BackgroundObesity is a condition characterized by a chronic state of low-grade inflammation due to increased cytokine production in visceral adipose tissue [1].Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PSA) are both autoimmune diseases that share comorbidities such as a high prevalence of obesity, a comorbidity that leads to a lower response to treatment with biologic drugs such as Anti-TNFs [2]. PSA has a higher prevalence of abdominal obesity to RA according to some recent studies [3]. Current research has shown that excess adiposity contributes to the development of cutaneous psoriasis in some patients and suggests that obesity may also be a key factor in the transition from cutaneous psoriasis to arthritis [4], however, it has not been proven the etiological role of obesity in RA [5].ObjectivesTo evaluate the waist circumference (WC) and the prevalence of obesity using the Body Mass Index (BMI) in a sample patients from the same hospital with a diagnosis of RA and PSA and to analyze the differences between both diseases.MethodsIt has been carried out an observational, retrospective, single center study. The population included in the study were patients from rheumatology clinic with a diagnosis of RA and PSA who were being treated with biological treatment. The variables analyzed were: age, sex, height (m), body mass (Kg) and WC (cm). The anthropometric variables were measured in the rheumatology nursing clinic. An anthropometric tape was used to measure the WC, taking the height of the navel as a reference in the patients. The BMI was calculated and the World Health Organization classification was used to categorize the patients. A descriptive analysis of the variables analyzed in the study was performed, including the mean and standard deviation (SD) of the continuous quantitative variables (BMI and WC). A one-factor ANOVA was performed to analyze the differences in the variables age, BMI, and WC between RA and PSA patients. Statistical significance was set a priori at p<0.05.ResultsIn this study a total of 245 RA and 122 PSA patients were included. The WC and BMI data of only 207 patients (121 with RA and 86 with PSA) were completed. The patients with PSA showed higher values of WC, observing significant differences with the patients with RA (103.66±15.05 cm vs 99.38±14.90 cm, p=0.04). However both patients with PSA and with RA showed WC measurements above the recommended values (74.41% vs 74.38%). Regarding BMI, patients with PSA had a higher mean BMI (31.29±6.37 cm vs 28.85±5.84 cm, p<0.043) than patients with RA.Table 1.Descriptive analysis.RAPSAN=20712186Age (Mean±SD)57,31±13,0156,03±10,74Sex26 men (21,5%)33 men(38,37%)95 women(78,5%)53 women (61,63%)BMI (Mean±SD; min-máx)28,85±5,84; 18,00-53,7831,29±6,37; 19,00-49,15WC (Mean±SD; min-máx)103.66±15.05; 100,44-106,8999.38±14.90; 96,70-102,06WC• Men ≥ 102 cm18 (69,23%)19 (57,57%)• Women ≥ 88 cm72 (75,78%)45 (84,90%)ConclusionIn the present study, patients with PSA showed stadistical differences and had higher values of WC and BMI compared to patients with RA, coinciding with recent studies. More studies are necesary to characterize obesity in patiens wih RA and PSA and treat it adequately.References[1]Moroni L, Farina#8232;N et al. Obesity and its role in the management of rheumatoid and psoriatic arthritis. Clinical Rheumatology(2020)39:1039–1047[2]Lyn D. Ferguson et al. Association of central adiposity with psoriasis, psoriatic arthritis and rheumatoid arthritis: a cross-sectional study of the UK Biobank.Rheumatology 2019;58:2137 2142 doi:10.1093/rheumatology/kez192[3]Li B, Huang H. Discrepancy in Metabolic Syndrome between Psoriatic Arthritis and Rheumatoid Arthritis: a Direct Comparison of Two Cohorts in One Center. Rheumatol Therhttps://doi.org/10.1007/s40744-022-00502-4[4]Ramírez K, Azuaga-Piñango AB et al. Update on Cardiovascular Risk and Obesity in Psoriatic Arthritis. Article 742713. Oct 2021.[5]Ulrich H, Häupl T et al.The etiology of rheumatoid arthritis.Journal of Autoimmunity 110 (2020) 102400.