Análisis de periodicidad de reinyección en gonartrosis con distintos tipos de ácidos hialurónicos / Analysis of reinjection periodicity in knee osteoarthritis with different types of hyaluronic acids

Objetivo: Evaluación de la periodicidad de reinyección de ácido hialurónico (AH) en pacientes con gonartrosis. Objetivo secundario: relacionar el grado de artrosis con el tiempo entre infiltraciones y posible estudio por subgrupos entre los diferentes preparados comerciales. Diseño: Estudio observacional retrospectivo. Materiales y método: Revisión de historias clínicas y radiografías de los pacientes con gonartrosis tratados con AH intraarticular en el Servicio de Rehabilitación en el periodo entre enero de 2017 y junio de 2019. Variables: sociodemográficas, lateralidad, fecha del acto, grado de artrosis según Kellgren y Lawrence, AH utilizado, tiempo entre infiltraciones. Análisis estadístico mediante curvas de Kaplan-Meier considerando la reinfiltración como evento final y test de Kruskal Wallis para valores cuantitativos no paramétricos. Resultados: Analizamos 110 actos de infiltración en 67 pacientes: media de edad en momento de infiltración 72,12 años, 85,1% mujeres, 59,1% rodilla derecha. Cuatro tipos de AH: 33 casos al 1%; PM: 0,9 MDa (AH1); 12 al 1,5%; PM: 1,5 – 2 MDa (AH2), 42 al 2%; PM: 1,2 MDa (AH3) y 6 Hilano G-F20; PM: 6 MDa (AH4). En 17 ocasiones no se registró el ácido hialurónico utilizado (AH5). Se reinfiltró en 32 ocasiones (29,09%). Media de meses (Intervalo de Confianza [IC] 95%) entre infiltraciones: AH1 6,9 (5,7-8,16), AH2 12,5 (0- 35), AH3 9,3 (5,5- 13,1), AH4 5 (3 – 6,9). En dos casos en que no se pudo establecer el tipo de preparado infiltrado, el valor medio entre reinfiltraciones fue 8,5 (5,6- 11,4).No hubo resultados estadísticamente significativos al realizar un análisis comparativo el tipo de AH ni el grado de artrosis con el tiempo de reinfiltración. Conclusiones: En nuestro estudio se observa que el AH3 presentó un mayor tiempo entre infiltraciones con respecto a los otros tipos sin poder establecer diferencias significativas.(AU)

Objective: To evaluate the periodicity of hyaluronic acid (HA) reinjection in patients with knee osteoarthritis. Secondary aim: To relate the degree of arthrosis with the time between infiltrations and the possible study by subgroups between the different commercial preparations. Design: Retrospective observational study. Materials and method: Review of medical records and X-rays of patients with knee osteoarthritis that had been treated with intra-articular HA at the Rehabilitation Service in the period between January 2017 and June 2019. Variables: Socio-demographic, Laterality, Intervention Date, Degree of Arthrosis according to Kellgren and Lawrence, HA used, Time between filtrations. Statistical analysis carried out by Kaplan–Meier curves, taking into account the reinfiltration as final event, and Kruskal–Wallis test for non-parametric quantitative data. Results: We analysed 110 infiltration acts in 67 patients: average age at the time of infiltration 72.12 years, 85.1% women, 59.1% right knee. 4 types of HA: 33 cases at 1%. MW: 0.9MDa (HA1), 12 at 1.5%. MW: 1.5–2MDa (HA2), 42 at 2%. MW: 1.2MDa (HA3) and 6 Hylan G-F20. MW: 6MDa (HA4).We reinfiltrated in 31 occasions (28.2%). Average of months (IC 95%) between infiltrations: HA1 6.9 (5.7–8.16), HA2 12.5 (0–35), HA3 9.3 (5.5–13.1), HA4 5 (3–6.9). In 2 cases where it was not possible to establish the type of infiltrated formulations, the mean value between reinfiltrations was 8.5 (5.6–11.4)There were no statistically significant results by relating the HA type or the degree of arthrosis with the reinfiltration time. Conclusions: In our study, we observe that the HA3 presented a longer time between infiltrations in comparison with other types, with no possibility to detect significant differences.(AU)

