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Alvarado RN, Alle G, Tobar-Jaramillo MA, Palomino LC, Cáceres AG, Rosa JE, Machnicki G, Zazzetti F, Soriano E, Scolnik M. Burden of lupus activity on health care resources utilization in Buenos Aires, Argentina. Lupus 2023; 32:1656-1665. [PMID: 37955177 DOI: 10.1177/09612033231215386] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
OBJECTIVE The aim is to analyze health care resource utilization (HCRU) of patients with lupus (SLE) from a health management organization (HMO) in Buenos Aires, Argentina, compared with matched controls and comparing periods of flare, low disease activity, and remission. METHODS This is a retrospective observational study including all SLE incident cases (ACR 1997/SLICC 2012 criteria) between 2000 and 2020 and 5 matched controls. Clinical data and HCRU (medical and nonmedical consultations, lab and imaging tests performed, emergency room visits, hospitalizations, and drugs prescribed) were obtained from administrative databases and electronic medical records. For each patient with SLE, an activity state was determined in every month of follow-up: flare (BILAG A or 2 BILAG B); low disease activity (LLDAS); remission (DORIS definition); or intermediate activity (not fulfilling any of previous). Incidence rates for each HCRU item and incidence rate ratios between SLE and control patients were and between remission and flare periods were calculated. Multivariate negative binomial logistic regression analyses were performed for identification of variables associated with major resource use. RESULTS A total of 62 SLE and 310 control patients were included, 88.7% were women, the median age at diagnosis was 46 years, and were followed for more than 8 years. Patients with SLE contributed with 537.2 patient-years (CI 95% 461.1-613.3) and controls with 2761.9 patient-years (CI 95% 2600.9-2922.8). HCRU in patients with SLE was significantly higher than in controls in all items, even in remission periods. Patients with SLE remained 74.4% of the time in remission, 12.1% in LLDAS, 12.2% in intermediate activity, and 1.3% in flare (there were 64 flares in 36 patients). HCRU was significantly higher during flare periods compared with remission periods. Number of flares was independently associated with emergency department consultations, lab tests and X-ray performed, number of drugs prescribed, and hospitalizations. CONCLUSION Significantly more HCRU was observed in patients with SLE in flare compared to remission periods.
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Affiliation(s)
| | - Gelsomina Alle
- Department of Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Luis Carlos Palomino
- Department of Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Javier Eduardo Rosa
- Department of Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Federico Zazzetti
- Janssen Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson and Johnson, Titusville, NJ, USA
| | - Enrique Soriano
- Department of Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Marina Scolnik
- Department of Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Martínez Perez JM, Mollerach FB, Scaglioni V, Vergara F, Gandino IJ, Catoggio LJ, Rosa JE, Soriano ER, Scolnik M. Incidence and Prevalence of Polymyalgia Rheumatica and Giant Cell Arteritis in a Healthcare Management Organization in Buenos Aires, Argentina. J Rheumatol 2023; 50:93-97. [PMID: 36243415 DOI: 10.3899/jrheum.220084] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To estimate incidence and prevalence of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) in a university hospital-based health management organization (Hospital Italiano Medical Care Program) in Argentina. METHODS Overall and sex-specific incidence rates (IRs) and prevalence were calculated (age ≥ 50 yrs). Incidence study followed members with continuous affiliation ≥ 1 year from January 2000 to December 2015. Diagnosis as per the 2012 European Alliance of Associations for Rheumatology/American College of Rheumatology (ACR) criteria for PMR or the ACR 1990 criteria for GCA. Prevalence was calculated on January 1, 2015. RESULTS There were 176,558 persons who contributed a total of 1,046,620 person-years (PY). Of these, 825 developed PMR, with an IR (per 100,000 PY) of 78.8 (95% CI 73.4-84.2) overall, 90.1 (95% CI 82.9-97.2) for women, and 58.9 (95% CI 51.1-66.6) for men. Ninety persons developed GCA; the IR was 8.6 (95% CI 6.8-10.4) overall, 11.1 (95% CI 8.5-10.6) for women, and 4.2 (2.2-6.3) for men. There were 205 prevalent PMR cases and 23 prevalent GCA cases identified from a population of 80,335. Prevalence of PMR was 255 per 100,000 (95% CI 220-290) overall, 280 (95% CI 234-325) for women, and 209 (95% CI 150-262) for men; and the prevalence of GCA was 28.6 per 100,000 (95% CI 16.9-40.3) overall, 36.4 (95% CI 20.1-52.8) for women, and 14.2 (95% CI 0.3-28.1) for men. CONCLUSION This is the first study of incidence and prevalence of PMR and GCA in Argentina. There were similarities and differences with cohorts from other parts of the world, but population-based epidemiologic studies in Latin America are needed.
