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Article ; Online: ANCA-associated vasculitis and IgG4-related disease overlap syndrome: a case report and literature review.

Faz-Muñoz, David / Hinojosa-Azaola, Andrea / Mejía-Vilet, Juan M / Uribe-Uribe, Norma O / Rull-Gabayet, Marina / Muñoz-Castañeda, Wallace Rafael / Vargas-Parra, Nancy Janeth / Martín-Nares, Eduardo

Immunologic research

2022 Volume 70, Issue 4, Page(s) 550–559

Abstract: Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides are infrequent autoimmune diseases characterized by inflammation of the walls of small vessels leading to tissue and endothelial damage. On the other hand, IgG4-related disease is a ... ...

Abstract	Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides are infrequent autoimmune diseases characterized by inflammation of the walls of small vessels leading to tissue and endothelial damage. On the other hand, IgG4-related disease is a fibroinflammatory disease characterized histologically by lymphoplasmacytic infiltrates with IgG4+ plasma cells, storiform fibrosis, and obliterative phlebitis that may affect nearly every organ of the body. There are similarities in clinical, serological, radiological, and histopathological features between both diseases, and hence, they usually mimic each other complicating the differential diagnosis. Furthermore, reports of patients with the coexistence of both conditions (overlap syndrome) have been reported. We herein report a patient with an unequivocal diagnosis of ANCA-associated vasculitis, specifically granulomatosis with polyangiitis (posterior uveitis, polyneuropathy, pauci-immune glomerulonephritis with crescent formation and granulomas, and MPO-ANCA positivity) and IgG4-related disease (thoracic aortitis, tubulointerstitial nephritis with prominent IgG4+ plasma cell infiltration, fibrosis, and obliterative arteritis, high levels of serum IgG4, and eosinophilia) overlap syndrome.
MeSH term(s)	Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ; Antibodies, Antineutrophil Cytoplasmic ; Autoimmune Diseases/diagnosis ; Fibrosis ; Humans ; Immunoglobulin G ; Immunoglobulin G4-Related Disease/diagnosis
Chemical Substances	Antibodies, Antineutrophil Cytoplasmic ; Immunoglobulin G
Language	English
Publishing date	2022-04-21
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	632857-x
ISSN	1559-0755 ; 0257-277X
ISSN (online)	1559-0755
ISSN	0257-277X
DOI	10.1007/s12026-022-09279-8
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Zs.A 1755: Show issues

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Article ; Online: Risk factors for ischemic antiphospholipid syndrome: A case-control study.

Matus-Mayorga, Roxana / Barrera-Vargas, Ana / Rull-Gabayet, Marina / Aguirre-Aguilar, Eduardo / Valdez-López, Martín / Espinoza-Lira, Fernando / Ramos-Ventura, Cristina / Cano-Nigenda, Vanessa / Barboza, Miguel A / Merayo-Chalico, Javier / Arauz, Antonio

Clinical neurology and neurosurgery

2021 Volume 202, Page(s) 106492

Abstract: Objective: The objective of this study was to identify clinical and laboratory risk factors for ischemic stroke (IS) in primary antiphospholipid syndrome (APS) patients.: Materials and methods: We performed a case-control study with consecutive ... ...

