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1. Novel risk loci for COVID-19 hospitalization among admixed American populations

Author

Silvia Diz-de Almeida, Raquel Cruz, Andre D Luchessi, José M Lorenzo-Salazar, Miguel López de Heredia, Inés Quintela, Rafaela González-Montelongo, Vivian Nogueira Silbiger, Marta Sevilla Porras, Jair Antonio Tenorio Castaño, Julian Nevado, Jose María Aguado, Carlos Aguilar, Sergio Aguilera-Albesa, Virginia Almadana, Berta Almoguera, Nuria Alvarez, Álvaro Andreu-Bernabeu, Eunate Arana-Arri, Celso Arango, María J Arranz, Maria-Jesus Artiga, Raúl C Baptista-Rosas, María Barreda- Sánchez, Moncef Belhassen-Garcia, Joao F Bezerra, Marcos AC Bezerra, Lucía Boix-Palop, María Brion, Ramón Brugada, Matilde Bustos, Enrique J Calderón, Cristina Carbonell, Luis Castano, Jose E Castelao, Rosa Conde-Vicente, M Lourdes Cordero-Lorenzana, Jose L Cortes-Sanchez, Marta Corton, M Teresa Darnaude, Alba De Martino-Rodríguez, Victor del Campo-Pérez, Aranzazu Diaz de Bustamante, Elena Domínguez-Garrido, Rocío Eirós, María Carmen Fariñas, María J Fernandez-Nestosa, Uxía Fernández-Robelo, Amanda Fernández-Rodríguez, Tania Fernández-Villa, Manuela Gago-Dominguez, Belén Gil-Fournier, Javier Gómez-Arrue, Beatriz González Álvarez, Fernan Gonzalez Bernaldo de Quirós, Anna González-Neira, Javier González-Peñas, Juan F Gutiérrez-Bautista, María José Herrero, Antonio Herrero-Gonzalez, María A Jimenez-Sousa, María Claudia Lattig, Anabel Liger Borja, Rosario Lopez-Rodriguez, Esther Mancebo, Caridad Martín-López, Vicente Martín, Oscar Martinez-Nieto, Iciar Martinez-Lopez, Michel F Martinez-Resendez, Angel Martinez-Perez, Juliana F Mazzeu, Eleuterio Merayo Macías, Pablo Minguez, Victor Moreno Cuerda, Silviene F Oliveira, Eva Ortega-Paino, Mara Parellada, Estela Paz-Artal, Ney PC Santos, Patricia Pérez-Matute, Patricia Perez, M Elena Pérez-Tomás, Teresa Perucho, Mellina Pinsach-Abuin, Guillermo Pita, Ericka N Pompa-Mera, Gloria L Porras-Hurtado, Aurora Pujol, Soraya Ramiro León, Salvador Resino, Marianne R Fernandes, Emilio Rodríguez-Ruiz, Fernando Rodriguez-Artalejo, José A Rodriguez-Garcia, Francisco Ruiz-Cabello, Javier Ruiz-Hornillos, Pablo Ryan, José Manuel Soria, Juan Carlos Souto, Eduardo Tamayo, Alvaro Tamayo-Velasco, Juan Carlos Taracido-Fernandez, Alejandro Teper, Lilian Torres-Tobar, Miguel Urioste, Juan Valencia-Ramos, Zuleima Yáñez, Ruth Zarate, Itziar de Rojas, Agustín Ruiz, Pascual Sánchez, Luis Miguel Real, SCOURGE Cohort Group, Encarna Guillen-Navarro, Carmen Ayuso, Esteban Parra, José A Riancho, Augusto Rojas-Martinez, Carlos Flores, Pablo Lapunzina, and Ángel Carracedo

Subjects
GWAS, COVID-19, SNP, Medicine, Science, Biology (General), QH301-705.5
Abstract

The genetic basis of severe COVID-19 has been thoroughly studied, and many genetic risk factors shared between populations have been identified. However, reduced sample sizes from non-European groups have limited the discovery of population-specific common risk loci. In this second study nested in the SCOURGE consortium, we conducted a genome-wide association study (GWAS) for COVID-19 hospitalization in admixed Americans, comprising a total of 4702 hospitalized cases recruited by SCOURGE and seven other participating studies in the COVID-19 Host Genetic Initiative. We identified four genome-wide significant associations, two of which constitute novel loci and were first discovered in Latin American populations (BAZ2B and DDIAS). A trans-ethnic meta-analysis revealed another novel cross-population risk locus in CREBBP. Finally, we assessed the performance of a cross-ancestry polygenic risk score in the SCOURGE admixed American cohort. This study constitutes the largest GWAS for COVID-19 hospitalization in admixed Latin Americans conducted to date. This allowed to reveal novel risk loci and emphasize the need of considering the diversity of populations in genomic research.

