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  1. Article ; Online: The Role of Autoantibody Testing in Modern Personalized Medicine.

    Kayser, Cristiane / Dutra, Lívia Almeida / Dos Reis-Neto, Edgard Torres / Castro, Charlles Heldan de Moura / Fritzler, Marvin J / Andrade, Luis Eduardo C

    Clinical reviews in allergy & immunology

    2022  Volume 63, Issue 2, Page(s) 251–288

    Abstract: Personalized medicine (PM) aims individualized approach to prevention, diagnosis, and treatment. Precision Medicine applies the paradigm of PM by defining groups of individuals with akin characteristics. Often the two terms have been used interchangeably. ...

    Abstract Personalized medicine (PM) aims individualized approach to prevention, diagnosis, and treatment. Precision Medicine applies the paradigm of PM by defining groups of individuals with akin characteristics. Often the two terms have been used interchangeably. The quest for PM has been advancing for centuries as traditional nosology classification defines groups of clinical conditions with relatively similar prognoses and treatment options. However, any individual is characterized by a unique set of multiple characteristics and therefore the achievement of PM implies the determination of myriad demographic, epidemiological, clinical, laboratory, and imaging parameters. The accelerated identification of numerous biological variables associated with diverse health conditions contributes to the fulfillment of one of the pre-requisites for PM. The advent of multiplex analytical platforms contributes to the determination of thousands of biological parameters using minute amounts of serum or other biological matrixes. Finally, big data analysis and machine learning contribute to the processing and integration of the multiplexed data at the individual level, allowing for the personalized definition of susceptibility, diagnosis, prognosis, prevention, and treatment. Autoantibodies are traditional biomarkers for autoimmune diseases and can contribute to PM in many aspects, including identification of individuals at risk, early diagnosis, disease sub-phenotyping, definition of prognosis, and treatment, as well as monitoring disease activity. Herein we address how autoantibodies can promote PM in autoimmune diseases using the examples of systemic lupus erythematosus, antiphospholipid syndrome, rheumatoid arthritis, Sjögren syndrome, systemic sclerosis, idiopathic inflammatory myopathies, autoimmune hepatitis, primary biliary cholangitis, and autoimmune neurologic diseases.
    MeSH term(s) Autoantibodies ; Autoimmune Diseases ; Humans ; Lupus Erythematosus, Systemic ; Precision Medicine ; Sjogren's Syndrome/complications
    Chemical Substances Autoantibodies
    Language English
    Publishing date 2022-03-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1239045-8
    ISSN 1559-0267 ; 1080-0549
    ISSN (online) 1559-0267
    ISSN 1080-0549
    DOI 10.1007/s12016-021-08918-6
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  2. Article ; Online: Incidence of Cytomegalovirus Antigenemia in patients with autoimmune rheumatic diseases: a 3-year retrospective study.

    Santos, Rebeka Paulo / Dos Reis-Neto, Edgard Torres / Pinheiro, Marcelo Medeiros

    Advances in rheumatology (London, England)

    2019  Volume 59, Issue 1, Page(s) 18

    Abstract: Objective: To determine the incidence of positive CMV antigenemia (CMV-Ag) in patients with autoimmune rheumatic diseases (AIRD) and to describe the outcomes of these patients.: Methods: From January 2011 to December 2014, a total of 443 patients ... ...

