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Rheumatoid artrhitis treatment in Brazil: data from a large real-life multicenter study.
Gomides, Ana Paula Monteiro; de Albuquerque, Cleandro Pires; Santos, Ana Beatriz Vargas; Bértolo, Manoel Barros; Júnior, Paulo Louzada; Giorgi, Rina Dalva Neubarth; Radominski, Sebastião Cezar; Resende Guimarães, Maria Fernanda B; Bonfiglioli, Karina Rossi; de Fátima Lobato da Cunha Sauma, Maria; Pereira, Ivânio Alves; Brenol, Claiton Viegas; da Mota, Licia Maria Henrique; da Rocha Castelar Pinheiro, Geraldo.
Afiliación
  • Gomides APM; Universidade de Brasília- UnB, Brasília, DF, Brazil. anapmgomides@gmail.com.
  • de Albuquerque CP; Universidade de Brasília- UnB, Brasília, DF, Brazil.
  • Santos ABV; Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
  • Bértolo MB; Universidade Estadual de Campinas, Campinas, SP, Brazil.
  • Júnior PL; Faculdade de Medicina da Universidade de Ribeirao Preto, Universidade de Sao Paulo, Ribeirão Preto, SP, Brazil.
  • Giorgi RDN; Instituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
  • Radominski SC; Universidade Federal do Paraná, Curitiba, PR, Brazil.
  • Resende Guimarães MFB; Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
  • Bonfiglioli KR; Universidade de São Paulo, São Paulo, SP, Brazil.
  • de Fátima Lobato da Cunha Sauma M; Universidade Federal do Pará, Belém, PA, Brazil.
  • Pereira IA; Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
  • Brenol CV; Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
  • da Mota LMH; Universidade de Brasília- UnB, Brasília, DF, Brazil.
  • da Rocha Castelar Pinheiro G; Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Adv Rheumatol ; 60(1): 16, 2020 02 27.
Article en En | MEDLINE | ID: mdl-32106881
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / Corticoesteroides / Antirreumáticos Tipo de estudio: Clinical_trials Límite: Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: Adv Rheumatol Año: 2020 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / Corticoesteroides / Antirreumáticos Tipo de estudio: Clinical_trials Límite: Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: Adv Rheumatol Año: 2020 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Reino Unido