Published
2024
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2. Use of risk chart algorithms for the identification of psoriatic arthritis patients at high risk for cardiovascular disease: findings derived from the project CARMA cohort after a 7.5-year follow-up period

Author

Jesús Tornero, Alba Erra, Santos Castañeda, Carolina Pérez-García, Raimon Sanmartí, Sara Marsal, Ingrid Moller, Esperanza Naredo, Miguel A González-Gay, Celia Erausquin, Ivan Castellví, Javier Llorca, Alejandro Muñoz, María Galindo, Enrique Raya, Lydia Abasolo, Gema Bonilla, Alfonso Corrales, Inmaculada Ureña, Carlos Rodríguez-Lozano, Carlos González-Juanatey, Cristina Fernandez Carballido, Francisco J López-Longo, Miguel Ángel González-Gay, Eduardo Collantes, José A Miranda-Filloy, Sagrario Bustabad, Indalecio Monteagudo, Jose A Piqueras, Tatiana Cobo, Joan Maymó, Carmen Barbadillo, Soledad Ojeda, Jaime Calvo Alen, Antonio Fernandez Nebro, Isabel Rodríguez, Pilar Font, Martina Steiner, Eugenio Chamizo Carmona, Beatriz González Álvarez, Santiago Munoz, Joan M Nolla, Fernando Sánchez-Alonso, Julio Sanchez, Raul Menor Almagro, Ana Pérez Gómez, Monica Ibañez, Elena Heras-Recuero, Trinidad Pérez Sandoval, Miren Uriarte-Ecenarro, Angela Pecondón, Hye Sang Park, Jessica Polo y La Borda, Zulema Plaza, Carmen García Gómez, Ivan Ferraz-Amaro, Jesús Tomás Sanchez-Costa, Olga Carmen Sánchez-González, Ana Isabel Turrión-Nieves, Ana Perez-Alcalá, José L FernándezSueiro, José A Pinto-Tasende, Eugenia Gonzálezde Rábago, María J González-Fernández, Ramón Huguet Codina, Beatriz Yoldi, Mercedes Ramentol, Gabriela Ávila, Cayetano Alegre, Fernando Gamero, José García Torón, María P Moreno-Gil, Antonio Juan-Mas, Pilar Espiño, Inmaculada Ros, Horacio Berman, Oscar Fontseré Patón, Benjamín Fernández Gutiérrez, José M Pina-Salvador, María D Fábregas, Montserrat Romera, Jesús A García-Vadillo, Rosario García de Vicuña, María A Belmonte, María V Irigoyen, Olga Martínez González, Rebeca Belmonte Gómez, Pastora Granados Bautista, Azucena Hernández Sanz, José Santos Rey, Carmen O Sánchez-González, Javier Bachiller, Antonio Zea, Francisco J Manero, Chesús Beltrán Audera, Marta Medrano, Jesús Babío Herráez, Javier del Pino, Ruth López González, María Enriqueta Peiró, José M Senabre, José C Rosas, Isabel Rotés, Estefanía Moreno, Javier Calvo, Amalia Rueda, Pilar Morales, Ana Nieto, Ana Ruibal Escribano, Sergio Ros Expósito, Ginés Sánchez Nievas, Enrique Júdez Navarro, Manuela Sianes Fernández, Silvia Martínez Pardo, Manel Pujol, Alberto Cantabrana, Esmeralda Delgado, Sergio Rodríguez Montero, Javier Rivera Redondo, Teresa González Hernández, Francisco J González-Polo, José M Moreno, Emilio Giner Serret, Laura Cebrián Méndez, María Teresa Navío, Teresa Pedraz Penalva, Encarnación Pagán, Pablo Mesadel Castillo, Ana Cruz, Ana Turrión, Desireé Ruíz, Antonio López Meseguer, Manuel J Moreno, Luis F Linares, Mercedes Morcillo, María L González-Gómez, José M Aramburu, Natalia A Rivera, Olaia Fernández Berrizbeitia, Manel Riera, Yolanda María León, Miriam Amirall, Jordi Fiter, Julia Fernández Melón, Luis Espadaler, Joaquín Belzunegui, Inmaculada Bañegil, César Díaz, Ramón Valls, María Bonet, Eva Revuelta Evrard, Javier R Godo, and José A González-Fernández

