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M M de Souza S, Medeiros-Ribeiro AC, Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Botelho R, Brenol C, Da Silveira DE Carvalho HM, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, De Leon de Lima H, Pereira I, Ohira Gazzeta M, Kakehasi A, Louzada P, Hayata ALS, Pina F, Alves Ferreira M, Balarini L, Silveira IG, Kowalski S, Titton D, Mendonça Da Silva Chakr R, Ranzolin A, Laurindo I, Xavier R. AB1173 INCIDENT CASES OF COVID-19 AND VACCINATION ADHERENCE IN A MULTICENTRIC COHORT OF INFLAMMATORY ARTHRITIS IN BRAZIL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe SARS-CoV-2 virus has caused a worldwide health crisis. Patients with inflammatory arthritis are at higher risk of hospitalization and death by COVID-19 due to comorbidities or immunosuppressive treatments. Vaccination is one the most important strategies to control the pandemic.ObjectivesTo evaluate the incident cases of SARS-CoV-2 infection in a multicentric cohort of inflammatory arthritis in Brazil.MethodsBiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or tsDMARD (1). The present analysis is a retrospective evaluation of adult patients with inflammatory arthritis (rheumatoid arthritis – RA, spondylarthritis -SpA and psoriatic arthritis-PsA) that were alive since the beginning of the COVID-19 pandemics in Brazil in February 2020. We evaluated the incidence and severity of COVID-19 infection and the adherence to anti- SARS-CoV-2 vaccines schedules, up to January 2022.ResultsA total of 300 patients were interviewed and 69 (23.0%) reported confirmed anti-SARS-CoV infection and 5 (1.7%) had a second infection. Among known infected patients, 18.8% need hospitalization and oxygen support, 7.2% were admitted at ICU, and 5.8% died. After COVID-19 infection, 31.8% reported worsening of disease activity but only 6.1% had modification in medication due to disease activity. Distribution of cases followed the pattern of waves observed in Brazil (Figure 1). Regarding vaccination, 285 (95%) reported to have received at least one dose of any anti-SARS-CoV-2 vaccine: 43% received the first with the adenovirus ChAdOx1 nCoV-19 (AstraZeneca) adenovirus vaccine, 32% received the Sinovac-CoronaVac inactivated vaccine, 22% received the BNT162b2 (Pfizer-BioNtech) mRNA vaccine and 3% received the BNT162b2 (Pfizer-BioNtech) adenovirus vaccine. Almost all (98.1%) of these patients had already received the second dose of vaccine and after the first and second vaccine doses, 6% and 4% of patients, respectively, reported worsening of articular disease activity, while, after the third dose, no patient reported disease activity worsening.Figure 1.ConclusionDuring the pandemics, patients with inflammatory arthritis had a pattern of distribution of cases very similar to general population. Adherence to vaccination is high and well tolerated.References[1]Bredemeier et al. J Rheumatol 2021;48:1519-27Disclosure of InterestsNone declared
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Chakr R, Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Medeiros-Ribeiro AC, Botelho R, Brenol C, Da Silveira De Carvalho HM, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, Pereira I, De Leon de Lima H, Ohira Gazzeta M, Kakehasi A, Louzada P, Hayata ALS, Pina F, Lupo C, Balarini L, Silveira I, Schowalski S, Titton D, Ranzolin A, Laurindo I, Xavier R. POS0650 THE IMPACT OF OLD AGE ON THE PERSISTENCE AND SAFETY OF TREATMENT WITH BIOLOGIC AGENTS OR JAK INHIBITORS IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe effect of age on persistence and safety of treatment with biologic disease modifying anti-rheumatic drugs (bDMARDs) in rheumatoid arthritis has been a subject to research interest. Two recently published studies did not observe significantly different survival of treatment with bDMARDs among older age (≥ 65 years) individuals (1,2); incidence of serious adverse events was higher in these patients (2).Objectivesto evaluate association of the age with treatment survival and overall safety among patients receiving one or multiple courses of bDMARDs or targeted synthetic (ts-) DMARDs.MethodsBiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or tsDMARD (3). The present analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over one or multiple (up to six) courses of treatment necessarily involving a bDMARD or tsDMARD (latest date, Nov 19, 2019). Treatment course is defined as a period during which the medication scheme does not change, except for dose adjustments. Primary outcome was the incidence treatment interruption for any reason (except for pregnancy or disease remission), while interruption due to adverse events (AEs; including death) and due to inefficacy served as secondary outcomes. Incidence of serious adverse events (SAEs) also served as a secondary outcome. Extended (frailty) multivariate Cox proportional hazards models and negative binomial regression with generalized estimating equations (to calculate incidence rate ratios [IRRs]) were used for statistical analyses (both types of analyses including time-varying covariates over multiple courses of treatment).ResultsIn total, 1316 patients (2335 treatment courses, 6508 patient-years [PY]) were enrolled. Of these, 160 patients (643 PY; 237 treatment courses) were ≥ 65 years old, mean age at starting treatment = 71 ± 5 yrs (84% female). Old age was not significantly associated with treatment interruption for any reason, but presented higher risk of interruption due to adverse events (after multivariate adjustment) and lower risk of stopping because of inefficacy (see Table 1). Older patients presented higher incidence of SAEs than younger ones (16.0 vs 8.4/100 PY, respectively; multivariate IRR: 2.06, 95% CI: 1.51 to 2.80, P<0.001). Among old patients, tocilizumab (HR: 2.73, 95% CI: 1.13 to 6.64, P=0.026), etanercept (2.13, 1.12 to 4.07, P=0.022), and infliximab (2.39, 1.19 to 4.79, P=0.014) presented higher risk of treatment termination as compared with adalimumab. In this subgroup (age ≥65 yrs), there was no significant difference in the risk of SAEs between different bDMARDs/tsDMARDs.Table 1.Univariate and multivariate hazard ratios (HRs) of interruption of treatment course comparing older (≥65 years) versus younger patients (reference category). Results are HRs, 95% CIs, and P values.Cause of interruption (n of events)Crude analysisAdjusted covariates*Interruption - any reason (1321)0.96 (0.75 to 1.23), P=0.7601.09 (0.82 to 1.43), P=0.550Interruption - adverse events (368)1.33 (0.75 to 0.89), P=0.1601.59 (1.07 to 2.35), P=0.020Interruption - inefficacy (680)0.56 (0.39 to 0.80), P=0.0020.57 (0.38 to 0.87), P=0.009* Age, baseline DAS28, disease duration, gender, smoking, RF or anti-CCP, previous malignancy, interstitial lung disease, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, concomitant use of each cs-, b-, and tsDMARDs, corticosteroids, starting year, osteoporosis, hepatitis B,C, treatment sequence.ConclusionThe overall risk of treatment interruption with biologic or targeted synthetic DMARDs is not higher in older patients. Higher risk of interruption due to AE was balanced by a lower risk of stopping treatment due to inefficacy. Older patients had a higher incidence of SAEs.References[1]Mathieu et al. Rheumatol Int 2021;41:879-85.[2]Freitas et al. Drugs Aging 2020;37:899-907.[3]Bredemeier et al. J Rheumatol 2021;48:1519-27.Disclosure of InterestsNone declared
