Group Of Spondyloarthritis Patients Research Articles

Depresión y autoestima en pacientes con Espondiloartrítis del Departamento de Reumatología del Hospital de Clínicas. San Lorenzo. Paraguay

Introduction: Spondyloarthritis is an umbrella term for a group of chronic rheumatic diseases, genetically and clinically related, that lead to an important and often undervalued physical and psychological load. For this reason, the objective of this work is to identify patients with depression and low self-esteem in a group of spondyloarthritis patients with regular follow-up in the Department of Rheumatology at the Hospital de Clinicas, San Lorenzo, from January to December 2017. Methodology: Descriptive cross-sectional study. Patients who fulfilled ASAS criteria for spondyloarthritis were included. Data was collected from the entry questionnaire to the spondyloarthritis patients’ registry of the Department of Rheumatology of the Hospital de Clinicas during 2017. The questionnaire included the mayor depression inventory, Rosemberg self-esteem test, BASDAI, BASFI, HAQ questionnaire, Graffar scale of social stratification and demographic data, such as age at disease onset, age at diagnosis and disease duration. Results: We included 19 patients, 14 (73.7%) male and 5 (26.3%) female, with a mean age of 38.57 ± 13.97 and 38 ± 11.16 years, respectively. Most were single (10/19, 52.6%) and from Gran Asuncion (13/19, 68.4%). The mean age at symptom onset was 23.35±12.52 years in men and 22.6 8.93 years in women, with a mean disease duration of 200.28±167.28 months in men and 202.6±131.05 months in women. Only 3/19 (15.8%) of patients were found to be depressed and 12/19 (63.1%) had high self-esteem. Concerning disease in-dexes, 42.2% of patients presented with a BASDAI score >4, 7 (36.8%) had a BASFI = 0,5 and 73.7% had an HAQ <1,14. Conclusion: The majority of patients are men in the 30-40 age range, without depression or low self-esteem.

IgG1 Allotypes Influence the Pharmacokinetics of Therapeutic Monoclonal Antibodies through FcRn Binding

Because IgG1 allotypes might have different half-lives, their influence on infliximab (G1m17,1 allotype) pharmacokinetics was investigated in a group of spondyloarthritis patients. Infliximab was found to have a shorter half-life in patients homozygous for the G1m17,1 allotypes than in those carrying the G1m3 with no G1m1 (G1m3,-1) allotype. Because the neonatal FcR (FcRn) is involved in the pharmacokinetics of mAbs, the interaction of different IgG1 allotypes with FcRn was examined using cellular assays and surface plasmon resonance. G1m17,1 mAbs, such as infliximab and rituximab, were shown to bind more efficiently to FcRn and to be transcytosed better than the G1m3,-1 mAb cetuximab, which explains why infliximab is a better competitor for endogenous IgG1 in G1m3,-1 allotype-bearing patients. A set of four allotype variants of adalimumab (G1m17,1; G1m17,-1; G1m3,1; and G1m3,-1) was also tested for its binding to FcRn, revealing that the G1m3,1 variant, not present in commercial mAbs, binds more efficiently to FcRn and is transcytosed better than the other three variants, all of which are found in therapeutic mAbs.

Safety of Etoricoxib, Celecoxib, and Nonselective Nonsteroidal Antiinflammatory Drugs in Ankylosing Spondylitis and Other Spondyloarthritis Patients: A Swedish National Population-Based Cohort Study.

Safety data regarding the use of etoricoxib and other nonsteroidal antiinflammatory drugs (NSAIDs) in ankylosing spondylitis (AS) and other spondyloarthritis (SpA) patients are rather limited. Our objective was to estimate and compare rates of gastrointestinal, renovascular, and cardiovascular adverse events in patients exposed to etoricoxib, celecoxib, or nonselective NSAIDs or totally unexposed to NSAIDs. We performed a national register-based cohort study on patients with AS or SpA (n = 21,872) identified in the Swedish national patient register from 1987-2009. Treatment exposure was assessed time dependently based on the prescription drug register from 2006-2009, adjusting for sociodemographics and comorbidities derived from national population-based registers. Exposure to etoricoxib, celecoxib, and nonselective NSAIDs was 7.6%, 3.9%, and 71.2%, respectively. No major risk differences for serious cardiovascular, gastrointestinal, or renal adverse events were seen among the 3 exposure groups. Patients unexposed to NSAIDs had more baseline comorbidities and an increased relative risk for congestive heart failure events during the study period (2.0, 95% confidence interval [95% CI] 1.3-3.2). The relative risk for atherosclerotic events was nonsignificant when compared to the nonselective NSAID group (1.0, 95% CI 0.7-1.5), while the relative risk for gastrointestinal events was lower for unexposed patients (0.5, 95% CI 0.4-0.7). Overall, serious adverse events related to nonselective NSAIDs, etoricoxib, and celecoxib were similar and in the range of what would be expected in a group of SpA patients. Patients unexposed to NSAIDs had considerably more baseline comorbidities and increased risk for congestive heart failure, reflecting a selection of patients being prescribed NSAIDs in clinical practice.