Reumatologia Clinica最新文献_第5页

Establishing reference values for serum urate in healthy adults from Mexico City: Data from the Tlalpan 2020 cohort 建立墨西哥城健康成人血清尿酸的参考值：来自Tlalpan 2020队列的数据

IF 1.3 Q4 RHEUMATOLOGY

Reumatologia Clinica

Pub Date : 2025-08-19 DOI: 10.1016/j.reuma.2025.501943

Hilary Miranda-Mendoza , Daniel Paulino-González , Julio Sesma-Soto , Stephany Segura-García , Gerardo Tirado-Ojeda , Abraham Romero-Beltrán , Fernando Ortiz-Sanchez , Michele Enríquez-Luna , Brandon Fisher-Bautista , Guadalupe O. Gutiérrez-Esparza , Mireya Martínez-García , Luis M. Amezcua-Guerra

Background

Urate is the final product of purine catabolism, and its levels have been linked to various cardiometabolic disorders. In Mexico, most epidemiological data on urate levels derive from populations with existing comorbidities, limiting the establishment of normative reference values.

Objective

To characterize the distribution of serum urate concentrations in a healthy adult population residing in Mexico City.

Methods

A cross-sectional analysis was conducted using data from 3099 healthy adults (64.6% women) enrolled in the Tlalpan 2020 cohort. Participants with chronic diseases, abnormal blood pressure or glucose levels, or exposure to urate-altering medications were excluded. Clinical, anthropometric, and biochemical parameters were recorded, and serum urate concentrations were analyzed overall and stratified by sex.

Results

The median serum urate level in the overall cohort was 5.16 mg/dL (interquartile range, 4.32–6.15), with a central 95% reference interval ranging from 3.05 to 7.98 mg/dL. Median urate levels differed significantly by sex: 4.60 mg/dL (3.99–5.28) in women and 6.39 mg/dL (5.61–7.09) in men. The prevalence of hyperuricemia in the total cohort was 16.5%, notably higher in men (28.4%) compared to women (10.0%).

Conclusion

This study establishes sex-specific reference values for serum urate in a healthy Mexican adult population. The findings may inform clinical decision-making and future research on urate-related risk stratification.

尿酸是嘌呤分解代谢的最终产物，其水平与各种心脏代谢疾病有关。在墨西哥，大多数关于准确水平的流行病学数据来自已有合并症的人群，限制了规范性参考值的建立。目的了解墨西哥城健康成人血清尿酸浓度的分布特征。方法采用来自Tlalpan 2020队列的3099名健康成年人（64.6%为女性）的数据进行横断面分析。患有慢性疾病、血压或血糖水平异常或暴露于改变尿酸的药物的参与者被排除在外。记录临床、人体测量和生化参数，并按性别对血清尿酸浓度进行总体和分层分析。结果整个队列的血清尿酸水平中位数为5.16 mg/dL（四分位数范围为4.32 ~ 6.15），中心95%参考区间为3.05 ~ 7.98 mg/dL。中位尿酸水平因性别而有显著差异：女性为4.60 mg/dL(3.99-5.28)，男性为6.39 mg/dL（5.61-7.09）。在整个队列中，高尿酸血症的患病率为16.5%，男性（28.4%）明显高于女性（10.0%）。结论：本研究建立了墨西哥健康成人血清尿酸盐的性别特异性参考值。这些发现可能会为临床决策和未来的研究提供准确相关风险分层的信息。

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引用次数: 0

Association between hypothyroidism and elderly-onset rheumatoid arthritis: A cross-sectional study at national hospital in Peru 甲状腺功能减退与老年类风湿关节炎之间的关系：秘鲁国家医院的横断面研究

IF 1.3 Q4 RHEUMATOLOGY

Reumatologia Clinica

Pub Date : 2025-08-12 DOI: 10.1016/j.reuma.2025.501948

Paul J. Tejada-Llacsa , Vidia Lumbe Diaz , Carlos Diaz-Arocutipa

Objective

To determine the association between hypothyroidism and elderly-onset rheumatoid arthritis (EORA).

