Características de los pacientes con espondiloartritis seguidos en unidades de reumatología en España. Estudio emAR II

Casals-Sánchez, J.L.; Prous, María Jesús García de Yébenes y; Descalzo, Miguel Ángel; Olmos, Juan Manuel Barrio; Carmona, Loreto; García, César

doi:10.1016/j.reuma.2012.01.006

Cited by 10 publications

(5 citation statements)

References 19 publications

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“…In 2012, Casals-Sánchez et al analyzed a valid sociodemographic data of 1,168 patients with SpA and found AS to be the predominant form. In that cohort, 52.8% of patients had an active working life [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Oral manifestations associated with inflammatory bowel disease and early endoscopic findings in patients with spondyloarthritis

et al. 2022

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Background and aims Spondyloarthritis (SpA) is a group of autoinflammatory disorders, of which the primary extra-articular manifestation is inflammatory bowel disease (IBD). The oral cavity being a part of gastrointestinal tract, is significantly compromised in IBD, and in many cases, it is the first site of clinical manifestations of IBD. This study aimed to identify changes in the oral mucosa associated with the onset of IBD and their association with endoscopic/histological findings. Materials and methods The study assessed 80 patients with SpA and 52 healthy controls. Oral, rheumatological, and gastroenterological assessments were performed. The ileocolonoscopy was performed via digital magnification chromoendoscopy. The statistical analysis consisted of Chi-square, Fisher's exact, and multiple correspondence discriminant analysis tests. Results From the disease cohort, 63.0% patients showed oral lesions (p = 0.050). These manifestations ranged from gingivitis (55.0%, p = 0.001), aphthous stomatitis (3.8%, p = 0.091), angular cheilitis (2.6%, p = 0.200), and perioral erythema with scaling (1.3%, p = 0.300). All patients who presented with alterations in colonic mucosa also had oral lesions associated with IBD (p = 0.039), specifically gingivitis/aphthous stomatitis (p = 0.029). Conclusion The patients with SpA without IBD present significant oral signs and symptoms. Gingivitis seems to be the most relevant because of its associations with early endoscopic and histological findings. Clinical relevance An integral approach to the diagnostic tests that includes evaluations of oral, rheumatological and gastroenterological tissues may favor timely attention and improve patients’ quality of life.

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Section: Discussionmentioning

confidence: 99%

Oral manifestations associated with inflammatory bowel disease and early endoscopic findings in patients with spondyloarthritis

et al. 2022

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“…The data provided in the analysis of the result of the self-assessments show that some of the problems identified in recent multinational reports [4,7] are also identified in Spain. In view of these results, care integrated by interdisciplinary teams has not been implemented, the implementation of practice guidelines requires greater effort and monitoring of patients over time is highly variable.…”

Section: Discussionmentioning

confidence: 86%

“…The conclusions of this group indicated variable care across health systems, which may result in progression of the disease does not stop, there is a gradual reduction in function, an increase in disability and a poor quality of life of the patients. For example, in Spain it has been observed that around 60% of the medical records did not quantify the joint involvement and in 87% there was no composite joint index and 84% did not have a measure of function [4,5].…”

Section: Introductionmentioning

confidence: 99%

Evaluating standards of care in psoriatic arthritis of the QUANTUM project (qualitative initiative to improve outcomes): results of an accreditation project in Spain

et al. 2020

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In Spain, the QUANTUM project has been promoted to reduce variability in clinical practice and improve the care and quality of life of people with psoriatic arthritis (PsA) by accrediting PsA units throughout the Spanish national health system. To present the results of this approach which sought to ensure an optimum level of quality for patients with PsA. Descriptive analysis of the self-assessments that the PsA units have carried out assessing their degree of compliance with the quality standards established in the QUANTUM project grouped into four blocks: shortening time to diagnosis; optimizing disease management; improving multidisciplinary collaboration; and improving patient monitoring. A total of 41 PsA units were self-evaluated. They met 64.1% of the defined quality standards. Optimize disease management obtained a higher level of standards compliance (72%) and improve multidisciplinary collaboration the lesser (63.9%). Accessibility to the treatments available for PsA in all hospitals was guaranteed (100%). Appropriate diagnostic equipment is available (97.6%). Compliance with specific quality standards leads to detect actions that should be implemented: quality of life assessment (9.8%), locomotor system assessment (12.2%), physical examination data record (14.6%), periodic cardiovascular risk assessment (17.1%). The QUANTUM project results make it possible to visualise how to care for patients with PsA is being developed in Spain. Problems identified in recent multinational reports are also identified in Spain.

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“…Previous responses to them, in monotherapy, in synergism to treat-2-target in all domains of this spondyloarthritis (SpA) justi ed this option. We were facing not only a rare disease, corresponding to only about 1% of spondyloarthritis cases [3,4], but also an unusual therapeutic combination for all rheumatologic diseases, with only studies published speci cally for rheumatoid arthritis (RA) [5][6][7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Combination therapy - is it time to start using? - A case-based review

Ferrari

Franco

Saad

et al. 2023

Preprint

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Background This case-based review presents a Reactive arthritis (ReA) refractory to conventional therapies with excellent response to the combination of ustekinumab and tofacitinib. This is the first case report of ReA with combination therapy with a bDMARD and a tsDMARD. Although not a consensus, combination therapy is already used especially in psoriasis, psoriatic arthritis and inflammatory bowel diseases, motivating this choice since in monotherapy the last two drugs achieved the best responses in different domains, justifying the possibility of blocking several pathophysiological mechanisms of immune-mediated arthritis. Case presentation: A man with peripheral and axial arthritis, conjunctivitis, balanoposthitis, keratoderma blenorrhagicum and urethral discharge preceded by diarrhea, treated with antibiotics, then methotrexate and prednisone were introduced for ReA. Along the years he received three different anti-TNF drugs with no response. Same as IL-17a monoclonal antibody with primary failure. Treatment was changed to ustekinumab with resolution of cutaneous involvement, but not articular. Then, tofacitinib was tried and arthritis improved but skin relapsed. Since severity and refractoriness of the case, combination of ustekinumab and tofacitinib was considered, achieving remission in both domains Conclusions ReA has a difficult diagnosis and treatment, anti-TNF, anti-IL 17, anti-IL 12/23, and JAK inhibitors may be used based on limited data and clinical experience, specially adapted from other spondyloarthritis. This case had poor disease control with all such bDMARD used separately, but achieved low disease activity and resolution of skin lesions with combination of JAK inhibitor and anti-IL 12/23 with no severe adverse effects during follow-up.

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Características de los pacientes con espondiloartritis seguidos en unidades de reumatología en España. Estudio emAR II

Cited by 10 publications

References 19 publications

Oral manifestations associated with inflammatory bowel disease and early endoscopic findings in patients with spondyloarthritis

Oral manifestations associated with inflammatory bowel disease and early endoscopic findings in patients with spondyloarthritis

Evaluating standards of care in psoriatic arthritis of the QUANTUM project (qualitative initiative to improve outcomes): results of an accreditation project in Spain

Combination therapy - is it time to start using? - A case-based review

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