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Challenges in the Management of Psoriatic Arthritis in Latin America: A Systematic Review.
Ribeiro, Andre Lucas; Dullius, Larissa; Sartori, Natália Sarzi; Azeredo-da-Silva, Andre; Kohem, Charles Lubianca; Coates, Laura; Monticielo, Odirlei André; Palominos, Penelope.
Afiliación
  • Ribeiro AL; Hospital de Clínicas de Porto Alegre, Rheumatology Department, Porto Alegre, Brazil. Electronic address: lucasribeiro.andre@gmail.com.
  • Dullius L; Hospital de Clínicas de Porto Alegre, Rheumatology Department, Porto Alegre, Brazil.
  • Sartori NS; Hospital de Clínicas de Porto Alegre, Rheumatology Department, Porto Alegre, Brazil.
  • Azeredo-da-Silva A; Hospital de Clínicas de Porto Alegre, Internal Medicine, Porto Alegre, Brazil.
  • Kohem CL; Hospital de Clínicas de Porto Alegre, Rheumatology Department, Porto Alegre, Brazil.
  • Coates L; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Rheumatology, Oxford, United Kingdom.
  • Monticielo OA; Hospital de Clínicas de Porto Alegre, Rheumatology Department, Porto Alegre, Brazil.
  • Palominos P; Hospital de Clínicas de Porto Alegre, Rheumatology Department, Porto Alegre, Brazil.
Clin Ther ; 45(9): 860-867, 2023 09.
Article en En | MEDLINE | ID: mdl-37198042
PURPOSE: In 2020, the International League of Associations for Rheumatology published recommendations for managing psoriatic arthritis (PsA), aiming to adapt the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis and the European Alliance of Associations for Rheumatology recommendations to low-income countries. At that time, the paucity of clinical studies examining the management of patients with PsA in Latin America was remarked on by the international working group. Therefore, the primary objective of this systematic literature review was to investigate the main challenges in managing PsA in Latin America as described in recent publications. METHODS: A systematic literature review of trials reporting at least one challenge/difficulty in the management of PsA in Latin America was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. References published in the PubMed, EMBASE, and LILACS (Latin American and Caribbean Health Sciences Literature) databases between 1980 and February 2023 were included. The selection of references was conducted independently by 2 researchers in the Rayyan Qatar Computing Research Institute program. Two other reviewers independently extracted data. All challenges were noted and categorized into domains. Data analysis was descriptive. FINDINGS: The search strategy yielded 2085 references, with 21 studies included in the final analysis. Most studies were conducted in Brazil (66.6%; n = 14) and were observational studies (100%; N = 21). Difficulties faced by PsA patients and physicians included the high incidence of opportunistic infections (described in 42.8% of the publications; n = 9), followed by nonadherence to therapy, discordance between patients and physicians regarding remission rates, low drug persistence, limited access to disease-modifying antirheumatic drugs, issues related to the storage of biologic drugs, elevated cost of biologic drugs, limited access to medical care, diagnostic delay, and the individual- and country-level impact of socioeconomic factors on work- and health-related outcomes. IMPLICATIONS: Challenges in the management of PsA in Latin America extend beyond the care of opportunistic infections, encompassing several other socioeconomic factors. More research is needed to better understand the peculiarities of treating PsA in Latin America to improve patient care. PROSPERO identifier: CRD42021228297.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Productos Biológicos / Artritis Psoriásica / Antirreumáticos Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Systematic_reviews Aspecto: Equity_inequality Límite: Humans Idioma: En Revista: Clin Ther Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Productos Biológicos / Artritis Psoriásica / Antirreumáticos Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Systematic_reviews Aspecto: Equity_inequality Límite: Humans Idioma: En Revista: Clin Ther Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos