Clinical remission in subjects with rheumatoid arthritis treated with subcutaneous tocilizumab as monotherapy or in combination with methotrexate or other synthetic dmards: a realworld clinical trial (tospace)

Background: Subcutaneous tocilizumab (TCZ-SC) has demonstrated noninferiority to TCZ-IV and superiority to placebo. Objectives: The primary objective of this study was to assess the 24-week efficacy and safety of subcutaneous (SC) tocilizumab (TCZ) 162 mg weekly (qw) as monotherapy or in combination with methotrexate (MTX) or other synthetic (s) DMARDs in patients with active rheumatoid arthritis (RA) in the real world setting. Methods: This multinational (Spain, Ireland, Portugal), multicenter, phase IIIb study. Subjects ≥18 years of age with active RA (DAS 28-ESR >3.2) who have had inadequate response or intolerance to sDMARDs or to a first anti-TNF drug. The study comprised a phase 1 with open-label design in which patients received TCZ-SC 162 mg qw (+/- oral/SC MTX or other sDMARDs) for 24 weeks and the main outcome was the percentage of patients achieving sustained clinical remission (DAS 28-ESR <2.6) at Week 20 and Week 24 (primary outcome of the study); and a phase 2 where patients achieving sustained clinical remission during the phase 1 were randomized to receive TCZ-SC 162 mg qw or TCZ-SC 162 mg q2w (+/- oral/SC MTX or other sDMARDs) for an additional 24 weeks; the main outcome of the phase 2 was the percentage of patients who maintained the remission at Week 48 (i.e. DAS 28-ESR <2.6).S

Vol. 30, nº 08. La utilidad clínica y organizativa de las teleconsultas.

Enfermedades de Declaración Obligatoria por provincias. Semana 07/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “La utilidad clínica y organizativa de las teleconsultas”, de “Paola Tatiana García Giraldo,, Soledad Benot López”.Ye

Vol. 30, nº 05. Mapeado de líneas y grupos de I+D+I en salud pública en Andalucía: área de vigilancia y sistemas inteligentes.

Enfermedades de Declaración Obligatoria por provincias. Semana 04/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Mapeado de líneas y grupos de I+D+I en salud pública en Andalucía: área de vigilancia y sistemas inteligentes”, de “Cristina Medina Prado, Virginia Nieto Guerrero y Belén Jiménez Ojeda”.N

Vol. 30, nº 12. Análisis de situación epidemiológica de enfermedad neumocócica invasiva causada por serotipo 4 en Andalucía: 2022-2024.

Enfermedades de Declaración Obligatoria por provincias. Semana 11/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Análisis de situación epidemiológica de enfermedad neumocócica invasiva causada por serotipo 4 en Andalucía: 2022-2024”, de “Elvira Marín Caba, Esteban Pérez Morilla, Virtudes Gallardo García, Enrique Pérez Ostos, Nicola Lorusso”.N

Vol. 30, nº 07. Vigilancia y control de las infecciones relacionadas con la asistencia sanitaria en unidades de cuidados intensivos: protocolo pilotaje vigilancia centralizada en 2024.

Enfermedades de Declaración Obligatoria por provincias. Semana 06/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Vigilancia y control de las infecciones relacionadas con la asistencia sanitaria en unidades de cuidados intensivos: protocolo pilotaje vigilancia centralizada en 2024”, de “Rafael Ruiz Montero, Irene Morales Arjona”.N

The still incomplete pursuit of universal access to medicines.

A substantial share of the global population continues to face barriers to accessing essential medicines. While the pharmaceutical industry's business model has successfully facilitated the development of innovative medications, efforts to promote universal access to medicines (UAM) remain ineffective. This paper critically assesses the existing barriers to global access to medicines, including the role of unsuitable governance, the protection of intellectual property rights, and other market barriers such as shortages, quality shortcomings, and high prices. Furthermore, we explore a number of promising potential strategies that can help towards achieving the UAM. Specifically, we evaluate the evidence from various initiatives, including alternative models of innovation, manufacturing, procurement, intellectual property management, and structural/organisational operations. We argue that the effective realisation of UAM requires a robust framework to implement these initiatives. This framework must strike a delicate balance between addressing public health needs, incentivising research and development, and ensuring affordability. Achieving such a balance encompasses a careful oversight and collaboration between national and international regulatory bodies.Ye

Advanced metrology in patiens with axial spondyloarthritis: lumbar or thoracic plus lumbar measurements for spinal mobility assessment?

