Rheumatoid artrhitis treatment in Brazil: data from a large real-life multicenter study
Adv Rheumatol
;
60: 16, 2020. tab
Article
in English
| LILACS
| ID: biblio-1088647
ABSTRACT
Abstract Background:
Last decades witnessed great technological advances in rheumatoid arthritis (RA) management, but their implementation in clinical practice might prove difficult. Despite the efficacy demonstrated in controlled trials this information needs to be confirmed by real life data. This study assessed real-life treatment among RA patients.Methods:
REAL study included Brazilian RA patients from eleven centers. Interview and medical records were performed. Continuous variables were compared using Student's t or Mann-Whitney and categorical variables were assessed with chi-square or Fisher's exact tests.Results:
1115 patients were included, women 89.5%. Median age 56.6 years, disease duration 152.5 months; 78.7% were rheumatoid fator positive; 55.2% had erosive disease; DAS28 (disease activity index-28 joints) = 3.5, HAQ (health assessment questionnaire) =0.875. The median duration of symptoms until the start of first DMARD was 12 months. A total of 529 (47.2%) patients used corticosteroids; 1022 (90.8%) were on conventional synthetic (cs) DMARDs and 406 (36.1%) on biological (b) DMARDs. Methotrexate (MTX) was the most frequent csDMARD 748 (66.5%) patients, followed by leflunomide (LFN), used by 381 (33.9%) of patients. MTX was associated to LFN in 142 (12.6%) patients. Only five (0.4%) patients used triple therapy (MTX + hydroxychloroquine + sulfasalazine) or sulfasalazine in monotherapy.Conclusions:
Despite advances in therapeutic resources, roughly half RA patients failed achieve T2T goals and 55.2% developed erosive disease. The frequent use of corticosteroids and delay in initiating DMARDs were demonstrated. Issues concerning timely access to medical care are crucial for effective management.(AU)
Full text:
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Index:
LILACS (Americas)
Main subject:
Arthritis, Rheumatoid
Type of study:
Controlled clinical trial
/
Observational study
Limits:
Humans
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Adv Rheumatol
Journal subject:
Artrite
/
Reumatologia
Year:
2020
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Hospital do Servidor Público Estadual de São Paulo/BR
/
Universidade Estadual de Campinas/BR
/
Universidade Federal de Minas Gerais/BR
/
Universidade Federal de Santa Catarina/BR
/
Universidade Federal do Paraná/BR
/
Universidade Federal do Pará/BR
/
Universidade Federal do Rio Grande do Sul/BR
/
Universidade de Brasília- UnB/BR
/
Universidade de Ribeirao Preto/BR
/
Universidade de São Paulo/BR
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