    Abstract Objective: To determine the incidence of positive CMV antigenemia (CMV-Ag) in patients with autoimmune rheumatic diseases (AIRD) and to describe the outcomes of these patients.
    Methods: From January 2011 to December 2014, a total of 443 patients with AIRD were enrolled in this retrospective analysis. Demographic, clinical and laboratory data, current clinical manifestations, organs affected by CMV infection, therapeutic management and outcomes were evaluated. The CMV-Ag was considered positive when one cell was detected at least.
    Results: CMV-Ag was requested in 70 (15.8%) patients with suspicious CMV infection and was positive in 24 (34.3%). The incidence rate of positive CMV-Ag was 4.97% (95% CI 3.1-7.4%). Systemic lupus erythematosus (SLE) (59%), followed by ANCA-related vasculitis (18.2%) and rheumatoid arthritis (9%) were the diseases more associated with positive CMV-Ag. At the time of CMV infection, SLE patients had moderate to severe disease activity, with high frequency of positive anti-dsDNA antibody (69.2%) and complement consumption (61.5%), as well as high doses of corticosteroids and use of immunosuppressants. The main CMV sites involved were lung (45.5%), bone marrow (40.9%) and gut (27.3%). Mortality rate was 45.5%, especially in those with higher doses of daily oral corticosteroids (107 ± 55.4 mg vs. 71.7 ± 46.3 mg; p = 0.07) and lower number of lymphocytes (309 ± 368.2/mm
    Conclusions: Our data showed high incidence of CMV-Ag in AIRD patients, particularly those with SLE and greater disease severity. In addition, it was observed high mortality in these patients, highlighting the CMV infection should be included in differential diagnosis.
    MeSH term(s) Adolescent ; Adrenal Cortex Hormones/therapeutic use ; Adult ; Aged ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/immunology ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/mortality ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/virology ; Antigens, Viral/blood ; Arthritis, Rheumatoid/drug therapy ; Arthritis, Rheumatoid/immunology ; Arthritis, Rheumatoid/mortality ; Arthritis, Rheumatoid/virology ; Bone Marrow/immunology ; Bone Marrow/virology ; Brazil/epidemiology ; Cytomegalovirus/immunology ; Cytomegalovirus Infections/immunology ; Female ; Granulomatosis with Polyangiitis/immunology ; Granulomatosis with Polyangiitis/virology ; Humans ; Immunosuppressive Agents/therapeutic use ; Intestines/immunology ; Intestines/virology ; Lung/immunology ; Lung/virology ; Lupus Erythematosus, Systemic/drug therapy ; Lupus Erythematosus, Systemic/immunology ; Lupus Erythematosus, Systemic/mortality ; Lupus Erythematosus, Systemic/virology ; Male ; Middle Aged ; Retrospective Studies ; Rheumatic Fever/immunology ; Rheumatic Fever/virology ; Time Factors ; Young Adult
    Chemical Substances Adrenal Cortex Hormones ; Antigens, Viral ; Immunosuppressive Agents
    Language English
    Publishing date 2019-05-14
    Publishing country England
    Document type Journal Article
    ISSN 2523-3106
    ISSN (online) 2523-3106
    DOI 10.1186/s42358-019-0061-0
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  3. Article: A Brazilian Cohort of Patients With Immuno-Mediated Chronic Inflammatory Diseases Infected by SARS-CoV-2 (ReumaCoV-Brasil Registry): Protocol for a Prospective, Observational Study.

    Marques, Claudia / Kakehasi, Adriana Maria / Gomides, Ana Paula Monteiro / Paiva, Eduardo Dos Santos / Dos Reis Neto, Edgard Torres / Pileggi, Gecilmara Cristina Salviato / Provenza, José Roberto / Mota, Licia / Xavier, Ricardo Machado / Ferreira, Gilda Aparecida / Pinheiro, Marcelo Medeiros

    JMIR research protocols

    2020  Volume 9, Issue 12, Page(s) e24357

    Abstract: Background: Patients with immune-mediated rheumatic diseases (IMRD) are at increased risk of infections, including significant morbidity and high mortality. Considering the potential for unfavorable outcomes of SARS-CoV-2 infection in patients with IMRD, ...

