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‣ Epidemiology of Spondyloarthritis in Brazil

SAMPAIO-BARROS, Percival D.
Fonte: LIPPINCOTT WILLIAMS & WILKINS Publicador: LIPPINCOTT WILLIAMS & WILKINS
Tipo: Artigo de Revista Científica
Português
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During the period of 2006 to 2007, 28 university centers in Brazil used a standardized protocol of investigation to study the epidemiological, clinical and radiological variables of 1036 consecutive patients with the diagnosis of spondyloarthritis (SpA). Validated translated (Portuguese) versions of the Bath Ankylosing Spondylitis (AS) Disease Activity Index and the Bath AS Functional Index were applied. Patient diagnoses were predominantly AS (72.3%), followed by psoriatic arthritis (13.7%), undifferentiated SpA (6.3%), reactive arthritis (3.6%), juvenile SpA (3.1%) and arthritis related to inflammatory bowel disease (1.0%). There was a predominance of male (73.6%) and white (59.5%) patients. Pure axial disease was observed in 36.7% of the patients, whereas the mixed pattern (axial, peripheral and entheseal) was observed in 47.9%. The most common extra-articular involvement was anterior uveitis (20.2%). HLA-B27 was positive in 69.5% of the tested patients.

‣ Ethnic Influence in Clinical and Functional Measures of Brazilian Patients with Spondyloarthritis

Skare, Thelma L.; Bortoluzzo, Adriana B.; Goncalves, Celio R.; Braga da Silva, Jose Antonio; Ximenes, Antonio Carlos; Bertolo, Manoel B.; Ribeiro, Sandra L. E.; Keiserman, Mauro; Menin, Rita; Carneiro, Sueli; Azevedo, Valderilio F.; Vieira, Walber P.; Alb
Fonte: J RHEUMATOL PUBL CO; TORONTO Publicador: J RHEUMATOL PUBL CO; TORONTO
Tipo: Artigo de Revista Científica
Português
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Objective. Spondyloarthritides (SpA) can present different disease spectra according to ethnic background. The Brazilian Registry of Spondyloarthritis (RBE) is a nationwide registry that comprises a large databank on clinical, functional, and treatment data on Brazilian patients with SpA. The aim of our study was to analyze the influence of ethnic background in SpA disease patterns in a large series of Brazilian patients. Methods. A common protocol of investigation was prospectively applied to 1318 SpA patients in 29 centers distributed through the main geographical regions in Brazil. The group comprised whites (65%), African Brazilians (31.3%), and people of mixed origins (3.7%). Clinical and demographic variables and various disease index scores were compiled. Ankylosing spondylitis (AS) was the most frequent disease in the group (65.1%); others were psoriatic arthritis (18.3%), undifferentiated SpA (6.8%), enteropathic arthritis (3.7%), and reactive arthritis (3.4%). Results. White patients were significantly associated with psoriasis (p = 0.002), positive HLA-B27 (p = 0.014), and use of corticosteroids (p < 0.0001). Hip involvement (p = 0.02), axial inflammatory pain (p = 0.04), and radiographic sacroiliitis (p = 0.025) were associated with African Brazilian descent. Sex distribution...

‣ Ethnic Influence in Clinical and Functional Measures of Brazilian Patients with Spondyloarthritis

