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Isnardi CA, Soriano ER, Graf C, de la Vega MC, Pons-Estel BA, Roberts K, Quintana R, Gomez G, Yazdany J, Saurit V, Báez RM, Coello VVC, Pisoni CN, Berbotto G, Vivero F, Zelaya MD, Haye Salinas MJ, Reyes Torres ÁA, Ornella S, Nieto RE, Maldonado FN, Gamba MJ, Severina MDLÁ, Tissera Y, Alba P, Cogo AK, Alle G, Gobbi C, Baños A, Velozo E, Pera M, Tanten R, Albiero JA, Maldonado Ficco H, Martire MV, Elkin MSG, Cosatti M, Cusa MA, Pereira D, Savio VG, Pons-Estel GJ. Does the Use of Immunosuppressive Drugs Impact on SARS-CoV-2 Infection Outcome? Data From A National Cohort of Patients With Immune-Mediated Inflammatory Diseases (SAR-COVID Registry). J Clin Rheumatol 2023; 29:68-77. [PMID: 36454054 PMCID: PMC9940788 DOI: 10.1097/rhu.0000000000001903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
BACKGROUND/OBJECTIVE This study describes the impact of immunomodulatory and/or immunosuppressive (IM/IS) drugs in the outcomes of COVID-19 infection in a cohort of patients with immune-mediated inflammatory diseases (IMIDs). METHODS Adult patients with IMIDs with a confirmed SARS-CoV-2 infection were included. Data were reported by the treating physician between August 13, 2020 and July 31, 2021. Sociodemographic data, comorbidities, and DMARDs, as well as clinical characteristics, complications, and treatment of the SARS-CoV-2 infection, were recorded. Descriptive analysis and multivariable logistic regression models were carried out. RESULTS A total of 1672 patients with IMIDs were included, of whom 1402 were treated with IM/IS drugs. The most frequent diseases were rheumatoid arthritis (47.7%) and systemic lupus erythematosus (18.4%). COVID-19 symptoms were present in 95.2% of the patients. A total of 461 (27.6%) patients were hospitalized, 8.2% were admitted to the intensive care unit, and 4.4% died due to COVID-19.Patients without IM/IS treatment used glucocorticoids less frequently but at higher doses, had higher levels of disease activity, were significantly older, were more frequently hospitalized, admitted to the intensive care unit, and died due to COVID-19. After adjusting for these factors, treatment with IM/IS drugs was not associated with a worse COVID-19 outcome (World Health Organization-Ordinal Scale ≥5) (odds ratio, 1.24; 95% confidence interval, 0.73-2.06). CONCLUSIONS SAR-COVID is the first multicenter Argentine registry collecting data from patients with rheumatic diseases and SARS-CoV-2 infection. After adjusting for relevant covariates, treatment with IM/IS drugs was not associated with severe COVID-19 in patients with IMIDs. STUDY REGISTRATION This study has been registered in ClinicalTrials.gov under the number NCT04568421.