    Abstract Background: Patients with immune-mediated rheumatic diseases (IMRD) are at increased risk of infections, including significant morbidity and high mortality. Considering the potential for unfavorable outcomes of SARS-CoV-2 infection in patients with IMRD, several questions were raised regarding the impact of COVID-19 at the start of the pandemic.
    Objective: This paper presents the protocol of a study that aims to prospectively evaluate patients with IMRD and a confirmed COVID-19 diagnosis (using criteria provided by the Brazilian Ministry of Health).
    Methods: The study comprised a prospective, observational cohort (patients with IMRD and COVID-19) and a comparison group (patients with only IMRD), with a follow-up time of 6 months to evaluate differences in health outcomes. The primary outcomes will be changes in IMRD disease activity after SARS-CoV-2 infection at 4 time points: (1) at baseline, (2) within 4-6 weeks after infection, (3) at 3 months after the second assessment (±15 days), and (4) at 6 months (±15 days). The secondary outcomes will be the progression rate to moderate or severe forms of COVID-19, need for intensive care unit admission and mechanical ventilation, death, and therapeutic changes related to IMRD. Two outcomes-pulmonary and thromboembolic events in patients with both IMRD and SARS-CoV-2 infection-are of particular interest and will be monitored with close attention (clinical, laboratory, and function tests as well as imaging).
    Results: Recruitment opened in May 2020, with 1300 participants recruited from 43 sites as of November 2020. Patient recruitment will conclude by the end of December 2020, with follow-up occurring until April 2021. Data analysis is scheduled to start after all inclusion data have been collected, with an aim to publish a peer-reviewed paper in December 2020.
    Conclusions: We believe this study will provide clinically relevant data on the general impact of COVID-19 on patients with IMRD.
    Trial registration: Brazilian Registry of Clinical Trials RBR-33YTQC; http://www.ensaiosclinicos.gov.br/rg/RBR-33ytqc/.
    International registered report identifier (irrid): DERR1-10.2196/24357.
    Keywords covid19
    Language English
    Publishing date 2020-12-15
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2719222-2
    ISSN 1929-0748
    ISSN 1929-0748
    DOI 10.2196/24357
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  4. Article ; Online: Revisiting hydroxychloroquine and chloroquine for patients with chronic immunity-mediated inflammatory rheumatic diseases.

    Dos Reis Neto, Edgard Torres / Kakehasi, Adriana Maria / de Medeiros Pinheiro, Marcelo / Ferreira, Gilda Aparecida / Marques, Cláudia Diniz Lopes / da Mota, Licia Maria Henrique / Dos Santos Paiva, Eduardo / Pileggi, Gecilmara Cristina Salviato / Sato, Emília Inoue / Reis, Ana Paula Monteiro Gomides / Xavier, Ricardo Machado / Provenza, José Roberto

    Advances in rheumatology (London, England)

    2020  Volume 60, Issue 1, Page(s) 32

    Abstract: Hydroxychloroquine and chloroquine, also known as antimalarial drugs, are widely used in the treatment of rheumatic diseases and have recently become the focus of attention because of the ongoing COVID-19 pandemic. Rheumatologists have been using ... ...