Methods

A cross-sectional study was performed including patients with rheumatoid arthritis at the Adolfo Guevara Velasco National Hospital, Cusco, Peru in 2024. The outcome was EORA, defined as disease onset after 60 years old. The exposure was a history of hypothyroidism, and the following covariates were considered: sex, smoking, family history of autoimmune disease in first-degree relatives, rheumatoid factor and anti-CCP levels. The association between hypothyroidism and EORA was assessed using prevalence ratios (PR) with their 95% confidence interval (CI), estimated by generalized linear models with a Poisson family, log link, and robust variance. A p-value <0.05 was considered statistically significant.

Results

A total of 133 patients were included, 14 (10.5%) of whom had EORA. The mean age was 55 ± 12.6 years and 90% were female. Only 8.3% of patients reported a history of hypothyroidism. Hypothyroidism was significantly associated with EORA (adjusted PR 9.03, 95% CI 3.17–26.68). Other factors associated with EORA were disease duration, smoking, the history of autoimmune disease in a first-degree relative, and rheumatoid factor.

Conclusions

A history of hypothyroidism was independently associated with EORA in patients with rheumatoid arthritis from Peru. Screening for hypothyroidism in EORA patients may enhance management and address autoimmune comorbidities.

目的探讨甲状腺功能减退与老年类风湿关节炎（EORA）的关系。方法对2024年在秘鲁库斯科阿道夫·格瓦拉·贝拉斯科国立医院就诊的类风湿性关节炎患者进行横断面研究。结果为EORA，定义为60岁以后发病。暴露为甲状腺功能减退史，考虑了以下协变量：性别、吸烟、一级亲属自身免疫性疾病家族史、类风湿因子和抗ccp水平。甲状腺功能减退和EORA之间的关系通过患病率（PR）及其95%置信区间（CI）进行评估，并通过泊松家族、对数关联和稳健方差的广义线性模型进行估计。p值<；0.05被认为具有统计学意义。结果共纳入133例患者，其中EORA患者14例（10.5%）。平均年龄55±12.6岁，女性占90%。仅有8.3%的患者报告有甲状腺功能减退病史。甲状腺功能减退与EORA显著相关（调整后的PR为9.03,95% CI为3.17-26.68）。与EORA相关的其他因素有病程、吸烟、一级亲属自身免疫性疾病史和类风湿因子。结论秘鲁类风湿关节炎患者甲状腺功能减退史与EORA独立相关。筛查EORA患者的甲状腺功能减退可以加强管理和解决自身免疫性合并症。

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引用次数: 0

Survival of first line biological and targeted synthetic disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis in Chile 智利类风湿关节炎患者一线生物和靶向合成疾病改善抗风湿药物的生存期

IF 1.3 Q4 RHEUMATOLOGY

Reumatologia Clinica

Pub Date : 2025-08-11 DOI: 10.1016/j.reuma.2025.501946

Marcos Cruces Olivar , Allan D. Burboa , Yolanda M. Gómez

Introduction

In Chile, patients with refractory rheumatoid arthritis (RA) are candidates for treatment with biologic and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs). Due to the cost and diversity of drugs currently available to treat RA, there is a greater need to evaluate their survival in the real world and mainly to provide local and national data.

Objectives

To describe the survival and cause of discontinuation/change of first line b/tsDMARDs in patients with active refractory RA at the rheumatology clinic of the Regional Hospital of Copiapó.

Materials and methods

Patients with refractory RA on first-line treatment with b/tsDMARDs were included. Data were obtained from the RA registry of patients from January 01, 2018, until July 31, 2023, and by reviewing medical records. Demographic and clinical characteristics of the patients, survival of b/tsDMARDs, and cause of discontinuation/change of therapy are described. Kaplan–Meier plots and log-rank tests were performed. Cox model was used to identify factors that affected treatment discontinuation.

Results

One hundred thirty patients met the selection criteria. Survival of the different treatments was calculated, excluding rituximab and tocilizumab due to n <10. There were no significant differences between the survival of the groups (anti-TNF, abatacept, tofacitinib), with p > 0.05. The mean survival time for b/tsDMARDs was 194 weeks. In this cohort, 34.62% (n = 45) of the patients had treatment discontinuation/change, with lack of efficacy representing 80%.

Conclusion

In this cohort of patients with RA, there were no statistically significant differences in survival after first-line treatment with b/tsDMARDs. The choice of initial therapy will depend on multiple clinical, demographic, economic and regulatory factors.