Advanced technologies for measuring human mobility have recently emerged, such as motion capture systems, inertial measurement units (IMUs), and wearable devices. Some of these are used to assess mobility in patients with rheumatic diseases. Certain devices focus solely on assessing lumbar mobility. However, Axial Spondyloarthritis (axSpA) reduces spinal mobility across all spinal segments, not just the lumbar region. The objective of this study was to analyze the contribution of the thoracic spine to overall spinal mobility and determine whether this contribution should be considered in the metrological assessment of patients with axSpA. A total of 20 patients with axSpA and 20 age-, BMI-, and sex-matched healthy controls were recruited. Spinal mobility was measured using an IMU-based system (ViMove©), which employs two IMU sensors and calculates the angle between them in real time. Two tests were performed: one using the standard anatomical positions (pelvis and L1) and another combining lumbar and thoracic movement (pelvis and T3). Conventional metrology, radiographic structural damage in axSpA patients, and patient-reported outcomes (PROs) were also collected. The results table displays the mobility measurements for lumbar only and lumbar + thoracic movement in both groups. The thoracic spine’s contribution is expressed as a percentage of total movement. Pearson correlation coefficients (for axSpA patients only) with conventional metrology (BASMI), PROs (BASDAI, BASFI, and ASQoL), and structural damage (mSASSS) are also presented.S

Vol. 30, nº 03. Parotiditis: Andalucía, años 2021 a 2023.

Enfermedades de Declaración Obligatoria por provincias. Semana 02/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Parotiditis: Andalucía, años 2021 a 2023”, de “Virtudes Gallardo García, Nicola Lorusso.”.Ye

Vol. 30, nº 16. Vigilancia de sarampión en atención primaria: análisis de un estudio de contactos en el distrito Granada-Metropolitano.

Enfermedades de Declaración Obligatoria por provincias. Semana 16/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Vigilancia de sarampión en atención primaria: análisis de un estudio de contactos en el distrito Granada-Metropolitano”, de “José Antonio Marín Rodríguez, Laura Leyva Valverde, Andrea Luque Martínez, Diego Almagro Nievas, Begoña López Hernández, Manuel Carlos del Moral Campaña”.Ye

Comprehensive analysis of West Nile Virus transmission: Environmental, ecological, and individual factors. An umbrella review.

Background: West Nile Virus (WNV) exemplifies the complexities of managing vector-borne diseases, expanding globally due to human activities and ecological changes. Originating from Africa and transmitted by Culex mosquitoes, WNV is now reported across multiple continents. The aim of this study was to identify the environmental, ecological, and individual factors influencing WNV transmission. Methods: An umbrella review was conducted. Comprehensive searches were performed in PubMed, Scopus, Web of Science, Embase, and LILACS. Inclusion criteria were reviews involving WNV transmission agents (reservoirs, vectors, hosts) and associative analyses between environmental, ecological, or individual factors and WNV transmission. Data extraction and quality appraisal were performed using templates and the AMSTAR 2 tool. Results: From 404 retrieved studies, 23 systematic reviews and meta-analyses were included. Almost 70 % were low or critically low quality. The co-occurrence network highlighted emerging research on climate change and environmental factors. Temperature, precipitation, and land use significantly influence WNV transmission. Warmer temperatures enhance mosquito populations and viral replication, while extreme weather events like droughts increase mosquito-human contact. Climate change significantly contributes to WNV dynamics by altering temperature and precipitation patterns, enhancing vector proliferation, and extending transmission seasons. Ecological factors such as higher avian diversity, vegetation indexes, and distribution of mosquito species can impact WNV transmission significantly. Education and income levels influence preventive behaviors and infection risk, with lower socioeconomic status linked to higher WNV risk. Certain occupational groups are also at elevated risk of WNV infection. Conclusion: Environmental factors like temperature and precipitation critically affect WNV transmission by influencing mosquito behavior and avian reservoir dynamics. Socio-economic status and education levels significantly impact individual preventive behaviors and infection risk. Multifactorial influences on infection risk make necessary integrated surveillance systems and public health strategies. Longitudinal studies with One Health approaches are necessary to better understand WNV dynamics and reduce WNV transmission.Ye