    Abstract Hydroxychloroquine and chloroquine, also known as antimalarial drugs, are widely used in the treatment of rheumatic diseases and have recently become the focus of attention because of the ongoing COVID-19 pandemic. Rheumatologists have been using antimalarials to manage patients with chronic immune-mediated inflammatory rheumatic diseases for decades. It is an appropriate time to review their immunomodulatory and anti-inflammatory mechanisms impact on disease activity and survival of systemic lupus erythematosus patient, including antiplatelet effect, metabolic and lipid benefits. We also discuss possible adverse effects, adding a practical and comprehensive approach to monitoring rheumatic patients during treatment with these drugs.
    MeSH term(s) Antimalarials/pharmacology ; Antiphospholipid Syndrome/drug therapy ; Antiphospholipid Syndrome/immunology ; Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/drug therapy ; Arthritis, Rheumatoid/immunology ; COVID-19 ; Chloroquine/pharmacology ; Coronavirus Infections/drug therapy ; Drug Eruptions/etiology ; Drug Interactions ; Female ; Glucose/metabolism ; Heart Diseases/chemically induced ; Humans ; Hydroxychloroquine/pharmacology ; Lipids/blood ; Lupus Erythematosus, Cutaneous/drug therapy ; Lupus Erythematosus, Cutaneous/immunology ; Lupus Erythematosus, Systemic/drug therapy ; Lupus Erythematosus, Systemic/immunology ; Lupus Erythematosus, Systemic/mortality ; Male ; Pandemics ; Platelet Aggregation/drug effects ; Pneumonia, Viral/drug therapy ; Pregnancy ; Renal Insufficiency/prevention & control ; Retinal Diseases/chemically induced ; Sjogren's Syndrome/drug therapy ; Sjogren's Syndrome/immunology
    Chemical Substances Antimalarials ; Antirheumatic Agents ; Lipids ; Hydroxychloroquine (4QWG6N8QKH) ; Chloroquine (886U3H6UFF) ; Glucose (IY9XDZ35W2)
    Keywords covid19
    Language English
    Publishing date 2020-06-09
    Publishing country England
    Document type Journal Article ; Systematic Review
    ISSN 2523-3106
    ISSN (online) 2523-3106
    DOI 10.1186/s42358-020-00134-8
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  5. Article ; Online: Prevalence of musculoskeletal symptoms in the five urban regions of Brazil-the Brazilian COPCORD study (BRAZCO).

    Dos Reis-Neto, Edgard Torres / Ferraz, Marcos Bosi / Kowalski, Sérgio Candido / Pinheiro, Geraldo da Rocha Castelar / Sato, Emilia Inoue

    Clinical rheumatology

    2016  Volume 35, Issue 5, Page(s) 1217–1223

    Abstract: The objective of this study is to describe the prevalence of musculoskeletal symptoms (MSK-S) in the five urban geographical regions of Brazil using the Portuguese version of the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) core ...

    Abstract The objective of this study is to describe the prevalence of musculoskeletal symptoms (MSK-S) in the five urban geographical regions of Brazil using the Portuguese version of the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) core questionnaire (CQ)-BRAZCO study. From April to May 2013, a population-based survey was conducted by applying the CQ for 5000 individuals aged over 15 years in 16 capitals of the Brazilian regions. Trained teams assessed the MSK-S and socioeconomic status. The sample consisted of representative quotas of the Brazilian population, proportional to the capitals' population density. It respected the groups' quotas of gender and age and included all socioeconomic classes, educational levels, and occupations. There were 1342 (26.9 %) participants who presented MSK-S unrelated to trauma in 7 days preceding the interview. A higher prevalence of these complaints were in females (65.2 %), elderly people, in the north region of the country (30.7 %), and a lower prevalence was found in single individuals (41.7 %) and in the south (23.3 %). The most frequent pain sites were the spine (76.7 %) and knees (49.6 %), and the mean pain intensity was 6.8 (VAS). The BRAZCO study shows that Brazilian population presents a higher rate of MSK-S unrelated to trauma than many Asian countries. These results can be applied to guide the assessment of prevalence of rheumatic diseases. Additionally, it can help in the design of policies for health care workforce organization and its accessibility, as well as to reduce the risk of rheumatic diseases at the community level.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Brazil/epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Musculoskeletal Diseases/diagnosis ; Musculoskeletal Diseases/epidemiology ; Prevalence ; Sex Factors ; Surveys and Questionnaires ; Young Adult
    Language English
    Publishing date 2016-05
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 604755-5
    ISSN 1434-9949 ; 0770-3198
    ISSN (online) 1434-9949
    ISSN 0770-3198
    DOI 10.1007/s10067-015-2963-5
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  6. Article ; Online: A Brazilian Cohort of Patients With Immuno-Mediated Chronic Inflammatory Diseases Infected by SARS-CoV-2 (ReumaCoV-Brasil Registry)