在智利，难治性类风湿关节炎（RA）患者是生物和靶向合成疾病修饰抗风湿药物（b/tsDMARDs）治疗的候选者。由于目前可用于治疗类风湿性关节炎的药物的成本和多样性，更需要评估它们在现实世界中的生存期，主要是提供地方和国家数据。目的了解Copiapó地区医院风湿科门诊活动性难治性RA患者b/ tsdmard一线停药/改变的生存期及原因。材料和方法纳入b/tsDMARDs一线治疗的难治性RA患者。数据来自2018年1月1日至2023年7月31日期间RA患者的注册表，并通过查看医疗记录获得。描述了患者的人口统计学和临床特征，b/tsDMARDs的生存以及停药/改变治疗的原因。Kaplan-Meier图和log-rank检验。采用Cox模型确定影响停药的因素。结果130例患者符合入选标准。计算不同治疗的生存期，不包括利妥昔单抗和托珠单抗，因为n <；10。抗肿瘤坏死因子组、阿巴接受组、托法替尼组的生存率差异无统计学意义，p > 0.05。b/tsDMARDs的平均生存时间为194周。在该队列中，34.62% （n = 45）的患者停药/改变治疗，80%的患者缺乏疗效。结论在这组RA患者中，b/tsDMARDs一线治疗后的生存率无统计学差异。初始治疗的选择将取决于多种临床、人口、经济和监管因素。

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引用次数: 0

Rotator cuff tendinopathy is associated with increased activity score in rheumatoid arthritis 类风湿性关节炎患者肩袖肌腱病变与活动评分增高相关

IF 1.3 Q4 RHEUMATOLOGY

Reumatologia Clinica

Pub Date : 2025-08-06 DOI: 10.1016/j.reuma.2025.501947

Jorge Medina-Castillo , Rodrigo J. Castillo-de la Garza , David Vega-Morales , Jorge A. Esquivel-Valerio , Axel A. De León-Pérez , Lorenia De La Cruz-Becerra , Alondra Elizabeth Montoya-Montes , Lourdes Gil-Flores , Dionicio Ángel Galarza-Delgado

Introduction and objective

Rheumatoid arthritis (RA) is often accompanied by musculoskeletal (MS) symptoms, which can hinder the diagnosis of concurrent conditions like rotator cuff tendinopathy (RCT), the most common cause of shoulder pain. Undiagnosed RCT in patients with RA may be associated with higher disease activity scores. This study aimed to assess the difference in these scores between RA patients with and without RCT, considering ultrasound pathological findings.

Methods

We conducted a cross-sectional, observational, comparative study in patients with shoulder pain who met the 2010 ACR-EULAR classification criteria for RA between January 2022 and January 2023. The measurements of Disease Activity Score based on 28 joints using C-Reactive Protein (DAS28-CRP), Erythrocyte Sedimentation Rate (DAS28-ESR), and the Clinical Disease Activity Index (CDAI) were used to evaluate RA activity, while functional capacity was assessed using the Health Assessment Questionnaire Disability Index (HAQ-DI). The Disabilities of the Arm, Shoulder, and Hand questionnaire (DASHe) and shoulder ultrasound examination was performed to detect the presence or absence of RCT.

Results

Patients with RCT had greater mean scores on DAS28-CRP (5.23, 1.28 vs. 3.08, p < 0.001), and DAS 28-ESR (5.43, SD = 1.28 vs. 3.66, p < 0.001). VAS median scores were higher in the RCT group (70.00 vs. 2.00, p < 0.001). By ultrasound 12 patients (21%) had acromioclavicular synovitis. Glenohumeral and acromioclavicular arthrosis was found in both groups. No patients had arthritis in the glenohumeral joint.

Conclusion

RA patients with RCT have higher composite index and disease activity scores than those without RCT. An intentional RCT screening should be recommended for those with shoulder pain and elevated disease activity.