Abstract	Objective: The objective of this study was to identify clinical and laboratory risk factors for ischemic stroke (IS) in primary antiphospholipid syndrome (APS) patients. Materials and methods: We performed a case-control study with consecutive primary APS patients divided into two groups, those who presented with IS, vs. those with no history of stroke. Demographics, vascular risk factors, therapeutic approaches, laboratory, imaging and functional outcomes were recorded. Results: Fifty-three confirmed primary APS patients with IS and sixty-six non-stroke primary APS controls were recruited. Most patients were female (65.5 %), with a median age of 33 years. The main vascular risk factors for primary APS-associated stroke were hypertension (11.3 %), diabetes (11.3 %) and hypercholesterolemia (9.4 %). Among patients with stroke, median NIHSS score was 6; 15.1 % of these patients presented a recurrent stroke, and 88.8 % had a good functional outcome at the final follow-up. Positive lupus anticoagulant (OR = 6.1, 95 %CI 2.7-13.5), anti-β2 glycoprotein IgG (OR = 3.6, 95 %CI 1.7-7.9), and anticardiolipin IgG (OR = 2.8, 95 %CI 1.3-5.9) were more prevalent in non-stroke primary APS, with a triple-positive antibody presence in 46.4 % of controls vs. 22.2 % of patients with stroke (OR = 3.0, 95 %CI 1.3-6.7). At the time of the index event (arterial or venous), 14 known primary APS patients were using vitamin K antagonists, but only 35.7 % of them had achieved therapeutic INR. Conclusion: Patients with primary APS and IS have similar vascular risk factors and lower antibody positivity than those with extracranial thrombosis.
MeSH term(s)	Adult ; Antibodies, Anticardiolipin/immunology ; Anticoagulants/therapeutic use ; Antiphospholipid Syndrome/drug therapy ; Antiphospholipid Syndrome/epidemiology ; Antiphospholipid Syndrome/immunology ; Case-Control Studies ; Diabetes Mellitus/epidemiology ; Female ; Functional Status ; Humans ; Hypercholesterolemia/epidemiology ; Hypertension/epidemiology ; International Normalized Ratio ; Ischemic Stroke/epidemiology ; Ischemic Stroke/etiology ; Ischemic Stroke/immunology ; Ischemic Stroke/physiopathology ; Lupus Coagulation Inhibitor/immunology ; Male ; Mesenteric Ischemia/epidemiology ; Mesenteric Ischemia/etiology ; Mesenteric Vascular Occlusion/epidemiology ; Mesenteric Vascular Occlusion/etiology ; Middle Aged ; Portal Vein ; Pulmonary Embolism/epidemiology ; Pulmonary Embolism/etiology ; Risk Factors ; Venous Thrombosis/epidemiology ; Venous Thrombosis/etiology
Chemical Substances	Antibodies, Anticardiolipin ; Anticoagulants ; Lupus Coagulation Inhibitor ; anti-beta 2 glycoprotein I autoantibody
Language	English
Publishing date	2021-01-15
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2021.106492
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Ui I Zs.53: Show issues

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Article ; Online: Disease activity is associated with changes in the innate immune function in patients with systemic lupus erythematosus.

Torres-Ruiz, Jiram / Rull-Gabayet, Marina / Mejía-Domínguez, Nancy R / Carrillo-Vázquez, Daniel Alberto / Reyes-Islas, Juan Alberto / Cassiano-Quezada, Fabiola / Cuellar-Rodríguez, Jennifer / Sierra-Madero, Juan / Sánchez, Jessica Márquez / Serrano-García, Jesús Salvador / González, Alexia Esquinca / Juárez-Vega, Guillermo / Tapia-Rodríguez, Miguel / Gómez-Martín, Diana

Clinical rheumatology

2023 Volume 43, Issue 1, Page(s) 501–509

Abstract: Objective: To address the relationship between systemic lupus erythematosus (SLE) disease activity and the functional parameters of the innate immunity.: Methods: We evaluated a cohort of 26 adult SLE patients and 10 sex and age-paired healthy donors. ...

