CAMILLE PINTO FIGUEIREDO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina

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  • article 13 Citação(ões) na Scopus
    Treatment tapering and stopping in patients with rheumatoid arthritis in stable remission (RETRO): a multicentre, randomised, controlled, open-label, phase 3 trial
    (2021) TASCILAR, Koray; HAGEN, Melanie; KLEYER, Arnd; SIMON, David; REISER, Michaela; HUEBER, Axel J.; MANGER, Bernhard; ENGLBRECHT, Matthias; FINZEL, Stephanie; TONY, Hans-Peter; SCHUCH, Florian; KLEINERT, Stefan; WENDLER, Joerg; RONNEBERGER, Monika; FIGUEIREDO, Camille P.; COBRA, Jayme F.; FEUCHTENBERGER, Martin; FLECK, Martin; MANGER, Karin; OCHS, Wolfgang; SCHMITT-HAENDLE, Matthias; LORENZ, Hanns-Martin; NUESSLEIN, Hubert; ALTEN, Rieke; KRUGER, Klaus; HENES, Joerg; SCHETT, Georg; RECH, Juergen
    Background Owing to increasing remission rates, the management of patients with rheumatoid arthritis in sustained remission is of growing interest. The Rheumatoid Arthritis in Ongoing Remission (RETRO) study investigated tapering and withdrawal of disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis in stable remission to test whether remission could be retained without the need to take DMARD therapy despite an absence of symptoms. Methods RETRO was an investigator-initiated, multicentre, prospective, randomised, controlled, open-label, parallel group phase 3 trial in patients aged at least 18 years with rheumatoid arthritis for at least 12 months before randomisation who were in sustained Disease Activity Score using 28 joints with erythrocyte sedimentation rate (ESR) remission (score <2middot6 units). Eligible patients were recruited consecutively from 14 German hospitals or rheumatology practices and randomly assigned (1:1:1) without stratification and regardless of baseline treatment, using a sequence that was computer-generated by the study statistician, to continue 100% dose DMARD (continue group), taper to 50% dose DMARD (taper group), or 50% dose DMARD for 6 months before stopping DMARDs (stop group). Neither patients nor investigators were masked to the treatment assignment. Patients were assessed every 3 months and screened for disease activity and relapse. The primary endpoint was the proportion of patients in sustained DAS28-ESR remission without relapse at 12 months, analysed using a log-rank test of trend and Cox regression. Analysis by a trained statistician of the primary outcome and safety was done in a modified intention-to treat population that included participants with non-missing baseline data. This study is completed and closed to new participants and is registered with ClinicalTrials.gov (NCT02779114). Findings Between May 26, 2010, and May 29, 2018, 303 patients were enrolled and allocated to continue (n=100), taper (n=102), or stop DMARDs (n=101). 282 (93%) of 303 patients were analysed (93 [93%] of 100 for continue, 93 [91%] of 102 for taper, and 96 [95%] of 101 for stop). Remission was maintained at 12 months by 81middot2% (95% CI 73middot3-90middot0) in the continue group, 58middot6% (49middot2-70middot0) in the taper group, and 43middot3% (34middot6-55middot5) in the stop group (p=0middot0005 with log-rank test for trend). Hazard ratios for relapse were 3middot02 (1middot69-5middot40; p=0middot0003) for the taper group and 4middot34 (2middot48-7middot60; p<0.0001)) for the stop group, in comparison with the continue group. The majority of patients who relapsed regained remission after reintroduction of 100% dose DMARDs. Serious adverse events occurred in ten of 93 (11%) patients in the continue group, seven of 93 (8%) patients in taper group, and 13 of 96 (14%) patients in the stop group. None were considered to be related to the intervention. The most frequent type of serious adverse event was injuries or procedural complications (n=9). Interpretation Reducing antirheumatic drugs in patients with rheumatoid arthritis in stable remission is feasible, with maintenance of remission occurring in about half of the patients. Because relapse rates were significantly higher in patients who tapered or stopped antirheumatic drugs than in patients who continued with a 100% dose, such approaches will require tight monitoring of disease activity. However, remission was regained after reintroduction of antirheumatic treatments in most of those who relapsed in this study. These results might help to prevent overtreatment in a substantial number of patients with rheumatoid arthritis. Funding None.