Skare, Thelma L.; Bortoluzzo, Adriana B.; Goncalves, Celio R.; Braga da Silva, Jose Antonio; Ximenes, Antonio Carlos; Bertolo, Manoel B.; Ribeiro, Sandra L. E.; Keiserman, Mauro; Menin, Rita; Carneiro, Sueli; Azevedo, Valderilio F.; Vieira, Walber P.; Alb
Fonte: J Rheumatol Publ Co; Toronto Publicador: J Rheumatol Publ Co; Toronto
Tipo: Artigo de Revista Científica
Português
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Objective. Spondyloarthritides (SpA) can present different disease spectra according to ethnic background. The Brazilian Registry of Spondyloarthritis (RBE) is a nationwide registry that comprises a large databank on clinical, functional, and treatment data on Brazilian patients with SpA. The aim of our study was to analyze the influence of ethnic background in SpA disease patterns in a large series of Brazilian patients. Methods. A common protocol of investigation was prospectively applied to 1318 SpA patients in 29 centers distributed through the main geographical regions in Brazil. The group comprised whites (65%), African Brazilians (31.3%), and people of mixed origins (3.7%). Clinical and demographic variables and various disease index scores were compiled. Ankylosing spondylitis (AS) was the most frequent disease in the group (65.1%); others were psoriatic arthritis (18.3%), undifferentiated SpA (6.8%), enteropathic arthritis (3.7%), and reactive arthritis (3.4%). Results. White patients were significantly associated with psoriasis (p = 0.002), positive HLA-B27 (p = 0.014), and use of corticosteroids (p < 0.0001). Hip involvement (p = 0.02), axial inflammatory pain (p = 0.04), and radiographic sacroiliitis (p = 0.025) were associated with African Brazilian descent. Sex distribution...

‣ Demographic, clinical, laboratory and treatment characteristics of spondyloarthritis patients with and without acute anterior uveitis

Gehlen,Marcelo; Regis,Kelly Cristina; Skare,Thelma Larocca
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2012 Português
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CONTEXT AND OBJECTIVE: Acute anterior uveitis is a common extra-articular manifestation in spondyloarthritis patients. The aim of this study was to compare demographic, clinical, laboratory and treatment data among spondyloarthritis patients with and without acute anterior uveitis. DESIGN AND SETTING: This was a cross-sectional analytical study at the Rheumatology Outpatient Clinic of the Evangelical University Hospital, Curitiba, Brazil. METHODS: Spondyloarthritis patients with without acute anterior uveitis were compared regarding demographic data, spondyloarthritis subtype, peripheral arthritis, enthesitis, disease activity, functional index, physical examination, radiological involvement, HLA-B27 and treatment. RESULTS: Presence of acute anterior uveitis was not found to have any relationship with functional index, degree of radiological involvement, peripheral arthritis or enthesitis. Acute anterior uveitis showed a negative association with skin manifestations (P = 0.04) and a trend towards higher disease activity (P = 0.06). CONCLUSION: In the study sample, it could not be shown that AAU had any association with the functional and radiological prognoses. The patients with spondyloarthritis with and without acute anterior uveitis did not differ clinically except for a higher proportion of ankylosing spondylitis and smaller presence of skin involvement in those with uveitis.

‣ Comparison of performance of the Assessment of Spondyloarthritis International Society, the European Spondyloarthropathy Study Group and the modified New York criteria in a cohort of Chinese patients with spondyloarthritis

Chung, Ho Yin; Lau, Chak Sing; Wu, Ka Pik; Wong, Woon Sing; MOK, Mo Yin
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
Português
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Early diagnosis of spondyloarthritis (SpA) is essential as anti-tumor necrosis factor therapy can achieve significant symptomatic relief and control of disease activity. This study aims to compare the clinical characteristics, disease activity, and functional status of a Chinese cohort of SpA patients who were re-classified into ankylosing spondylitis (AS) patients fulfilling the modified New York (MNY) criteria, those with undifferentiated SpA (USpA) fulfilling the European Spondyloarthropathy Study Group (ESSG) classification criteria only (USpA/ESSG) and those who fulfill Assessment of SpondyloArthritis International Society (ASAS) only (USpA/ASAS). Disease activity was evaluated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), severity of morning stiffness, patient global assessment, and C-reactive protein. Functional status was evaluated by Bath Ankylosing Spondylitis Functional Index (BASFI), modified Schober index, and dimension of chest expansion. One hundred and twenty-eight patients with disease duration of 16.3 ± 10.4 years were recruited. Patients in USpA/ESSG and USpA/ASAS were significantly younger (p = 0.01), had shorter disease duration (p < 0.01), and lower BASFI (p = 0.03) than established AS patients. All three groups have active disease with comparable BASDAI >3. BASFI correlated inversely with dimension of chest expansion and negatively modified Schober index in AS patients (p < 0.01) and modestly with BASDAI (r = 0.25...