Abstract	Objective: To address the relationship between systemic lupus erythematosus (SLE) disease activity and the functional parameters of the innate immunity. Methods: We evaluated a cohort of 26 adult SLE patients and 10 sex and age-paired healthy donors. When the patients had a disease flare (baseline) and when they achieve clinical response (follow-up), we assessed the systemic lupus erythematosus disease activity index 2 K (SLEDAI 2 K) and the following parameters with flow cytometry and confocal microscopy: monocyte subsets, their expression of TLR2, phagocytic monocytes and neutrophils using the pHrodo Red E. coli BioParticles, the respiratory burst with 123-dihydrorhodamine in neutrophils, and the spontaneous and lipopolysaccharide (LPS)-induced production of neutrophil extracellular traps (NETs). We used the Wilcoxon test to compare the paired medians with interquartile range (IQR) and the Mann-Whitney U test for independent medians. To assess the effect of prednisone and SLEDAI 2 K on the mentioned parameters, we applied a generalized mixed linear model. Results: Twenty-three patients (88.4%) were women. The SLEDAI 2 K was higher at baseline 8 (6-14) in comparison to that at follow-up (6 (4-8), P = 0.028). At baseline, SLE patients had a decreased percentage of intermediate monocytes, a higher expression of TLR2 in total monocytes, increased phagocytosis in monocytes and neutrophils, a decreased respiratory burst intensity, and an increased production of NETs. In the mix model, the SLEDAI 2 K was the main factor influencing these functional innate immune parameters. Conclusion: Disease activity regulates the innate immune function in SLE which may contribute to the clinical features and infection predisposition. Key points • This is the first cohort study addressing the effect of disease activity and prednisone use on the innate immune function of lupus patients. • Our results show that the disease activity is a key regulator of the respiratory burst, phagocytosis, and the production of neutrophil extracellular traps. • Also, we observed a differential proportion of monocyte subsets according to SLE disease activity. • We consider that our manuscript contributes to the evidence addressing the intrinsic immune abnormalities of patients with SLE regardless of the use of immunosuppressants and set the bases for new research work considering the disease activity as an element to decide the prescription and duration of antibiotic prophylaxis in SLE patients, which is of interest to all rheumatologists.
MeSH term(s)	Adult ; Humans ; Female ; Male ; Prednisone/therapeutic use ; Toll-Like Receptor 2 ; Cohort Studies ; Escherichia coli ; Lupus Erythematosus, Systemic/drug therapy ; Immunity
Chemical Substances	Prednisone (VB0R961HZT) ; Toll-Like Receptor 2
Language	English
Publishing date	2023-11-15
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/s10067-023-06810-6
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Zs.A 1740: Show issues

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Article ; Online: Colchicine Is Safe Though Ineffective in the Treatment of Severe COVID-19: a Randomized Clinical Trial (COLCHIVID).

Absalón-Aguilar, Abdiel / Rull-Gabayet, Marina / Pérez-Fragoso, Alfredo / Mejía-Domínguez, Nancy R / Núñez-Álvarez, Carlos / Kershenobich-Stalnikowitz, David / Sifuentes-Osornio, José / Ponce-de-León, Alfredo / González-Lara, Fernanda / Martín-Nares, Eduardo / Montesinos-Ramírez, Sharon / Ramírez-Alemón, Martha / Ramírez-Rangel, Pamela / Márquez, Manlio F / Plata-Corona, Juan Carlos / Juárez-Vega, Guillermo / Gómez-Martín, Diana / Torres-Ruiz, Jiram

Journal of general internal medicine

2021 Volume 37, Issue 1, Page(s) 4–14

Abstract: Background: Colchicine is an available, safe, and effective anti-inflammatory drug and has been suggested as a COVID-19 treatment, but its usefulness in hospitalized severe COVID-19 patients has not been thoroughly demonstrated.: Objective: To ... ...

Abstract	Background: Colchicine is an available, safe, and effective anti-inflammatory drug and has been suggested as a COVID-19 treatment, but its usefulness in hospitalized severe COVID-19 patients has not been thoroughly demonstrated. Objective: To address the safety and efficacy of colchicine in hospitalized patients with severe COVID-19. Design: We conducted a triple-blind parallel non-stratified placebo-controlled clinical trial. Participants: We recruited 116 hospitalized patients with severe COVID-19 in Mexico. Interventions: Patients were randomized to receive 1.5 mg of colchicine or placebo at the time of the recruitment in the study (baseline) and 0.5 mg BID PO to complete 10 days of treatment. Main measures: The primary composite outcome was the progression to critical disease or death. Besides, we evaluated immunological features at baseline and after recovery or disease progression in 20 patients. Key results: Fifty-six patients were allocated to colchicine and 60 patients received placebo. The study was suspended after the second interim analysis demonstrated colchicine had no effect on the primary outcome (OR 0.83, 95%CI 0.35-1.93, P = 0.67), nor in the days of ICU and hospital stays. Adverse events were similar between groups (OR 1.63, 95% CI 0.66-3.88, P = 0.37). After colchicine treatment, patients had higher BUN and lower serum levels of IL-8, IL-12p70, and IL-17A. Conclusions: Colchicine is safe but not effective in the treatment of severe COVID-19. Trial registration: ClinicalTrials.gov Identifier: NCT04367168.
MeSH term(s)	Colchicine/adverse effects ; Hospitalization ; Humans ; SARS-CoV-2 ; Treatment Outcome ; COVID-19 Drug Treatment
Chemical Substances	Colchicine (SML2Y3J35T)
Language	English
Publishing date	2021-11-09
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1007/s11606-021-07203-8
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Zs.A 2205: Show issues

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Article ; Online: Improvement in OMERACT domains and renal function with regular treatment for gout: a 12-month follow-up cohort study.