简介和目的类风湿性关节炎（RA）通常伴有肌肉骨骼（MS）症状，这可能会阻碍并发疾病的诊断，如肩袖肌腱病变（RCT），这是最常见的肩部疼痛原因。RA患者中未确诊的RCT可能与较高的疾病活动度评分相关。本研究旨在考虑超声病理结果，评估有和没有RCT的RA患者之间这些评分的差异。方法：我们对2022年1月至2023年1月期间符合2010年ACR-EULAR分类标准的肩痛患者进行了一项横断面、观察性、比较研究。采用c -反应蛋白（DAS28-CRP）、红细胞沉降率（DAS28-ESR）和临床疾病活动性指数（CDAI）对28个关节进行疾病活动性评分，评估RA活动性，采用健康评估问卷残疾指数（HAQ-DI）评估功能能力。通过手臂、肩膀和手的残疾问卷（DASHe）和肩部超声检查来检测是否存在RCT。结果RCT组患者在DAS28-CRP（5.23分，1.28比3.08分，p < 0.001）和DAS 28-ESR（5.43分，SD = 1.28比3.66,p < 0.001）上的平均得分更高。RCT组VAS中位评分较高（70.00 vs. 2.00, p < 0.001）。超声检查显示肩锁滑膜炎12例（21%）。两组患者均有肩关节和肩锁关节病变。没有患者有肩关节关节炎。结论RCT组ra患者的综合指数和疾病活动性评分均高于无RCT组。对于肩部疼痛和疾病活动度升高的患者，建议进行随机对照试验筛查。

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引用次数: 0

Factores asociados a la calidad de vida relacionada con la salud en pacientes con vasculitis asociada a anticuerpos anticitoplasma de neutrófilos: datos de la Almenara Vasculitis Cohort 中性粒细胞抗细胞质抗体引起的血管炎患者与健康相关的生活质量因素：来自Almenara血管炎队列的数据

IF 1.3 Q4 RHEUMATOLOGY

Reumatologia Clinica

Pub Date : 2025-08-01 DOI: 10.1016/j.reuma.2025.501942

Allison Milagros Figueroa-Sánchez , Leonor Stefani León-Yaurimucha , Manuel F. Ugarte-Gil , Victor R. Pimentel-Quiroz

Objective

To determine the factors associated with health-related quality of life (HRQoL) in adult patients with ANCA-associated vasculitis.

Methodology

An observational, analytical, retrospective study was conducted using a convenience sampling technique. Data were obtained from the Almenara Vasculitis Cohort during the period from December 2022 to December 2023. Sociodemographic and disease-related features were obtained using a data collection form. Disease activity, damage accrual, and HRQoL were assessed using the BVASv3, VDI, and SF-36 questionnaires, respectively. Cross-sectional univariable and multivariable linear regression models were performed. Multivariate models were generated using a backward selection procedure with an alpha to stay in the model of 0.05.

Results

Fifty-five patients were evaluated; 41 (74.6%) of them were female. Their mean age and disease duration were 58.7 (13.5) and 5.8 (5.2) years, respectively. In the multivariate analysis, low socioeconomic status, older age, and higher erythrocyte sedimentation rate were associated with worse HRQoL. Conversely, male sex, have a diagnosis of eosinophilic granulomatosis with polyangiitis, have an employment, and the use of immunosuppressive drugs other than cyclophosphamide or rituximab were associated with better HRQoL.

Conclusions

In our study, male sex, have an employment, the eosinophilic granulomatosis with polyangiitis subtype, and treatment with immunosuppressive drugs other than rituximab and cyclophosphamide were associated with better HRQoL. Meanwhile, older age, low socioeconomic status, and high erythrocyte sedimentation rate levels were associated with worse HRQoL.

目的探讨成人anca相关性血管炎患者健康相关生活质量（HRQoL）的相关因素。方法采用方便抽样法进行观察性、分析性、回顾性研究。数据来自2022年12月至2023年12月期间的Almenara血管炎队列。使用数据收集表获得社会人口学和疾病相关特征。分别使用BVASv3、VDI和SF-36问卷评估疾病活动性、损害累积和HRQoL。采用截面单变量和多变量线性回归模型。使用反向选择程序生成多变量模型，alpha保持在0.05的模型中。结果共评估55例患者；其中女性41例（74.6%）。平均年龄58.7（13.5）岁，病程5.8（5.2）岁。在多变量分析中，低社会经济地位、年龄较大和较高的红细胞沉降率与HRQoL较差相关。相反，男性，诊断为嗜酸性肉芽肿病合并多血管炎，有工作，使用除环磷酰胺或利妥昔单抗外的免疫抑制药物与较好的HRQoL相关。结论在我们的研究中，男性、有工作、嗜酸性肉芽肿伴多血管炎亚型、使用非利妥昔单抗和环磷酰胺的免疫抑制药物治疗可获得较好的HRQoL。同时，年龄较大、社会经济地位低、红细胞沉降率高与HRQoL较差相关。