Subjects
Medicine
Abstract

Objective To assess the predictive value of four cardiovascular (CV) risk algorithms for identifying high-risk psoriatic arthritis (PsA) patients.Methods Evaluation of patients with PsA enrolled in the Spanish prospective project CARdiovascular in RheuMAtology. Baseline data of 669 PsA patients with no history of CV events at the baseline visit, who were followed in rheumatology outpatient clinics at tertiary centres for 7.5 years, were retrospectively analysed to test the performance of the Systematic Coronary Risk Assessment (SCORE), the modified version (mSCORE) European Alliance of Rheumatology Associations (EULAR) 2015/2016, the SCORE2 algorithm (the updated and improved version of SCORE) and the QRESEARCH risk estimator version 3 (QRISK3).Results Over 4790 years of follow-up, there were 34 CV events, resulting in a linearised rate of 7.10 per 1000 person-years (95% CI 4.92 to 9.92). The four CV risk scales showed strong correlations and all showed significant associations with CV events (p

Published
2024
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3. Open-label phase I/II clinical trial of SARS-CoV-2 receptor binding domain-tetanus toxoid conjugate vaccine (FINLAY-FR-2) in combination with receptor binding domain-protein vaccine (FINLAY-FR-1A) in children

Author

Rinaldo Puga-Gómez, Yariset Ricardo-Delgado, Chaumey Rojas-Iriarte, Leyanis Céspedes-Henriquez, Misleidys Piedra-Bello, Dania Vega-Mendoza, Noelvia Pestana Pérez, Beatriz Paredes-Moreno, Meiby Rodríguez-González, Carmen Valenzuela-Silva, Belinda Sánchez-Ramírez, Laura Rodríguez-Noda, Rocmira Pérez-Nicado, Raul González-Mugica, Tays Hernández-García, Talía Fundora-Barrios, Martha Dubet Echevarría, Juliet María Enriquez-Puertas, Yenicet Infante-Hernández, Ariel Palenzuela-Díaz, Evelyn Gato-Orozco, Yanet Chappi-Estévez, Julio Cesar Francisco-Pérez, Miladi Suarez-Martinez, Ismavy C. Castillo-Quintana, Sonsire Fernandez-Castillo, Yanet Climent-Ruiz, Darielys Santana-Mederos, Yanelda García-Vega, María Eugenia Toledo-Romani, Delaram Doroud, Alireza Biglari, Yury Valdés-Balbín, Dagmar García-Rivera, Vicente Vérez-Bencomo, María Elena Mesa-Herrera, Yarmila García-Cristiá, Leonor Verdecia-Sánchez, Rafael del Valle Rodríguez, Yudalvies Oquendo-de la Cruz, Daysi Álvarez-Montalvo, Randy Grillo-Fortún, Liset López-González, Omaida Fonte Galindo, Yeseni Reyes-González, Ana Beatriz González-Álvarez, Linet Gorrita-Mora, Rodrigo Valera-Fernández, Ivis Ontivero-Pino, Marisel Martínez-Pérez, Esperanza Caballero-Gonzalez, Aniurka Garcés-Hechavarría, Dayle Martínez-Bedoya, Maite Medina-Nápoles, Yeney Regla Domínguez-Pentón, Yadira Cazañas-Quintana, Thais Fundora Barrios, Diana R. Hernández Fernández, Gretchen Bergado-Báez, Ivette Orosa-Vazquez, Franciscary Pi-Estopiñan, Marianniz Díaz-Hernández, Otto Cruz-Sui, Enrique Noa-Romero, Arilia García-López, Sandra Rivadereira Muro, and Gerardo Baro-Roman

Subjects
COVID-19, SARS-CoV-2, Conjugate vaccine, Pediatric vaccine, Heterologous scheme, Subunit vaccine, Infectious and parasitic diseases, RC109-216
Abstract

Objectives: To evaluate a heterologous vaccination scheme in children 3-18 years old (y/o) combining two SARS-CoV-2r- receptor binding domain (RBD)protein vaccines. Methods: A phase I/II open-label, adaptive, and multicenter trial evaluated the safety and immunogenicity of two doses of FINLAY-FR-2 (subsequently called SOBERANA 02) and the third heterologous dose of FINLAY-FR-1A (subsequently called SOBERANA Plus) in 350 children 3-18 y/o in Havana Cuba. Primary outcomes were safety (phase I) and safety/immunogenicity (phase II) measured by anti-RBD immunoglobulin (Ig)G enzyme-linked immunoassay (ELISA), molecular and live-virus neutralization titers, and specific T-cells response. A comparison with adult immunogenicity and predictions of efficacy were made based on immunological results. Results: Local pain was the unique adverse event with frequency >10%, and none was serious neither severe. Two doses of FINLAY-FR-2 elicited a humoral immune response similar to natural infection; the third dose with FINLAY-FR-1A increased the response in all children, similar to that achieved in vaccinated young adults. The geometric mean (GMT) neutralizing titer was 173.8 (95% confidence interval [CI] 131.7; 229.5) vs Alpha, 142 (95% CI 101.3; 198.9) vs Delta, 24.8 (95% CI 16.8; 36.6) vs Beta and 99.2 (95% CI 67.8; 145.4) vs Omicron. Conclusion: The heterologous scheme was safe and immunogenic in children 3-18 y/o. Trial registry: https://rpcec.sld.cu/trials/RPCEC00000374

