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3.
J Korean Med Sci ; 37(19): e159, 2022 May 16.
Article in English | MEDLINE | ID: mdl-35578590

ABSTRACT

BACKGROUND: Unnecessary and inappropriate laboratory testing accounts for a significant portion of waste in health care utilization. The aim of this study was to examine the diagnostic value of the anti-nuclear antibody (ANA) test by examining the rate of ANA associated rheumatic disease (AARD) diagnosis among ANA tested and ANA positive subjects and positive predictive value (PPV) of ANA test leading to AARD diagnosis in different ANA titers and different subsets of patients in 5 hospitals affiliated with a university. METHODS: We retrospectively extracted data from all subjects who were tested for ANA from year 2010 to 2019. Those who were first evaluated at or referred to rheumatology were further evaluated with extraction of data including ANA titer and ultimate diagnosis. PPVs for ANA test were evaluated after stratification according to clinically relevant key parameters, such as patient age (younger < 65 years vs. older), sex, and requesting department. RESULTS: From 2010 to 2019, A total of 94,153 patients were tested for ANA, of which 13,600 (14.4% of the total) were positive. AARD was diagnosed in only 0.69% among all ANA tested patients and 4.74% among ANA positive patients. The AARD diagnosis rate of ANA positive patients varied widely from 0.1% to 8.7% by requesting department. Using cutoff values above 1:320 yielded PPVs of 15.6 and 7.8% for all AARs and systemic lupus erythematosus. The PPV was significantly higher in young age (< 65 years) and in women, and when it was requested from internal medicine vs other departments. CONCLUSION: AARD was diagnosed in less than 1% of all ANA tested patients in university-affiliated hospitals. This result shows that careful consideration before ordering the screening ANA is needed to improve the utility of the test for providers and patients and to reduce health costs spurred by unnecessary testing and its consequences.


Subject(s)
Lupus Erythematosus, Systemic , Rheumatic Diseases , Aged , Antibodies, Antinuclear , Female , Hospitals, University , Humans , Lupus Erythematosus, Systemic/diagnosis , Republic of Korea , Retrospective Studies , Rheumatic Diseases/diagnosis , Universities
4.
Zhongguo Dang Dai Er Ke Za Zhi ; 24(4): 447-453, 2022 Apr 15.
Article in Chinese | MEDLINE | ID: mdl-35527423

ABSTRACT

Tofacitinib is a Janus kinase inhibitor and can block the Janus kinase-signal transducer and activator of transcription signal transduction pathway and reduce the production and release of a variety of cytokines. It has great potential in the treatment of various rheumatic diseases with a rapid onset of action and can reduce corticosteroid dependence and related adverse events. The therapeutic effect of tofacitinib in adult patients has been confirmed, and it has been increasingly used in pediatric patients in recent years. This article reviews the clinical application of tofacitinib in the treatment of pediatric autoimmune diseases.


Subject(s)
Piperidines , Rheumatic Diseases , Adult , Child , Humans , Janus Kinases/metabolism , Piperidines/therapeutic use , Protein Kinase Inhibitors/therapeutic use , Pyrimidines/pharmacology , Pyrimidines/therapeutic use , Rheumatic Diseases/chemically induced , Rheumatic Diseases/drug therapy
6.
Arthritis Res Ther ; 24(1): 100, 2022 May 07.
Article in English | MEDLINE | ID: mdl-35526074

ABSTRACT

BACKGROUND: Polyunsaturated fatty acid (PUFA) supplementation has been reported to improve disease activity in inflammatory rheumatic diseases (IRDs). However, data are often conflicting and studies insufficiently large to draw conclusions. This systematic literature review and meta-analysis aimed to better estimate the effect of oral supplementation with omega (n)-3 and n-6 PUFA on IRD activity in terms of duration, dose, type, and source. METHODS: The literature was searched in PubMed, EMBASE, and Cochrane Library databases up to October 2020. Studies were reviewed in accordance with PRISMA guidelines. The effect of PUFA supplementation on disease activity was expressed as the standardized mean difference (95% CI). Metaregression and subgroup analyses involved type of IRD, Jadad score, PUFA source (animal or vegetable), and doses. RESULTS: We obtained 42 references; 30 randomized controlled studies were included comparing the effects of PUFA versus control on disease activity (710 IRD patients receiving PUFA supplementation and 710 controls, most with rheumatoid arthritis). We found a significant improvement in pain, swollen and tender joint count, Disease Activity Score in 28 joints, and Health Assessment Questionnaire score in IRD patients receiving PUFA supplementation as compared with controls, with a significant decrease in erythrocyte sedimentation rate but not C-reactive protein level. Although meta-regression revealed no difference by IRD type or source or dose of PUFA supplementation, subgroup analysis revealed more parameters significantly improved with animal- than vegetable-derived PUFAs and 3- to 6-month supplementation. Most studies examined high-dose supplementation (>2 g/day). CONCLUSION: PUFA consumption, especially omega-3 from animal source >2 g/day, may improve IRD activity and might be an adjuvant therapy in rheumatoid arthritis. TRIAL REGISTRATION: The protocol was registered at PROSPERO ( CRD42021253685 ).


