PERCIVAL DEGRAVA SAMPAIO BARROS

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

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Assunto: ankylosing-spondylitis ×

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  • article 33 Citação(ões) na Scopus
    Effect of age at disease onset in the clinical profile of spondyloarthritis: a study of 1424 Brazilian patients
    (2012) SKARE, T. L.; LEITE, N.; BORTOLUZZO, A. B.; GONCALVES, C. R.; SILVA, J. A. B. da; XIMENES, A. C.; BERTOLO, M. B.; RIBEIRO, S. L. E.; KEISERMAN, M.; MENIN, R.; CARNEIRO, S.; AZEVEDO, V. F.; VIEIRA, W. P.; ALBUQUERQUE, E. N.; BIANCHI, W. A.; BONFIGLIOLI, R.; CAMPANHOLO, C.; CARVALHO, H. M. S.; COSTA, I. P.; DUARTE, A. P.; GAVI, M. B. O.; KOHEM, C. L.; LIMA, S. A. L.; MEIRELLES, E. S.; PEREIRA, I. A.; PINHEIRO, M. M.; POLITO, E.; RESENDE, G. G.; ROCHA, F. A. C.; SANTIAGO, M. B.; SAUMA, M. F. L. C.; SAMPAIO-BARROS, P. D.
    Objectives To analyse demographic and clinical variables in patients with disease onset before and after 40, 45 and 50 years in a large series of Brazilian SpA patients. Methods A common protocol of investigation was prospectively applied to 1424 SpA patients in 29 centres distributed through the main geographical regions in Brazil. The mean age at disease onset was 28.56 +/- 12.34 years, with 259 patients (18.2%) referring disease onset after 40 years, 15.1 (10.6%) after 45 years and 81 (5.8%) after 50 years. Clinical and demographic variables and disease indices (BASDAI, BASFI, BASRI, MASES, ASQoL) were investigated. Ankylosing spondylitis was the most frequent disease (66.3%), followed by psoriatic arthritis (18%), undifferentiated SpA (6.7%), reactive arthritis (5.5%), and enteropathic arthritis (3.5%). Results Comparing the groups according to age of disease onset, those patients with later onset presented statistical association with female gender, peripheral arthritis, dactylitis, nail involvement and psoriasis, as well as negative statistical association with inflammatory low hack pain, alternating buttock pain, radiographic sacroiliitis, hip involvement, positive familial history, HLA-B27 and uveitis. BASDAI, BASFI and quality of life, as well as physicians and patient's global assessment, were similar in all the groups. Radiographic indices showed worse results in the younger age groups. Conclusion There are two different clinical patterns in SpA defined by age at disease onset: one with predominance of axial symptoms in the group with disease onset <= 40 years and another favouring the peripheral manifestations in those with later disease onset.
  • article 19 Citação(ões) na Scopus
    Recommendations for the management and treatment of psoriatic arthritis
    (2013) CARNEIRO, Sueli; AZEVEDO, Valderilio Feijo; BONFIGLIOLI, Rubens; RANZA, Roberto; GONCALVES, Celio Roberto; KEISERMAN, Mauro; MEIRELLES, Eduardo de Souza; PINHEIRO, Marcelo de Medeiros; XIMENES, Antonio Carlos; BERNARDO, Wanderley; SAMPAIO-BARROS, Percival Degrava
  • article 31 Citação(ões) na Scopus
    Hypertension and diabetes significantly enhance the risk of cardiovascular disease in patients with psoriatic arthritis
    (2014) FAVARATO, M. H.; MEASE, P.; GONCALVES, C. R.; SAAD, C. Goncalves; SAMPAIO-BARROS, P. D.; GOLDENSTEIN-SCHAINBERG, C.