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Affiliation(s)
| | | | - Cesar Graf
- Argentine Society of Rheumatology, Argentina
| | | | | | | | | | | | - Jinoos Yazdany
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA
| | | | | | | | - Cecilia Nora Pisoni
- Centro de Educación Médica e Investigaciones Clínicas, Ciudad Autónoma de Buenos Aires
| | - Guillermo Berbotto
- Hospital Escuela Eva Perón, Granadero Baigorria
- Sanatorio Británico, Chief of the Rheumatology Service, Rosario, Santa Fe
| | | | | | | | | | | | - Romina Estefanía Nieto
- Centro Regional de Enfermedades Autoinmunes y Reumáticas, Rosario, Argentina
- Hospital Escuela Eva Perón, Granadero Baigorria
- Hospital Intendente Carrasco, Rosario, Santa Fe
| | | | | | | | | | - Paula Alba
- Hospital Córdoba, Córdoba
- Hospital Materno-Neonatal
- Hospital Italiano de Córdoba, Córdoba, Córdoba
| | - Adriana Karina Cogo
- Hospital Interzonal Luis Guemes, Haedo
- Hospital San Juan de Dios, Castelar, Buenos Aires
| | - Gelsomina Alle
- Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires
| | - Carla Gobbi
- Cátedra de Clínica Médica I, Hospital Córdoba, FCM, UNC, Córdoba, Córdoba
| | - Andrea Baños
- Fundación CIDEA, Ciudad Autónoma de Buenos Aires
- Sanatorio Adventista del Plata, Libertador San Martín, Entre Ríos
| | - Edson Velozo
- Sanatorio Adventista del Plata, Libertador San Martín, Entre Ríos
| | - Mariana Pera
- Hospital Ángel C Padilla, San Miguel de Tucumán, Tucumán
| | - Romina Tanten
- Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires
| | | | | | | | | | - Micaela Cosatti
- Centro de Educación Médica e Investigaciones Clínicas, Ciudad Autónoma de Buenos Aires
| | | | | | - Verónica G. Savio
- Hospital Córdoba, Córdoba
- Consultora Integral de Salud CMP, Córdoba, Córdoba
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Isnardi CA, Roberts K, Saurit V, Petkovic I, Báez RM, Quintana R, Tissera Y, Ornella S, D.Angelo Exeni ME, Pisoni CN, Castro Coello VV, Berbotto G, Haye Salinas MJ, Velozo E, Reyes Torres ÁA, Tanten R, Zelaya MD, Gobbi C, Alonso CG, de los Ángeles Severina M, Vivero F, Paula A, Cogo AK, Alle G, Pera M, Nieto RE, Cosatti M, Asnal C, Pereira D, Albiero JA, Savio VG, Maldonado FN, Gamba MJ, Germán NF, Baños A, Gallino Yanzi J, Gálvez Elkin MS, Morbiducci JS, Martire MV, Maldonado Ficco H, Schmid MM, Villafañe Torres JA, de los Ángeles Correa M, Medina MA, Cusa MA, Scafati J, Agüero SE, Lloves Schenone NM, Soriano ER, Graf C, Pons-Estel BA, Gomez G, Landi M, De la Vega MC, Pons-Estel GJ. Sociodemographic and clinical factors associated with poor COVID-19 outcomes in patients with rheumatic diseases: data from the SAR-COVID Registry. Clin Rheumatol 2023; 42:563-578. [PMID: 36201124 PMCID: PMC9535223 DOI: 10.1007/s10067-022-06393-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND/OBJECTIVE This study aims to describe the course and to identify poor prognostic factors of SARS-CoV-2 infection in patients with rheumatic diseases. METHODS Patients ≥ 18 years of age, with a rheumatic disease, who had confirmed SARS-CoV-2 infection were consecutively included by major rheumatology centers from Argentina, in the national, observational SAR-COVID registry between August 13, 2020 and July 31, 2021. Hospitalization, oxygen requirement, and death were considered poor COVID-19 outcomes. RESULTS A total of 1915 patients were included. The most frequent rheumatic diseases were rheumatoid arthritis (42%) and systemic lupus erythematosus (16%). Comorbidities were reported in half of them (48%). Symptoms were reported by 95% of the patients, 28% were hospitalized, 8% were admitted to the intensive care unit (ICU), and 4% died due to COVID-19. During hospitalization, 9% required non-invasive mechanical ventilation (NIMV) or high flow oxygen devices and 17% invasive mechanical ventilation (IMV). In multivariate analysis models, using poor COVID-19 outcomes as dependent variables, older age, male gender, higher disease activity, treatment with glucocorticoids or rituximab, and the presence of at least one comorbidity and a greater number of them were associated with worse prognosis. In addition, patients with public health insurance and Mestizos were more likely to require hospitalization. CONCLUSIONS In addition to the known poor prognostic factors, in this cohort of patients with rheumatic diseases, high disease activity, and treatment with glucocorticoids and rituximab were associated with worse COVID-19 outcomes. Furthermore, patients with public health insurance and Mestizos were 44% and 39% more likely to be hospitalized, respectively. STUDY REGISTRATION This study has been registered in ClinicalTrials.gov under the number NCT04568421. Key Points • High disease activity, and treatment with glucocorticoids and rituximab were associated with poor COVID-19 outcome in patients with rheumatic diseases. • Some socioeconomic factors related to social inequality, including non-Caucasian ethnicity and public health insurance, were associated with hospitalization due to COVID-19.