Subject(s)
Arthritis, Rheumatoid , Fatty Acids, Omega-3 , Rheumatic Diseases , Animals , Arthritis, Rheumatoid/drug therapy , Dietary Supplements , Fatty Acids, Unsaturated/therapeutic use , Humans , Rheumatic Diseases/drug therapy
7.
J Exp Med ; 219(6)2022 Jun 06.
Article in English | MEDLINE | ID: mdl-35510951

ABSTRACT

Sexual dimorphism in the composition and function of the human immune system has important clinical implications, as males and females differ in their susceptibility to infectious diseases, cancers, and especially systemic autoimmune rheumatic diseases. Both sex hormones and the X chromosome, which bears a number of immune-related genes, play critical roles in establishing the molecular basis for the observed sex differences in immune function and dysfunction. Here, we review our current understanding of sex differences in immune composition and function in health and disease, with a specific focus on the contribution of the X chromosome to the striking female bias of three autoimmune rheumatic diseases.


Subject(s)
Autoimmune Diseases , Rheumatic Diseases , Female , Humans , Male , Sex Characteristics
8.
Reumatismo ; 74(1)2022 May 03.
Article in English | MEDLINE | ID: mdl-35506317

ABSTRACT

Post-coronavirus disease (COVID) syndrome (PCS) is a term used to describe the clinical condition of patients who have recovered from COVID-19 but are still experiencing prolonged effects of infection or persistent symptoms for longer than expected. Although PCS has been previously studied in the general population, it has not been investigated in a specific population of patients with inflammatory rheumatic disease (IRD). This study aims to evaluate the presence and frequency of PCS among our rheumatology outpatients. This is a cross-sectional study of patients with IRD whose symptoms persisted for 12 weeks after the detection of COVID-19 infection. The patients were assessed with a survey form during their routine clinic follow-up or by contacting them by phone. Patients' demographics, diagnosis, medication, comorbidities, outcome of COVID-19, and symptoms related to PCS were collected. Fifty-three patients with IRD and COVID (mean age: 48.5 13.99 years, 71.7% women) were included. PCS was observed in 36 (67.9%) patients. Twenty-two (41.5%) of them had three or more symptoms; 14 (26.4%) had one or two symptoms. Although more than 30 symptoms were detected, the most frequent were fatigue and weakness. No significant relationship was detected between the development of PCS and gender, age, disease duration, presence of COVID-related complications, and the need for oxygen support, except for smoking which showed a protective effect (p=0.008). PCS was detected in more than half of the patients. There was no independent risk factor for the development of PCS, except smoking.


Subject(s)
COVID-19 , Post-Concussion Syndrome , Rheumatic Diseases , COVID-19/complications , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Post-Concussion Syndrome/diagnosis , Post-Concussion Syndrome/epidemiology , Post-Concussion Syndrome/etiology , Prevalence , Rheumatic Diseases/complications , Rheumatic Diseases/epidemiology
10.
Curr Rheumatol Rep ; 24(5): 119-131, 2022 May.
Article in English | MEDLINE | ID: mdl-35486218

ABSTRACT

PURPOSE OF REVIEW: Changing attitudes about marijuana have led to an increase in use of medicinal marijuana, especially for painful chronic conditions. Patients ask rheumatologists for guidance on this topic. This review provides up-to-date information on the safety and efficacy of medicinal cannabis for rheumatic disease pain. RECENT FINDINGS: The number of publications related to rheumatic disease and cannabis has increased, but recent literature skews heavily toward reviews vs primary research. Data supporting a role for cannabinoids in rheumatic disease continue to grow. Observational and survey studies show increased use of medicinal cannabis, both by people with rheumatic disease and the general population, and suggest that patients find these treatments beneficial. Prospective studies, however, including randomized controlled clinical trials, are rare and sorely needed. As medicinal cannabis use for rheumatic diseases rises, despite lack of evidence, we review the sparse data available and provide tips for conversations about medicinal cannabis for rheumatologists.


