. We estimated the area under the curve (AUC) to predict the DXA results of 16 combinations of PIXI plus risk scores. A formula including the best combination was derived from a regression model and its predictability estimated. We included 505 women, in whom the prevalence of osteoporosis was 20 %, similar in both settings. The best algorithm was a combination of PIXI + OST + SCORE with an AUC of 0.826 (95 % CI 0.782-0.869). The proposed formula is Risk = (-12) × [PIXI + (-5)] × [OST + (-2)] × SCORE and showed little bias in the estimation (0.0016). If the formula had been implemented and the intermediate risk cutoff set at -5 to 20, the system would have saved <euro>4,606.34 in the study year. The formula proposed, derived from previously validated risk scores plus a peripheral bone density measurement, can be used reliably in primary care to avoid unnecessary central DXA measurements in postmenopausal women.
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Manrique-Arija S, Ureña-Garnica I, Lόpez-Lasanta M, Espiño-Lorenzo P, Irigoyen-Oyarzabal M, Fernández-Nebro A. AB0430 Fulfillment of some GUIPCAR-2007 recommendations for the care of patients with recent-onset reumatoid arthritis in spanish rheumatology centres. EMAR-II study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.430] [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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