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Time to diagnosis in systemic lupus erythematosus: Associated factors and its impact on damage accrual and mortality. Data from a multi-ethnic, multinational Latin American lupus cohort
(2024)
Romina Nieto
;
Rosana Quintana
;
Ernesto Zavala-Flores
;
Rosa Serrano
;
Karen Roberts
<jats:sec><jats:title>Background</jats:title><jats:p> Systemic lupus erythematosus (SLE) often mimics symptoms of other diseases, and the interval between symptom onset and diagnosis may be long in some of these patients. Aims: To describe the characteristics associated with the time to SLE diagnosis and its impact on damage accrual and mortality in patients with SLE from a Latin American inception cohort. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Patients were from a multi-ethnic, multi-national Latin-American SLE inception cohort. All participating centers had specialized lupus clinics. Socio-demographic, clinical/laboratory, disease activity, damage, and mortality between those with a longer and a shorter time to diagnosis were compared using descriptive statistical tests. Multivariable Cox regression models with damage accrual and mortality as the end points were performed, adjusting for age at SLE diagnosis, gender, ethnicity, level of education, and highest dose of prednisone for damage accrual, plus highest dose of prednisone, baseline SLEDAI, and baseline SDI for mortality. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Of the 1437 included in these analyses, the median time to diagnosis was 6.0 months (Q1–Q3 2.4–16.2); in 721 (50.2%) the time to diagnosis was longer than 6 months. Patients whose diagnosis took longer than 6 months were more frequently female, older at diagnosis, of Mestizo ethnicity, not having medical insurance, and having “non-classic” SLE symptoms. Longer time to diagnosis had no impact on either damage accrual (HR 1.09, 95% CI 0.93–1.28, p = 0.300) or mortality (HR 1.37, 95% CI 0.88–2.12, p = 0.200). </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> In this inception cohort, a maximum time of 24 months with a median of 6 months to SLE diagnosis had no apparent negative impact on disease outcomes (damage accrual and mortality). </jats:p></jats:sec>
Scopus© Citations 8 1
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Pan American League of Associations for Rheumatology recommendations for the management of axial spondyloarthritis
(2023)
Wilson Bautista-Molano
;
Daniel G. Fernández-Ávila
;
María Lorena Brance
;
María Gabriela Ávila Pedretti
;
Ruben Burgos-Vargas
3Scopus© Citations 45
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Identification of clinical phenotypes of peripheral involvement in patients with spondyloarthritis, including psoriatic arthritis: a cluster analysis in the worldwide ASAS-PerSpA study
(2021)
Clementina López-Medina
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Sylvie Chevret
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Anna Molto
;
Joachim Sieper
;
Tuncay Duruöz
<jats:sec><jats:title>Objective</jats:title><jats:p>To identify clusters of peripheral involvement according to the specific location of peripheral manifestations (ie, arthritis, enthesitis and dactylitis) in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), and to evaluate whether these clusters correspond with the clinical diagnosis of a rheumatologist.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Cross-sectional study with 24 participating countries. Consecutive patients diagnosed by their rheumatologist as PsA, axial SpA or peripheral SpA were enrolled. Four different cluster analyses were conducted: one using information on the specific location from all the peripheral manifestations, and a cluster analysis for each peripheral manifestation, separately. Multiple correspondence analyses and k-means clustering methods were used. Distribution of peripheral manifestations and clinical characteristics were compared across the different clusters.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The different cluster analyses performed in the 4465 patients clearly distinguished a predominantly axial phenotype (cluster 1) and a predominantly peripheral phenotype (cluster 2). In the predominantly axial phenotype, hip involvement and lower limb large joint arthritis, heel enthesitis and lack of dactylitis were more prevalent. In the predominantly peripheral phenotype, different subgroups were distinguished based on the type and location of peripheral involvement: a predominantly involvement of upper versus lower limbs joints, a predominantly axial enthesitis versus peripheral enthesitis, and predominantly finger versus toe involvement in dactylitis. A poor agreement between the clusters and the rheumatologist‘s diagnosis as well as with the classification criteria was found.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>These results suggest the presence of two main phenotypes (predominantly axial and predominantly peripheral) based on the presence and location of the peripheral manifestations.</jats:p></jats:sec>