‣ Juvenile Spondyloarthritis Treatment Recommendations

Tse, Shirley; Burgos-Vargas, Ruben; Colbert, Robert A.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /05/2012 Português
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No specific recommendations for the treatment of juvenile spondyloarthritis have been established. Important differences exist in how spondyloarthritis begins and progresses in children and adults, supporting the need for pediatric-specific recommendations. Recently published recommendations for the treatment of juvenile arthritis consider children with sacroiliitis in a separate group, and allow for more accelerated institution of a TNF inhibitor depending on disease activity and prognostic factors that derive primarily from studies of other forms of juvenile arthritis. There is a need to develop measures of disease activity and prognosis specific for juvenile spondyloarthritis that reflect spinal disease, as well as other major clinical features such as enthesitis, before significant progress can be made in this area.

‣ The assessment of the spondyloarthritis international society concept and criteria for the classification of axial spondyloarthritis and peripheral spondyloarthritis: A critical appraisal for the pediatric rheumatologist

Burgos-Vargas, Ruben
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 31/05/2012 Português
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This review refers to the origin and current state of the assessment of the SpondyloArthritis International Society (ASAS) criteria for the classification of axial and peripheral spondyloarthritis (SpA) and the possible implications in the pediatric population. The ASAS criteria evolved from the idea that the earlier the recognition of patients with ankylosing spondylitis, the better the efficacy of tumor necrosis factor blockers. Strategies included the development of new concepts, definitions, and techniques for the study of clinical signs and symptoms. Of relevance, the new definition of inflammatory back pain (IBP) and the introduction of sacroiliitis by magnetic resonance imaging represented the most important advance in the early identification of AS in the “pre-radiographic stage” of the disease. AS is considered in this paper as a disease continuum with symptoms depending on age at onset. The application of those specific strategies in children and adolescents with SpA seems limited because the most important manifestation in the early stage of disease is not IBP, but peripheral arthritis and enthesitis. In this instance, the logical approach to juvenile onset SpA according to ASAS criteria should not be through the axial criteria but rather the peripheral set of criteria.

‣ Entheses and Bones in Spondyloarthritis: 2008 Annual Research and Education Meeting of the Spondyloarthritis Research and Therapy Network (SPARTAN)

Colbert, Robert A; Deodhar, Atul A; Fox, David; Gravallese, Ellen M; Khan, Muhammad Asim; McGonagle, Dennis; Reveille, John D; Schett, Georg; Weisman, Michael; Clegg, Daniel O;
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /07/2009 Português
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The Spondyloarthritis Research and Therapy Network (SPARTAN), founded in 2003 to promote research, education, and treatment of ankylosing spondylitis (AS) and related forms of spondyloarthritis (SpA), held its sixth Annual Research and Education Meeting in July 2008 in Cleveland, Ohio. The overall theme of the meeting was entheses and bones in SpA, which included presentations on the anatomy and physiology of the synovial-entheseal complex; bone formation and destruction, and the impact of inflammation on bone; the Th17 axis, HLA-B27, IL23R, and ARTS1; and breakout sessions on epidemiology and registries.

‣ Clinical and Radiological Presentations of Late-Onset Spondyloarthritis

Hmamouchi, Ihsane; Bahiri, Rachid; Hajjaj-Hassouni, Najia
Fonte: International Scholarly Research Network Publicador: International Scholarly Research Network
Tipo: Artigo de Revista Científica
Publicado em 20/03/2011 Português
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The last few years have witnessed considerable progress in the diagnosis and treatment of spondyloarthritis (SpA). Tools are now available for establishing the diagnosis at an early stage, when appropriate treatment may be able to control the inflammatory process, limit the functional impairments, and improve quality of life. Late-onset SpA after the age of 50 years is uncommon. All the spondyloarthritis subgroups are represented in the elderly. Thus, late onset spondyloarthritis is underdiagnosed in favour of other inflammatory disorders that are more frequently observed in the elderly because the clinical or radiological presentations of late-onset spondyloarthritis are modified in the elderly. They deserve further attention because age population is increasing and new criteria for axial SpA including sacroiliitis detected by MRI may help the clinician with diagnosis. Specific studies evaluating the benefit/risk ratio of TNFα-blocking agents in late onset SpA patients are required.

