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Papadimitropoulos E, Brnabic A, Vorstenbosch E, Leonardi F, Moyano S, Gomez D. The burden of illness of rheumatoid arthritis in Latin America-A systematic literature review. Int J Rheum Dis 2022; 25:405-421. [PMID: 35102697 DOI: 10.1111/1756-185x.14295] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/19/2021] [Accepted: 12/21/2021] [Indexed: 11/30/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease which, when left untreated, may result in the destruction of multiple joints and damage a wide variety of body systems, including the skin, eyes, lungs, heart, and blood vessels. The objective of this study was to conduct a systematic review of disease burden for RA in Argentina, Brazil, Colombia, Mexico, and Venezuela. PubMed/Medline, Embase, and Web of Science were searched for publications in English, Spanish, or Portuguese from 2008 through June 2018. A total of 1700 records were retrieved and 36 articles were included. The estimated prevalence of RA for these countries ranged from 0.15% (Colombia) to 2.8% (Mexico). The Global Burden of Disease initiative 2019 estimated that RA accounted for 0.13% of world disability-adjusted life-years. For Latin America, these figures were higher: Argentina 0.16%, Brazil 0.16%, Colombia 0.21%, Mexico 0.30%, and Venezuela 0.24%. RA has a negative impact on physical, mental, and emotional well-being as shown by substantially lower scores on measures of quality of life (SF-36) compared with the general population. The annual direct cost in Mexico was estimated at US$3599 per person. For patients with severe RA in Brazil these costs were approximately US$10 000. Data from other studied countries were similar. Though evidence of the full cost and impact of RA in Latin American countries is scarce and additional studies are needed, the burden of RA in these regions is significant and comparable to other parts the world.
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Affiliation(s)
- Emmanuel Papadimitropoulos
- Eli Lilly and Company, Toronto, Ontario, Canada.,Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Alan Brnabic
- Eli Lilly and Company, Sydney, New South Wales, Australia
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Germano JL, Reis-Pardal J, Tonin FS, Pontarolo R, Melchiors AC, Fernandez-Llimos F. Prevalence of rheumatoid arthritis in South America: a systematic review and meta-analysis. CIENCIA & SAUDE COLETIVA 2021; 26:5371-5382. [PMID: 34787226 DOI: 10.1590/1413-812320212611.3.05152020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 04/20/2020] [Indexed: 11/22/2022] Open
Abstract
Rheumatoid arthritis (RA) is among the most prevalent chronic autoimmune and inflammatory diseases worldwide. The aim of this study was to establish a pooled estimate of the RA prevalence in South America by means of a meta-analysis of the available epidemiologic studies. Systematic searches in PubMed, Lilacs, SciELO, Scopus, and Web of Science databases (updated May 2019) were done followed by a systematic grey literature search to identify original research articles and reports, published after 2000, providing data of RA prevalence in any South American country. Proportion meta-analysis of weighted pooled was performed, with between-trial heterogeneity assessed by the inconsistency relative index. Sensitivity analyses and sub-group analyses were also done. A total of 25 articles, representing 27 population-based studies were included. Pooled prevalence of RA resulted in 0.48% with 591,981 cases in a population of 114,537,812 individuals (I2=99%). Brazil and Colombia presented the lowest rates of RA prevalence 0.22%, and 0.24%, respectively. RA prevalence in indigenous population was higher 1.45%, and studies using COPCORD method reported also the highest rates 1.07%.
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Affiliation(s)
- Jaqueline L Germano
- Secretaria de Estado da Saúde do Paraná. R. Piquiri 170, Rebouças. 80230-140 Curitiba PR Brasil. .,Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Paraná (UFPR). Curitiba PR Brasil
| | - Joana Reis-Pardal
- Departamento de Farmácia, Hospital de Sant'Ana, Santa Casa da Misericórdia de Lisboa. Parede Portugal
| | - Fernanda S Tonin
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Paraná (UFPR). Curitiba PR Brasil
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3
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Quintana R, Fernández S, Orzuza SM, Silvestre AMR, Bensi A, Goñi M, Iglesias P, Mathern N, García-Bianco V, Honeri A, Pons-Estel BA, Valdata M, Peláez-Ballestas I. «Living with rheumatoid arthritis» in an indigenous qom population in Argentina. A qualitative study. ACTA ACUST UNITED AC 2021; 17:543-548. [PMID: 34756317 DOI: 10.1016/j.reumae.2020.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/22/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is a chronic disease which impacts patients' quality of life. The prevalence of RA in the qom population was 2.4% and represented an aggressive and disabling disease. The study goal was to describe the experience of the indigenous qom community individual suffering from RA, along with their experience with the local health care system in the city of Rosario, Santa Fe, Argentina. METHODS Qualitative Study using techniques of participant observation and semi-structured interviews; following a guideline developed by a multidisciplinary research group comprising anthropologists, rheumatologists, nurses, and psychologists. A triangulation strategy was implemented for the analysis. RESULTS A total of 33 interviews were conducted in 29 individuals with RA. The results showed a "normalization" of their symptoms and of their limitations in performing daily tasks. The individuals' relationship with the local health care system was complex and limited in several aspects (e.g. access to health care, continuity of treatment, complexity of medical care pathway and lack of cultural competence). CONCLUSIONS RA is a disease that has a negative impact on the daily lives of the qom people living in Rosario. Improving the relationship between this population and the local health care system as well as the implementation of multidisciplinary work should be priorities.
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Affiliation(s)
- Rosana Quintana
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina.
