Drug survival and causes of discontinuation of the first anti-tnf in ankylosing spondylitis compared with rheumatoid arthritis: analysis from biobadabrasil photoinitiators

Treatment survival with biological therapy may be influenced by many factors, and it seems to be different among various rheumatic diseases and biological agents. The goal of the study was to compare the drug survival and the causes of discontinuation of anti-tumoral necrosis factor (anti-TNF) therapy in ankylosing spondylitis (AS) with rheumatoid arthritis (RA). Study participants were a cohort from the Brazilian Registry of Biological Therapies in Rheumatic Diseases (BIOBADABRASIL) between 2008 and 2012. The observation time was up to 4 years following the introduction of the first treatment. Gender, age, disease duration, disease activity, comorbidities, and concomitant therapies were assessed. A total of 1303 patients were included: 372 had AS and 931 had RA in which 38.7%(n=504) used infliximab (IFX), 34.9 % (n=455) used adalimumab (ADA), and 26.4 % (n=344) used etanercept (ETA). The anti-TNF drug survival of patients with AS was 63.08 months (confidence interval (CI) 60.24, 65.92) and patients with RA was 47.5 months (CI 45.65, 49.36). It was significant higher in AS (log-rank; p=0.001). Patients with RA discontinued anti-TNF more than patients with AS when adjusted to gender and corticosteroid. The adjHR (95 % CI) was 1.6 (1.14, 2.31). Female patients who were also corticosteroid users, but not of advanced age, have shown lower survival for both diseases (log-rank, p=0.001). The discontinuation rate of IFX, but not of ADA or ETA, was significantly higher in RA than in SA; HR (95 % CI) was 2.49 (1.46, 4.24). The main causes of discontinuation were ineffectiveness and adverse event in both diseases. AS patients have better drug survival adjusted to gender, age, and corticosteroid. This results appear to be related to the disease mechanism.Treatment survival with biological therapy may be influenced by many factors, and it seems to be different among various rheumatic diseases and biological agents. The goal of the study was to compare the drug survival and the causes of discontinuation of345921927sem informaçãosem informaçãoWe thank the BIOBADASER Registry Group and Patrícia D. Cabral for monitoring BIOBADABRASIL data. This study was supported by the Brazilian Society of Rheumatolog

HLA-B27 did not protect against COVID-19 in patients with axial spondyloarthritis – data from the ReumaCov-Brasil Registry