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Lysie Libardi Lira Machado K, Martins Filho OA, Reis Neto E, Miyamoto ST, Ribeiro Moulaz I, Lorenzoni Grillo L, Pizzol Pasti L, Simões Moulin AC, Oliveira Souza B, Faé F, Smith Sobral Vieira G, Filipe Surlo H, De Oliveira Macabú M, Da Silva Corona H, Zava Lorencini P, Athayde P, Gonçalves Rodrigues Aguiar L, Fiorotti Albertino L, Deorce de Lima M, Neves Burian AP, Cruz V, Kakehasi A, Gomes C, Azevedo VF, Melo AK, Poubel Vieira DE Rezende R, Ribeiro S, Vieira RMR, Casian Tuão R, Barbosa Beloni Lirio M, De Moraes Ribeiro Espirito Santo T, Pretti FZ, Cristina Filgueira Alves Batista D, Monticielo O, De Souza V, Pinheiro M, Ferreira G, Sato E, Teixeira-Carvalho A, Xavier R, Salviato Pileggi G, Valim V. POS1285 IMMUNOGENICITY AND SAFETY OF THE CHADOX 1 COVID-19 VACCINE IN PATIENTS WITH AUTOIMMUNE DISEASES AND HEALTHY CONTROLS: DATA FROM SAFER STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPatients with autoimmune inflammatory diseases (AID) have been prioritized for urgent vaccination to mitigate COVID-19 risk. However, few studies in the literature assessed the immunogenicity and safety of the COVID-19 vaccine in patients with AID.ObjectivesIn this context, the present study aims to evaluate the immunogenicity and safety of the vaccine against COVID-19 in patients with AID.MethodsThese data are from “Safety and efficacy on COVID-19 Vaccine in Rheumatic Disease” - SAFER study, a Brazilian multicentric prospective phase IV study to evaluate COVID-19 Vaccine in AID, in the real-life, in Brazil. Immunogenicity and adverse events (AE) from a single center were assessed, after 2 doses of ChAdOx1 (Oxford/AstraZeneca), 8 weeks of interval, in patients with AID and healthy controls (HC). Inclusion criteria were age ≥ 18 years and fulfilling criteria according to international classification for AID. Exclusion criteria: pregnancy, previous severe AE to any vaccine, other immunosuppression causes. Stratification of post-vaccination AE was performed using a diary, filled out daily and returned at the end of 28 days for each dose. Participants were followed up through blood collection for measurement of IgG antibodies against SARS-CoV-2 spike receptor-binding domain by chemiluminescence (SARS-CoV-2 IgG II Quant assay, Abbott Laboratories, Abbott Park, IL, USA) at baseline and 28 days after the second dose. The seropositivity was defined for titers ≥50 AU/mL. Quantitative analyses were presented as observed frequency, percentage, central tendency, and variability measurements. The sample’s normal distribution was verified through the Shapiro-Wilk test. The Kruskal-Wallis test and the post-hoc Dwass-Steel-Critchlow-Fligner pairwise comparisons test were used to compare the IgG-S titers between the groups through the evaluation period. Categorical data were addressed using the Fisher´s exact or Chi-squared (χ2) test. An alpha level of 5% significance was used in all analyses.ResultsA total of 377 volunteers with AID and 50 HC were included in the study. Patients with spondyloarthritis (N=64), systemic lupus erythematosus (N=63), rheumatoid arthritis (N=61), primary Sjögren’s syndrome (N=61), vasculitis (N=31), systemic sclerosis (N=14), inflammatory myopathy (N=9), Crohn´s disease (N=49), ulcerative colitis (N=11) and other systemics AID (N=12) were evaluated. Both groups had female predominance (73.5% vs. 74.0%, p=0.937) and were homogeneous for age (43.5 vs. 41.7,p=0.308). The seroconversion among those not reactive (IgG-S negative at baseline) (46 HC and 191 AID), 28 days after second dose was 97.1% for spondyloarthritis (p=0.425), systemic lupus erythematosus 88.2% (0.006), rheumatoid arthritis 93.5% (0.158), primary Sjögren’s syndrome 92.6% (0.133), systemic sclerosis or inflammatory myopathy 47.1% (0.001), inflammatory bowel disease 100% (0.999) and vasculitis 80% (0.006), while in healthy control was 100%. In comparison with HC, there was a statistically significant difference in IgG-S titles only in systemic sclerosis or inflammatory myopathy (1.694 AU/ml vs. 3.719 AU/ml; p=0.006). Both groups only presented mild AE. Pain at the injection (85.7% vs. 78.4%, p=0.239), headache (67.3% vs. 53.8, p=0.074) and fatigue (59.2% Vs. 46.2%, p=0.089) were more common in HC than AID. Overall, reactions like arthralgia (52.6 vs. 22.4%, p<0.001), hematoma (14.1 vs. 4.1%, p=0.05), cutaneous rash (9.5 vs. 0%, p=0.024) were more frequent in AID. Most participants related that they felt safer after receiving a COVID-19 vaccination, and 52.4% did not reported a worse patient global assessment (PGA) index.ConclusionIn conclusion, our data indicated that ChAdOx1 vaccine is safe and induced high titers and seroconversion rate in AID. More severe AID, such as vasculitis, systemic lupus erythematosous, and systemic sclerosis and myositis showed a lower seroconversion rate. Further analysis will explore the association between immunossupressant and reactivity, and booster dose.AcknowledgementsAcknowledgements to DECIT/MS and ICEPI/SESA for supporting the study.Disclosure of InterestsNone declared
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Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Medeiros-Ribeiro AC, Botelho R, Brenol C, Da Silveira DE Carvalho HM, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, De Leon de Lima H, Pereira I, Ohira Gazzeta M, Kakehasi A, Louzada P, Hayata ALS, Pina F, Alves Ferreira M, Balarini L, Silveira IG, Kowalski S, Titton D, Mendonça Da Silva Chakr R, Ranzolin A, Laurindo I, Xavier R. POS0242 THE EFFECT OF ANTIMALARIALS ON THE OVERALL SAFETY AND PERSISTENCE OF TREATMENT WITH BIOLOGIC AGENTS OR JAK INHIBITORS IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAntimalarials (AM) are frequently part of the initial scheme of conventional synthetic DMARDs in the treatment of rheumatoid arthritis (RA), and have been associated with lower incidence of diabetes and better lipid profile in these patients (1). However, the role of AM in schemes involving biologic (b-) or targeted synthetic (ts-) DMARDs has been much less extensively studied. In addition, a recent large scale study (2) and a consensus article (1) casted doubt on the long-term cardiovascular safety of AM.ObjectivesTo evaluate the association of concomitant use of AM with the overall safety and survival oftreatment course among patients receiving one or multiple courses of bDMARDs or tsDMARDsMethodsBiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or tsDMARD (3). The present analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over one or multiple (up to six) courses of treatment (latest date, Nov 19, 2019). A treatment course is defined as a period during which the medication scheme does not change. The primary outcome was the incidence of serious adverse events (SAEs). Total and system-specific adverse events (AEs), treatment interruption for any reason, interruption due to AEs and due to inefficacy served as secondary outcomes. Negative binomial regression with generalized estimating equations (to calculate the incidence rate ratios [ÌRRs]) and extended (frailty) Cox proportional hazards models were used for statistical analyses (both types of analyses including time-varying covariates over multiple courses of treatment).ResultsIn total, 1316 patients (2335 treatment courses, 6711 patient-years [PY]) were enrolled. The overall incidence of serious adverse events was 9.2/100 PY. AM were used over 354 courses (1254.5 PY) of therapy. The IRRs for the primary and secondary outcomes are presented in Table 1. AM were also associated with better treatment course survival (Figure 1), reducing the risk of interruption due to AEs (multivariate hazard ratio: 0.56, 95% CI: 0.39 to 0.81, P=0.002) and inefficacy (0.65, 0.48 to 0.87, P=0.003).Figure 1.Table 1.Univariate and multivariate incidence rate ratios (IRRs) of adverse events comparing use versus non-use (reference category) of antimalarials. Results are IRRs, 95% CIs, and P values.Type of adverse event (n of events)Crude analysisAdjusted covariates*Serious adverse events (617)0.60 (0.41 to 0.87), P=0.0070.51 (0.37 to 0.69), P<0.001Any adverse event (3494)0.65 (0.54 to 0.77), P<0.0010.68 (0.57 to 0.81), P<0.001Cardiovascular‡Serious (52)1.04 (0.49 to 2.20), P=0.9241.06 (0.45 to 2.50), P=0.891Total (163)0.90 (0.59 to 1.38), P=0.6420.93 (0.59 to 1.45), P=0.737InfectionsSerious (277)0.78 (0.44 to 1.39), P=0.4040.53 (0.34 to 0.83), P=0.006Total (1400)0.77 (0.61 to 0.98), P=0.0330.75 (0.60 to 0.94), P=0.014Hepatic‡Total (66)0.20 (0.07 to 0.64), P=0.0070.16 (0.04 to 0.57), P=0.005Glicemic control-relatedTotal (34)0.74 (0.29 to 1.92), P=0.5400.73 (0.26 to 2.00), P=0.535DyslipidemiaTotal (83)0.60 (0.31 to 1.13), P=0.1140.55 (0.28 to 1.06), P=0.074*Age, baseline DAS28, disease duration, gender, smoking, seropositivity (RF or anti-CCP), previous malignancy, interstitial lung disease, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, concomitant use of each cs-, b-, and tsDMARDs, corticosteroids, starting year, osteoporosis, hepatitis B and C, and treatment sequence. ‡ Excluding infections.ConclusionAmong RA patients on treatment with bDMARDs or tsDMARDs, concomitant use of antimalarials reduced the incidence of serious and total AEs, including infections and hepatic AEs, and prolonged treatment course survival. No significant increase in the risk of cardiovascular AEs was observed.References[1]Desmarais et al. Arthritis Rheumatol 2021;73:2151-60.[2]Lane et al. Lancet Rheumatol 2020;2:e698–e711[3]Bredemeier et al. J Rheumatol 2021;48:1519-27.Disclosure of InterestsNone declared
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Silla L, Valim V, Pezzi A, da Silva M, Wilke I, Nobrega J, Vargas A, Amorin B, Correa B, Zambonato B, Scherer F, Merzoni J, Sekine L, Huls H, Cooper LJ, Paz A, Lee DA. Adoptive immunotherapy with double-bright (CD56 bright /CD16 bright ) expanded natural killer cells in patients with relapsed or refractory acute myeloid leukaemia: a proof-of-concept study. Br J Haematol 2021; 195:710-721. [PMID: 34490616 DOI: 10.1111/bjh.17751] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 05/18/2021] [Revised: 07/10/2021] [Accepted: 07/21/2021] [Indexed: 12/26/2022]
Abstract
Patients with acute myeloid leukaemia (AML) have a five-year survival rate of 28·7%. Natural killer (NK)-cell have anti-leukaemic activity. Here, we report on a series of 13 patients with high-risk R/R AML, treated with repeated infusions of double-bright (CD56bright /CD16bright ) expanded NK cells at an academic centre in Brazil. NK cells from HLA-haploidentical donors were expanded using K562 feeder cells, modified to express membrane-bound interleukin-21. Patients received FLAG, after which cryopreserved NK cells were thawed and infused thrice weekly for six infusions in three dose cohorts (106 -107 cells/kg/infusion). Primary objectives were safety and feasibility. Secondary endpoints included overall response (OR) and complete response (CR) rates at 28-30 days after the first infusion. Patients received a median of five prior lines of therapy, seven with intermediate or adverse cytogenetics, three with concurrent central nervous system (CNS) leukaemia, and one with concurrent CNS mycetoma. No dose-limiting toxicities, infusion-related fever, or cytokine release syndrome were observed. An OR of 78·6% and CR of 50·0% were observed, including responses in three patients with CNS disease and clearance of a CNS mycetoma. Multiple infusions of expanded, cryopreserved NK cells were safely administered after intensive chemotherapy in high-risk patients with R/R AML and demonstrated encouraging outcomes.
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Affiliation(s)
- Lucia Silla
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Vanessa Valim
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Annelise Pezzi
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Maria da Silva
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Ianae Wilke
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Juliana Nobrega
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Alini Vargas
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Bruna Amorin
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Bruna Correa
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bruna Zambonato
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | | | - Joice Merzoni
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Leo Sekine
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Helen Huls
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Alessandra Paz
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Dean A Lee
- Nationwide Children's Hospital, Columbus, OH, USA
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Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Medeiros A, Botelho R, Brenol C, Negrão Gonçalo Dias D, Carvalho H, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, Pereira I, Ohira Gazzeta M, Maria Kakehasi A, Louzada P, Hayata ALS, Pina F, Lupo C, Balarini L, Silveira I, Kowalski S, Titton D, Chakr R, Ranzolin A, Laurindo I, Xavier R. POS0676 SURVIVAL OF THE FIRST COURSE OF BIOLOGIC OR JAK INHIBITOR IN RHEUMATOID ARTHRITIS: ASSOCIATION WITH THE CHOICE OF AGENT AND CONCOMITANT CONVENTIONAL SYNTHETIC DMARDS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:After failure of conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) in the therapy of rheumatoid arthritis (RA), treatment may be escalated to biologic (bDMARDs) or JAK inhibitors (JAKi) (1). Analysis of drug survival can provide useful information on the effectiveness of these therapeutic schemes.Objectives:to evaluate the association of the choice of therapeutic agent with the survival of treatment course in RA patients receiving their first bDMARD or JAKi.Methods:BiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients starting their first bDMARD/JAKi (2). This analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over the first course of treatment with a bDMARD/JAKi until censoring (latest date, Nov 19, 2019) or occurrence of the outcome of interest. A treatment course is defined as a period during which the medication scheme does not change, except for dose adjustments. The primary outcome was the interruption of treatment course for any reason (except for pregnancy or disease remission); interruption of treatment due to adverse events (AEs) or death and due to inefficacy served as secondary outcomes. Multivariate Cox proportional hazards models were used for analyses.Results:In total, 1177 patients (3800 patient-years [PY]) were enrolled. The overall incidence of treatment interruption was 17.5/100 PY. Adalimumab