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dc.contributor.advisorSarmiento Monroy, Juan Camilo 
dc.contributor.advisorMantilla Hernández, Rubén Darío 
dc.creatorRodríguez López, Julieth Milena 
dc.date.accessioned2016-07-05T19:39:52Z
dc.date.available2016-07-05T19:39:52Z
dc.date.created2016-05-23
dc.date.issued2016
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/12183
dc.descriptionINTRODUCCION Dado que la artritis reumatoide es la artropatía inflamatoria más frecuente en el mundo, siendo altamente discapacitante y causando gran impacto de alto costo, se busca ofrecer al paciente opciones terapéuticas y calidad de vida a través del establecimiento de un tratamiento oportuno y eficaz, teniendo presentes aquellos predictores de respuesta previo a instaurar determinada terapia. Existen pocos estudios que permitan establecer aquellos factores de adecuada respuesta para inicio de terapia biológica con abatacept, por lo cual en este estudio se busca determinar cuáles son esos posibles factores. METODOLOGIA Estudio analítico de tipo corte transversal de 94 pacientes con diagnóstico de AR, evaluados para determinar las posibles variables que influyen en la respuesta a terapia biológica con abatacept. Se incluyeron 67 de los 94 pacientes al modelo de regresión logística, que son aquellos pacientes en que fue posible medir la respuesta al tratamiento (respuesta EULAR) a través de la determinación del DAS 28 y así discriminar en dos grupos de comparación (respuesta y no respuesta). DISCUSION DE RESULTADOS La presencia de alta actividad de la enfermedad al inicio de la terapia biológica, aumenta la probabilidad de respuesta al tratamiento respecto al grupo con baja/moderada actividad de la enfermedad; OR 4,19 - IC 95%(1,18 – 14.9), (p 0,027). La ausencia de erosiones óseas aumenta la probabilidad de presentar adecuada respuesta a la terapia biológica respecto aquellos con erosiones, con un OR 3,1 (1,01-9,55), (p 0,048). Niveles de VSG y presencia de manifestaciones extra-articulares son otros datos de interés encontrados en el análisis bivariado. Respecto a las variables o características como predictores de respuesta al tratamiento con abatacept, se encuentran estudios que corroboran los hallazgos de este estudio, respecto al alto puntaje del DAS 28 al inicio de la terapia (9, 12). CONCLUSIONES Existen distintas variables que determinan la respuesta a los diferentes biológicos para manejo de AR. Es imprescindible evaluar dichos factores de manera individual con el fin de lograr de manera efectiva el control de la enfermedad y así mejorar la calidad de vida del individuo (medicina personalizada). Existen variables tales como la alta actividad de la enfermedad y la ausencia de erosiones como predictores de respuesta en la terapia con abatacept.
dc.description.abstractBACKGROUND Since rheumatoid arthritis is the most common in the world inflammatory arthropathy, being highly disabling and causing great impact of high cost, we seek to offer the patient treatment options and quality of life through the establishment of a timely and effective treatment, recognizing those prior to establish predictors of response given therapy. There are few studies to establish those factors appropriate response to the start of biological therapy with abatacept, so this study is to determine what those factors are possible. METHODS This was a cross-sectional analytical study of 94 patients diagnosed with RA, assessed to determine possible variables that influence the biological response to abatacept therapy type. 67 were included in the regression model, which are those patients in whom it was possible to measure the response to treatment (EULAR response) through the determination of the DAS 28 and thus discriminate two comparison groups (response and nonresponse ). DISCUSSION OF RESULTS The presence of high activity of the disease at the start of biological therapy increases the likelihood of response to treatment compared to the group with low /moderate disease activity; OR 4.19 - 95% CI (1.18 - 14.9), (p 0.027). The absence of bone erosions increases the probability of adequate response to biological therapy compared with those erosions, with an OR 3.1 (1.01 to 9.55), (p 0.048). ESR and the presence of extra-articular manifestations: other data of interest in the bivariate analysis found. Regarding the variables or characteristics as predictors of response to treatment with abatacept, they are studies that corroborate the findings of this study, regarding the high DAS 28 score at the start of therapy (9, 12). CONCLUSIONS There are several variables that determine the biological response to different handling of AR. It is essential to assess these factors individually in order to achieve effectively control the disease and improve the quality of life of the individual (personalized medicine). There are variables such as high disease activity and the absence of erosions as predictors of response in abatacept therapy.
dc.description.sponsorshipUniversidad del Rosario
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
dc.sourceinstname:Universidad del Rosario
dc.sourcereponame:Repositorio Institucional EdocUR
dc.subjectTerapia biológica
dc.subjectactividad de la enfermedad
dc.subjectmedicina personalizada
dc.subject.ddcIncidencia & prevención de la enfermedad 
dc.subject.lembEpidemiología
dc.titleFactores asociados a respuesta de abatacept subcutaneo en artritis reumatoide
dc.typebachelorThesis
dc.publisherUniversidad del Rosario
dc.creator.degreeEspecialista en Epidemiología (en Convenio con el CES)
dc.publisher.departmentFacultad de medicina
dc.subject.keywordArtritis reumatoide
dc.subject.keywordRheumatoid arthritis
dc.subject.keywordbiological therapy
dc.subject.keywordabatacept
dc.subject.keywordabatacept
dc.subject.keyworddisease activity
dc.subject.keywordpersonalized medicine
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.subject.decsEpidemiología
dc.subject.decsArtritis reumatoide
dc.subject.decsEnfermedades autoinmunes
dc.type.spaTrabajo de grado
dc.rights.accesoAbierto (Texto completo)
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
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dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.


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