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引用次数: 0

Algas aclorofílicas y bursitis crónica: una asociación excepcional 嗜氯藻类与慢性滑囊炎：独特的关联

IF 1.3 Q4 RHEUMATOLOGY

Reumatologia Clinica

Pub Date : 2025-08-01 DOI: 10.1016/j.reuma.2025.501920

Pablo González del Pozo, Paula Álvarez Peñalba, Stefanie Burger, Norma Alejandra Callejas Pineda, Rubén Queiro Silva, Sara Alonso Castro

We describe a case about a 79-year-old woman with rheumatoid arthritis with chronic left olecranon bursitis refractory to conventional therapy. Following appropriate diagnostic workup, Prototheca spp. alga was identified as the causative agent. The exceptional nature of the case is emphasized.

我们描述一个病例约79岁的妇女类风湿关节炎慢性左鹰嘴滑囊炎难治性常规治疗。经过适当的诊断检查，原鞘藻类被确定为病原体。强调了该案件的特殊性质。

引用次数: 0

Anti-MDA5 antibody dermatomyositis: PET findings of early interstitial lung disease 抗mda5抗体皮肌炎：早期间质性肺病的PET表现

IF 1.3 Q4 RHEUMATOLOGY

Reumatologia Clinica

Pub Date : 2025-08-01 DOI: 10.1016/j.reuma.2025.501919

Wan-Hao Tsai , Chiehyu Shen

引用次数: 0

Cognitive dysfunction in systemic lupus erythematosus: Insights from a two-year longitudinal study in a Brazilian cohort 系统性红斑狼疮的认知功能障碍：来自巴西一项为期两年的纵向研究的见解

IF 1.3 Q4 RHEUMATOLOGY

Reumatologia Clinica

Pub Date : 2025-08-01 DOI: 10.1016/j.reuma.2025.501941

Eduarda Scoto Dias , José Henrique Tercziany Vanzin , Eduardo Augusto Borba , Mahara Freitas dos Santos , Thiago Alberto F.G. dos Santos , Thelma Skare , Renato Nisihara

Objectives

The objective of this study was to examine cognitive dysfunction in a Brazilian sample of SLE patients for two years.

Methods

A sample of 50 individuals with SLE was assessed at baseline for epidemiological and treatment data, disease activity by SLEDAI 2K (SLE disease activity 2000), cumulative damage by SLICC/ACR DI (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index), depression by CES-D (Center for Epidemiological Studies-Depression) and cognitive function through MoCA (Montreal Cognitive Assessment). The same assessment was repeated after two years.

Results

The prevalence of cognitive impairment at baseline was 68%. The baseline cognitive assessment showed impairment in visuospatial/executive function (p = 0.002), naming (p = 0.04), attention (p < 0.0001) and delayed recall (p < 0.0001). The median MoCA results did not change in two years (p = 0.45), but 6 individuals (12%) that had normal cognitive function at baseline developed mild cognitive impairment and two (4%) that had mild cognitive impairment, improved. When considering the MoCA domains the only significant difference was improvement in abstraction (p = 0.001). No correlations between MoCA delta (difference between second and first value) and delta SLEDAI, delta SLICC and delta CES-D were found (all with p > 0.05). Also, no associations were found with used treatment or autoantibodies profile.

Conclusions

Cognitive dysfunction in SLE is dynamic and may require periodic re-assessments. Changes in cognition were not associated with disease activity, depression or cumulative damage in this sample.

本研究的目的是研究巴西SLE患者两年的认知功能障碍。方法50例SLE患者在基线时进行流行病学和治疗资料评估，疾病活动性通过SLEDAI 2K （SLE疾病活动性2000）评估，累积损害通过SLICC/ACR DI（系统性狼疮国际合作诊所/美国风湿病学会损伤指数）评估，抑郁通过CES-D（抑郁症流行病学研究中心）评估，认知功能通过MoCA（蒙特利尔认知评估）评估。两年后又进行了同样的评估。结果基线时认知障碍患病率为68%。基线认知评估显示视觉空间/执行功能（p = 0.002）、命名（p = 0.04）、注意力(p <；0.0001)和延迟召回(p <；0.0001)。MoCA的中位数结果在两年内没有变化（p = 0.45），但6名（12%）基线认知功能正常的患者出现轻度认知障碍，2名（4%）轻度认知障碍患者出现改善。当考虑MoCA域时，唯一显著的差异是抽象的改善（p = 0.001）。MoCA δ（二值与一值之差）与δ SLEDAI、δ SLICC和δ CES-D之间无相关性(均为p >；0.05)。此外，未发现与使用的治疗方法或自身抗体谱相关。结论SLE患者的认知功能障碍是动态的，可能需要定期重新评估。在这个样本中，认知的改变与疾病活动、抑郁或累积损伤无关。