| | - Sofía Fernández
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Stella M Orzuza
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Adriana M R Silvestre
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
| | - Ana Bensi
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Mario Goñi
- Centro de Especialidades Médicas Ambulatorias de Rosario, Secretaría de Salud Pública, Municipalidad de Rosario, Argentina
| | - Paola Iglesias
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Nora Mathern
- Instituto de Reumatología, Ortopedia y Fisiatría, Rosario, Argentina
| | - Vanina García-Bianco
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
| | - Andrés Honeri
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Bernardo A Pons-Estel
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
| | - Marcela Valdata
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
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Radu AF, Bungau SG. Management of Rheumatoid Arthritis: An Overview. Cells 2021; 10:2857. [PMID: 34831081 PMCID: PMC8616326 DOI: 10.3390/cells10112857] [Citation(s) in RCA: 238] [Impact Index Per Article: 79.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/16/2021] [Accepted: 10/22/2021] [Indexed: 02/06/2023] Open
Abstract
Rheumatoid arthritis (RA) is a multifactorial autoimmune disease of unknown etiology, primarily affecting the joints, then extra-articular manifestations can occur. Due to its complexity, which is based on an incompletely elucidated pathophysiological mechanism, good RA management requires a multidisciplinary approach. The clinical status of RA patients has improved in recent years due to medical advances in diagnosis and treatment, that have made it possible to reduce disease activity and prevent systemic complications. The most promising results were obtained by developing disease-modifying anti-rheumatic drugs (DMARDs), the class to which conventional synthetic, biologic, and targeted synthetic drugs belong. Furthermore, ongoing drug development has led to obtaining molecules with improved efficacy and safety profiles, but further research is needed until RA turns into a curable pathology. In the present work, we offer a comprehensive perspective on the management of RA, by centralizing the existing data provided by significant literature, emphasizing the importance of an early and accurate diagnosis associated with optimal personalized treatment in order to achieve better outcomes for RA patients. In addition, this study suggests future research perspectives in the treatment of RA that could lead to higher efficacy and safety profiles and lower financial costs.
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Affiliation(s)
- Andrei-Flavius Radu
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania
| | - Simona Gabriela Bungau
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
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Isnardi CA, Capelusnik D, Schneeberger EE, Bazzarelli M, Berloco L, Blanco E, Benítez CA, Luján Benavidez F, Scarafia S, Lázaro MA, Pérez Alamino R, Colombres F, Kohan MP, Sosa J, Gonzalez Lucero L, Barbaglia AL, Maldonado Ficco H, Citera G. Depression Is a Major Determinant of Functional Capacity in Rheumatoid Arthritis. J Clin Rheumatol 2021; 27:S180-S185. [PMID: 32732521 DOI: 10.1097/rhu.0000000000001506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE 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. METHODS We performed a cross-sectional study of consecutive adults with RA. Sociodemographic data, comorbidities, RA disease activity, and current treatment were assessed. The following instruments were used to evaluate quality of life (EQ-5D-3 L [EURO Quality 5-dimension 3 lines], QOL-RA [Quality of Life-Rheumatoid Arthritis]), functional capacity (HAQ-A [Health Assessment Questionnaire-Argentinean version]), and depression (PHQ-9 [Patient Health Questionnaire 9]; scores 5-9: mild, 10-14: moderate, 15-19: moderate-severe, and ≥20: severe depression, a cutoff value ≥10 is diagnostic of major depression). RESULTS Two hundred fifty-eight patients were included, with a median disease duration of 9 years (interquartile range, 3.6-16.7 years). The m PHQ-9 score was 6 (interquartile range, 2-12.3 years). The prevalence of major depression was 33.8%. The frequency of mild, moderate, moderate/severe, and severe depression was 66 (25.6%), 42 (16.3%), 27 (10.5%), and 18 (7%), respectively. Patients with major depression had worse functional capacity (HAQ-A: mean ± SD, 1.6 ± 0.8 vs. 0.7 ± 0.7; p < 0.0001), poorer quality of life (QOL-RA: mean ± SD, 5.4 ± 1.8 vs. 7.3 ± 1.6; p < 0.0001), greater pain (visual analog scale: mean ± SD, 56.2 ± 27.5 mm vs. 33.4 ± 25.7 mm; p < 0.0001), higher disease activity (Disease Activity Score in 28 joints: mean ± SD, 4.3 ± 1.4 vs. 3.3 ± 1.3; p < 0.0001), higher frequency of comorbidities (67% vs. 33%; p = 0.017), and lower frequency of physical activity (22% vs. 35%; p = 0.032). In the multivariate analysis, patients with moderate and severe depression had worse functional capacity (odds ratio, 2.1; 95% confidence interval, 1.6-4.3; p < 0.0001) and quality of life (odds ratio, 0.7; 95% confidence interval, 0.5-0.8; p < 0.0001), independently of disease activity. CONCLUSIONS A third of RA patients in this Argentinean cohort had major depression. In those patients, depression was associated with worst functional capacity and quality of life.
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Affiliation(s)
- Carolina A Isnardi
- From the Section of Rheumatology, Instituto de Rehabilitación Psicofísica, Ciudad Autónoma de Buenos Aires
| | - Dafne Capelusnik
- From the Section of Rheumatology, Instituto de Rehabilitación Psicofísica, Ciudad Autónoma de Buenos Aires
| | - Emilce Edith Schneeberger
- From the Section of Rheumatology, Instituto de Rehabilitación Psicofísica, Ciudad Autónoma de Buenos Aires
| | - Marcela Bazzarelli
- Section of Rheumatology, Hospital Interzonal General de Agudos Petrona V. de Cordero
| | - Laura Berloco
- Section of Rheumatology, Hospital Interzonal General de Agudos Petrona V. de Cordero
| | - Eliana Blanco
- Section of Rheumatology, Hospital General de Agudos Dr. Cosme Argerich, Ciudad Autónoma de Buenos Aires
| | - Cristian A Benítez
- Section of Rheumatology, Hospital General de Agudos Dr. Cosme Argerich, Ciudad Autónoma de Buenos Aires
| | - Federico Luján Benavidez
- Section of Rheumatology, Hospital General de Agudos Dr. Cosme Argerich, Ciudad Autónoma de Buenos Aires
| | | | - María A Lázaro
- Instituto de Asistencia Reumatológica Integral, Buenos Aires
| | | | | | - María P Kohan
- Section of Rheumatology, Hospital General de Agudos Dr. Enrique Tornú, Ciudad Autónoma de Buenos Aires, Buenos Aires
| | - Julia Sosa
- Section of Rheumatology, Hospital General de Agudos Dr. Enrique Tornú, Ciudad Autónoma de Buenos Aires, Buenos Aires
| | | | | | | | - Gustavo Citera
- From the Section of Rheumatology, Instituto de Rehabilitación Psicofísica, Ciudad Autónoma de Buenos Aires
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Pierini FS, Brom M, Scolnik M, Scaglioni V, Rosa JE, Soriano ER. Osteoporotic fractures in rheumatoid arthritis patients in Argentina: a matched retrospective cohort study. Adv Rheumatol 2021; 61:21. [PMID: 33827708 DOI: 10.1186/s42358-021-00179-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 03/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare the incidence of osteoporotic fractures in patients with rheumatoid arthritis (RA) with matched controls from a university hospital. METHODS Consecutive RA patients (n = 100) were matched (age and sex) with controls (1:2). The follow-up period began at the index date, defined as the date of diagnosis for RA patients and the date of the first medical claim at the Health Management Organization (HMO) for non-RA patients. Fracture incidence rates per 1000 persons-years (PY) for distinct types of fractures were calculated. Multivariate cox regression analysis was performed to identify factors associated with fractures. RESULTS One hundred RA patients were followed for a total of 975.1 patients-years and 200 controls for 1485.7 patients-years. No difference was found in the overall fracture incidence rate per 1000 PY between RA and controls (19.5, 95% CI 12.7-28.6 vs 12.1, 95% CI 7.7-18.7, p = 0.07). In the Cox regression analysis, only age (HR 1.06, 95% CI 1.02-1.11, p = 0.006) and history of a prior fracture (HR 9.85, 95% CI 2.97-32.64, p < 0.001) were associated with fractures after the index date. The stratified analysis of the fractures by location showed that only the vertebral fractures were more frequent in RA patients compared with controls (12.9 per 1000 PY, 95% CI 8.9-25.8, vs. 3.4, 95% CI 1.4-8.1, respectively, p = 0.01). CONCLUSION Patients with RA didn't show an overall increased risk of osteoporotic fractures compared with matched controls, but vertebral fractures were more frequently observed in patients with RA.
