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Bautista-Molano W, Ibatá L, Martínez S, Chacón A. Burden of Disease in Psoriatic Arthritis in Latin America: a Systematic Literature Review. Clin Rheumatol 2024; 43:677-693. [PMID: 38114817 DOI: 10.1007/s10067-023-06838-8] [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: 08/29/2023] [Revised: 11/02/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Psoriatic arthritis is a chronic inflammatory pathology that generates a substantial and progressive deterioration of functionality and quality of life. It is associated with comorbidities (cardiovascular and metabolic) and involvement of mental health. In Latin America, information regarding the disease is limited. This study reviews the burden of disease (disease activity, functional involvement, clinical manifestations, comorbidities, patient-reported outcomes, quality of life, and use of health resources) in PsA patients in Latin America. METHODS Systematic literature review of publications in PUBMED, EMBASE, Cochrane Database of Systematic Reviews-CDSR/Database of Abstracts of Reviews of Effects, LILACS, Scielo, Redalyc, conference abstracts, and grey literature. Two independent assessors selected studies and extracted information. Quality was assessed according to the type of study. RESULTS We identified 692 references, selecting 50 studies: 41 cross-sectional, four economic-studies, four cohort studies and one systematic review. The information comes mainly from Brazil, Argentina, and Mexico. The estimated disease prevalence for Latin America ranges from 0.004 to 0.08% (95% CI 0.02-0.20). Measurements with validated instruments suggest suboptimal assessment of disease domains, significant functional compromise, loss of productivity, and high frequency of comorbidities, including mental health. Methodological and population considerations limit the generalizability of the findings. CONCLUSIONS The available information reports a considerable burden of disease in patients with PsA in Latin America, with involvement of quality of life associated with disability in relation to disease activity and its various manifestations. Future research and funding efforts should be aimed at generating more standardized information about the impact of PsA in the region. Key Points •The functional involvement related to disease activity, the impact on the quality of life, and the frequency of cardiometabolic and psychological comorbidities are remarkable in Latin American patients with PsA. •The current synthesis offers an overview of the burden of disease (disease activity, functional involvement, clinical manifestations, comorbidities, patient-reported outcomes, quality of life, and use of health resources) in PsA patients in Latin America. •Future research efforts and clinical strategies are required in order to generate standardized data on the patients and better estimate the burden of disease in the region.
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Affiliation(s)
- Wilson Bautista-Molano
- Rheumatologist University Hospital Fundación Santa Fe de Bogotá, School of Medicine Universidad El Bosque, School of Medicine Universidad Militar Nueva Granada, Bogotá, Colombia.
| | - Linda Ibatá
- Epidemióloga, MPH, InValue Health Solutions, Bogotá, Colombia
| | - Susan Martínez
- Epidemióloga, MPH, InValue Health Solutions, Bogotá, Colombia
| | - Andrea Chacón
- Chemistry Pharmaceutical Epidemiologist, InValue Health Solutions, Bogotá, Colombia
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Jamal M, van Delft ETAM, den Braanker H, Kuijper TM, Hazes JMW, Lopes Barreto D, Weel AEAM. Increase in axial spondyloarthritis diagnoses after the introduction of the ASAS criteria: a systematic review. Rheumatol Int 2023; 43:639-649. [PMID: 36637486 DOI: 10.1007/s00296-022-05262-6] [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: 09/11/2022] [Accepted: 11/25/2022] [Indexed: 01/14/2023]
Abstract
To explore the proportion of axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) diagnoses within all newly referred patients visiting rheumatology outpatient clinics. And more specifically, to analyze whether there is an effect of the introduction of the ASAS and CASPAR classification criteria for axSpA and PsA. We systematically searched Embase, Medline Ovid, Cochrane Central and Web of Science from database inception to November 2022. Articles that investigated new onsets of axSpA and PsA in adults from rheumatology clinics were included. In total, 170 out of 7139 studies were found eligible for full-text review, after which 33 unique studies were included. Seventeen studies reported new onsets of axSpA, and 20 studies of PsA. The pooled proportion of axSpA within all newly referred patients was 19% (95% CI 15-23%) and 18% (95% CI 14-22%) for PsA. The proportion of axSpA before 2009 was 3% (95% CI 0-6%) and increased up to 21% (95% CI 14-28%) after 2009. For PsA, limited data were available in order to analyze the proportions of PsA before 2006. Overall, heterogeneity was high (I2 > 95%, p < 0.001) that was most likely caused by geographical area, study design, setting and use of different referral strategies. The pooled proportion of axSpA and PsA among patients referred to the rheumatology outpatient clinic was 19 and 18%, respectively. Although the proportion of diagnosed axSpA patients seemed to increase after the introduction of the ASAS criteria, due to the large heterogeneity our findings should be interpreted with caution.