Fabricación de modelos anatómicos articulares para formación en intervencionismo ecoguiado / Anatomic joint models for eco-guided interventionism training manufacture

Introducción: El intervencionismo ecoguiado ha supuesto un cambio en la forma en que los especialistas de medicina física y rehabilitación se enfrentan al dolor musculoesquelético y a otros problemas como la espasticidad. La implantación de las unidades de intervencionismo ecoguiado mejora los resultados de los tratamientos mínimamente invasivos, habituales en la práctica clínica de nuestra especialidad. El mayor inconveniente de esta práctica es la larga curva de aprendizaje y la dificultad para llevar a cabo prácticas durante los cursos de formación. Objetivo: Desarrollar un sistema de fantomas que permita la práctica de intervencionismo en modelos anatómicos acortando los tiempos de aprendizaje y mejorando la certeza al alcanzar el objetivo de la práctica intervencionista. Métodos: Se describe el método de fabricación de modelos tridimensionales de articulaciones a partir de imágenes obtenidas de tomografía axial computarizada, y su inclusión posterior en moldes realizados con gelatina alimenticia, que permiten obtener unos fantomas similares a modelos articulares reales que posibilitan su estudio mediante técnicas de ecografía y la práctica del intervencionismo ecoguiado. Conclusión: Los modelos articulares tridimensionales con gelatina alimenticia son útiles en la práctica y aprendizaje de las técnicas de intervencionismo ecoguiado articular.(AU)

Introduction: Eco-guided interventionism has changed the way Physical Medicine and Rehabilitation specialists deal with musculoskeletal pain and other problems such as spasticity. The implementation of the Eco-Guided Intervention Units improves the results of the usual minimally invasive treatments in our speciality's clinical practice. The biggest drawback of this practice is the long learning curve and the difficulty of practice during training courses. Objective: To develop a system of phantoms that allow the practice of interventionism in anatomical models by shortening learning times and improving certainty by achieving the objective of interventionist practice. Methods: Describes the method of manufacturing three-dimensional models of joints with images obtained from computerized axial tomography, and their subsequent inclusion in gelatin's made molds, which allow to obtain phantoms, similar to real joint models, that allow to study using ultrasound techniques, and the practice of eco-guided interventionism. Conclusion: Three-dimensional joint models made with gelatin are useful in the practice and learning of joint eco-guided interventionism techniques.(AU)

[Anatomic joint models for eco-guided interventionism training manufacture]. / Fabricación de modelos anatómicos articulares para formación en intervencionismo ecoguiado.

INTRODUCTION: Eco-guided interventionism has changed the way Physical Medicine and Rehabilitation specialists deal with musculoskeletal pain and other problems such as spasticity. The implementation of the Eco-Guided Intervention Units improves the results of the usual minimally invasive treatments in our speciality's clinical practice. The biggest drawback of this practice is the long learning curve and the difficulty of practice during training courses. OBJECTIVE: To develop a system of phantoms that allow the practice of interventionism in anatomical models by shortening learning times and improving certainty by achieving the objective of interventionist practice. METHODS: Describes the method of manufacturing three-dimensional models of joints with images obtained from computerized axial tomography, and their subsequent inclusion in gelatin's made molds, which allow to obtain phantoms, similar to real joint models, that allow to study using ultrasound techniques, and the practice of eco-guided interventionism. CONCLUSION: Three-dimensional joint models made with gelatin are useful in the practice and learning of joint eco-guided interventionism techniques.

[Analysis of reinjection periodicity in knee osteoarthritis with different types of hyaluronic acids]. / Análisis de periodicidad de reinyección en gonartrosis con distintos tipos de ácidos hialurónicos.