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Affiliation(s)
- Florencia S Pierini
- Rheumatology Unit, Internal Medicine Department, Hospital Italiano de Buenos Aires, Perón 4190, 1181, Buenos Aires, Argentina.
| | - Martin Brom
- Rheumatology Unit, Internal Medicine Department, Hospital Italiano de Buenos Aires, Perón 4190, 1181, Buenos Aires, Argentina
| | - Marina Scolnik
- Rheumatology Unit, Internal Medicine Department, Hospital Italiano de Buenos Aires, Perón 4190, 1181, Buenos Aires, Argentina
| | - Valeria Scaglioni
- Rheumatology Unit, Internal Medicine Department, Hospital Italiano de Buenos Aires, Perón 4190, 1181, Buenos Aires, Argentina
| | - Javier E Rosa
- Rheumatology Unit, Internal Medicine Department, Hospital Italiano de Buenos Aires, Perón 4190, 1181, Buenos Aires, Argentina
| | - Enrique R Soriano
- Rheumatology Unit, Internal Medicine Department, Hospital Italiano de Buenos Aires, Perón 4190, 1181, Buenos Aires, Argentina
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Castillo-Cañón JC, Trujillo-Cáceres SJ, Bautista-Molano W, Valbuena-García AM, Fernández-Ávila DG, Acuña-Merchán L. Rheumatoid arthritis in Colombia: a clinical profile and prevalence from a national registry. Clin Rheumatol 2021; 40:3565-3573. [PMID: 33772350 DOI: 10.1007/s10067-021-05710-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/24/2021] [Accepted: 03/21/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND There is a need to describe the demographic and clinical characteristics of people diagnosed with rheumatoid arthritis who are attended within the Colombian health system. This characterization allows prioritizing populations with specific risks, programming the use of health services, and planning the costs necessary to guarantee equitable care. OBJECTIVE To assess the demographic and clinical characteristics of a cohort of patients with rheumatoid arthritis using national data collected by the High-Cost Disease Fund (CAC in Spanish). METHODS A cross-sectional study from a secondary source. Data was gathered from a national administrative registry. A descriptive analysis was performed on sociodemographic and clinical characteristics. Age-standardized prevalence was estimated at national level and by geographical regions. Remission rates were also estimated for Colombian departments and regions. RESULTS By 2019, 81,386 patients with rheumatoid arthritis were reported in Colombia. The relation female-male was 5.2:1. The median age was 59 years (IQR: 50-67). Prevalence was higher in people aged 50-69 years. The most frequent comorbidities were high blood pressure (31.15%) and osteoporosis (19.46%). Age-standardized prevalence of rheumatoid arthritis was 0.24 per 100 population (95% CI: 0.23-0.24). In cases with complete information, 57.57% of departments had remission rates up to 30%. CONCLUSION Rheumatoid arthritis in Colombia was more frequent in females aged ≥50 year. Age-standardized prevalence was lower than reported by other studies performed in Colombia but similar to the estimated internationally for the country. Key Points • More than 80,000 rheumatoid arthritis patients were reported to this national registry in Colombia in 2019, finding an age-standardized prevalence of 0.24 per 100 population. • Hypertension was the most common comorbidity reported in people with rheumatoid arthritis. This finding is similar to the reports by similar studies such as the COMORA. • A major strength of this study is the large sample size since data come from a nationwide registry of people with rheumatoid arthritis, supported by the National Ministry of Health. Additionally, this registry has a rigorous data monitoring process that guarantees the internal validity of data and provides valuable information for decision-making based on local evidence. • Prevalence of rheumatoid arthritis was higher in females between 50 and 65 years. Age-standardized prevalence was lower than previously reported in Colombia, but similar to the world estimations.
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Affiliation(s)
| | | | - Wilson Bautista-Molano
- University Hospital Fundación Santa Fe de Bogotá, Universidad El Bosque, Bogotá D.C., Colombia
| | | | - Daniel G Fernández-Ávila
- Rheumatology Unit, Department of Internal Medicine, Hospital Universitario San Ignacio-School of Medicine, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
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Castro-Santos P, Olloquequi J, Verdugo RA, Gutiérrez MA, Pinochet C, Quiñones LA, Díaz-Peña R. HLA-DRB1*07:01 and * 08:02 Alleles Confer a Protective Effect Against ACPA-Positive Rheumatoid Arthritis in a Latin American Admixed Population. BIOLOGY 2020; 9:biology9120467. [PMID: 33327594 PMCID: PMC7765073 DOI: 10.3390/biology9120467] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 06/12/2023]
Abstract
HLA-DRB1 shared epitope (SE) alleles are important genetic contributors for the risk of developing anti-citrullinated protein antibodies (ACPA)-positive rheumatoid arthritis (RA), particularly in Caucasians. We aimed to analyze the contribution of HLA-DRB1 alleles and single nucleotide polymorphisms (SNPs) within the major histocompatibility complex (MHC) region to the susceptibility to develop ACPA-positive RA in a Latin American (LA) population with admixed ancestry. A total of 289 ACPA-positive RA patients and 510 controls were enrolled in this study. The presence of HLA-DRB1*04:01, *09:01 and *10:01 was increased in ACPA-positive RA patients compared with healthy controls (p < 0.0001, p < 0.001 and p < 0.01, respectively), whereas DRB1*07:01 and *08:02 was associated with a decreased risk of ACPA-positive RA (p < 0.001 and p < 0.01, respectively). These results showed a strong correlation with estimates from studies in Asians but not in Caucasian populations. The present study describes the protective effects of the HLA-DRB1*07:01 and *08:02 alleles in ACPA-positive RA patients in a LA population for the first time. Identifying relationships between HLA-DRB1 alleles and RA is important for identifying disease associations in different ethnic groups in order to reach a better understanding of RA worldwide.