Published
2023
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4. Analysis of the impact of social determinants and primary care morbidity on population health outcomes by combining big data: A research protocol

Author

Sabela Couso-Viana, Carmen Bentué-Martínez, María Victoria Delgado-Martín, Elena Cabeza-Irigoyen, Montserrat León-Latre, Ana Concheiro-Guisán, María Xosé Rodríguez-Álvarez, Miguel Román-Rodríguez, Javier Roca-Pardiñas, María Zúñiga-Antón, Ana García-Flaquer, Pau Pericàs-Pulido, Raquel Sánchez-Recio, Beatriz González-Álvarez, Sara Rodríguez-Pastoriza, Irene Gómez-Gómez, Emma Motrico, José Luís Jiménez-Murillo, Isabel Rabanaque, and Ana Clavería

Subjects
social determinants of health (MeSH), socioeconomic factors (MeSH), big data, electronic health records—HER, morbidity, Medicine (General), R5-920
Abstract

BackgroundIn recent years, different tools have been developed to facilitate analysis of social determinants of health (SDH) and apply this to health policy. The possibility of generating predictive models of health outcomes which combine a wide range of socioeconomic indicators with health problems is an approach that is receiving increasing attention. Our objectives are twofold: (1) to predict population health outcomes measured as hospital morbidity, taking primary care (PC) morbidity adjusted for SDH as predictors; and (2) to analyze the geographic variability of the impact of SDH-adjusted PC morbidity on hospital morbidity, by combining data sourced from electronic health records and selected operations of the National Statistics Institute (Instituto Nacional de Estadística/INE).MethodsThe following will be conducted: a qualitative study to select socio-health indicators using RAND methodology in accordance with SDH frameworks, based on indicators published by the INE in selected operations; and a quantitative study combining two large databases drawn from different Spain’s Autonomous Regions (ARs) to enable hospital morbidity to be ascertained, i.e., PC electronic health records and the minimum basic data set (MBDS) for hospital discharges. These will be linked to socioeconomic indicators, previously selected by geographic unit. The outcome variable will be hospital morbidity, and the independent variables will be age, sex, PC morbidity, geographic unit, and socioeconomic indicators.AnalysisTo achieve the first objective, predictive models will be used, with a test-and-training technique, fitting multiple logistic regression models. In the analysis of geographic variability, penalized mixed models will be used, with geographic units considered as random effects and independent predictors as fixed effects.DiscussionThis study seeks to show the relationship between SDH and population health, and the geographic differences determined by such determinants. The main limitations are posed by the collection of data for healthcare as opposed to research purposes, and the time lag between collection and publication of data, sampling errors and missing data in registries and surveys. The main strength lies in the project’s multidisciplinary nature (family medicine, pediatrics, public health, nursing, psychology, engineering, geography).

Published
2022
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5. Tocilizumab in refractory Caucasian Takayasu’s arteritis: a multicenter study of 54 patients and literature review

Author

Diana Prieto-Peña, Pilar Bernabeu, Paloma Vela, Javier Narváez, Jesús C. Fernández-López, Mercedes Freire-González, Beatriz González-Álvarez, Roser Solans-Laqué, José L. Callejas Rubio, Norberto Ortego, Carlos Fernández-Díaz, Esteban Rubio, Salvador García-Morillo, Mauricio Minguez, Cristina Fernández-Carballido, Eugenio de Miguel, Sheila Melchor, Eva Salgado, Beatriz Bravo, Susana Romero-Yuste, Juan Salvatierra, Cristina Hidalgo, Sara Manrique, Carlos Romero-Gómez, Patricia Moya, Noelia Álvarez-Rivas, Javier Mendizabal, Francisco Ortiz-Sanjuán, Iván Pérez de Pedro, José L. Alonso-Valdivielso, Laura Perez-Sanchez, Rosa Roldán, Nagore Fernandez-Llanio, Ricardo Gómez de la Torre, Silvia Suarez, María Jesús Montesa Cabrera, Mónica Delgado Sánchez, Javier Loricera, Belén Atienza-Mateo, Santos Castañeda, Miguel A. González-Gay, and Ricardo Blanco