‣ Role of HLA-B Alleles and Clinical Presentation of B27 Negative Spondyloarthritis Patients from Mumbai, Western India

Parasannanavar, Devaraj J.; Rajadhyaksha, Anjali; Ghosh, Kanjaksha
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
Português
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Seronegative spondyloarthritis (SpA) are variably associated with HLA-B∗27 antigen. HLA-B∗27 negative SpA has also been reported from different parts of the world. There is paucity of data on this entity from Indian subcontinent. We studied 100 consecutively diagnosed HLA-B27 negative spondyloarthritis patients from a tertiary care center in India. Modified New York Criteria for ankylosing spondylitis (AS) and ESSG criteria for SpA were used for diagnosing patients. HLA-B∗27 typing was done by an in-house PCR-SSP technique in SpA patients to exclude B∗27 positive patients and PCR-SSOP technique was used to type 100 B∗27 negative SpA patients and 100 controls from the same ethnicity. Frequency of B∗07 was significantly increased (B∗07: % PF 54 versus 18; OR 5.348; 95% CI 2.808–10.186; P value 1.14E − 07), whereas frequency of B∗40 was significantly decreased (B∗40: % PF 17 versus 32; OR 0.435; 95% CI 0.222–0.850; P value 0.013) when compared with B∗27 negative controls. Among 100 SpA patients, 47 were undifferentiated spondyloarthritis and 33 patients were reactive arthritis patients. 40% of the patients were suffering from polyarticular arthritis, 35% had pauciarticular arthritis with knee joint, hip joint...

‣ The Prevalence of Sacroiliitis and Spondyloarthritis in Patients with Sarcoidosis

Kobak, Senol; Sever, Fidan; Ince, Ozlem; Orman, Mehmet
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
Português
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Introduction. Sarcoidosis is a chronic granulomatous disease, which can involve different organs and systems. Coexistence of sarcoidosis and spondyloarthritis has been reported in numerous case reports. Purpose. To determine the prevalence of sacroiliitis and spondyloarthritis in patients previously diagnosed with sarcoidosis and to investigate any possible relation with clinical findings. Materials and Methods. Forty-two patients with sarcoidosis were enrolled in the study. Any signs and symptoms in regard to spondyloarthritis (i.e., existence of inflammatory back pain, gluteal pain, uveitis, enthesitis, dactylitis, inflammatory bowel disease, and psoriasis) were questioned in detail and biochemical tests were evaluated. Sacroiliac joint imaging and lateral heel imaging were performed in all patients. Results. Sacroiliitis was found in 6 of the 42 (14.3%) sarcoidosis patients and all of these patients were female. Common features of the disease in these six patients were inflammatory back pain as the major clinical complaint, stage 2 sacroiliitis as revealed by radiological staging, and the negativity of HLA B-27 test. These six patients with sacroiliitis were diagnosed with spondyloarthritis according to the criteria of ASAS and of ESSG. Conclusion. We found spondyloarthritis in patients with sarcoidosis at a higher percentage rate than in the general population (1–1.9%). Controlled trials involving large series of patients are required for the confirmation of the data.

‣ The window of opportunity: a relevant concept for axial spondyloarthritis

Robinson, Philip C; Brown, Matthew A
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
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The window of opportunity is a concept critical to rheumatoid arthritis treatment. Early treatment changes the outcome of rheumatoid arthritis treatment, in that response rates are higher with earlier disease-modifying anti-rheumatic drug treatment and damage is substantially reduced. Axial spondyloarthritis is an inflammatory axial disease encompassing both nonradiographic axial spondyloarthritis and established ankylosing spondylitis. In axial spondyloarthritis, studies of magnetic resonance imaging as well as tumor necrosis factor inhibitor treatment and withdrawal studies all suggest that early effective suppression of inflammation has the potential to reduce radiographic damage. This potential would suggest that the concept of a window of opportunity is relevant not only to rheumatoid arthritis but also to axial spondyloarthritis. The challenge now remains to identify high-risk patients early and to commence treatment without delay. Developments in risk stratification include new classification criteria, identification of clinical risk factors, biomarkers, genetic associations, potential antibody associations and an ankylosing spondylitis-specific microbiome signature. Further research needs to focus on the evidence for early intervention and the early identification of high-risk individuals.

