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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  • 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 0 Citação(ões) na Scopus
    Factors associated with neuropsychiatric involvement in Latin American patients with systemic lupus erythematosus
    (2021) BARILE-FABRIS, Leonor A.; FRAGOSO-LOYO, Hilda; WOJDYLA, Daniel; QUINTANA, Rosana; PONS-ESTEL, Guillermo J.; CATOGGIO, Luis J.; GARCIA, Mercedes A.; SAURIT, Veronica; DRENKARD, Cristina; BONFA, Eloisa; BORBA, Eduardo F.; SATO, Emilia; BRENOL, Joao C. Tavares; CAVALCANTI, Fernando; SILVA, Nilzio A. Da; COSTALLAT, Lilian T. Lavras; TOLEDANO, Marlene Guibert; MASSARDO, Loreto; NEIRA, Oscar; CARDIEL, Mario H.; AMIGO, Mary Carmen; TORRE, Ignacio Garcia De La; SILVEIRA, Luis H.; VASQUEZ, Eduardo M. Acevedo; CHACON-DIAZ, Rosa; ESTEVA-SPINETTI, Maria H.; ALARCON, Graciela S.; PONS-ESTEL, Bernardo A.
    Introduction Factors related to presentation of neuropsychiatric (NP) SLE manifestations, early in the course of the disease, and during follow up have not been clearly established. Purpose To identify disease and non-disease related factors associated with NP manifestations in early SLE. Methods We included 1193 patients from the GLADEL inception cohort free of NP involvement at cohort entry. We evaluated the association of demographic, clinical and laboratory data with NP involvement during follow-up. Statistical methods Independent factors associated with NP involvement were identified using a multivariable Cox regression model. Results Factors independently associated with NP manifestations were: mestizo ethnicity (HR 1.701, 95% CI 1.282-2.258, p = 0.0002), myalgias/myositis (HR 1.832, 95% CI 1.335-2.515, p = 0.0002), pneumonitis (HR 2.476, 95% CI 1.085-5.648, p = 0.0312), shrinking lung (HR 2.428, 95% CI 1.074-5.493, p = 0.0331) and hemolytic anemia (HR 1.629, 95% CI 1.130-2.347, p = 0.0089). Longer disease duration at cohort entry (13 to 24 months) was associated with a lower risk of developing NP manifestations (HR 0.642, 95% CI 0.441-0.934, p = 0.0206). Conclusions Patients with myalgias/myositis, pneumonitis, shrinking lung and hemolytic anemia are at higher risk of NP involvement, whereas longer disease duration at cohort entry is associated with a lower risk of developing NP involvement.
  • article 10 Citação(ões) na Scopus
    Factors predictive of high disease activity early in the course of SLE in patients from a Latin-American cohort
    (2017) PIMENTEL-QUIROZ, Victor R.; UGARTE-GIL, Manuel E.; PONS-ESTEL, Guillermo J.; SORIANO, Enrique R.; SAURIT, Veronica; SATO, Emilia I.; COSTALLAT, Lilian T. Lavras; MOLINA, Jose Fernando; IGLESIAS-GAMARRA, Antonio; REYES-LLERENA, Gil; NEIRA, Oscar J.; BARILE, Leonor A.; SILVEIRA, Luis H.; SEGAMI, Maria Ines; CHACON-DIAZ, Rosa; WOJDYLA, Daniel; ALARCON, Graciela S.; PONS-ESTEL, Bernardo A.; BONFA, Eloisa; BORBA, Eduardo Ferreira
    Aims: To determine the factors predictive of disease activity early in the course of SLE (baseline visit). Methods: Patients from GLADEL, a multi-national, multi-ethnic, Latin-American lupus cohort were included. Disease activity was evaluated at baseline with the SLEDAI score. Demographic characteristics (age at diagnosis, gender, ethnicity, marital status, educational level, medical coverage and socioeconomic status) were assessed. Disease duration was defined as the time between the fourth ACR criterion and baseline. Time to criteria accrual was defined as the interval between the first and fourth ACR criterion. Use of glucocorticoids was recorded as the highest dose received before the baseline visit. Antimalarials and immunosuppressive drugs were recorded as use or not use. Univariable and multivariable analysis were performed. Model selection was based on backward elimination. Results: One thousand two hundred sixty-eight patients were included; 1136 (89.6%) of them were female. Mean age at diagnosis was 29.2 (SD: 12.3) years. Five hundred sixty-five (44.6%) were Mestizo, 539 (42.5%) were Caucasians and 164 (12.9%) were African-Latin-Americans. The mean SLEDAI at baseline was 10.9 (SD: 8.4). Longer time between first and fourth ACR criterion, medical coverage, a dose of prednisone between 15 and 60 mg/d, and the use of antimalarials were factors protective of disease activity, while Mestizo and African-Latin-American ethnicities were predictive factors. Conclusions: Mestizo and African-Latin-American ethnicities were predictive whereas antimalarial use, medical coverage, and longer time to criteria accrual were protective of higher disease activity early in the disease course.
