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Predictores de remisión clínica en pacientes con artritis reumatoide temprana : revisión sistemática

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  • المؤلفون: Jaramillo Arroyave, Daniel; Castro Campos, Natalia
  • المصدر:
    instname:Universidad del Rosario; reponame:Repositorio Institucional EdocUR; Scott DL, Wolfe F, Huizinga TWJ. Rheumatoid arthritis. Lancet [Internet]. 2010 Sep 25 [cited 2014 Jul 16];376(9746):1094–108. Available from:; Gremese E, Salaffi F, Bosello SL, Ciapetti A, Bobbio-Pallavicini F, Caporali R, et al. Very early rheumatoid arthritis as a predictor of remission: a multicentre real life prospective study. Ann Rheum Dis [Internet]. 2013 Jun;72(6):858–62. Available from:; Soderlin MK, Petersson IF, Bergman S, Svensson B. Smoking at onset of rheumatoid arthritis (RA) and its effect on disease activity and functional status: experiences from BARFOT, a long-term observational study on early RA. Scand J Rheumatol. 2011;40(4):249–55.; Balsa A. [Defining remission in Rheumatoid Arthritis. New ACR/EULAR criteria]. Reumatol Clin [Internet]. 2011 Mar 1 [cited 2016 May 20];6S3(Notice: Undefined index: numeroInicial in /var/; Pincus T, Sokka T. Quantitative measures for assessing rheumatoid arthritis in clinical trials and clinical care. Best Pract Res Clin Rheumatol. 2003 Oct;17(5):753–81.; Bird P, Nicholls D, Barrett R, de Jager J, Griffiths H, Roberts L, et al. Longitudinal study of clinical prognostic factors in patients with early rheumatoid arthritis: the PREDICT study. Int J Rheum Dis [Internet]. 2017 Apr;20(4):460–8. Available from:; Euesden J, Matcham F, Hotopf M, Steer S, Cope AP, Lewis CM, et al. The Relationship Between Mental Health, Disease Severity, and Genetic Risk for Depression in Early Rheumatoid Arthritis. Psychosom Med. 2017;79(6):638–45; Curtis JR, McVie T, Mikuls TR, Reynolds RJ, Navarro-Millan I, O’Dell J, et al. Clinical response within 12 weeks as a predictor of future low disease activity in patients with early RA: results from the TEAR Trial. J Rheumatol. 2013 May;40(5):572–8; MH M, F I, D W, A H, EH C, PD K, et al. Remission in early rheumatoid arthritis: predicting treatment response. In: Journal of rheumatology [Internet]. Canada; 2012. p. 470–5. Available from:; T. R, J. A, P. H, T. Y-K, P. E, L. P, et al. Three out of every four patients with DMARD-naive early rheumatoid arthritis meet DAS28 remission at 12 months in Finland. Ann Rheum Dis [Internet]. 2016;75:697–8. Available from:; M.C. G, I. B, F. C, S. F, C. I, G. C, et al. Hypovitaminosis D predicts more aggressive evolution and lower response to treatment in early rheumatoid arthritis after 12 months of follow-up. Ann Rheum Dis [Internet]. 2013;72. Available from:; Arnold MB, Bykerk VP, Boire G, Haraoui BP, Hitchon C, Thorne C, et al. Are there differences between young- and older-onset early inflammatory arthritis and do these impact outcomes? An analysis from the CATCH cohort. Rheumatology (Oxford). 2014 Jun;53(6):1075–86.; Kuriya B, Xiong J, Boire G, Haraoui B, Hitchon C, Pope J, et al. Earlier time to remission predicts sustained clinical remission in early rheumatoid arthritis - Results from the Canadian Early Arthritis Cohort (CATCH). J Rheumatol. 2014;41(11):2161–6.; Schulman E, Bartlett SJ, Schieir O, Andersen KM, Boire G, Pope JE, et al. Overweight and Obesity Reduce the Likelihood of Achieving Sustained Remission in Early Rheumatoid Arthritis: Results from the Canadian Early Arthritis Cohort Study. Arthritis Care Res (Hoboken) [Internet]. :n/a-n/a. Available from:; Sandberg MEC, Bengtsson C, Kallberg H, Wesley A, Klareskog L, Alfredsson L, et al. Overweight decreases the chance of achieving good response and low disease activity in early rheumatoid arthritis. Ann Rheum Dis. 2014 Nov;73(11):2029–33.; Quintana-Duque MA, Caminos JE, Varela-Narino A, Calvo-Paramo E, Yunis JJ, Iglesias-Gamarra A. The Role of 25-Hydroxyvitamin D as a Predictor of Clinical and Radiological Outcomes in Early Onset Rheumatoid Arthritis. J Clin Rheumatol. 2017 Jan;23(1):33–9; Quintana-Duque MA, Rondon-Herrera F, Mantilla RD, Calvo-Paramo E, Yunis JJ, Varela-Narino A, et al. Predictors of remission, erosive disease and radiographic progression in a Colombian cohort of early onset rheumatoid arthritis: a 3-year follow-up study. Clin Rheumatol. 2016 Jun;35(6):1463–73; Steunebrink LMM, Versteeg GA, Vonkeman HE, Ten Klooster PM, Kuper HH, Zijlstra TR, et al. Initial combination therapy versus step-up therapy in treatment to the target of remission in daily clinical practice in early rheumatoid arthritis patients: results from the DREAM registry. Arthritis Res Ther. 2016 Mar;18:60.; Kuijper TM, Luime JJ, de Jong PHP, Gerards AH, van Zeben D, Tchetverikov I, et al. Tapering conventional synthetic DMARDs in patients with early arthritis in sustained remission: 2-year follow-up of the tREACH trial. Ann Rheum Dis. 2016 Dec;75(12):2119–23.; Contreras-Yanez I, Pascual-Ramos V. Window of opportunity to achieve major outcomes in early rheumatoid arthritis patients: how persistence with therapy matters. Arthritis Res Ther. 2015 Jul;17:177
