EDUARDO FERREIRA BORBA NETO

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Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina

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  • conferenceObject
    Factors Associated with Accrual of Damage over Time in Patients with SLE: Results from a Multinational Latin American Cohort
    (2019) MIMICA, Milena; PADILLA, Oslando; AGUILERA, Felipe; CAVALCANTI, Fernando; BORBA, Eduardo; GUIBERT-TOLEDANO, Marlene; CHACON-DIAZ, Rosa; VASQUEZ, Gloria; PONS-ESTEL, Guillermo; CARDIEL, Mario; NEIRA, Oscar; AMIGO, Mary-Carmen; BONFA, Eloisa; ALARCON, Graciela; PONS-ESTEL, Bernardo A.; MASSARDO, Loreto
  • article 56 Citação(ões) na Scopus
    Factors predictive of serious infections over time in systemic lupus erythematosus patients: data from a multi-ethnic, multi-national, Latin American lupus cohort
    (2019) PIMENTEL-QUIROZ, V. R.; UGARTE-GIL, M. F.; HARVEY, G. B.; WOJDYLA, D.; PONS-ESTEL, G. J.; QUINTANA, R.; ESPOSTO, A.; GARCIA, M. A.; CATOGGIO, L. J.; CARDIEL, M. H.; BARILE, L. A.; AMIGO, M-C; I, E. Sato; BONFA, E.; BORBA, E.; COSTALLAT, L. T. Lavras; NEIRA, O. J.; MASSARDO, L.; GUIBERT-TOLEDANO, M.; CHACON-DIAZ, R.; ALARCON, G. S.; PONS-ESTEL, B. A.; SORIANO, Enrique R.; RECALDE, Maria Flavia Ceballos; VELOZO, Edson; MANNI, Jorge A.; GRIMAUDO, Sebastian; SARANO, Judith; MALDONADO-COCCO, Jose A.; ARRIOLA, Maria S.; GOMEZ, Graciela; MARCOS, Ana Ines; MARCOS, Juan Carlos; SCHERBARTH, Hugo R.; LOPEZ, Jorge A.; MOTTA, Estela L.; DRENKARD, Cristina; GAMRON, Susana; BULIUBASICH, Sandra; ONETTI, Laura; CAEIRO, Francisco; ALVARELLOS, Alejandro; SAURIT, Veronica; GENTILETTI, Silvana; QUAGLIATTO, Norberto; GENTILETTI, Alberto A.; MACHADO, Daniel; ABDALA, Marcelo; PALATNIK, Simon; BERBOTTO, Guillermo A.; BATTAGLIOTTI, Carlos A.; SOUZA, Alexandre Wagner S.; BERTOLO, Manoel Barros; COIMBRA, Ibsen Bellini; BRENOL, Joao C. Tavares; MONTICIELO, Odirlei; XAVIER, Ricardo; CAVALCANTI, Fernando de Souza; DUARTE, Angela Luzia Branco; MARQUES, Claudia Diniz Lopes; SILVA, Nilzio Antonio da; SILVA, Ana Carolina de O e; PACHECO, Tatiana Ferracine; MOLINA-RESTREPO, Jose Fernando; MOLINA-LOPEZ, Javier; VASQUEZ, Gloria; RAMIREZ, Luis A.; URIBE, Oscar; IGLESIAS-GAMARRA, Antonio; IGLESIAS-RODRIGUEZ, Antonio; EGEA-BERMEJO, Eduardo; GUZMAN-MORENO, Renato A.; RESTREPO-SUAREZ, Jose F.; REYES-LLERENA, Gil Alberto; HERNANDEZ-MARTINEZ, Alfredo; JACOBELLI, Sergio; GUZMAN, Leonardo R.; GARCIA-KUTZBACH, Abraham; CASTELLANOS, Claudia; CAJAS, Erwin; PASCUAL-RAMOS, Virginia; SILVEIRA, Luis H.; TORRE, Ignacio Garcia De La; OROZCO-BAROCIO, Gerardo; ESTRADA-CONTRERAS, Magali L.; POZO, Maria Josefina Sauza del; BACA, Laura E. Aranda; QUEZADA, Adelfia Urenda; HUERTA-YANEZ, Guillermo F.; ACEVEDO-VAZQUEZ, Eduardo M.; ALFARO-LOZANO, Jose Luis; CUCHO-VENEGAS, Jorge M.; SEGAMI, Maria Ines; CHUNG, Cecilia P.; ALVA-LINARES, Magaly; ABADI, Isaac; RANGEL, Neriza; SNIH, Soham Al Snih Al; ESTEVA-SPINETTI, Maria H.; VIVAS, Jorge
    Aim The aim of this study was to identify factors predictive of serious infections over time in patients with systemic lupus erythematosus (SLE). Methods A multi-ethnic, multi-national Latin American SLE cohort was studied. Serious infection was defined as one that required hospitalization, occurred during a hospitalization or led to death. Potential predictors included were sociodemographic factors, clinical manifestations (per organ involved, lymphopenia and leukopenia, independently) and previous infections at baseline. Disease activity (SLEDAI), damage (SLICC/ACR Damage Index), non-serious infections, glucocorticoids, antimalarials (users and non-users), and immunosuppressive drugs use; the last six variables were examined as time-dependent