    Objective New evidence has lightened the linkage between psoriatic arthritis (PsA) and the development of atherosclerosis and cardiovascular disease (CVD). We aimed to describe the prevalence of cardiovascular events and associated risk factors among patients with PsA. Methods Retrospective evaluation of medical records from consecutive PsA patients who fulfilled the CASPAR criteria for PsA attending a specialised spondyloarthritis clinic at a single referral centre. CVD was defined based on the occurrence of coronary artery disease (CAD) or cerebrovascular ischaemic disease events. Results We evaluated 158 PsA patients, 48.7% females and 51.3% males, aged 53.7+/-13.9 yrs. Mean PsA duration was 13.7+/-8.9 yrs and polyarticular subtype affected 66(42%) patients. According to drug therapy, 85 (54%) were using NSAIDs and 21 (13%) low-dose prednisone; 32 (20%) were on anti-TNF agents, 94 (60%) metothrexate, 18 (11%) leflunomide, 13 (8%) sulfasalazine, 5 (3%) other immunossupressors and 4 (2.5%) were on chloroquine. Over half patients (87, 55%) had arterial hypertension (AH); 51 (32%) had dyslipidaemia (DLP), 38 (29%) hypertriglyceridaemia and 36(23%) diabetes mellitus (DM). Lipid profile was similar for both genders with mean total cholesterol= 186.5+/-38.6mg/dl, LDL=112.3+/-30.6 mg/dl, HDL=47.89+/-14.6 and triglycerides=127.4+/-65.6 mg/dl. Of note, 14% PsA patients have had CVD, namely cerebrovascular or coronary heart disease. Sex, age, disease duration, joint involvement subtype, disease activity, CRP and lipid levels were similar among patients with and without CVD. The prevalence of All (95% vs. 45%, p<0.001), DLP (75% vs. 27.7%, p<0.001) and DM (60% vs. 19%, p<0.001) were significantly greater in PsA patients who have had CVD compared to those without CVD, conferring an odds ratio of 21.0 for All and of 5.4 for DM. Conclusion The high prevalence of CVD in PsA patients is influenced by increased All and DM. Hence early recognition and specific treatment is mandatory in order to reduce the risk for CVD, avoiding early morbidity and mortality.
  • article 0 Citação(ões) na Scopus
    Reflections on the prevalence of human leukocyte antigen-B27 and human leukocyte antigen-B51 co-occurrence in patients with spondylarthritis
    (2022) GONCALVES, Jucier; SAMPAIO-BARROS, Percival Degrava; SHINJO, Samuel Katsuyuki
    We performed a literature mini-review of the clinical profile of patients with spondylarthritis who are also human leukocyte antigen (HLA)-B51-positive. It seems to us that patients with HLA-B27 and HLA-B51 are more common in men, Asians and between the third and ninth decades of life. They are more likely to develop peripheral joint conditions, with cutaneous manifestations (e.g., oral ulcers) and uveitis. Therefore, more robust epidemiological studies with more accurate methodology and multicenter locations are needed to better map the role of the interaction between HLA-B51 in patients with spondylarthritis.
  • article 59 Citação(ões) na Scopus
    Gender characterization in a large series of Brazilian patients with spondyloarthritis
    (2012) CARVALHO, Hellen M. S. de; BORTOLUZZO, Adriana B.; GONCALVES, Celio R.; SILVA, Jose Antonio Braga da; XIMENES, Antonio Carlos; BERTOLO, Manoel B.; RIBEIRO, Sandra L. E.; KEISERMAN, Mauro; MENIN, Rita; SKARE, Thelma L.; CARNEIRO, Sueli; AZEVEDO, Valderilio F.; VIEIRA, Walber P.; ALBUQUERQUE, Elisa N.; BIANCHI, Washington A.; BONFIGLIOLI, Rubens; CAMPANHOLO, Cristiano; COSTA, Izaias P.; DUARTE, Angela P.; GAVI, Maria Bernadete O.; KOHEM, Charles L.; LEITE, Nocy H.; LIMA, Sonia A. L.; MEIRELLES, Eduardo S.; PEREIRA, Ivanio A.; PINHEIRO, Marcelo M.; POLITO, Elizandra; RESENDE, Gustavo G.; ROCHA, Francisco Airton C.; SANTIAGO, Mittermayer B.; SAUMA, Maria de Fatima L. C.; SAMPAIO-BARROS, Percival D.