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Affiliation(s)
- Patricia Castro-Santos
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3460000, Chile; (P.C.-S.); (J.O.)
- Inmunología, Centro de Investigaciones Biomédicas (CINBIO), Universidad de Vigo, 36310 Vigo, Spain
| | - Jordi Olloquequi
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3460000, Chile; (P.C.-S.); (J.O.)
| | - Ricardo A. Verdugo
- Programa de Genética Humana, ICBM, Facultad de Medicina, Universidad de Chile, Santiago 8389100, Chile;
- Departamento de Oncología Básico-Clínico, Facultad de Medicina, Universidad de Chile, Santiago 8389100, Chile
| | - Miguel A. Gutiérrez
- Rheumatology, Almirante Nef Naval Hospital, Viña del Mar, Valparaíso 2340000, Chile;
- School of Medicine, Valparaíso University, Valparaíso 2340000, Chile
| | | | - Luis A. Quiñones
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology, Faculty of Medicine, University of Chile, Santiago 8320000, Chile
- Latin American Network for Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), 28015 Madrid, Spain
| | - Roberto Díaz-Peña
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3460000, Chile; (P.C.-S.); (J.O.)
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Abstract
Rheumatoid arthritis (RA) prevalence is believed to be around 1% worldwide, although it varies considerably among different populations. The aim of EPISER2016 study was to estimate the prevalence of RA in the general adult population in Spain. We designed a population-based cross-sectional study. A national survey was conducted between November 2016 and October 2017 involving a probabilistic sample from the general population aged 20 years or older. Subjects were randomly selected for phone screening using a computer-assisted telephone interviewer system. Positive RA screening results were evaluated by a rheumatologist. Cases fulfilled the 1987 ACR and/or the 2010 ACR/EULAR criteria; previous diagnosis established by a rheumatologist and clearly identified in medical records were also accepted regardless of the criteria used. Prevalence estimates with 95% CI were calculated taking into account the design of the sample (weighting based on age, sex, and geographic origin using as a reference the distribution of the population in Spain). 4916 subjects participated in the study and 39 RA cases were confirmed. RA estimated prevalence was 0.82% (95% CI 0.59–1.15). Mean age of RA cases was 60.48 (14.85) years, they were more frequently women (61.5%), from urban areas (74.4%), non-smokers (43.6%), and with a high body mass index (53.8% with overweight). Extrapolating to the population in Spain (approximately 37 million are ≥ 20 years old), it was estimated that there were between 220,000 and 430,000 people aged 20 years or older with RA. No undiagnosed cases were detected, which could be related to the establishment of early arthritis clinics around the country, increasing the rates of diagnosis during early phases of RA.
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Latin American Genes: The Great Forgotten in Rheumatoid Arthritis. J Pers Med 2020; 10:jpm10040196. [PMID: 33114702 PMCID: PMC7711650 DOI: 10.3390/jpm10040196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/19/2020] [Accepted: 10/24/2020] [Indexed: 11/28/2022] Open
Abstract
The successful implementation of personalized medicine will rely on the integration of information obtained at the level of populations with the specific biological, genetic, and clinical characteristics of an individual. However, because genome-wide association studies tend to focus on populations of European descent, there is a wide gap to bridge between Caucasian and non-Caucasian populations before personalized medicine can be fully implemented, and rheumatoid arthritis (RA) is not an exception. In this review, we discuss advances in our understanding of genetic determinants of RA risk among global populations, with a focus on the Latin American population. Geographically restricted genetic diversity may have important implications for health and disease that will remain unknown until genetic association studies have been extended to include Latin American and other currently under-represented ancestries. The next few years will witness many breakthroughs in personalized medicine, including applications for common diseases and risk stratification instruments for targeted prevention/intervention strategies. Not all of these applications may be extrapolated from the Caucasian experience to Latin American or other under-represented populations.
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Durán J, Massardo L, Llanos C, Iacobelli S, Burgos PI, Cisternas M, Iruretagoyena M, Armstrong M, Aguilera R, Radrigán F, Martinez ME, Passi-Solar A, Riedemann P, Crisóstomo N, Cifuentes C, Hagedorn L, Cisternas A, Vasquez N, Margozzini P. The Prevalence of Rheumatoid Arthritis in Chile: A Nationwide Study Performed as Part of the National Health Survey. J Rheumatol 2020; 47:951-958. [PMID: 31474598 DOI: 10.3899/jrheum.190396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Genetic and environmental backgrounds influence the development of rheumatoid arthritis (RA). In Latin America, epidemiologic data are scarce. We aimed to determine the prevalence of RA in Chile in a population-based study. METHODS The National Health Survey was a cross-sectional household survey with a stratified multistage probability sample of 6233 participants performed between August 2016 and March 2017. A screening instrument for RA was applied to a random sample of 3847 subjects > 30 years old. Positive screening was defined by at least 1 of the following: 2 swollen joints for at least 4 consecutive weeks (past/present), and/or a diagnosis of arthritis in the past. Individuals with positive screening had rheumatoid factor, anticitrullinated protein antibodies, and C-reactive protein measured, as well as clinical examination performed by a rheumatologist. Self-report of doctor-diagnosed RA was also performed. RESULTS The screening questionnaire was applied to 2998 subjects. A positive screening was found for 783 (22.1%). Among subjects with positive screening, 493 (66%) had a clinical evaluation performed by a rheumatologist. Using the American College of Rheumatology/European League Against Rheumatism 2010 classification criteria, prevalence was 0.6% (95% CI 0.3-1.2). Prevalence was higher in women, and 3.3% of subjects self-reported having RA. CONCLUSION According to this national population-based study, RA prevalence in Chile is 0.6% (0.3-1.2), a value similar to what has been found in developed countries and slightly lower than some Latin American countries. Self-reporting leads to overestimating RA.