  • conferenceObject
    Performance of FRAX® Brazil and NOGG Methodology with and Without Bone Mineral Density upon Predicting Fractures on a Community-Dwelling Elderly Population with High Incidence of Osteoporotic Fractures - The Sao Paulo Ageing and Health (SPAH) Study
    (2023) FREITAS, Thiago Q.; OLALLA, Leonardo F. Guerron; TAKAYAMA, Liliam; CAPARBO, Valeria F.; FIGUEIREDO, Camille P.; MACHADO, Luana G.; DOMICIANO, Diogo S.; PEREIRA, Rosa M. R.
  • article 29 Citação(ões) na Scopus
    Age- and Sex-Dependent Changes of Intra-articular Cortical and Trabecular Bone Structure and the Effects of Rheumatoid Arthritis
    (2017) SIMON, David; KLEYER, Arnd; STEMMLER, Fabian; SIMON, Christoph; BERLIN, Andreas; HUEBER, Axel J.; HASCHKA, Judith; RENNER, Nina; FIGUEIREDO, Camille; NEUHUBER, Winfried; BUDER, Thomas; ENGLBRECHT, Matthias; RECH, Juergen; ENGELKE, Klaus; SCHETT, Georg
    The objective of this cross-sectional study was to define normal sex- and age-dependent values of intra-articular bone mass and microstructures in the metacarpal heads of healthy individuals by high-resolution peripheral quantitative computed tomography (HR-pQCT) and test the effect of rheumatoid arthritis (RA) on these parameters. Human cadaveric metacarpal heads were used to exactly define intra-articular bone. Healthy individuals of different sex and age categories and RA patients with similar age and sex distribution received HR-pQCT scans of the second metacarpal head and the radius. Total, cortical, and trabecular bone densities as well as microstructural parameters were compared between 1) the different ages and sexes in healthy individuals; 2) between metacarpal heads and the radius; and 3) between healthy individuals and RA patients. The cadaveric study allowed exact definition of the intra-articular (intracapsular) bone margins. These data were applied in measuring intra-articular and radial bone parameters in 214 women and men (108 healthy individuals, 106 RA patients). Correlations between intra-articular and radial bone parameters were good (r=0.51 to 0.62, p<0.001). In contrast to radial bone, intra-articular bone remained stable until age 60 years (between 297 and 312mg HA/cm(3)) but decreased significantly (p<0.001) in women thereafter (237.5 +/- 44.3) with loss of both cortical and trabecular bone. Similarly, RA patients showed significant (p<0.001) loss of intra-articular total (263.0 +/- 44.8), trabecular (171.2 +/- 35.6), and cortical bone (610.2 +/- 62.0) compared with sex- and age-adjusted controls. Standard sex- and age-dependent values for physiological intra-articular bone were defined. Postmenopausal state and RA led to significant decrease of intra-articular bone. (c) 2016 American Society for Bone and Mineral Research.
  • conferenceObject
    EFFECT OF SARCOPENIA, SUBCUTANEOUS ADIPOSE TISSUE AND ABDOMINAL VISCERAL FAT ON MORTALITY RISK OF COMMUNITY-DWELLING OLDER ADULTS: A POPULATION-BASED PROSPECTIVE COHORT STUDY IN BRAZIL
    (2017) SANTANA, F. M.; DOMICIANO, D.; GONCALVES, M.; MACHADO, L. G.; FIGUEIREDO, C. P.; LOPES, J. B.; CAPARBO, V.; TAKAYAMA, L.; PEREIRA, . M. R.
  • conferenceObject
    PREVALENCE OF SARCOPENIA AND ASSOCIATED RISK FACTORS BY TWO DIAGNOSTIC CRITERIA IN COMMUNITY-DWELLING OLDER WOMEN: THE SAO PAULO AGEING & HEALTH STUDY (SPAH)
    (2016) DOMICIANO, D. S.; FIGUEIREDO, C. P.; LOPES, J. B.; CAPARBO, V. F.; TAKAYAMA, L.; MENEZES, P. R.; PEREIRA, R. M.
