BACKGROUND: Ankylosing spondylitis (AS) is characterised as a chronic inflammatory disease of the axial skeleton. The force platform is an option for performing the postural assessment of these individuals OBJECTIVES: To review and evaluate the behaviour of the centre of pressure (CoP) variables during the postural control examination in patients with AS compared to a control group METHOD: A systematic review, registered in PROSPERO, that followed the PRISMA Statement. A search was carried out in the following databases: Medline, Web of Science, Embase, Scopus, and Scielo, from 1945 to 2023. Studies were selected that aimed to understand the use of the force platform for the assessment of postural control. The risk of bias assessment was performed using the AXIS tool RESULTS: Five studies were included, with a total of 247 participants. The assessment of risk of bias presented high scores in the AXIS tool. Patients with a diagnosis of AS presented increased thoracic kyphosis in most of the studies, as well as large displacements in the anteroposterior (AP) and mediolateral (ML) directions, and altered total mean velocity (TMV) and frequency, indicating worse postural stability. Regarding the functional status, the most used questionnaires were the Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Bath Ankylosing Disease Activity Index (BASDAI CONCLUSION: Patients with ankylosing spondylitis present postural instability, verified by means of higher values of centre of posture variables CLINICAL IMPLICATIONS: Individuals with ankylosing spondylitis presented postural instability and balance deficit. Therefore, exercises for balance training and postural control are essential in the clinical management of these patients

ABSTRACT Background: Monoclonal antibodies have proven efficacy in the management of several conditions and infliximab (IFX) is one of the most important drugs of the class. Some recent data have shown low rates of both persistence and adherence to several available biologics. Objective: The objective of this study was to describe adherence and persistence rate to IFX treatment and also persistence in the patient support program (PSP), among patients diagnosed with inflammatory bowel diseases (IBD) or rheumatic diseases (RD) enrolled in the program of a large pharmaceutical company in Brazil. Methods: Retrospective observational analysis using the PSP database. IBD or RD patients using IFX enrolled on the PSP database between September 2015 and August 2019 were retrospectively evaluated to identify the persistence rate and adherence and followed up until March 1, 2020. Patients were excluded if treatment start date was prior to program entry; first infusion prior to September 1st, 2015 or after August 31st, 2019; the patients did not started treatment; and patients with “OTHERS” in “Indication” field. Persistence was assessed considering both persistence in the program (“PSP persistence”) and persistence on IFX in the PSP (“IFX persistence in the PSP”). PSP persistence was defined as the proportion of patients remaining in the program at 6, 12, 24, 36 and 48 months after initiating IFX. To determine IFX persistence in the PSP, censoring was defined at the time the patient left the program, died, or was lost to follow-up. Adherence to treatment was measured by medication possession ratio ((MPR) - All days supply / elapsed days from first prescription to last day of medication possession)). Descriptive statistics were initially used. Kaplan-Meier curve, the median time estimated by the survival function, Cox regression model, and restricted mean survival time (RMST) were used to evaluate the treatment persistence time at 24 months and the logistic regression model was performed aiming to identify variables associated with adherence (MPR ≥80%). Results: A total of 10,233 patients were analyzed, 5,826 (56.9%) with the diagnosis of RD and 4,407 (43.1%) of IBD. At the end of the follow-up (median 9.1 months from PSP entry to the last infusion), persistence in the PSP was 65.6%, 48.2%, 31.0%, 20.7% and 13.1% at 6, 12, 24, 36 and 48 months, respectively. Considering persistence on IFX in the PSP, estimates were 93.7%, 87.8%, 77.0%, 62.4% and 53.0% at 6, 12, 24, 36 and 48 months, respectively. Variables associated with the risk of non-persistence were gender, country region and diagnosis of rheumatoid arthritis and ankylosing spondylitis. Median MPR was 94.2%, while the percentage of patients with MPR ≥80% was 91.0%. Variables associated with MPR≥80% were country region and diagnosis of Crohn’s disease. Conclusion: Many patients leave the program without discontinuing IFX, since the 12-month persistence were very different between program and medication estimates, while high adherence rates were observed among patients enrolled in the PSP. Data highlights the benefits of a PSP. Background (IFX class biologics Objective , (PSP) (IBD (RD Brazil Methods 201 1 2020 1st st 31st OTHERS “OTHERS Indication “Indication field persistence” . PSP”) 6 12 3 4 died followup. followup follow up. ((MPR possession. possession)) KaplanMeier Kaplan Meier curve function RMST (RMST 2 ≥80%. 80 ≥80%) Results 10233 10 233 10,23 analyzed 5826 5 826 5,82 56.9% 569 56 9 (56.9% 4407 407 4,40 43.1% 431 43 (43.1% 91 9. infusion, infusion) 656 65 65.6% 482 48.2% 310 31 0 31.0% 207 20 7 20.7 131 13 13.1 respectively 937 93 93.7% 878 87 8 87.8% 770 77 77.0% 624 62 62.4 530 53 53.0 nonpersistence non gender spondylitis 942 94 94.2% ≥80 910 91.0% MPR80 MPR≥80 Crohns Crohn s disease Conclusion 12month month (PSP 202 PSP” possession) 1023 23 10,2 582 82 5,8 56.9 (56.9 440 40 4,4 43.1 (43.1 65.6 48.2 31.0 20. 13. 93.7 87.8 77.0 62. 53. 94.2 ≥8 91.0 MPR8 MPR≥8 102 10, 58 5, 56. (56. 44 4, 43. (43. 65. 48. 31. 93. 87. 77. 94. ≥ 91. MPR≥ (56 (43 (5 (4 (

