ABSTRACT
OBJECTIVE: To assess effectiveness and safety of certolizumab PEGol (CZP) in rheumatoid arthritis (RA) patients after 12 months of treatment and to detect predictors of response. METHODS: Observational longitudinal prospective study of RA patients from 35 sites in Spain. Variables (baseline, 3- and 12-month assessment): sociodemographics, previous Disease Modifying Anti-Rheumatic Drug (DMARD) and previous Biological Therapies (BT) use; TJC, SJC, ESR, CRP, DAS28, SDAI. Response variables: TJC, SJC, CRP, ESR, and steroids dose reductions, EULAR Moderate/Good Response, SDAI response and remission, DAS28 remission. Safety variables: discontinuation due to side-effects. Descriptive, comparative and Logistic regression analyses were performed. RESULTS: We included 168 patients: 79.2% women, mean age 54.5 years (±13.2 SD), mean disease duration 7.5 years (±7.3 SD). Mean number of prior DMARD: 1.4 (±1.2 SD), mean number of prior BT was 0.8 (±1.1). Mean time on CZP was 9.8 months (±3.4 SD). A total of 71.4% were receiving CZP at 12-month assessment. Baseline predictors of response: lower prior number DMARD; low number prior BT; higher CRP, ESR, TJC, SJC, DAS28 and SDAI (p < 0.05) scores. A 25/46.4% Moderate/Good Response, a 20% SDAI remission, and a 44% DAS28 remission were observed. We observed 48 discontinuations (28.6%), 31 due to partial or complete ineffectiveness, and 17 due to side-effects. CONCLUSIONS: CZP showed benefit in severe RA patients, with significant reduction of all effectiveness parameters, despite the high prevalence of previous BT exposure in our series. We found CRP, ESR, prior DMARD/BT number, TJC, SJC, DAS28, and SDAI as baseline predictors of response. CZP was mostly well tolerated.
Subject(s)
Hemoptysis/etiology , Lung Neoplasms/complications , Sarcoma, Synovial/complications , Adult , Brain Neoplasms/secondary , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/surgery , Male , Pneumonectomy , Prognosis , Sarcoma, Synovial/diagnosis , Sarcoma, Synovial/secondary , Sarcoma, Synovial/surgeryABSTRACT
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Subject(s)
Humans , Male , Adult , Sarcoma, Synovial/pathology , Lung Neoplasms/pathology , Hemoptysis/etiology , PneumonectomyABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Hypothermia/complications , Hypothermia/diagnosis , Hypothermia/therapy , Emergency Medical Services/methods , Body Temperature/physiology , Electrocardiography , Insulin/therapeutic use , Diabetes Mellitus/complications , Glasgow Coma Scale/trends , Glasgow Coma Scale , Diabetic Ketoacidosis/complicationsABSTRACT
El síndrome de anticuerpos antifosfolipídicos catastrófico (SAAFC) es una forma rara de presentación del síndrome de anticuerpos antifosfolipídicos, de mal pronóstico, por lo que son necesarios un diagnóstico y un tratamiento precoces. Presentamos un paciente que tuvo gangrena como manifestación inicial de un SAAFC (AU)
Catastrophic antiphospholipid syndrome (CAPS) is an unusual form of presentation of antiphospholipid syndrome with a poor prognosis, so early diagnosis and treatment are necessary. We report a patient who had gangrene as the initial manifestation of CAPS (AU)
Subject(s)
Humans , Female , Adult , Antiphospholipid Syndrome/complications , Gangrene/etiology , Antibodies, Antiphospholipid/isolation & purification , Early Diagnosis , Foot Ulcer/etiology , Glucocorticoids/therapeutic use , Heparin, Low-Molecular-Weight/therapeutic use , Blood TransfusionABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Pulmonary Embolism/diagnosis , Syncope/etiology , Pulmonary Embolism/complications , Pulmonary Heart Disease/complicationsABSTRACT
Catastrophic antiphospholipid syndrome (CAPS) is an unusual form of presentation of antiphospholipid syndrome with a poor prognosis, so early diagnosis and treatment are necessary. We report a patient who had gangrene as the initial manifestation of CAPS.
ABSTRACT
El cuadro clínico de la endocarditis infecciosa es inespecífico. La fiebre y la auscultación de un soplo cardíaco son los síntomas más frecuentes. La asociación de artralgias es relativamente común, y es inusual la presentación en forma de poliartritis. Presentamos un caso de endocarditis infecciosa que se inicia con clínica subaguda de fiebre y poliartritis (AU)
Clinical signs of infective endocarditis are inespecific. Fever and heart murmur are the most frequent symptoms. Arthralgiass association is fairly common but presentation as polyarthritis is inusual. We report a cse of infective endocarditis that begins with subacute fever and polyarthritis (AU)
Subject(s)
Humans , Male , Adult , Endocarditis, Bacterial/complications , Arthritis/etiology , Endocarditis, Bacterial/diagnosis , Fever/etiology , Enterococcus faecalis/isolation & purification , Anti-Bacterial Agents/therapeutic useABSTRACT
La enfermedad cardiovascular es común en la artritis reumatoide. No obstante, la afección miocárdica es inusual y suele cursar de forma asintomática. Presentamos un caso de miocardiopatía dilatada en una paciente con artritis reumatoide e insuficiencia cardíaca progresiva que requirió su inclusión en lista de trasplante cardíaco (AU)
Cardiovascular pathology is common in rheumatoid arthritis. However, myocardial affection is unusual and clinical disease is rare. We report a case of dilated cardiomyopathy in a patient with rheumatoid arthritis and progressive heart failure that required inclusion into a heart transplantation list (AU)
Subject(s)
Humans , Cardiomyopathies/complications , Arthritis, Rheumatoid/complications , Heart Transplantation , Waiting Lists , Heart Failure/complications , Rheumatoid Factor/isolation & purification , Cardiomyopathies/diagnosisABSTRACT
Cardiovascular pathology is common in rheumatoid arthritis. However, myocardial affection is unusual and clinical disease is rare. We report a case of dilated cardiomyopathy in a patient with rheumatoid arthritis and progressive heart failure that required inclusion into a heart transplantation list.
ABSTRACT
Clinical signs of infective endocarditis are inespecific. Fever and heart murmur are the most frequent symptoms. Arthralgias's association is fairly common but presentation as polyarthritis is inusual. We report a cse of infective endocarditis that begins with subacute fever and polyarthritis.