Examinando por Autor "Iglesias-Gamarra, A."

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  • Miniatura
    ÍtemAcceso Abierto
    Factors predictive of high disease activity early in the course of SLE in patients from a Latin-American cohort
    (W.B. Saunders, 2017) Pimentel-Quiroz, V.R.; Ugarte-Gil, M.F.; Pons-Estel, G.J.; Soriano, E.R.; Saurit V.; Sato, E.I.; Lavras Costallat, L.T.; Molina J.F.; Iglesias-Gamarra, A.; Reyes-Llerena, G.; Neira O.J.; Barile L.A.; Silveira, L.H.; Segami, M.I.; Chacón-Díaz, R.; Wojdyla, D.; Alarcón, G.S.; Pons-Estel, B.A.
    Aims: To determine the factors predictive of disease activity early in the course of SLE (baseline visit). Methods: Patients from GLADEL, a multi-national, multi-ethnic, Latin-American lupus cohort were included. Disease activity was evaluated at baseline with the SLEDAI score. Demographic characteristics (age at diagnosis, gender, ethnicity, marital status, educational level, medical coverage and socioeconomic status) were assessed. Disease duration was defined as the time between the fourth ACR criterion and baseline. Time to criteria accrual was defined as the interval between the first and fourth ACR criterion. Use of glucocorticoids was recorded as the highest dose received before the baseline visit. Antimalarials and immunosuppressive drugs were recorded as use or not use. Univariable and multivariable analysis were performed. Model selection was based on backward elimination. Results: One thousand two hundred sixty-eight patients were included; 1136 (89.6%) of them were female. Mean age at diagnosis was 29.2 (SD: 12.3) years. Five hundred sixty-five (44.6%) were Mestizo, 539 (42.5%) were Caucasians and 164 (12.9%) were African-Latin-Americans. The mean SLEDAI at baseline was 10.9 (SD: 8.4). Longer time between first and fourth ACR criterion, medical coverage, a dose of prednisone between 15 and 60. mg/d, and the use of antimalarials were factors protective of disease activity, while Mestizo and African-Latin-American ethnicities were predictive factors. Conclusions: Mestizo and African-Latin-American ethnicities were predictive whereas antimalarial use, medical coverage, and longer time to criteria accrual were protective of higher disease activity early in the disease course. © 2017 Elsevier Inc.
  • Miniatura
    ÍtemAcceso Abierto
    Features associated with hematologic abnormalities and their impact in patients with systemic lupus erythematosus: data from a multiethnic Latin American cohort
    (W.B. Saunders, 2016) González-Naranjo, L.A.; Betancur, O.M.; Alarcón, G.S.; Ugarte-Gil, M.F.; Jaramillo-Arroyave, D.; Wojdyla, D.; Pons-Estel, G.J.; Rondón-Herrera, F.; Vásquez-Duque, G.M.; Quintana-López, G.; Da Silva, N.A.; Tavares Brenol, J.C.; Reyes-Llerena, G.; Pascual-Ramos, V.; Amigo, M.C.; Massardo, L.; Alfaro-Lozano, J.; Segami, M.I.; Esteva-Spinetti, M.H.; Iglesias-Gamarra, A.; Pons-Estel, B.A.
    Objective: To examine hematological manifestations' correlates and their impact on damage accrual and mortality in SLE patients from the multiethnic, Latin American, GLADEL cohort. Methods: In patients with recent SLE diagnosis (≤2 years), the association between follow-up hematological manifestations (per ACR criteria) and socio-demographic and clinical variables was examined by univariable and multivariable logistic regressions; their impact on damage accrual and mortality was examined by Poisson and Cox proportional-hazards regression analyses, respectively. Results: Of 1437 patients, 948 (66.0%) developed ≥1 hematological manifestation [5.5% hemolytic anemia (AHA), 16.3% thrombocytopenia, and 56.4% lymphopenia] over 4.3 (3.3) follow-up years. Younger age, Mestizo ethnicity, hematologic disorder (at/or before SLE diagnosis), and first damage recorded were associated with hematological manifestations while antimalarials were negatively associated. AHA (at/or before SLE diagnosis), anti-Sm, and anti-RNP antibodies were associated with subsequent AHA occurrence while musculoskeletal involvement was negatively associated. Thrombocytopenia (at/or before SLE diagnosis), AHA, anti-phospholipid antibodies (aPLs), anti-SSA/Ro, anti-SSB/La antibodies, and first damage recorded were associated with later thrombocytopenia occurrence. Lymphopenia (at/or before SLE diagnosis), younger age at diagnosis, Mestizo ethnicity, having medical insurance, and first damage recorded were associated with subsequent lymphopenia occurrence while antimalarials and azathioprine treatment were negatively associated. AHA was associated with damage accrual and mortality after adjusting for variables known to affect these outcomes. Conclusions: Mestizo ethnicity and early hematological manifestations are risk factors for their subsequent occurrence while antimalarials have a protective effect. The associations between AHA and aPLs and thrombocytopenia were corroborated. AHA contributes independently to damage accrual and diminished survival. © 2016 Elsevier Inc..