Análise do Registro Brasileiro de Monitorização de Terapias Biológicas em Doenças Reumáticas (BIOBADABRASIL) dos pacientes com Artrite Reumatóide, atendidos no Serviço de Reumatologia do Hospital Universitário da UFMS

Abstract

A Artrite Reumatóide é uma doença de etiologia não esclarecida, tendo como característica principal da doença sinoviopatia inflamatória. Caracterizar epidemiológica clinica e laboratorial de pacientes com Artrite Reumatóide, atendidos no Serviço de Reumatologia do Hospital Universitário da UFMS: análise do Registro Brasileiro de Monitorização de Terapias Biológicas em doenças reumáticas (BIOBADABRASIL/SBR). É um estudo retrospectivo, com 62 pacientes de Artrite Reumatóide, sendo 87,1% do sexo feminino e 12,9% do sexo masculino. A prevalência de sexo feminino foi maior em relação ao masculino (6,5:1). A HAS foi a comorbidades mais presente com 50%. As manifestações extra-articulares não tiveram correlação estatística com a presença de auto anticorpo. O FR e o anti CCP, dado alta positividade, se mostraram como excelente marcador laboratorial da AR. A infecção por tuberculose latente foi relativamente baixa (14,3%), na população estudada, em relação a estudos epidemiológicos nocionais sem doença reumática. O infliximab foi a DMCD biológica mais utilizada e a que apresentou maior índice de troca terapêutica por ineficácia. A hepatite medicamentosa foi o único evento adverso relatado pelo uso de DMCD sintética (MTX). As DMCD biológicas tiveram maior numero de eventos adversos (56,5%) comparados com as sintéticas (1,6%), sendo a infecção (29%) a principal causa.

Rheumatoid arthritis is a disease of unknown etiology, having as main characteristic sinoviopatia inflammatory disease. Objective To characterize epidemiological and clinical findings of patients with rheumatoid arthritis treated at the Department of Rheumatology at the University Hospital of UFMS: analysis of the Brazilian Registry Monitoring Biological Therapies in rheumatic diseases (BiobadaBrasil/SBR). It is a retrospective study, 62 patients with rheumatoid arthritis, with 87.1% female and 12.9% male. Comorbidities: 50% had hypertension, 9.7% DM, hypothyroidism 4.8%, 9.7% dyslipidemia, fibromyalgia 14.5 %, 11.3% osteoporosis, osteopenia 9.7%, 3.2 % COPD 1.6% severe depression, and 16.% were smokers. Clinically, 27.4% had peripheral deformities, rheumatoid lung 9.7%, 19.4% rheumatoid nodule, 19.4% Sjögren syndrome 2° and 1.6% vasculitis. Laboratory tests: 83.3% were RF positive and 16.7% negative FR, 75.8% anti-CCP positive, 24.2% anti -CCP negative, 27.7% had positive ANA, ANA was negative 72.3%. The 35 patients who were screened for tuberculosis, 14.3% had PPD reactor. Regarding treatment: 56.5% underwent treatment with biologic DMCD and 43.5% with synthetic DMCD. Of these 57.1% required return between biological DMCD, with the loss of effectiveness the biggest reason of exchange with 34.1%. Adverse events were the most frequently encountered infectious, 32.3% had serious adverse events, 24.2% were non-serious adverse event and 1.6% were fatal. Conclusion: The prevalence of females was higher than males (6.5:1). Hypertension was the most common comorbidities present with 50%. The extra-articular manifestations were not correlated statistically with the presence of auto antibodies. The RF and anti CCP, as high yield proved as excellent laboratory marker of RA. The latent TB infection was relatively low (14.3%) in the study population in relation to epidemiological notional without rheumatic disease. Infliximab was the most widely used biological DMCD and who had a higher rate of return for therapeutic ineffectiveness. Hepatitis drug was the only adverse event reported by the use of synthetic DMCD (MTX). The biologic DMCD had a higher number of adverse events (56.5 %) compared with synthetic ones (1.6%), and infection (29%) the main cause.