RESUMO Contexto: Os anticorpos monoclonais têm eficácia comprovada no manejo de diversas condições e o infliximabe (IFX) é um dos medicamentos mais importantes da classe. Alguns dados recentes demonstram baixas taxas de persistência e adesão a vários dos biológicos disponíveis. Objetivo: O objetivo deste estudo foi descrever a adesão e persistência ao tratamento com IFX e a persistência no programa de suporte ao paciente (PSP), entre pacientes diagnosticados com doenças inflamatórias intestinais (DII) ou doenças reumáticas (DR) inscritos no PSP de uma grande indústria farmacêutica no Brasil. Métodos: Análise observacional retrospectiva utilizando o banco de dados do PSP. Pacientes com DII ou DR usando IFX inscritos no banco de dados do PSP entre setembro de 2015 e agosto de 2019 foram avaliados retrospectivamente para identificar a taxa de persistência e adesão e acompanhados até 1º de março de 2020. Os pacientes foram excluídos se a data de início do tratamento fosse anterior à entrada no programa; primeira infusão antes de 1º de setembro de 2015 ou após 31 de agosto de 2019; o paciente não iniciou o tratamento; e pacientes com “OUTROS” no campo “indicação”. A persistência foi avaliada considerando tanto a persistência no programa (“persistência PSP”) quanto a persistência em uso de infliximabe no PSP (“persistência IFX no PSP”). A persistência no PSP foi definida como a proporção de pacientes que permaneceram no programa aos 6, 12, 24, 36 e 48 meses após o início do IFX. Para determinar a persistência do IFX no PSP, a censura foi definida quando o paciente deixou o programa, morreu ou perdeu o acompanhamento. A adesão ao tratamento foi medida pela razão de posse do medicamento (MPR)): todos os dias de fornecimento / decorridos da primeira prescrição ao último dia de posse do medicamento). A estatística descritiva foi inicialmente utilizada. A curva de Kaplan-Meier, o tempo mediano estimado pela função de sobrevida, o modelo de regressão de Cox e o tempo de sobrevida médio restrito (RMST) foram utilizados para avaliar o tempo de persistência do tratamento em 24 meses e o modelo de regressão logística foi realizado para identificar variáveis associadas à adesão (MPR ≥80%). Resultados: Foram analisados 10.233 pacientes, 5.826 (56,9%) com diagnóstico de DR e 4.407 (43,1%) de DII. Ao final do seguimento (mediana de 9,1 meses desde a entrada no PSP até a última infusão), a persistência no PSP foi de 65,6%, 48,2%, 31,0%, 20,7% e 13,1% aos 6, 12, 24, 36 e 48 meses, respectivamente. Considerando a persistência no IFX no PSP, as estimativas foram de 93,7%, 87,8%, 77,0%, 62,4% e 53,0% aos 6, 12, 24, 36 e 48 meses, respectivamente. As variáveis associadas ao risco de não persistência foram sexo, região do país e diagnóstico de artrite reumatoide e espondilite anquilosante. A mediana do MPR foi de 94,2%, enquanto o percentual de pacientes com MPR ≥80% foram de 91,0%. As variáveis associadas a MPR ≥80% foram região do país e diagnóstico de doença de Crohn. Conclusão: Muitos pacientes abandonam o programa sem interromper o IFX, pois a persistência em 12 meses foi muito diferente entre as estimativas do programa e da medicação, enquanto altas taxas de adesão foram observadas entre os pacientes inscritos no PSP. Os dados destacam os benefícios de um PSP. Contexto (IFX classe disponíveis Objetivo , (PSP) (DII (DR Brasil Métodos 201 º 2020 3 OUTROS “OUTROS indicação. indicação . “indicação” PSP” 6 4 acompanhamento (MPR)) medicamento. medicamento) utilizada KaplanMeier, KaplanMeier Kaplan Meier, Meier Kaplan-Meier RMST (RMST 2 ≥80%. 80 ≥80%) Resultados 10233 10 233 10.23 5826 5 826 5.82 56,9% 569 56 9 (56,9% 4407 407 4.40 43,1% 431 43 1 (43,1% 91 9, infusão, infusão) 656 65 65,6% 482 48,2% 310 0 31,0% 207 20 7 20,7 131 13 13,1 respectivamente 937 93 93,7% 878 87 8 87,8% 770 77 77,0% 624 62 62,4 530 53 53,0 sexo anquilosante 942 94 94,2% ≥80 910 91,0% Crohn Conclusão medicação (PSP 202 “indicação (MPR) 1023 23 10.2 582 82 5.8 56,9 (56,9 440 40 4.4 43,1 (43,1 65,6 48,2 31,0 20, 13, 93,7 87,8 77,0 62, 53, 94,2 ≥8 91,0 102 10. 58 5. 56, (56, 44 4. 43, (43, 65, 48, 31, 93, 87, 77, 94, ≥ 91, (56 (43 (5 (4 (

ABSTRACT BACKGROUND AND OBJECTIVES: The feet may be involved in patients with ankylosing spondylitis (AS), causing pain and walking difficulties. This research aimed to study the involvement of the foot in a sample of Brazilian patients with AS. METHODS: The Brazilian version of the Foot Function Index (FFI-BR) was applied to 103 individuals (57 AS patients and 46 controls). Clinical profiles were obtained in AS patients as well as the measurement of disease activity by the ASDAS (Ankylosing Spondylitis Disease Activity Score)-ESR (erythrocyte sedimentation rate), ASDAS-CRP (C reactive protein) and BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and function by BASFI (Bath Ankylosing spondylitis functional score). RESULTS: Only 19.2% of AS patients did not have any foot complaints and the FFI-BR score presented worse results than the control group (p = 0.02). The "pain" domain of FFI-BR scored highest in AS patients, followed by "disability". There was no association between the results of the FFI-BR and the clinical profile of patients with AS, but there was an association between the score and the disease activity indexes (r = 0.50, p = 0.003 with ASDAS-ESR; r = 0.44, p = 0.005 with ASDAS-CRP; and r = 0.60, p < 0.0001 with BASDAI). The BASFI also showed a positive correlation (r = 0.72; p < 0.0001). CONCLUSION: Pain and disability are common in AS patients and these symptoms are associated with disease activity. OBJECTIVES , (AS) difficulties METHODS FFIBR FFI BR (FFI-BR 10 57 (5 4 controls. controls . controls) ScoreESR Score ESR erythrocyte rate, rate rate) ASDASCRP CRP C protein Bath score. score) RESULTS 192 19 2 19.2 0.02. 002 0.02 0 02 0.02) "pain disability. "disability" 050 50 0.50 0003 003 0.00 ASDASESR ASDAS-ESR 044 44 0.44 0005 005 060 60 0.60 00001 0001 0.000 BASDAI. BASDAI) 0.72 072 72 0.0001. 0.0001) CONCLUSION (AS 1 5 ( 19. 00 0.0 "disability 05 0.5 000 04 0.4 06 6 0.6 0000 0.7 07 7 0.