Subject(s)
Cannabis , Chronic Pain , Medical Marijuana , Musculoskeletal Pain , Rheumatic Diseases , Analgesics/therapeutic use , Chronic Pain/drug therapy , Chronic Pain/etiology , Humans , Medical Marijuana/therapeutic use , Prospective Studies , Rheumatic Diseases/drug therapy
11.
Arthritis Rheumatol ; 74(5): e21-e36, 2022 05.
Article in English | MEDLINE | ID: mdl-35474640

ABSTRACT

OBJECTIVE: To provide guidance to rheumatology providers on the use of COVID-19 vaccines for patients with rheumatic and musculoskeletal diseases (RMDs). METHODS: A task force was assembled that included 9 rheumatologists/immunologists, 2 infectious disease specialists, and 2 public health physicians. After agreeing on scoping questions, an evidence report was created that summarized the published literature and publicly available data regarding COVID-19 vaccine efficacy and safety, as well as literature for other vaccines in RMD patients. Task force members rated their agreement with draft consensus statements on a 9-point numerical scoring system, using a modified Delphi process and the RAND/University of California Los Angeles Appropriateness Method, with refinement and iteration over 2 sessions. Consensus was determined based on the distribution of ratings. RESULTS: Despite a paucity of direct evidence, statements were developed by the task force and agreed upon with consensus to provide guidance for use of the COVID-19 vaccines, including supplemental/booster dosing, in RMD patients and to offer recommendations regarding the use and timing of immunomodulatory therapies around the time of vaccination. CONCLUSION: These guidance statements are intended to provide direction to rheumatology health care providers on how to best use COVID-19 vaccines and to facilitate implementation of vaccination strategies for RMD patients.


Subject(s)
COVID-19 , Musculoskeletal Diseases , Rheumatic Diseases , Rheumatology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Humans , Muscular Diseases , United States , Vaccination
12.
Viruses ; 14(4)2022 03 27.
Article in English | MEDLINE | ID: mdl-35458425

ABSTRACT

The present study aimed to describe the seroprevalence infection, Epstein-Barr virus (EBV) genotypes, relate the infection's profile with the epidemiological and corticotherapy data of patients with Autoimmune inflammatory rheumatic diseases (AIRD). A cross-sectional study was carried out with 139 individuals, 92 with systemic lupus erythematosus (SLE), 27 with rheumatoid arthritis (RA) and 20 with other autoimmune diseases, who were undergoing clinical follow-up in Brazil. Serological tests for the detection of EBV anti-VCA IgM and IgG antibodies, as well as the amplification of a segment of the EBV EBNA-3c gene by conventional PCR were performed to identify the infection and the viral subtype. The Epstein-Barr nuclear antigen 3 (EBNA3C) gene participates of maintenance of viral latency and infected B-lymphocytes immortalization by unclear signaling cascades. The association of active/latent EBV infection with EBV infection profile was assessed by Fisher's exact test and multiple logistic regression. The seroprevalence of EBV anti-VCA IgG was 100%, while that of anti-VCA IgM was 1.43% (2/139). Active-phase infection was confirmed by the presence of EBV DNA in 40.29% of the population evaluated (56/139), with 45.65% (42/92) in SLE, 25.92% (7/27) in the RA and in 35% (7/20) in other autoimmune diseases. It was observed that individuals with SLE had a higher prevalence of active/lytic EBV infection and that oral corticosteroid therapy at a dose lower than 20 mg/day increased the risk of EBV activity by up to 11 times. Only the presence of EBV-1 was identified. Thus, EBV lytic infection was higher in individuals with SLE when compared to other autoimmune diseases with rheumatologic involvement and the lytic activity of the virus precedes corticosteroid-induced immunosuppression.


