Tratamiento del lupus eritematoso sistémico: nuevas opciones terapéuticas / Treatment of systemic lupus erythematosus: New therapeutic options

El lupus eritematoso sistémico (LES) es una enfermedad inflamatoria autoinmune sistémica de causa desconocida, con heterogeneidad en su presentación clínica, así como una variabilidad en su curso clínico y pronóstico. El objetivo actual del tratamiento es conseguir la remisión de la enfermedad o al menos un estado de baja actividad, y por consiguiente mejorar la calidad de vida del paciente. La terapia biológica en el lupus, a diferencia de otras entidades, si bien no ha conseguido instaurarse plenamente, ha irrumpido en los últimos años con novedades terapéuticas importantes. En esta revisión se pretende actualizar las herramientas terapéuticas del tratamiento del LES enfocado a las nuevas moléculas que han conseguido superar los objetivos de sus ensayos clínicos (AU)

Systemic lupus erythematosus (SLE) is a systemic autoimmune inflammatory disease of unknown cause, with heterogeneity in its clinical presentation, as well as variability in its clinical course and prognosis. The current goal of treatment is to achieve disease remission or a state of low activity, and thereby improve the patient's quality of life. Biological therapy in lupus, unlike other entities, although it has not been fully established, in recent years it has burst onto the scene with important therapeutic novelties. This review aims to update the therapeutic tools for the treatment of SLE focusing on the new molecules that have achieved the objectives of their clinical trials (AU)

Treatment of systemic lupus erythematosus: new therapeutic options.

Systemic lupus erythematosus (SLE) is a systemic autoimmune inflammatory disease of unknown cause, with heterogeneity in its clinical presentation, as well as variability in its clinical course and prognosis. The current goal of treatment is to achieve disease remission or a state of low activity, and thereby improve the patient's quality of life. Biological therapy in lupus, unlike other entities, although it has not been fully established, in recent years it has burst onto the scene with important therapeutic novelties. This review aims to update the therapeutic tools for the treatment of SLE focusing on the new molecules that have achieved the objectives of their clinical trials.

Prevalencia de esteatosis hepática no alcohólica en una ciudad española: estudio poblacional / Prevalence of nonalcoholic fatty liver disease in a Spanish town: A population-based study

Objetivo La esteatosis hepática no alcohólica (EHNA) es la causa más importante de esteatosis hepática e hipertransaminasemia en los países occidentales. El objetivo consistía en determinar la prevalencia de EHNA entre 261025 personas del área de salud pública de Valladolid Este en España. Métodos Se seleccionó al azar a 1800 participantes a partir de una base de datos de tarjetas del sistema sanitario público, que fueron representativos de la mayor parte de la población. En todos los pacientes se realizó una historia clínica, medición de parámetros antropométricos, ecografía abdominal y análisis de sangre para descartar hepatopatía. También se calculó la puntuación FLI en todos los casos. Resultados Cuatrocientos cuarenta y ocho participantes aceptaron participar en el estudio. La prevalencia de EHNA en nuestro estudio fue del 22,3% (18,5-26,2%). La prevalencia fue máxima entre los 50 y los 70 años, y se incrementó con la edad (p <0,006). No hubo diferencias significativas en cuanto al sexo (p=0,338). La mediana del índice de masa corporal fue de 27,2 y la EHNA se relacionó con el peso (p <0,001) y el perímetro abdominal (p <0,001). El análisis de regresión logística reveló que una γ-GT inferior a 26 UI/ml, un índice de masa corporal superior a 31 y una puntuación HOMA-IR superior a 2,54 fueron factores predictivos independientes de EHNA en la muestra. El diagnóstico de EHNA se correspondió con una puntuación FLI elevada en el 88% de los casos. Conclusiones De acuerdo con otros estudios epidemiológicos, la prevalencia de EHNA es muy alta. Un estudio completo con consulta clínica, estudios de imagen y análisis de sangre en todos los pacientes permite determinar la prevalencia de EHNA en la población (AU)

Objective Nonalcoholic fatty liver disease (NAFLD) is western countries’ most important cause of hepatic steatosis and hypertransaminasemia. The objective was to evaluate the prevalence of NAFLD among 261,025 people in the East Valladolid public healthcare area in Spain. Methods We randomly selected 1800 participants from a public healthcare system card database, representing most of the population. We performed a medical record, measurement of anthropometric parameters, abdominal ultrasound, and blood tests to rule out hepatic disease in all patients. We calculated the FLI score in all patients. Results Four hundred and forty-eight participants agreed to participate in the study. The prevalence of nonalcoholic fatty liver disease in our study was 22.3% [18.5–26.2%]. Prevalence was highest between 50 and 70 years, increasing with age (p < 0.006). There were no significant differences in sex (p = 0.338). The median body mass index was 27.2, and NAFLD was related to the weight (p < 0.001) and abdominal perimeter (p < 0.001). Logistic regression analysis showed GGT lower than 26UI/ml, body mass index higher than 31, and HOMA IR greater than 2.54 as independent factors to predict NAFLD in the sample. NAFLD diagnosis matched with an elevated FLI score in 88% of cases. Conclusion According to other epidemiological studies, NAFLD's prevalence is very high. A complete study with a clinical consultation, image studies, and blood tests in all patients allows us to assess the prevalence of NAFLD in the population (AU)

Prevalence of nonalcoholic fatty liver disease in a Spanish town: a population-based study.

OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is western countries' most important cause of hepatic steatosis and hypertransaminasemia. The objective was to evaluate the prevalence of NAFLD among 261,025 people in the East Valladolid public healthcare area in Spain. METHODS: We randomly selected 1800 participants from a public healthcare system card database, representing most of the population. We performed a medical record, measurement of anthropometric parameters, abdominal ultrasound, and blood tests to rule out hepatic disease in all patients. We calculated the FLI score in all patients. RESULTS: 448 participants agreed to participate in the study. The prevalence of nonalcoholic fatty liver disease in our study was 22.3% [18.5%-26.2%]. Prevalence was highest between 50 and 70 years, increasing with age (p < 0.006). There were no significant differences in sex (p = 0.338). The median Body mass index was 27.2, and NAFLD was related to the weight (p < 0,001) and abdominal perimeter (p < 0.001). Logistic regression analysis showed GGT lower than 26 UI/ml, body mass index higher than 31, and HOMA IR greater than 2.54 as independent factors to predict NAFLD in the sample. NAFLD diagnosis matched with an elevated FLI score in 88% of cases. CONCLUSION: According to other epidemiological studies, NAFLD's prevalence is very high. A complete study with a clinical consultation, image studies, and blood tests in all patients allows us to assess the prevalence of NAFLD in the population.