was the most frequently prescribed agent, followed by infliximab (n= 267). The hazards ratios (HR) of the primary and secondary outcomes are presented in Table 1. Figure 1 compares the survival of treatment curves of different bDMARDs/JAKi.Table 1.Hazard ratios (HR) of interruption of therapy course of each therapeutic agent (the reference category for bDMARDs/ JAKi is infliximab). Results are HR, 95% CIs, and P values*.Agent (number of patients)Interruption for any reason (665 events)Interruption due to adverse events or death (196 events)Interruption due to inefficacy (319 events)Adalimumab (354)0.83 (0.68 to 1.01), P= 0.0620.68 (0.48 to 0.96), P=0.0291.08 (0.80 to 1.44), P=0.621Etanercept (257)0.81 (0.66 to 1.01), P=0.0630.56 (0.37 to 0.83), P=0.0040.93 (0.68 to 1.29), P=0.674Certolizumab (80)0.74 (0.47 to 1.16), P=0.1850.33 (0.13 to 0.86), P=0.0241.32 (0.74 to 2.35), P=0.350Golimumab (53)0.86 (0.53 to 1.38), P=0.5300.46 (0.18 to 1.19), P=0.1111.07 (0.53 to 2.15), P=0.849JAKi (tofacitinib) (59)0.54 (0.30 to 0.99), P=0.0470.19 (0.04 to 0.82), P=0.0260.89 (0.41 to 1.96), P=0.779Rituximab (48)0.87 (0.55 to 1.37), P=0.5400.48 (0.20 to 1.18), P=0.1090.58 (0.26 to 1.34), P=0.205Abatacept (30)0.52 (0.25 to 1.07), P=0.0770.46 (0.14 to 1.56), P=0.2150.46 (0.14 to 1.52), P=0.203Tocilizumab (29)0.29 (0.14 to 0.63), P=0.0020.40 (0.12 to 1.30), P=0.1260.28 (0.09 to 0.90), P=0.033Methotrexate (792)0.95 (0.79 to 1.14), P=0.5610.86 (0.62 to 1.19), P=0.3620.98 (0.75 to 1.28), P=0.860Leflunomide (497)1.17 (0.99 to 1.39), P=0.0611.44 (1.06 to 1.96), P=0.0201.02 (0.80 to 1.30), P=0.856Sulfasalazine (48)1.18 (0.80 to 1.75), P=0.4011.94 (1.07 to 3.54), P=0.0300.85 (0.45 to 1.59), P=0.605Antimalarials (230)0.80 (0.65 to 0.98), P=0.0270.67 (0.45 to 0.99), P=0.0430.67 (0.50 to 0.92), P=0.011* All tests adjusted for other variables presented in the table and for age, baseline DAS28, disease duration, gender, smoking, seropositivity (RF/anti-CCP), previous malignancy, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, use of corticosteroids, starting year, hypercholesterolemia, osteoporosis, hepatitis B and C.Conclusion:In our study, infliximab was related to an overall higher hazard of treatment course interruption than tolicizumab and tofacitinib, and higher hazard of interruption due to AEs than most other anti-TNF agents and tofacitinib. Maintaining antimalarials in patients receiving advanced therapies for RA may reduce interruption of treatment due to inefficacy and AEs.Disclosure of Interests:None declared
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Basualto S, Ziroldo Lopes JV, Rizzo Borges A, Abreu M, Albuquerque C, Araújo N, Bacchiega AB, Bica B, Brito D, Duarte A, Realle P, Ferreira G, Wagner Poti Gomes K, Melo AK, Stadler B, Maria Kakehasi A, Klumb E, Mariz H, Marques C, Mota L, Munhoz G, Paiva E, Pereira H, Salviato Pileggi G, Pinheiro M, Provenza JR, Gomides AP, Reis Neto E, Ribeiro S, Sato E, Laroca Skare T, De Souza V, Teodoro MLM, Valadares LDDA, Valim V, Calderaro D. AB0848 PARTICIPATION OF UNDERGRADUATE MEDICAL STUDENTS AS INVESTIGATORS IN A RHEUMATOLOGIC COHORT: IMPACT ON DEPRESSION, ANXIETY & STRESS SCALE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Mental health was widely affected during the new coronavirus pandemic. In addition, some measures adopted by most countries in order to contain the virus spread, such as isolation and social distancing, leading to the interruption of routine activities, including partial or complete interruption of face-to-face classes may be associated with increased stress, depression and anxiety among undergraduate medical students (1). From March to September, 2020, the Brazilian Society of Rheumatology carried out the Mario Pinotti II Project (MPII), a prospective, multicenter, observational cohort study designed to monitor the COVID-19 in patients with rheumatic disease on hydroxychloroquine, using periodic telephone calls performed by undergraduate medical students (2).Objectives:To compare the mental health status of medical students who were participating from the MPII with theirs colleagues not involved in this project.Methods:A web-based survey via google forms platform was developed by a panel composed of undergraduate medical students, rheumatologists, medical school professors, and a psychology professor. It included details on demographic and life habits data and domains regarding depression, anxiety and stress, using the DASS-21 (Depression, Anxiety & Stress Scale), Brazilian version. Data collection occurred from July 20th to August 31st, 2020. Statistical analysis was performed using the SPSS version 20.0. Univariate and multivariate linear regression analysis were performed to verify associations with the DASS-21, defined as dependent variable. A p-value < 0.05 was deemed as significant. This study was approved by the Institutional Research Ethics Committee.Results:A total of 684 undergraduate medical students were included in this study, of whom 228 as MPII volunteers (VG) and 456 as control group (CG). Median age was 23 years (IQ 21-24) and the CG was older than the VG (p<0.03). Most of them were white (68.8%) and women (63%). There were no significant differences regarding comorbidities, ethnicity, smoking status, alcohol intake and physical activity. Older age, male gender, participation of MPII study, absence of a worsening in sleep pattern during the pandemic and a lower number of prior comorbidities were associated with lower DASS21 scores, suggesting a better mental health (Table 1).Conclusion:Several aspects may be involved with mental health, including increased emotional maturity, gender and sleep pattern. Although with marginal independent association, medical students with participation in the MPII study had better mental health than their student colleagues not engaged with this research. Our data pointed out that voluntary participation in a research project which foresees interaction by telephone contact with rheumatic patients, professors, rheumatologists, and colleagues is associated with better mental health.References:[1]Meo SA, Abukhalaf AA, Alomar AA, Sattar K, Klonoff DC. Covid-19 pandemic: Impact of quarantine on medical students’ mental wellbeing and learning behaviors. Pakistan J Med Sci 2020;36(COVID19-S4):S43–8.[2]Gomides A, Ferreira G, Kakehas A, Lacerda M, Marques C, Paiva E et al. Impact of chronic use of antimalarials on SARS-COV-2 infection in patients with immune-mediated rheumatic diseases: protocol design for a multicentric observational cohort in Brazil. JMIR Research Protocols, 2020.PreprintTable 1.Univariate and multivariate analysis of predictors associated to the DASS-21 in undergraduate medical students during the COVID-19 pandemicUnivariate analysisMultivariate analysisVariableB95%CIp-ValueB95%CIp-ValueAge-0.32-0.61 to -0.030.03-0.47-0.81 to -0.130.008Female gender4.883.021 to 6.76<0.001---Stable love relationship-2.49-4.35 to -0.640.008-2.5-4.4 to -0.590.01Number of previous comorbidities reported4.693.71 to 5.68<0.0014.823.73 to 5.92<0.001MP-II volunteering-2.81-4.74 to -0.860.005---Worsening in sleep pattern6.414.62 to 8.20<0.0015.013.07 to 6.96<0.001Disclosure of Interests:None declared