    An increasing number of women have been diagnosed with spondyloarthritis (SpA) in recent decades. While a few studies have analyzed gender as a prognostic factor of the disease, no studies have addressed this matter with a large number of patients in South America, which is a peculiar region due to its genetic heterogeneity. The aim of the present study was to analyze the influence of gender on disease patterns in a large cohort of Brazilian patients with SpA. A prospective study was carried out involving 1,505 patients [1,090 males (72.4%) and 415 females (27.6%)] classified as SpA according to the European Spondyloarthropaties Study Group criteria who attended at 29 reference centers for rheumatology in Brazil. Clinical and demographic variables were recorded and the following disease indices were administered: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Radiologic Index (BASRI), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), and Ankylosing Spondylitis Quality of Life (ASQoL). Ankylosing spondylitis (AS) was the most frequent disease in the group (65.4%), followed by psoriatic arthritis (18.4%), undifferentiated SpA (6.7%), reactive arthritis (3.3%), arthritis associated to inflammatory bowel disease (3.2%), and juvenile SpA (2.9%). The male-to-female ratio was 2.6:1 for the whole group and 3.6:1 for AS. The females were older (p<0.001) and reported shorter disease duration (p=0.002) than the male patients. The female gender was positively associated to peripheral SpA (p<0.001), upper limb arthritis (p<0.001), dactylitis (p=0.011), psoriasis (p<0.001), nail involvement (p<0.001), and family history of SpA (p=0.045) and negatively associated to pure axial involvement (p< 0.001), lumbar inflammatory pain (p=0.042), radiographic sacroiliitis (p<0.001), and positive HLA-B27 (p=0.001). The number of painful (p<0.001) and swollen (p=0.006) joints was significantly higher in the female gender, who also achieved higher BASDAI (p<0.001), BASFI (p=0.073, trend), MASES (p=0.019), ASQoL (p=0.014), and patient's global assessment (p=0.003) scores, whereas the use of nonsteroidal anti-inflammatory drugs (p<0.001) and biological agents (p=0.003) was less frequent in the female gender. Moreover, BASRI values were significantly lower in females (p<0.001). The female gender comprised one third of SpA patients in this large cohort and exhibited more significant peripheral involvement and less functional disability, despite higher values in disease indices.
  • article 32 Citação(ões) na Scopus
    Effect of Enthesitis on 1505 Brazilian Patients with Spondyloarthritis
    (2013) CARNEIRO, Sueli; BORTOLUZZO, Adriana; GONCALVES, Celio; SILVA, Jose Antonio Braga da; XIMENES, Antonio C.; BERTOLO, Manoel; RIBEIRO, Sandra Lucia; KEISERMAN, Mauro; SKARE, Thelma; MENIN, Rita; AZEVEDO, Valderilio; VIEIRA, Walber; ALBUQUERQUE, Elisa; BIANCHI, Washington; BONFIGLIOLI, Rubens; CAMPANHOLO, Cristiano; CARVALHO, Hellen Mary de; COSTA, Izaias da; DUARTE, Angela; KOHEM, Charles; LEITE, Nocy; LIMA, Sonia A. L.; MEIRELLES, Eduardo S.; PEREIRA, Ivanio A.; PINHEIRO, Marcelo M.; POLITO, Elizandra; RESENDE, Gustavo G.; ROCHA, Francisco Airton C.; SANTIAGO, Mittermayer B.; SAUMA, Maria de Fatima L. C.; VALIM, Valeria; SAMPAIO-BARROS, Percival D.