Vazquez-Mellado, Janitzia / Peláez-Ballestas, Ingris / Burgos-Vargas, Rubén / Alvarez-Hernández, Everardo / García-Méndez, Sergio / Pascual-Ramos, Virginia / Rull-Gabayet, Marina

Clinical rheumatology

2018 Volume 37, Issue 7, Page(s) 1885–1894

Abstract: OMERACT proposed a set of mandatory and discretionary domains to evaluate the effect of treatment in patients with gout. To determine the percentage of improvement and the effect size 6 and 12 months after starting a proper treatment in patients with ... ...

Abstract	OMERACT proposed a set of mandatory and discretionary domains to evaluate the effect of treatment in patients with gout. To determine the percentage of improvement and the effect size 6 and 12 months after starting a proper treatment in patients with gout from our cohort (GRESGO) based on the OMERACT proposal for chronic gout. GRESGO is a cohort of consecutive, new patients with gout attending either of two dedicated clinics. This report includes 141 patients evaluated at baseline and 6 months plus 101 of them completing a 12-month follow-up in 2012. Clinical data including the OMERACT domains for chronic gout were collected at baseline and every 6 months. Treatment was prescribed by their attending physician with the purpose of getting < 6 mg/dL of seric uric acid (sUA). Most patients were males (96%) with inappropriate treatment (95%); 66% had tophi, 30% metabolic syndrome, and 32% low renal function. Mean dose of allopurinol at baseline and throughout the study went from 344 ± 168 mg/day to 453 ± 198 at 12 months. Most OMERACT domains and renal function improved significantly; 73% improved > 20% from 6 to 12 months. Greater improvement was observed in the domains: flares, index tophus size, pain, general health assessment, and HAQ score, all of them associated to lower sUA values. Chronic gout patients improve significantly in most OMERACT domains when conventional and regular treatment is indicated. sUA < 6 mg/dL is associated with greater improvement.
MeSH term(s)	Adult ; Allopurinol/administration & dosage ; Female ; Follow-Up Studies ; Gout/blood ; Gout/drug therapy ; Gout/physiopathology ; Gout Suppressants/administration & dosage ; Humans ; Kidney/drug effects ; Kidney/physiopathology ; Male ; Mexico ; Middle Aged ; Time Factors ; Treatment Outcome ; Uric Acid/blood
Chemical Substances	Gout Suppressants ; Uric Acid (268B43MJ25) ; Allopurinol (63CZ7GJN5I)
Language	English
Publishing date	2018-03-15
Publishing country	Germany
Document type	Journal Article ; Multicenter Study
ZDB-ID	604755-5
ISSN	1434-9949 ; 0770-3198
ISSN (online)	1434-9949
ISSN	0770-3198
DOI	10.1007/s10067-018-4065-7
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Zs.A 1740: Show issues

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Article ; Online: Radiographic outcome in Hispanic early rheumatoid arthritis patients treated with conventional disease modifying anti-rheumatic drugs.

Contreras-Yáñez, Irazú / Rull-Gabayet, Marina / Vázquez-Lamadrid, Jorge / Pascual-Ramos, Virginia

European journal of radiology

2011 Volume 79, Issue 2, Page(s) e52–7

Abstract: Objectives: To determine rates of incident erosive disease in early rheumatoid arthritis patients, to identify baseline predictors and to evaluate erosion's impact on patient-reported outcomes.: Methods: 82 patients with ≤ 12 months of disease ... ...