6Scopus© Citations 18
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Refractory systemic juvenile idiopathic arthritis successfully treated with rapamycin
(2021)
Sara Concha
;
Emma Rey-Jurado
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M Cecilia Poli
;
Rodrigo Hoyos-Bachiloglu
;
Arturo Borzutzky
Scopus© Citations 6 1
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Therapeutic strategies in NMOSD and MOGAD patients: A multicenter cohort study in Latin America
(2023)
Juan Ignacio Rojas
;
Pablo A. López
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Juan Criniti
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Juan Pablo Pettinicchi
;
Alejandro Caride
46Scopus© Citations 7
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Approach to the Patient with Axial Spondyloarthritis and Suspected Inflammatory Bowel Disease
(2020)
IBAÑEZ, SEBASTIAN
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María Paz Poblete De La Fuente
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Elisa Catalina Parra Cancino
3 1Scopus© Citations 2
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Multisystem inflammatory syndrome in children and adults (MIS-C/A): Case definition & guidelines for data collection, analysis, and presentation of immunization safety data
(2021)
Tiphanie P. Vogel
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Karina A. Top
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Christos Karatzios
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David C. Hilmers
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Lorena I. Tapia
8Scopus© Citations 185
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Patients with axial spondyloarthritis report significant differences between men and women and high impact of the disease: Large websurvey analysis
(2020)
Sebastian E. Ibáñez Vodnizza
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Rianne E. van Bentum
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VALENZUELA LETELIER, OMAR ANTONIO
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Irene E. van der Horst-Bruinsma
Scopus© Citations 12 2
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Clinical Utility of Serial Measurements of Antineutrophil Cytoplasmic Antibodies Targeting Proteinase 3 in ANCA-Associated Vasculitis
(2020)
Gwen E. Thompson
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Lynn A. Fussner
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Amber M. Hummel
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Darrell R. Schroeder
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Francisco Silva
14Scopus© Citations 19
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Factors associated with neuropsychiatric involvement in Latin American patients with systemic lupus erythematosus
(2021)
Leonor A Barile-Fabris
;
Hilda Fragoso-Loyo
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Daniel Wojdyla
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Rosana Quintana
;
Guillermo J Pons-Estel
<jats:sec><jats:title>Introduction</jats:title><jats:p> Factors related to presentation of neuropsychiatric (NP) SLE manifestations, early in the course of the disease, and during follow up have not been clearly established. </jats:p></jats:sec><jats:sec><jats:title>Purpose</jats:title><jats:p> To identify disease and non-disease related factors associated with NP manifestations in early SLE. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> We included 1193 patients from the GLADEL inception cohort free of NP involvement at cohort entry. We evaluated the association of demographic, clinical and laboratory data with NP involvement during follow-up. </jats:p></jats:sec><jats:sec><jats:title>Statistical methods</jats:title><jats:p> Independent factors associated with NP involvement were identified using a multivariable Cox regression model. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Factors independently associated with NP manifestations were: mestizo ethnicity (HR 1.701, 95% CI 1.282–2.258, p = 0.0002), myalgias/myositis (HR 1.832, 95% CI 1.335–2.515, p = 0.0002), pneumonitis (HR 2.476, 95% CI 1.085–5.648, p = 0.0312), shrinking lung (HR 2.428, 95% CI 1.074–5.493, p = 0.0331) and hemolytic anemia (HR 1.629, 95% CI 1.130–2.347, p = 0.0089). Longer disease duration at cohort entry (13 to 24 months) was associated with a lower risk of developing NP manifestations (HR 0.642, 95% CI 0.441–0.934, p = 0.0206). </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Patients with myalgias/myositis, pneumonitis, shrinking lung and hemolytic anemia are at higher risk of NP involvement, whereas longer disease duration at cohort entry is associated with a lower risk of developing NP involvement. </jats:p></jats:sec>
15Scopus© Citations 3

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