    Objective. To analyze the clinical effect of enthesitis in a large Brazilian cohort of patients with spondyloarthritis (SpA). Methods. A common protocol of investigation was prospectively applied to 1505 patients with SpA in 29 centers in Brazil. Clinical and demographic variables and disease indexes were investigated. The Maastricht Ankylosing Spondylitis Enthesitis Score was used to investigate the enthesitis component. Ankylosing spondylitis was the most frequent disease in the group (65.4%). Others were psoriatic arthritis (18.4%), undifferentiated SpA (6.7%), reactive arthritis (3.3%), and enteropathic arthritis (3.2%). Results. At least 1 affected enthesis was observed in 54% of the patients with SpA, with a mean of 2.12 +/- 2.98 entheses affected. According to the clinical presentation, enthesitis was significantly more frequent in patients with axial + peripheral joint involvement compared to isolated axial or peripheral involvement (p < 0.001). There was a statistical association between the presence of enthesites and axial symptoms (buttock pain, cervical pain, and hip pain), and peripheral symptoms (lower limb arthritis, number of painful and swollen joints; p < 0.05). Patients with enthesitis also presented higher mean scores of Bath Ankylosing Spondylitis Functional Index (BASFI; p < 0.001), Bath Ankylosing Spondylitis Disease Activity Index (p < 0.001), and Ankylosing Spondylitis Quality of Life (ASQoL; p < 0.001). Multivariate logistic regression showed that BASFI (p < 0.0001; OR 74.839), ASQoL (p = 0.0001; OR 14.645), and Achilles tendonitis (p = 0.0059; OR 7.593) were associated with work incapacity. Conclusion. The clinical presence of enthesitis in this large cohort of patients with SpA was frequent and was associated with a significant increase in disease activity and decline in functional capacity and quality of life.
  • article 11 Citação(ões) na Scopus
    Different ethnic background is associated with distinct clinical profiles in the spondyloarthritides in the North and South of Brazil
    (2019) RIBEIRO, Sandra Lucia Euzebio; CAMPOS, Ana Paula Beckhauser de; PALOMINOS, Penelope Esther; BORTOLUZZO, Adriana Bruscato; COSTA, Marta Aline Coelho da; RIBEIRO, Talita de Oliveira; SAMPAIO-BARROS, Percival Degrava
    The objective of this study was to analyze the clinical profile of the spondyloarthritides (SpA) in distinct Brazilian regions. A common protocol of investigation was prospectively applied to 202 SpA patients, including 138 patients from the South and 64 patients from the North. All the patients were classified as axial or peripheral SpA. Clinical and demographic variables and disease indexes were analyzed. Bonferroni correction was used to adjust the level of significance of each test; results with p value <0.003 were considered statistically relevant. White ethnicity was associated with positive HLA-B27, while non-Whites presented higher frequency of peripheral arthritis, although not statistically significant. When comparing non-White patients from the North with those from the South, the Southerners presented significantly higher scores of Ankylosing Spondylitis Disease Activity Score using C-reactive protein (p=0.001) and Health Assessment Questionnaire (p=0.001). Although not statistically significant, Northern non-White patients were more frequently males, while Southerners had higher frequency of anterior uveitis and higher Bath Ankylosing Spondylitis Disease Activity Index and Ankylosing Spondylitis Quality of Life. Brazilian SpA patients present distinct patterns of disease according to the geographic region, especially regarding the non-White populations.
  • article 19 Citação(ões) na Scopus
    Ethnic Influence in Clinical and Functional Measures of Brazilian Patients with Spondyloarthritis
    (2012) SKARE, Thelma L.; BORTOLUZZO, Adriana B.; GONCALVES, Celio R.; SILVA, Jose Antonio Braga da; XIMENES, Antonio Carlos; BERTOLO, Manoel B.; RIBEIRO, Sandra L. E.; KEISERMAN, Mauro; MENIN, Rita; CARNEIRO, Sueli; AZEVEDO, Valderilio F.; VIEIRA, Walber P.; ALBUQUERQUE, Elisa N.; BIANCHI, Washington A.; BONFIGLIOLI, Rubens; CAMPANHOLO, Cristiano; CARVALHO, Hellen M. S.; COSTA, Izaias P.; DUARTE, Angela P.; GAVI, Maria Bernadete O.; KOHEM, Charles L.; LEITE, Nocy H.; LIMA, Sonia A. L.; MEIRELLES, Eduardo S.; PEREIRA, Ivanio A.; PINHEIRO, Marcelo M.; POLITO, Elizandra; RESENDE, Gustavo G.; ROCHA, Francisco Airton C.; SANTIAGO, Mittermayer B.; SAUMA, Maria de Fatima L. C.; SAMPAIO-BARROS, Percival D.
