Examinando por Materia "Rheumatoid arthritis"
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Publicación Sólo datos Artritis reumatoide y telemedicina en tiempos de COVID-19(Sociedad de Cirugía de Bogotá, Hospital de San José y Fundación Universitaria de Ciencias de la Salud, 2022-04-05) Rodríguez-Vargas, Gabriel Santiago; Nieto-Zambrano, Paula Daniela; Rubio-Rubio, Jaime Andrés; Santos-Moreno, Pedro; Rojas-Villarraga, AdrianaPublicación Acceso abierto Rheumatoid factor as predictor of response to treatment with anti-TNF alpha drugs in patients with rheumatoid arthritis(Wolters Kluwer Health, Inc., 2019-02) Santos Moreno, Pedro; Sánchez, Guillermo; Castro, CarlosWe determined whether rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) can predict remission or severe disability in rheumatoid arthritis (RA) patients treated with anti-tumor necrosis factor (TNF) alpha drugs. We performed a cohort study based on the clinical data from a referral center for the treatment of RA in Bogotá, Colombia, were included patients aged ≥18 years with diagnosis of RA with an active disease and for whom a treatment scheme was begun with anti- TNF alpha medication, with a minimum follow-up time of 12 months. Disease activity of Rheumatoid Arthritis was assessed through measurement of RF, ACPA, disease activity score (DAS28), and health assessment questionnaire (HAQ). We calculated the incidence rates (IRs) for remission and severe disability. We also calculated the incidence rate ratio (IRR) for each outcome by adjusting for possible confounders using the Poisson regression method. The hypothesis was tested with a P value of <.05. Statistical analysis was performed in Stata 15. We included 400 patients receiving an anti-TNF alpha agent. Median age was 60 years, and 322 patients were women (80.5%). RF was positive in 357 patients (89%), ACPA in 348 patients (87%), and co-positivity in 324 patients (81%). Median follow-up was 41 months (range, 12–79 months). The IR for remission was 23 per 100 person-years in RF-negative patients and 16 per 100 personyears in RF-positive patients. The adjusted IRR (age sex, treatment, and ACPA) was 1.51 (95%CI, 1.05–2.18). The IR for severe disability was 10.8 per 100 person-years in the RF-positive cohort and 2.3 per 100 person-years in the RF-negative cohort. The IRR adjusted for these factors was 4.37 (95%CI, 1.6–12). Co-positivity had a similar behavior to RF. No differences were recorded in the rates of remission or disability in ACPA-positive and ACPA-negative patients. Our findings suggest that remission is less frequent and severe disability more frequent in RF-positive patients treated with anti- TNF alpha agents than in RF-negative patients. Abbreviations: ACPA = anticyclic citrullinated peptide antibody, DAS28 = disease activity score, DMARDs = disease-modifying antirheumatic drugs, HAQ = health assessment questionnaire, IR = incidence rate, IRR = incidence rate ratio, RF = rheumatoid factor, TNF = tumor necrosis factor.Publicación Acceso abierto Subcutaneous abatacept in rheumatoid arthritis: A real-life experience(Elsevier BV, 2019-12) Sarmiento Monroy, Juan Camilo; Parada Arias, Luisa; Rodríguez López, Milena; Rodríguez Jiménez, Mónica; Molano González, Nicólas; Rojas Villarraga, Adriana; Mantilla, Rubén DaríoObjectives: To assess the effectiveness, safety, and drug survival of subcutaneous (SC) abatacept (ABA) in a cohort of rheumatoid arthritis (RA) patients in a real-world setting. Methods: This was a retrospective cohort study from 2014 to 2018 in which patients with RA (1987 ACR criteria) were included. Patients were evaluated at a single rheumatology outpatient center in Bogot a, Colombia. The patients were classified according to their treatment background: biological-naïve (n ¼ 65), switched from IV to SC ABA administration (125 mg-wk) (n ¼ 32), and inadequate response to biological DMARD (n ¼ 62). The pri- mary endpoint was a change in DAS28-CRP and RAPID3 from baseline to 12 months. A linear mixed effect model was used to correlate repeated measures. Adverse events were assessed and recorded during each visit to the rheumatology center. Several Cox proportional hazard regression models were used to test if there were any differences in drug survival curves based on seropositivity for rheumatoid factor (RF), and anti-Cyclic Citrulli- nated Peptide Antibodies (anti-CCP). Statistical analysis was done using software R version 3.4.4. Results: A total of 159 patients were included. Baseline characteristics of patients were as follows: female gender 84%, median age of 54 years (IQR 16), median disease duration 10 years (11), RF positive 96%, anti-CCP positive 89%, erosive disease 55%, median DAS28-CRP 5.0 (2), and median RAPID3 17 (10). Concomitant use of methotrexate and SC ABA monotherapy were reported at 52% and 30% respectively. Demographics and disease characteristics were similar for all groups, except for baseline DAS28-CRP, and RAPID3 in the group that switched route of administration. The interaction between time and group was significant (p ¼ 0.0073) for RAPID3. In- fections, constitutional symptoms, and headaches were the most frequent AEs. Retention rate corresponded to 60% at 48 months. The most frequent reason for drug suspension was loss of efficacy. Median time of treatment for SC ABA was 31 months (IQR 30). The only association that reached statistical significance was anti-CCP concentration [Q1–Q4] (p ¼ 0.005). According to the Cox proportional hazard regression model, there were significant differences between survival curves for Q1 (HR 0.15; 0.03–0.64 95% CI; p ¼ 0.0096), and Q2 (HR 0.28; 0.08–0.92 95% CI; p ¼ 0.0363) compared to the seronegative group. Conclusions: The results showed an improvement in RA disease activity and physical function in patients under SC ABA treatment. Patients switching from IV to SC administration of ABA had lower activity and functional impairment at baseline. SC ABA demonstrated a good safety profile consistent with previously published data. Patients with baseline levels of anti-CCP antibody concentrations had better drug survival than seronegative patients.