OBJECTIVE: To evaluate the periodicity of hyaluronic acid (HA) reinjection in patients with knee osteoarthritis. Secondary aim: To relate the degree of arthrosis with the time between infiltrations and the possible study by subgroups between the different commercial preparations. DESIGN: Retrospective observational study. MATERIALS AND METHOD: Review of medical records and X-rays of patients with knee osteoarthritis that had been treated with intra-articular HA at the Rehabilitation Service in the period between January 2017 and June 2019. VARIABLES: Socio-demographic, Laterality, Intervention Date, Degree of Arthrosis according to Kellgren and Lawrence, HA used, Time between filtrations. Statistical analysis carried out by Kaplan-Meier curves, taking into account the reinfiltration as final event, and Kruskal-Wallis test for non-parametric quantitative data. RESULTS: We analysed 110 infiltration acts in 67 patients: average age at the time of infiltration 72.12 years, 85.1% women, 59.1% right knee. 4 types of HA: 33 cases at 1%. MW: 0.9MDa (HA1), 12 at 1.5%. MW: 1.5-2MDa (HA2), 42 at 2%. MW: 1.2MDa (HA3) and 6 Hylan G-F20. MW: 6MDa (HA4). We reinfiltrated in 31 occasions (28.2%). Average of months (IC 95%) between infiltrations: HA1 6.9 (5.7-8.16), HA2 12.5 (0-35), HA3 9.3 (5.5-13.1), HA4 5 (3-6.9). In 2 cases where it was not possible to establish the type of infiltrated formulations, the mean value between reinfiltrations was 8.5 (5.6-11.4) There were no statistically significant results by relating the HA type or the degree of arthrosis with the reinfiltration time. CONCLUSIONS: In our study, we observe that the HA3 presented a longer time between infiltrations in comparison with other types, with no possibility to detect significant differences.

Desplazamiento activo en adolescentes: importancia de las barreras percibidas y el acompañamiento / Active Commuting in Adolescents: Importance of Perceived Barriers and Accompaniment

El presente estudio tiene como objetivo conocer el valor predictivo de la edad, el acompañamiento, y las barreras físicas y psicosociales en el desplazamiento activo. Participaron un total de 1325 estudiantes procedentes de centros educativos de Educación Primaria y Educación Secundaria de la Comunidad Autónoma de Extremadura (España), con edades comprendidas entre los 10-17 años ( =12.1; DT= 1.60). Los estudiantes cumplimentaron información sobre el modo, distancia, tiempo y acompañamiento a través del cuestionario PACO, y de las barreras percibidas para el desplazamiento activo mediante la escala BATACE. Los resultados revelaron una importante incidencia del acompañamiento, la distancia y las barreras psicosociales percibidas para la realización de desplazamiento activo hacia el colegio (R2 = .53; p = 0.00). Se concluye en la importancia de la distancia hasta el centro educativo, las barreras psicosociales, y el acompañamiento como elementos más importantes en la realización de desplazamiento activo. (AU)

The present study aims to know the predictive value of age, accompaniment, and physical and psychosocial barriers in active commuting. A total of 1,325 students from Primary Education and Secondary Education centers of the Autonomous Community of Extremadura (Spain) participated, with ages between 10-17 years (M =12.1; SD = 1.60). The students filled in information on the mode, distance, time and accompaniment through the PACO questionnaire, and the perceived barriers to active displacement using the BATACE scale. The results showed a significant incidence of accompaniment, distance, and perceived psychosocial barriers for active travel to school (R2 = .53; p = 0.00). It concludes on the importance of distance to the educational center, psychosocial barriers, and accompaniment as the most important elements in the realization of active displacement. (AU)

Análisis descriptivo de coste de tratamiento de la espasticidad con diferentes tipos de toxina botulínica A, a lo largo de un año / Descriptive analysis of the annual cost of treating spasticity with different types of botulinum toxin A