    Marques, Claudia / Kakehasi, Adriana Maria / Gomides, Ana Paula Monteiro / Paiva, Eduardo Dos Santos / dos Reis Neto, Edgard Torres / Pileggi, Gecilmara Cristina Salviato / Provenza, José Roberto / Mota, Licia / Xavier, Ricardo Machado / Ferreira, Gilda Aparecida / Pinheiro, Marcelo Medeiros

    JMIR Research Protocols, Vol 9, Iss 12, p e

    Protocol for a Prospective, Observational Study

    2020  Volume 24357

    Abstract: BackgroundPatients with immune-mediated rheumatic diseases (IMRD) are at increased risk of infections, including significant morbidity and high mortality. Considering the potential for unfavorable outcomes of SARS-CoV-2 infection in patients with IMRD, ... ...

    Abstract BackgroundPatients with immune-mediated rheumatic diseases (IMRD) are at increased risk of infections, including significant morbidity and high mortality. Considering the potential for unfavorable outcomes of SARS-CoV-2 infection in patients with IMRD, several questions were raised regarding the impact of COVID-19 at the start of the pandemic. ObjectiveThis paper presents the protocol of a study that aims to prospectively evaluate patients with IMRD and a confirmed COVID-19 diagnosis (using criteria provided by the Brazilian Ministry of Health). MethodsThe study comprised a prospective, observational cohort (patients with IMRD and COVID-19) and a comparison group (patients with only IMRD), with a follow-up time of 6 months to evaluate differences in health outcomes. The primary outcomes will be changes in IMRD disease activity after SARS-CoV-2 infection at 4 time points: (1) at baseline, (2) within 4-6 weeks after infection, (3) at 3 months after the second assessment (±15 days), and (4) at 6 months (±15 days). The secondary outcomes will be the progression rate to moderate or severe forms of COVID-19, need for intensive care unit admission and mechanical ventilation, death, and therapeutic changes related to IMRD. Two outcomes—pulmonary and thromboembolic events in patients with both IMRD and SARS-CoV-2 infection—are of particular interest and will be monitored with close attention (clinical, laboratory, and function tests as well as imaging). ResultsRecruitment opened in May 2020, with 1300 participants recruited from 43 sites as of November 2020. Patient recruitment will conclude by the end of December 2020, with follow-up occurring until April 2021. Data analysis is scheduled to start after all inclusion data have been collected, with an aim to publish a peer-reviewed paper in December 2020. ConclusionsWe believe this study will provide clinically relevant data on the general impact of COVID-19 on patients with IMRD. Trial RegistrationBrazilian Registry of Clinical Trials RBR-33YTQC; ...
    Keywords Medicine ; R ; Computer applications to medicine. Medical informatics ; R858-859.7
    Subject code 610
    Language English
    Publishing date 2020-12-01T00:00:00Z
    Publisher JMIR Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Factors Associated With Mortality in Patients With Immune-Mediated Rheumatic Diseases and COVID-19 From Latin America: Data From Argentina, Mexico, and Brazil.

    Isnardi, Carolina Ayelen / Alpizar-Rodriguez, Deshire / Calderaro, Débora Cerqueira / Marques, Claudia Diniz Lopes / Pons-Estel, Guillermo Javier / Xavier, Ricardo Machado / Saurit, Verónica / Pisoni, Cecilia Nora / Tissera, Yohana Soledad / D'Angelo Exeni, Maria Eugenia / Alba, Paula / Pereira, Dora / Gobbi, Carla Andrea / Gamba, Maria Julieta / Alfaro, María Agustina / Virasoro, Belén María / Colunga-Pedraza, Iris Jazmín / Irazoque-Palazuelos, Fedra / Reyes-Cordero, Greta /
    Rodriguez-Reyna, Tatiana S / Veloz-Aranda, Jose Antonio / Skinner-Taylor, Cassandra Michele / Juárez-Mora, Ingrid Maribel / Silveira, Luis H / Pacheco Tena, Cesar Francisco / Xibille-Friedmann, Daniel Xavier / Ferreira, Gilda Aparecida / Kakehasi, Adriana Maria / Pinheiro, Marcelo Medeiros / Gomides, Ana Paula Monteiro / Pileggi, Gecilmara Cristina Salviato / da Mota, Licia Maria Henrique / Dos Reis-Neto, Edgard Torres / Ribeiro, Sandra Lúcia Euzébio / de Azevedo Valadares, Lilian David / Martínez-Martínez, Marco Ulises

    Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases

    2023  Volume 30, Issue 1, Page(s) e9–e17

    Abstract: Objective: To describe characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with rheumatic immune-mediated inflammatory diseases (IMIDs) from Argentina, Mexico and Brazil, and to assess factors associated ...

    Abstract Objective: To describe characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with rheumatic immune-mediated inflammatory diseases (IMIDs) from Argentina, Mexico and Brazil, and to assess factors associated with mortality in this population.
    Methods: Data from 3 national registries, SAR-COVID (Argentina), CMR-COVID (Mexico), and ReumaCoV-Brasil (Brazil), were combined. Adult patients with IMIDs and SARS-CoV-2 infection were recruited. Sociodemographic data, comorbidities, IMID clinical characteristics and treatment, and SARS-CoV-2 infection presentation and outcomes were recorded.
    Results: A total of 4827 individuals were included: 2542 (52.7%) from SAR-COVID, 1167 (24.2%) from CMR-COVID, and 1118 (23.1%) from ReumaCoV-Brasil. Overall, 82.1% were female with a mean age of 49.7 (SD, 14.3) years; 22.7% of the patients were hospitalized, and 5.3% died because of COVID-19 (coronavirus disease 2019). Argentina and Brazil had both 4% of mortality and Mexico 9.4%. In the multivariable analysis, older age (≥60 years; odds ratio [OR], 7.4; 95% confidence interval [CI], 4.6-12.4), male sex (OR, 1.5; 95% CI, 1.1-2.1), living in Mexico (OR, 3.0; 95% CI, 2.0-4.4), comorbidity count (1 comorbidity: OR, 1.5; 95% CI, 1.0-2.1), diagnosis of connective tissue disease or vasculitis (OR, 1.8; 95% CI, 1.3-2.4), and other diseases (OR, 2.6; 95% CI, 1.6-4.1) compared with inflammatory joint disease, high disease activity (OR, 4.2; 95% CI, 2.5-7.0), and treatment with glucocorticoids (OR, 1.9; 95% CI, 1.4-2.5) or rituximab (OR, 4.2; 95% CI, 2.7-6.6) were associated with mortality.
    Conclusions: Mortality in patients with IMIDs was particularly high in Mexicans. Ethnic, environmental, societal factors, and different COVID-19 mitigation measures adopted have probably influenced these results.
    MeSH term(s) Adult ; Humans ; Male ; Female ; Middle Aged ; COVID-19 ; SARS-CoV-2 ; Mexico/epidemiology ; Latin America ; Argentina/epidemiology ; Brazil/epidemiology ; Rheumatic Diseases/epidemiology ; Immunomodulating Agents
    Chemical Substances Immunomodulating Agents
    Language English
    Publishing date 2023-11-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1283266-2
    ISSN 1536-7355 ; 1076-1608
    ISSN (online) 1536-7355
    ISSN 1076-1608
    DOI 10.1097/RHU.0000000000002038
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  8. Article ; Online: Supervised physical exercise improves endothelial function in patients with systemic lupus erythematosus.

    dos Reis-Neto, Edgard Torres / da Silva, Aline Evelyn / Monteiro, Carlos Manoel de Castro / de Camargo, Luciano Monteiro / Sato, Emilia Inoue

    Rheumatology (Oxford, England)

    2013  Volume 52, Issue 12, Page(s) 2187–2195

    Abstract: Objective: The objective of this study was to evaluate the effect of supervised physical exercise on endothelial function, ergospirometric test variables and disease activity in SLE patients.: Methods: We conducted a prospective study in which women ... ...