Abstract	Objectives: To determine rates of incident erosive disease in early rheumatoid arthritis patients, to identify baseline predictors and to evaluate erosion's impact on patient-reported outcomes. Methods: 82 patients with ≤ 12 months of disease duration, ≥ 3 years of follow-up and conventional treatment were included. Consecutive evaluations assessed swollen and tender joint counts, treatment and comorbidity, acute reactant-phase determinations and patient-reported outcomes. Digitized radiographs of the hands and feet were obtained at baseline and yearly thereafter. RA was defined as erosive when at least one unequivocal cortical bone defect was detected. Descriptive statistics and Cox regression analysis were performed. Results: At baseline, 71 of the patients were ♀, population median (range) age was of 38.7 (16-78.2) years, 58 patients had antibodies and all the patients had active disease and substantial disability. Follow-up cohort was of 299.3 person-years. At last follow-up (49 ± 13.8 months), 28 patients developed erosions. Erosion's location was the feet, in 12 patients. Incident rates of erosive disease at one, two, three and four years were of 8.1, 12.8, 13.8 and 5.6 per 100 person-years, respectively. Higher C-reactive protein (HR: 1.20, 95%CI: 1.04-1.4, p=0.01) and positive antibodies (HR: 5.09, 95%CI: 1.08-23.86, p=0.04) were baseline predictors of incident erosive disease. Erosions had minor impact on patient-reported outcomes. Conclusion: Rheumatoid arthritis patients with antibodies and higher C reactive protein at baseline are at risk for incident erosions which appear most frequently at the feet. Up to 1/3 patients conventionally treated develop incident erosions, which minimally impact function.
MeSH term(s)	Adolescent ; Adult ; Aged ; Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/diagnostic imaging ; Arthritis, Rheumatoid/drug therapy ; Arthritis, Rheumatoid/ethnology ; Chi-Square Distribution ; Female ; Follow-Up Studies ; Humans ; Male ; Mexico ; Middle Aged ; Predictive Value of Tests ; Proportional Hazards Models ; Radiography ; Treatment Outcome
Chemical Substances	Antirheumatic Agents
Language	English
Publishing date	2011-08
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	138815-0
ISSN	1872-7727 ; 0720-048X
ISSN (online)	1872-7727
ISSN	0720-048X
DOI	10.1016/j.ejrad.2011.03.036
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Zs.A 1630: Show issues

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Article: Inhibidores adquiridos de la coagulación en una paciente con lupus eritematoso sistémico y anticuerpos antifosfolipídicos: respuesta a rituximab.

Ortiz Jiménez, Enrique / Loera Fragoso, Sergio / Rull Gabayet, Marina

Reumatologia clinica

2008 Volume 4, Issue 2, Page(s) 74–76

Abstract: Hematologic signs of systemic lupus erythematosus are diverse (SLE). Although a delayed coagulation time is anti-phospholipid antibody related, thrombotic events are the usual clinical manifestation. Spontaneous appearance of circulating anticoagulant in ...

Title translation	Aquired inhibitors of coagulation in a patient with systemic lupus erythematosus and antiphospholipid antibodies: response to rituximab.
Abstract	Hematologic signs of systemic lupus erythematosus are diverse (SLE). Although a delayed coagulation time is anti-phospholipid antibody related, thrombotic events are the usual clinical manifestation. Spontaneous appearance of circulating anticoagulant in the absence of a previous coagulation disorder is secondary to the development of antibodies to factors II, V, VIII, IX, XI, XII,vonWillebrand, and other membrane glucoproteins, all of them uncommon causes (1 case per million persons per year) of life threatening coagulopathies. We report a case of SLE and antiphospholipid antibodies in a woman with a hemorrhagic syndrome, probably caused by multiple antibodies to coagulation factors, unresponsive to steroids and high-dose immunosupressive therapy and a favorable response to rituximab.
Language	Spanish
Publishing date	2008-03
Publishing country	Spain
Document type	English Abstract ; Journal Article
ZDB-ID	2231357-6
ISSN	1699-258X
ISSN	1699-258X
DOI	10.1016/S1699-258X(08)71804-7
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Zs.A 6265: Show issues

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Article ; Online: Novel clinical and immunological features associated with persistent post-acute sequelae of COVID-19 after six months of follow-up: a pilot study.

