Browsing by Author "Bernardes, M."
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- Adalimumab and number of previous biological disease-modifying antirheumatic drugs as predictive factors for the development of immune-mediated skin lesionsPublication . Martins, A.; Oliveira, D. Santos; Martins, F. R.; Nicolau, R.; Pinheiro, F. Oliveira; Rato, M.; Bernardo, A.; Pimenta, S.; Bernardes, M.; Costa, L.Treatment of inflammatory rheumatic diseases has dramatically changed with the introduction of biologic disease modifying anti-rheumatic drugs (bDMARDs). However, these drugs aren’t exempt from risks and skin lesions are the most frequent adverse reactions. Among the possible adverse skin reactions, immune-mediated skin lesions (IMSL) may occur. Risk factors associated with the occurrence of IMSL in rheumatic patients under bDMARDs are poorly known and studied.
- Asdas responses in patients with axial spondyloarthritis starting bdmards: results from a multicentre prospective cohortPublication . Santos, M. E.; Ramiro, S.; Van der Heijde, D.; Landewé, R.; Santos, F. Pimentel; Machado, A. R. Cruz; Ferreira, C.; Gomes, C.; Soares, C. Dantas; Miguel, C.; Albuquerque, F.; Martins, F.; Silva, L.; Santos, H.; Almeida, I.; Bernardes, M.; Khmelinskii, N.; Valente, P.; Teixeira, P. M.; Matias, S. Emídio; Fraga, V.; Branco, J. C.; Sepriano, A.ASAS and EULAR recommend the use of an improvement ≥1.1 in ASDAS at 12 weeks to determine the continuation of a bDMARD. However, it is debated whether improvements can occur and whether patients’ characteristics influence (time to) response.
- Immune-mediated skin lesions related to biological disease-modifying antirheumatic drugs: a 22-year experience of a tertiary centerPublication . Martins, A.; Oliveira, D. Santos; Martins, F. R.; Nicolau, R.; Pinheiro, F. Oliveira; Rato, M.; Bernardo, A.; Pimenta, S.; Bernardes, M.; Costa, L.Biological disease-modifying antirheumatic drugs (bDMARDs) have revolutionized the treatment of chronic inflammatory rheumatic diseases. However, the physician and the patient should be aware of possible adverse reactions. Skin is one of the most frequent organs involved in bDMARD adverse reactions and immune-mediated skin lesions (IMSL) have rarely been described before in cohort studies and their incidence is unknown.
- Neutrophile to lymphocyte and platelet to lymphocyte ratios predict clinical response to bDMARD in naïve spondylarthritis patientsPublication . Martins, F. Rajão; Bernardes, M.; Sequeira, G.; Costa, L.; Carvalho, P. DavidObjective: We aim to study association between neutrophile to lymphocyte (NLR) and platelet to lymphocyte (PLR) ratios and disease activity, and their value to predict bDMARD response. Methods: A set of spondylarthritis (SpA) patients under bDMARD registered in the Reuma.pt registry was studied. Sociodemographic, clinical and laboratorial variables were assessed on bDMARD initiation, 6, 12, 18 and 24 months (M) thereafter. Univariable and multivariable generalized estimation equations models assessed associations with disease activity. The NLR and PLR predictive value was assessed using univariable and multivariable logistic regression models. Results: A total of 170 patients were included. Most were male (54.7%), with a predominantly axial phenotype (84.7%). Significant associations were observed between NLR [B=1.55, 95% confidence interval (CI) = (1.38; 1.74)] and PLR [(B=1.16, 95% CI = (1.09; 1.24)] with ASDAS-CRP (p < 0.001). Both baseline ratios predicted ∆ ASDAS-CRP ≥ 1.1 at 6 months [OR = 2.20, 95% CI = (1.21, 4.00) for NLR; OR = 1.02, 95% CI = (1.01, 1.04) for PLR, p < 0.01)]. PLR was a significant predictor of ∆ ASDAS-CRP ≥ 1.1 in all timepoints [OR (12 M) = 1.02, 95% CI = (1.00, 1.03), p < 0.05; OR (18M) = 1.02, 95% CI = (1.01, 1.03), p < 0.001; OR (24M) = 1.01, 95% CI = (1.01, 1.02), p < 0.01]. Conclusion: NLR and PLR were associated with disease activity during the follow up of these patients. They seem to be significant predictors of therapeutic response to bDMARD in naïve SpA patients.
- Prevalence and clinical characteristics of late Onset Axial Spondyloarthritis: Results from a multicentre nationwide studyPublication . Rocha, Margarida Lucas; Torres, R.; Ramiro, S.; Castro, A. M.; Neves, A.; Martins, A.; Chícharo, A. T.; Mendes, B.; Matos, C. O.; Soares, C.; Oliveira, C. P.; Parente, H.; Gomes, J. A. M.; Luís, M.; Santos, M.; Couto, M.; Bernardes, M.; Valente, P.; Costa, R.; Sousa, S.; Branco, J.; Pimentel-Santos, F.; Sepriano, A.Axial spondyloarthritis (axSpA) typically starts before the fourth decade oflife. Consistent with that, the Assessment of SpondyloArthritis international Society (ASAS)classification criteria for axSpA should be applied only in patients with chronic back pain startingbefore 45 years of age. It has, however, been suggested that axSpA can sometimes start later in lifewith a distinctive phenotype, the so-called ‘late onset axSpA’ (lo-axSpA). There is, nevertheless, onlylimited data in support of the existence of such phenotype. We aimed to evaluate the occurrence oflo-axSpA and if these patients differ from those with early onset axSpA (eo-axSpA).