Subject(s)
Autoimmune Diseases , Epstein-Barr Virus Infections , Lupus Erythematosus, Systemic , Rheumatic Diseases , Antibodies, Viral , Antigens, Viral , Autoimmune Diseases/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Epstein-Barr Virus Infections/complications , Epstein-Barr Virus Infections/epidemiology , Herpesvirus 4, Human/genetics , Humans , Immunoglobulin G , Immunoglobulin M , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/epidemiology , Rheumatic Diseases/complications , Rheumatic Diseases/epidemiology , Seroepidemiologic Studies , Serologic Tests
13.
Cells ; 11(8)2022 Apr 15.
Article in English | MEDLINE | ID: mdl-35456038

ABSTRACT

Autophagy is a lysosomal pathway for the degradation of damaged proteins and intracellular components that promotes cell survival under specific conditions. Apoptosis is, in contrast, a critical programmed cell death mechanism, and the relationship between these two processes influences cell fate. Recent evidence suggests that autophagy and apoptosis are involved in the self-tolerance promotion and in the regulatory mechanisms contributing to disease susceptibility and immune regulation in rheumatic diseases. The aim of this review is to discuss how the balance between autophagy and apoptosis may be dysregulated in multiple rheumatic diseases and to dissect the role of autophagy in the pathogenesis of rheumatoid arthritis, systemic lupus erythematosus, and Sjögren's syndrome. Furthermore, to discuss the potential capacity of currently used disease-modifying antirheumatic drugs (DMARDs) to target and modulate autophagic processes.


Subject(s)
Antirheumatic Agents , Arthritis, Rheumatoid , Rheumatic Diseases , Sjogren's Syndrome , Antirheumatic Agents/therapeutic use , Autophagy , Humans , Rheumatic Diseases/drug therapy , Sjogren's Syndrome/drug therapy
14.
Molecules ; 27(8)2022 Apr 07.
Article in English | MEDLINE | ID: mdl-35458586

ABSTRACT

Pluchea indica (L.) Less. (Asteraceae) commonly known as Indian camphorweed, pluchea, or marsh fleabane has gained great importance in various traditional medicines for its nutritional and medicinal benefits. It is utilized to cure several illnesses such as lumbago, kidney stones, leucorrhea, inflammation, gangrenous and atonic ulcer, hemorrhoids, dysentery, eye diseases, itchy skin, acid stomach, dysuria, abdominal pain, scabies, fever, sore muscles, dysentery, diabetes, rheumatism, etc. The plant or its leaves in the form of tea are commonly used for treating diabetes and rheumatism. The plant is a rich source of calcium, vitamin C, dietary fiber, and ß-carotene. Various biomolecules have been isolated from P. indica, including thiophenes, terpenes, quinic acids, sterols, lignans, phenolics, and flavonoids. The current review reports detailed information about the phytoconstituents and pharmacological relevance of P. indica and the link to its traditional uses. The reported studies validated the efficacy and safety of P. indica, as well as supported its traditional uses for treating various ailments and promoting health and well-being. Thus, this could encourage the development of this plant into a healthy food supplement or medicine for the prevention and treatment of various diseases. However, further studies on the drug interactions, mechanism of action, pharmacokinetics, toxicology, and metabolism, as well as clinical trials, should be carried out.


Subject(s)
Asteraceae , Dysentery , Plants, Medicinal , Rheumatic Diseases , Dysentery/drug therapy , Humans , Phytochemicals/pharmacology , Phytochemicals/therapeutic use , Phytotherapy , Plant Extracts , Rheumatic Diseases/drug therapy
15.
Vnitr Lek ; 67(6): 330-333, 2021.
Article in English | MEDLINE | ID: mdl-35459374

ABSTRACT

Systemic rheumatoid diseases form a large group of entities with variable clinical picture and different involvement and degree of organ impairment. Respiratory tract represents major site of damage, with lung interstitium, pleura, pulmonary vasculature and airways possibly affected. In systemic sclerodermia and rheumatoid arthritis, lung disease is the most significant cause of morbidity and mortality. Breathing difficulties may either present as first symptoms of underlying rheumatoid disease or may appear at any time during the course of the disease. Rheumatologists should routinely screen their patients for possible lung impairment. Similarly, extrapulmonal signs should be assessed by pulmonologists in patients referred for dyspnea. Currently, novel antifibrotic therapy is available not only for patients with idiopathic pulmonary fibrosis (IPF), but also for selected group of patients with non-IPF progressive fenotype associated interstitial lung disease having solid evidence-based background. Interdisciplinary approach in terms of collaboration between pulmonologist and rheumatologist is of key importance as proper identification of possible candidates and early onset of therapy is crucial.