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Affiliation(s)
- Carolina A. Isnardi
- Present Address: Unidad de Investigación de la Sociedad Argentina de Reumatología, Buenos Aires, Argentina
| | - Karen Roberts
- Present Address: Unidad de Investigación de la Sociedad Argentina de Reumatología, Buenos Aires, Argentina
| | - Verónica Saurit
- grid.413199.70000 0001 0368 1276Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | | | - Roberto M. Báez
- Hospital Francisco López Lima, General Roca, Río Negro, Argentina
| | - Rosana Quintana
- Present Address: Centro Regional de Enfermedades Autoinmunes Y Reumáticas, Rosario, Argentina
| | - Yohana Tissera
- grid.497623.dPresent Address: Hospital Córdoba, Córdoba, Argentina
| | - Sofía Ornella
- HIGA San Martín de La Plata, La Plata, Buenos Aires, Argentina
| | | | - Cecilia N. Pisoni
- grid.418248.30000 0004 0637 5938CEMIC—Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina
| | | | - Guillermo Berbotto
- Hospital Escuela Eva Perón, Sanatorio Británico, Granadero Baigorria; Rosario, Santa Fe, Argentina
| | - María J. Haye Salinas
- grid.441659.b0000 0001 2201 7776CEMMA, Universidad Nacional de La Rioja, La Rioja, Argentina
| | - Edson Velozo
- grid.441666.70000 0001 2284 8908Sanatorio y Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina
| | - Álvaro A. Reyes Torres
- grid.414775.40000 0001 2319 4408Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Romina Tanten
- grid.414775.40000 0001 2319 4408Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Carla Gobbi
- grid.10692.3c0000 0001 0115 2557Cátedra de Clínica Médica I, Hospital Córdoba, FCM, UNC, Córdoba, Argentina
| | | | | | | | - Alba Paula
- Hospital Materno-Neonatal, Córdoba, Argentina
| | - Adriana K. Cogo
- Hospital Interzonal Luis Guemes, Haedo; Hospital San Juan de Dios, Castelar, Buenos Aires, Argentina
| | - Gelsomina Alle
- grid.414775.40000 0001 2319 4408Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Mariana Pera
- Hospital Ángel C Padilla, San Miguel de Tucumán, Tucumán, Argentina
| | | | - Micaela Cosatti
- grid.418248.30000 0004 0637 5938CEMIC—Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina
| | | | | | | | | | | | | | | | - Andrea Baños
- Fundación CIDEA, Ciudad Autónoma de Buenos Aires, Sindicato Empleados de Junín, Junín, Buenos Aires, Argentina
| | | | | | | | | | | | | | | | - Maria de los Ángeles Correa
- grid.419103.eInstituto de Rehabilitación Psicofísica, Instituto de Diagnóstico E Investigaciones Metabólicas, Buenos Aires, Argentina
| | | | | | - Julia Scafati
- HIGA San Martín de La Plata, La Plata, Buenos Aires, Argentina
| | - Santiago E. Agüero
- Centro de Rehabilitación Dr Mauricio Figueroa, Artrosport Catamarca, San Fernando del Valle de Catamarca, Catamarca, Argentina
| | | | - Enrique R. Soriano
- grid.414775.40000 0001 2319 4408Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Cesar Graf
- Sociedad Argentina de Reumatología, Buenos Aires, Argentina
| | - Bernardo A. Pons-Estel
- Present Address: Centro Regional de Enfermedades Autoinmunes Y Reumáticas, Rosario, Argentina
| | - Gimena Gomez
- Present Address: Unidad de Investigación de la Sociedad Argentina de Reumatología, Buenos Aires, Argentina
| | - Margarita Landi
- Present Address: Unidad de Investigación de la Sociedad Argentina de Reumatología, Buenos Aires, Argentina
| | | | - Guillermo J. Pons-Estel
- Present Address: Unidad de Investigación de la Sociedad Argentina de Reumatología, Buenos Aires, Argentina