‣ Might axial myofascial properties and biomechanical mechanisms be relevant to ankylosing spondylitis and axial spondyloarthritis?

Masi, Alfonse T
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Português
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Ankylosing spondylitis and axial spondyloarthropathy have characteristic age- and sex-specific onset patterns, typical entheseal lesions, and marked heritability, but the integrative mechanisms causing the pathophysiological and structural alterations remain largely undefined. Myofascial tissues are integrated in the body into webs and networks which permit transmission of passive and active tensional forces that provide stabilizing support and help to control movements. Axial myofascial hypertonicity was hypothesized as a potential excessive polymorphic trait which could contribute to chronic biomechanical overloading and exaggerated stresses at entheseal sites. Such a mechanism may help to integrate many of the characteristic host, pathological, and structural features of ankylosing spondylitis and axial spondyloarthritis. Biomechanical stress and strain were recently documented to correlate with peripheral entheseal inflammation and new bone formation in a murine model of spondyloarthritis. Ankylosing spondylitis has traditionally been classified by the modified New York criteria, which require the presence of definite radiographic sacroiliac joint lesions. New classification criteria for axial spondyloarthritis now include patients who do not fulfill the modified New York criteria. The male-to-female sex ratios clearly differed between the two patient categories - 2:1 or 3:1 in ankylosing spondylitis and 1:1 in non-radiographic axial spondyloarthritis - and this suggests a spectral concept of disease and...

‣ UPDATE ON THE AMERICAN COLLEGE OF RHEUMATOLOGY/SPONDYLOARTHRITIS RESEARCH AND TREATMENT NETWORK/SPONDYLITIS ASSOCIATION OF AMERICA AXIAL SPONDYLOARHTRITIS TREATMENT GUIDELINES PROJECT

Ward, Michael M.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
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The American College of Rheumatology, the Spondyloarthritis Research and Treatment Network, and the Spondylitis Association of America have begun collaborating on a project to develop treatment guidelines for axial spondyloarthritis. The project will use the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method, which is based on systematic literature reviews and quantitative evidence summaries, to develop treatment recommendations for the use of pharmacological interventions, rehabilitation, surgery, preventive care, and disease monitoring in patients with ankylosing spondylitis and axial spondyloarthritis.

‣ Coexistence of osteopoikilosis with seronegative spondyloarthritis and spinal stenosis

Demir, Saliha Eroglu; Özaras, Nihal; Poyraz, Emine; Toprak, Hüseyin; Güler, Mustafa
Fonte: The Society of Physical Therapy Science Publicador: The Society of Physical Therapy Science
Tipo: Artigo de Revista Científica
Português
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[Purpose] Osteopoikilosis is a rare hereditary bone disease that is usually asymptomatic. It is generally diagnosed incidentally on plain radiography. The coexistence of osteopoikilosis with seronegative spondyloarthritis or spinal stenosis is rarely reported. Here, we report the case of a 27-year-old male patient with osteopoikilosis, seronegative spondyloarthritis, and spinal stenosis. [Subject] A 27-year-old male patient with buttock pain and back pain radiating to the legs. [Methods] A plain anteroposterior radiograph of the pelvis revealed numerous round and oval sclerotic bone areas of varying size. Investigation of the knee joints showed similar findings, and the patient was diagnosed with osteopoikilosis. Lumbar magnetic resonance images showed spinal stenosis and degenerative changes in his lumbar facet joints. Magnetic resonance images of the sacroiliac joints showed bilateral involvement with narrowing of both sacroiliac joints, nodular multiple sclerotic foci, and contrast enhancement in both joint spaces and periarticular areas. HLA B-27 test was negative. [Results] The patient was diagnosed with osteopoikilosis, seronegative spondyloarthritis, and spinal stenosis. Treatment included asemetasin twice daily and exercise therapy. [Conclusion] Symptomatic patients with osteopoikilosis should be investigated for other possible coexisting medical conditions; this will shorten the times to diagnosis and treatment.