covariates. Cox regression models were used to evaluate the predictors of serious infections using a backward elimination procedure. Univariable and multivariable analyses were performed. Results Of the 1243 patients included, 1116 (89.8%) were female. The median (interquartile range) age at diagnosis and follow-up time were 27 (20-37) years and 47.8 (17.9-68.6) months, respectively. The incidence rate of serious infections was 3.8 cases per 100 person-years. Antimalarial use (hazard ratio: 0.69; 95% confidence interval (CI): 0.48-0.99; p = 0.0440) was protective, while doses of prednisone >15 and <= 60 mg/day (hazard ratio: 4.18; 95 %CI: 1.69-10.31; p = 0.0019) and >60 mg/day (hazard ratio: 4.71; 95% CI: 1.35-16.49; p = 0.0153), use of methylprednisolone pulses (hazard ratio: 1.53; 95% CI: 1.10-2.13; p = 0.0124), increase in disease activity (hazard ratio: 1.03; 95% CI: 1.01-1.04; p = 0.0016) and damage accrual (hazard ratio: 1.22; 95% CI: 1.11-1.34; p < 0.0001) were predictive factors of serious infections. Conclusions Over time, prednisone doses higher than 15 mg/day, use of methylprednisolone pulses, increase in disease activity and damage accrual were predictive of infections, whereas antimalarial use was protective against them in SLE patients.
  • article 39 Citação(ões) na Scopus
    Establishing Surrogate Kidney End Points for Lupus Nephritis Clinical Trials: Development and Validation of a Novel Approach to Predict Future Kidney Outcomes
    (2019) MACKAY, Meggan; DALL'ERA, Maria; FISHBEIN, Joanna; KALUNIAN, Kenneth; LESSER, Martin; SANCHEZ-GUERRERO, Jorge; LEVY, Deborah M.; SILVERMAN, Earl; PETRI, Michelle; ARRIENS, Cristina; LEWIS, Edmund J.; KORBET, Stephen M.; CONTI, Fabrizio; TESAR, Vladimir; HRUSKOVA, Zdenka; BORBA, Eduardo F.; BONFA, Eloisa; CHAN, Tak Mao; RATHI, Manish; GUPTA, K. L.; JHA, Vivekanand; HASNI, Sarfaraz; WEST, Melissa R.; SOLOMONS, Neil; HOUSSIAU, Frederic A.; ROMERO-DIAZ, Juanita; MEJIA-VILET, Juan; ROVIN, Brad H.
    Objective End points currently used in lupus nephritis (LN) clinical trials lack uniformity and questionably reflect long-term kidney survival. This study was undertaken to identify short-term end points that predict long-term kidney outcomes for use in clinical trials. Methods A database of 944 patients with LN was assembled from 3 clinical trials and 12 longitudinal cohorts. Variables from the first 12 months of treatment after diagnosis of active LN (prediction period) were assessed as potential predictors of long-term outcomes in a 36-month follow-up period. The long-term outcomes examined were new or progressive chronic kidney disease (CKD), severe kidney injury (SKI), and the need for permanent renal replacement therapy (RRT). To predict the risk for each outcome, hazard index tools (HITs) were derived using multivariable analysis with Cox proportional hazards regression. Results Among 550 eligible subjects, 54 CKD, 55 SKI, and 22 RRT events occurred. Variables in the final CKD HIT were prediction-period CKD status, 12-month proteinuria, and 12-month serum creatinine level. The SKI HIT variables included prediction-period CKD status, International Society of Nephrology (ISN)/Renal Pathology Society (RPS) class, 12-month proteinuria, 12-month serum creatinine level, race, and an interaction between ISN/RPS class and 12-month proteinuria. The RRT HIT included age at diagnosis, 12-month proteinuria, and 12-month serum creatinine level. Each HIT validated well internally (c-indices 0.84-0.92) and in an independent LN cohort (c-indices 0.89-0.92). Conclusion HITs, derived from short-term kidney responses to treatment, correlate with long-term kidney outcomes, and now must be validated as surrogate end points for LN clinical trials.