RESUMO JUSTIFICATIVA E OBJETIVOS: Os pés podem ser acometidos em pacientes com espondilite anquilosante (EA), causando dor e dificuldade de locomoção. O objetivo deste trabalho foi estudar o envolvimento do pé em uma amostra de pacientes brasileiros com EA. MÉTODOS: A versão brasileira do Foot Function Index (FFI-BR) foi aplicada a 103 indivíduos (57 pacientes com EA e 46 controles). O perfil clínico foi obtido para pacientes com EA, bem como a medição da atividade da doença por meio do ASDAS (Ankylosing Spondylitis Disease Activity Score)-ESR. (velocidade de hemossedimentação), ASDAS-CRP (proteína C reativa) e BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) e função pelo BASFI (Bath Ankylosing Spondylitis Functional Score). RESULTADOS: Apenas 19,2% dos pacientes com EA não apresentaram queixas nos pés e o escore FFI-BR apresentou resultados piores do que os do grupo controle (p = 0,02). O domínio "dor" do FFI-BR apresentou a maior pontuação nos pacientes com EA seguido pelo domínio "disfunção". Não se observou associação dos resultados do FFI-BR com o perfil clínico dos pacientes com EA, mas houve associação do escore com os índices de atividade da doença (r = 0,50, p = 0,003 com ASDAS-ESR; r = 0,44, p = 0,005 com ASDAS-CRP; e r = 0,60, p < 0,0001 com BASDAI). O BASFI também apresentou correlação positiva (r = 0,72; p< 0,0001). CONCLUSÃO: Dor e disfunção são comuns em pacientes com EA e estes sintomas se associam com atividade de doença. OBJETIVOS , (EA) locomoção MÉTODOS FFIBR FFI BR (FFI-BR 10 57 (5 4 controles. controles . controles) ScoreESR. ScoreESR Score ESR. ESR Score)-ESR velocidade hemossedimentação, hemossedimentação hemossedimentação) ASDASCRP CRP proteína reativa Bath Score. Score) RESULTADOS 192 19 2 19,2 0,02. 002 0,02 0 02 0,02) "dor disfunção. "disfunção" 050 50 0,50 0003 003 0,00 ASDASESR ASDAS-ESR 044 44 0,44 0005 005 060 60 0,60 00001 0001 0,000 BASDAI. BASDAI) 0,72 072 72 0,0001. 0,0001) CONCLUSÃO (EA 1 5 ( 19, 00 0,0 "disfunção 05 0,5 000 04 0,4 06 6 0,6 0000 0,7 07 7 0,

Abstract Background The diagnostic and prognostic relevance of Human Leukocyte Antigen B-27 (HLA-B27) in Axial Spondyloarthritis (AxSpA) is undeniable, with 70% of Ankylosing Spondylitis (AS) patients carrying the B27 gene, contrasted with a mere 4.35% in the general population. Flow cytometry (FC) and Polymerase Chain Reaction (PCR) have emerged as the predominant techniques for routine HLA-B27 typing. While various studies have compared these methods, none have catered to the unique characteristics of the Brazilian demographic. Therefore, this research aims to compare FC and PCR in a Brazilian cohort diagnosed with AxSpA. Methods An analytical cross-sectional study was undertaken involving 62 AxSpA outpatients from a Brazilian University Hospital. Both FC and PCR-SSP assays were utilized to ascertain HLA-B27 typing. The outcomes (either confirming or refuting the allele’s presence) underwent rigorous scrutiny. Agreement between the methodologies was assessed using the kappa statistic. A p-value of < 0.05 was deemed statistically significant. Results Of the participants, 90.3% (n= 56) were HLA-B27 positive according to FC, while 79% (n= 49) were identified as positive using the PCR method. FC exhibited a sensitivity rate of 98% paired with a specificity of 38.5%. The Positive Predictive Value for FC stood at 85.7%, and the Negative Predictive Value was 83.5%. Consequently, the overall accuracy of the FC method was gauged at 85.5%. A kappa coefficient of κ = 0.454 was derived. Conclusions FC demonstrated noteworthy sensitivity and satisfactory accuracy in HLA-B27 detection, albeit with a reduced specificity when contrasted with PCR-SSP. Nevertheless, given its cost-effectiveness and streamlined operation relative to PCR, FC remains a pragmatic option for preliminary screening in clinical practice, especially in low-income regions. To optimize resource allocation, we advocate for a refined algorithm that initiates by assessing the relevance of HLA-B27 typing based on Choosing Wisely recommendations. It then leans on FC, and, if results are negative yet clinical suspicion persists, advances to PCR. This approach aims to balance diagnostic accuracy and financial prudence, particularly in regions contending with escalating medical costs. B 27 B-2 HLAB27 HLAB HLA (HLA-B27 (AxSpA undeniable 70 AS (AS B2 gene 435 4 35 4.35 population (FC (PCR HLA-B2 methods demographic Therefore crosssectional cross sectional 6 Hospital PCRSSP SSP either alleles allele s presence scrutiny statistic pvalue p value 005 0 05 0.0 significant participants 903 90 3 90.3 n= n (n 56 79 49 98 385 38 5 38.5% 857 85 7 85.7% 835 83 83.5% Consequently 855 85.5% 0454 454 0.45 derived detection PCRSSP. SSP. Nevertheless costeffectiveness cost effectiveness practice lowincome low income allocation recommendations persists prudence costs 2 B- HLAB2 (HLA-B2 43 4.3 HLA-B 00 0. 9 90. 38.5 8 85.7 83.5 85.5 045 45 0.4 (HLA-B 4. 38. 85. 83. 04

