Assuntos
Coriorretinopatia Serosa Central/induzido quimicamente , Polimialgia Reumática/tratamento farmacológico , Prednisona/efeitos adversos , Coriorretinopatia Serosa Central/diagnóstico , Angiofluoresceinografia , Fundo de Olho , Glucocorticoides/efeitos adversos , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Prednisona/uso terapêutico , Epitélio Pigmentado da Retina/efeitos dos fármacos , Epitélio Pigmentado da Retina/patologia , Tomografia de Coerência ÓpticaRESUMO
OBJECTIVES: We aimed to investigate the existence of an association between hidrosadenitis suppurativa and spondyloarthritis. METHODS: We performed a single-centre, cross-sectional study in patients with hidrosadenitis suppurativa followed in a tertiary care center, and in healthy volunteers without dermatological disease, matched for age (±5years) and gender. For each subject included, clinical examinations, HLA-B27 testing and sacro-iliac MRI were performed in order to diagnose spondyloarthritis according to the Assessment of SpondyloArthritis international Society (ASAS) criteria. RESULTS: In total, 39 subjects were included in each group (70% women in each group, mean age 35.6±11.1 in the hidrosadenitis suppurativa group and 36.0±11.1 in the control group). Eleven (28.2%) patients in the hidrosadenitis suppurativa group were diagnosed with spondyloarthritis (in 4 of these, spondyloarthritis was already previously documented), and in 1 (2.6%) subject in the control group (OR 11.0; 95% CI 4.1-83.3; P=0.02). Axial spondyloarthritis was the most common form of spondyloarthritis, observed in 9/11 patients in the hidrosadenitis suppurativa group, the remainder were peripheral spondyloarthritis. In the hidrosadenitis suppurativa group, only HLA B27 was found to be associated with a diagnosis of spondyloarthritis. CONCLUSIONS: Our results indicate that hidrosadenitis suppurativa is significantly associated with an increased risk of spondyloarthritis, independently of age and sex. Patients with hidrosadenitis suppurativa presenting osteoarticular symptoms, specially low back pain or dactylitis, should be monitored for spondyloarthritis.
Assuntos
Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/epidemiologia , Espondilartrite/diagnóstico , Espondilartrite/epidemiologia , Adulto , Distribuição por Idade , Comorbidade , Estudos Transversais , Feminino , França , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Valores de Referência , Medição de Risco , Distribuição por Sexo , Centros de Atenção Terciária , Adulto JovemRESUMO
PURPOSE: Evaluation of effectiveness and safety of ustekinumab in psoriatic arthritis after anti-TNFα failure. METHODS: We conducted a retrospective and monocentric study. The evaluation of articular and cutaneous effectiveness by the patient was made with numeric scale and satisfaction scale and by the physician during a rhumatological-dermatological consultation. The safety was analyzed by collecting the adverse effects. RESULTS: Nine patients with anti-TNF failure were included. Five of them stopped the treatment because of severe adverse effects. The mean duration treatment of ustekinumab was 24 months. Articular and cutaneous effectiveness were respectively 4.4/10 and 6.7/10. Two thirds of the patients were "satisfied" and one third could stop any analgesic treatment. The mean PASI score decreased from 8.4 to 1.7 after 3 months treatment. Only minor adverse effects were collected and there were no recidivism of the adverse effects observed with anti-TNFα. CONCLUSION: Ustekinumab is an effective and safe alternative for patients with anti-TNFα failure in psoriatic arthritis.