CLAUDIA GOLDENSTEIN SCHAINBERG
Projetos de Pesquisa
Unidades Organizacionais
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Management of Peripheral Arthritis in Patients With Psoriatic Arthritis: An Updated Literature Review Informing the 2021 GRAPPA Treatment Recommendations(2023) LEUNG, Ying-Ying; KOROTAEVA, Tatiana V.; CANDIA, Liliana; PEDERSEN, Susanne Juhl; MOLANO, Wilson Bautista; RUDERMAN, Eric M.; BISOENDIAL, Radjesh; PEREZ-ALAMINO, Rodolfo; OLSDER, Wendy; MOELLER, Burkhard; GRAZIO, Simeon; GUDU, Tania; MODY, Girish M.; PINEDA, Carlos; RAFFAYOVA, Helena; ROHEKAR, Sherry; GOLDENSTEIN-SCHAINBERG, Claudia; URENA, Sergio R. Gutierrez; VARGAS, Julio Cesar Casasola; MEGHNATHI, Bhowmik; PRASAD, Roopa; RICHETTE, Pascal; MIRANDA, Jose Roberto S.; MALLIOTIS, Nikolas; LINDQVIST, Ulla; SIMON, David; EZEONYELI, Amara; SORIANO, Enrique R.; FITZGERALD, OliverObjective. We aimed to compile evidence for the efficacy and safety of therapeutic options for the periph-eral arthritis domain of psoriatic arthritis (PsA) for the revised 2021 Group in Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations. Methods. A working group consisting of clinicians and patient research partners was convened. We reviewed the evidence from new randomized controlled trials (RCTs) for PsA treatment from February 19, 2013, to August 28, 2020. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-informed approach to derive evidence for the classes of therapeutic options for 3 patient groups: (1) naive to treatment, (2) inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), and (3) inadequate response to biologic DMARDs (bDMARDs). Recommendations were derived through consensus meetings. Results. The evidence review included 69 RCTs. We derived GRADE evidence for each class of therapeutic options and achieved consensus for the recommendations. For patients naive to treatment, the working group strongly recommends csDMARDs (methotrexate, sulfasalazine, leflunomide) and phosphodi-esterase 4 inhibitors, and emphasizes regular assessment and early escalation to achieve treatment target. bDMARDs (tumor necrosis factor inhibitors [TNFi], interleukin 17 inhibitors [IL-17i], IL-12/23i, IL-23i) and Janus kinase inhibitors (JAKi) are also strongly recommended. For patients with inadequate response to csDMARDs, we strongly recommend TNFi, IL-17i, IL-12/23i, IL-23i, and JAKi. For those who had prior experience with bDMARDs, we strongly recommend a second TNFi, IL-17i, IL-23i, and JAKi. The evidence supporting nonpharmacological interventions was very low. An expert panel conditionally recom-mends adequate physical activity, smoking cessation, and diet to control weight gain. Conclusion. Evidence supporting optimal therapy for the peripheral arthritis domain of PsA was compiled for the revised 2021 GRAPPA treatment recommendations.
- Developing a provisional definition of flare in patients with established gout(2012) GAFFO, Angelo L.; SCHUMACHER, H. Ralph; SAAG, Kenneth G.; TAYLOR, William J.; DINNELLA, Janet; OUTMAN, Ryan; CHEN, Lang; DALBETH, Nicola; SIVERA, Francisca; VAZQUEZ-MELLADO, Janitzia; CHOU, Chung-Tei; ZENG, Xuejun; PEREZ-RUIZ, Fernando; KOWALSKI, Sergio C.; GOLDENSTEIN-SCHAINBERG, Claudia; CHEN, Lan; BARDIN, Thomas; SINGH, Jasvinder A.Objective Various nonvalidated criteria for disease flare have been used in studies of gout. Our objective was to develop empirical definitions for a gout flare from patient-reported features. Methods Possible elements for flare criteria were previously reported. Data were collected from 210 gout patients at 8 international sites to evaluate potential gout flare criteria against the gold standard of an expert rheumatologist definition. Flare definitions based on the presence of the number of criteria independently associated with the flare and classification and regression tree approaches were developed. Results The mean +/- SD age of the study participants was 56.2 +/- 15 years, 207 of them (98%) were men, and 54 of them (26%) had flares of gout. The presence of any patient-reported warm joint, any patient-reported swollen joint, patient-reported pain at rest score of >3 (010 scale), and patient-reported flare were independently associated with the study gold standard. The greatest discriminating power was noted for the presence of 3 or more of the above 4 criteria (sensitivity 91% and specificity 82%). Requiring all 4 criteria provided the highest specificity (96%) and positive predictive value (85%). A classification tree identified pain at rest with a score of >3, followed by patient self-reported flare, as the rule associated with the gold standard (sensitivity 83% and specificity 90%). Conclusion We propose definitions for a disease flare based on self-reported items in patients previously diagnosed as having gout. Patient-reported flare, joint pain at rest, warm joints, and swollen joints were most strongly associated with presence of a gout flare. These provisional definitions will next be validated in clinical trials.