Abstract Background There is a remarkable variability in the frequency of HLA-B27 positivity in patients with spondyloarthritis (SpA), which may be associated with different clinical presentations worldwide. However, there is a lack of data considering ethnicity and sex on the evaluation of the main clinical and prognostic outcomes in mixed-race populations. The aim of this study was to evaluate the frequency of HLA-B27 and its correlation with disease parameters in a large population of patients from the Brazilian Registry of Spondyloarthritis (RBE). Methods The RBE is a multicenter, observational, prospective cohort that enrolled patients with SpA from 46 centers representing all five geographic regions of Brazil. The inclusion criteria were as follow: (1) diagnosis of axSpA by an expert rheumatologist; (2) age ≥18 years; (3) classification according to ASAS axial. The following data were collected via a standardized protocol: demographic data, disease parameters and treatment historical. Results A total of 1096 patients were included, with 73.4% HLA-B27 positivity and a mean age of 44.4 (±13.2) years. Positive HLA-B27 was significantly associated with male sex, earlier age at disease onset and diagnosis, uveitis, and family history of SpA. Conversely, negative HLA-B27 was associated with psoriasis, higher peripheral involvement and disease activity, worse quality of life and mobility. Conclusions Our data showed that HLA-B27 positivity was associated with a classic axSpA pattern quite similar to that of Caucasian axSpA patients around the world. Furthermore, its absence was associated with peripheral manifestations and worse outcomes, suggesting a relevant phenotypic difference in a highly miscegenated population. HLAB27 HLAB HLA B27 B HLA-B2 SpA, , (SpA) worldwide However mixedrace mixed race populations RBE. . (RBE) multicenter observational 4 Brazil follow 1 (1 rheumatologist 2 (2 18 ≥1 years 3 (3 axial protocol historical 109 included 734 73 73.4 444 44 44. ±13.2 132 13 (±13.2 uveitis Conversely psoriasis activity mobility world Furthermore HLAB2 B2 HLA-B (SpA (RBE ( ≥ 10 7 73. ±13. (±13. ±13 (±13 ±1 (±1 ± (±

Abstract Introduction: both spondyloarthritis (SpA) and Takayasu arteritis (TAK) are rare diseases, and their association is even rarer. Objectives: to present a series of patients with a concomitant diagnosis of SpA or with features of SpA and TAK in Argentina and review the literature regarding this association. Materials and methods: the demographic, clinical and therapeutic characteristics of patients with a concomitant diagnosis of SpA or with some features of SpA and TAK were collected from different health centers in Argentina. Results: 7 patients are described, of which 4 had SpA, one with juvenile axial involvement (axSpA), another with psoriatic arthritis (PsA), another with ankylosing spondylitis (AS) and the last patient with pure axSpA and 3 of them had features of SpA (Crohn's disease, psoriasis and asymmetric oligoarthritis of large joints). In most cases, SpA features presented a median of 4 years before TAK. Conclusions: several case reports and case series reported overlap between these two diseases. Although they could share a certain common genetic basis, we still do not have solid evidence that allows us to estimate that this association is not coincidental.

Resumen Introducción: tanto las espondiloartritis (EspA) como la arteritis de Takayasu (TAK) son enfermedades infrecuentes y su asociación es aún más rara. Objetivos: presentar una serie de pacientes con diagnóstico concomitante de EspA o con rasgos de EspA y TAK en Argentina, y realizar una revisión de la literatura respecto de esta asociación. Materiales y métodos: se recopilaron las características demográficas, clínicas y terapéuticas de pacientes con diagnóstico concomitante de EspA o con algunos rasgos de EspA y TAK, de distintos centros de salud de la República Argentina. Resultados: se describen 7 pacientes, de los cuales 4 presentaban EspA, uno con compromiso axial (EspAax) juvenil, otro con artritis psoriásica (APs), otro con espondilitis anquilosante (EA) y el último con EspAax pura, y 3 de ellos tuvieron rasgos de EspA (enfermedad Crohn, psoriasis y oligoartritis asimétrica de grandes articulaciones). En la mayoría de los casos, los rasgos de EspA se presentaron con una mediana de 4 años antes de la TAK. Conclusiones: varios reportes y series de casos relatan la superposición entre estas dos enfermedades. Si bien las mismas podrían compartir cierta base genética común, todavía no contamos con evidencia sólida que permita estimar que esta asociación no es casual.

Abstract Background Kidney disease is a rare manifestation of ankylosing spondylitis (AS) and its pathological alterations remain poorly described. The aim of this study was to investigate the clinical presentation and pathological alterations on kidney biopsy of AS patients and review and discuss the current literature on the issue. Methods: We retrospectively studied the clinical presentation and kidney pathological alterations of 15 Caucasian AS patients submitted to kidney biopsy between October 1985 and March 2021. Results: Patients were predominantly male (66.7%) with median age at the time of kideney biopsy of 47 years [IQR 34 - 62]. Median serum creatinine at presentation was 1.3 mg/dL [IQR 0.9 - 3] and most patients also had either proteinuria (85.7%) and/or hematuria (42.8%). The most common indication for kidney biopsy was nephrotic syndrome (33.3%), followed by acute or rapidly progressive kidney injury (20%) and chronic kidney disease of unknown etiology (20%). Chronic interstitial nephritis (CIN) (n=3) and AA amyloidosis (n=3) were the most common diagnosis. Others included IgA nephropathy (IgAN) (n=2), focal segmental glomerulosclerosis (n=2), membranous nephropathy (n=1), and immune complex-mediated membranoproliferative glomerulonephritis (IC-MPGN)(n=1). Conclusions: We present one of the largest series of biopsy-proven kidney disease in Caucasian AS patients. We found a lower prevalence of IgAN than previously reported in Asian cohorts. We found a higher prevalence of CIN and a lower prevalence of AA amyloidosis than that described in previous series of Caucasian patients. We also present the first case of AS-associated IC-MPGN. (AS issue Methods 1 198 2021 Results 66.7% 667 66 7 (66.7% 4 IQR 3 62. 62 . 62] 13 1. mgdL mg dL 09 0 9 0. 85.7% 857 85 (85.7% andor 42.8%. 428 42.8% 42 8 (42.8%) 33.3%, 333 33.3% , 33 (33.3%) 20% 20 (20% 20%. (CIN n=3 n3 n (n=3 diagnosis (IgAN n=2, n2 n=2 2 (n=2) n=1, n1 n=1 (n=1) complexmediated complex mediated ICMPGNn=1. ICMPGNn1 ICMPGNn IC MPGN (IC-MPGN)(n=1) Conclusions biopsyproven proven cohorts ASassociated associated ICMPGN. ICMPGN MPGN. IC-MPGN 19 202 66.7 6 (66.7 85.7 (85.7 42.8 (42.8% 33.3 (33.3% (20 n= (n= (n=2 (n=1 ICMPGNn=1 (IC-MPGN)(n=1 66. (66. 85. (85. 42. (42.8 33. (33.3 (2 (n ICMPGNn= (IC-MPGN)(n= (66 (85 (42. (33. ( (IC-MPGN)(n (6 (8 (42 (33 (4 (3