‣ Occasional presence of herpes viruses in synovial fluid and blood from patients with rheumatoid arthritis and axial spondyloarthritis

Burgos, Rubén; Ordoñez, Graciela; Vázquez-Mellado, Janitzia; Pineda, Benjamín; Sotelo, Julio
Fonte: Springer London Publicador: Springer London
Tipo: Artigo de Revista Científica
Português
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Viral agents have been suspected as participants of immune-mediated disorders. In the case of rheumatic diseases, the synovial joint cavity represents a secluded area of inflammation which could harbor etiological agents. We analyzed by polymerase chain reaction the possible presence of DNA from various herpes viruses in blood and synovial fluid from patients with either rheumatoid arthritis (n = 18), axial spondyloarthritis (n = 11), or osteoarthritis (n = 8). Relevant findings were as follows: DNA from varicella zoster virus was found in synovial fluid but not in blood mononuclear cells from 33 % of patients with rheumatoid arthritis and in 45 % of patients with axial spondyloarthritis but not in patients with osteoarthritis. Also, DNA from herpes simplex viruses 1 and 2 was found both in the blood and in the synovial fluid from 33 % of patients with rheumatoid arthritis. Our results indicate the occasional presence of DNA from herpes viruses in patients with rheumatoid arthritis or with axial spondyloarthritis. However, these findings might represent a parallel epiphenomenon of viral activation associated either with immunosuppressive therapy or with primary immune disturbances, rather than the etiological participation of herpes viruses in these disorders.

‣ Gender characterization in a large series of Brazilian patients with spondyloarthritis

de Carvalho, Hellen M. S.; Bortoluzzo, Adriana B.; Goncalves, Celio R.; Braga da Silva, Jose Antonio; Ximenes, Antonio Carlos; Bertolo, Manoel B.; Ribeiro, Sandra L. E.; Keiserman, Mauro; Menin, Rita; Skare, Thelma L.; Carneiro, Sueli; Azevedo, Valderilio
Fonte: SPRINGER LONDON LTD; LONDON Publicador: SPRINGER LONDON LTD; LONDON
Tipo: Artigo de Revista Científica
Português
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An increasing number of women have been diagnosed with spondyloarthritis (SpA) in recent decades. While a few studies have analyzed gender as a prognostic factor of the disease, no studies have addressed this matter with a large number of patients in South America, which is a peculiar region due to its genetic heterogeneity. The aim of the present study was to analyze the influence of gender on disease patterns in a large cohort of Brazilian patients with SpA. A prospective study was carried out involving 1,505 patients [1,090 males (72.4%) and 415 females (27.6%)] classified as SpA according to the European Spondyloarthropaties Study Group criteria who attended at 29 reference centers for rheumatology in Brazil. Clinical and demographic variables were recorded and the following disease indices were administered: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Radiologic Index (BASRI), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), and Ankylosing Spondylitis Quality of Life (ASQoL). Ankylosing spondylitis (AS) was the most frequent disease in the group (65.4%), followed by psoriatic arthritis (18.4%), undifferentiated SpA (6.7%)...

