ANA CRISTINA DE MEDEIROS RIBEIRO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
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Resultados de Busca
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- Human papillomavirus and chlamydia trachomatis infections in rheumatoid arthritis under anti-TNF therapy: an observational study(2015) WAISBERG, Mariana G.; RIBEIRO, Ana C. M.; CANDIDO, Wellington M.; MEDEIROS, Poliana B.; MATSUZAKI, Cezar N.; BELDI, Mariana C.; TACLA, Maricy; CAIAFFA-FILHO, Helio H.; BONFA, Eloisa; SILVA, Clovis A.The objective of this study was to evaluate human papillomavirus (HPV) and Chlamydia trachomatis (CT) infections in RA patients pre- and post-TNF blocker. Fifty female RA patients (ACR criteria), who were eligible to anti-TNF therapy [n = 50 at baseline (BL) and n = 45 after 6 months of treatment (6 M)], and 50 age-matched healthy controls were prospectively enrolled. They were assessed for demographic data, gynecologic, sexual, cervical cytology and histological evaluations, disease parameters and current treatment. HPV DNA and CT DNA testing in cervical specimens were done using Hybrid Capture II assays. At BL, the median current age of RA patients and controls was 49 (18-74) versus 49 (18-74) years, p = 1.0. A trend of lower frequency of HPV infection was observed in AR patients pre-anti-TNF compared with controls (14 vs. 30 %, p = 0.054). Further evaluation of AR patients with and without HPV infection before anti-TNF therapy showed that the former group had higher frequency of sexual intercourses (100 vs. 48 %, p = 0.014), higher median number of sexual partners [1 (1-1) vs. 0 (0-1), p = 0.032] and higher frequency of abnormal cervical cytology (43 vs. 7 %, p = 0.029). Current age, disease duration, disease parameters and treatments were alike in both groups (p > 0.05). At 6 M after TNF blockage, HPV infection remained unchanged in five patients, whereas two became negative and one additional patient turned out to be positive (p = 1.0). CT infection was uniformly negative in RA patients pre- and post-TNF blockage and in controls. Anti-TNF does not seem to increase short-term risk of exacerbation and/or progression of HPV and CT infections in RA patients.
- ALTERED SLEEP PATTERNS, FATIGUE, ANXIETY AND DEPRESSION LEVELS ARE IMPORTANT FEATURES AMONG PATIENTS WITH PSORIATIC ARTHRITIS(2015) AQUILA, L. Arancibia; MEDEIROS, A. C.; GONCALVES, C. R.; BARROS, P. D. Sampaio; SCHAINBERG, C. Goldenstein
- Short and long-term immunogenicity and safety following the 23-valent polysaccharide pneumococcal vaccine in juvenile idiopathic arthritis patients under conventional DMARDs with or without anti-TNF therapy(2015) AIKAWA, Nadia E.; FRANCA, Ivan L. A.; RIBEIRO, Ana C.; SALLUM, Adriana M. E.; BONFA, Eloisa; SILVA, Clovis A.Objectives: To assess immunogenicity and safety of the 23-valent polysaccharide pneumococcal vaccine (PPV23) in juvenile idiopathic arthritis (JIA) patients under conventional DMARDs with or without anti-TNF therapy. The influences of demographic data, disease activity and treatment on immune response and the potential deleterious effects of vaccine on disease itself were also evaluated. Methods: 17 JIA patients immediately pre-etanercept (Group 1) and 10 JIA patients on stable dose of methotrexate (Group 2) received one dose of PPV23. All patients were evaluated pre-vaccination, 2 months and 12 months post-vaccination for seven pneumoccocal serotypes. Serology was performed by enzyme immunoassay and the immunogenicity endpoints included seroprotection (SP), seroconversion (SP) and geometric mean concentration of antibodies(GMC). Clinical and laboratorial parameters of JIA were evaluated before and after vaccination. Results: Groups I and 2 were comparable regarding age, gender, disease duration and other DMARDs use (p > 0.05). Pre-immunization SP and GMC were alike in patients with and without anti-TNF therapy (p > 0.05). The frequencies of patients achieving adequate vaccine response (seroconversion in >= 50% of all serotypes) at 2 months (53 vs. 30%, p = 0.424) and 12 months (36 vs. 40%, p = 1.0) were similar in JIA patients with and without anti-TNF therapy. Further comparison of patients with and without adequate response at 2 months revealed no influence of demographic, clinical and laboratorial JIA parameters (p > 0.05). Serious adverse events were not observed. Conclusions: Anti-TNF therapy in JIA patients does not seem to have an additional deleterious effect on short/long-term PPV23 immunogenicity compared to MTX alone and no influence on disease parameters was observed with this vaccine.