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1.
Mod Rheumatol ; 26(3): 336-341, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26418571

RESUMO

OBJECTIVE: To assess effectiveness and safety of certolizumab PEGol (CZP) in rheumatoid arthritis (RA) patients after 12 months of treatment and to detect predictors of response. METHODS: Observational longitudinal prospective study of RA patients from 35 sites in Spain. Variables (baseline, 3- and 12-month assessment): sociodemographics, previous Disease Modifying Anti-Rheumatic Drug (DMARD) and previous Biological Therapies (BT) use; TJC, SJC, ESR, CRP, DAS28, SDAI. Response variables: TJC, SJC, CRP, ESR, and steroids dose reductions, EULAR Moderate/Good Response, SDAI response and remission, DAS28 remission. Safety variables: discontinuation due to side-effects. Descriptive, comparative and Logistic regression analyses were performed. RESULTS: We included 168 patients: 79.2% women, mean age 54.5 years (±13.2 SD), mean disease duration 7.5 years (±7.3 SD). Mean number of prior DMARD: 1.4 (±1.2 SD), mean number of prior BT was 0.8 (±1.1). Mean time on CZP was 9.8 months (±3.4 SD). A total of 71.4% were receiving CZP at 12-month assessment. Baseline predictors of response: lower prior number DMARD; low number prior BT; higher CRP, ESR, TJC, SJC, DAS28 and SDAI (p < 0.05) scores. A 25/46.4% Moderate/Good Response, a 20% SDAI remission, and a 44% DAS28 remission were observed. We observed 48 discontinuations (28.6%), 31 due to partial or complete ineffectiveness, and 17 due to side-effects. CONCLUSIONS: CZP showed benefit in severe RA patients, with significant reduction of all effectiveness parameters, despite the high prevalence of previous BT exposure in our series. We found CRP, ESR, prior DMARD/BT number, TJC, SJC, DAS28, and SDAI as baseline predictors of response. CZP was mostly well tolerated.

2.
Med Phys ; 37(9): 4930-7, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20964212

RESUMO

PURPOSE: In vivo two-dimensional (2D) fractal dimension (D2D) analysis of the cancellous bone at 1.5 T has been related to bone structural complexity and shown to be a potential imaging-based biomarker for osteoporosis. The objectives of this study were to assess at 3 T the in vivo feasibility of three-dimensional (3D) bone fractal dimension (D3D) analysis, analyze the relationship of D2D and D3D with osteoporosis, and investigate the relationship of D3D with spinal bone mineral density (BMD). METHODS: A total of 24 female subjects (67 +/- 7 yr old, mean +/- SD) was included in this study. The cohort consisted of 12 healthy volunteers and 12 patients with osteoporosis. MR image acquisitions were performed in the nondominant metaphysis of the distal radius with a 3 T MR scanner and an isotropic resolution of 180 microm. After segmentation and structural reconstruction, 2D and 3D box-counting algorithms were applied to calculate the fractal complexity of the cancellous bone. D2D and D3D values were compared between patients with osteoporosis and healthy subjects, and their relationship with radius BV/TV and spinal BMD was also assessed. RESULTS: Significant differences between healthy subjects and patients with osteoporosis were obtained for D3D (p < 0.001), with less differentiation for D2D (p = 0.04). The relationship between fractal dimension and BMD was not significant (r = 0.43, p = 0.16 and r = 0.23, p = 0.48, for D2D and D3D, respectively). CONCLUSIONS: The feasibility of trabecular bone D3D calculations at 3 T and the relationship of both D2D and D3D parameters with osteoporosis were demonstrated, with a better differentiation for the 3D method. Furthermore, the D3D parameter has probably a different nature of information regarding the trabecular bone status not directly explained by BMD alone. Future studies with subjects with osteopenia and larger sample sizes are warranted to further establish the potential of D2D and D3D in the study of osteoporosis.


Assuntos
Osso e Ossos , Fractais , Imagem Tridimensional/métodos , Imagem por Ressonância Magnética/métodos , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea , Osso e Ossos/patologia , Osso e Ossos/fisiopatologia , Estudos de Casos e Controles , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , Osteoporose/diagnóstico , Osteoporose/fisiopatologia
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