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Salviato Pileggi G, Ferreira G, Gomides AP, Reis Neto E, Abreu M, Albuquerque C, Araújo N, Bacchiega AB, Bianchi D, Bica B, Bonfa E, Borba E, Brito D, Duarte A, Peixoto Gu e Silva de Souza M, Wagner Poti Gomes K, Maria Kakehasi A, Cavalheiro Do Espírito Santo R, Realle P, Klumb E, Lanna CC, Marques C, Monticielo O, Mota L, Munhoz G, Paiva E, Pereira H, Provenza JR, Ribeiro S, Rocha Jr L, Sampaio C, Sampaio V, Sato E, Laroca Skare T, De Souza V, Valim V, Lacerda M, Xavier R, Pinheiro M. POS1252 COVID-19 IN PATIENTS WITH RHEUMATIC DISEASES ON CHRONIC USE OF HYDROXYCHLOROQUINE IN A LARGE BRAZILIAN COHORT – A 24-WEEK PROSPECTIVE STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The role of chronic use of hydroxychloroquine (HCQ) in rheumatic disease (RD) patients during the SARS-CoV-2 pandemic is still subject of discussion.Objectives:To compare the occurrence of COVID-19 and its outcomes between RD patients on HCQ use with individuals from the same household not taking the drug during community viral transmission in an observational prospective multicenter study in Brazil.Methods:Participants were enrolled and monitored through 24-week (From March 29th to Sep 30th, 2020) regularly scheduled phone calls performed by trained medical professionals. Epidemiological and demographic data, as well as RD disease activity status and current treatment data, specific information about COVID-19, hospitalization, need for intensive care, and death was recorded in both groups and stored in the Research Electronic Data Capture (REDCap) database. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. The statistical analysis was performed using IBM-SPSS v.20.0 software. Group comparisons were made using the Man-Whitney, Chi-Square and Fisher Exact Test, as well as multivariate regression models adjusted to confounders. Survival curves were performed using Kaplan-Meier analysis.Results:A total of 10,427 participants mean age (SD) of 44.04 (14.98) years were enrolled, including 6004 (57.6%) rheumatic disease patients, of whom 70.8% had systemic lupus erythematosus (SLE), 6.7% rheumatoid arthritis (RA), 4% primary Sjögren’s syndrome (pSS), 1.8% mixed connective tissue disease (DMTC), 1% systemic sclerosis (SSc) and others (15.9), including overlap syndromes. In total, 1,132 (10.8%) participants fulfilled criteria for COVID-19, being 6.7% RD patients and 4.1% controls (p=0.002). A recent influenza vaccination had a protective role (p<0.001). Moderate and severe COVID-19 included the need for hospitalization, intensive care, mechanical ventilation or death. Infection severity was not different between groups (p=0.391) (Table 1). After adjustments for multiple confounders, the main risk factors significantly associated with COVID-19 were higher education level (OR=1.29 95%CI 1.05-1.59), being healthcare professionals (OR=1.91; 95%CI 1.45-2.53), presence of two comorbidities (OR=1.31; 95%CI 1.01-1.66) and three or more comorbidities associated (OR=1.69; 95%CI 1.23-2.32). Interestingly, age >=65 years (OR=0.20; 95%CI 0.11-0.34) was negatively associated. Regarding RD, the risk factors associated with COVID-19 diagnosys were SLE (OR= 2.37; 95%CI 1.92-293), SSc (OR=2.25; 95%CI 1.05-4.83) and rituximab use (OR=1.92; 95%CI 1.13-3.26). In addition, age >=65 years (OR=5.47; 95%CI 1.7-19.4) and heart disease (OR=2.60; 95%CI 1.06-6.38) were associated with hospitalization. Seven female RD patients died, six with SLE and one with pSS, and the presence of two or more comorbidities were associated with higher mortality rate.Conclusion:Chronic HCQ use did not prevent COVID-19 in RD compared to their household cohabitants. Health care profession, presence of comorbidities LES, SSc and rituximab were identified as main risk factors for COVID-19 and aging and heart disease as higher risk for hospitalization. Our data suggest these outcomes could be considered to manage them in clinical practice.Table 1.Frequency and severity of COVID-19 in patients with rheumatic diseases on chronic use of hydroxychloroquine compared to their household controlsCOVID-19 outcomesTotal(%)GroupsPPatients(%)Controls (%)DiagnosisNo9256 (89.1)5300 (88.3)3956 (90.2)0.002Yes1132 (10.9)704 (11.7)428 (9.8)SeverityMild1059 (93.6)662 (94.0)397 (92.8)0.391Moderate52 (4.6)32 (4.5)20 (4.7)Severe21 (1.9)10 (1.4)11 (2.6)HCQ: hydroxychloroquine.Moderate and severe COVID-19 included the need for any of the following: hospitalization, intensive care, mechanical ventilation or death.Acknowledgements:To the Brazilian Society of Rheumatology for technical support and rapid nationwide mobilization.To all the 395 interviewers (medical students and physicians) who collaborated in the study and the participantsTo CNPq (Number 403442/2020-6)Disclosure of Interests:None declared
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Paz A, Rigoni L, Fischer G, Schittler M, Pezzi A, Valim V, Dahmer A, Zambonato B, Amorin B, Sehn F, Silva MAD, Daudt L, Silla L. Donor characteristics and hematopoietic stem cell transplantation outcome: experience of a single center in Southern Brazil. Hematol Transfus Cell Ther 2018; 40:136-142. [PMID: 30057987 PMCID: PMC6000883 DOI: 10.1016/j.htct.2017.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 05/03/2017] [Accepted: 11/23/2017] [Indexed: 01/12/2023] Open
Abstract
Background Hematopoietic stem cell transplantation is a curative treatment for many patients with hematological disorders. Donor-recipient genetic disparity, especially involving the human leukocyte antigen system is a critical factor for transplant outcome. Objective To evaluate retrospectively donor characteristics and correlations with the occurrence of acute and chronic graft-versus-host disease, disease-free survival and overall survival in a Brazilian population submitted to allogeneic hematopoietic stem cell transplantation between 1994 and 2012 in a single center. Results Three hundred and forty-seven consecutive transplantations were included. Related transplants (81.2%) were significantly more common than unrelated transplants (18.7%); donor and recipient median ages were 34 (range: 1-61) and 33 (range: 3-65) years respectively with donor HLAs being matched for 333 (95.9%) patients. Donor gender, cytomegalovirus status and ABO incompatibility did not influence the five-year overall survival. In univariate analyses, overall survival was negatively influenced by the presence of acute graft-versus-host disease (33% vs. 47%, respectively; p-value = 0.04), unrelated transplant (41.5% vs. 50.9%, respectively; p-value = 0.045) and donors aged over 40 years (41% vs. 52%, respectively; p-value = 0.03). Older donors were associated with a higher rate of acute (52% vs. 65.8%; p-value = 0.03) and chronic graft-versus-host disease (60% vs. 43%, respectively; p-value = 0.015). In multivariate analyses, acute graft-versus-host disease [relative risk (RR): 1.8; 95% confidence interval (CI): 1.1-29; p-value = 0.008] and older donors (RR: 1.6; 95% CI 1.11-2.24; p-value = 0.013) were associated with higher transplant-related mortality. Conclusions In transplant patients, to have a donor older than 40 years of age seems to significantly increase the incidence of acute and chronic graft-versus-host disease and transplant-related mortality with no impact on disease-free survival and overall survival. In spite of the rather small cohort of patients, these findings are similar to what is described in the literature suggesting that a younger donor should be chosen whenever possible.