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Quintana R, Fernández S, Orzuza SM, Silvestre AMR, Bensi A, Goñi M, Iglesias P, Mathern N, García-Bianco V, Honeri A, Pons-Estel BA, Valdata M, Peláez-Ballestas I. «Living with Rheumatoid Arthritis» in an Indigenous Qom Population in Argentina. A Qualitative Study. REUMATOLOGIA CLINICA 2020; 17:S1699-258X(20)30112-1. [PMID: 32600980 DOI: 10.1016/j.reuma.2020.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/13/2020] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is a chronic disease which impacts patients' quality of life. The prevalence of RA in the qom population was 2.4% and represented an aggressive and disabling disease. The study goal was to describe the experience of the indigenous qom community individual suffering from RA, along with their experience with the local health care system in the city of Rosario, Santa Fe, Argentina. METHODS Qualitative Study using techniques of participant observation and semi-structured interviews; following a guideline developed by a multidisciplinary research group comprising anthropologists, rheumatologists, nurses, and psychologists. A triangulation strategy was implemented for the analysis. RESULTS A total of 33 interviews were conducted in 29 individuals with RA. The results showed a «normalization» of their symptoms and of their limitations in performing daily tasks. The individual relationships with the local health care system was complex and limited in several aspects (e.g. access to health care, continuity of treatment, complexity of medical care pathway and lack of cultural competence). CONCLUSIONS RA is a disease that has a negative impact on the daily lives of the qom people living in Rosario. Improving the relationship between this population and the local health care system as well as the implementation of multidisciplinary work should be priorities.
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Affiliation(s)
- Rosana Quintana
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina.
| | - Sofía Fernández
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Stella M Orzuza
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Adriana M R Silvestre
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
| | - Ana Bensi
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Mario Goñi
- Centro de Especialidades Médicas Ambulatorias de Rosario, Secretaría de Salud Pública, Municipalidad de Rosario, Argentina
| | - Paola Iglesias
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Nora Mathern
- Instituto de Reumatología, Ortopedia y Fisiatría, Rosario, Argentina
| | - Vanina García-Bianco
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
| | - Andrés Honeri
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
| | - Bernardo A Pons-Estel
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
| | - Marcela Valdata
- Centro de Estudios Aplicados a Problemáticas Socio-culturales (CEAPROS), Facultad de Humanidades y Artes, Universidad Nacional de Rosario, Argentina
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Prevalence of chronic pain with or without neuropathic characteristics in France using the capture–recapture method: a population-based study. Pain 2018; 159:2394-2402. [DOI: 10.1097/j.pain.0000000000001347] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pharmacogenomics of etanercept, infliximab, adalimumab and methotrexate in rheumatoid arthritis. A structured review. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.rcreue.2018.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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15
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Tundia N, Kotze PG, Rojas Serrano J, Mendes de Abreu M, Skup M, Macaulay D, Signorovitch J, Chaves L, Chao J, Bao Y. Economic impact of expanded use of biologic therapy for the treatment of rheumatoid arthritis and Crohn's disease in Argentina, Brazil, Colombia, and Mexico. J Med Econ 2016; 19:1187-1199. [PMID: 27376404 DOI: 10.1080/13696998.2016.1209508] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To estimate economic impact resulting from increased biologics use for treatment of rheumatoid arthritis (RA) and Crohn's disease (CD) in Argentina, Brazil, Colombia, and Mexico. METHODS The influence of increasing biologics use for treatment of RA during 2012-2022 and for treatment of CD during 2013-2023 was modeled from a societal perspective. The economic model incorporated current and projected medical, indirect, and drug costs and epidemiologic and economic factors. Costs associated with expanded biologics use for RA were compared with non-expanded use in Argentina, Brazil, Colombia, and Mexico. A similar analysis was conducted for CD in Brazil, Colombia, and Mexico. RESULTS Accounting for additional costs of biologics and medical and indirect cost offsets, the model predicts that expanded use of biologics for patients with RA from 2012 to 2022 will result in cumulative net cost savings of ARS$2.351 billion in Argentina, R$9.004 billion in Brazil, COP$728.577 billion in Colombia, and MXN$18.02 billion in Mexico; expanded use of biologics for patients with CD from 2013 to 2023 will result in cumulative net cost savings for patients with CD of R$0.082 billion in Brazil, COP$502.74 billion in Colombia, and MXN$1.80 billion in Mexico. Indirect cost offsets associated with expanded biologics use were a key driver in reducing annual per-patient net costs for RA and CD. LIMITATIONS Future economic projections are limited by the potential variance between projected and actual future values of biologic prices, wages, medical costs, and gross national product for each country. CONCLUSIONS Increasing biologics use to treat RA and CD may limit cost growth over time by reducing medical and indirect costs. These findings may inform policy decisions regarding biologics use in Argentina, Brazil, Colombia, and Mexico.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Yanjun Bao
- a AbbVie Inc. , North Chicago , IL , USA
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SCUBLINSKY DARIO, GONZALEZ CLAUDIOD. Quantifying Disease in Challenging Conditions: Incidence and Prevalence of Rheumatoid Arthritis. J Rheumatol 2016; 43:1263-4. [DOI: 10.3899/jrheum.160522] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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17
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Di WT, Vergara F, Bertiller E, Gallardo MDLA, Gandino I, Scolnik M, Martinez MJ, Schpilberg MG, Rosa J, Soriano ER. Incidence and Prevalence of Rheumatoid Arthritis in a Health Management Organization in Argentina: A 15-year Study. J Rheumatol 2016; 43:1306-11. [DOI: 10.3899/jrheum.151262] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2016] [Indexed: 11/22/2022]
Abstract
Objective.To estimate incidence and prevalence rates of rheumatoid arthritis (RA) in the city of Buenos Aires (CABA), Argentina, using data from a university hospital–based health management organization.Methods.Global, age-specific, and sex-specific incidence and prevalence rates were calculated for members of the Hospital Italiano Medical Care Program (HIMCP), age ≥ 18 years. Incidence study followed members with continuous affiliation ≥ 1 year from January 2000 to January 2015 until he/she voluntarily left the HIMCP, RA was diagnosed, death, or study finalization. Cases from the Rheumatology Section database, electronic medical records, laboratory database, and pharmacy database were filtered with the 2010 American College of Rheumatology/European League Against Rheumatism criteria. Prevalence was calculated on January 1, 2015, and standardized for CABA. Capture-recapture (C-RC) analysis estimated true population sizes.Results.In the study period, incidence rates (cases per 100,000 person-yrs) were 18.5 (95% CI 16.7–20.4) overall, 25.2 (95% CI 22.4–28.0) for women, and 8.8 (95% CI 6.8–10.8) for men. Prevalence rates (percentage of RA cases in the sample population) were 0.329 (95% CI 0.298–0.359) overall, 0.464 (95% CI 0.417–0.510) for women, and 0.123 (95% CI 0.093–0.152) for men. Standardized CABA prevalence rate was 0.300 (95% CI 0.292–0.307). C-RC adjusted rates were almost the same as unadjusted rates.Conclusion.This study’s incidence and prevalence rates are in the lower range of the rates found around the world. Our female to male prevalence ratio was 4:1. Our peak incidence age was in the sixth and seventh decades for both sexes.