    Objective. Spondyloarthritides (SpA) can present different disease spectra according to ethnic background. The Brazilian Registry of Spondyloarthritis (RBE) is a nationwide registry that comprises a large databank on clinical, functional, and treatment data on Brazilian patients with SpA. The aim of our study was to analyze the influence of ethnic background in SpA disease patterns in a large series of Brazilian patients. Methods. A common protocol of investigation was prospectively applied to 1318 SpA patients in 29 centers distributed through the main geographical regions in Brazil. The group comprised whites (65%), African Brazilians (31.3%), and people of mixed origins (3.7%). Clinical and demographic variables and various disease index scores were compiled. Ankylosing spondylitis (AS) was the most frequent disease in the group (65.1%); others were psoriatic arthritis (18.3%), undifferentiated SpA (6.8%), enteropathic arthritis (3.7%), and reactive arthritis (3.4%). Results. White patients were significantly associated with psoriasis (p = 0.002), positive HLA-B27 (p = 0.014), and use of corticosteroids (p < 0.0001). Hip involvement (p = 0.02), axial inflammatory pain (p = 0.04), and radiographic sacroiliitis (p = 0.025) were associated with African Brazilian descent. Sex distribution, family history, and presence of peripheral arthritis, uveitis, dactylitis, urethritis, and inflammatory bowel disease were similar in the 3 groups, as well as age at disease onset, time from first symptom until diagnosis, and use of anti-tumor necrosis factor-a agents (p > 0.05). Schober test and thoracic expansion were similar in the 3 groups, whereas African Brazilians had higher Maastricht Ankylasing Spondylitis Enthesitis Scores (p = 0.005) and decreased lateral lumbar flexion (p = 0.003), while whites had a higher occiput-to-wall distance (p = 0.02). African Brazilians reported a worse patient global assessment of disease (p = 0.011). Other index scores and prevalence of work incapacity were similar in the 3 groups, although African Brazilians had worse performance in the Ankylosing Spondylitis Quality of Life questionnaire (p < 0.001). Conclusion. Ethnic background is associated with distinct clinical aspects of SpA in Brazilian patients. African Brazilian patients with SpA have a poorer quality of life and report worse disease compared to whites.
  • article 1 Citação(ões) na Scopus
    HLA-B27 positivity in a large miscegenated population of 5,389,143 healthy blood marrow donors in Brazil
    (2023) RESENDE, Gustavo Gomes; SAAD, Carla Goncalves Schahin; OLIVEIRA, Danielli Cristina Muniz de; BUENO FILHO, Julio Silvio de Sousa; SAMPAIO-BARROS, Percival Degrava; PINHEIRO, Marcelo de Medeiros
    BackgroundThe prevalence of HLA-B27 gene positivity in healthy Caucasian communities varies between 8 and 14%. However, there is a lack of information in countries with a high rate of miscegenation, such as Brazil.AimTo estimate the frequency of HLA-B27 in the Brazilian general population using a large national registry database.MethodsThis is a cross-sectional ecological study using the Brazilian Registry of Volunteer Bone Marrow Donors (REDOME) database on HLA-B27 allelic frequency and proportion of positives of healthy donors (18-60 years old). Data were analyzed according to sex, age, race (by self-reported skin color recommended by the Brazilian Institute of Geography and Statistics - IBGE), and geographic region of residence.ResultsFrom 1994 to 2022, a total of 5,389,143 healthy bone marrow donors were included. The overall positivity for HLA-B27 was 4.35% (CI 95% 4.32-4.37%), regardless of sex and age (57.2% were women, mean age was 41.7yo). However, there was a difference between races: 4.85% in Whites; 2.92% in Blacks; 3.76% in Pardos (Browns i.e. mixed races); 3.95% in Amarelos (Yellows i.e. Asian Brazilians); and 3.18% in Indigenous. There was also a difference regarding geographic region of residence (North: 3.62%; Northeast: 3.63%; Southeast: 4.29%; Midwest: 4.5% and 5.25% in South). The homozygosity rate for the HLA-B27 was 1.32% of all the positives and only 0.06% in the general population.ConclusionsOur findings provide the first Brazilian national prevalence for HLA-B27 in 4.35%. There is a gradient gene positivity from North to South, suggesting that the genetic background related to the miscegenation due to colonization, slavery, and some later waves of immigration together with internal migratory flows, could explain our findings.