Introducción: La toxina botulínica A es el tratamiento de elección para la espasticidad localizada. Sin embargo, no se tiene un conocimiento real de su repercusión económica.El objetivo de este trabajo es describir los costes reales del tratamiento de la espasticidad en adultos con toxina botulínica A en una consulta de espasticidad de un Servicio de Rehabilitación, a lo largo de un año.MétodosSe ha realizado la revisión retrospectiva de todos los actos médicos llevados a cabo a lo largo del año 2017. Se han recogido el tipo de toxina utilizado (incobotulinumtoxin A, onabotulinumtoxin A, abobotulinumtoxin A), las unidades inyectadas, la región anatómica y el tiempo transcurrido entre infiltraciones. Se han obtenido los costes de la medicación y los costes indirectos, como los de personal o los fungibles.ResultadosEste es el primer trabajo que describe los costes reales del tratamiento de la espasticidad en adultos con toxina botulínica A en España. En 2017 se realizaron 510 actos de infiltración en 164 pacientes. El coste total de tratamiento de espasticidad en nuestro servicio fue de 116.789,70 €. El coste medio anual por paciente fue 603,64 € para onabotulinumtoxin A, de 642,69 € para abobotulinumtoxin A y de 707,59 € para incobotulinumtoxin A.ConclusionesNuestro estudio económico de actividad clínica real sigue una pauta similar a la descrita en los modelos teóricos publicados en la literatura. Las diferentes características de cada toxina y la imposibilidad de establecer una equivalencia entre las unidades de cada una de ellas impiden la comparación directa de estos costes. (AU)

Introduction: Botulinum toxin A is the first-line treatment for localised spasticity. However, the economic impact of this treatment is not fully known.This study aimed to describe the real costs of botulinum toxin A for the treatment of adult patients with spasticity at a spasticity clinic pertaining to a rehabilitation service, over a period of one year.MethodsWe retrospectively reviewed all medical procedures carried out during the year 2017. We collected data on the type of toxin used (incobotulinumtoxin A, onabotulinumtoxin A, or AAbobotulinumtoxin A), the number of units injected, the anatomical region, and the time elapsed between infiltrations. The costs of medication and indirect costs, such as staff and consumables, were also calculated.ResultsThis is the first study to describe the real costs of botulinum toxin treatment of spasticity in adult patients in Spain. In 2017, 510 infiltration procedures were performed in 164 patients. The total cost of treating spasticity in our service was €116 789.70. The mean annual cost per patient was €603.64 for onabotulinumtoxin A, €642.69 for abobotulinumtoxin A, and €707.59 for incobotulinumtoxin A.ConclusionsOur economic study of real clinical practice is consistent with the theoretical models published in the literature. The different characteristics of each toxin and the inability to establish an equivalence between the units of each drug prevents us from directly comparing these costs. (AU)

Motivación y barreras del desplazamiento activo en los profesores: Un estudio exploratorio / Motivation and Barriers to Active Commuting in Teachers: An Exploratory Study

El presente trabajo tuvo por objetivo conocer la relación entre la motivación intrínseca y motivación extrínseca con las barreras al desplazamiento activo en docentes. Se reclutaron un total de 156 profesores de 25 y 56 años (37.98 ± 12.28). Se utilizó una adaptación del cuestionario BREQ-3 para medir la motivación hacia el desplazamiento activo. Las barreras percibas se midieron con la escala BATACE. Se realizaron análisis descriptivos, correlaciones y modelos de regresiones de las variables de estudio. Los resultados mostraron que la motivación intrínseca estaba asociada negativamente con las barreras de planificación y psicosociales hacia el desplazamiento activo. La motivación extrínseca se asoció positivamente con las barreras ambientales y seguridad y con las barreras de planificación y psicosociales. Las intervenciones futuras, cuyo objetivo sea aumentar la cantidad de desplazamientos al centro educativo del profesorado, deberían aumentar la motivación intrínseca para conseguir resultados positivos en este comportamiento entre los docentes. (AU)

The aim of this study was to know the relationship between intrinsic and extrinsic motivation with the barriers associated with active commuting among Spanish teachers. The sample was formed by 156 teachers, ranging in age from 25 to 56 years old (37.98 ± 12.28). An adaptation of BREQ-3 questionnaire was used to measure the motivation towards active commuting. The perceived barriers were measured with the BATACE scale. Descriptive analysis, correlations and regression models of the studied variables were conducted. Results proved that the intrinsic variable was negatively associated with the planning and psychosocial barriers towards active commuting. Extrinsic motivation was positively related with the environmental and security barriers, as well as with planning and psychosocial barriers. Thus, future interventions aimed at increasing the number of teachers´ active travels to their schools should improve intrinsic motivation in order to achieve positive behavioral outcomes. (AU)

Descriptive analysis of the annual cost of treating spasticity with different types of botulinum toxin A. / Análisis descriptivo de coste de tratamiento de la espasticidad con diferentes tipos de toxina botulínica A, a lo largo de un año.

