The aim of this study was to determine the prevalence and incidence of Systemic Lupus Erythematosus (SLE) in Tucumán, Argentina. Methods: The study included inpatient and outpatient charts from four public hospitals and private practice rheumatology clinics, all of them members of the Tucumán Rheumatology Society. Patients older than 16 years with diagnosis of SLE between January 2005 and December 2012 were included. Prevalence and annual incidence were calculated as the number of cases per 100.000 inhabitants during the period 2005 to 2012. Results: Three hundred fifty-three patients were identified. The mean age at diagnosis was 30.5 ± 11.7 years, 93.5% women, 83% mestizos. Prevalence was 24.3 cases/100.000 inhabitants (CI 95% 22.6–28.8) and age-adjusted (≥16 years) of 34.9 cases/100.000 inhabitants (CI 95% 32.8–41.1). The annual incidence in 2005 was 1.8 cases/100.000 inhabitants (95% CI 1–2.9) and 2012 of 4.2 cases/100.000 inhabitants (95% CI 2.9–5.8). Mortality was 9.1%, with infections being the most frequent cause (14/32). Conclusion: The prevalence of SLE in the province of Tucumán was 34.9 cases/100.000 inhabitants.
The aim of this study was to determine the prevalence of depression among rheumatoid arthritis (RA) Argentinean patients and its association with sociodemographic and clinical factors.
ObjectivesThe aim of the study was to translate and validate the ASAS Health Index (ASAS-HI) for Argentinean patients with spondyloarthritis.MethodsTranslation was done using a forward-backward procedure and qualitative interview were done with the translation. Patients fulfilling ASAS classification criteria for either axial (axSpA) or periphereal SpA (pSpA) were included to test psychometric properties. Test-retest reliability was assessed by intraclass correlation coefficient (ICC) in patients without treatment changes (stable disease state). In patients who required therapeutic modifications due to changes of disease activity, responsiveness was evaluated using a standardized response mean (SRM). Construct validity against other health outcomes was evaluated by Spearman correlation. Internal consistency (Cronbach-alfa) and discriminative ability between ASAS-HI and ASDAS were assessed.ResultsTranslation into Argentinean Spanish was accepted with minor changes. Fifty two patients were recruited [65% male, mean (SD) age 39. 5 (12.5) years and median (IQR) disease duration 72 (45–138) months]. Most of the patients had axSpA diagnosis (AS: 26, nr-axSpA: 18) while the rest had pSpA (8). The total score of the ASAS-HI was 7.4 (SD: 4.4), BASDAI: 4.4 (SD: 2.7), BASFI: 4.0 (SD: 3.1), ASDAS-CRP: 2.4 (SD: 0.9). Test-retest reliability (n: 20) was good ICC: 0.88 (95%IC 0.76 to 0.98). Sensitivity to change was tested in 13 patients and SMR was -0.61 for those patients receiving TNF inhibitors (n: 11). Convergent validity ranged as hypothesized with Spearman correlations from low (age: 0.27) to good (pain: 0.65), (table 1). The ASAS-HI discriminated well between patients with different stages of disease activity and function irrespective of the measure applied (ASDAS, BASDAI and BASFI) (table 2). The internal consistency according to Cronbach's alfa was 0.81.Table 1.Spearmen correlation coefficientCharacteristicsSpearmen correlation coefficient ASAS-HI (0–17)p value Age0.27<0.05Pain (0–10)0.65<0.001Night spinal pain (0–10)0.54<0.001ASDAS0.51<0.001BASDAI (0–10)0.60<0.001BASFI (0–10)0.54<0.001SF-36 Total0.46<0.001Table 2.ASDAS Status GroupsASDAS Status Groups Inactive (n: 9)Moderate (n: 9)High (n: 29)very high (n: 5) ASAS-HI (0–17)3.44 (± 3.9)5.77 (± 4.79)9. 06 (± 3.49)10.05 (± 4.5)BASFI (0–10)0,53 (± 0,35)1.41 (± 1.40)5.5 (± 2.46)6.46 (± 3.12)BASDAI (0–10)1.21 (± 0.49)2.37 (± 1.7)5.73 (± 1.91)6.46 (± 3.38)ConclusionsThe Argentinean version of the ASAS-HI was comprehensive and reliable by patients with SpA. The ASAS-HI is a valid tool for assessing overall functioning and health in spondyloarthritis.References The ASAS Health Index (ASAS HI)a new tool to assess the health status of patients with spondyloarthritis, Clin Exp Rheumatol 2014;32:S105-S108. Disclosure of InterestV. Duarte Employee of: Novartis Argentina, U. Kiltz: None declared, V. Navarro-Compán: None declared, N. Lloves: None declared, G. Crespo Amaya: None declared, L. Ferreyra: None declared, C. Orozco: None declared, E. Schneeberger: None declared, H. Mald...
