Assessment of Response to B-Cell Depletion Using Rituximab in Cutaneous Lupus Erythematosus.

Importance: Cutaneous lupus erythematosus (CLE) can be severe and treatment resistant. B-cell depletion therapy (BCDT) with rituximab is well recognized in organ involvement in systemic lupus erythematosus (SLE), but its efficacy in cutaneous manifestations is less well established. Objective: To evaluate the outcomes of BCDT in CLE and its clinical subtypes in the setting of associated SLE. Design, Setting, and Participants: This single-center, retrospective, cohort study was performed at the adult tertiary referral Rheumatology Department of University College London Hospital, London, United Kingdom, from January 1, 2000, through March 31, 2016, with 12-month follow-up completed on March 31, 2017. Adult patients with carefully classified CLE and mucocutaneous British Isles Lupus Assessment Group (BILAG) grade A or B who were treated with rituximab BCDT were selected from a prospective database of 709 patients with SLE. Data were analyzed from April through December 2017. Main Outcomes and Measures: Clinical response was examined at 6 and 12 months after treatment for CLE and its subtypes acute CLE (ACLE), subacute CLE (SCLE), chronic CLE (CCLE), and nonspecific LE (NSLE). A complete response was defined as achieving BILAG grade D; partial response, BILAG grade C; stable disease, no change; and disease flare, change from BILAG grade C or D to grade A or B. Results: A total of 50 patients with SLE were eligible for inclusion; mean (SD) age at diagnosis was 26.9 (12.1) years, and 49 (98%) were women. Twenty-one patients had ACLE; 6, SCLE; 10, CCLE; and 11, NSLE (including 2 with concurrent ACLE and CCLE). Overall, at 6 months, 38 patients (76%) improved their mucocutaneous BILAG grade A or B status, including 20 (40%) with a complete response. At 12 months, 28 of 46 patients (61%) maintained this response, including 24 (52%) with a complete response. Two of 6 patients (33%) with SCLE showed a complete response at 6 and 12 months. Five of 12 patients (42%) with CCLE showed a complete response at 6 months, and 5 of 11 (45%), at 12 months. Fifteen patients (30%) required further rituximab therapy within 12 months for cutaneous involvement. Conclusions and Relevance: B-cell depletion therapy using rituximab appears effective in patients with SLE and severe active CLE; however, outcomes are variable in those with SCLE and CCLE subtypes.

Consejo breve para la prevención del tabaquismo en escolares de 2º a 4º de Educación Secundaria Obligatoria de Zaragoza / No disponible

Se realizó una intervención en el ámbito escolar para administrar consejo breve antitabacoa escolares de la Educación Secundaria Obligatoria (ESO) en Zaragoza durante los cursos2006-2007 y 2007-2008. Los objetivos del estudio fueron medir la efectividad del consejobreve apoyado por material escrito y estudiar la progresión del tabaquismo. El estudióincluyó una encuesta autoadministrada y una coximetría, así como una reevaluación un añodespués.Se estudiaron 15 centros escolares, 8 del grupo intervención y 7 de control. Se administróconsejo apoyado con un folleto frente al control en el que no se utilizaba el folleto. Laasignación a los grupos no fue aleatoria.Se evaluaron 1.720 estudiantes entre los dos cursos 2006-07 y 2007-08 de los cuales51,95% fueron hombres y 48,5% mujeres. La edad media fue 14,6 años (desviación estándar[DE] = 1,36) y fueron fumadores el 19,7%. Entre las mujeres fueron fumadoras el24,7% frente al 18,3% de los hombres (p < 0,0001). No hubo diferencias significativas parael tabaquismo según grupo de intervención o control. La progresión del tabaquismo crecióun 8,8% en el grupo intervención frente a un 12% en el de control entre 2.º y 3.º. Las diferenciasfueron 3% para el grupo intervención frente al 1,1% en el de control entre 3.º y 4.º,no siendo estas diferencias estadísticamente significativas. Conclusiones: el porcentaje de fumadores en escolares de ESO es del 19,7%. La escaladade consumo se produce entre 2.º y 3.º. No se demostró una mayor efectividad del consejobreve mediante el uso de un folleto(AU)

