RETRACTED ARTICLE: Quality of life of patients with rheumatoid arthritis in Argentina: reliability, validity, and sensitivity to change of a Spanish version of the Rheumatoid Arthritis Quality of Life questionnaire (original) (raw)

Adherence to treatment in patients with ankylosing spondylitis

This study aims to determine the level of adherence to treatment in ankylosing spondylitis (AS) patients and to identify possible factors associated to lack of adherence. We included consecutive AS patients (NY modified criteria). Sociodemographic and clinical data were collected. Patients answered auto-reported questionnaires: Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life, and Center for Epidemiological Studies Depression scale. Patients with rheumatoid arthritis (RA) (ACR'87 criteria) were assessed as the control group. The adherence of the studied groups to medical treatment and exercises was measured by means of two questionnaires: Compliance Questionnaire on Rheumatology (CQR) and Exercise Attitude Questionnaire-18 (EAQ-18). The study included 59 patients with AS and 53 patients with RA. Of the AS patients, 43 (72.9 %) were male, median age 47 years (interquartile range (IQR) 33-57) and median disease duration of 120 months (IQR 33-57). Of the RA patients, 37 (69.8 %) were female, had a median age of 56 years (IQR 43.5-60) and a median disease duration of 156 months (IQR 96-288). There were no significant differences in the results of the adherence questionnaires between both groups, with a total median of 68.42 for the CQR in both groups and of 40.7 in AS vs. 42.6 in RA for the EAQ. When dichotomizing patients as adherent and non-adherent, taking as good adherence a cut value in the CQR and EAQ higher than 60, adherence to pharmacological treatment was significantly higher in RA vs. AS (92.5 vs. 74.6 %, p=0.01) and there were no differences in the EAQ. On the uni-and multivariate analysis, lack of adherence to treatment was not associated to sex, age, disease duration, education, health insurance, depressive status, and disease activity parameters in neither group of patients. AS have an acceptable adherence to pharmacological treatment, although it is lower than RA patients; nonetheless, both groups show a lack of adherence to exercise.

Prevalence of psoriatic arthritis in psoriasis patients according to newer classification criteria

Clinical Rheumatology, 2014

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Clinical and immunogenetic characterization in psoriatic arthritis patients

Clinical Rheumatology, 2014

In psoriatic arthritis (PsA), genetic factors play a substantial role in disease susceptibility as well as in its expression. This study aims to determine the distribution of class I and class II HLA antigens in PsA patients and secondly to analyze the influence of genetic factors in the clinical expression of the disease. Consecutive PsA patients (CASPAR criteria) with less than 1 year of disease duration were included. Sociodemographic and clinical data were recorded. Blood samples were obtained, DNA was extracted by polymerase chain reaction (PCR), and class I (A, B, and C) and class II (DR) HLA antigens were determined by oligotyping. A control group of 100 nonrelated healthy controls from the general population served as control. p values were corrected (pc) according to the number of alleles tested. A total of 73 patients were included, 37 were females (50.7 %) with a median disease duration of 72 months (interquartile range (IQR) 24-149). Thirty-three patients (45.2 %) had a family history of psoriasis. When analyzing all the class I and class II HLA antigens, a significantly higher frequency of B38 (odds ratio (OR) 2.95, p=0.03) and Cw6 (OR 2.78, p=0.009) was found in PsA patients compared to the control group. On the contrary, the HLA-A11 (OR 0.14, p=0.04) and B7 (OR 0.31, p = 0.03) were significantly more frequent among healthy controls. Furthermore, B18 was significantly more frequent in patients with early arthritis onset (less than 40 years): seven patients (22.6 %) with early onset compared to two patients (4.8 %) with late onset (p=0.03). No association between HLA-B27 and spondylitis or HLA-DR4 with polyarticular involvement was observed. The HLA-B38 and Cw6 alleles are associated with a greater PsA susceptibility in Argentine population.

Clinical significance of anti-Ro antibodies in rheumatoid arthritis

Clinical Rheumatology, 2008

The objective of our study was to determine the frequency of anti-Ro antibodies in patients with rheumatoid arthritis (RA), their clinical significance and possible serologic and genetic associations. Consecutive patients with RA (ACR '87) were studied. Other connective tissues diseases were excluded. Demographic characteristics, extra articular manifestations, and treatment were reviewed. Presence of leukopenia, thrombocytopenia, hypergammaglobulinemia, hypocomplementemia, and cryoglobulinemia were consigned. Rheumatoid factor (RF), antinuclear antibodies (ANAs), anti-Ro, and anti-La were determined by ELISA in all patients; and HLA-DR was determined by PCR and oligotyping. X-rays of the hands and feet were evaluated by Larsen's score. The study included 106 patients, 94 women and 12 men; mean age was 50.3± 11.4 years, mean disease duration was 11.2±6.8 years. Main extra articular manifestations were subcutaneous nodules, xerophthalmia, and xerostomia; 75.5% of the patients were RF+. Anti-Ro antibodies were detected in 12.2% of the patients. When positive and negative anti-Ro patients were compared, no significant difference in any studied variable was observed. According to our results, anti-Ro antibodies lack clinical relevance in patients with RA.

