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

Advances in Rheumatology

Paulo Louzada Júnior¹  Rina Dalva Neubarth Giorgi²  Manoel Barros Bértolo³  Maria Fernanda B. Resende Guimarães⁴  Ivânio Alves Pereira⁵  Sebastião Cezar Radominski⁶  Maria de Fátima Lobato da Cunha Sauma⁷  Claiton Viegas Brenol⁸  Licia Maria Henrique da Mota⁹  Ana Paula Monteiro Gomides⁹  Cleandro Pires de Albuquerque⁹  Karina Rossi Bonfiglioli^1,10  Ana Beatriz Vargas Santos^1,11  Geraldo da Rocha Castelar Pinheiro^1,11 

[1] Faculdade de Medicina da Universidade de Ribeirao Preto, Universidade de Sao Paulo;Instituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual de São Paulo;Universidade Estadual de Campinas;Universidade Federal de Minas Gerais;Universidade Federal de Santa Catarina;Universidade Federal do Paraná;Universidade Federal do Pará;Universidade Federal do Rio Grande do Sul;Universidade de Brasília- UnB;Universidade de São Paulo;Universidade do Estado do Rio de Janeiro;

关键词: Rheumatoid arthritis;    Drug therapy;    Observational study;    Latin America;   

DOI  :  10.1186/s42358-020-0119-z

来源: DOAJ

【 摘 要 】

Abstract 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.

【 授权许可】

Unknown