INTRODUCTION: Botulinum toxin A is the first-line treatment for localised spasticity. However, the economic impact of this treatment is not fully known. This study aimed to describe the real costs of botulinum toxin A for the treatment of adult patients with spasticity at a spasticity clinic pertaining to a rehabilitation service, over a period of one year. METHODS: We retrospectively reviewed all medical procedures carried out during the year 2017. We collected data on the type of toxin used (incobotulinumtoxin A, onabotulinumtoxin A, or AAbobotulinumtoxin A), the number of units injected, the anatomical region, and the time elapsed between infiltrations. The costs of medication and indirect costs, such as staff and consumables, were also calculated. RESULTS: This is the first study to describe the real costs of botulinum toxin treatment of spasticity in adult patients in Spain. In 2017, 510 infiltration procedures were performed in 164 patients. The total cost of treating spasticity in our service was €116 789.70. The mean annual cost per patient was €603.64 for onabotulinumtoxin A, €642.69 for abobotulinumtoxin A, and €707.59 for incobotulinumtoxin A. CONCLUSIONS: Our economic study of real clinical practice is consistent with the theoretical models published in the literature. The different characteristics of each toxin and the inability to establish an equivalence between the units of each drug prevents us from directly comparing these costs.

Central nystagmus and alterations in vestibular tests due to an inadvertent gentamicin administration into spinal space: A CARE case report.

INTRODUCTION: Gentamicin has a well-known potential for damaging the peripheral vestibular organs. However, it is considered to be innocuous to the CNS as it crosses the blood-brain barrier poorly. Here, we describe central neuro-otological abnormalities developed by a patient after deployment of gentamicin into his spinal space. CASE SUMMARY: A 61-year-old male unintentionally received gentamicin during spinal locoregional anesthesia for a urological procedure. During the first 48 hours the patient presented upper extremity dysmetria, dysarthria, and bilateral abducens nerve paralysis from which he recovered completely. He remained asymptomatic from day 3 to 10 after the incident. On day 11 he presented an acute vestibular syndrome. Severe bilateral vestibulopathy was confirmed by means of video head impulse testing. From day 14 onwards, he presented a persistent horizontal left-beating nystagmus, showing no variation or signs of compensation after 14 months, not responding to intensive vestibular rehabilitation or vestibular suppressant drugs. During follow-up, intercurrent gaze-evoked/direction-changing nystagmus has been recorded in various opportunities. DISCUSSION: We interpreted these findings as signs of both severe peripheral bilateral vestibulopathy and cerebellar and/or midbrain late-onset neurotoxicity, which can be explained by the intrinsic neurotoxic capability of high doses of gentamicin in the CNS.

Cost of peripheral facial palsy treatment with Botulinum Toxin type A.

INTRODUCTION: Facial palsy (FP) is one of the most common neuropathies. Overall, 15%-30% of patients develop chronic sequelae. Several studies support the use of botulinum toxin A (BoNT-A) in the treatment of FP sequelae. No studies have analyzed the cost of treating FP with BoNT-A. METHODS: A retrospective review of data from all clinical records of consultations and procedures that took place at the FP Treatment Unit clinic throughout 2017. Type of BoNT-A used, total dose used, unilateral or bilateral injection, date of consultation, and gender were collected. The price of expendable materials, BoNT-A, and the 2017 salary scale was obtained to establish costs. RESULTS: During 2017, 605 clinical procedures were conducted in 240 patients. The mean number of procedures was 2.5 (0.80). The average time between procedures was 124(28.72) days. The total annual cost was 34.155,10€. The average annual cost of BoNT-A for each procedure was 39,93€, and the total annual cost of BoNT-A was 24.160,58€. On average, more units of IncotoxA were injected. This difference is not reflected in the final cost of each BoNT-A. For patients who achieved treatment stability, the average annual cost per patient was 106,6€ (OnatoxA) and 100,6€ (IncotoxA). CONCLUSION: In our unit, treatment with BoNT-A in FP sequelae had an average annual cost of 124,31€ per patient, requiring a visit to the hospital to receive treatment every 124 days. Given the functional and quality of life improvements, we should consider that it is a beneficial treatment at an acceptable cost.

