High levels of polypharmacy in rheumatoid arthritis—a challenge not covered by current management recommendations : data from a large real-life study

Rheumatoid arthritis (RA) is associated with high frequency of comorbidities and increased risk of polypharmacy. Although there is a great potential for complications, there is a gap in literature on polypharmacy in patients with rheumatic arthritis. To evaluate the prevalence and factors associated with polypharmacy in a population in a real-life setting. Methods: A cross-sectional multicenter study was conducted in Brazil. Patients underwent clinical evaluation and medical records analysis. Polypharmacy was considered as a dependent variable. To test independent variables, we used Poisson regression. We evaluated 792 patients (89% female, median age 56.6 years). Median duration of disease was 12.7 years, 78.73% had a positive rheumatoid factor. The median of disease activity score-28 was 3.5 (disease with mild activity), median of the clinical disease activity index score was 9, and median of health assessment questionnaire-disability index was 0.875; 47% used corticosteroids, 9.1% used nonsteroidal anti-inflammatory drugs, 90.9% used synthetic disease-modifying antirheumatic drugs, 35.7% used biologic disease-modifying antirheumatic drugs (DMARDs). In total, 537 (67.9%) patients used 5 or more drugs. Polypharmacy showed a relationship with a number of comorbidities and use of specific drugs (corticosteroids, methotrexate, and biological DMARDs). We found a high prevalence of polypharmacy (67.9%) in RA. Solutions to management this problem should be stimulatedThe author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Brazilian Society of Rheumatology (BSR). For this project, BSR received specific grant support from the following companies: Bristol-Myers Squibb Farmacêutica Ltda; Eli Lilly do Brasil Ltda; Janssen-Cilag Farmacêuticos Ltda; Laboratórios Pfizer Ltda; Produtos Roche Químicos e Farmacêuticos S.A.; and UCB Biopharma Ltda. The funding body or the companies had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscrip

Ingestão de alimentos e adequação de nutrientes no final da infância Food intake and nutritional adequacy in final phase of childhood

Este trabalho reúne informações sobre a ingestão de alimentos e a adequação dos nutrientes no período final da infância. O grupo estudado foi composto por 247 escolares, sendo 150 do sexo feminino e 97 do masculino, com idade de nove e dez anos, pertencentes a escolas públicas municipais de Maceió. Os dados sobre ingestão de alimentos foram coletados através do recordatório de 24 horas e comparados com as recomendações preconizadas pelo National Research Council de 1989. De acordo com os resultados, a ingestão alimentar dos escolares apresentou-se deficiente em relação à energia e aos micronutrientes, especialmente as vitaminas e alguns minerais pesquisados, com exceção do ferro. Essa deficiência foi encontrada independente do sexo. Tais achados sugerem que o aporte insuficiente dos nutrientes estudados, se persistente, poderá contribuir negativamente para o desempenho do crescimento linear durante a fase da adolescência.<br>This study analyzes the results of a dietary intake survey. The main goal was to estimate the nutrient and energy intake of children in final phase of childhood and the nutritional adequacy of their diet. The studied group was composed of 247 schoolchildren (150 females and 97 males, aged nine to ten years old) from public schools of the city of Maceió, state of Alagoas. Food intake data were collected through a 24-hour dietary recall and compared with the standards of National Research Council-Recommended Dietary Allowances (RDA, 1989). According to the results, the children food intake, independently of the sex, was deficient in energy and micronutrients, specially vitamins and some minerals, with the exception of iron. These findings suggest that in this group specific nutrients deficits can be a limiting factor which may contribute to an inadequate growth performance during adolescence