Browsing by Author "Sepriano, A."
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- 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.
- Portuguese recommendations for the management of Raynaud’s phenomenon and digital ulcers in systemic sclerosis and other connective tissue diseasesPublication . Santiago, T.; Duarte, A. C.; Sepriano, A.; Castro, A.; Rosa, B.; Resende, C.; Oliveira, D.; Dourado, D.; Costa, E.; Santos, F. Cunha; Terroso, G.; Boleto, G.; Silva, I.; Barbosa, L.; Silva, J.; Neves, J. Sousa; Salvador, M. J.; Gonçalves, M. J.; Guerra, M. Gomes; Ferreira, R. M.; Fernandes, R. Duarte; Barreira, S.; Teixeira, C. Silvestre; Tomás, A. L.; Romão, V. C.; Cordeiro, A.Objective: To develop evidence-based recommendations for the non-pharmacological and pharmacological management of Raynaud's phenomenon (RP) and digital ulcers (DUs) in patients with systemic sclerosis and other immune-mediated connective tissue diseases (CTDs). Methods: A task force comprising 21 rheumatologists, 2 surgeons (vascular and plastic), 2 nurses, and 1 patient representative was established. Following a systematic literature review performed to inform the recommendations, statements were formulated and discussed during two meetings (one online and one in-person). Levels of evidence, grades of recommendation (GoR), and level of agreement (LoA) were determined. Results: Five overarching principles and 13 recommendations were developed. GoR ranged from A to D. The mean +/- standard difference (SD) LoA with the overarching principles and recommendations ranged from 7.8 +/- 2.1 to 9.8 +/- 0.4. Briefly, the management of RP and DUs in patients with CTDs should be coordinated by a multidisciplinary team and based on shared decisions with patients. Nifedipine should be used as first-line therapy for RP and/ or DUs. Sildenafil, tadalafil, and/or iloprost IV are second-line options for severe and/or refractory patients with RP and/or DUs. Sildenafil, tadalafil and/or Iloprost IV, should be prescribed for healing and prevention (also including bosentan) of DUs. In patients with RP and/or DUs, non-pharmacological interventions might be considered as add-ons, but there is limited quality and quantity of scientific evidence supporting their use. Conclusions: These recommendations will inform rheumatologists, specialist nurses, other healthcare professionals, and patients about a comprehensive and personalized management of RP and DUs. A research agenda was developed to address unmet needs, particularly for non-pharmacologic interventions.
- 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).