Torres-Ruiz, Jiram / Lomelín-Gascón, Julieta / Lira Luna, Jaquelin / Vargas-Castro, Ana Sofia / Pérez-Fragoso, Alfredo / Nuñez-Aguirre, Miroslava / Alcalá-Carmona, Beatriz / Absalón-Aguilar, Abdiel / Balderas-Miranda, Jennifer T / Maravillas-Montero, José Luis / Mejía-Domínguez, Nancy R / Núñez-Álvarez, Carlos / Llorente, Luis / Romero-Ramírez, Sandra / Sosa-Hernández, Victor Andrés / Cervantes-Díaz, Rodrigo / Juárez-Vega, Guillermo / Meza-Sánchez, David / Rull-Gabayet, Marina /

Martínez-Juárez, Luis Alberto / Morales, Linda / López-López, Lizeth Naomi / Negrete-Trujillo, José Adrián / Falcón-Lezama, Jorge Abelardo / Valdez-Vázquez, Rafael Ricardo / Gallardo-Rincón, Héctor / Tapia-Conyer, Roberto / Gómez-Martín, Diana

Infectious diseases (London, England)

2023 Volume 55, Issue 4, Page(s) 243–254

Abstract: Background: Currently, there is scant information regarding the features associated to the persistence of post-COVID-19 syndrome, which is the main aim of the present study.: Methods: A cohort study of 102 COVID-19 patients was conducted. The post- ... ...

Abstract	Background: Currently, there is scant information regarding the features associated to the persistence of post-COVID-19 syndrome, which is the main aim of the present study. Methods: A cohort study of 102 COVID-19 patients was conducted. The post-COVID-19 symptoms were assessed by a standardised questionnaire. Lymphocyte immunophenotyping was performed by flow cytometry and chemokines/cytokines, neutrophil extracellular traps, the tripartite motif 63, anti-cellular, and anti-SARS-CoV-2 IgG antibodies were addressed in serum. The primary outcome was the persistence of post-COVID-19 syndrome after six months follow-up. Results: Thirteen patients (12.7%) developed the primary outcome and had a more frequent history of post-COVID-19 syndrome 3 months after infection onset ( Conclusion: Our data suggest an important relationship between a pro-inflammatory state mediated through metabolic pathways related to obesity and increased cellular senescence as a key element in the persistence of post-COVID-19 syndrome at six months of follow-up.
MeSH term(s)	Humans ; COVID-19/complications ; Pilot Projects ; Post-Acute COVID-19 Syndrome ; CD8-Positive T-Lymphocytes ; Cohort Studies ; Chemokine CXCL10 ; Obesity
Chemical Substances	Chemokine CXCL10
Language	English
Publishing date	2023-01-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2839775-7
ISSN	2374-4243 ; 2374-4235
ISSN (online)	2374-4243
ISSN	2374-4235
DOI	10.1080/23744235.2022.2158217
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Zs.A 600: Show issues

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Article ; Online: FANSY POSTCOV: A composite clinical immunological predictive index for post-COVID-19 syndrome unveils distinctive features in a cohort study of mild to critical patients.

Torres-Ruiz, Jiram / Lomelín-Gascón, Julieta / Lira-Luna, Jaquelin / Pérez-Fragoso, Alfredo / Tapia-Conyer, Roberto / Nuñez-Aguirre, Miroslava / Alcalá-Carmona, Beatriz / Absalón-Aguilar, Abdiel / Maravillas-Montero, José Luis / Mejía-Domínguez, Nancy Raquel / Núñez-Álvarez, Carlos / Llorente, Luis / Romero-Ramírez, Sandra / Sosa-Hernández, Victor Andrés / Cervantes-Díaz, Rodrigo / Juárez-Vega, Guillermo / Meza-Sánchez, David / Rull-Gabayet, Marina / Martínez-Juárez, Luis Alberto /

Morales-Juárez, Linda / López-López, Lizeth Naomi / Negrete-Trujillo, José Adrián / Falcón-Lezama, Jorge Abelardo / Valdez-Vázquez, Rafael Ricardo / Gallardo-Rincón, Héctor / Gómez-Martín, Diana