Authors report a community school study about smoking adolescent behaviour, 8º, 9º,and 10 º year in Zaragoza (Spain). The study was implemented in the 2006-2007 and 2007-2008 courses respectively. The study’s objectives were to asses the effectiveness of smokingcounselling with the aid of a specifically designed leaflet. The study also included an evaluationof expired CO. The authors surveyed on smoking behaviour as well as on personaldetails of the students.The study includes 8 intervention schools and 7 control schools. Allocation wasn’t randomizeddue to logistic reasons. The interventional group received advice against smokingby means of spoken counsel from a professional supported by a leaflet. The control grouponly received the spoken counsel. The expired CO was assessed in each group. The counselwas repeated in each group one year later to the same students.In all 1,720 students were assessed: 51.95% men and 48.5% women. The median ageof the students was 14.6 years SD: 1.36. The authors found that 19.7% of the students weresmokers. The distribution of smokers by sex was 24.7% of women versus 15.3% of men X2= 24.1 p < 0.0001. Smoking behaviour between interventional or control group wasn’t statisticallydifferent.Conclusions: There wasn’t any evidence of effectiveness in using a leaflet added to thespoken counsel. Prevalence of smoking was very high: 19.7% among adolescents of Zaragoza.The study shows a increase of smoking between 8º and 10º(AU)

Estudio de la publicidad exterior de tabaco y alcohol en el entorno de centros de enseñanza secundaria de Zaragoza (España) / Study of static advertising on tobacco and alcohol around the secondary school places in Zaragoza (Spain)

OBJETIVOS. Estudiar la publicidad exterior de los alrededores de doce centros de enseñanza secundaria, analizando el número de anuncios de bebidas alcohólicas y tabaco encontrados en un mismo trimestre de los años 2004 y 2007. Comprobar si en el año 2007 se cumplen las restricciones respecto a publicidad exterior de la nueva Ley antitabaco 28/2005. MÉTODOS. Se seleccionaron doce centros de enseñanza secundaria de Zaragoza. Se han ido haciendo fotografías digitales semanales a lo largo de los meses de febrero, marzo y abril de los años 2004 y 2007, de una valla publicitaria que estuviera a menos de 200 metros de cada uno de los centros, anotando si hace referencia a alcohol, tabaco, campañas antidrogas u otros productos. Finalmente se compararon las cifras de los años 2004 y 2007. RESULTADOS. Vemos que del año 2004 al 2007, la publicidad exterior de bebidas alcohólicas ha disminuido de un 25,8 a un 20,1%. También observamos que ha desaparecido la publicidad de tabaco (en 2004 había un 7,8% a pesar de la ¿autorregulación¿ de las compañías de tabaco) y la de campañas antidrogas (un 3,9% en 2004). CONCLUSIONES. Estas diferencias encontradas en la publicidad de tabaco se deben seguramente a la entrada en vigor de la Ley 28/2005, en la que se prohíbe la publicidad de este producto. Respecto a las bebidas alcohólicas, vemos que los fabricantes siguen dirigiendo claramente su publicidad a los menores, un sector social no habilitado para consumir (AU)

OBJECTIVES. To study static advertising on tobacco andalcohol around the secondary school places and to analyzethe number of announcements of alcoholic drinks and tobaccoin the same quarter of the years 2004 and 2007.To verify if the restrictions regarding static advertising ofthe new advertising ban on tobacco products 28/2005 werefulfilled in 2007.METHOD. Twelve secondary school centers in Zaragoza(Spain) were selected. Several digital pictures of static advertisementslocated within 200 meters of each center weretaken on a weekly basis during February, March and April,in both 2004 and 2007. The locations of tobacco, alcohol oranti-drugs advertisement campaigns were recorded. Finally,data for the years 2004 and of 2007 were compared.RESULTS. It was verified that static advertising of alcoholicdrinks decreased from 25.8% to 20.1% from 2004 to2007. We also observed that external advertising of tobaccoproducts disappeared in 2007 (in 2004 there was 7.8% regardlessof the “self-regulations” of tobacco companies) andthat of anti-drug advertising, which was 3.9% in 2004.CONCLUSIONS. The tobacco advertising ban in 2005 hasled to the end of tobacco advertising. However, manufacturersof alcohol drinks have clearly continued to direct theiradvertising towards minors, a social sector in which theirconsumption is not permitted (AU)