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Affiliation(s)
- Maha Jamal
- Department of Rheumatology, Maasstad Hospital, Maasstadweg 21, 3079 DZ, Rotterdam, The Netherlands.
| | | | - Hannah den Braanker
- Department of Rheumatology, Maasstad Hospital, Maasstadweg 21, 3079 DZ, Rotterdam, The Netherlands
- Department of Rheumatology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | | | | | - Deirisa Lopes Barreto
- Department of Rheumatology, Maasstad Hospital, Maasstadweg 21, 3079 DZ, Rotterdam, The Netherlands
| | - Angelique Elisabeth Adriana Maria Weel
- Department of Rheumatology, Maasstad Hospital, Maasstadweg 21, 3079 DZ, Rotterdam, The Netherlands
- Department of Rheumatology, Erasmus Medical Centre, Rotterdam, The Netherlands
- Health Technology Assessment, Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
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Vega-Hinojosa O, Cardiel MH, Ochoa-Miranda P. Prevalencia de manifestaciones musculoesqueléticas y discapacidad asociada en una población peruana urbana habitante a gran altura. Estudio COPCORD. Estadio I. ACTA ACUST UNITED AC 2018; 14:278-284. [DOI: 10.1016/j.reuma.2017.01.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 12/09/2016] [Accepted: 01/26/2017] [Indexed: 11/27/2022]
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DiBonaventura M, de Carvalho AVE, Souza CDS, Squiassi HB, Ferreira CN. The association between psoriasis and health-related quality of life, work productivity, and healthcare resource use in Brazil. An Bras Dermatol 2018; 93:197-204. [PMID: 29723361 PMCID: PMC5916390 DOI: 10.1590/abd1806-4841.20186069] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 02/06/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Psoriasis is a chronic, immune mediated inflammatory condition that affects a significant amount of the global population. Yet geographic variability in the consequences of psoriasis warrants region-level analyses. OBJECTIVE The current study contributes to the psoriasis outcomes literature by offering a comprehensive assessment of the humanistic and economic burden in Brazil. METHODS The 2012 Brazil National Health and Wellness Survey (N=12,000) was used to assess health-related quality of life (Short Form-12, version 2), work productivity, and healthcare resource use associated with experiencing psoriasis vs. no psoriasis, along with varying levels of psoriasis severity. RESULTS A total of 210 respondents reported diagnosis of psoriasis (N=157, 42, and 11 reporting mild, moderate, and severe psoriasis, respectively). Compared with controls, respondents with psoriasis reported diminished mental component summary scores and health utilities, as well as increased presenteeism, activity impairment, and physician visits over the past six months, adjusting for covariates. Among those with psoriasis, physical health decreased as psoriasis severity increased. Although work productivity and healthcare resource utilization did not differ with psoriasis severity, the high rates of productivity loss (e.g. 45.5% presenteeism in the severe psoriasis group) suggest an economic burden. STUDY LIMITATIONS Cost analyses were not performed, and cross-sectional patient-reported data limit causal conclusions and may reflect reporting biases. CONCLUSIONS Nevertheless, these results suggest a significant burden to patients with psoriasis across both humanistic and economic outcomes. The association between psoriasis and mental health aspects and health utilities were particularly strong and exceeded what would be considered clinically meaningful.
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Affiliation(s)
| | - André Vicente Esteves de Carvalho
- Psoriasis Outpatient Clinic, Complexo Hospitalar Santa Casa de
Porto Alegre - Porto Alegre (RS), Brazil
- Medical Residency Program, Complexo Hospitalar Santa Casa de Porto
Alegre - Porto Alegre (RS), Brazil
| | - Cacilda da Silva Souza
- Department of Internal Medicine, Faculdade de Medicina de
Ribeirão Preto - Universidade de São Paulo (FMRP-USP) -
Ribeirão Preto (SP), Brazil
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Caturegli G, Caturegli P. Disease prevalence in a rural Andean population of central Peru: a focus on autoimmune and allergic diseases. AUTOIMMUNITY HIGHLIGHTS 2016; 7:3. [PMID: 26861900 PMCID: PMC4749512 DOI: 10.1007/s13317-016-0076-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 01/19/2016] [Indexed: 01/22/2023]
Abstract
Introduction
The hygiene hypothesis, formulated to explain the increased incidence of allergic and autoimmune diseases observed in industrialized countries, remains controversial. We reflected upon this hypothesis during a medical mission to rural and impoverished villages of central Peru. Materials and methods
The mission was carried out in July 2015 to aid three Andean villages located near Cusco, and comprised 10 American physicians, 4 nurses, and 24 students. After recording the vital signs, patients were triaged by nurses based on the major complaint, visited by physicians, and prescribed medications. Physicians wrote their notes on a one-page form and established diagnoses purely on clinical grounds, without laboratory or imaging testing. Physician notes were then analyzed retrospectively in a de-identified and double-blinded fashion. Results A total of 1075 patients (357 men and 718 women) were visited during 5 consecutive clinic days, 840 being adults and 235 <18 years of age. The most common complaints were back pain, stomach pain, headache, and vision loss. Osteoarthritis, gastritis, visual disturbances, and parasitic infections dominated the diagnostic categories. Thirty-seven patients (3 %) were diagnosed with an allergic or autoimmune disease, mainly represented by asthma, rheumatoid arthritis, and Hashimoto’s thyroiditis, a prevalence that was not significantly lower than that reported in industrialized countries. Conclusions Although a study of this nature cannot definitively support or refute the hygiene hypothesis, it does provide a novel snapshot of disease prevalence in rural Andean villages of central Peru. The study could serve as a basis to implement basic public health interventions and prepare for future missions to the same or comparable regions. Electronic supplementary material The online version of this article (doi:10.1007/s13317-016-0076-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Patrizio Caturegli