Resumo Antecedentes: A doença renal é uma manifestação rara de espondilite anquilosante (EA) e as suas alterações patológicas permanecem pouco descritas. O objetivo deste estudo foi investigar a apresentação clínica e alterações patológicas na biópsia renal de doentes com EA bem como rever e discutir a literatura atual sobre o assunto. Métodos: Estudamos retrospectivamente a apresentação clínica e alterações patológicas renais de 15 doentes caucasianos com EA submetidos a biópsia renal entre Outubro de 1985 e Março de 2021. Resultados: Os doentes eram predominantemente homens (66,7%) com idade mediana no momento da biópsia de 47 anos [IIQ 34 - 62]. A creatinina sérica mediana na apresentação foi de 1,3 mg/dL [IIQ 0,9 - 3] e a maioria dos pacientes apresentava também proteinúria (85,7%) e/ou hematúria (42,8%). A indicação mais comum para biópsia renal foi a síndrome nefrótica (33,3%), seguida de lesão renal aguda ou rapidamente progressiva (20%) e doença renal crónica de etiologia desconhecida (20%). A Nefrite intersticial crónica (NIC) (n=3) e a amiloidose AA (n=3) foram os diagnósticos mais comuns. Outros incluíram nefropatia por IgA (NIgA) (n=2), glomeruloesclerose segmentar focal (n=2), nefropatia membranosa (n=1) e glomerulonefrite membranoproliferativa mediada por imunocomplexos (GNMP-IC) (n=1). Conclusões: Apresentamos uma das maiores séries de doenças renais comprovadas por biópsia em doentes caucasianos com EA. Encontramos uma prevalência de NIgA menor do que a relatada anteriormente em coortes asiáticas. Encontramos uma maior prevalência de NIC e uma prevalência menor de amiloidose AA do que a descrita em séries anteriores de pacientes caucasianos. Também apresentamos o primeiro caso de GNMP-IC associada à EA. Antecedentes (EA descritas assunto Métodos 1 198 2021 Resultados 66,7% 667 66 7 (66,7% 4 IIQ 3 62. 62 . 62] 13 1, mgdL mg dL 09 0 9 0, 85,7% 857 85 (85,7% eou 42,8%. 428 42,8% 42 8 (42,8%) 33,3%, 333 33,3% , 33 (33,3%) 20% 20 (20% 20%. (NIC n=3 n3 n (n=3 comuns (NIgA n=2, n2 n=2 2 (n=2) n=1 n1 (n=1 GNMPIC GNMP IC (GNMP-IC n=1. Conclusões asiáticas 19 202 66,7 6 (66,7 85,7 (85,7 42,8 (42,8% 33,3 (33,3% (20 n= (n= (n=2 66, (66, 85, (85, 42, (42,8 33, (33,3 (2 (n (66 (85 (42, (33, ( (6 (8 (42 (33 (4 (3

Abstract Background Ankylosing Spondylitis (AS) patients face several challenges due to the nature of the disease and its physical and psychological complications. Sleep disorders are among the most important concerns. Sleep disorders can aggravate the signs and symptoms of the disease and ultimately reduce the quality of patients’ lives. This study uses a systematic review and meta-analysis to pool the reported prevalence of sleep disorders among AS patients. Methods To find related studies, the WoS, PubMed, ScienceDirect, Scopus, Embase, and Google Scholar databases were systematically searched without a lower time limit. Heterogeneity among the identified studies was checked using the I2 index, and the Begg and Mazumdar correlation test examined the existence of published bias. Comprehensive Meta-Analysis (v.2) software was adopted to analyze the data. Results In the review of 18 studies with a sample size of 5,840, the overall pooled prevalence of sleep disorders among AS patients based on the random effects method was found to be 53% (95% CI: 44.9–61). The highest and lowest prevalence was in Egypt at 90% and Australia at 19.2%, respectively. Our meta-regression results show that with the increase in ‘sample size’ and ‘year of publication’, the overall prevalence of sleep disorders in patients with AS decreases (p < 0.05). Conclusion The results of the present study indicate a high and significant prevalence of sleep disorders among AS patients. Thus, health policymakers and healthcare providers must focus on timely diagnosis and effective educational and therapeutic interventions for the prevention and proper treatment of sleep disorders in this population of patients. (AS complications concerns lives metaanalysis meta analysis WoS PubMed ScienceDirect Scopus Embase limit I index bias MetaAnalysis Meta Analysis v.2 v2 v 2 (v.2 data 1 5840 5 840 5,840 53 95% 95 (95 CI 44.9–61. 44961 44.9–61 . 44 9 61 44.9–61) 90 192 19 19.2% respectively metaregression regression year publication, publication , publication’ p 0.05. 005 0.05 0 05 0.05) Thus v. (v. 584 84 5,84 (9 4496 44.9–6 4 6 19.2 00 0.0 (v 58 8 5,8 ( 449 44.9– 19. 0. 5, 44.9 44.