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引用次数: 0

Transcultural adaptation and validation of the Transition Readiness Assessment Questionnaire (TRAQ) into Mexican Spanish 墨西哥西班牙语的跨文化适应和过渡准备评估问卷（TRAQ）的验证

IF 1.3 Q4 RHEUMATOLOGY

Reumatologia Clinica

Pub Date : 2025-08-01 DOI: 10.1016/j.reuma.2025.501917

Sara G. Rosiles-De la Garza , Ingris Pelaez-Ballestas , Fernando García-Rodríguez , Ana V. Villarreal-Treviño , Elisa L. Dávila-Sotelo , Leonor G. Hinojosa-Amaya , Jesús E. Treviño-Alvarado , Óscar González-Llano , Laura Villarreal-Matínez , Yajaira V. Jiménez-Antolínez , Julia E. Colunga-Pedraza , Nadina E. Rubio-Pérez

Purpose

The aim of the present study was to translate and perform a transcultural adaptation and validation of the TRAQ into Mexican Spanish.

Methodology

Transversal and observational study. First, the TRAQ was translated and transculturally adapted into Mexican Spanish. Then, the adapted TRAQ was administered to patients of any gender between 12 and 21 years of age and a chronic disease diagnosis. Correlation matrices for the questionnaire were obtained and their reliability was measured through homogeneity and internal consistency.

Results

The TRAQ was successfully translated and transculturally adapted into Mexican Spanish. After this, a pilot test of the questionnaire was performed with 40 patients. Lastly, the final validation phase was undertaken with 141 patients, with a median age of 13.9 years. The internal consistency analysis revealed a Cronbach's alpha global evaluation of 0.76, while the results organized through domains varied from 0.47 to 0.60.

Conclusions

The translated and transculturally adapted TRAQ revealed a good internal consistency, similar to other transcultural adoptions previously described in the medical literature. This process will allow us to ensure cultural and linguistic relevance for Mexican patients, particularly given the unique socio-cultural context of the Mexican population.

目的：本研究的目的是将TRAQ翻译成墨西哥西班牙语，并对其进行跨文化改编和验证。方法：横向观察性研究。首先，TRAQ被翻译并跨文化改编成墨西哥西班牙语。然后，对年龄在12至21岁之间的任何性别和慢性疾病诊断的患者进行适应性TRAQ。获得问卷的相关矩阵，并通过同质性和内部一致性测量问卷的信度。结果TRAQ被成功翻译成墨西哥西班牙语，并进行了跨文化改编。在此之后，对40名患者进行了问卷的初步测试。最后，141例患者进行了最后的验证阶段，中位年龄为13.9岁。内部一致性分析显示，Cronbach's alpha整体评价为0.76，而通过域组织的结果从0.47到0.60不等。结论TRAQ的翻译和跨文化改编显示出良好的内部一致性，类似于先前在医学文献中描述的其他跨文化采用。这一过程将使我们能够确保墨西哥患者的文化和语言相关性，特别是考虑到墨西哥人口独特的社会文化背景。

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引用次数: 0

Effectiveness of a checklist for the control of the disease activity in patients with axial spondyloarthritis 检查表对控制轴性脊柱炎患者疾病活动的有效性

IF 1.3 Q4 RHEUMATOLOGY

Reumatologia Clinica

Pub Date : 2025-08-01 DOI: 10.1016/j.reuma.2025.501918

Raquel Almodóvar , Elia Pérez-Fernández , Marta Valero , Virginia Villaverde , Laura González , Beatriz Joven Ibáñez , Eva Tomero Muriel , Alejandro Prada Ojeda , M.a Teresa Navio , Laura Cebrián Méndez , Leticia Lojo , Ramón Mazzucchelli , Pedro Zarco Montejo

Objectives

To assess the effectiveness of a checklist for disease activity and comorbidity control in patients with axial spondyloarthritis (axSpA).

