PORTUGUESE RECOMMENDATIONS FOR THE USE OF BIOLOGICAL THERAPIES IN PATIENTS WITH PSORIATIC ARTHRITIS--2015 UPDATE.

OBJECTIVE: To update recommendations for the treatment of psoriatic arthritis with biological therapies, endorsed by the Portuguese Society of Rheumatology (SPR). METHODS: These treatment recommendations were formulated by Portuguese rheumatologists based on literature evidence and consensus opinion. At a national meeting the 16 recommendations included in this document were discussed and updated. The level of agreement among Portuguese Rheumatologists was assessed using an online survey. A draft of the full text of the recommendations was then circulated and suggestions were incorporated. A final version was again circulated before publication. RESULTS: A consensus was achieved regarding the initiation, assessment of response and switching biological therapies in patients with psoriatic arthritis (PsA). Specific recommendations were developed for several disease domains: peripheral arthritis, axial disease, enthesitis and dactylitis. CONCLUSION: These recommendations may be used for guidance in deciding which patients with PsA should be treated with biological therapies. They cover a rapidly evolving area of therapeutic intervention. As more evidence becomes available and more biological therapies are licensed, these recommendations will have to be updated.

Prevalence of self-reported rheumatic diseases in a Portuguese population.

OBJECTIVES: With this study we attempted to estimate the prevalence of self-reported rheumatic diseases in a Portuguese population. It was also our objective to evaluate the influence of the variables sex and age on the prevalence of these diseases. PATIENTS AND METHODS: The study population was comprised of 297 individuals from a total of 573 random telephone numbers selected from the city of Lisbon telephone book (landline/residents). Those 297 were the ones that agreed to answer the proposed questionnaire. RESULTS: The prevalence value of self-reported rheumatic diseases was 26.3%. A prevalence value of self-declared osteoarthritis of 21.2% was found, 7.7% for osteoporosis, 1.3% for rheumatoid arthritis and 0.3% each for gout, systemic lupus erythematosus, Behçet's disease and fibromyalgia. An association with the variables sex and age was achieved for the total of rheumatic diseases. The same association was obtained for osteoarthritis and osteoporosis. CONCLUSIONS: This study emphasizes the good self- -judgment that the inquired population has about their rheumatic diseases, and some of the obtained results are in agreement with the national and worldwide literature.

Rituximab use in pediatric autoimmune diseases: four case reports.

Rituximab (RTX) is currently used in many diseases, but its efficacy and safety in juvenile systemic lupus erythematosus (SLEj) is still unknown. In this chapter we present four case reports of children treated with RTX: three SLE and one immune thrombocytopenic purpura (ITP). Two of the three SLEj patients had class IV lupus nephritis (LN) and hematologic manifestations (pancytopenia), both reaching complete recovery of blood counts and improvement of LN with RTX treatment. Our third SLE patient had a severe onset with generalized microangiopathic manifestations in association with antiphospholipid antibodies and has been in remission for almost 1 year after RTX. However, our fourth case, a patient with ITP and renal failure, was treated with RTX without either hematologic or renal response.