RESUMEN
OBJECTIVE: We studied whether the use of hydroxychloroquine (HCQ) for COVID-19 resulted in supply shortages for patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). METHODS: We used US claims data (IQVIA PHARMETRICS® Plus for Academics [PHARMETRICS]) and hospital electronic records from Spain (Institut Municipal d'Assistència Sanitària Information System [IMASIS]) to estimate monthly rates of HCQ use between January 2019 and March 2022, in the general population and in patients with RA and SLE. Methotrexate (MTX) use was estimated as a control. RESULTS: More than 13.5 million individuals (13,311,811 PHARMETRICS, 207,646 IMASIS) were included in the general population cohort. RA and SLE cohorts enrolled 135,259 and 39,295 patients, respectively, in PHARMETRICS. Incidence of MTX and HCQ were stable before March 2020. On March 2020, the incidence of HCQ increased by 9- and 67-fold in PHARMETRICS and IMASIS, respectively, and decreased in May 2020. Usage rates of HCQ went back to prepandemic trends in Spain but remained high in the United States, mimicking waves of COVID-19. No significant changes in HCQ use were noted among patients with RA and SLE. MTX use rates decreased during HCQ approval period for COVID-19 treatment. CONCLUSION: Use of HCQ increased dramatically in the general population in both Spain and the United States during March and April 2020. Whereas Spain returned to prepandemic rates after the first wave, use of HCQ remained high and followed waves of COVID-19 in the United States. However, we found no evidence of general shortages in the use of HCQ for both RA and SLE in the United States.
RESUMEN
Obstructive sleep apnea (OSA) is a common sleep disorder and polysomnography (PSG) is the gold standard for its diagnosis and treatment monitoring. There are nowadays several activity trackers measuring sleep quality through the detection of sleep stages. To allow an easier monitoring of the treatment efficacy at home, this work explores the possibility of using one of those commercial smart-bands. To this aim, we studied the signals provided by PSG and a Fitbit smart-band on 26 consecutive patients, admitted to the hospital after the diagnosis of OSA, and submitted to ventilation or positional treatment. They underwent monitoring for three nights (basal, titration, and control). We developed both a visualization software allowing doctors to visually compare the two hypnograms, and a set of statistics for assessing the concordance of the two methods. Results indicate that Fitbit can detect normal sleep patterns, while it is less able to detect the abnormal ones.