Clinical and translational medicine

2021 Volume 11, Issue 11, Page(s) e623

MeSH term(s)	Area Under Curve ; B-Lymphocytes/immunology ; B-Lymphocytes/metabolism ; Biomarkers/metabolism ; CD4-Positive T-Lymphocytes/immunology ; CD4-Positive T-Lymphocytes/metabolism ; CD8-Positive T-Lymphocytes/immunology ; CD8-Positive T-Lymphocytes/metabolism ; COVID-19/complications ; COVID-19/diagnosis ; COVID-19/immunology ; Cohort Studies ; Female ; Humans ; Male ; Odds Ratio ; Predictive Value of Tests ; ROC Curve ; Sex Factors ; Vascular Endothelial Growth Factor A/blood
Chemical Substances	Biomarkers ; Vascular Endothelial Growth Factor A
Language	English
Publishing date	2021-11-29
Publishing country	United States
Document type	Letter
ZDB-ID	2697013-2
ISSN	2001-1326 ; 2001-1326
ISSN (online)	2001-1326
ISSN	2001-1326
DOI	10.1002/ctm2.623
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Article ; Online: Medication persistence over 2 years of follow-up in a cohort of early rheumatoid arthritis patients: associated factors and relationship with disease activity and with disability.

Pascual-Ramos, Virginia / Contreras-Yáñez, Irazú / Villa, Antonio R / Cabiedes, Javier / Rull-Gabayet, Marina

Arthritis research & therapy

2009 Volume 11, Issue 1, Page(s) R26

Abstract: Introduction: Aggressive treatment with disease-modifying antirheumatic drugs (DMARDs) plays a major role in improving early rheumatoid arthritis (RA) patient outcomes. Persistence and adherence with medication occurs variably (20% to 70%). The ... ...

Abstract	Introduction: Aggressive treatment with disease-modifying antirheumatic drugs (DMARDs) plays a major role in improving early rheumatoid arthritis (RA) patient outcomes. Persistence and adherence with medication occurs variably (20% to 70%). The objectives of the study were to determine medication persistence (MP) in early RA patients over 13 consecutive visits each 2 months apart, to investigate the relationship between MP and disease activity, disability and structural damage, and to identify baseline prognosticators. Methods: Charts from 75 patients of an early RA cohort were reviewed. At each visit, a rheumatologist interviewed patients regarding therapy, scored disease activity with the 28-joint disease activity score (DAS28) and disability with the health assessment questionnaire (HAQ), and recorded comorbidities and treatment. A complete medical history was obtained at baseline. MP was defined as the duration of time from initiation to discontinuation of at least one DMARD and/or corticosteroids for at least 1 week and was reported as a dichotomous variable at consecutive evaluations. Structural damage was defined by detection of new erosions on radiography. Descriptive statistics, Student's t test, the chi-squared test, and logistic regression analyses were used. Results: The proportion of MP patients decreased from 98% at 2 months to 34% at 2 years. MP patients (n = 32) had similar DAS28 to non-MP patients (n = 53) at initial visits, lower DAS28 and greater DAS28 improvements at follow-ups (P < or = 0.05 at visits 4, 6, 7 and 9) and reached sustained remission (> or = 3 consecutive visits with DAS28 < 2.6) more frequently (82.8% versus 46.5%, P = 0.003) and earlier (7.7 +/- 4.6 versus 13.6 +/- 5.7 months, P = 0.001) than non-MP patients. MP patients had similar baseline HAQ scores, but lower HAQ scores at follow-up (P < or = 0.05 at visits 3, 5, 6, 7, 9, 10 and 13). More non-MP patients developed erosive disease than MP patients (26.8% versus 17.9%, P = 0.56). Older age at baseline was associated with therapy discontinuation (odds ratio = 1.1, 95% confidence interval = 1.007 to 1.103, P = 0.02). Conclusions: Discontinuation of DMARDs was frequent and progressive in an early RA cohort. Patients with persistence on therapy were younger, had lower disease activity and disability during follow-up, and reached sustained remission more frequently and earlier than patients without it. MP should intentionally be evaluated during follow-up of early RA patients, as it seems to play a major role in outcome.
MeSH term(s)	Adult ; Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/drug therapy ; Arthritis, Rheumatoid/pathology ; Disability Evaluation ; Female ; Health Status ; Humans ; Male ; Medication Adherence/statistics & numerical data ; Severity of Illness Index ; Treatment Outcome
Chemical Substances	Antirheumatic Agents
Language	English
Publishing date	2009-02-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2107602-9
ISSN	1478-6362 ; 1478-6354
ISSN (online)	1478-6362
ISSN	1478-6354
DOI	10.1186/ar2620
Database	MEDical Literature Analysis and Retrieval System OnLINE

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