  • conferenceObject
    Association between Metabolic Syndrome and Bone Mineral Density in a Community-dwelling Older Women: the Sao Paulo Ageing & Health Study (SPAH)
    (2013) MACHADO, Luana; DOMICIANO, Diogo; LOPES, Jaqueline; FIGUEIREDO, Camille; CAPARBO, Valeria; TAKAYAMA, Liliam; PEREIRA, Rosa
  • conferenceObject
    A COMPARISON OF TWO METHODS TO SEGMENT BONE EROSIONS IN THE METACARPOPHALANGEAL JOINTS OF RHEUMATOID ARTHRITIS PATIENTS
    (2016) FIGUEIREDO, C.; SIMON, D.; STEMMLER, F.; WEISSENFELS, A.; WEISHAEUPL, D.; MUSEYKO, O.; FRIEDBERGER, A.; RECH, J.; HUEBER, A. J.; HASCHKA, J.; SCHETT, G.; ENGELKE, K.; KLEYER, A.
  • article 4 Citação(ões) na Scopus
    HR-pQCTin vivoimaging of periarticular bone changes in chronic inflammatory diseases: Data from acquisition to impact on treatment indications
    (2021) FIGUEIREDO, Camille P.; PEREZ, Mariana O.; SALES, Lucas Peixoto; SCHETT, Georg; PEREIRA, Rosa M. R.
    Imaging is essential for the assessment of bone and inflammatory joint diseases. There are several imaging techniques available that differ regarding resolution, radiation exposure, time expending, precision, cost, availability or ability to predict disease progression. High-resolution peripheral quantitative computed tomography (HR-pQCT) that was introduced in 2004 allows thein vivoevaluation of peripheral bone microarchitecture and demonstrated high precision in assessing bone changes in inflammatory musculoskeletal diseases. This review summarizes the use of HR-pQCT for the evaluation of the hand skeleton in inflammatory joint diseases. We conducted a review of the literature regarding the protocols that involve hand joints assessment and evaluation of bone changes as erosions and osteophytes in chronic inflammatory diseases. Apart from measuring bone density and structure of the radius and the tibia, HR-pQCT has contributed to assessment of bone erosions and osteophytes, considered the hallmark of diseases as rheumatoid arthritis and psoriatic arthritis, respectively. In this way, there are some conventions recently established by rheumatic study groups that we just summarized here in order to standardize HR-pQCT measurements.
  • article 1 Citação(ões) na Scopus
    Erosion Identification in Metacarpophalangeal Joints in Rheumatoid Arthritis using High-Resolution Peripheral Quantitative Computed Tomography
    (2023) AL-KHOURY, Yousif; FINZEL, Stephanie; FIGUEIREDO, Camille; BURGHARDT, Andrew J.; STOK, Kathryn S.; TAM, Lai-Shan; CHENG, Isaac; TSE, Justin J.; MANSKE, Sarah L.
    Bone erosions are a pathological feature of several forms of inflammatory arthritis including rheumatoid arthritis (RA). The increased presence and size of erosions are associated with poor outcomes, joint function, and disease progression. High-resolution peripheral quantitative computed tomography (HR-pQCT) provides unparalleled in vivo visualization of bone erosions. However, at this resolution, discontinuities in the cortical shell (cortical breaks) that are associated with normal physiological processes and pathology are also visible. The Study grouP for xtrEme Computed Tomography in Rheumatoid Arthritis previously used a consensus process to develop a definition of pathological erosion in HR-pQCT: a cortical break detected in at least two consecutive slices, in at least two perpendicular planes, non-linear in shape, with underlying trabecular bone loss. However, despite the availability of a consensus definition, erosion identification is a demanding task with challenges in inter-rater variability. The purpose of this work is to introduce a training tool to provide users with guidance on identifying pathological cortical breaks on HRpQCT images for erosion analysis. The protocol presented here uses a custom-built module (Bone Analysis Module (BAM) Training), implemented as an extension to an open-source image processing software (3D Slicer). Using this module, users can practice identifying erosions and compare their results to erosions annotated by expert rheumatologists.
  • conferenceObject
    Performance of FRAX (R) Brazil and NOGG Methodology with and Without Bone Mineral Density upon Predicting Fractures on a Community-Dwelling Elderly Population with High Incidence of Osteoporotic Fractures: The Sao Paulo Ageing and Health (SPAH) Study
    (2022) FREITAS, Thiago Q.; OLALLA, Leonardo F. G.; TAKAYAMA, Liliam; CAPARBO, Valeria; FIGUEIREDO, Camille; MACHADO, Luana; DOMICIANO, Diogo; PEREIRA, Rosa