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Quintana R, Silvestre AMR, Goñi M, García V, Mathern N, Jorfen M, Miljevic J, Dhair D, Laithe M, Conti S, Midauar F, Martin MC, Barrios MC, Nieto R, Prigione C, Sanabria A, Gervasoni V, Grabbe E, Gontero R, Peláez-Ballestas I, Pons-Estel BA. Prevalence of musculoskeletal disorders and rheumatic diseases in the indigenous Qom population of Rosario, Argentina. Clin Rheumatol 2016; 35 Suppl 1:5-14. [PMID: 26852314 PMCID: PMC4954830 DOI: 10.1007/s10067-016-3192-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 12/17/2015] [Accepted: 01/23/2016] [Indexed: 12/29/2022]
Abstract
This study aimed to estimate the prevalence of musculoskeletal disorders and rheumatic diseases among the indigenous Qom (Toba) population in the city of Rosario, Santa Fe, Argentina. An analytical cross-sectional study using methodology of the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) was performed. Subjects ≥18 years of age were interviewed by advanced students of medicine and nursing, bilingual translator-facilitators, and coordinators. Individuals with musculoskeletal pain (positive cases) were evaluated sequentially for 7 days by internists and rheumatologists for diagnosis and treatment. The study included 1656 individuals (77 % of the census population). Of these, 1020 (61.5 %) were female, with mean age of 35.3 (SD 13.9) years, and 1028 (62.0 %) were bilingual. The public health care system covers 87.1 % of the population. Musculoskeletal pain in the previous 7 days and/or at some time during their life was present in 890 subjects (53.7 %). Of those with pain in the last 7 days, 302 (64.1 %) subjects had an Health Assessment Questionnaire Disability Index (HAQ-DI) score ≥0.8. The most frequent pain sites were lumbar spine (19.3 %), knees (13.0 %), and hands (12.0 %). The prevalence of rheumatic diseases was as follows: mechanical back pain (20.1 %), rheumatic regional pain syndrome (2.9 %), osteoarthritis (4.0 %) rheumatoid arthritis (2.4 %), inflammatory back pain (0.2 %), systemic sclerosis (0.1 %), Sjögren syndrome (0.1 %), fibromyalgia (0.1 %), mixed connective tissue disease (0.06 %), and systemic lupus erythematosus (0.06 %). The prevalence of musculoskeletal disorders was 53.7 % and rheumatic diseases 29.6 %. Rheumatoid arthritis prevalence was 2.4 % using COPCORD methodology, one of the highest reported at present.
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Affiliation(s)
- Rosana Quintana
- Hospital Provincial de Rosario, Leandro N. Alem 1450, Rosario, Santa Fe, Argentina
| | | | - Mario Goñi
- Centro de Especialidades Médicas Ambulatorias de Rosario, Secretaría de Salud Pública, Municipalidad de Rosario, Santa Fe, Argentina
| | - Vanina García
- Ministerio de Salud, Gobierno de la Provincia de Santa Fe, Santa Fe, Argentina
| | - Nora Mathern
- Instituto de Reumatología, Ortopedia y Fisiatría, Rosario, Santa Fe, Argentina
| | - Marisa Jorfen
- Centro de Especialidades Médicas Ambulatorias de Rosario, Secretaría de Salud Pública, Municipalidad de Rosario, Santa Fe, Argentina
| | - Julio Miljevic
- Juan Bautista Alberdi Hospital, Rosario, Santa Fe, Argentina
| | - Daniel Dhair
- Juan Bautista Alberdi Hospital, Rosario, Santa Fe, Argentina
| | - Matias Laithe
- Juan Bautista Alberdi Hospital, Rosario, Santa Fe, Argentina
| | - Silvana Conti
- Hospital Provincial de Rosario, Leandro N. Alem 1450, Rosario, Santa Fe, Argentina
| | - Fadua Midauar
- Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Santa Fe, Argentina
| | - Maria Celeste Martin
- Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Santa Fe, Argentina
| | - Maria Cecilia Barrios
- Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Santa Fe, Argentina
| | - Romina Nieto
- Hospital Provincial de Rosario, Leandro N. Alem 1450, Rosario, Santa Fe, Argentina
| | - Cristina Prigione
- Hospital Provincial de Rosario, Leandro N. Alem 1450, Rosario, Santa Fe, Argentina
| | - Alvaro Sanabria
- Hospital Provincial de Rosario, Leandro N. Alem 1450, Rosario, Santa Fe, Argentina
| | - Viviana Gervasoni
- Hospital Provincial de Rosario, Leandro N. Alem 1450, Rosario, Santa Fe, Argentina
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Abstract
Rheumatoid arthritis (RA) is one of the most important rheumatic diseases. Its prevalence varies among ethnic groups. Genetic and environmental factors influence its incidence and prevalence. This chronic disease will increase its frequency in the future due to population aging. The personal impact of this disease on many relevant areas of an individual requires special efforts to prevent and treat it properly. Adequate advice on several recently described risk factors such as tobacco and alcohol exposure, infections, obesity, and physical exercise should be part of every medical consultation. This knowledge should be incorporated to improve health care prevention programs. Patients and clinicians must work together through better communication skills to finally improve outcomes. Including RA in priority health care lists will need special effort from rheumatology societies and better communication with policy makers.
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Affiliation(s)
- L A Ramírez
- Sección de Reumatología, Universidad de Antioquia, Medellín, Colombia
| | | | - M H Cardiel
- Centro de Investigación Clínica de Morelia, Virrey de Mendoza 1998-Int 522. Col, Félix Ireta, CP 58070, Morelia, Michoacán, Mexico.