  • article 88 Citação(ões) na Scopus
    First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus: Latin American Group for the Study of Lupus (GLADEL, Grupo Latino Americano de Estudio del Lupus)-Pan-American League of Associations of Rheumatology (PANLAR)
    (2018) PONS-ESTEL, Bernardo A.; BONFA, Eloisa; SORIANO, Enrique R.; CARDIEL, Mario H.; IZCOVICH, Ariel; POPOFF, Federico; CRINITI, Juan M.; VASQUEZ, Gloria; MASSARDO, Loreto; DUARTE, Margarita; BARILE-FABRIS, Leonor A.; GARCIA, Mercedes A.; AMIGO, Mary-Carmen; ESPADA, Graciela; CATOGGIO, Luis J.; SATO, Emilia Inoue; LEVY, Roger A.; VASQUEZ, Eduardo M. Acevedo; CHACON-DIAZ, Rosa; GALARZA-MALDONADO, Claudio M.; GAMARRA, Antonio J. Iglesias; MOLINA, Jose Fernando; NEIRA, Oscar; SILVA, Clovis A.; PENA, Andrea Vargas; GOMEZ-PUERTA, Jose A.; SCOLNIK, Marina; PONS-ESTEL, Guillermo J.; UGOLINI-LOPES, Michelle R.; SAVIO, Veronica; DRENKARD, Cristina; ALVARELLOS, Alejandro J.; UGARTE-GIL, Manuel F.; BABINI, Alejandra; CAVALCANTI, Andre; LINHARES, Fernanda Athayde Cardoso; SALINAS, Maria Jezabel Haye; FUENTES-SILVA, Yurilis J.; SILVA, Ana Carolina Montandon de Oliveira e; GARNICA, Ruth M. Eraso; URIBE, Sebastian Herrera; GOMEZ-MARTIN, Diana; SEVRINI, Ricardo Robaina; QUINTANA, Rosana M.; GORDON, Sergio; FRAGOSO-LOYO, Hilda; ROSARIO, Violeta; SAURIT, Veronica; APPENZELLER, Simone; REIS NETO, Edgard Torres dos; CIEZA, Jorge; NARANJO, Luis A. Gonzalez; BELLO, Yelitza C. Gonzalez; COLLADO, Maria Victoria; SARANO, Judith; RETAMOZO, Soledad; SATTLER, Maria E.; GAMBOA-CARDENAS, Rocio V.; CAIROLI, Ernesto; CONTI, Silvana M.; AMEZCUA-GUERRA, Luis M.; SILVEIRA, Luis H.; BORBA, Eduardo F.; PERA, Mariana A.; MOREYRA, Paula B. Alba; ARTURI, Valeria; BERBOTTO, Guillermo A.; GERLING, Cristian; GOBBI, Carla A.; GERVASONI, Viviana L.; SCHERBARTH, Hugo R.; BRENOL, Joao C. Tavares; CAVALCANTI, Fernando; COSTALLAT, Lilian T. Lavras; SILVA, Nilzio A. Da; MONTICIELO, Odirlei A.; SEGURO, Luciana Parente Costa; XAVIER, Ricardo M.; LLANOS, Carolina; GUARDADO, Ruben A. Montufar; TORRE, Ignacio Garcia de la; PINEDA, Carlos; HERNANDEZ, Margarita Portela; DANZA, Alvaro; GUIBERT-TOLEDANO, Marlene; REYES, Gil Llerena; COLMAN, Maria Isabel Acosta; AQUINO, Alicia M.; MORA-TRUJILLO, Claudia S.; MUNOZ-LOUIS, Roberto; VALLADARES, Ignacio Garcia; OROZCO, Maria Celeste; BURGOS, Paula I.; BETANCUR, Graciela V.; ALARCON, Graciela S.
    Systemic lupus erythematosus (SLE), a complex and heterogeneous autoimmune disease, represents a significant challenge for both diagnosis and treatment. Patients with SLE in Latin America face special problems that should be considered when therapeutic guidelines are developed. The objective of the study is to develop clinical practice guidelines for Latin American patients with lupus. Two independent teams (rheumatologists with experience in lupus management and methodologists) had an initial meeting in Panama City, Panama, in April 2016. They selected a list of questions for the clinical problems most commonly seen in Latin American patients with SLE. These were addressed with the best available evidence and summarised in a standardised format following the Grading of Recommendations Assessment, Development and Evaluation approach. All preliminary findings were discussed in a second face-to-face meeting in Washington, DC, in November 2016. As a result, nine organ/system sections are presented with the main findings; an 'overarching' treatment approach was added. Special emphasis was made on regional implementation issues. Best pharmacologic options were examined for musculoskeletal, mucocutaneous, kidney, cardiac, pulmonary, neuropsychiatric, haematological manifestations and the antiphospholipid syndrome. The roles of main therapeutic options (ie, glucocorticoids, antimalarials, immunosuppressant agents, therapeutic plasma exchange, belimumab, rituximab, abatacept, low-dose aspirin and anticoagulants) were summarised in each section. In all cases, benefits and harms, certainty of the evidence, values and preferences, feasibility, acceptability and equity issues were considered to produce a recommendation with special focus on ethnic and socioeconomic aspects. Guidelines for Latin American patients with lupus have been developed and could be used in similar settings.