‣ Gender characterization in a large series of Brazilian patients with spondyloarthritis

de Carvalho, Hellen M. S.; Bortoluzzo, Adriana B.; Goncalves, Celio R.; Braga da Silva, Jose Antonio; Ximenes, Antonio Carlos; Bertolo, Manoel B.; Ribeiro, Sandra L. E.; Keiserman, Mauro; Menin, Rita; Skare, Thelma L.; Carneiro, Sueli; Azevedo, Valderilio
Fonte: Springer; London Publicador: Springer; London
Tipo: Artigo de Revista Científica
Português
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373.7958%
An increasing number of women have been diagnosed with spondyloarthritis (SpA) in recent decades. While a few studies have analyzed gender as a prognostic factor of the disease, no studies have addressed this matter with a large number of patients in South America, which is a peculiar region due to its genetic heterogeneity. The aim of the present study was to analyze the influence of gender on disease patterns in a large cohort of Brazilian patients with SpA. A prospective study was carried out involving 1,505 patients [1,090 males (72.4%) and 415 females (27.6%)] classified as SpA according to the European Spondyloarthropaties Study Group criteria who attended at 29 reference centers for rheumatology in Brazil. Clinical and demographic variables were recorded and the following disease indices were administered: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Radiologic Index (BASRI), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), and Ankylosing Spondylitis Quality of Life (ASQoL). Ankylosing spondylitis (AS) was the most frequent disease in the group (65.4%), followed by psoriatic arthritis (18.4%), undifferentiated SpA (6.7%)...

‣ Pharmacological treatment of spondyloarthritis: exploring the effectiveness of nonsteroidal anti-inflammatory drugs, traditional disease-modifying antirheumatic drugs and biological therapies

Caso, Francesco; Costa, Luisa; Del Puente, Antonio; Di Minno, Matteo Nicola Dario; Lupoli, Gelsy; Scarpa, Raffaele; Peluso, Rosario
Fonte: SAGE Publications Publicador: SAGE Publications
Tipo: Artigo de Revista Científica
Publicado em /11/2015 Português
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Spondyloarthritis represents a heterogeneous group of articular inflammatory diseases that share common genetic, clinical and radiological features. The therapy target of spondyloarthritis relies mainly in improving patients’ quality of life, controlling articular inflammation, preventing the structural joints damage and preserving the functional abilities, autonomy and social participation of patients. Among these, traditional disease-modifying antirheumatic drugs have been demonstrated to be effective in the management of peripheral arthritis; moreover, in the last decade, biological therapies have improved the approach to spondyloarthritis. In patients with axial spondyloarthritis, tumor necrosis factor α inhibitors are currently the only effective therapy in patients for whom conventional therapy with nonsteroidal anti-inflammatory drugs has failed. The aim of this review is to summarize the current experience and evidence about the pharmacological approach in spondyloarthritis patients.

‣ Management of early spondyloarthritis: from diagnosis to treatment in clinical practice

Moltó Revilla, Anna; Tor, Jordi
Fonte: [Barcelona] : Universitat Autònoma de Barcelona, Publicador: [Barcelona] : Universitat Autònoma de Barcelona,
Tipo: Tesis i dissertacions electròniques; info:eu-repo/semantics/doctoralThesis; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em //2015 Português
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L'objectiu d'aquesta recerca era avaluar el diagnòstic i el tractament de les formes primerenques d‘espondiloartritis a la practica diària. Per això, hem inclòs en aquesta tesi tres articles que reflecteixen els tres punts claus de la nostra recerca. Primer, hem validat els criteris ASAS per a les espondiloartritis axials en la pràctica clínica, avaluant el seu rendiment per a la classificació dels pacients però també per al diagnòstic, comparant-los amb altres criteris d'espondiloartritis, i en diferents subgrups d ‘espondiloartritis (com l'artritis psoriàsica, o l'artritis relacionada amb la malaltia inflamatòria intestinal). En segon lloc, donat que el braç "clínic" dels criteris ASAS per a les espondiloartritis axials no està completament reconegut per alguns col·legues i algunes instàncies sanitàries i de governs, vàrem investigar si les característiques demogràfiques fenotípiques i de la malaltia de pacients dels pacients que pertanyien al braç "imatge" i "clínic" dels criteris ASAS eren diferents, en un grup de espondiloartritis primerenques. Finalment, ens vam interessar a l'efecte terapèutic dels inhibidors del TNF alfa a la practica clínica i en les formes primerenques d ‘espondiloartritis...