Descriptive analysis of the annual cost of treating spasticity with different types of botulinum toxin A.

INTRODUCTION: Botulinum toxin A is the first-line treatment for localised spasticity. However, the economic impact of this treatment is not fully known. This study aimed to describe the real costs of botulinum toxin A for the treatment of adult patients with spasticity at a spasticity clinic pertaining to a rehabilitation service, over a period of one year. METHODS: We retrospectively reviewed all medical procedures carried out during the year 2017. We collected data on the type of toxin used (incobotulinumtoxin A, onabotulinumtoxin A, or Abobotulinumtoxin A), the number of units injected, the anatomical region, and the time elapsed between infiltrations. The costs of medication and indirect costs, such as staff and consumables, were also calculated. RESULTS: This is the first study to describe the real costs of botulinum toxin treatment of spasticity in adult patients in Spain. In 2017, 510 infiltration procedures were performed in 164 patients. The total cost of treating spasticity in our service was 116 789.70. The mean annual cost per patient was 603.64 for onabotulinumtoxin A, 642.69 for abobotulinumtoxin A, and 707.59 for incobotulinumtoxin A. CONCLUSIONS: Our economic study of real clinical practice is consistent with the theoretical models published in the literature. The different characteristics of each toxin and the inability to establish an equivalence between the units of each drug prevents us from directly comparing these costs.

The role of strangeness in chiral and U ( 1 ) A restoration.

We use recently derived Ward identities and lattice data for the light- and strange-quark condensates to reconstruct the scalar and pseudoscalar susceptibilities ( χ S κ , χ P K ) in the isospin 1/2 channel. We show that χ S κ develops a maximum above the QCD chiral transition, after which it degenerates with χ P K . We also obtain χ S κ within Unitarized Chiral Perturbation Theory (UChPT) at finite temperature, when it is saturated with the K 0 ∗ ( 700 ) (or κ ) meson, the dominant lowest-energy state in the isospin 1/2 scalar channel of π K scattering. Such UChPT result reproduces the expected peak structure, revealing the importance of thermal interactions, and makes it possible to examine the χ S κ dependence on the light- and strange-quark masses. A consistent picture emerges controlled by the m l / m s ratio that allows one studying K - κ degeneration in the chiral, two-flavor and SU(3) limits. These results provide an alternative sign for O ( 4 ) × U ( 1 ) A restoration that can be explored in lattice simulations and highlight the role of strangeness, which regulated by the strange-quark condensate helps to reconcile the current tension among lattice results regarding U ( 1 ) A restoration.

Total Arsenic Concentrations in Sea Turtle Tissues from the Mediterranean Coast of Spain.

In this work we studied total arsenic concentrations in liver, muscle and kidney of 49 individuals of two sea turtle species (loggerhead sea turtles, n = 45; leatherback turtles, n = 4) stranded in Murcia (South-eastern Spain) coastline between 2009 and 2018. In accordance with the literature, muscle was the tissue with the highest concentrations in both species, followed by liver and kidney. Although differences in arsenic concentrations were not statistically significant between the study species, loggerhead sea turtles showed concentrations two or three times higher than those of leatherback turtles, which we attribute to differences on feeding behavior and habitat preferences. Arsenic concentrations in turtles from this area increase evidence of western Mediterranean Sea as a hotspot for metal pollution. Based on the scarce existing knowledge on arsenic toxicity in sea turtles, those levels found in our study are below those responsible for liver damage.