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Bono AE, Learreta JA, Rodriguez G, Marcos JC. Stomatognathic system involvement in rheumatoid arthritis patients. Cranio 2014; 32:31-7. [PMID: 24660644 DOI: 10.1179/0886963413z.0000000003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
AIMS Temporomandibular joint (TMJ) and stomatognathic system involvement are usually observed during the course of rheumatoid arthritis. METHODOLOGY This article presents the findings during examination of 190 TMJs from rheumatoid arthritis (RA) patients, and 44 TMJs from controls without RA, including a description of signs and symptoms related to the stomatognathic system, radiological findings in hands-, and TMJ, erythrocyte sedimentation rate (ESR) values, and scores obtained in the Disease Activity Score (Das 28) and the Health Assessment Questionnaire (HAQ). RESULTS The sample included 57.89% TMJs associated with spontaneous pain, 87.89% with signs of destruction in radiological images, and 58.94% with 20 teeth or less. Restricted mouth opening was detected in 42.1% of RA patients, from which 71% had blocked opening; headache was present in 58%, and pain in the masticatory muscles was found in 57%. TMJ erosions had a significant association with Larsen scores (r=0.62), but not with the Das 28, HAQ, and ESR values. CONCLUSIONS The early evaluation of this joint and the collaborative work of odontologists and rheumatologists are both necessary for a better management of TMJ pathologies.
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Aranda F, Perés Wingeyer SD, Schneeberger E, Valerio M, Saint Martin E, Dal Pra F, Correa MDLÁ, Citera G, Martínez L, Mannucci P, Remondino G, de Larrañaga GF. The -308 G/A polymorphism in the tumor necrosis factor-α gene is not associated with development and progression of rheumatoid arthritis in Argentinean patients. Int J Rheum Dis 2014; 19:476-81. [PMID: 24673827 DOI: 10.1111/1756-185x.12343] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
AIM A polymorphism in the tumor necrosis factor-alpha (TNF-α) promoter region has been associated with disease susceptibility and progression in rheumatoid arthritis (RA). The presence of an adenosine (TNF2 allele) instead of a guanine (TNF1 allele) at position -308 may be responsible for a general increase in the transcriptional activity of the TNF-α gene. Our aim was to evaluate the association of the TNF2 allele with the risk of disease development and/or progression of RA in an Argentine population cohort. METHODS Two hundred and twenty-three consecutive patients with RA according to the 1987 criteria of the American College of Rheumatology were included in the study. Clinical variables, Disease Activity Score 28, Health Assessment Questionnaire and Rheumatoid Arthritis Quality of Life were recorded. The radiographic erosions were determined by the method of Sharp/van der Heijde. A group of 111 healthy subjects matched by sex and age was used as a control. All samples were genotyped for the -308 G/A TNF-α polymorphism. RESULTS No significant differences were observed either in the frequency of the TNF2 allele or in the genotypic distributions of the -308 G/A TNF-α polymorphism (P > 0.05) between the control group and the RA patients. No association was found between the TNF2 allele and the variables related to the course and outcome of the disease (P > 0.05). CONCLUSION In this cohort of Argentinean patients with RA, the TNF2 allele was neither associated with susceptibility to the disease nor was it associated with the variables related to the course and outcome of the disease.
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Affiliation(s)
- Federico Aranda
- Hemostasis and Thrombosis Laboratory, Hospital of Infectious Diseases "F. J. Muñiz", Buenos Aires, Argentina
| | - Silvia D Perés Wingeyer
- Hemostasis and Thrombosis Laboratory, Hospital of Infectious Diseases "F. J. Muñiz", Buenos Aires, Argentina
| | - Emilce Schneeberger
- Rheumatology Section, Instituto de Rehabilitación Psicofísica (IREP), Buenos Aires, Argentina
| | - María Valerio
- Rheumatology Section, Instituto de Rehabilitación Psicofísica (IREP), Buenos Aires, Argentina
| | - Emilia Saint Martin
- Rheumatology Section, Instituto de Rehabilitación Psicofísica (IREP), Buenos Aires, Argentina
| | - Fernando Dal Pra
- Rheumatology Section, Instituto de Rehabilitación Psicofísica (IREP), Buenos Aires, Argentina
| | | | - Gustavo Citera
- Rheumatology Section, Instituto de Rehabilitación Psicofísica (IREP), Buenos Aires, Argentina
| | - Liliana Martínez
- Department of Internal Medicine, Hospital General de Agudos Dr. J. A. Fernández, Buenos Aires, Argentina
| | - Pablo Mannucci
- Department of Internal Medicine, Hospital General de Agudos Dr. J. A. Fernández, Buenos Aires, Argentina
| | - Graciela Remondino
- Department of Internal Medicine, Hospital General de Agudos Dr. J. A. Fernández, Buenos Aires, Argentina
| | - Gabriela F de Larrañaga
- Hemostasis and Thrombosis Laboratory, Hospital of Infectious Diseases "F. J. Muñiz", Buenos Aires, Argentina
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Falfán-Valencia R, Camarena Á, Pineda CL, Montaño M, Juárez A, Buendía-Roldán I, Pérez-Rubio G, Reséndiz-Hernández JM, Páramo I, Vega A, Granados J, Zúñiga J, Selman M. Genetic susceptibility to multicase hypersensitivity pneumonitis is associated with the TNF-238 GG genotype of the promoter region and HLA-DRB1*04 bearing HLA haplotypes. Respir Med 2014; 108:211-7. [DOI: 10.1016/j.rmed.2013.11.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 10/12/2013] [Accepted: 11/07/2013] [Indexed: 01/30/2023]
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Hudson M, Avina-Zubieta A, Lacaille D, Bernatsky S, Lix L, Jean S. The validity of administrative data to identify hip fractures is high--a systematic review. J Clin Epidemiol 2013; 66:278-85. [PMID: 23347851 DOI: 10.1016/j.jclinepi.2012.10.004] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 09/08/2012] [Accepted: 10/18/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine the validity of the diagnostic algorithms for osteoporosis and fractures in administrative data. STUDY DESIGN AND SETTING A systematic search was conducted to identify studies that reported the validity of a diagnostic algorithm for osteoporosis and/or fractures using administrative data. RESULTS Twelve studies were reviewed. The validity of the diagnosis of osteoporosis in administrative data was fair when at least 3 years of data from hospital and physician visit claims were used (area under the receiver operating characteristic [ROC] curve [AUC]=0.70) or when pharmacy data were used (with or without the use of hospital and physician visit claims data, AUC>0.70). Nonetheless, the positive predictive values (PPVs) were low (<0.60). There was good evidence to support the use of hospital data to identify hip fractures (sensitivity: 69-97%; PPV: 63-96%) and the addition of physician claims diagnostic and procedural codes to hospitalization diagnostic codes improved these characteristics (sensitivity: 83-97%; PPV: 86-98%). Vertebral fractures were difficult to identify using administrative data. There was some evidence to support the use of administrative data to define other fractures that do not require hospitalization. CONCLUSIONS Administrative data can be used to identify hip fractures. Existing diagnostic algorithms to identify osteoporosis and vertebral fractures in administrative data are suboptimal.
