Anticuerpos anti-RNA polimerasa III en esclerosis sistémica: estudio multicéntrico de Argentina / Anti-RNA Polymerase III Antibodies in Systemic Sclerosis: Multicentric Study from Argentina

Objetivo: Describir la frecuencia del anticuerpo anti-RNA polimerasa III positivo en pacientes con esclerosis sistémica (ES) de un grupo de centros asistenciales de Argentina, y explorar las diferencias entre pacientes con anti-RNA polimerasa III positivo y negativo. Pacientes y métodos: Se recopilaron datos de las historias clínicas, anamnesis y exámenes físicos de 135 pacientes con ES (ACR/EULAR 2013), de los cuales se obtuvo una muestra de suero para la detección de anti-RNA polimerasa III IgG por ELISA. Resultados: El 92,6% fueron mujeres, la mediana de edad al diagnóstico fue de 53 años (rango: 12-87), el 77,7% tenía ES limitada, el 19,3% tenía ES difusa y el 2,9% con ES sine esclerodermia. El 67,5% de los pacientes pertenecían a la etnia mestiza o amerindia. La frecuencia de anti-RNA polimerasa III positivo fue del 5,9%. En 36 pacientes los anticuerpos anticentrómero (ACA) y anti-Scl70 fueron negativos; el anti-RNA polimerasa III fue positivo en el 16,7% de estos 36 pacientes. El grupo de pacientes con anti-RNA polimerasa III positivo tuvo una mayor frecuencia de cicatrices puntiformes e hipertensión arterial pulmonar, y una mayor edad al diagnóstico. No se encontró asociación con ectasia vascular gástrica antral. La única paciente con crisis renal esclerodérmica, fue anti-RNA polimerasa III positiva. Conclusiones: La frecuencia de anti-RNA polimerasa III encontrada en este estudio fue una de las más bajas reportadas, lo cual podría estar relacionado con el predominio de la etnia mestiza y amerindia. Si bien se necesitan más estudios, es posible que la detección del anti-RNA polimerasa III permita clasificar mejor a los pacientes con ES, conocer su pronóstico y mejorar el seguimiento.(AU)

Objective: To describe the frequency of anti-RNA polymerase III antibody in patients with Systemic Sclerosis (SSc) of a group of healthcare centres from Argentina and to explore differences among patients with positive and negative anti-RNA polymerase III antibody. Patients and Methods: Data from clinical records, anamnesis and physical examination were collected from 135 patients with SSc (ACR/EULAR 2013). A serum sample from each patient was obtained for the detection of anti-RNA polymerase III IgG antibodies by ELISA. Results: In all, 97.8% were women and the median age at diagnosis was 53 years (range: 12-87), 77.7% had limited cutaneous SSc (lcSSC), 19,3% patients had diffuse cutaneous SSc (dcSSC) and 2.9% had scleroderma sine scleroderma. The 67.5% of the patients were from a Mestizos or Amerindian ethnic group. Anti-RNA polymerase III was positive in 5.9% of the patients. In 36 patients, the anticentromere (ACA) and anti-Scl70 antibodies were negative; anti-RNA polymerase III was positive in 16.7% of these 36 patients. Pitting scars and pulmonary artery hypertension were more frequent in anti-RNA polymerase III positive patients who were also older at diagnosis. No association with gastric antral vascular ectasia was found. The only patient with scleroderma renal crisis was anti-RNA polymerase III positive. Conclusions: Anti-RNA polymerase III frequency found in this study was one of the lowest reported, which could be related to the predominance of the Amerindian and Mestizo ethnic group. It is possible that the detection of anti-RNA polymerase III allows better classification of SSc patients, to know their prognosis and to improve their follow-up, therefore more studies are needed.(AU)

Anti-RNA polymerase III antibodies in systemic sclerosis: Multicentric study from Argentina.