Persistencia de tratamiento con antagonistas del factor de necrosis tumoral frente a antagonistas de interleucinas en psoriasis moderada-grave / Persistence of treatment with tumor necrosis factor antagonists versus interleukin antagonists in moderate-severe psoriasis

Objetivo: Evaluar y comparar el tiempo de persistencia y analizar los motivos de suspensión con fármacos antagonistas del factor de necrosis tumoral (anti-TNF) frente a antagonistas de interleucinas (anti-IL) en primera línea de tratamiento biológico en pacientes con psoriasis.Material y métodos: Estudio retrospectivo observacional realizado entre 01/2010 y 05/2019. Se incluyeron pacientes adultos diagnosticados de psoriasis moderada-grave en tratamiento con anti-TNF o anti-IL en primera línea de tratamiento biológico. Se estudiaron variables demográficas y relacionadas con el tratamiento, calculándose el tiempo de persistencia con el fármaco de estudio, así como las suspensiones de tratamiento. Resultados: Se incluyeron 94 pacientes (39 mujeres) con una media de 49 años (desviación estándar 13,0), 46 (48,9%) pacientes tratados con anti-TNF (35/46 adalimumab y 11/46 etanercept) y 48 (51,1%) pacientes tratados con anti-IL (26/48 secukinumab, 15/48 ustekinumab y 7/48 ixekizumab). El tiempo de persistencia en primera línea de tratamiento biológico fue de 18,4 (rango intercuartílico (RIQ) 22,2) meses, siendo 9,3 (RIQ 21,7) meses superior en los pacientes tratados con anti-IL (24,7 vs. 15,4 meses; p=0,002). A la finalización del seguimiento el 38,3% (36/94) de la población había interrumpido el tratamiento, debido a: falta de efectividad (34,8% (16/46) anti-TNF vs. 14,6% (7/48) anti-IL; p=0,003), eventos adversos (2,2% (1/46) anti-TNF) y otros motivos (17,4% (8/46) anti-TNF vs. 8,3% (4/48) con anti-IL; p>0,05). Conclusiones: El tiempo de persistencia en primera línea de tratamiento biológico fue de 18,4 meses, siendo significativamente superior en los pacientes tratados con anti-IL. El principal motivo de suspensión fue la falta de efectividad en ambos grupos de tratamiento. (AU)

Objective: To evaluate and compare the time of persistence and to analyse the discontinuation reasons with tumor necrosis factor antagonists (anti-TNF) vs. interleukin antagonists (anti-IL) as first line with biological treatments in patients with psoriasis. Material and methods: Retrospective observational study carried out between 01/2010 and 05/2019. Adult patients diagnosed with moderate to severe psoriasis in treatment with anti-TNF or anti-IL as first line with biological treatments were included. Demographic and treatment-related variables were studied, calculating the time of persistence with the study drug, as well as treatment discontinuations. Results: We included 94 patients (39 women) with a mean of 49 years (standard deviation 13.0), 46 (48.9%) patients treated with anti-TNF (35/46 adalimumab and 11/46 etanercept) and 48 (51.1%) patients treated with anti-IL (26/48 secukinumab, 15/48 ustekinumab and 7/48 ixekizumab). Persistence time with biological treatment in first line was 18.4 (interquartile range (IQR) 22.2) months, being 9.3 (IQR 21.7) months higher in patients treated with anti-IL (24.7 vs. 15.4 months; p=0.002). At the end of the follow-up, 38.3% (36/94) of the population had discontinued their treatments. The reasons for discontinuation were: lack of effectiveness (34.8% (16/46) anti-TNF vs. 14.6% (7/48) anti-IL; p=0.003), side effects (2.2% (1/46) anti-TNF) and other reasons (17.4% (8/46) anti-TNF vs. 8.3% (4/48) anti-IL; p>0.05). Conclusion: The persistence time with biological treatment in first line was 18.4 months, being significantly higher in the anti-IL group. The main reason of discontinuation was lack of effectiveness in both groups of treatment. (AU)