Background:Depression is present in up to half of patients with Rheumatoid Arthritis (RA). The association between this mood disorder and disease activity scores, including DAS28, SDAI and CDAI, has previously been described by various authors.Objectives:The aim of our study was assessed the effect of depression on the components of different disease activity scores.Methods:We performed a cross-sectional study of consecutive adults with RA, according to ACR/EULAR 2010 criteria. Sociodemographic data, comorbidities and current treatment were recorded. Disease activity was evaluated using DAS28-ESR, DAS28-CRP, SDAI and CDAI. Depression was assessed using PHQ-9 questionnaire. The PHQ-9 values were categorized in 4 groups as follows: 5 to 9, 10 to 14, 15 to 19, 20 or greater, represents mild, moderate, moderate/severe, and severe depression, respectively. A cutoff value of 10 or greater was set to define major depression. Statistical analysis: Student´s T, ANOVA and Chi2 tests. Multiple logistic regression.Results:Two hundred fifty eight patients were included, with a median (m) disease duration of 9 years (IQR 3.6-16.7). The m PHQ-9 score was 6 (IQR 2-12.3) and the prevalence of major depression was 33.7%. Patients with major depression had more tender and swollen joint count (TJC and SJC) (mean 4.9±4.3 vs 2.3±3.7, p<0.0001 and 2.9±3.3 vs 1.7±3.4, p=0.009), more pain (VAS [cm] mean 5.6±2.7 vs 3.3±2.6, p<0.0001), higher patient and physician global assessment (PGA and PhGA) (VAS [cm] mean 5.4±2.9 vs 3.1±2.5, p<0.0001 and 4.4±2.7 vs 2.4±2.4, p<0.0001) and CRP (mean 1.7±3.3 vs 0.7±1.1 mg/dl, p=0.01). ESR values were higher in the group with major depression, but the difference did not reach significance. Disease activity was higher in the depression group by all scores: DAS28-ESR (mean 4.3±1.4 vs 3.3±1.3, p<0.0001), DAS28-CRP (mean 3.9±1.4 vs 2.8±1.7, p<0.0001), SDAI (mean 19.2±12.7 vs 10.3±10.1, p<0.0001) and CDAI (mean 17.6±10.9 vs 9.6±9.9, p<0.0001). While 41 (15.9%) patients had high disease activity according to DAS28-ESR, only 34 (13.2%) had SDAI>26.In the multivariate analysis, evaluating the association of major depression with the different components of DAS28-ESR, DAS28-CRP, SDAI and CDAI, we observed that the presence of this mood disorder remained significantly associated with higher PGA in all the scores. In addition, a significant association was seen with higher TJC in both DAS28 scores.Conclusion:Patients with major depression had higher disease activity. It´s presence has a significantly association with the subjective items of the disease activity scores, particularly PGA. CRP value was the only objective component associated with depression.Disclosure of Interests:Carolina Ayelen Isnardi Speakers bureau: Bristol Myers Squibb, Janssen, Grant/research support from: Pfizer, Emilce Edith Schneeberger Speakers bureau: Abbvie, Amgen, Bristol Myers Squibb, Janssen, Eli Lilly, Boehringer Ingelheim, Pfizer, Genzyme, Grant/research support from: Pfizer, Dafne Capelusnik Speakers bureau: Bristol Myers Squibb, Grant/research support from: Pfizer, Marcela Bazzarelli: None declared, Laura Barloco: None declared, Eliana Soledad Blanco: None declared, Alejandro Benitez Speakers bureau: Abbvie, Novartis, Amgen, Federico Benavidez: None declared, SANTIAGO SCARAFIA: None declared, María Alicia Lazaro Speakers bureau: Abbvie, Rodolfo Perez Alamino Speakers bureau: Pfizer, Abbvie, Amgen, Bristol-Myers-Squibb, Lilly, Janssen, Novartis, Federico Colombres: None declared, María Paula Kohan: None declared, Julia Sosa: None declared, Luciana Gonzalez Lucero: None declared, Ana Lucía Barbaglia: None declared, Hernan Maldonado Ficco Speakers bureau: Pfizer, Abbvie, Jansen, Novartis, Bago, Bristol, Eli Lilly., Consultant of: Pfizer, Abbvie, Novartis, Jansen, Bago, Eli Lilly., Gustavo Citera Speakers bureau: Abbvie, Bristol-Myers-Squibb, Lilly, Jansen, Gema, Pfizer, Roche, Grant/research support from: Pfizer
Depression is one of the most frequent comorbidity in patients with Rheumatoid Arthritis (RA). It´s presence is associated with higher healthcare costs, mortality rate and reduced odds of achieving a good treatment response. Objective: to determine the prevalence of depression in Argentinean patients with RA and to establish its relationship with different sociodemographic and clinical factors. Material and methods: consecutive patients ≥18 years old, with a diagnosis of RA according to ACR-EULAR 2010 criteria were included. Sociodemographic data, comorbidities, RA characteristics, disease activity and current treatment were registered. Questionnaires were administered: EQ-5D-3L, QOL-RA, HAQ-A and PHQ-9. PHQ-9 scores of 5-9, 10-14, 15-19, ≥20 represent mild, moderate, moderate/severe and severe depression, respectively and a cut-off value ≥10, major depression. Statistical analysis: Student´s T, ANOVA and Chi2 tests. Multiple logistic regression.
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