OBJECTIVE: To describe the frequency of anti-RNA polymerase III antibody in patients with Systemic Sclerosis (SSc) of a group of healthcare centres from Argentina and to explore differences among patients with positive and negative anti-RNA polymerase III antibody. PATIENTS AND METHODS: Data from clinical records, anamnesis and physical examination were collected from 135 patients with SSc (ACR/EULAR 2013). A serum sample from each patient was obtained for the detection of anti-RNA polymerase III IgG antibodies by ELISA. RESULTS: In all, 97.8% were women and the median age at diagnosis was 53 years (range 12-87), 77.7% had limited cutaneous SSc (lcSSC), 19,3% patients had diffuse cutaneous SSc (dcSSC) and 2.9% had scleroderma sine scleroderma. The 67.5% of the patients were from a Mestizos or Amerindian ethnic group. Anti-RNA polymerase III was positive in 5.9% of the patients. In 36 patients, the anticentromere (ACA) and anti-Scl70 antibodies were negative; anti-RNA polymerase III was positive in 16.7% of these 36 patients. Pitting scars and pulmonary artery hypertension were more frequent in anti-RNA polymerase III positive patients who were also older at diagnosis. No association with gastric antral vascular ectasia was found. The only patient with scleroderma renal crisis was anti-RNA polymerase III positive. CONCLUSIONS: Anti-RNA polymerase III frequency found in this study was one of the lowest reported, which could be related to the predominance of the Amerindian and Mestizo ethnic group. It is possible that the detection of anti RNA polymerase III allows better classification of SSc patients, to know their prognosis and to improve their follow-up, therefore more studies are needed.

Anti-RNA Polymerase III Antibodies in Systemic Sclerosis: Multicentric Study from Argentina. / Anticuerpos anti-RNA polimerasa III en esclerosis sistémica: estudio multicéntrico de Argentina.

OBJECTIVE: To describe the frequency of anti-RNA polymerase III antibody in patients with Systemic Sclerosis (SSc) of a group of healthcare centres from Argentina and to explore differences among patients with positive and negative anti-RNA polymerase III antibody. PATIENTS AND METHODS: Data from clinical records, anamnesis and physical examination were collected from 135 patients with SSc (ACR/EULAR 2013). A serum sample from each patient was obtained for the detection of anti-RNA polymerase III IgG antibodies by ELISA. RESULTS: In all, 97.8% were women and the median age at diagnosis was 53 years (range: 12-87), 77.7% had limited cutaneous SSc (lcSSC), 19,3% patients had diffuse cutaneous SSc (dcSSC) and 2.9% had scleroderma sine scleroderma. The 67.5% of the patients were from a Mestizos or Amerindian ethnic group. Anti-RNA polymerase III was positive in 5.9% of the patients. In 36 patients, the anticentromere (ACA) and anti-Scl70 antibodies were negative; anti-RNA polymerase III was positive in 16.7% of these 36 patients. Pitting scars and pulmonary artery hypertension were more frequent in anti-RNA polymerase III positive patients who were also older at diagnosis. No association with gastric antral vascular ectasia was found. The only patient with scleroderma renal crisis was anti-RNA polymerase III positive. CONCLUSIONS: Anti-RNA polymerase III frequency found in this study was one of the lowest reported, which could be related to the predominance of the Amerindian and Mestizo ethnic group. It is possible that the detection of anti-RNA polymerase III allows better classification of SSc patients, to know their prognosis and to improve their follow-up, therefore more studies are needed.

En respuesta a carta al editor del Dr. Javier Rosa, por "Estudio multicéntrico no intervencional en pacientes con artritis reumatoidea tratados con tocilizumab" / In response to a letter to the editor of Dr. Javier Rosa, for "Non-interventional multicenter study in patients with rheumatoid arthritis treated with tocilizumab"

En relación al artículo "Estudio multicéntrico no intervencional en pacientes con artritis reumatoidea tratados con tocilizumab" publicado en la Revista Argentina de Reumatología 2017; 28(3):23-28, quiero destacar que este estudio es parte del estudio global ACT uP. El objetivo primario del estudio fue observar, en la práctica clínica habitual, los patrones de uso de Tocilizumab en pacientes con AR con respecto a la adherencia y al cumplimiento de las recomendaciones aprobadas en el prospecto y, como objetivo secundario, observar la efectividad, seguridad y las características demográficas de los pacientes que inician tratamiento con tocilizumab, así como también las modificaciones de dosis