Abstract Background Some studies have suggested the HLA-B27 gene may protect against some infections, as well as it could play a benefit role on the viral clearance, including hepatitis C and HIV. However, there is lack of SARS-CoV-2 pandemic data in spondyloarthritis (SpA) patients. Aim To evaluate the impact of HLA-B27 gene positivity on the susceptibility and severity of COVID-19 and disease activity in axial SpA patients. Methods The ReumaCoV-Brasil is a multicenter, observational, prospective cohort designed to monitor immune-mediated rheumatic diseases patients during SARS-CoV-2 pandemic in Brazil. Axial SpA patients, according to the ASAS classification criteria (2009), and only those with known HLA-B27 status, were included in this ReumaCov-Brasil’s subanalysis. After pairing them to sex and age, they were divided in two groups: with (cases) and without (control group) COVID-19 diagnosis. Other immunodeficiency diseases, past organ or bone marrow transplantation, neoplasms and current chemotherapy were excluded. Demographic data, managing of COVID-19 (diagnosis, treatment, and outcomes, including hospitalization, mechanical ventilation, and death), comorbidities, clinical details (disease activity and concomitant medication) were collected using the Research Electronic Data Capture (REDCap) database. Data are presented as descriptive analysis and multiple regression models, using SPSS program, version 20. P level was set as 5%. Results From May 24th, 2020 to Jan 24th, 2021, a total of 153 axial SpA patients were included, of whom 85 (55.5%) with COVID-19 and 68 (44.4%) without COVID-19. Most of them were men (N = 92; 60.1%) with mean age of 44.0 ± 11.1 years and long-term disease (11.7 ± 9.9 years). Regarding the HLA-B27 status, 112 (73.2%) patients tested positive. There were no significant statistical differences concerning social distancing, smoking, BMI (body mass index), waist circumference and comorbidities. Regarding biological DMARDs, 110 (71.8%) were on TNF inhibitors and 14 (9.15%) on IL-17 antagonists. Comparing those patients with and without COVID-19, the HLA-B27 positivity was not different between groups (n = 64, 75.3% vs. n = 48, 48%, respectively; p = 0.514). In addition, disease activity was similar before and after the infection. Interestingly, no new episodes of arthritis, enthesitis or extra-musculoskeletal manifestations were reported after the COVID-19. The mean time from the first symptoms to hospitalization was 7.1 ± 3.4 days, and although the number of hospitalization days was numerically higher in the B27 positive group, no statistically significant difference was observed (5.7 ± 4.11 for B27 negative patients and 13.5 ± 14.8 for B27 positive patients; p = 0.594). Only one HLA-B27 negative patient died. No significant difference was found regarding concomitant medications, including conventional or biologic DMARDs between the groups. Conclusions No significant difference of COVID-19 frequency rate was observed in patients with axial SpA regarding the HLA-B27 positivity, suggesting a lack of protective effect with SARS-CoV-2 infection. In addition, the disease activity was similar before and after the infection. Trial registration This study was approved by the Brazilian Committee of Ethics in Human Research (CONEP), CAAE 30186820.2.1001.8807, and was registered at the Brazilian Registry of Clinical Trials – REBEC, RBR-33YTQC. All patients read and signed the informed consent form before inclusion

Potencial de propagação de cultivares de marmeleiro por estaquia Potencial of propagation of cultivars of quince for cuttings

Devido à escassez de trabalhos com o enraizamento de estacas de marmeleiro, realizou-se o presente trabalho com o objetivo de verificar o potencial de enraizamento de estacas de cultivares de marmeleiro. Utilizaram-se estacas lenhosas e lisas coletadas de plantas de marmeleiro 'Radiolo', 'Mendoza Inta-37', 'Much Prolife', 'Pineapple', 'Smyrna', 'De Patras', 'Provencia', 'Van Deman', 'Provance', 'Meliforme', 'Portugal' (Cydonia oblonga) e 'Japonês' (Chaenomelis sinensis L.), sendo estas padronizadas com 20 cm de comprimento. As estacas foram enterradas até a metade do comprimento em canteiro de terra e coberto por tela sombrite 50%, sendo umedecidas diariamente através de regas manuais. Após 75 dias, coletaram-se os seguintes dados biométricos: porcentagem de estacas enraizadas e brotadas, número de folhas e brotos, comprimento da maior raiz, comprimento médio das brotações e número de raízes emitidas por estaca. As cultivares Pineapple, De Patras, Provencia e Mendoza Inta-37 apresentaram maior potencialidade de propagação via estaquia.<br>Due to the shortage of works with the quince cutting, the present work was developed with the objective to verify the rooting potential of quince cultivars cutting. Hardwoody cuttings of quince were collected from 'Radiolo', 'Mendoza Inta-37', 'Much Prolife', 'Pineapple', 'Smyrna', 'De Patras', 'Provencia', 'Van Deman', 'Provance', 'Meliforme', 'Portugal' (Cydonia oblonga) and 'Japonês' (Chaenomelis sinensis L.), being these samples standardized with 20 cm of length. Soon after, half of the length of the cutting was put in a substrate constituted by soil and covered by sombrite 50%, being daily humidified by water. After 75 days, were evaluated the percentage of rooting and sprouting, number of leaves and sprouts, length of the largest root and sprouting and number of roots emitted by cutting. The cultivars Pineapple, De Patras, Provencia and Mendoza Inta-37 presented larger potentiality of propagation of cutting