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1.
J Clin Rheumatol ; 27(6S): S173-S179, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-33337815

RESUMO

BACKGROUND: Enerceptan (EtaBS) has been developed as a proposed biosimilar of etanercept. METHODS: This randomized, multicenter, evaluator-blinded, noninferiority study conducted in Argentina included adults with active, moderate, and severe rheumatoid arthritis with inadequate response to methotrexate. Subjects were randomly assigned to 32 weeks treatment with EtaBS (n = 99) or etanercept (n = 51) at a weekly 50-mg dose administered subcutaneously. Patients were categorized according to prior use of biologic disease-modifying antirheumatic drugs and concomitant use of steroids. The primary efficacy endpoint was ACR20 response rate at week 32. Safety, immunogenicity, and steady-state concentration of both drugs were evaluated. The noninferiority margin for ACR20 was estimated at 12%. RESULTS: In the per-protocol population, 85 subjects (92.4%) treated with EtaBS and 44 subjects (93.6%) treated with etanercept achieved ACR20 (difference, -1.2%; 95% confidence interval, -10.1% to 7.6%). Frequent adverse drug reactions occurred in 34.3% and 38% of subjects treated with EtaBS and etanercept, respectively. The most common reaction was upper respiratory tract infection. Six and 3 serious adverse events occurred in 4 and 3 subjects treated with EtaBS and etanercept, respectively. Injection site reactions occurred in 67.7% and 66.0% of subjects treated with EtaBS and etanercept, respectively. Two subjects treated with EtaBS and 1 subject treated with etanercept developed antibodies by week 32. CONCLUSIONS: Efficacy outcomes for EtaBS were noninferior to original etanercept in patients with moderate-to-severe rheumatoid arthritis with inadequate response to methotrexate. Safety and immunogenicity results were comparable between the two. This study is a major step toward improving access to biologics in Latin America.


Assuntos
Antirreumáticos , Artrite Reumatoide , Medicamentos Biossimilares , Adulto , Antirreumáticos/efeitos adversos , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/tratamento farmacológico , Medicamentos Biossimilares/efeitos adversos , Método Duplo-Cego , Quimioterapia Combinada , Etanercepte/efeitos adversos , Humanos , Metotrexato/efeitos adversos , Resultado do Tratamento
2.
J Clin Rheumatol ; 16(7): 317-21, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20859227

RESUMO

OBJECTIVE: The objective of this study was to assess the prevalence of rheumatoid arthritis (RA) in the population of a city of 70,000 inhabitants located in Buenos Aires, Argentina. METHODS: Based on the hypothesis that RA is an underdiagnosed disease in Argentina, a capture-recapture method was applied. A local registry of RA patients of Luján City was taken as the primary source; a telephone survey was specifically carried out as a secondary source of information. Patients suspected of having RA were referred to a local hospital to be examined by a team of 12 rheumatologists. Anamnesis and physical examination were followed by hand and foot radiography and erythrocyte sedimentation rate and rheumatoid factor measurements. RESULTS: According to the American College of Rheumatology criteria, a prevalence rate of 0.94% (95% confidence interval [CI], 0.86%-1.02%) was found in the surveyed population; in agreement with other studies, this prevalence was higher in women when compared with men (for female, 1.54% [95% CI, 1.40%-1.69%]; for male, 0.40% [95% CI, 0.32%-0.49%]). CONCLUSION: The prevalence of RA in a representative sample of the population of a city from the central region of Argentina seems to be close to 1%.


Assuntos
Artrite Reumatoide/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Argentina/epidemiologia , Artrite Reumatoide/diagnóstico , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Sistema de Registros , Distribuição por Sexo , Saúde da População Urbana , Adulto Jovem
3.
Rev. argent. reumatolg. (En línea) ; 31(2): 10-17, jun. 2020. ilus, graf, tab
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1143926

RESUMO

Existen diversos índices capaces de valorar el daño radiográfico en pacientes con artritis psoriásica (APs), sin embargo la mayoría fueron creados para su uso en Artritis Reumatoidea y luego modificados para APs, por lo tanto no valoran lesiones características como la osteoproliferación. El objetivo de este estudio fue validar el Reductive X-Ray Score for Psoriatic Arthritis (ReXSPA), el cual fue recientemente desarrollado para su uso en cohortes observacionales. Material y métodos: Estudio de corte transversal, en el cual se incluyeron pacientes ≥18 años de edad, en forma consecutiva, con diagnóstico de APs según criterios CASPAR. A todos los pacientes se les realizaron radiografías de manos y pies en proyección anteroposterior. Dos lectores ciegos para las características clínicas de los pacientes y previamente entrenados, analizaron las mismas por medio de los índices Sharp van der Heijde modificado para APs (SvdHmAPs) y ReXSPA. Se midió el tiempo empleado para la lectura de los índices radiográficos y para el cálculo de los mismos. Resultados: Se incluyeron 66 pacientes, 50% mujeres, con tiempo de evolución de la APs mediano de 8 años (RIC: 4-14.3). 132 radiografías fueron evaluadas según los índices SvdHmAPs [m 35 (RIC: 16.3-72.5)] y el ReXSPA [m 22 (RIC: 7-46.3)]. El tiempo para la lectura radiográfica fue significativamente menor para ReXSPA comparado con SvdHmAPs [media 5.8±2.1 vs media 7.5±2.5 minutos, p<0.0001], al igual que el tiempo para calcularlo [media 26.5±14.7 vs media 55.3±38.3 segundos, p<0.0001]. La correlación entre estos últimos fue excelente (Rho: 0.93). En el análisis multivariado se observó asociación de ambos índices con el tiempo de evolución de la enfermedad y en el caso de ReXSPA también con la edad. Conclusión: El índice ReXSPA ha demostrado validez y una excelente correlación con el índice SvdHmAPs, con menor tiempo para su lectura y cálculo. Evaluaciones longitudinales posteriores permitirán demostrar la validez de estos hallazgos.