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Martire MV, Girard Bosch MP, Scarafia S, Cosentino V, Tapia Moreira MJ, Estrella N, Marín J, Sommerfleck F, Maldonado Ficco H, Catay ER, Benegas M, Kerzberg E, Soriano ER. Spanish Validation of the GEPARD Questionnaire for the Detection of Psoriatic Arthritis in Argentinian Patients with Psoriasis. Dermatology 2019; 235:101-106. [PMID: 30654384 DOI: 10.1159/000495983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 12/04/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/OBJECTIVE Psoriatic arthritis (PsA) is preceded by psoriasis in approximately 80% of cases. Dermatologists are pivotal for early detection. It is important to have simple tools that allow the detection of PsA in patients with skin psoriasis. The aim of our study was to evaluate the performance of an adapted version of the GEPARD Questionnaire in Spanish in Argentinian patients with psoriasis. METHODS This is a cross-sectional study. A new Spanish (Argentinian) (GEPARDa) translated version of the original questionnaire (German) was developed and then tested as a diagnostic tool in patients with psoriasis, PsA, osteoarthritis associated to psoriasis, and osteoarthritis, all evaluated by rheumatologists who used the CASPAR criteria. RESULTS Eighty-three patients were included (55 [66.3%] women with a mean age of 50.7 years [SD 6.3]). Forty-four patients had PsA (29 [34.9%] patients had previous diagnosis of PsA, and 15 [18%] were newly diagnosed after referral by their dermatologists), and 39 patients were without PsA (18 [21.6%] patients had psoriasis without articular involvement, 6 [7.22%] had psoriasis associated with osteoarthritis, and 15 [18%] had osteoarthritis). An area under the curve of 0.9554 (SD 0.01; 95% CI 0.91-0.99) was calculated considering the CASPAR criteria as the gold standard. With a cutoff of ≥6 the questionnaire showed a sensitivity of 88.64%, a specificity of 89.74%, a positive likelihood ratio of 8.6, and a negative likelihood ratio of 0.12. CONCLUSIONS The GEPARDa version has proven to be a diagnostic tool with excellent performance so that it can be considered a valid tool for the detection of PsA in Argentinian patients.
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Affiliation(s)
| | | | - Santiago Scarafia
- Instituto de Asistencia Reumatológica Integral, Buenos Aires, Argentina
| | | | | | | | - Josefina Marín
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Pérez S, Santa Cruz M, Sosa J, Kohan P, Medina M, Klajn D, Papasidero S, Caracciolo J, Pendón G, Giordano F, Pereira D, Alvarez D, Astudillo V, Kerzberg E, Perez Dávila A, Bohr A, Melo F, Lloves N, Mamani M, Hartvig C, Sanchez G, Sacnum M, Chichotky Y, Velazco Zamora J, Benegas M, Rosa J, García M, Raiti L, Cruzat V, Quintana R, Pons-Estel B, Kirmayr K, D'Orazio A, Retamozo C, Romano O, Perez Alamino R, Correa M, Citera G, Rillo O, Zalazar M, Costi A, García M, Gomez G, Maldonado Ficco H. Evaluation of the Educational Needs in Argentine Patients with Rheumatoid Arthritis Using the SpENAT Questionnaire. ACTA ACUST UNITED AC 2018; 16:386-390. [PMID: 30385296 DOI: 10.1016/j.reuma.2018.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 09/10/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The SpENAT, a Spanish version of the Educational Needs Assessment Tool, is a self-completed questionnaire that assesses educational needs (ENs) with the purpose of providing tailored and patient-centered information. It consists of 39 questions grouped into the 7 following domains: Pain management, Movement, Feelings, Arthritic process, Treatments, Self-help measures and Support system. OBJECTIVES The objective of the study was to describe the ENs of rheumatoid arthritis (RA) patients using the SpENAT and to determine the main sources of information consulted by these patients. MATERIAL AND METHODS Multicenter, observational, cross-sectional study. We included consecutive patients≥18 years with diagnosis of RA (ACR 87/ACR-EULAR 2010). Sociodemographic data, disease characteristics and clinimetric properties were recorded. All patients completed the SpENAT and were asked about the sources employed to obtain information about their