Rheumatoid artrhitis treatment in Brazil: data from a large real-life multicenter study

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art_GOMIDES_Rheumatoid_artrhitis_treatment_in_Brazil_data_from_a_2020.PDF (548.92 KB)
Citações na Scopus
3
Tipo de produção
article
Data de publicação
2020
DOI
SciELO
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
BMC
Autores
GOMIDES, Ana Paula Monteiro
ALBUQUERQUE, Cleandro Pires de
SANTOS, Ana Beatriz Vargas
BERTOLO, Manoel Barros
JUNIOR, Paulo Louzada
GIORGI, Rina Dalva Neubarth
RADOMINSKI, Sebastiao Cezar
GUIMARAES, Maria Fernanda B.
SAUMA, Maria de Fatima Lobato da Cunha
Citação
ADVANCES IN RHEUMATOLOGY, v.60, n.1, article ID 16, 7p, 2020
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background Last decades witnessed great technological advances in rheumatoid arthritis (RA) management, but their implementation in clinical practice might prove difficult. Despite the efficacy demonstrated in controlled trials this information needs to be confirmed by real life data. This study assessed real-life treatment among RA patients. Methods REAL study included Brazilian RA patients from eleven centers. Interview and medical records were performed. Continuous variables were compared using Student's t or Mann-Whitney and categorical variables were assessed with chi-square or Fisher's exact tests. Results 1115 patients were included, women 89.5%. Median age 56.6 years, disease duration 152.5 months; 78.7% were rheumatoid fator positive; 55.2% had erosive disease; DAS28 (disease activity index-28 joints) = 3.5, HAQ (health assessment questionnaire) =0.875. The median duration of symptoms until the start of first DMARD was 12 months. A total of 529 (47.2%) patients used corticosteroids; 1022 (90.8%) were on conventional synthetic (cs) DMARDs and 406 (36.1%) on biological (b) DMARDs. Methotrexate (MTX) was the most frequent csDMARD: 748 (66.5%) patients, followed by leflunomide (LFN), used by 381 (33.9%) of patients. MTX was associated to LFN in 142 (12.6%) patients. Only five (0.4%) patients used triple therapy (MTX + hydroxychloroquine + sulfasalazine) or sulfasalazine in monotherapy. Conclusions Despite advances in therapeutic resources, roughly half RA patients failed achieve T2T goals and 55.2% developed erosive disease. The frequent use of corticosteroids and delay in initiating DMARDs were demonstrated. Issues concerning timely access to medical care are crucial for effective management.
Palavras-chave
Rheumatoid arthritis, Drug therapy, Observational study, Latin America
URI
https://observatorio.fm.usp.br/handle/OPI/48718
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/17
Artigos e Materiais de Revistas Científicas - ODS/03