Changes in the use patterns of bDMARDs in patients with rheumatic diseases over the past 13 years.

The better understanding of the safety of biologic DMARDs (bDMARDs), as well as the emergence of new bDMARDs against different therapeutic targets and biosimilars have likely influenced the use patterns of these compounds over time. The aim of this study is to assess changes in demographic characteristics, disease activity and treatment patterns in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), or ankylosing spondylitis (AS) who started a first- or second-line biologic between 2007 and mid-2020. Patients diagnosed with RA, PsA or AS included in the BIOBADASER registry from January 2007 to July 2020 were included. According to the start date of a first- or second-line biologic therapy, patients were stratified into four time periods: 2007-2009; 2010-2013; 2014-2017; 2018-2020 and analyzed cross-sectionally in each period. Demographic and clinical variables, as well as the type of biologic used, were assessed. Generalized linear models were applied to study the evolution of the variables of interest over time periods, the diagnosis, and the interactions between them. A total of 4543 patients initiated a first biologic during the entire time frame of the study. Over the four time periods, disease evolution at the time of biologic initiation (p

Factors associated with long-term retention of treatment with golimumab in a real-world setting: an analysis of the Spanish BIOBADASER registry.

The retention rate of a biological drug (percentage of patients remaining on treatment over time) provides an index of a drug's overall effectiveness. The golimumab retention rate as first-line biological therapy was high in clinical trial extensions lasting 5 years. Real-world studies also indicate good retention rates but have been of shorter duration. The probability of retention with golimumab treatment was assessed, as any line of anti-tumor necrosis factor-alpha therapy, for up to 5 years in patients with rheumatoid arthritis (RA), axial spondyloarthritis (SpA) or psoriatic arthritis (PsA), associated factors were analyzed. A retrospective database analysis of the Spanish registry of patients with rheumatic disorders receiving biological drugs (BIOBADASER) was performed. Among 353 patients, 29.8% had RA, 41.6% SpA and 28.6% PsA. Golimumab was the first biological drug in 40.1% of patients, second in 30.1% and third/later in 29.8%. The overall probability of retention of golimumab at years 1, 2, 3, 4 and 5 was 85.9% (95% confidence interval 81.4-89.5%), 73.7% (67.1-79.1%), 68.5% (60.5-75.1%), 60.6% (50.2-69.5%) and 57.1% (44.9-67.5%), respectively. Retention was similar across indications (p = 0.070) but was greater when golimumab was used as the first biological agent compared with later therapy lines (p

Derechos Humanos y Genealogía de la dignidad en América Latina

El concepto de dignidad es clave para comprender la diversidad cultural que desde enfoques adscritos al interculturalismo, entendiendo por ellos perspectivas éticas que promueven el reconocimiento de la condición humana culturalmente diversa, al tiempo que la considera un valor que hay que conservar a través de diálogos profundos entre las culturas. La reunión del concepto de dignidad en su sentido moderno y el de derechos humanos aparece en la segunda posguerra del siglo XX, y de manera contundente en el ámbito internacional en la Declaración Universal de Derechos Humanos aprobada por la asamblea General de la ONU el 10 de diciembre de 1948. Las propuestas que el lector encontrará en este libro pertenecen a distintas disciplinas, que coinciden en la necesidad de que la diversidad cultural, representada por los pueblo originarios de América Latina, contribuye desde otras matrices culturales a enriquecer el significado de dignidad occidental, por lo tanto, es un soporte que no puede dejarse de lado para construir criterios éticos sobre los que las relaciones entre los pueblos originarios y los gobiernos deberían ser políticamente tratados, así como en todas las estrategias públicas de los estados latinoamericano