Clinical rheumatology
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Clinical rheumatology · Feb 2017
Multicenter Study Observational StudyTreatment with ustekinumab in a Spanish cohort of patients with psoriasis and psoriatic arthritis in daily clinical practice.
After approval of the use of ustekinumab for treatment of moderate to severe psoriasis, patients with psoriatic arthritis have treated with this drug in daily clinical practice. The aims of this study were to describe baseline characteristics and evolution of a cohort of patients with psoriasis and psoriatic arthritis treated with ustekinumab and to compare differences between patients who discontinued treatment and those who maintained. A retrospective multicenter observational study including patients who had received ustekinumab for a minimum of 3 months from 2009 to 2015 was performed. ⋯ The main indication was dermatological (72.4% of cases), and treatment with ustekinumab was maintained in most patients (62.1% of cases) with low discontinuation by side effects and rheumatological lack of efficacy. Discontinuation of ustekinumab was correlated with more number of obese patients, less presence of plaque psoriasis and more number of previous biological therapies. Ustekinumab demonstrated efficacy and safety in the management of patients with psoriasis and psoriatic arthritis in daily clinical practice in our cohort of patients.
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Clinical rheumatology · Feb 2017
The additional benefit of ultrasonography to 2010 ACR/EULAR classification criteria when diagnosing rheumatoid arthritis in the absence of anti-cyclic citrullinated peptide antibodies.
The aim of this study was to assess the benefit of ultrasonography (US) contributing to 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria in diagnosing rheumatoid arthritis (RA), when anti-citrullinated protein (CCP) antibody and radiographic erosions are absent. Ninety-four patients suffering from arthritis of at least one joint in hands, symptom duration of less than 2 years, normal radiographs at baseline, and negative anti-CCP had 22 joint US assessments and were followed prospectively for at least 12 months. Sensitivity and specificity for final RA diagnosis based on 1987 RA criteria were determined for ultrasound variables. ⋯ The area under curve (AUC) values of GS and power Doppler (PD) were comparable, higher than bone erosion. However, regression analysis demonstrated that only PD involvement of joints, especially wrists, provided independently predictive data, with improved AUC values from 0.738 to 0.872 combined with 2010 ACR/EULAR classification criteria. PD scanning of hand joints, especially wrists, may provide independently assistance to 2010 ACR/EULAR criteria in the early diagnosis of RA in those patients who are negative for anti-CCP antibody.