    Abstract Objective: The objective of this study was to evaluate the effect of supervised physical exercise on endothelial function, ergospirometric test variables and disease activity in SLE patients.
    Methods: We conducted a prospective study in which women with SLE who were available to perform physical exercise were allocated to the exercise group (EG) to practise supervised physical exercise for 1 h three times per week for 16 weeks. Those who were not available for this activity were allocated to the control group (CG). Intervention consisted of walking at a heart rate corresponding to the ventilatory 1 threshold obtained from ergospirometry and monitored by a frequency meter. At baseline (T0) and after 16 weeks (T16), patients were assessed for endothelial function by brachial artery (flow-mediated dilation), ergospirometry and disease activity (SLEDAI). Statistical analysis was performed through normality tests, Student's t-test and non-parametric tests for data with non-normal distribution. P < 0.05 was considered significant.
    Results: Eighteen patients were allocated in the EG and 20 in the CG. After 16 weeks there was an increase in FMD in the EG [6.3 (6.7)% vs 14.1 (9.1)%, P = 0.006] without a change in the CG [8.4 (8.2)% vs 9.4 (5.7)%, P = 0.598]. Regarding the ergospirometric test, we found improvement in exercise tolerance [12.3 (2.4) vs 13.4 (2.6) min, P = 0.027], maximum speed [7.7 (1.0) vs 8.3 (1.2) km/h, P = 0.027] and threshold speed [5.6 (0.7) vs 6.1 (0.9) km/h, P = 0.005] in the EG without a difference in the CG. There was no difference in the SLEDAI score in both groups.
    Conclusion: Physical exercise is a useful strategy to improve endothelial function and aerobic capacity without worsening disease activity in SLE patients. TRIAL REGISTRATION; ClinicalTrials.gov (http://www.clinicaltrials.gov), NCT01712529.
    MeSH term(s) Adolescent ; Adult ; Cardiovascular Diseases/physiopathology ; Directly Observed Therapy/methods ; Endothelium, Vascular/physiology ; Exercise Therapy/methods ; Female ; Humans ; Lupus Erythematosus, Systemic/physiopathology ; Lupus Erythematosus, Systemic/therapy ; Middle Aged ; Prospective Studies ; Risk Factors ; Spirometry ; Young Adult
    Language English
    Publishing date 2013-12
    Publishing country England
    Document type Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/ket283
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  9. Article: Revisiting hydroxychloroquine and chloroquine for patients with chronic immunity-mediated inflammatory rheumatic diseases

    Dos Reis Neto, Edgard Torres / Kakehasi, Adriana Maria / de Medeiros Pinheiro, Marcelo / Ferreira, Gilda Aparecida / Marques, Cláudia Diniz Lopes / da Mota, Licia Maria Henrique / Dos Santos Paiva, Eduardo / Pileggi, Gecilmara Cristina Salviato / Sato, Emília Inoue / Reis, Ana Paula Monteiro Gomides / Xavier, Ricardo Machado / Provenza, José Roberto

    Adv Rheumatol

    Abstract: Hydroxychloroquine and chloroquine, also known as antimalarial drugs, are widely used in the treatment of rheumatic diseases and have recently become the focus of attention because of the ongoing COVID-19 pandemic. Rheumatologists have been using ... ...