Subjects
Diseases of the musculoskeletal system, RC925-935
Abstract

Objective: To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu’s arteritis (TAK) in clinical practice. Methods: A multicenter study of Caucasian patients with refractory TAK who received TCZ. The outcome variables were remission, glucocorticoid-sparing effect, improvement in imaging techniques, and adverse events. A comparative study between patients who received TCZ as monotherapy (TCZ MONO ) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZ COMBO ) was performed. Results: The study comprised 54 patients (46 women/8 men) with a median [interquartile range (IQR)] age of 42.0 (32.5–50.5) years. TCZ was started after a median (IQR) of 12.0 (3.0–31.5) months since TAK diagnosis. Remission was achieved in 12/54 (22.2%), 19/49 (38.8%), 23/44 (52.3%), and 27/36 (75%) patients at 1, 3, 6, and 12 months, respectively. The prednisone dose was reduced from 30.0 mg/day (12.5–50.0) to 5.0 (0.0–5.6) mg/day at 12 months. An improvement in imaging findings was reported in 28 (73.7%) patients after a median (IQR) of 9.0 (6.0–14.0) months. Twenty-three (42.6%) patients were on TCZ MONO and 31 (57.4%) on TCZ COMBO : MTX ( n = 28), cyclosporine A ( n = 2), azathioprine ( n = 1). Patients on TCZ COMBO were younger [38.0 (27.0–46.0) versus 45.0 (38.0–57.0)] years; difference (diff) [95% confidence interval (CI) = -7.0 (-17.9, -0.56] with a trend to longer TAK duration [21.0 (6.0–38.0) versus 6.0 (1.0–23.0)] months; diff 95% CI = 15 (-8.9, 35.5), and higher c-reactive protein [2.4 (0.7–5.6) versus 1.3 (0.3–3.3)] mg/dl; diff 95% CI = 1.1 (-0.26, 2.99). Despite these differences, similar outcomes were observed in both groups (log rank p = 0.862). Relevant adverse events were reported in six (11.1%) patients, but only three developed severe events that required TCZ withdrawal. Conclusion: TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin.

Published
2021
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6. Valoración del riesgo de fractura en población general en España mediante el algoritmo FRAX®: Estudio EPISER2016

Author

Carmen Gómez-Vaquero, Dolores Fábregas-Canales, Daniel Seoane-Mato, Carlos Sánchez-Piedra, Federico Díaz-González, Sagrario Bustabad-Reyes, Lucía Silva-Fernández, Francisca Sivera, Neus Quilis Martí, Francisco J. Blanco, Fernando Pérez Ruiz, Joana Atxotegi Sáenz de Buruaga, Irati Urionagüena Onaindia, Boris Anthony Blanco Cáceres, Antonio Juan-Mas, José M. Pego-Reigosa, Javier Narváez, Raúl Cortés Verdú, Fred Antón-Pagés, Víctor Quevedo Vila, Laura Garrido Courel, Natividad del Val del Amo, Inmaculada Paniagua Zudaire, Gustavo Añez Sturchio, Fermín Medina Varo, Myriam Gandía Martínez, Antonio Romero Pérez, Javier Ballina, Anahy Brandy García, Dolores Fábregas Canales, Teresa Font Gayá, Carolina Bordoy Ferrer, Beatriz González Álvarez, Laura Casas Hernández, Fátima Álvarez Reyes, Mónica Delgado Sánchez, Cristina Martínez Dubois, Simón Ángel Sánchez-Fernández, Luisa Marena Rojas Vargas, Paula Virginia García Morales, Alejandro Olivé, Paula Rubio Muñoz, Marta Larrosa, Noemí Navarro Ricos, Eduard Graell Martín, Eugenio Chamizo, Lara Chaves Chaparro, Sara Rojas Herrera, Jordi Pons Dolset, Miguel Ángel Polo Ostariz, Susana Ruiz-Alejos Garrido, Cristina Macía Villa, Ana Cruz Valenciano, María Luisa González Gómez, Mercedes Morcillo Valle, Deseada Palma Sánchez, María José Moreno Martínez, and Marta Mayor González

Subjects
03 medical and health sciences, 0302 clinical medicine, business.industry, Medicine, 030212 general & internal medicine, General Medicine, business, Humanities
Abstract