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundLeishmaniasis is an infectious disease caused by an intracellular parasite of the genus Leishmania. According to the clinical expression, it can be identified: subclinical, cutaneous (CL) and visceral leishmaniasis (VL). The immune response triggered in this type of infections is based in the activation of the TH1 pathway, in which molecules such as TNF α and interleukins such as IL 12 and IL1 are involved [1,2]. In recent years, an increase in the incidence of opportunistic infectious diseases, such as leishmaniasis, has been observed in patients with rheumatological diseases under treatment with anti-TNFα drugs, such as Psoriatic Arthritis (PsA), Ankylosing Spondylitis (AS) or Rheumatoid Arthritis (RA) [1,3,4].ObjectivesEvaluate the prevalence of Leishmaniasis in a sample of patients in a hospital center in treatment with biologic therapies. As secondary objective, study the characteristics of the patients with Leishmania.MethodsIt can been carried out an observational, descriptive, retrospective, and single-center study. The sample consisted of patients followed in a rheumatology department between January 1, 2022 and January 1, 2023, whose only inclusion criteria was to be in treatment with biologic therapies, including a total of 720 subjects, and, only five patients were found with de diagnosis of leishmaniasis.ResultsFive patients were found diagnosed with leishmaniasis in the 720 subjects on biological treatment included in the sample, which represents a prevalence of 0.69%. Three patients were male (60%) and two were female (30%). The mean age was 52.164 ± 10.38 years with a mean duration of rheumatic disease of 13.2 ± 7.8 years. All the subjets were diagnosed with spondyloarthritis: 3 with AS (60%), 1 with PsA (20%) and another with spondyloarthritis associated with inflammatory instetinal disease (20%). About the forms of leishmaniasis, four subjects were diagnosed with CL (80%) and only one patient was diagnosed with LV (20%). The 100% of the patients diagnosed with LC were on treatment or had been on treatment before with an antiTNFα (75% with adalimumab and 25% with infliximab). The only case diagnosed with LV, was in treatment with an anti-IL 17, although the patient had been on adalimumab up to 3 months prior to diagnosis. It can be stated that 100% of the patients diagnosed with leishmaniasis had received treatment with an anti-TNFα, with a mean duration of the treatment of 6.94 ± 4.7 years.Table 1.Subjects diagnosed with leishmaniasis included in the study.Gender/AgeDiseaseCurrent biologicalCL/VLLocalizationM43ASADALIMUMABLCthighM48SpondyloarthritisADALIMUMABLCelbowsM62ASINFLIXIMABLCelbowW40PsASECUKINUMABLVW66ASADALIMUMABLCelbowFigure 1.Biological treatment administered at the time of diagnosis of leishmaniasis.ConclusionIn the present study, 100% of the subjects suffering from Leishmaniasis were on treatment with an anti-TNF α molecule, being adalimumab the most frequent, which coincides with other case series published in the literature.References[1]Bosch-Nicolau P, Ubals M, Salvador F, Sánchez-Montalvá A, Aparicio G, Erra A, Martínez de Salazar P, Sulleiro E, Molina I. Leishmaniasis and tumor necrosis factor-alpha antagonists in the Mediterranean basin. A change in clinical expression. PLoS Negl Trop Dis. 2019 Aug 30;13(8):e0007708[2]Kurizky PS, Marianelli FF, Cesetti MV, Damiani G, Sampaio RNR, Gonçalves LMT, Sousa CAF, Martins SS, Vernal S, Mota LMHD, Gomes CM. A comprehensive systematic review of leishmaniasis in patients undergoing drug-induced immunosuppression for the treatment of dermatological, rheumatological and gastroenterological diseases. Rev Inst Med Trop Sao Paulo. 2020;62:e28.[3]Sánchez-Rodríguez G, Puig L. Skin. Formación Continuada en Dermatología, 2022-06-01, Volume 37, Number 6, Pages 356-360.[4]Plachouri KM, Gkermpesi M, Vryzaki E, Kollyrou P, Marangos M, Georgiou S. A rare infectious complication of treatment with biologics: adalimumab-associated disseminated cutaneous leishmaniasis. Dermatol Pract Concept. 2020 Jun 29;10(3):e2020061.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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