    Abstract Hydroxychloroquine and chloroquine, also known as antimalarial drugs, are widely used in the treatment of rheumatic diseases and have recently become the focus of attention because of the ongoing COVID-19 pandemic. Rheumatologists have been using antimalarials to manage patients with chronic immune-mediated inflammatory rheumatic diseases for decades. It is an appropriate time to review their immunomodulatory and anti-inflammatory mechanisms impact on disease activity and survival of systemic lupus erythematosus patient, including antiplatelet effect, metabolic and lipid benefits. We also discuss possible adverse effects, adding a practical and comprehensive approach to monitoring rheumatic patients during treatment with these drugs.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #591986
    Database COVID19

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  10. Article ; Online: Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force.

    Tavares, Anna Carolina Faria Moreira Gomes / de Melo, Ana Karla Guedes / Cruz, Vítor Alves / de Souza, Viviane Angelina / de Carvalho, Joana Starling / Machado, Ketty Lysie Libardi Lira / de Azevedo Valadares, Lilian David / Dos Reis Neto, Edgard Torres / de Rezende, Rodrigo Poubel Vieira / de Resende Guimarães, Maria Fernanda Brandão / Ferreira, Gilda Aparecida / de Sousa Braz, Alessandra / de Abreu Vieira, Rejane Maria Rodrigues / de Medeiros Pinheiro, Marcelo / Ribeiro, Sandra Lúcia Euzébio / Bica, Blanca Elena Gomes Rios / Baptista, Kátia Lino / da Costa, Izaias Pereira / Marques, Claudia Diniz Lopes /
    Lopes, Maria Lúcia Lemos / Martinez, José Eduardo / Giorgi, Rina Dalva Neubarth / da Mota, Lícia Maria Henrique / da Rocha Loures, Marcos Antônio Araújo / Dos Santos Paiva, Eduardo / Monticielo, Odirlei André / Xavier, Ricardo Machado / Kakehasi, Adriana Maria / Pileggi, Gecilmara Cristina Salviato

    Advances in rheumatology (London, England)

    2022  Volume 62, Issue 1, Page(s) 3

    Abstract: Objective: To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice based on the shared-making ... ...

    Abstract Objective: To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice based on the shared-making decision (SMD) process.
    Methods: A task force was constituted by 24 rheumatologists (panel members), with clinical and research expertise in immunizations and infectious diseases in immunocompromised patients, endorsed by the Brazilian Society of Rheumatology (BSR), to develop guidelines for COVID-19 vaccination in patients with IMRD. A consensus was built through the Delphi method and involved four rounds of anonymous voting, where five options were used to determine the level of agreement (LOA), based on the Likert Scale: (1) strongly disagree; (2) disagree, (3) neither agree nor disagree (neutral); (4) agree; and (5) strongly agree. Nineteen questions were addressed and discussed via teleconference to formulate the answers. In order to identify the relevant data on COVID-19 vaccines, a search with standardized descriptors and synonyms was performed on September 10th, 2021, of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and LILACS to identify studies of interest. We used the Newcastle-Ottawa Scale to assess the quality of nonrandomized studies.
    Results: All the nineteen questions-answers (Q&A) were approved by the BSR Task Force with more than 80% of panelists voting options 4-agree-and 5-strongly agree-, and a consensus was reached. These Guidelines were focused in SMD on the most appropriate timing for IMRD patients to get vaccinated to reach the adequate covid-19 vaccination response.
    Conclusion: These guidelines were developed by a BSR Task Force with a high LOA among panelists, based on the literature review of published studies and expert opinion for COVID-19 vaccination in IMRD patients. Noteworthy, in the pandemic period, up to the time of the review and the consensus process for this document, high-quality evidence was scarce. Thus, it is not a substitute for clinical judgment.
    MeSH term(s) COVID-19 ; COVID-19 Vaccines ; Humans ; Rheumatic Diseases ; Rheumatology ; SARS-CoV-2 ; Vaccination/methods
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2022-01-17
    Publishing country England
    Document type Journal Article ; Practice Guideline
    ISSN 2523-3106
    ISSN (online) 2523-3106
    DOI 10.1186/s42358-022-00234-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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