- Department of Pathology, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA.,Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA
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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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Ranza R, Carneiro S, Qureshi AA, Martins G, Rodrigues JJ, Romiti R, Barros TBM, Carneiro J, Sampaio AL, Grynszpan R, Markus J, Pinto RMC, Goldenstein-Schainberg C. Prevalence of Psoriatic Arthritis in a Large Cohort of Brazilian Patients with Psoriasis. J Rheumatol 2015; 42:829-34. [DOI: 10.3899/jrheum.140474] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2015] [Indexed: 02/08/2023]
Abstract
Objective.To determine the prevalence of psoriatic arthritis (PsA) in a large cohort of Brazilian patients with psoriasis (PsO) being seen at dermatology centers.Methods.A multicenter study was conducted in 4 university dermatology clinics. In each center, consecutive patients with confirmed diagnoses of PsO were evaluated by a rheumatologist. Individuals were classified as having PsA according to the ClASsification criteria for Psoriatic ARthritis (CASPAR). Laboratory tests and radiographs were performed, as needed, based on the clinical judgment of the rheumatologist.Results.A total of 524 patients with PsO were evaluated. The mean age was 48.5 ± 14.5 years, 50% were women, and the mean PsO duration was 15.4 ± 11.7 years. A diagnosis of PsA was documented in 175 patients (33%), of whom 49% were newly identified by the rheumatologist. Most individuals with PsA (72%) had peripheral involvement, 11% had isolated axial involvement, and 17% had both peripheral and axial involvement. Dactylitis occurred in 20% and clinical enthesitis in 30% of the patients. Laboratory and/or radiograph tests were necessary for a definitive diagnosis of PsA in 42 of 175 individuals (24%).Conclusion.In our study, one-third of Brazilian patients with PsO, followed in dermatology settings, were diagnosed with PsA by a rheumatologist. Almost half of subjects with PsA had no previous diagnosis. A collaboration between dermatologists and rheumatologists is greatly needed to establish earlier PsA diagnoses and adequate multidisciplinary management.
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Saad CGS, Gonçalves CR, Sampaio-Barros PD. Seronegative arthritis in Latin America: a current review. Curr Rheumatol Rep 2015; 16:438. [PMID: 25023724 DOI: 10.1007/s11926-014-0438-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In many Latin American countries seronegative arthritis, especially the spondyloarthritides (SpA), is commonly characterized by associated axial and peripheral involvement. In this article, the authors review the ethnic distribution of the population and the different SpA in 10 Latin American countries, and the main characteristics of the Ibero-American Registry of Spondyloarthropathies (RESPONDIA) compared with other international registries. The peripheral component of SpA is more frequent in mixed-race populations, whereas psoriatic arthritis is significantly more frequent in countries with predominantly white populations.
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Affiliation(s)
- Carla Gonçalves Schain Saad
- Disciplina de Reumatologia, Faculdade de Medicina, Universidade de São Paulo, Av. Dr Arnaldo, 455 - 3°. Andar - Cerqueira César, São Paulo, SP, Brasil, CEP: 01246-903
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Mease PJ, Gladman DD. Prologue: 2011 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). J Rheumatol Suppl 2012; 39:2181-3. [PMID: 23118282 DOI: 10.3899/jrheum.120818] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The 2011 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in July 2011 in Naples, Italy, and attended by rheumatologists, dermatologists, and representatives of biopharmaceutical companies and patient groups from around the world. The meeting began with a trainee symposium, where 25 rheumatology fellows and dermatology residents presented their original research work. Presentations and discussions by GRAPPA members during the remaining 2-day meeting included a 2-part discussion of the status of psoriatic disease biomarker research, summaries of the GRAPPA Composite Exercise and the GRAPPA video projects, a contribution from Italian members on their psoriasis and PsA projects, a lengthy discussion of research and collaborative initiatives from GRAPPA dermatologists, updates on ultrasound imaging in psoriatic disease and on plans to define inflammatory musculoskeletal disease, a presentation of the results of a small study of psoriasis and PsA in aboriginal people of Peru, and a review of global education and partnering opportunities. Introductions to these discussions are included in this prologue.
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Affiliation(s)
- Philip J Mease
- Swedish Medical Center and University of Washington, Seattle, Washington, USA.
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