Publicação
Eficiência do metotrexato na artrite psoriática
| Resumo: | Objective: Nowadays, MTX is the main drug recommended to treat peripheral manifestations of synovitis in PsA; however, strong piece of evidence is starting to emerge raising doubts about its efficiency in PsA. This is a prospective study which aim was to evaluate MTX efficiency in a group of PsA patients attending rheumatology appointments in Hospital Santa Maria until the present time. Methods: From 141 PsA patients having clinical information inserted into the portuguese national database ‘Reuma.pt’, not under treatment with Biologics, and under treatment with MTX while attending regular rheumatology appointments in HSM, 31 patients were selected. The primary endpoint to be analysed was the DAS28 4V. Other outcomes, were the individual components of the DAS28, HAQ, BASDAI, BASFI and PASI. Missing data from past appointments was recovered from patient’s medical records and inserted into ‘Reuma.pt’. Outcome parameters were compared using data from a baseline and a final appointements, each one defined for each patient according to their medical history. The statistical test used in this analysis was the paired samples’ T Test. Results: The outcome tools compared on the selected sample of 31 patients under treatment with MTX for an average time of 39.3 months, showed an improvement on average joint counts, ESR, patient’s global assessments, DAS28 4V, DAS28 4V PCR, DAS28 3V, BASDAI and PASI. This improvement was more pronounced concerning joint counts and DAS28 3V score (p < 0,001), being statiscally significant as well regarding the ESR, medical and patients’ disease global assessment, and DAS28 4V (p < 0,05). PASI and BASDAI improvements did not reach statistical significance; average CRP was similar beetween baseline and final appointments and average HAQ was higher on the final appointment. BASFI and patient global assessents concerning axial disease could not be adressed due to insufficient data. Conclusions: Despite the small sample of this trial, there was evidence supporting improvement of peripheral manifestations of synovitis in PsA with MTX by a significant improvement on DAS28 4V between the baseline and final appointments (p = 0,012). |
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| Autores principais: | Spencer, Ana Sofia Chantre |
| Assunto: | Artrite psoriática Eficiência do metotrexato Avaliação inicial e final |
| Ano: | 2014 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | português |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Objective: Nowadays, MTX is the main drug recommended to treat peripheral manifestations of synovitis in PsA; however, strong piece of evidence is starting to emerge raising doubts about its efficiency in PsA. This is a prospective study which aim was to evaluate MTX efficiency in a group of PsA patients attending rheumatology appointments in Hospital Santa Maria until the present time. Methods: From 141 PsA patients having clinical information inserted into the portuguese national database ‘Reuma.pt’, not under treatment with Biologics, and under treatment with MTX while attending regular rheumatology appointments in HSM, 31 patients were selected. The primary endpoint to be analysed was the DAS28 4V. Other outcomes, were the individual components of the DAS28, HAQ, BASDAI, BASFI and PASI. Missing data from past appointments was recovered from patient’s medical records and inserted into ‘Reuma.pt’. Outcome parameters were compared using data from a baseline and a final appointements, each one defined for each patient according to their medical history. The statistical test used in this analysis was the paired samples’ T Test. Results: The outcome tools compared on the selected sample of 31 patients under treatment with MTX for an average time of 39.3 months, showed an improvement on average joint counts, ESR, patient’s global assessments, DAS28 4V, DAS28 4V PCR, DAS28 3V, BASDAI and PASI. This improvement was more pronounced concerning joint counts and DAS28 3V score (p < 0,001), being statiscally significant as well regarding the ESR, medical and patients’ disease global assessment, and DAS28 4V (p < 0,05). PASI and BASDAI improvements did not reach statistical significance; average CRP was similar beetween baseline and final appointments and average HAQ was higher on the final appointment. BASFI and patient global assessents concerning axial disease could not be adressed due to insufficient data. Conclusions: Despite the small sample of this trial, there was evidence supporting improvement of peripheral manifestations of synovitis in PsA with MTX by a significant improvement on DAS28 4V between the baseline and final appointments (p = 0,012). |
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