Resumen Objetivos Analizar el riesgo de fractura calculado por FRAX® y la frecuencia de alto riesgo de fractura en la poblacion general en Espana. Metodos EPISER2016 es un estudio transversal multicentrico de base poblacional de la prevalencia de las enfermedades reumaticas en poblacion adulta en Espana. Un total de 3.154 sujetos de edad igual o superior a 40 anos (1.184 hombres y 1.970 mujeres) se seleccionaron mediante muestreo aleatorio estratificado. Las preguntas relacionadas con los factores de riesgo de fractura se realizaron mediante encuesta telefonica. El riesgo de fractura principal (RFP) y de cadera (RFC) se calcularon con la version espanola de la herramienta FRAX®, sin la inclusion de la densidad mineral osea. Para definir alto riesgo de fractura, se utilizaron los umbrales RFP ≥ 20%, RFP ≥ 10%, RFP ≥ 7,5% y RFC ≥ 3%. Resultados La mediana (rango intercuartilico) del RFP fue 2,61% (1,55-6,34%) en mujeres y 1,67% (1,15-2,87%) en hombres; la del RFC fue 0,39% (0,14-1,86%) y 0,18% (0,07-0,77%). El 3,83% de las mujeres y ningun hombre tenian un RFP ≥ 20%; el 15,71% y el 1,14% tenian un RFP ≥ 10%; el 20,62% y el 2,21%, un RFP ≥ 7,5%; y el 19,27% y el 8,05%, un RFC ≥ 3%. En las mujeres de 65 anos o mas, el RFC fue alto en el 58,09%. Conclusiones EPISER2016 nos ha permitido conocer el riesgo de fractura calculado por FRAX® y la prevalencia de alto riesgo de fractura en la poblacion general segun los diversos umbrales utilizados en Espana.

Published
2020

7. Tocilizumab in refractory Caucasian Takayasu's arteritis: a multicenter study of 54 patients and literature review

Author

Francisco Ortiz-Sanjuán, María Jesús Montesa Cabrera, Eva Salgado, Javier Loricera, Salvador García-Morillo, C. Hidalgo, Miguel A. González-Gay, Rosa Roldán, Carlos Romero-Gómez, Mercedes Freire-González, E. Rubio, José L. Alonso-Valdivielso, Juan Salvatierra, Susana Romero-Yuste, Eugenio de Miguel, Roser Solans-Laqué, Mónica Sánchez, José L. Callejas Rubio, Jesús Carlos Fernández-Lopez, Patricia Moya, Sara Manrique, Javier Narváez, Belén Atienza-Mateo, Paloma Vela, Ricardo Blanco, Noelia Álvarez-Rivas, Pilar Bernabeu, Ricardo Gómez de la Torre, Silvia Suarez, C. Fernández-Díaz, Mauricio Minguez, N. Fernández-Llanio, Javier Mendizabal, Laura Perez-Sanchez, Beatriz González-Álvarez, Norberto Ortego, Iván Pérez de Pedro, B. Bravo, Diana Prieto-Peña, Sheila Melchor, Cristina Fernández-Carballido, Santos Castañeda, Universidad de Cantabria, Institut Català de la Salut, [Prieto-Peña D] Department of Rheumatology, Research Group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL, Hospital Universitario Marqués de Valdecilla, Santander, Spain. [Bernabeu P, Vela P] Department of Rheumatology, Hospital General de Alicante, Alicante, Spain. [Narváez J] Department of Rheumatology, Hospital de Bellvitge, Barcelona, Spain. [Fernández-López JC, Freire-González M] Department of Rheumatology, Complejo H. Universitario de A Coruña, A Coruña, Spain. [Solans-Laqué R] Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
musculoskeletal diseases, Takayasu's arteritis, medicine.medical_specialty, Blancs, Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores], Diseases of the musculoskeletal system, 030204 cardiovascular system & hematology, Caucasian, Other subheadings::Other subheadings::/drug therapy [Other subheadings], Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Antibodies, Monoclonal::Antibodies, Monoclonal, Humanized [CHEMICALS AND DRUGS], 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Tocilizumab, Cardiovascular Diseases::Vascular Diseases::Aortic Diseases::Aortic Arch Syndromes::Takayasu Arteritis [DISEASES], Rheumatology, Refractory, medicine, Orthopedics and Sports Medicine, aminoácidos, péptidos y proteínas::proteínas::proteínas sanguíneas::inmunoproteínas::inmunoglobulinas::anticuerpos::anticuerpos monoclonales::anticuerpos monoclonales humanizados [COMPUESTOS QUÍMICOS Y DROGAS], Biological therapy, Arteritis, Other subheadings::/therapeutic use [Other subheadings], cardiovascular diseases, skin and connective tissue diseases, Vasculitis - Tractament, Original Research, 030203 arthritis & rheumatology, Caucasian, Takayasu’s arteritis, Tocilizumab, biological therapy, cDMARDs, Anticossos monoclonals - Ús terapèutic, cDMARDs, Whites, business.industry, Otros calificadores::/uso terapéutico [Otros calificadores], Takayasu’s arteritis, medicine.disease, Dermatology, Multicenter study, chemistry, RC925-935, Avaluació de resultats (Assistència sanitària), enfermedades cardiovasculares::enfermedades vasculares::enfermedades de la aorta::síndromes del arco aórtico::arteritis de Takayasu [ENFERMEDADES], business
Abstract

