RESUMEN
Objectives: The persistence in therapy of rheumatoid arthritis drugs and particularly bDMARD is a limiting factor for their long-term use. The randomized controlled trials (RCTs) may not reflect real-world contexts due to strict inclusion and exclusion criteria. Baricitinib, which targets both JAK1 and JAK2, has been used in Italy for several years. The aim of this multi-center study is to assess the real world persistence on therapy of baricitinib in RA patients and to identify predictive factors of baricitinib's survival rate. Methods: This is a retrospective, multicentric, Italian, longitudinal study. All patients were enrolled according to the following criteria: a) age ≥ 18 years old; b) diagnosed with RA according 2010 ACR/EULAR classification criteria; c) treated with baricitinib. In order to describe baricitinib clinical efficacy, the survival rate was evaluated by The Kaplan-Meier curve. Then, predictive factors of drug retention rate were assessed by performing the Cox analysis, identifying which risk factors influenced treatment persistence. Results: Overall, we included 478 patients treated with baricitinib. Among them, 380 (79.5%) were females. Baricitinib's survival rate was 94.6% at 6 months, 87.9% at 12 months, 81.7% at 24 months and 53.4% at 48 months. The Cox analysis regression showed that a higher bDMARDs/tsDMARD line of therapy seems to be a negative prognostic factor for the drug retention rate (HR 1.26 CI 95% 1.07-1.49, p = 0.006. Conclusion: Real-life study confirms baricitinib effectiveness up to 4 years, but previous treatment with bDMARDs was a negative prognostic factor for its survival rate.
RESUMEN
En los aparatos de rayos X odontologicos, que existen en el mercado brasileño, el unico factor de exposicion regulable es el dispositivo indicador de tiempo en que estos aparatos emiten durante el procedimiento radiografico. La propuesta de este estudio es evaluar los aparatos de rayos X que son habitualmente utilizados en las clinicas y laboratorios de la Facultad de Odontologia de Ribeirao Preto de USP, respecto al grado de precision de sus marcadores de tiempo de exposicion. Se analizaron 23 aparatos de rayos X de FORP/USP, en intervalos de tiempo de 0,25 segundos, 0,40 segundos y 1,00 segundo. Para eso se ha utilizado un cronometro de rayos X. Todos los aparatos controlados presentaron mal funcionamiento del marcador de tiempo; mas del 5 por ciento de error aceptable. Cuanto menor el "set" de exposicion, mayor es el equivoco registrado. El error medio fue entre el 11 por ciento y el 50 por ciento, lo que es altamente significativo cuando se utilizan filmes radiograficos del grupo E