Method

A quasi-experimental retrospective multicentre pre-post intervention study was carried out in Spain between 2016 and 2022. Improvement in disease activity and comorbidity status was determined before and after the implementation of a checklist control in patients diagnosed with axSpA. Disease activity was determined by means of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and C-reactive protein (CRP) levels. Comorbidity status was determined by analysing several risk factors (blood pressure, body weight, blood test, etc.). An analysis of variance with mixed models between pre and post collected values was performed. The change in therapeutic level and disease status (low activity, remission) was determined by means of the Mc-Nemar asymmetry test.

Results

A total of 108 patients with axSpA were included in the study. After checklist implementation, a statistically significant reduction in BASDAI of 0.44 (95%CI: 0.06–0.82, p = 0.023) and a significant reduction of 3.82 mg/L (p = 0.001) in CRP was observed. Besides, an increase in uricemia of 0.24 mg/dl was found (95%CI: 1.49–6.14, p = 0.001), while no other statistically significant change in comorbidities was observed.

Conclusions

The implementation of a checklist in daily clinical practice leads to a significant improvement in the control of disease activity in patients with axSpA.

目的评估轴性脊柱炎（axSpA）患者疾病活动性和合并症控制检查表的有效性。方法2016 - 2022年在西班牙开展准实验回顾性多中心干预前后研究。在诊断为axSpA的患者实施检查表对照前后，确定疾病活动性和合并症状态的改善。采用巴斯强直性脊柱炎疾病活动性指数（BASDAI）和c反应蛋白（CRP）水平测定疾病活动性。通过分析几个危险因素（血压、体重、血液检查等）确定合并症状况。使用混合模型对采集前后的数据进行方差分析。通过Mc-Nemar不对称检验确定治疗水平和疾病状态（低活动，缓解）的变化。结果共纳入108例axSpA患者。实施检查表后，BASDAI显著降低0.44 (95%CI: 0.06-0.82, p = 0.023)， CRP显著降低3.82 mg/L （p = 0.001）。此外，尿毒症增加0.24 mg/dl (95%CI: 1.49 ~ 6.14, p = 0.001)，而其他合并症无统计学意义的变化。结论在日常临床实践中实施检查表可显著改善axSpA患者疾病活动的控制。

{"title":"Effectiveness of a checklist for the control of the disease activity in patients with axial spondyloarthritis","authors":"Raquel Almodóvar , Elia Pérez-Fernández , Marta Valero , Virginia Villaverde , Laura González , Beatriz Joven Ibáñez , Eva Tomero Muriel , Alejandro Prada Ojeda , M.a Teresa Navio , Laura Cebrián Méndez , Leticia Lojo , Ramón Mazzucchelli , Pedro Zarco Montejo","doi":"10.1016/j.reuma.2025.501918","DOIUrl":"10.1016/j.reuma.2025.501918","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the effectiveness of a checklist for disease activity and comorbidity control in patients with axial spondyloarthritis (axSpA).</div></div><div><h3>Method</h3><div>A quasi-experimental retrospective multicentre pre-post intervention study was carried out in Spain between 2016 and 2022. Improvement in disease activity and comorbidity status was determined before and after the implementation of a checklist control in patients diagnosed with axSpA. Disease activity was determined by means of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and C-reactive protein (CRP) levels. Comorbidity status was determined by analysing several risk factors (blood pressure, body weight, blood test, etc.). An analysis of variance with mixed models between pre and post collected values was performed. The change in therapeutic level and disease status (low activity, remission) was determined by means of the Mc-Nemar asymmetry test.</div></div><div><h3>Results</h3><div><span><span>A total of 108 patients with axSpA were included in the study. After checklist implementation, a statistically significant reduction in </span>BASDAI of 0.44 (95%CI: 0.06–0.82, </span><em>p</em>   =0.001) in CRP was observed. Besides, an increase in uricemia of 0.24mg/dl was found (95%CI: 1.49–6.14, <em>p</em>  <!-->0.001), while no other statistically significant change in comorbidities was observed.</div></div><div><h3>Conclusions</h3><div>The implementation of a checklist in daily clinical practice leads to a significant improvement in the control of disease activity in patients with axSpA.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 7","pages":"Article 501918"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0