There are many scores available to measure radiographic joint damage in patients with Psoriatic Arthritis (PsA), but most of them were developed for Rheumatoid Arhtritis and then modified for PsA. These scores do not evaluate juxtaarticular bone proliferation. The aim of our study was to validate the Reductive X-Ray Score for Psoriatic Arthritis (ReXSPA), which was recently developed to be used in observational cohorts. Methods: A cross-sectional study was carried out. Consecutive patients ≥18 years old with PsA according to CASPAR criteria were included. All patients underwent X-rays of the hands and feet in an anteroposterior view. Two blind readers for the clinical characteristics of the patients and previously trained, scored them by Sharp van der Heijde modified for PsA (PsA-SvdH) and ReXSPA indexes. Time to read and calculate both scores were measured. Results: A total of 66 patients were included, half of them were female, median (m) disease duration of 8 years (IQR: 4-14.3). 132 X-Rays were scored according to PsA-SvdH [m 35 (IQR: 16.3-72.5)] and ReXSPA [m 22 (IQR: 7-46.3)]. Time to read was significantly shorter for ReXSPA than PsA-SvdH [mean 5.8±2.1 vs mean 7.5±2.5 minutes, p<0.0001], as well as, time to calculate them [mean 26.5±14.7 vs mean 55.3±38.3 seconds, p<0.0001]. The correlation between both indexes was excellent (Rho: 0.93). In the multivariate analysis, using both radiographic scores as dependent variable, association of each of the indices with disease duration was observed, and ReXSPA also had association with age. Conclusion: The ReXSPA index has shown validity and a very good correlation with PsA-SvdH. It is quicker to read and to calculate than PsA-SvdH. Subsequent longitudinal evaluations will allow demonstrating the validity of these findings.


Assuntos
Humanos , Artrite Psoriásica , Raios X , Doença , Estudos Transversais , Diagnóstico
4.
Rev. argent. reumatol ; 25(4): 32-36, 2014. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-835788

RESUMO

Introducción: La osteoartritis (OA) de manos es una de las patologías particulares más frecuentes en la consulta diaria. Una de las localizaciones de la OA comúnmente afectada es la articulación trapecio 1° metacarpiana (TPM), denominada rizartrosis, que puede traer, además del dolor, alteraciones funcionales. Respecto al tratamiento, guías nacionales e internacionales recomiendan el uso de ortesis y ejercicios. El taping o vendaje neuromuscular actúa sobre estímulos propioceptivos generando analgesia sin limitación de la movilidad articular. Objetivo: Evaluar los efectos de la aplicación de taping, comparado con el tratamiento ortésico convencional, en un programa de rehabilitación de rizartrosis. Material y métodos: Fueron incluidos pacientes de ambos sexos, mayores de 45 años con OA primaria que cumplían los criterios clínicos grado II-III de Eaton, y radiológicos grado 2-3 de Kellgren y Lawrence. Fueron divididos aleatoriamente en dos grupos, el GRUPO TAPING (GT) en donde se realizó un vendaje para la TPM y el GRUPO FÉRULA (GF) a quienes se les realizó una ortesis tipo Spica corta en termomoldeable. Todos iniciaron un programa de ejercicios específicos y fueron instruidos en principios de protección articular (PPA). Fueron evaluados al inicio y al mes del tratamiento: dolor (VAS), fuerza muscular (dinamómetro Jamar), habilidad y destreza (picking up test), capacidad funcional (Australian Canadian Osteoarthritis Hand Index: AUSCAN). Para el análisis estadístico se utilizó la prueba T Student, del programa Excel versión 2010.


Introduction: Osteoarthritis (OA) of hands is one of the most commonjoint diseases in daily practice. One of the locations of OA commonlyaffected is the trapezoid 1st metacarpal joint (TPM), namedrhizarthrosis, which may further pain bring functional alterations. Regarding treatment, national and international guidelines recommendbracing and exercises. The taping or neuromuscular bandageacts on proprioceptive stimuli generating analgesia without limitationof joint mobility.Objective: To evaluate the effects of applying taping compared withconventional orthotic treatment in a rehabilitation program of rhizarthrosis. Material and methods: We included patients of both sexes, olderthan 45 years with primary OA who met the clinical stage II- IIIof Eaton, and radiological grade 2-3 Kellgren and Lawrence. Theywere randomly divided into two groups: GROUP TAPING (GT) wherewas performed a bandage for TPM and GROUP SPLINT (GF) whounderwent into a thermomoldable Spica type orthosis. All began aprogram of specific exercises and were instructed in joint protectionprinciples (PPA). All were assessed at baseline and one monthafter treatment: pain (VAS), muscle strength (Jamar dynamometer), ability and skill (picking up test), functional capacity (Australian CanadianOsteoarthritis Hand Index: AUSCAN). For statistical analysiswas used the Student T test, from the Excel 2010 version.


Assuntos
Humanos , Bandagens , Osteoartrite
6.
Buenos Aires; Aktion; 2005. 224 p.
Monografia em Espanhol | LILACS | ID: biblio-971447
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