RENACER study: Assessment of 12-month efficacy and safety of 168 certolizumab PEGol rheumatoid arthritis-treated patients from a Spanish multicenter national database.

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.

Hemoptisis grave por sarcoma sinovial pulmonar / No disponible

No disponible

Onda de Osborn en la hipotermia / The Osborn, or J, wave in hypothermia

No disponible

Gangrena como manifestación inicial de un síndrome antifosfolipídico catastrófico / Gangrene as an initial manifestation of a catastrophic antiphospholipid syndrome

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)

Síncope como forma de presentación de un tromboembolismo pulmonar / Syncope as presentation form of pulmonary embolism

No disponible

[Gangrene as an initial manifestation of a catastrophic antiphospholipid syndrome]. / Gangrena como manifestación inicial de un síndrome antifosfolipídico catastrófico.

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.

Clínica: fiebre y artritis. Diagnóstico: endocarditis por enterococo / Clinical review: fever and arthritis. Diagnosis: endocarditis due to enterococcus

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. 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 (AU)

Miocardiopatía y artritis reumatoide. Una paciente en lista de trasplante cardíaco / Rheumatoid arthritis and myocardiopathy. A patient awaiting a heart transplant

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)

[Rheumatoid arthritis and myocardiopathy. A patient awaiting a heart transplant]. / Miocardiopatía y artritis reumatoide. Una paciente en lista de trasplante cardíaco.

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.

[Clinical review: Fever and arthritis. Diagnosis: endocarditis due to enterococcus]. / Clínica: fiebre y artritis. Diagnóstico: endocarditis por enterococo.

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.