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Affiliation(s)
- Alessandra Paz
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre, RS, Brazil
| | - Lisandra Rigoni
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Gustavo Fischer
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Monise Schittler
- Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre, RS, Brazil
| | - Annelise Pezzi
- Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre, RS, Brazil
| | - Vanessa Valim
- Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre, RS, Brazil
| | - Alice Dahmer
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Bruna Zambonato
- Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre, RS, Brazil
| | - Bruna Amorin
- Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre, RS, Brazil
| | - Filipe Sehn
- Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre, RS, Brazil
| | | | - Liane Daudt
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Lucia Silla
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre, RS, Brazil
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Pezzi A, Amorin B, Laureano Á, Valim V, Dahmer A, Zambonato B, Sehn F, Wilke I, Bruschi L, Silva MALD, Filippi-Chiela E, Silla L. Effects Of Hypoxia in Long-Term In Vitro Expansion of Human Bone Marrow Derived Mesenchymal Stem Cells. J Cell Biochem 2017; 118:3072-3079. [PMID: 28240374 DOI: 10.1002/jcb.25953] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [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: 02/22/2017] [Accepted: 02/23/2017] [Indexed: 12/21/2022]
Abstract
Mesenchymal stem cells (MSC) are considered multipotent stromal, non-hematopoietic cells with properties of self-renovation and differentiation. Optimal conditions for culture of MSC have been under investigation. The oxygen tension used for cultivation has been studied and appears to play an important role in biological behavior of mesenchymal cells. The aim is characterize MSC in hypoxia and normoxia conditions comparing their morphological and functional characteristics. Bone marrow-derived mesenchymal stem cells obtained from 15 healthy donors and cultured. MSC obtained from each donor were separated into two cultivation conditions normoxia (21% O2 ) and hypoxia (three donors at 1%, three donors at 2%, five donors at 3%, and four donors at 4% O2 ) up to second passage. MSC were evaluated for proliferation, differentiation, immunophenotyping, size and cell complexity, oxidative stress, mitochondrial activity, and autophagy. Culture conditions applied did not seem to affect immunophenotypic features and cellular plasticity. However, cells subjected to hypoxia showed smaller size and greater cellular complexity, besides lower proliferation (P < 0.002). Furthermore, cells cultured in low O2 tension had lower mitochondrial activity (P < 0.03) and a reduced tendency to autophagy, although oxidative stress did not vary among groups (P < 0.39). Oxygen tension seems to be a key regulator of cellular adaptation in vitro, and metabolic effects underlying this variable remain undescribed. Heterogeneity or even lack of results on the impact of oxygen concentration used for expanding MSC highlights the need for further research, in order to optimize conditions of cultivation and expansion and achieve greater safety and therapeutic efficacy. J. Cell. Biochem. 118: 3072-3079, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Annelise Pezzi
- Celular Therapy Center of Hospital de Clinicas de Porto Alegre, Center for Experimental Research, Porto Alegre, Brazil.,Post-graduation: Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruna Amorin
- Celular Therapy Center of Hospital de Clinicas de Porto Alegre, Center for Experimental Research, Porto Alegre, Brazil.,Centro Universitário Ritter dos Reis, Porto Alegre, Brazil
| | - Álvaro Laureano
- Celular Therapy Center of Hospital de Clinicas de Porto Alegre, Center for Experimental Research, Porto Alegre, Brazil.,Post-graduation: Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Vanessa Valim
- Celular Therapy Center of Hospital de Clinicas de Porto Alegre, Center for Experimental Research, Porto Alegre, Brazil.,Post-graduation: Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alice Dahmer
- Celular Therapy Center of Hospital de Clinicas de Porto Alegre, Center for Experimental Research, Porto Alegre, Brazil.,Post-graduation: Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruna Zambonato
- Celular Therapy Center of Hospital de Clinicas de Porto Alegre, Center for Experimental Research, Porto Alegre, Brazil.,Post-graduation: Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Filipe Sehn
- Celular Therapy Center of Hospital de Clinicas de Porto Alegre, Center for Experimental Research, Porto Alegre, Brazil.,Post-graduation: Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ianaê Wilke
- Celular Therapy Center of Hospital de Clinicas de Porto Alegre, Center for Experimental Research, Porto Alegre, Brazil.,Post-graduation: Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Maria Aparecida Lima da Silva
- Celular Therapy Center of Hospital de Clinicas de Porto Alegre, Center for Experimental Research, Porto Alegre, Brazil
| | | | - Lucia Silla
- Celular Therapy Center of Hospital de Clinicas de Porto Alegre, Center for Experimental Research, Porto Alegre, Brazil.,Post-graduation: Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Hematology and Bone Marrow Transplantation of Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
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Rodrigues L, Magalhães E, Morello F, Clemente T, Balarini L, Gianordoli A, Serrano E, Gavi M, Valim V, Duque R. EDEMA DE MÃO RECORRENTE, DIAGNÓSTICO DE UMA RARA DOENÇA: SÍNDROME DE SECRÉTAN. Revista Brasileira de Reumatologia 2017. [DOI: 10.1016/j.rbr.2017.07.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Lira K, Balarini L, De Lima S, Azevedo A, De Carvalho A, Paschoal V, Myiamoto S, De Souza A, Rocha P, Zanon T, Serrano E, Duque R, Gavi M, Dinis V, Caser L, Salume F, Dalmaso A, Burian A, Pinto L, Brandão, Polito E, Clemente T, Magalhaes E, Rodrigues L, Morello F, De Oliveira K, Thebit M, Bissoli M, Gouvea S, Assis O, De Moura L, Valim V. VACINAÇÃO ANTI‐AMARÍLICA EM PACIENTES COM DOENÇAS REUMÁTICAS IMUNOMEDIADAS: ANÁLISE RETROSPECTIVA. Revista Brasileira de Reumatologia 2017. [DOI: 10.1016/j.rbr.2017.06.119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Valim V, Miyamoto S, Zandonade E, Sardenberg W, Serrano E, Balarine G, Caser L, Tanure L, Ferreira G, Johan G, Ueland P, Mydel P, Brokstad K, Jonsson R. VIA INFLAMATÓRIA DAS QUINURENINAS MEDIADO POR INTERFERON‐GAMA: O ELO PERDIDO ENTRE ATIVIDADE DA DOENÇA E SINTOMAS NA SÍNDROME DE SJÖGREN PRIMÁRIA. Revista Brasileira de Reumatologia 2017. [DOI: 10.1016/j.rbr.2017.07.570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Valim V, Ribeiro T, Pretti R, Franzin A, Clemente T, Sales E, Huber M, Gavi M. AVALIAÇÃO DE MANIFESTAÇÕES ARTICULARES EM PACIENTES COM DOENÇA INFLAMATÓRIA INTESTINAL. Revista Brasileira de Reumatologia 2017. [DOI: 10.1016/j.rbr.2017.07.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Clemente T, Magalhães E, Rodrigues L, Morello F, Balarini L, Duque R, Serrano E, Gavi M, Gianordoli A, Dinis V, Huber M, Santos M, Valim V. SARCOMA HISTIOCÍTICO UM RARO TUMOR CAUSANDO MONOARTRITE CRÔNICA. Revista Brasileira de Reumatologia 2017. [DOI: 10.1016/j.rbr.2017.07.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Brito-Zeron P, Acar-Denizli N, Zeher M, Rasmussen A, Seror R, Mandl T, Li X, Baldini C, Gottenberg JE, Danda D, Quartuccio L, Priori R, Hernández-Molina G, Kruize A, Valim V, Kvarnstrom M, Sene D, Bartoloni E, Praprotnik S, Isenberg D, Solans R, Rischmueller M, Kwok SK, Nordmark G, Suzuki Y, Giacomelli R, Devauchelle-Pensec V, Bombardieri M, Hofauer B, Bootsma H, Hammenfors D, Fraile G, Carsons S, Gheita T, Morel J, Vollenveider C, Atzeni F, Retamozo S, Horvath IF, Sivils K, Theander E, Sandhya P, De Vita S, Sanchez-Guerrero J, van der Heijden E, Moça-Trevisano V, Wahren-Herlenius M, Mariette X, Ramos-Casals M. THU0352 Worldwide Heterogeneous Diagnostic Approach To Primary Sjögren Syndrome in 8315 Patients (EULAR-SS Task Force Big Data Sjögren Project). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Falcão J, Valim V, Titton D, Ranza R, Carvalho H, Bianchi W, Stadler B, Fernandes V, Louzada P, Bertolo M, Duarte A, Macieira J, Miranda J, Castelar G, Freire M, Toledo R, Moraes J, Costa I, Pereira I, Sauma M, Castro G, Brenol C, Zandonade E, Laurindo I, Baaklini C. FRI0195 Switching from anti-TNF To Non anti-TNF Therapy Yield Better Survival in Rheumatoid Arthritis (RA): Results from Brazilian Register of Biological Agents in Rheumatic Diseases – Biobadabrasil. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ranza R, Laurindo I, Titton D, Bertolo M, Bianchi W, Brenol C, Carvalho H, Castro G, Cecconi M, Costa I, Duarte A, Fernandes V, Freire M, Louzada P, Maciera J, Miranda J, Moraes J, Pereira I, Pinheiro G, Sauma M, Stadler B, Toledo R, Valim V, Baaklini C, Descalzo M. SAT0601 Incidence of Serious Infections in Patients with Rheumatoid Arthritis and Spondyloarthritis Exposed To a-TNF Therapy. Results from Biobadabrasil Registry. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Carvalho H, Laurindo I, Ranza R, Titton D, Bertolo M, Bianchi W, Brenol C, Castelar G, Castro G, Costa I, Duarte A, Fernandes V, Freire M, Louzada P, Macieira J, MIranda J, Moraes J, Pereira I, Sauma M, Stadler B, Toledo R, Valim V, Baaklini C. SAT0586 Herpes Zoster in The Brazilian Register -Biobadabrasil. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Brito-Zerόn P, Acar-Denizli N, Zeher M, Rasmussen A, Seror R, Mandl T, Li X, Baldini C, Gottenberg JE, Danda D, Quartuccio L, Priori R, Hernández-Molina G, Kruize A, Valim V, Kvarnstrom M, Sene D, Gerli R, Praprotnik S, Isenberg D, Solans R, Rischmueller M, Park SH, Nordmark G, Suzuki Y, Giacomelli R, Saraux A, Bombardieri M, Hofauer B, Bootsma H, Hammenfors D, Fraile G, Carsons S, Gheita T, Morel J, Vollenveider C, Atzeni F, Retamozo S, Horvath IF, Sivils K, Theander E, Sandhya P, De Vita S, Sanchez-Guerrero J, van der Heijden E, Moça-Trevisano V, Wahren-Herlenius M, Mariette X, Ramos-Casals M. SAT0287 Ethnic Differences Strongly Influence The Phenotypic Expression of Primary Sjögren: Study of 7887 Patients from 20 Countries on 5 Continents (EULAR-SS Task Force Big Data Sjögren Project). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ranza R, Laurindo I, Titton D, Bertolo M, Bianchi W, Brenol C, Bustamante M, Carvalho H, Castro G, Costa I, Duarte A, Fernandes V, Freire M, Louzada P, Maciera J, Miranda J, Moraes J, Pereira I, Pinheiro G, Sauma M, Stadler B, Toledo R, Valim V, Baaklini C, Descalzo M. THU0631 Incidence of Serious Adverse Events in Patients with Rheumatoid Arthritis Exposed To Biologic Therapies. Results from Biobadabrasil Registry. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rodrigues F, Pezzi A, Laureano Á, Valim V, Zambonato B, Dahmer A, Baggio L, Sehn F, Wilke I, L. da Silva MA, Amorin B. Adipocyte Derived Mesenchymal Stromal Cell and Platelet Lysate: Ideal Cell and Supplement for the Treatment of Immune-Inflammatory Diseases? Cell 2016. [DOI: 10.4236/cellbio.2016.52002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Rigoni L, Scroferneker ML, Pitombeira BS, Ottoni E, Paz A, Fischer G, Michalowski M, Pezzi A, Amorin B, Valim V, Baggio L, Laureano Á, da Silva MA, Silla L, Daudt L. Importance of early absolute lymphocyte count after allogeneic stem cell transplantation: a retrospective study. Transplant Proc 2015; 47:511-6. [PMID: 25769599 DOI: 10.1016/j.transproceed.2014.11.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 05/14/2014] [Accepted: 11/25/2014] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Early lymphocyte recovery after allogeneic hematopoietic stem cell transplantation (HSCT) is related to the prevention of serious infections and the clearing of residual tumor cells. METHODS We analyzed the absolute lymphocyte count at 20 (D+20) and 30 (D+30) days after HSCT in 100 patients with malignant hematologic diseases and correlated with the risk of transplant-related mortality, overall survival (OS), disease-free survival (DFS), nonrelapsed mortality (NRM), and risk of infection. RESULTS Patients presenting with lymphocyte counts of <300 × 103/μL on D+30 have a 3.76 times greater risk of death in <100 days. Over a medium follow-up of 20 months OS, DFS, and NRM were similar between the groups. CONCLUSION In our group of patients delayed lymphocyte recovery after HSCT was a predictor of early death post-HSCT.
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Affiliation(s)
- L Rigoni
- Hematology and Bone Marrow Transplantation, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - B S Pitombeira
- Hematology and Bone Marrow Transplantation, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - E Ottoni
- Hematology and Bone Marrow Transplantation, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - A Paz
- Hematology and Bone Marrow Transplantation, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - G Fischer
- Hematology and Bone Marrow Transplantation, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - M Michalowski
- Pediatric Oncology, Hospital Santo Antônio, Porto Alegre, Brazil
| | - A Pezzi
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratory of Cell Culture and Molecular Analysis of Hematopoietic Cells, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - B Amorin
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratory of Cell Culture and Molecular Analysis of Hematopoietic Cells, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - V Valim
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratory of Cell Culture and Molecular Analysis of Hematopoietic Cells, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - L Baggio
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratory of Cell Culture and Molecular Analysis of Hematopoietic Cells, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Á Laureano
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratory of Cell Culture and Molecular Analysis of Hematopoietic Cells, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - M A da Silva
- Laboratory of Cell Culture and Molecular Analysis of Hematopoietic Cells, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - L Silla
- Hematology and Bone Marrow Transplantation, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratory of Cell Culture and Molecular Analysis of Hematopoietic Cells, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
| | - L Daudt