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Affiliation(s)
- José Maximiliano Martínez Perez
- J.M. Martínez Perez, MD, F.B. Mollerach, MD, V. Scaglioni, MD, F. Vergara, MD, I.J. Gandino, MD, L.J. Catoggio, PhD, J. E. Rosa, MSc, E.R. Soriano, MSc, M. Scolnik, MD, Rheumatology Section, Hospital Italiano de Buenos Aires, Argentina
| | - Florencia Beatriz Mollerach
- J.M. Martínez Perez, MD, F.B. Mollerach, MD, V. Scaglioni, MD, F. Vergara, MD, I.J. Gandino, MD, L.J. Catoggio, PhD, J. E. Rosa, MSc, E.R. Soriano, MSc, M. Scolnik, MD, Rheumatology Section, Hospital Italiano de Buenos Aires, Argentina
| | - Valeria Scaglioni
- J.M. Martínez Perez, MD, F.B. Mollerach, MD, V. Scaglioni, MD, F. Vergara, MD, I.J. Gandino, MD, L.J. Catoggio, PhD, J. E. Rosa, MSc, E.R. Soriano, MSc, M. Scolnik, MD, Rheumatology Section, Hospital Italiano de Buenos Aires, Argentina
| | - Facundo Vergara
- J.M. Martínez Perez, MD, F.B. Mollerach, MD, V. Scaglioni, MD, F. Vergara, MD, I.J. Gandino, MD, L.J. Catoggio, PhD, J. E. Rosa, MSc, E.R. Soriano, MSc, M. Scolnik, MD, Rheumatology Section, Hospital Italiano de Buenos Aires, Argentina
| | - Ignacio Javier Gandino
- J.M. Martínez Perez, MD, F.B. Mollerach, MD, V. Scaglioni, MD, F. Vergara, MD, I.J. Gandino, MD, L.J. Catoggio, PhD, J. E. Rosa, MSc, E.R. Soriano, MSc, M. Scolnik, MD, Rheumatology Section, Hospital Italiano de Buenos Aires, Argentina
| | - Luis José Catoggio
- J.M. Martínez Perez, MD, F.B. Mollerach, MD, V. Scaglioni, MD, F. Vergara, MD, I.J. Gandino, MD, L.J. Catoggio, PhD, J. E. Rosa, MSc, E.R. Soriano, MSc, M. Scolnik, MD, Rheumatology Section, Hospital Italiano de Buenos Aires, Argentina
| | - Javier Eduardo Rosa
- J.M. Martínez Perez, MD, F.B. Mollerach, MD, V. Scaglioni, MD, F. Vergara, MD, I.J. Gandino, MD, L.J. Catoggio, PhD, J. E. Rosa, MSc, E.R. Soriano, MSc, M. Scolnik, MD, Rheumatology Section, Hospital Italiano de Buenos Aires, Argentina
| | - Enrique Roberto Soriano
- J.M. Martínez Perez, MD, F.B. Mollerach, MD, V. Scaglioni, MD, F. Vergara, MD, I.J. Gandino, MD, L.J. Catoggio, PhD, J. E. Rosa, MSc, E.R. Soriano, MSc, M. Scolnik, MD, Rheumatology Section, Hospital Italiano de Buenos Aires, Argentina
| | - Marina Scolnik
- J.M. Martínez Perez, MD, F.B. Mollerach, MD, V. Scaglioni, MD, F. Vergara, MD, I.J. Gandino, MD, L.J. Catoggio, PhD, J. E. Rosa, MSc, E.R. Soriano, MSc, M. Scolnik, MD, Rheumatology Section, Hospital Italiano de Buenos Aires, Argentina.
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Ranza R, de la Vega MC, Laurindo IMM, Gómez MG, Titton DC, Kakehasi AM, Brigante A, Benitez A, Ranzolin A, Granel A, Cappuccio AM, Quinteros A, Hayata ALS, Smichowski A, Duarte ÂLBP, Kahlow BS, Andia CS, Brenol CV, Velozo E, Mussano E, Soriano ER, Christopoulos GB, da Rocha Castelar Pinheiro G, de Castro GRW, Casado G, da Silveira Carvalho HM, Exeni IE, da Silveira IG, Petkovic I, Pereira IA, da Costa IP, Rosa JE, Miranda JRS, de Moraes JCB, Bertolo MB, Buhl M, Lázaro MA, da Sauma MDFLC, de Medeiros Pinheiro M, Díaz M, de Vechi MVSS, Cerda OL, Astesana P, Curi PF, Louzada-Jr P, Teodoro RB, Toledo RA, Papasidero S, Valim V, Fernandes V, Saurit V, Bianchi WA, de Melo Costa Pinto R, Descalzo MA, Gomez-Reino JJ. Changing rate of serious infections in biologic-exposed rheumatoid arthritis patients. Data from South American registries BIOBADABRASIL and BIOBADASAR. Clin Rheumatol 2019; 38:2129-2139. [DOI: 10.1007/s10067-019-04516-2] [Citation(s) in RCA: 4] [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: 01/06/2019] [Revised: 03/02/2019] [Accepted: 03/13/2019] [Indexed: 12/21/2022]
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