- PREDICTORS OF CLINICAL RESPONSE TO ABATACEPT IN CHILDREN WITH POLYARTICULAR JUVENILE IDIOPATHIC ARTHRITIS(2022) RUPERTO, N.; BRUNNER, H.; BERMAN, A.; ZAPATA, F. Avila; HORNEFF, G.; WAGNER-WEINER, L.; BELOT, A.; BURGOS-VARGAS, R.; GAMIR, M. L. Gamir; GOLDENSTEIN-SCHAINBERG, C.; TERRERI, M. T.; ASKELSON, M.; WONG, R.; MARTINI, A.; LOVELL, D. J.
- A Delphi Exercise to Identify Characteristic Features of Gout - Opinions from Patients and Physicians, the First Stage in Developing New Classification Criteria(2013) PROWSE, Rebecca L.; DALBETH, Nicola; KAVANAUGH, Arthur; ADEBAJO, Adewale O.; GAFFO, Angelo L.; TERKELTAUB, Robert; MANDELL, Brian F.; SURYANA, Bagus P. P.; GOLDENSTEIN-SCHAINBERG, Claudia; DIAZ-TORNE, Cesar; KHANNA, Dinesh; LIOTE, Frederic; MCCARTHY, Geraldine; KERR, Gail S.; YAMANAKA, Hisashi; JANSSENS, Hein; BARAF, Herbert F.; CHEN, Jiunn-Horng; VAZQUEZ-MELLADO, Janitzia; HARROLD, Leslie R.; STAMP, Lisa K.; LAAR, Mart A. Van de; JANSSEN, Matthijs; DOHERTY, Michael; BOERS, Maarten; EDWARDS, N. Lawrence; GOW, Peter; CHAPMAN, Peter; KHANNA, Puja; HELLIWELL, Philip S.; GRAINGER, Rebecca; SCHUMACHER, H. Ralph; NEOGI, Tuhina; JANSEN, Tim L.; LOUTHRENOO, Worawit; SIVERA, Francisca; TAYLOR, William J.Objective. To identify a comprehensive list of features that might discriminate between gout and other rheumatic musculoskeletal conditions, to be used subsequently for a case-control study to develop and test new classification criteria for gout. Methods. Two Delphi exercises were conducted using Web-based questionnaires: one with physicians from several countries who had an interest in gout and one with patients from New Zealand who had gout. Physicians rated a list of potentially discriminating features that were identified by literature review and expert opinion, and patients rated a list of features that they generated themselves. Agreement was defined by the RAND/UCLA disagreement index. Results. Forty-four experienced physicians and 9 patients responded to all iterations. For physicians, 71 items were identified by literature review and 15 more were suggested by physicians. The physician survey showed agreement for 26 discriminatory features and 15 as not discriminatory. The patients identified 46 features of gout, for which there was agreement on 25 items as being discriminatory and 7 items as not discriminatory. Conclusion. Patients and physicians agreed upon several key features of gout. Physicians emphasized objective findings, imaging, and patterns of symptoms, whereas patients emphasized severity, functional results, and idiographic perception of symptoms. (First Release Feb 15 2013; J Rheumatol 2013;40:498-505; doi:10.3899/jrheum.121037)