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Affiliation(s)
- Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Room A-725, 3755 Cote Ste Catherine Road, Montreal, Quebec H3T 1E2, Canada.
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Burgos-Vargas R, Catoggio LJ, Galarza-Maldonado C, Ostojich K, Cardiel MH. Current therapies in rheumatoid arthritis: A Latin American perspective. ACTA ACUST UNITED AC 2013; 9:106-12. [DOI: 10.1016/j.reuma.2012.09.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 09/06/2012] [Accepted: 09/08/2012] [Indexed: 11/30/2022]
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de la Vega M, da Silveira de Carvalho HM, Ventura Ríos L, Goycochea Robles MV, Casado GC. The importance of rheumatology biologic registries in Latin America. Rheumatol Int 2012; 33:827-35. [DOI: 10.1007/s00296-012-2610-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 12/08/2012] [Indexed: 10/27/2022]
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Barragán-Martínez C, Amaya-Amaya J, Pineda-Tamayo R, Mantilla RD, Castellanos-de la Hoz J, Bernal-Macías S, Rojas-Villarraga A, Anaya JM. Gender Differences in Latin-American Patients With Rheumatoid Arthritis. ACTA ACUST UNITED AC 2012; 9:490-510.e5. [DOI: 10.1016/j.genm.2012.10.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 10/10/2012] [Accepted: 10/11/2012] [Indexed: 02/08/2023]
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Gifford AH, Matsuoka M, Ghoda LY, Homer RJ, Enelow RI. Chronic inflammation and lung fibrosis: pleotropic syndromes but limited distinct phenotypes. Mucosal Immunol 2012; 5:480-4. [PMID: 22806097 DOI: 10.1038/mi.2012.68] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Experimental models of lung fibrosis have been disappointing in predicting therapeutic responses to a wide variety of interventions in clinical fibrosing lung diseases. There are multiple potential reasons, but this fundamentally calls into question the validity of the models and their fidelity to clinical syndromes. We propose that the clinical diseases associated with pulmonary fibrosis, although manifesting a broad array of widely different clinical presentations and features, result in essentially two distinct phenotypes of fibrosis that we will describe. The most common and problematic of these are not effectively modeled experimentally. In this review, we present several clinical entities as examples of the phenotypic distinctions. The first two represent the extremes: postinflammatory fibrosis observed in hypersensitivity pneumonitis (HP) and dysregulated matrix deposition as observed in idiopathic pulmonary fibrosis (IPF). We also present a third clinical entity, that of lung disease associated with rheumatoid arthritis (rheumatoid lung), representing a condition that can manifest as either phenotype, and offering a potential opportunity to explore the mechanisms underlying the pathogenesis of the two distinct fibrotic phenotypes.
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Affiliation(s)
- A H Gifford
- Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
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Catay E, del Cid CC, Narváez L, Velozo EJ, Rosa JE, Catoggio LJ, Soriano ER. Cost of rheumatoid arthritis in a selected population from Argentina in the prebiologic therapy era. CLINICOECONOMICS AND OUTCOMES RESEARCH 2012; 4:219-25. [PMID: 22977308 PMCID: PMC3430441 DOI: 10.2147/ceor.s28845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The present study aimed to estimate the cost of rheumatoid arthritis and its components in a university hospital-based health management organization in Argentina, during the prebiologic era. METHODS A one-year (2002) observational prevalence, cost-of illness study of patients with rheumatoid arthritis from the societal perspective was performed in a hospital-based health management organization population. Direct medical costs were obtained using administrative databases. Direct nonmedical and indirect costs were obtained from a semistructured questionnaire. Indirect costs included work absenteeism, permanent work disability, and housework lost for housewives, using the human capital approach. Costs are expressed in 2002 US dollars per patient per year. RESULTS A total of 165 patients (84% females), of mean age 61 ± 15 years and with a mean disease duration of 8.5 ± 8.3 years were included. Mean total direct medical costs were US$1862 (95% confidence interval [CI] 828-2899). Mean direct nonmedical costs were US$222 (95% CI 149-294). Mean indirect costs were US$1008 (95% CI 606-1412). The annual mean total cost was US$3093 without biologics. Hospitalizations represented 73% of total direct medical costs while drugs and outpatient procedures represented 16% and 8% of total direct medical costs, respectively. Sixty percent of the total costs were related to direct medical costs, while indirect costs represented 33% of total costs. CONCLUSION In our population, annual mean total costs in the prebiologic therapy era were mainly driven by direct medical costs. Even without the use of biologic agents, rheumatoid arthritis represents an important burden for society in developing countries.
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Affiliation(s)
- Erika Catay
- Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, PM Catoggio Foundation, Buenos Aires, Argentina
| | - Cecilia Castel del Cid
- Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, PM Catoggio Foundation, Buenos Aires, Argentina
| | - Lorena Narváez
- Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, PM Catoggio Foundation, Buenos Aires, Argentina
| | - Edson J Velozo
- Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, PM Catoggio Foundation, Buenos Aires, Argentina
| | - Javier E Rosa
- Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, PM Catoggio Foundation, Buenos Aires, Argentina
- University Institute Hospital Italiano de Buenos Aires, School of Medicine, PM Catoggio Foundation, Buenos Aires, Argentina
| | - Luis J Catoggio
- Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, PM Catoggio Foundation, Buenos Aires, Argentina
- University Institute Hospital Italiano de Buenos Aires, School of Medicine, PM Catoggio Foundation, Buenos Aires, Argentina
| | - Enrique R Soriano
- Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, PM Catoggio Foundation, Buenos Aires, Argentina
- University Institute Hospital Italiano de Buenos Aires, School of Medicine, PM Catoggio Foundation, Buenos Aires, Argentina
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