Abstract Background The prevalence of HLA-B27 gene positivity in healthy Caucasian communities varies between 8 and 14%. However, there is a lack of information in countries with a high rate of miscegenation, such as Brazil. Aim To estimate the frequency of HLA-B27 in the Brazilian general population using a large national registry database. Methods This is a cross-sectional ecological study using the Brazilian Registry of Volunteer Bone Marrow Donors (REDOME) database on HLA-B27 allelic frequency and proportion of positives of healthy donors (18–60 years old). Data were analyzed according to sex, age, race (by self-reported skin color recommended by the Brazilian Institute of Geography and Statistics - IBGE), and geographic region of residence. Results From 1994 to 2022, a total of 5,389,143 healthy bone marrow donors were included. The overall positivity for HLA-B27 was 4.35% (CI 95% 4.32–4.37%), regardless of sex and age (57.2% were women, mean age was 41.7yo). However, there was a difference between races: 4.85% in Whites; 2.92% in Blacks; 3.76% in Pardos (Browns i.e. mixed races); 3.95% in Amarelos (Yellows i.e. Asian Brazilians); and 3.18% in Indigenous. There was also a difference regarding geographic region of residence (North: 3.62%; Northeast: 3.63%; Southeast: 4.29%; Midwest: 4.5% and 5.25% in South). The homozygosity rate for the HLA-B27 was 1.32% of all the positives and only 0.06% in the general population. Conclusions Our findings provide the first Brazilian national prevalence for HLA-B27 in 4.35%. There is a gradient gene positivity from North to South, suggesting that the genetic background related to the miscegenation due to colonization, slavery, and some later waves of immigration together with internal migratory flows, could explain our findings. HLAB27 HLAB HLA B27 B HLA-B2 14 14% However Brazil crosssectional cross sectional REDOME (REDOME 18–60 1860 18 60 (18–6 old. old . old) selfreported self reported IBGE, IBGE , IBGE) 199 2022 5389143 5 389 143 5,389,14 included 435 4 35 4.35 CI 95 4.32–4.37%, 432437 4.32–4.37% 32 37 4.32–4.37%) 57.2% 572 57 2 (57.2 women 41.7yo. 417yo yo 41.7yo 41 7yo 41.7yo) races 485 85 4.85 Whites 292 92 2.92 Blacks 376 3 76 3.76 Browns ie i e i.e races) 395 3.95 Yellows Brazilians Brazilians) 318 3.18 Indigenous (North 3.62% 362 62 Northeast 3.63% 363 63 Southeast 4.29% 429 29 Midwest 45 4.5 525 25 5.25 South. South South) 132 1 1.32 006 0 06 0.06 colonization slavery flows HLAB2 B2 HLA-B 18–6 186 6 (18– 19 202 538914 38 5,389,1 43 4.3 9 43243 4.32–4.37 57.2 (57. 48 4.8 2.9 7 3.7 39 3.9 31 3.1 3.62 36 3.63 4.29 42 4. 52 5.2 13 1.3 00 0.0 18– (18 20 53891 5,389, 4324 4.32–4.3 57. (57 2. 3. 3.6 4.2 5. 1. 0. (1 5389 5,389 432 4.32–4. (5 ( 538 5,38 4.32–4 53 5,3 4.32– 5, 4.32

Abstract Background Secukinumab has shown high efficacy in randomized controlled trials in both ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Here, we investigated its real-life effectiveness and tolerability in a cohort of AS and PsA patients. Methods We retrospectively analyzed medical records of outpatients with AS or PsA treated with secukinumab between December 2017 and December 2019. ASDAS-CRP and DAS28-CRP scores were used to measure axial and peripheral disease activity in AS and PsA, respectively. Data were collected at baseline and after 8, 24, and 52 weeks of treatment. Results Eighty-five adult patients with active disease (29 with AS and 56 with PsA; 23 males and 62 females) were treated. Overall, mean disease duration was 6.7 years and biologic-naïve patients were 85%. Significant reductions in ASDAS-CRP and DAS28-CRP were observed at all time-points. Body weight (in AS) and disease activity status at baseline (particularly in PsA) significantly affected disease activity changes. ASDAS-defined inactive disease and DAS28-defined remission were achieved in comparable proportions between AS and PsA patients, at both 24 weeks (45% and 46%) and 52 weeks (65.5% and 68%, respectively); male sex was found an independent predictor of positive response (OR 5.16, P = 0.027). After 52 weeks, achievement of at least low disease activity and drug retention were observed in 75% of patients. Secukinumab was well-tolerated and only mild injection-site reactions were recorded in 4 patients. Conclusion In a real-world setting, secukinumab confirmed great effectiveness and safety in both AS and PsA patients. The influence of gender on treatment response deserves further attention. (AS PsA. . (PsA) Here reallife real life 201 2019 ASDASCRP ASDAS CRP DAS28CRP DASCRP DAS28 DAS respectively 8 5 Eightyfive Eighty five 29 (2 2 6 females Overall 67 7 6. biologicnaïve biologic naïve 85 85% timepoints. timepoints time points. points time-points particularly changes ASDASdefined defined DAS28defined DASdefined 45% 45 (45 46% 46 65.5% 655 65 (65.5 68 68% respectively) OR 516 16 5.16 0.027. 0027 0.027 0 027 0.027) 75 welltolerated well tolerated injectionsite injection site realworld world setting attention (PsA 20 DAS2 ( (4 65.5 (65. 51 1 5.1 002 0.02 02 65. (65 5. 00 0.0 (6 0.

