Real-World Treatment Patterns and Clinical Outcomes of Baricitinib in Rheumatoid Arthritis Patients in Spain: Results of a Multicenter, Observational Study in Routine Clinical Practice (The ORBIT-RA Study).

INTRODUCTION: Baricitinib is an oral Janus kinase (JAK)1/JAK2 inhibitor approved to treat rheumatoid arthritis (RA). This study aimed to investigate patients' characteristics, prescription patterns, effectiveness, and treatment persistence in patients receiving baricitinib in real-world practice in Spain. METHODS: This retrospective longitudinal cohort study conducted in five rheumatology units included adults with RA initiating baricitinib (Sep-2017-May-19) with at least a 6-month-follow-up. Demographic/clinical characteristics, prescription patterns, and changes in disease activity and pain level were collected until treatment discontinuation/end of follow-up. Treatment persistence was estimated by Kaplan-Meier methods. RESULTS: Data from 182 patients were included (mean (SD)): 83.5% women, 62.2 (12.3) years, body mass index 26.8 (5.1), disease duration 13.2 (10.8) years and Charlson Comorbidity Index score 2.4 (2.0). All patients had received at least one conventional synthetic disease-modifying anti-rheumatic drugs (csDMARD) before starting baricitinib and 78.0% at least one biologic disease-modifying anti-rheumatic drugs (bDMARD). Furthermore, 90.1% started with baricitinib 4 mg/day; 43.4% in monotherapy. One hundred and twelve (61.5%) of patients continued baricitinib at data collection time; mean persistence was 14.1 (0.5) months. Overall treatment persistence was 79.7/64.8/59.1% at 6/12/18 months. Seventy (38.5%) patients discontinued baricitinib during follow-up due to loss of efficacy (68.6%) or adverse events (18.6%). In those patients with available scores at the different observed cut-off points, remission or low disease activity was reported in 71.6 and 76.3% of patients at 6/12 months at any index: Disease Activity Score 28 joints using erythrocyte sedimentation rate (DAS28-ESR) (73.1 and 73.5%), Simplified Disease Activity Index (SDAI) (62.4 and 75.0%), and Clinical Disease Activity Index (CDAI) (66.7 and 78.1%). Good or moderate European League Against Rheumatism (EULAR)-response was noted in 80.0 and 78.2% of patients, respectively. Improvement from baseline in pain (Visual Analog Scale) was 2.5 cm and 3.0 cm at 6/12 months, respectively. CONCLUSIONS: This Spanish cohort of patients treated with baricitinib had a long-standing and refractory disease. Nevertheless, high persistence and improvements in disease activity and pain were found at 6 and 12 months after treatment initiation, independently of the composite disease activity measure used, reinforcing the effectiveness of baricitinib in routine clinical practice.

Nivel de conocimientos sobre alcoholismo en un grupo de adolescentes del Consultorio Médico de Familia No. 10 del Policlínico Universitario Norte del municipio Morón / Level of knowledge on alcoholism in a group of teenagers of Family Doctor's office No. 10 from North Polyclinic in Morón municipality

Se realizó un estudio Preexperimental (antes/después), a través una intervención educativa con el objetivo de elevar el nivel de conocimientos sobre el alcoholismo en un grupo de adolescentes entre 13 y 18 años, pertenecientes al Consultorio Médico de Familia No10 del Policlínico Universitario Norte, del municipio Morón, durante el período de diciembre del 2011 hasta noviembre del 2012. El universo estuvo conformado por los 82 adolescentes que se encontraban entre los 13 y 18 años de dicho consultorio, de los cuales se obtuvo una muestra de estudio que quedó finalmente conformada por 78 adolescentes que cumplieron con los criterios de inclusión y exclusión. Se encontró que la prevalencia fue baja 12.82 por ciento de consumidores, con predominio del bebedor social. La bebida alcohólica más consumida fue la cerveza, y la motivación psicosocial más frecuente fue la vinculación con los amigos que toman. Se concluyó que el nivel de conocimientos de los adolescentes encuestados sobre temas relacionados con el alcohol al inicio del estudio era bajo, y con la intervención educativa implementada se logró modificar el nivel de conocimientos se evidencia la efectividad de la intervención al aportar los conocimientos necesarios ante esta problemática (AU)

Pre experimental study (before/after) was carried out through an educational intervention with the aim of raising the level of knowledge about alcoholism in a group of adolescents between 13 and 18 years, belonging to the Family Medical Clinic No.10 North university Polyclinic of Moron municipality during December 2010 and November 2011. The universe consisted of 82 adolescents between 13 and 18 years, which a study sample was finally comprised by 78 adolescents that accomplish the inclusion and exclusion criteria. The prevalence was low 12.82 percent of consumers, predominantly social drinker. The most widely consumed alcoholic beverage was beer, and the most common psychosocial motivation was the correlation with drinker friends. It was concluded that the level of knowledge of adolescents on issues related to alcohol was low at the beginning, and the implemented educational intervention was able to change the level of knowledge evidencing the effectiveness of the intervention to provide the necessary knowledge to this problem (AU)

Influência do curso médico no aprendizado do alcoolismo / Influence of the medical course in teaching of alcoholism

Existem evidências de que o ensino de Alcoolismo nas escolas médicas é deficiente. A fim de verificar a validade dessa afirmativa foi feita uma análise dos conhecimentos dos alunos sobre o tema. Utilizou-se, para tanto, um questionário referente à etiologia do alcoolismo aplicado aos estudantes do 1§, 9§ e 12§ semestres da Faculdade de Medicina da Universidade Federal do Rio Grande do Sul. Os resultados, em geral, näo demonstraram ocorrer alteraçöes significativas no decorrer do curso médico. Este fato reforça a idéia de que a Faculdade de Medicina exerce pouca influência sobre o conhecimento dos alunos no que se refere à doença Alcoolismo