disease. STATISTICAL ANALYSIS Population characteristics were described. ENs were determined as percentages of the highest possible score for each domain. Needs for each domain according to sex, years of education, disease duration, use of biologicals and functional capacity were analyzed by means of ANOVA, and bivariate comparisons were made with Student's t-test and the Bonferroni correction. Correlation between domains was determined with the Spearman correlation coefficient. We compared patients' age by source of information with Student's t-test. RESULTS We included 496 patients from 20 centers across the country. More ENs were observed in the domains of Movement, Feelings and the Arthritic process. Patients with higher educational level (>7 years) reported more ENs in the Arthritic process and Self-help measure domains. A higher functional impairment (HAQ-A≥0.87) was associated with more ENs in every domain. Patients with high activity showed more ENs than those in remission in the domains of Pain management, Movement, Feelings, Treatments and Support system, as well as those with low activity in Self-help measures and Support system domains. All SpENAT domains showed positive correlations among each other (P<.0001), the most important being Pain management/Movement and Treatments/Arthritic process (r≥0.7). The source of information most frequently consulted was the rheumatologist (93.95%); those who made use of Internet were on average younger (P=.0004). CONCLUSION RA patients were very interested about knowing more about their disease. High functional impairment was associated with more ENs. Patients with high disease activity had higher EN levels in almost every domain. The rheumatologist was the main source of information for the patient with RA.
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Affiliation(s)
- Silvana Pérez
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina.
| | - María Santa Cruz
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - Julia Sosa
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - Paula Kohan
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - María Medina
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - Diana Klajn
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvia Papasidero
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - José Caracciolo
- Hospital General de Agudos Dr. E. Tornú, Ciudad Autónoma de Buenos Aires, Argentina
| | - Gisela Pendón
- Hospital Ricardo Gutiérrez, La Plata, Buenos Aires, Argentina
| | | | - Dora Pereira
- Hospital Ricardo Gutiérrez, La Plata, Buenos Aires, Argentina
| | - Damaris Alvarez
- Hospital Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | | | - Eduardo Kerzberg
- Hospital Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | - Adriana Perez Dávila
- Hospital de Rehabilitación Manuel Rocca, Ciudad Autónoma de Buenos Aires, Argentina
| | - Analía Bohr
- Hospital de Rehabilitación Manuel Rocca, Ciudad Autónoma de Buenos Aires, Argentina
| | - Fernando Melo
- Hospital Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires, Argentina
| | - Nicolás Lloves
- Hospital Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires, Argentina
| | - Marta Mamani
- Hospital Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires, Argentina
| | - Claudia Hartvig
- Hospital Provincial de Rosario, Rosario, Santa Fe, Argentina
| | | | - Mónica Sacnum
- Hospital Provincial de Rosario, Rosario, Santa Fe, Argentina
| | | | | | - Mariana Benegas
- Sanatorio de la Providencia, Ciudad Autónoma de Buenos Aires, Argentina
| | - Javier Rosa
- Hospital Italiano, Ciudad Autónoma de Buenos Aires, Argentina
| | - María García
- Hospital Italiano, Ciudad Autónoma de Buenos Aires, Argentina
| | - Laura Raiti
- Clínica Bessone, San Miguel, Buenos Aires, Argentina
| | - Vanesa Cruzat