Arteritis de Takayasu; Tocilizumab; Teràpia biològica Arteritis de Takayasu; Tocilizumab; Terapia biológica Takayasu’s arteritis; Tocilizumab; Biological therapy Objective: To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu’s arteritis (TAK) in clinical practice. Methods: A multicenter study of Caucasian patients with refractory TAK who received TCZ. The outcome variables were remission, glucocorticoid-sparing effect, improvement in imaging techniques, and adverse events. A comparative study between patients who received TCZ as monotherapy (TCZMONO) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZCOMBO) was performed. Results: The study comprised 54 patients (46 women/8 men) with a median [interquartile range (IQR)] age of 42.0 (32.5–50.5) years. TCZ was started after a median (IQR) of 12.0 (3.0–31.5) months since TAK diagnosis. Remission was achieved in 12/54 (22.2%), 19/49 (38.8%), 23/44 (52.3%), and 27/36 (75%) patients at 1, 3, 6, and 12 months, respectively. The prednisone dose was reduced from 30.0 mg/day (12.5–50.0) to 5.0 (0.0–5.6) mg/day at 12 months. An improvement in imaging findings was reported in 28 (73.7%) patients after a median (IQR) of 9.0 (6.0–14.0) months. Twenty-three (42.6%) patients were on TCZMONO and 31 (57.4%) on TCZCOMBO: MTX (n = 28), cyclosporine A (n = 2), azathioprine (n = 1). Patients on TCZCOMBO were younger [38.0 (27.0–46.0) versus 45.0 (38.0–57.0)] years; difference (diff) [95% confidence interval (CI) = -7.0 (-17.9, -0.56] with a trend to longer TAK duration [21.0 (6.0–38.0) versus 6.0 (1.0–23.0)] months; diff 95% CI = 15 (-8.9, 35.5), and higher c-reactive protein [2.4 (0.7–5.6) versus 1.3 (0.3–3.3)] mg/dl; diff 95% CI = 1.1 (-0.26, 2.99). Despite these differences, similar outcomes were observed in both groups (log rank p = 0.862). Relevant adverse events were reported in six (11.1%) patients, but only three developed severe events that required TCZ withdrawal. Conclusion: TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was partially supported by RETICS Programs, RD08/0075 (RIER), RD12/0009/0013 and RD16/0012 from “Instituto de Salud Carlos III” (ISCIII) (Spain). However, this research did not receive any specific grant from funding agencies in the commercial or not-for-profit sectors.

Published
2021

8. Analysis of Clinical Parameters, Drug Consumption and Use of Health Resources in a Southern European Population with Alcohol Abuse Disorder during COVID-19 Pandemic

Author

Ana Lear-Claveras, Beatriz González-Álvarez, Sabela Couso-Varela, Ana Clavería, and Bárbara Oliván-Blázquez

Subjects
psychiatry_mental_health_studies, Male, lifestyle, Adolescent, SARS-CoV-2, Health, Toxicology and Mutagenesis, Public Health, Environmental and Occupational Health, COVID-19, alcohol use disorder, lockdown, primary care, health resources, Alcoholism, Pharmaceutical Preparations, Communicable Disease Control, Medicine, Health Resources, Humans, Pandemics
Abstract

The disruption in healthcare attention to people with alcohol dependence, along with psychological decompensation consequence of lockdown derived from COVID-19 pandemic, could have a negative impact on people who suffers from alcohol abuse disorder. Retrospective observational study of 9,966 men aged ˃16 years registered as having diagnosis of alcohol abuse disorder in the electronic medical records (EMR) of the Aragon Regional Health Service (Spain). Of those who were not infected during the study period (9,576), clinical (Glutamate-oxaloacetate -GOT-, Glutamate pyruvate -GPT-, creatinine, glomerular filtration, systolic blood pressure -SBP-, diastolic blood pressure -DBP-, total cholesterol, LDL, HDL, triglycerides, and body mass index -BMI-), pharmacological (dose per inhabitant per day -DHD- of drugs used in addictive disorders, benzodiazepines and antidepressants) and health resource use variables (primary and specialized care) were considered. Student´s T-test for matched samples was performed. After carrying out the Levene´s test, the Student´s T-test was used to analyze the changes in clinical variables between alcohol abuse disorder patients with and without COVID-19. Only creatinine and LDL show a significant but clinically irrelevant changes just after and 6 months after the end of strict lockdown. The total number of DHDs for all drugs included in the study (except for Benzodiazepines), decreased. In the same way, the use of health services by these patients also decreased. The impact of COVID-19 among this group of patients has been moderate. The reorganization of health and social services after the declaration of the state of alarm in our country, made possible the maintenance of care for this vulnerable patients.

