Examinando por Autor "Pimentel-Quiroz, V.R."
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Ítem Acceso Abierto Abatacept for the treatment of systemic lupus erythematosus(Taylor and Francis Ltd, 2016) Pimentel-Quiroz, V.R.; Ugarte-Gil, M.F.; Alarcón, G.S.Introduction: Due to improvements in our understanding of the pathogenesis of systemic lupus erythematosus (SLE), several target drugs have been and are being developed. One of the possible targets in SLE is co-stimulation between antigen-presenting cells and T cells. Abatacept is a co-stimulation moderator approved for the treatment of several autoimmune diseases. There is an unmet need for drugs with a better efficacy and safety profile when treating patients with SLE.Areas covered: In this review, the authors discuss the mechanism of action of abatacept including its role in the immune system and glomeruli, and relevant information about its clinical efficacy and safety. Possible explanations for the failure of previous randomized clinical trials are also discussed.Expert opinion: Abatacept has demonstrated efficacy in other autoimmune diseases, but in SLE, randomized clinical trials have failed to achieve their primary outcome. Despite these disappointing results and based on its mechanism of action, abatacept seems to have a role in lupus nephritis and arthritis. This should be corroborated with new trials which hopefully will overcome the design pitfalls of the ones conducted to date. © 2016 Informa UK Limited, trading as Taylor & Francis Group.Ítem Acceso Abierto Coronary and aortic involvement as initial manifestations of possible giant cell arteritis in a patient without cardiovascular comorbidities(2016) Pimentel-Quiroz, V.R.; Ugarte-Gil, M.; Sumire-Umeres, J.; Pastor-Asurza, C.[No abstract available]Ítem Acceso Abierto Defining quality of rheumatologic care: Peru(Lippincott Williams and Wilkins, 2017) Reátegui-Sokolova, C.; Pimentel-Quiroz, V.R.; Elera-Fitzcarrald, C.; Ugarte-Gil, M.F.; Calvo, A.; Alarcón, G.S.[No abstract available]Ítem Acceso Abierto Factors associated with disease expression patterns in systemic lupus erythematosus patients: results from LUMINA (LXXVII), a multiethnic US cohort(SAGE Publications Ltd, 2017) Ugarte-Gil, M.F.; Pimentel-Quiroz, V.R.; Vilá, L.M.; Reveille, J.D.; McGwin, G.; Alarcón, G.S.Objective The objective of this study was to determine the association of disease expression patterns with demographic and clinical characteristics in SLE. Methods Patients from a multi-ethnic SLE cohort were included. Disease expression patterns were defined as acute SLE and insidious SLE; this group was divided into those who accrued three ACR criteria and then accrued the fourth (insidious pattern A) and those who have one or two and then accrued four criteria (insidious pattern B). Disease activity was ascertained with the SLAM-R and disease damage with SLICC/ACR damage index. Variables were compared using analysis of variance for numeric variables and X2 for categorical variables. Multivariable analyses adjusting for possible confounders were performed. Results Six hundred and forty patients were included; the most frequent pattern was the insidious pattern B, with 415 (64.8%) patients, followed by the acute SLE group with 115 (18.0%) and the insidious pattern A with 110 (17.2%) patients. Patients from the insidious pattern A were older at diagnosis (pattern A: 39.8 vs pattern B: 36.7 vs acute: 32.4 years; p < 0.0001), more educated (13.6 vs 13.1 vs 12.1; p = 0.0008) and with a less active disease at baseline (8.8 vs 9.2 vs 10.7; p = 0.0227). Caucasian and Hispanic (Puerto Rico) ethnicities were overrepresented in this group (40.0% vs 27.7% vs 19.1% and 18.2% vs 17.1% vs 9.6%; p = 0.0003). Conclusions More insidious onset is associated with older age, Caucasian ethnicity, higher level of education, and lower disease activity than those with acute onset. However, after multivariable analyses, disease activity was not associated with any disease expression pattern. © SAGE Publications.Ítem Acceso 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.