Background:The highest mortality rates in patients with small vessel systemic vasculitis occur within the first year after the diagnosis, however associated factors have been scarcely studied in our population.Objectives:To identify mortality associated factors at the time of diagnosis in patients with small vessel systemic vasculitis.Methods:Retrospective cohort (2009-2020) involving 81 patients diagnosed with systemic small vessel vasculitis. Demographic, clinical and biochemical parameters were studied as potential factors associated with one-year mortality.Results:Of the total of patients (n=81), 36 (44.4%) had generalized granulomatosis with polyangiitis, 32 (39.5%) had localized granulomatosis with polyangiitis and 5 (6.2%) had early systemic granulomatosis with polyangiitis, 7 (8.6%) had microscopic polyangiitis and 1 (1.25%) had eosinophilic granulomatosis with polyangiitis. Twenty-two deaths (27%) were observed, 14 of them (63.6%) happened within the first year of diagnosis. The leading cause of death was infection (64%). Patients who died within the first year of diagnosis had a higher frequency of hypoalbuminemia (p=0.05) and also presented hemoglobin lower than 10.8 g/dL (p=0.035) in comparison with those who died after the first year of diagnosis. Remission induction treatment did not differ between both groups.Conclusion:Our study suggests that hypoalbuminemia and anemia are factors associated with a higher mortality within the first year after the diagnosis in patients with systemic small vessel vasculitis which contrast with previously reported data. The study design and the reduced number of patients are two major limitations of the study.References:[1]Flossmann O, Berden A, Groot K, et al. Long-term patient survival in ANCA-associated vasculitis. Ann Rheum Dis. 2011;70:488-94.Disclosure of Interests:None declared
Background:Rheumatoid arthritis (RA) is the most common autoimmune disease. Older patients treated with biologic DMARDs (bDMARDs) are at a significantly greater risk of adverse effects (AEs) [1]. However, the rate of drug discontinuation because of adverse effects caused by bDMARDs has not differed in elderly compared to younger patients in different registries.Objectives:Determine if drug discontinuation of bDMARDs differs by age in patients with rheumatoid arthritis in the Mexican Adverse Events Registry (BIOBADAMEX).Methods:BIOBADAMEX is a Mexican ongoing cohort of patients using bDMARDs since 2016. In this analysis we included all patients with diagnosis of RA with at least two assessments. Survival on bDMARDs was estimated using Kaplan-Meier analysis. Predictors of discontinuation, including age older than median age in the sample were investigated by Cox regression analyses.Results:Among 743 patients in the registry, 497 had RA diagnosis, from which, 214 had at least two assessments. At baseline, patients had a median (IQR) age of 53.4 (45-61) years old, median disease duration of 10.7 (6-17) months and median DAS28 of 4.7 (3-6). Conventional DMARDS were used by 185 (87%) patients and 94 (44%) patients used corticosteroids. Comorbidities were present in 194 (91%). The most common bDMARDs received at baseline were abatacept 59 (27%), tocilizumab 45(21%), adalimumab 31 (15%) and certolizumab 30 (14%). At the time of analysis, the median bDMARDs treatment duration was 21.0(13-34) months, 128 (59%) had discontinued treatment, 66 for inefficacy, 32 for adverse events and 30 for others. Fig 1 shows discontinuation rate curves in patients younger and older than median age. Cox proportional-hazards demonstrated no significant differences regarding age older than median age (HR 1.1, 95% CI 0.8-1.4, p=0.7), female sex (HR 1.2, 95% CI 0.7-1.9, p=0.44), use of corticosteroids (HR 1.2, 95% CI 0.9-1.6, p=0.20), comorbidities (HR 0.9, 95% 0.6-1.5, p=0.78), DAS28 (HR 0.9, 95% 0.9-1.1, p=0.93) or other factors.Figure 1.Discontinuation rate curves in patients younger and older than median age (< 53.4 and >=53.4 years old)Conclusion:This analysis did not show a role of age on discontinuation of bDMARDs in Mexican RA patients. Further longitudinal analyses will be performed including more patients to assess retention rate of bDMARDs and identify predictive variables of discontinuation in Mexican population.References:[1]Akter R, et al. Can Geriatr J. 2020 May 1;23(2):184-189.[2]Ikari Y, et al. Medicine (Baltimore). 2020 Dec 24;99(52):e23861.Disclosure of Interests:None declared
ResumenAntecedente: en el 2010 el INEC reportó que en Ecuador los eventos cerebrovasculares (ECV) constituyen la quinta causa de defunción (5.3 %). Se desconocen las formas más comunes de presentación clínica, evolución, y grado de discapacidad residual. Por consiguiente, la práctica médica se basa principalmente en estadísticas internacionales. Objetivos: diseñar un registro de Guayaquil-Ecuador sobre las características clínicas, sociales y factores asociados a pacientes que desarrollan un primer ECV, valorar el nivel de discapacidad funcional a causa del ECV. Métodos: el presente estudio de casos y controles denominado REPLACE es parte del estudio INTERSTROKE (2009INTERSTROKE ( -2011; se incluyeron 417 pacientes que acuden con su primer ECV, en un máximo de 120 horas desde el inicio de los síntomas hasta 72 horas luego de la admisión hospitalaria. Un número igual de sujetos de atención ambulatoria con características epidemiológicas similares a los casos se consideraron como controles (n=417). Los resultados se expresan como medias, porcentajes y odds ratios. Resultados: la edad promedio de los casos fue de 62.6 años. La tasa de mortalidad al mes de seguimiento fue del 33.5 % y 22.7 % para los ECV hemorrágicos e isquémicos respectivamente (p=0.014) y el grado de discapacidad residual promedio fue 3.8 y 3.4 respectivamente (p=0.3). El análisis de regresión logística determinó que el género femenino (OR 2.5; IC 95 %, 1.7-3.5), la diabetes mellitus (OR 1.9; IC 95 %, 1.3-3.0) y consumo de alcohol (OR 4.4; IC 95 %, 2.9-6-4), fueron factores vinculados a un mayor riesgo de desarrollar un ECV. Las dislipidemias en tratamiento (OR 0.5; IC 95 %, 0.3-0.7) y perímetro abdominal aumentado según el género (OR 0.4; IC 95 %, 0.3-0.6), disminuyen la probabilidad de tener un ECV. Conclusión: en esta muestra los factores que se asociaron para desarrollar ECV fueron similares a los descritos en la literatura médica; sin embargo, la ponderación de los mismos fue distinta.PALABRAS CLAVE: trastornos cerebrovasculares, isquemia encefálica, hemorragia cerebral, Ecuador. Abstract Background: in 2010 the INEC reported that in Ecuador cerebrovascular accidents (CVA) are the fifth leading cause of death (5.3%). The most common clinical presentation, evolution, and degree of residual disability are unknown. Therefore, medical practice is largely based on international statistics. Objectives: to design a record of Guayaquil-Ecuador on the clinical social characteristics and factors associated with patients that develop their first CVA, and assess the level of functional disability due to CVA. Method: the present case-control study called REPLACE is part of the INTERSTROKE study (2009)(2010)(2011); 417 patients were included presenting their first CVA at a maximum of 120 hours from the onset of symptoms until 72 hours after hospital admission. An equal number of outpatient care subjects with epidemiological characteristics similar to the cases were considered as controls (n = 417). Results are expressed as means, percentages and odds ratio...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.