Work Productivity in Rheumatoid Arthritis: Relationship with Clinical and Radiological Features

Arthritis, 2012

Objective. To assess the relationship between work productivity with disease activity, functional capacity, life quality and radiological damage in patients with rheumatoid arthritis (RA). Methods. The study included consecutive employed patients with RA (ACR'87), aged over 18. Demographic, disease-related, and work-related variables were determined. The reduction of work productivity was assessed by WPAI-RA. Results. 90 patients were evaluated, 71% women. Age average is 50 years old, DAS28 4, and RAQoL 12. Median SENS is 18 and HAQ-A 0.87. Mean absenteeism was of 14%, presenting an average of 6.30 work hours wasted weekly. The reduction in performance at work or assistance was of 38.4% and the waste of productivity was of 45%. Assistance correlated with DAS28 (r = 0.446; P < 0.001), HAQ-A (r = 0.545; P < 0.001) and RAQoL (r = 0.475; P < 0.001). Lower total productivity was noticed in higher levels of activity and functional disability. Patients with SENS > 18 showed lower work productivity than those with SENS < 18 (50 versus 34; P = 0.04). In multiple regression analysis, variables associated with reduction of total work productivity were HAQ-A and RAQoL. Conclusion. RA patients with higher disease severity showed higher work productivity compromise.

GEO_RA.pdf

The age of onset of rheumatoid arthritis (RA) is an important outcome predictor. Northern countries report an age of RA onset of around 50 years, but apparently, variability exists across different geographical regions. The objective of the present study is to assess whether the age of onset of RA varies across latitudes worldwide. In a proof-of-concept crosssectional worldwide survey, rheumatologists from preselected cities interviewed 20 consecutive RA patients regarding the date of RA onset (RAO, when the patient first noted a swollen joint). Other studied variables included location of each city, rheumatologist settings, latitudes (10°increments, south to north), longitudes (three regions), intracountry consistency, and countries' Inequality-adjusted Human Development Index (IHDI). Data from 2481 patients (82% females) were obtained from 126 rheumatologists in 77 cities of 41 countries. Worldwide mean age of RAO was 44 ± 14 years (95% CI 44-45). In 28% of patients, RA began before age 36 years and before age 46 years in 50% of patients. RAO was 8 years earlier around the Tropic of Cancer when compared with northern latitudes (p < 0.001, 95% CI 3.5-13). Multivariate analysis showed that females, western cities, and latitudes around the Tropic of Cancer are associated with younger age of RAO (R 2 0.045, p < 0.001). A positive correlation was found between the age of RAO and IHDI (r = 0.7, p < 0.01, R 2 0.5). RA often begins at an early age and onset varies across latitudes worldwide. We postulate that countries' developmental status and their geographical and geomagnetic location influence the age of RAO.

MANAGEMENT OF REFRACTORY RHEUMATOID ARTHRITIS WITH WEEKLY ADALIMUMAB: REPORT OF TWO CASES: 153

Jcr-journal of Clinical Rheumatology, 2006

Objectives: Inform the recent advances of our early arthritis clinics network program sponsored by The Colombian Rheumatology Association (CRA) to this date. Methods: We asked rheumatologist to participate in a network of early arthritis clinics with the compromise of develop integrated policies and to fill similar standardized questionnaires in our centers and to respect decisions of general assembly of CRA. The CRA finance computers, software for data recollection (Arthros 6.1), and a visit lo Leiden Arthritis Clinic by representatives of each EAC besides of the Colombian protocol and early arthritis registry. Results: These are some achievements: We have completed evidence based clinical guidelines for rheumatoid arthritis, early rheumatoid arthritis, osteoarthritis and Ankylosing Spondylitis; we create a national network of early arthritis with 10 excellence centers trough the country in all major cities in which are working more than 57% of Colombian rheumatologists. They work in assistance to patients with similar policies trough the country and in to research. We are enrolling patients in "Cooperar" (Colombian protocol and Early Arthritis Registry) which consist in a standardized protocol and questionnaire with evaluations each 3 months of patients with early arthritis of less of one year of onset. We have included since May 2005 until know 158 patients. Conclusion: CRA helps to integrate rheumatologist of all around the country and permits to share unified work and protocols which are very important in current health system. Actually our guidelines are official papers for our health system and we hope results of Cooperar will help to establish early arthritis as a national policy in the care of rheumatic diseases. It permits significant collaborative work for the country in areas of low budget or few centers for research.

Cost of rheumatoid arthritis in a selected population from Argentina in the prebiologic therapy era

ClinicoEconomics and Outcomes Research, 2012

The present study aimed to estimate the cost of rheumatoid arthritis and its components in a university hospital-based health management organization in Argentina, during the prebiologic era. Methods: A one-year (2002) observational prevalence, cost-of illness study of patients with rheumatoid arthritis from the societal perspective was performed in a hospital-based health management organization population. Direct medical costs were obtained using administrative databases. Direct nonmedical and indirect costs were obtained from a semistructured questionnaire. Indirect costs included work absenteeism, permanent work disability, and housework lost for housewives, using the human capital approach. Costs are expressed in 2002 US dollars per patient per year. Results: A total of 165 patients (84% females), of mean age 61 ± 15 years and with a mean disease duration of 8.5 ± 8.3 years were included. Mean total direct medical costs were US$1862 (95% confidence interval [CI] 828-2899). Mean direct nonmedical costs were US$222 (95% CI 149-294). Mean indirect costs were US$1008 (95% CI 606-1412). The annual mean total cost was US$3093 without biologics. Hospitalizations represented 73% of total direct medical costs while drugs and outpatient procedures represented 16% and 8% of total direct medical costs, respectively. Sixty percent of the total costs were related to direct medical costs, while indirect costs represented 33% of total costs. Conclusion: In our population, annual mean total costs in the prebiologic therapy era were mainly driven by direct medical costs. Even without the use of biologic agents, rheumatoid arthritis represents an important burden for society in developing countries.