CAMILLE PINTO FIGUEIREDO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
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
14 resultados
Resultados de Busca
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- 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, JuergenBackground 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.- 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- LONGITUDINAL ASSESSMENT OF HAND AND WRIST BONE DESTRUCTION BY ULTRASOUND, AND ITS ASSOCIATION WITH DISEASE ACTIVITY IN PRIMARY SJOGREN'S SYNDROME(2023) FRANCO, A. Silva; MURAI, I.; YANG, T.; SALES, L. Peixoto; GUEDES, L.; PASOTO, S.; FIGUEIREDO, C.; PEREIRA, R. M.
- Bone erosions associated with systemic bone loss on HR-pQCT in women with longstanding polyarticular juvenile idiopathic arthritis(2023) RIBEIRO, Surian Clarisse C. R.; SALES, Lucas P.; FERNANDES, Alan L.; PEREZ, Mariana O.; TAKAYAMA, Liliam; CAPARBO, Valeria F.; ASSAD, Ana Paula L.; AIWAKA, Nadia E.; GOLDENSTEIN-SCHAINBERG, Claudia; BORBA, Eduardo F.; DOMICIANO, Diogo S.; FIGUEIREDO, Camille P.; PEREIRA, Rosa M. R.Objectives: To analyze longstanding polyarticular juvenile idiopathic arthritis (pJIA) for possible associations between localized bone damage (erosions), and systemic bone loss. Besides, to compare the systemic bone mass of pJIA with healthy controls. Methods: Thirty-four pJIA women and 99 healthy controls (HC) were included. Radius and tibia of all subjects were scanned by HR-pQCT. Volumetric bone mineral density (vBMD), bone microarchitecture, and -finite element parameters were analyzed. Patients underwent HR-pQCT of 2nd and 3rd metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the dominant hand, for bone erosions quantification. Results: The mean age of patients was 31.5 +/- 7.4yrs with a mean disease duration of 21.7 +/- 9.2yrs. Bone erosions were detectable in 79% of patients. The number of bone erosions was positively correlated with cortical porosity (Ct.Po) at tibia (r = 0.575, p = 0.001), and radius (r = 0.423, p = 0.018); and negatively correlated with cortical vBMD at tibia (r=-0.420, p = 0.015). In a logistic regression analysis, adjusted for anti-CCP, the presence of bone erosions was independently associated with Ct.Po at radius (p = 0.018) and cortical vBMD at tibia (p = 0.020). Moreover, cortical and trabecular vBMD, trabecular number, and mu-finite element parameters were decreased in patients compared to HC (p < 0.05). Conclusion: Bone erosions in longstanding pJIA women were associated with decreased cortical bone parameters, and these patients showed systemic bone impairment at peripheral sites compared with healthy controls.
- Transcriptomic characterization of classical monocytes highlights the involvement of immuno-inflammation in bone erosion in Rheumatoid Arthritis(2023) SALES, Lucas Peixoto; HOUNKPE, Bidossessi Wilfried; PEREZ, Mariana Ortega; CAPARBO, Valeria Falco; DOMICIANO, Diogo Souza; BORBA, Eduardo Ferreira; SCHETT, Georg; FIGUEIREDO, Camille Pinto; PEREIRA, Rosa Maria RodriguesIntroduction: Evidence-based data suggest that under inflammatory conditions, classical monocytes are the main source of osteoclasts and might be involved in bone erosion pathophysiology. Here, we analyze the transcriptomic profile of classical monocytes in erosive and non-erosive rheumatoid arthritis patients in order to better understand their contribution to bone erosion.Methods: Thirty-nine premenopausal RA patients were consecutively enrolled and divided into two groups based on the presence of bone erosions on hand joints. Classical monocytes were isolated from peripheral blood through negative selection, and RNA-seq was performed using a poly-A enrichment kit and Illumina (R) platform. Classical monocytes transcriptome from healthy age-matched women were also included to identify differentially expressed genes (DEGs). Therefore, gene sets analysis was performed to identify the enriched biological pathways.Results: RNA-seq analysis resulted in the identification of 1,140 DEGs of which 89 were up-regulated and 1,051 down-regulated in RA patients with bone erosion compared to those without bone erosions. Among up-regulated genes, there was a highlighted expression of IL18RAP and KLF14 related to the production of pro-inflammatory cytokines, innate and adaptive immune response. Genes related to collagen metabolism (LARP6) and bone formation process (PAPPA) were down-regulated in RA patients with erosions. Enriched pathways in patients with erosions were associated with greater activation of immune activation, and inflammation. Interestingly, pathways associated with osteoblast differentiation and regulation of Wnt signaling were less activated in RA patients with erosions.Conclusion: These findings suggest that alterations in expression of monocyte genes related to the inflammatory process and impairment of bone formation might have an important role in the pathophysiology of bone erosions in RA patients.
- RNA-SEQUENCING OF CLASSICAL MONOCYTES FROM RHEUMATOID ARTHRITIS PATIENTS WITH AND WITHOUT BONE EROSION(2023) SALES, L. Peixoto; HOUNKPE, B.; PEREZ, M.; CAPARBO, V.; DOMICIANO, D. S.; BORBA, E.; FIGUEIREDO, C.; PEREIRA, R. M.
- THE CORRELATION BETWEEN URIC ACID AND BONE MINERAL DENSITY OF TOTAL HIP WITH BONE MICROARCHITECTURE ANALYSIS IN TOPHACEOUS GOUT PATIENTS(2023) SANTOS, J. Barco Dos; ROCHA, G.; SALES, L. Peixoto; FRANCO, A. Silva; CAPARBO, V.; DOMICIANO, D.; FULLER, R.; FIGUEIREDO, C.; PEREIRA, R. M.
conferenceObject PERFORMANCE OF THE FRACTURE RISK ASSESSMENT TOOL (F R A X)® ACCORDING TO THE NATIONAL OSTEOPOROSIS GUIDELINE GROUP (N O G G) METHODOLOGY ON FRACTURE PREDICTION IN ELDERLY COMMUNITY-DWELLING: THE SAO PAULO AGEING & HEALTH (S P A H) STUDY(2023) FREITAS, Thiago Quadrante; OLALLA, Leonardo Flavio Guerron; TAKAYAMA, Liliam; CAPARBO, Valeria de Falco; FIGUEIREDO, Camille Pinto; MACHADO, Luana Gerheim; DOMICIANO, Diogo Souza; PEREIRA, Rosa Maria Rodrigues