  • نوع التسجيلة:
    Electronic Resource
  • الدخول الالكتروني :
    http://repository.urosario.edu.co/handle/10336/18501
  • معلومة اضافية
    • Publisher Information:
      Universidad del Rosario Maestría en Epidemiología Facultad de medicina 2018-05-25 2018-09-24T19:11:58Z info:eu-repo/date/embargoEnd/2019-09-24
    • نبذة مختصرة :
      Introducción: La remisión clínica es el principal objetivo en los pacientes con artritis reumatoide (RA). Su diagnóstico temprano, la optimización del tratamiento oportuno así como el conocimiento de las características iniciales pronosticas representan un paso crucial y determinante para lograr la remisión clínica, controlar la progresión de la enfermedad así prevenir el daño articular y la discapacidad funcional. El objetivo de esta revisión sistemática fue reconocer y analizar posibles predictores de remisión clínica en pacientes con AR temprana que cumplan los criterios de ACR/EULAR 2010. Métodos: Se llevó a cabo una revisión sistemática de la literatura, siguiendo las guías PRISMA. Se incluyeron estudios pronósticos en las siguientes bases de datos: PubMed, Scopus, Embase, Cochrane y Web of Science, hasta noviembre de 2017. La evaluación de calidad de evidencia se realizó a través de la herramienta Quality In Prognosis Studies (QUIPS). Resultados: Se evaluaron 19 estudios, que incluyeron 11.633 individuos en total. Todos los estudios cumplieron con los criterios de inclusión. El desenlace fue la remisión clínica, evaluada mediante el índice de actividad clínica (DAS-28 ≤ 2.6). Las variables encontradas como predictores de remisión en AR temprana, según su categoría fueron: demográficas: sexo masculino, menor edad, abstinencia de alcohol; marcadores genéticos: expresión intracelular de miR125b; clínicas: IMC <25; DAS-28 inicial ≤ 2.6, tiempo en lograr la primera remisión clínica, <5 articulaciones dolorosas, duración de la enfermedad; laboratorio y radiografía: valor de ESG, FR, anti-CCP y ANA negativos, vitamina D ≤ 20 mg/ml; índice de Sharp–van der Heijde; Clinimetría: puntaje reducido de salud mental, HAQ inicial bajo, evaluación global médica a los tres meses; respuesta al tratamiento: uso temprano de metotrexate subcutáneo, uso de corticoide a bajas dosis, inicio de triple terapia con FARMEs; inicio de FARMES dentro de los 3 meses, uso de FARMEs en combinac
      Background/purpose: Clinical remission is the target in patients with rheumatoid arthritis (RA). Early diagnosis, optimal treatment, and recognize of baseline characteristics represents a crucial step for controlling the progression of the disease and the best opportunity to achieve full disease remission and prevention of joint injury and disability as well. The aim of this systematic review was to recognize and analyze predictors of remission that allow efficient stratification strategies and treatment options for patients with early RA fulfilling the 2010 ACR/EULAR classification criteria. Methods: A systematic literature review was conducted following the PRISMA guidelines. The search was performed in PubMed, Scopus, Embase, Cochrane, Science Citation Index (Web of Science) databases (up to November 2017) for prognostic studies in adults with early RA. The studies’ quality was examined using Quality in Prognosis Studies (QUIPS) tool. Results: A total of nineteen studies which had a total of 11.633 participants. All citations, fulfilled the inclusion criteria and were included in this study. The mayor outcome was clinical remission, defined using the disease activity score in 28 joints (DAS28 ≤ 2.6). The following variables were found to be the independent predictors of early RA remission: demographics: male sex, young age, abstaining from alcohol; genetics markers: high baseline miR-125b expression; Baseline clinical assessment: BMI <25; baseline remission; longer time to first remission; < 5 TJC-28; VERA; Laboratory measurements and radiography assessment: ESR, RF, ACPA, and ANA negativity 25-HydroxyvitaminD ≤ 20 mg/ml; Sharp–van der Heijde method; functional status: baseline MH; lower HAQ at baseline, PGA at 3 months response to treatments: early use of subcutaneous methotrexate, less use of steroids, initial treatment with triple therapy with DMARDs; DMARDs in combination within the 3rd month, fewer increases in medication after the initial visit and FIN-RACo
    • الموضوع:
    • Availability:
      Open access content. Open access content
      info:eu-repo/semantics/embargoedAccess
    • Note:
      application/pdf
      Spanish
    • Other Numbers:
      COUDR oai:repository.urosario.edu.co:10336/18501
      1099296494
    • Contributing Source:
      UNIVERSIDAD DEL ROSARIO
      From OAIster®, provided by the OCLC Cooperative.
    • الرقم المعرف:
      edsoai.on1099296494
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