Abstract The aim of this study was to evaluate tumor necrosis factor alpha (TNF-α), interleukin (IL)- 17A/F levels in the serum of ankylosing spondylitis (AS) patients after anti-TNF therapy, in order to understand how these cytokines are involved in this therapeutic response. Forty-four AS patients were included in the study: thirty using anti-TNF therapy were classified according to their therapy response as responders (15) and non-responders (15) and 14 without anti-TNF therapy were classified as AS control. Fifteen healthy individuals formed the control group. Serum levels of TNF-α were determined using Luminex technology and for IL-17A and IL-17F using ELISA. The non-responder patients presented higher serum levels of TNF-α than the responders and AS control; the same results were found when HLA-B*27 positive or negative patients were separately analyzed. IL-17A and IL17F serum levels were similar for all groups. According to the clinical disease activity, AS patients with BASDAI ≥4 had higher serum levels of TNF-α than AS patients with BASDAI <4. Positive correlation was found between TNF-α levels and BASDAI. In AS patients, TNF-α serum levels were associated with anti-TNF therapy and disease activity independently of HLA-B*27, and IL-17A and IL-17F were not related to anti-TNF treatment. TNFα, TNFα TNF α , (TNF-α) IL (IL) 17AF AF 17A F A (AS antiTNF anti Fortyfour Forty four 15 (15 nonresponders non 1 group IL17A ILA ILF 17F ELISA nonresponder responder HLAB*27 HLAB27 HLAB HLA B*27 B 27 HLA-B*2 analyzed groups 4 ≥ <4 HLAB*27, B*27, treatment (TNF-α (IL (1 HLAB*2 HLAB2 B27 B*2 2 HLA-B* < ( HLAB* B2 B* HLA-B

SUMMARY OBJECTIVE: The aim of this study was to assess the relation of systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index with disease activity, functional status, and general health status in ankylosing spondylitis. METHODS: Patients with ankylosing spondylitis and healthy volunteers were included in this cross-sectional study. Demographic data; disease activity measurements such as the Bath Ankylosing Spondylitis Disease Activity Index, the Ankylosing Spondylitis Disease Activity Score with C-reactive protein, and the Ankylosing Spondylitis Disease Activity Score with erythrocyte sedimentation rate; functional status such as the Bath Ankylosing Spondylitis Functional Index; and general health status such as the Assessment of Spondyloarthritis International Society Health Index of the patients were recorded. C-reactive protein, erythrocyte sedimentation rate, platelet to lymphocyte ratio, neutrophil to lymphocyte ratio, monocyte to lymphocyte ratio, systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index values were recorded. Patients were grouped as active and remission according to the Bath Ankylosing Spondylitis Disease Activity Index score and as inactive-low and high-very high disease activity according to the Ankylosing Spondylitis Disease Activity Score. The correlation of laboratory parameters with disease-related parameters was tested. RESULTS: The indexes were significantly higher in patients compared to controls (p<0.001, for platelet to lymphocyte ratio p=0.03). No significant differences existed in any blood cell-derived indexes among patient groups categorized by disease activity (p<0.05 for all). Systemic immune inflammation index was weakly correlated with Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ρ=0.197 and p=0.049) and Ankylosing Spondylitis Disease Activity Score-erythrocyte sedimentation rate (ρ=0.201 and p=0.045). Systemic immune inflammation index was not correlated with Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, and Assessment of Spondyloarthritis International Society Health Index. No correlation was found between other indexes and disease-related variables. Platelet to lymphocyte ratio, systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index showed a weak positive correlation with C-reactive protein and erythrocyte sedimentation rate (ρ=0.200–0.381). CONCLUSION: Systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index can be used to indicate systemic inflammatory burden in ankylosing spondylitis patients. However, these indexes are not effective in indicating patients’ disease activity, general health status, and functional status. OBJECTIVE METHODS crosssectional cross sectional data Creactive C reactive recorded inactivelow inactive low highvery very diseaserelated related tested RESULTS p<0.001, p0001 p 0 001 (p<0.001 p=0.03. p003 p=0.03 . 03 p=0.03) cellderived cell derived p<0.05 p005 05 (p<0.0 all. all all) ρ=0.197 ρ0197 ρ 197 (ρ=0.19 p=0.049 p0049 049 Scoreerythrocyte ρ=0.201 ρ0201 201 (ρ=0.20 p=0.045. p0045 p=0.045 045 p=0.045) variables ρ=0.200–0.381. ρ02000381 ρ=0.200–0.381 200 381 (ρ=0.200–0.381) CONCLUSION However p<0.001 p000 00 (p<0.00 p00 p=0.0 p<0.0 (p<0. ρ=0.19 ρ019 19 (ρ=0.1 p=0.04 p004 04 ρ=0.20 ρ020 20 (ρ=0.2 ρ0200038 ρ=0.200–0.38 38 (ρ=0.200–0.381 p<0.00 p0 p=0. p<0. (p<0 ρ=0.1 ρ01 1 (ρ=0. ρ=0.2 ρ02 2 ρ020003 ρ=0.200–0.3 3 (ρ=0.200–0.38 p=0 p<0 (p< ρ=0. ρ0 (ρ=0 ρ02000 ρ=0.200–0. (ρ=0.200–0.3 p= p< (p ρ=0 (ρ= ρ0200 ρ=0.200–0 (ρ=0.200–0. ρ= (ρ ρ=0.200– (ρ=0.200–0 ρ=0.200 (ρ=0.200– (ρ=0.200

