Burden of illness of rheumatoid arthritis in Latin America: a regional perspective

Ramírez, Luis Alberto; Rodríguez, Cecilia; Cardiel, Mario H.

doi:10.1007/s10067-015-3012-0

Cited by 15 publications

(10 citation statements)

References 35 publications

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“…The disease is complex and involves environmental factors that trigger the disease in genetically susceptible individuals [ 1 ]. RA prevalence is around 1% around the world but this number changes in different ethnic populations [ 2 ]. Early therapeutic intervention with disease-modifying antirheumatic drugs (DMARDs) including methotrexate (MTX), biological treatments, and Janus Kinase inhibitors are supposed to halt inflammation, improve symptoms and signs, and preserve structural integrity of the joints in RA [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Subcutaneous abatacept in rheumatoid arthritis: A real-life experience

Sarmiento-Monroy

Parada-Arias

Rodríguez-López

et al. 2019

Journal of Translational Autoimmunity

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Objectives To assess the effectiveness, safety, and drug survival of subcutaneous (SC) abatacept (ABA) in a cohort of rheumatoid arthritis (RA) patients in a real-world setting. Methods This was a retrospective cohort study from 2014 to 2018 in which patients with RA (1987 ACR criteria) were included. Patients were evaluated at a single rheumatology outpatient center in Bogotá, Colombia. The patients were classified according to their treatment background: biological-naïve (n = 65), switched from IV to SC ABA administration (125 mg-wk) (n = 32), and inadequate response to biological DMARD (n = 62). The primary endpoint was a change in DAS28-CRP and RAPID3 from baseline to 12 months. A linear mixed effect model was used to correlate repeated measures. Adverse events were assessed and recorded during each visit to the rheumatology center. Several Cox proportional hazard regression models were used to test if there were any differences in drug survival curves based on seropositivity for rheumatoid factor (RF), and anti-Cyclic Citrullinated Peptide Antibodies (anti-CCP). Statistical analysis was done using software R version 3.4.4. Results A total of 159 patients were included. Baseline characteristics of patients were as follows: female gender 84%, median age of 54 years (IQR 16), median disease duration 10 years (11), RF positive 96%, anti-CCP positive 89%, erosive disease 55%, median DAS28-CRP 5.0 (2), and median RAPID3 17 (10). Concomitant use of methotrexate and SC ABA monotherapy were reported at 52% and 30% respectively. Demographics and disease characteristics were similar for all groups, except for baseline DAS28-CRP, and RAPID3 in the group that switched route of administration. The interaction between time and group was significant (p = 0.0073) for RAPID3. Infections, constitutional symptoms, and headaches were the most frequent AEs. Retention rate corresponded to 60% at 48 months. The most frequent reason for drug suspension was loss of efficacy. Median time of treatment for SC ABA was 31 months (IQR 30). The only association that reached statistical significance was anti-CCP concentration [Q1–Q4] (p = 0.005). According to the Cox proportional hazard regression model, there were significant differences between survival curves for Q1 (HR 0.15; 0.03–0.64 95% CI; p = 0.0096), and Q2 (HR 0.28; 0.08–0.92 95% CI; p = 0.0363) compared to the seronegative group. Conclusions The results showed an improvement in RA disease activity and physical function in patients under SC ABA treatment. Patients switching from IV to SC administration of ABA had lower activity and functional impairment at baseline. SC ABA demonstrated a good safety profile consistent with previously published data. Patients with baseline levels of anti-CCP antibody concentrations had better drug survival than seronegative patients.

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Section: Introductionmentioning

confidence: 99%

Subcutaneous abatacept in rheumatoid arthritis: A real-life experience

Sarmiento-Monroy

Parada-Arias

Rodríguez-López

et al. 2019

Journal of Translational Autoimmunity

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“…Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease of unknown etiology that is characterized by polyarticular pain and swelling. [1,2] RA should be diagnosed and treated early in order to limit joint damage, associated complications, and progressive disability. [3] The worldwide prevalence of RA is estimated to be around 1%, with considerable variation depending on the population studied.…”

Section: Introductionmentioning

confidence: 99%

Rheumatoid factor as predictor of response to treatment with anti-TNF alpha drugs in patients with rheumatoid arthritis

2019

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We determined whether rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) can predict remission or severe disability in rheumatoid arthritis (RA) patients treated with anti-tumor necrosis factor (TNF) alpha drugs. We performed a cohort study based on the clinical data from a referral center for the treatment of RA in Bogotá, Colombia, were included patients aged ≥18 years with diagnosis of RA with an active disease and for whom a treatment scheme was begun with anti-TNF alpha medication, with a minimum follow-up time of 12 months. Disease activity of Rheumatoid Arthritis was assessed through measurement of RF, ACPA, disease activity score (DAS28), and health assessment questionnaire (HAQ). We calculated the incidence rates (IRs) for remission and severe disability. We also calculated the incidence rate ratio (IRR) for each outcome by adjusting for possible confounders using the Poisson regression method. The hypothesis was tested with a P value of <.05. Statistical analysis was performed in Stata 15. We included 400 patients receiving an anti-TNF alpha agent. Median age was 60 years, and 322 patients were women (80.5%). RF was positive in 357 patients (89%), ACPA in 348 patients (87%), and co-positivity in 324 patients (81%). Median follow-up was 41 months (range, 12–79 months). The IR for remission was 23 per 100 person-years in RF-negative patients and 16 per 100 person-years in RF-positive patients. The adjusted IRR (age sex, treatment, and ACPA) was 1.51 (95%CI, 1.05–2.18). The IR for severe disability was 10.8 per 100 person-years in the RF-positive cohort and 2.3 per 100 person-years in the RF-negative cohort. The IRR adjusted for these factors was 4.37 (95%CI, 1.6–12). Co-positivity had a similar behavior to RF. No differences were recorded in the rates of remission or disability in ACPA-positive and ACPA-negative patients. Our findings suggest that remission is less frequent and severe disability more frequent in RF-positive patients treated with anti-TNF alpha agents than in RF-negative patients.

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“…The worldwide prevalence of rheumatoid arthritis is approximately 1%, and in Mexico, it affects 1.6% of the general population and is the main reason for consultation in rheumatology services (this value can vary, depending on the geographic region, ranging from 0.7 to 2.8%), and is a chronic and progressive autoimmune disease more common in women than men (3 : 1). Although gender‐based differences may play a complex role in promoting an autoimmune dysfunction, to date the comprehensive knowledge of the link between gender and RA is still partially lacking …”

Section: Discussionmentioning

confidence: 99%