- Clínica Bessone, San Miguel, Buenos Aires, Argentina
| | | | | | - Karin Kirmayr
- Sanatorio San Carlos, Bariloche, Río Negro, Argentina
| | - Andrea D'Orazio
- Hospital Interzonal General De Agudos Dr. José Penna, Bahía Blanca, Buenos Aires, Argentina
| | - Cinthya Retamozo
- Centro de Estudios sobre Derecho y Religión, San Ramón de la Nueva Orán, Salta, Argentina
| | - Olga Romano
- Hospital de Clínicas Pte. Dr. Nicolás Avellaneda, San Miguel de Tucumán, Tucumán, Argentina
| | - Rodolfo Perez Alamino
- Hospital de Clínicas Pte. Dr. Nicolás Avellaneda, San Miguel de Tucumán, Tucumán, Argentina
| | - María Correa
- Instituto de Rehabilitación Psicofísica, Ciudad Autónoma de Buenos Aires, Argentina
| | - Gustavo Citera
- Instituto de Rehabilitación Psicofísica, Ciudad Autónoma de Buenos Aires, Argentina
| | - Oscar Rillo
- Hospital Pirovano, Ciudad Autónoma de Buenos Aires, Argentina
| | - María Zalazar
- Hospital Pirovano, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ana Costi
- Hospital San Martín, La Plata, Buenos Aires, Argentina
| | | | - Graciela Gomez
- Instituto Lanari, Ciudad Autónoma de Buenos Aires, Argentina
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Maldonado Ficco H, Citera G, Maldonado Cocco JA. Prevalence of psoriatic arthritis in psoriasis patients according to newer classification criteria. Clin Rheumatol 2013; 33:243-6. [PMID: 24150746 DOI: 10.1007/s10067-013-2412-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 08/24/2013] [Accepted: 10/09/2013] [Indexed: 11/30/2022]
Abstract
The aim of this study is to determine the prevalence of psoriatic arthritis (PsA) according to CASPAR criteria, ASAS peripheral and axial SpA criteria, and New York criteria for AS. The first 100 patients consecutively attending a psoriasis dermatology clinic were assessed. Demographic and clinical data were collected; all patients were questioned and examined for joint manifestations. Rheumatoid factor and radiographies of hands, feet, cervical spine, and pelvis for sacroiliac joints were obtained. X-rays were read independently by two experienced observers in blind fashion. Patients with objective joint manifestations, both axial and peripheral, were evaluated for fulfillment of CASPAR, ASAS peripheral and axial, and New York criteria. Median age 48 years; 93 % of patients had psoriasis vulgaris and 56 % nail involvement. Seventeen patients had peripheral arthritis as follows: nine mono/oligoarticular and eight polyarthritis. Median arthritis duration was 8 years. Seventeen percent of patients fulfilled CASPAR and ASAS peripheral criteria, 6 % New York, and 5 % ASAS axial criteria. Patients who met CASPAR criteria showed a significantly higher psoriasis duration compared to those without arthritis (M 16 vs. 10 years, p = 0.02), and a higher frequency of nail involvement (88.2 vs. 49.4 %, p = 0.003). Five patients (29.4 %) fulfilled ASAS axial criteria; all of them had peripheral involvement as follows: mono/oligoarticular in three patients and polyarticular in two. Patients with peripheral and axial involvement presented a significantly higher frequency of erythrodermic psoriasis compared to the other patients (35.3 vs. 1.2 %, p = 0.0006 and 80 vs. 16.7 %, p = 0.02). Prevalence of PsA, for CASPAR and ASAS peripheral criteria, was of 17 %. Five percent of patients met ASAS axial criteria, while 6 % met New York criteria. Worth noting, few patients without signs or symptoms of arthritis had radiological changes, both axial and peripheral, precluding a proper classification.
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Affiliation(s)
- Hernán Maldonado Ficco
- Rheumatology Section, Instituto de Rehabilitación Psicofísica and Argentine Rheumatologic Foundation "Dr. Osvaldo García Morteo", Echeverría 955, 1428, Buenos Aires, Argentina
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