Subject(s)
Idiopathic Pulmonary Fibrosis , Lung Diseases, Interstitial , Rheumatic Diseases , Humans , Indoles/adverse effects , Lung Diseases, Interstitial/complications , Lung Diseases, Interstitial/drug therapy , Rheumatic Diseases/complications , Rheumatic Diseases/drug therapy
16.
Reumatol Clin (Engl Ed) ; 18(4): 207-226, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35443927

ABSTRACT

OBJECTIVE: To analyse the efficacy, adherence, patient satisfaction, safety, pharmacodynamics and cost-effectiveness of parenteral methotrexate (MTX) in patients with rheumatic diseases. METHODS: A systematic review of literature was carried out in Medline, Embase and Cochrane Central from the beginning until June 2019. Studies including adult patients with rheumatic diseases being treated with parenteral MTX were identified and data on efficacy, adherence, satisfaction, safety, pharmacokinetics, and cost-effectiveness analysed. As for the designs, systematic reviews, clinical trials, or observational studies were permitted, including cross-sectional and small-sample studies if they were pharmacokinetic studies. RESULTS: Out of 4160 identified articles, 80 articles were finally included. The efficacy profile of parenteral MTX seems useful in general and in those patients with insufficient response to oral MTX. The parenteral route does not seem to increase the rate or severity of adverse events due to the use of MTX. The use of parenteral MTX is an appropriate way to reduce costs in patients with inadequate response to oral MTX. Adherence and satisfaction are favoured by training programmes in the use of the parenteral route. The results in rheumatic diseases other than rheumatoid arthritis (RA) are very scarce and do not enable obtaining conclusive data. CONCLUSIONS: Parenteral MTX can be an alternative to the use of oral MTX, due to its profile of efficacy, safety, adherence and pharmacoeconomic results, especially in those patients with RA.


Subject(s)
Antirheumatic Agents , Arthritis, Rheumatoid , Rheumatic Diseases , Adult , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , Cross-Sectional Studies , Humans , Methotrexate/adverse effects , Rheumatic Diseases/drug therapy
17.
Autoimmun Rev ; 21(6): 103087, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35421608

ABSTRACT

OBJECTIVE: We conducted a systematic review, on behalf of the EULAR Study Group on Microcirculation in Rheumatic Diseases (EULAR SG MC/RD), to investigate the value of nailfold videocapillaroscopy (NVC) in idiopathic inflammatory myopathies (IIM). METHODS: Three electronic databases were systematically searched to find all relevant manuscripts reporting NVC outcomes in IIM patients. Articles were assessed based on study design, population, NVC methodology and description of NVC results. To allow comparison between the articles, all NVC results were interpreted according to standardised capillaroscopic terminology, as previously consented by the EULAR SG MC/RD and the Scleroderma Clinical Trials Consortium (SCTC) Group on Capillaroscopy. RESULTS: Of the 653 identified records; five were retained after critical appraisal on title, abstract and manuscript level. A marked difference in NVC was observed between (juvenile) dermatomyositis [(j)DM] versus polymyositis, healthy controls and systemic sclerosis patients. In addition, reduced capillary density and scleroderma pattern seem to be associated with active disease in (j)DM, while immunosuppressive treatment appears to reduce NVC abnormalities. CONCLUSION: This is the first systematic review investigating NVC in IIM, interpreting the results according to an international consented standardised manner, as proposed by the EULAR SG MC/RD and SCTC Group on Capillaroscopy. We can conclude that NVC presents a promising asset in the diagnosis of (j)DM. Moreover, NVC could be a biomarker for organ involvement and follow-up. Large multicentre prospective standardised studies are further needed to definitely describe associations with clinical and laboratory parameters in the different IIM subtypes.


Subject(s)
Autoimmune Diseases , Dermatomyositis , Myositis , Rheumatic Diseases , Scleroderma, Localized , Scleroderma, Systemic , Capillaries , Humans , Microcirculation , Microscopic Angioscopy/methods , Myositis/diagnosis , Nails/blood supply , Prospective Studies , Rheumatic Diseases/diagnosis , Scleroderma, Systemic/diagnosis
18.
Pediatr Rheumatol Online J ; 20(1): 27, 2022 Apr 12.
Article in English | MEDLINE | ID: mdl-35413991

ABSTRACT

INTRODUCTION: In Oman, the ""transition" of health care of adolescents to adult care occurs at a young age, like many other GCC countries for cultural reasons. In order to address this concern, this study was conducted to determine the transition readiness skills of adolescents and young adults with childhood onset rheumatic diseases using a cross-cultural adaptation of the UNC TRxANSITION scale. METHODS: We used a professionally translated/back translated, provider-administered UNC TRxANSITION Scale. This 32-question scale measures HCT in 10 domains including knowledge about diagnosis or treatment, diet, reproductive health, school/work, insurance, ability to self-manage and identification of new health providers. The maximum transitional score of 10, was categorized as low (1-4), moderate (4 - 7) and high (7 -10) transitional readiness scores. RESULTS: We enrolled 81 Omani adolescents and young adults (AYA) with chronic childhood onset rheumatic diseases. The cohort consisted of 79% females, with mean age of 15.8 years (± 3.53) and mean disease duration of 6.95 years (± 4.83). Our cohort's overall mean score is low 5.22 (±1.68). Only 14.8% of the cohort achieved a high transition score (≥7). Significant direct relationship was observed between age and the mean transition readiness score (r = .533, P < .001). The mean transition readiness score in the younger age group (10-13 years) was 4.07 (±1.29), the middle age group (14-18 years) was 5.43 (±1.27), while the older age group (19-21 year), was 6.12 (±1.81). Mean transition score of youngest age group was found to be significantly lower than the other two age groups (p = .003). CONCLUSION: Overall, the transition readiness of AYA in Oman is low compared to other western countries indicating the need to initiate a health care transition preparation program for patients with chronic diseases across the country. In addition, we need to establish regional guidelines to address the transfer and transition policies to be in line to international recommendations. As transition continues after transfer, and is preferably guided by adolescent developmental status rather than chronological age, it would be preferable to refer to the transition and transfer policies 9rather than transitional age policy) to be in line to international recommendations.


Subject(s)
Rheumatic Diseases , Transition to Adult Care , Adolescent , Aged , Child , Chronic Disease , Delivery of Health Care , Female , Humans , Male , Oman/epidemiology , Rheumatic Diseases/epidemiology , Rheumatic Diseases/therapy , Young Adult
19.
Einstein (Sao Paulo) ; 20: eAO6453, 2022.
Article in English | MEDLINE | ID: mdl-35416831

ABSTRACT

OBJECTIVE: To evaluate the therapeutic response (functionality) and its associated factors in patients on biological drugs on the Public Health System for treatment of rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. METHODS: An open prospective cohort was carried out from 2011 to 2019, in Belo Horizonte (MG). Functionality was assessed using the Health Assessment Questionnaire Disability-Index at baseline, and after 6 and 12 months of follow-up. Factors associated with poor functionality were identified through logistic regression. RESULTS: The median Health Assessment Questionnaire Disability-Index at baseline was 1.5 (interquartile range of 0.8-1.9), with poor functionality observed in patients with rheumatoid arthritis. Improved functionality was seen at 6 months of treatment for the three diseases. The predictors of poor functionality at 6 months for psoriatic arthritis and ankylosing spondylitis were female sex, low education levels, and high disease activity; and for rheumatoid arthritis and psoriatic arthritis were female sex, advanced age, and high disease activity. In 12 months, the three diseases had predictors of worse functionality: female sex, low education, and high disease activity. CONCLUSION: There was a significant improvement in functionality during the follow-up, with better response at 6 months of treatment. Poor functionality was observed in older, female patients, with low education and high disease activity.


Subject(s)
Antirheumatic Agents , Arthritis, Psoriatic , Arthritis, Rheumatoid , Rheumatic Diseases , Spondylitis, Ankylosing , Aged , Antirheumatic Agents/therapeutic use , Arthritis, Psoriatic/drug therapy , Arthritis, Rheumatoid/drug therapy , Female , Humans , Male , Prospective Studies , Public Health , Rheumatic Diseases/drug therapy , Spondylitis, Ankylosing/drug therapy
20.
Rheum Dis Clin North Am ; 48(2): 397-409, 2022 May.
Article in English | MEDLINE | ID: mdl-35400367

ABSTRACT

Patients with rheumatic diseases are susceptible to infections due to their underlying disease states as well as from immunosuppressive medications, highlighting the importance of vaccination, these same factors also pose challenges to vaccine efficacy, safety, and uptake. This article reviews the impact of immunosuppressive therapies and rheumatic disease on vaccine efficacy in this vulnerable patient population as well as discusses best practices.


Subject(s)
Antirheumatic Agents , Rheumatic Diseases , Antirheumatic Agents/therapeutic use , Humans , Immunosuppressive Agents/therapeutic use , Rheumatic Diseases/drug therapy , Vaccination
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