  • article 10 Citação(ões) na Scopus
    Perfil epidemiológico da espondiloartrite de início juvenil comparada com a espondiloartrite de início na vida adulta em uma grande coorte brasileira
    (2014) DUARTE, Angela P.; MARQUES, Claudia D. L.; BORTOLUZZO, Adriana B.; GONCALVES, Celio R.; SILVA, Jose Antonio Braga da; XIMENES, Antonio Carlos; BERTOLO, Manoel B.; RIBEIRO, Sandra Lucia E.; KEISERMAN, Mauro; SKARE, Thelma L.; CARNEIRO, Sueli; MENIN, Rita; AZEVEDO, Valderilio F.; VIEIRA, Walber P.; ALBUQUERQUE, Elisa N.; BIANCHI, Washington A.; BONFIGLIOLI, Rubens; CAMPANHOLO, Cristiano; CARVALHO, Hellen M. S.; COSTA, Izaias P.; KOHEM, Charles L.; LEITE, Nocy; LIMA, Sonia A. L.; MEIRELLES, Eduardo S.; PEREIRA, Ivanio A.; PINHEIRO, Marcelo M.; POLITO, Elizandra; RESENDE, Gustavo G.; ROCHA, Francisco Airton C.; SANTIAGO, Mittermayer B.; SAUMA, Maria de Fatima L. C.; VALIM, Valeria; BARROS, Percival D. Sampaio
    Objective: To analyze the clinical and epidemiologic characteristics ofjuvenile-onset spondyloarthritis (SpA) (<16 years) and compare them with a group of adult-onset (> 16 years) SpA patients. Patients and methods: Prospective, observational and multicentric cohort with 1,424 patients with the diagnosis of SpA according to the European Spondyloarthropathy Study Group (ESSG) submitted to a common protocol of investigation and recruited in 29 reference centers participants of the Brazilian Registry of Spondyloarthritis (RBE - Registro Brasileiro de Espondiloartrites). Patients were divided in two groups: age at onset < 16 years (JOSpA group) and age at onset 16 years (A0SpA group). Results: Among the 1,424 patients, 235 presented disease onset before 16 years (16.5%). The clinical and epidemiologic variables associated with JOSpA were male gender (p <0.001), lower limb arthritis (p = 0.001), enthesitis (p = 0.008), anterior uveitis (p = 0.041) and positive HLA-B27 (p = 0.017), associated with lower scores of disease activity (Bath Ankylosing Spondylitis Disease Activity Index - BASDAI; p = 0.007) and functionality (Bath Ankylosing Spondylitis Functional Index - BASFI; p = 0.036). Cutaneous psoriasis (p <0.001), inflammatory bowel disease (p = 0.023), dactylitis (p = 0.024) and nail involvement (p = 0.004) were more frequent in patients with adult-onset SpA. Conclusions: Patients with JOSpA in this large Brazilian cohort were characterized predominantly by male gender, peripheral involvement (arthritis and enthesitis), positive HLA-B27 and lower disease scores.