Published
2022

9. Prevalence of rheumatic diseases in adult population in Spain (EPISER 2016 study): Aims and methodology

Author

Daniel, Seoane-Mato, Carlos, Sánchez-Piedra, Lucía, Silva-Fernández, Francisca, Sivera, Francisco J, Blanco, Fernando, Pérez Ruiz, Antonio, Juan-Mas, José M, Pego-Reigosa, Javier, Narváez, Neus, Quilis Martí, Raúl, Cortés Verdú, Fred, Antón-Pagés, Víctor, Quevedo Vila, Laura, Garrido Courel, Natividad Del Val, Del Amo, Inmaculada, Paniagua Zudaire, Gustavo, Añez Sturchio, Fermín, Medina Varo, María Del Mar, Ruiz Tudela, Antonio, Romero Pérez, Javier, Ballina, Anahy, Brandy García, Dolores, Fábregas Canales, Teresa, Font Gayá, Carolina, Bordoy Ferrer, Beatriz, González Álvarez, Laura, Casas Hernández, Fátima, Álvarez Reyes, Mónica, Delgado Sánchez, Cristina, Martínez Dubois, Simón Ángel, Sánchez-Fernández, Luisa Marena, Rojas Vargas, Paula Virginia, García Morales, Alejandro, Olivé, Paula, Rubio Muñoz, Marta, Larrosa, Noemí, Navarro Ricos, Eduard, Graell Martín, Eugenio, Chamizo, Lara, Chaves Chaparro, Sara, Rojas Herrera, Jordi, Pons Dolset, Miguel Ángel, Polo Ostariz, Susana, Ruiz-Alejos Garrido, Cristina, Macía Villa, Ana, Cruz Valenciano, María Luisa, González Gómez, Mercedes, Morcillo Valle, Deseada, Palma Sánchez, María José, Moreno Martínez, Marta, Mayor González, Joana, Atxotegi Sáenz de Buruaga, Irati, Urionagüena Onaindia, Boris Anthony, Blanco Cáceres, Federico, Díaz-González, and Sagrario, Bustabad

Subjects
Adult, Male, musculoskeletal diseases, Fibromyalgia, Gout, Epidemiology, Osteoporotic fracture, 03 medical and health sciences, 0302 clinical medicine, Systemic lupus erythematosus, Rheumatic Diseases, Osteoarthritis, Prevalence, Humans, 030212 general & internal medicine, Rheumatoid arthritis, Aged, Aged, 80 and over, 030203 arthritis & rheumatology, Methodology, General Medicine, Middle Aged, Cross-Sectional Studies, Research Design, Spain, Sjogren's syndrome, Psoriatic arthritis, Female, Ankylosing spondylitis
Abstract

Aim: To describe the methodology of the EPISER 2016 (study of the prevalence of rheumatic diseases in adult population in Spain), as well its strengths and limitations. The aim of this study is to estimate the prevalence of rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), Sjogren's syndrome (SS), osteoarthritis (knee, hip, hands, and cervical and lumbar spine), fibromyalgia, gout and clinical osteoporotic fracture. Material and method: Population-based, multicenter, cross-sectional study, with the participation of 45 municipalities in the 17 Spanish autonomous communities. The reference population will consist of adults aged 20 years and over residing in Spain. A computer-assisted telephone interview (CATI) system will be used for data collection. Diagnostic suspicions and diagnoses received by the participants will be studied by rheumatologists in the referral hospitals in the selected municipalities. Statistical analysis: the prevalence of the rheumatic diseases will be calculated using estimators and their 95% confidence intervals. Weights will be calculated in each of the sampling stages in accordance with the probability of selection. The distribution of the population in Spain will be obtained from the Spanish Statistics Institute. Conclusions: Sociodemographic and lifestyle changes over the last 16 years justify EPISER 2016. This study will provide current data about the prevalences of RA, AS, PsA, SLE, SS, osteoarthritis, fibromyalgia, gout and clinical osteoporotic fracture. The results will allow comparisons with studies from other countries and EPISER 2000. (C) 2017 Elsevier Espana, S.L.U. and Sociedad Espanola de Reumatologia y Colegio Mexicano de Reumatologia. All rights reserved.

Published
2019

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