- Hematology and Bone Marrow Transplantation, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Brito Zeron P, Kostov B, Seror R, Baldini C, Quartuccio L, Kvarnstrom M, Kruize A, Hernández Molina G, Praprotnik S, Bartoloni E, Solans R, Theander E, Valim V, Priori R, Zeher M, Isenberg D, Rasmussen A, Giacomelli R, Carsons S, Hammenfors D, Vollenweider C, Atzeni F, Mandl T, De Vita S, Wahren-Herlenius M, Sanchez-Guerrero J, Gerli R, Sivils K, Mowa S, Brun J, Mariette X, Ramos-Casals M. FRI0419 Big Data Sjogren Project (Eular-SS Task Force International Network): Systemic Involvement at Diagnosis Evaluated by the Essdai in 3314 Patients with Primary Sjögren Syndrome. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Miyamoto S, Altoé R, Carletti L, Perez A, Sauer D, Diaz L, Serrano E, Ng WF, Trenell M, Natour J, Valim V. AB0607 Oxygen Uptake, Fatigue and Quality of Life in Patients with Primary Sjögren's Syndrome: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Valim V, Trevisani V, Pasoto S, Serrano E, Ribeiro S, Fidelix T, Vilela V, Prado L, Libόrio-Kimura T, de Brito Filho O, Barros L, Miyamoto S, Lourenço S, Santos M, Vieira L, Adán C. AB0533 Recommendations of Brazilian Society of Rheumatology for the Treatment of SjÖGren's Syndrome. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Brito Zeron P, Kostov B, Zeher M, Theander E, Gottenberg JE, Baldini C, Quartuccio L, Priori R, Kvarnstrom M, Kruize A, Hernández Molina G, Praprotnik S, Isenberg D, Bartoloni E, Rasmussen A, Solans R, Valim V, Giacomelli R, Carsons S, Hammenfors D, Vollenweider C, Atzeni F, Mandl T, De Vita S, Wahren-Herlenius M, Sanchez-Guerrero J, Gerli R, Sivils K, Mowa S, Brun J, Mariette X, Ramos-Casals M. OP0089 Big Data Sjögren Project (Eular-SS Task Force International Network): Characterization at Diagnosis of 5027 Patients with Primary Sjögren Syndrome. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Dias L, Miyamoto S, Valim V, Altoé R. SAT0422 Impact of Symptoms and Disease Activity on Quality of Life in Primary SjÖgren's Syndrome: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Duarte F, Lemes R, Vasconcelos J, Rocha F, Zalcberg I, Coutinho D, Silla L, Valim V, Barbosa M, Santos T, Gonçalves R, Carlos L, Vasconcelos P. 182 ANALYSIS OF EXPANSION MESENCHYMAL STROMAL IN PATIENTS WITH LOW RISK MYELODYSPLASTIC SYNDROME. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30183-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Duarte F, Lemes R, Vasconcelos J, Rocha F, Zalcberg I, Coutinho D, Silla L, Valim V, Barbosa M, Santos T, Gonçalves R, Carlos L, Vasconcelos P. 214 ANALYSIS OF PROTEIN EXPRESSION AND CHANGES IN GENE P53 IN CELLS AND HEMATOPOIETIC MESENCHYMAL BONE MARROW IN PATIENTS WITH LOW RISK MYELODYSPLASTIC SYNDROME. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30215-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Silla L, Valim V, Amorin B, Alegretti AP, Dos Santos de Oliveira F, Lima da Silva MA, Dahmer A, Emerim Lemos N, Mentz Albrecht MA, Macedo Laureano Á, Bonfim C, Moraes Júnior L, Pezzi A, Baggio L, Albrecht CAM, Capra M, Fogliatto L, Della Costa Rigoni L, Fischer G, Paz A, Esteves Daudt L. A safety and feasibility study with platelet lysate expanded bone marrow mesenchymal stromal cells for the treatment of acute graft-versus-host disease in Brazil. Leuk Lymphoma 2014; 55:1203-5. [PMID: 23844820 DOI: 10.3109/10428194.2013.823495] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Lucia Silla
- Cellular Therapy Center of Hospital de Clinicas de Porto Alegre, Center for Experimental Research , Porto Alegre, Rio Grande do Sul , Brazil
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Chakr R, Pavan T, Siqueira I, Zanchet D, Calegaro N, Andrade N, Neto G, Neves M, Bredemeier M, Palominos P, Kohem C, Amorin B, Valim V, Alegretti A, Silla L, Monticielo O, Brenol C, Xavier R, Brenol J. AB0505 Case report of allogeneic unrelated-donor mesenchymal stem cells (msc) infusion in systemic sclerosis (ssc). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.2827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Valim V, Amorin B, Pezzi A, Aparecida Lima da Silva M, Paula Alegretti A, Silla L. Optimization of the Cultivation of Donor Mesenchymal Stromal Cells for Clinical Use in Cellular Therapy. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/cellbio.2014.31003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Fafá B, Valim V, Peçanha P, Laurindo I, Ranzolin A, Hayata A, Duarte Â, Brenol C, Carvalho H, Pinheiro GC, Silveira I, Pereira IA, Costa I, Macieira J, Miranda JR, Moraes JC, Barbosa LSG, Bértolo M, Sauma M, Silva M, Freire M, Scheinberg M, Júnior PL, Toledo R, Ranza R, Oliveira S, Fernandes V, Bianchi W, Titton D, Brasil B. AB0524 Biological agents survival comparisons among different rheumatic disease - brazilian register of biological agents in rheumatic diseases - biobadabrasil. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Paganotti M, Valim V, Serrano EV, Miyamoto ST, Altoé R, Santos MCS. AB0435 Cross-cultural adaptation and psychometric properties of the “eular sjögren’s syndrome patient report index” for portuguese language. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pereira AM, Valim V, Zandonade E, Ciconelli RM. Prevalence of musculoskeletal manifestations in the adult Brazilian population: a study using copcord questionnaires. Clin Exp Rheumatol 2009; 27:42-46. [PMID: 19327228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To estimate the prevalence of musculoskeletal manifestations in the population of Vitoria, Brazil, using the COPCORD questionnaire. METHODS This was a cross-sectional study of 578 people with an age range of 18-65. The sample was probabilistic and stratified according to sex, age and socio-economic class, proportional to the 2000 demographic census data of the Brazilian Institute of Geography and Statistics-IBGE. The COPCORD core questionnaire was used for all subjects, and a rheumatologist evaluated those patients who presented pain and/or functional disability. Laboratory tests and radiographs were carried out in some patients to confirm the diagnosis. RESULTS One hundred and seventy-six patients (30.4%) with a mean age of 41 (SD 13) and predominantly female had pain. Among the patients with pain, 23.2% were unable to do daily living activities. One hundred and thirty (73.9%) were evaluated by a rheumatologist. CONCLUSION The prevalence of musculoskeletal manifestations evaluated by the COPCORD questionnaire was 30.4%.
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Affiliation(s)
- A M Pereira
- Rheumatology Department, Espírito Santo Federal University, Brazil
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Valim V, Assis LSS, Simões MFJ, Trevisani VFM, Pucinelli MLC, Andrade LEC. Correlation between serum E-selectin levels and panoramic nailfold capillaroscopy in systemic sclerosis. Braz J Med Biol Res 2004; 37:1423-7. [PMID: 15334209 DOI: 10.1590/s0100-879x2004000900018] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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: 11/22/2022] Open
Abstract
E-selectin is expressed by the activated endothelium and its plasma levels are increased in patients with systemic sclerosis. Eighteen patients fulfilling the American Rheumatism Association criteria for systemic sclerosis, 15 females and 3 males, 42-70 years old, 9 with diffuse and 9 with limited forms, were sequentially recruited for this study. Serum E-selectin levels were determined by commercially available ELISA and their association with nailfold capillaroscopic abnormalities was investigated. Nailfold capillaries were analyzed by 16X magnification wide-field capillaroscopy. Two parameters on capillaroscopy were used to correlate to serum E-selectin: deletion and ectasia. Data were analyzed statistically by the Student t-test and Spearman correlation. Two-tailed P values below 0.05 were considered significant. E-selectin range was 38 to 200 ng/ml (80 +/- 39.94). There was a correlation between serum E-selectin levels and the deletion capillaroscopic score (r = 0.50, P < 0.035). This correlation was even stronger within the first 48 months of diagnosis (r = 0.63, P < 0.048). On the other hand, no association was observed between selectin and ectasia. Patients with diffuse disease presented higher serum E-selectin levels than patients with limited disease, although the difference was not statistically significant (96.44 +/- 48.04 vs 63.56 +/- 21.77 ng/dl; P = 0.08). The present study is the first showing a correlation between soluble serum E-selectin levels and alterations in capillaroscopy. The stronger correlation of deletion score in capillaroscopy in early disease suggests that serum E-selectin levels might be a useful biochemical marker of disease activity in systemic sclerosis.
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Affiliation(s)
- V Valim
- Divisão de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
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