SUMMARY OBJECTIVE: The Oswestry Disability Index is considered the gold standard in the evaluation of disability in patients with chronic mechanical back pain. The aim of this study was to assess the applicability of Oswestry Disability Index in patients with ankylosing spondylitis and its relationship with disease assessment parameters for ankylosing spondylitis. METHODS: A total of 100 patients diagnosed with ankylosing spondylitis were included in the study group. The control group consisted of 50 individuals with nonspecific low back pain. The Oswestry Disability Index and Bath Ankylosing Spondylitis Disease Activity Index were applied to both groups. In addition, the Visual Analog Scale, the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein, the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate, the Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and the Ankylosing Spondylitis Quality of Life scales were applied in the study group. the Erythrocyte Sedimentation Rate, C-Reactive Protein levels, and HLA-B27 analysis were noted as laboratory markers in ankylosing spondylitis patients. RESULTS: The scores of Oswestry Disability Index had a significant correlation with scores of Bath Ankylosing Spondylitis Disease Activity Index in ankylosing spondylitis patients (r=0.543) and in the control group (r=0.401). There was a significant correlation between the scores of Oswestry Disability Index and the Bath Ankylosing Spondylitis Functional Index (r=0.544), Bath Ankylosing Spondylitis Metrology Index (r=0.317), the Ankylosing Spondylitis Quality of Life (r=0.723), the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate (r=0.501), the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein (r=0.530), Visual Analog Scale-Rest (r=0.476), and Visual Analog Scale-Activity (r=0.441) values in patients with ankylosing spondylitis. CONCLUSION: Evaluation of Oswestry Disability Index in conjunction with Bath Ankylosing Spondylitis Disease Activity Index may warn the physician to interpret high Bath Ankylosing Spondylitis Disease Activity Index scores in the context of mechanical pain. Therefore, the use of Oswestry Disability Index in patients with ankylosing spondylitis will be beneficial. OBJECTIVE pain METHODS 10 5 groups addition Scale CReactive C Reactive Scorethe levels HLAB27 HLAB HLA B27 B HLA-B2 RESULTS r=0.543 r0543 r 0 543 (r=0.543 r=0.401. r0401 r=0.401 . 401 (r=0.401) r=0.544, r0544 r=0.544 , 544 (r=0.544) r=0.317, r0317 r=0.317 317 (r=0.317) r=0.723, r0723 r=0.723 723 (r=0.723) r=0.501, r0501 r=0.501 501 (r=0.501) r=0.530, r0530 r=0.530 530 (r=0.530) ScaleRest Rest r=0.476, r0476 r=0.476 476 (r=0.476) ScaleActivity r=0.441 r0441 441 (r=0.441 CONCLUSION Therefore beneficial 1 HLAB2 B2 HLA-B r=0.54 r054 54 (r=0.54 r040 r=0.40 40 (r=0.401 (r=0.544 r031 r=0.31 31 (r=0.317 r072 r=0.72 72 (r=0.723 r050 r=0.50 (r=0.501 r053 r=0.53 53 (r=0.530 r047 r=0.47 47 (r=0.476 r=0.44 r044 44 (r=0.44 r=0.5 r05 (r=0.5 r04 r=0.4 4 (r=0.40 r03 r=0.3 3 (r=0.31 r07 r=0.7 7 (r=0.72 (r=0.50 (r=0.53 (r=0.47 (r=0.4 r=0. r0 (r=0. (r=0.3 (r=0.7 r=0 (r=0 r= (r= (r

Abstract Objective This study aims to evaluate the effect of functional versus resistance exercise training on the functional capacity and quality of life of psoriatic arthritis patients. Methods Forty-one psoriatic arthritis patients (18 to 65 years old) were randomized into two groups: functional training group and resistance exercise group. The functional training group underwent functional exercises with elastic band and the functional training group underwent machine resistance exercise twice a week for 12 weeks. Outcome measures were: The Bath Ankylosing Spondylitis Functional Index (BASFI) and Health Assessment Questionnaire for the Spondyloarthropathies (HAQ-S) for functional capacity and functional status, one-repetition maximum test for muscle strength, the Short Form 36 health survey questionnaire (SF-36) for quality of life, and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Disease Activity Score 28 (DAS-28) for disease activity. Analyzes were performed by a blinded evaluator at baseline (T0), six (T6) and twelve (T12) weeks after the beginning of the exercise. Results At baseline, the groups were homogeneous in the clinical and demographic characteristics. There was a statistical intra-group improvement for both groups in the BASFI, BASDAI, HAQ-s, and DAS-28. In the quality-of-life assessment, both groups showed statistical intra-group improvements for all domains except the “emotional aspect” domain in the resistance exercise group. In the muscle strength, there was a statistical improvement for all exercises in both groups, except for the “alternate biceps (bilateral)” exercise. Conclusion Functional training and resistance exercise are similarly effective in improving functional capacity, functional status, disease activity, general quality of life, and muscle strength in patients with psoriatic arthritis. Trial Registration ClinicalTrials.gov: NCT04304326. Registered 11 March 2020, https://clinicaltrials.gov/ct2/show/NCT04304326?term=NCT04304326&draw=2&rank=1. Fortyone Forty one 18 (1 6 old 1 BASFI (BASFI HAQS HAQ S (HAQ-S status onerepetition repetition 3 SF36 SF (SF-36 BASDAI (BASDAI 2 DAS28 DAS (DAS-28 activity T0, T0 T , (T0) T6 (T6 T12 (T12 characteristics intragroup intra HAQs, HAQs s, s HAQ-s DAS28. 28. DAS-28 qualityoflife assessment emotional aspect alternate bilateral (bilateral) ClinicalTrials.gov ClinicalTrialsgov ClinicalTrials gov NCT04304326 NCT 2020 https//clinicaltrials.gov/ct2/show/NCT04304326term=NCT04304326&draw=2&rank=1. httpsclinicaltrialsgovct2showNCT04304326termNCT04304326draw2rank1 httpsclinicaltrialsgovctshowNCTtermNCTdrawrank https //clinicaltrials.gov/ct2/show/NCT04304326 term=NCT04304326&draw=2&rank=1. clinicaltrials ct2 show term draw rank ct https://clinicaltrials.gov/ct2/show/NCT04304326?term=NCT04304326&draw=2&rank=1 ( SF3 (SF-3 DAS2 (DAS-2 (T0 (T T1 (T1 DAS-2 (bilateral NCT0430432 202 NCT04304326term https//clinicaltrials.gov/ct2/show/NCT04304326term=NCT04304326&draw=2&rank=1 httpsclinicaltrialsgovct showNCT termNCT httpsclinicaltrialsgovct2showNCT04304326termNCT04304326draw2rank clinicaltrialsgovct2showNCT04304326 clinicaltrialsgovctshowNCT //clinicaltrials.gov/ct2/show/NCT0430432 termNCT04304326draw2rank1 termNCTdrawrank term=NCT04304326&draw=2&rank=1 https://clinicaltrials.gov/ct2/show/NCT04304326?term=NCT04304326&draw=2&rank= (SF- (DAS- DAS- NCT043043 20 NCTterm https//clinicaltrials.gov/ct2/show/NCT04304326term=NCT04304326&draw=2&rank= clinicaltrialsgovct clinicaltrialsgovct2showNCT0430432 //clinicaltrials.gov/ct2/show/NCT043043 termNCT04304326draw2rank term=NCT04304326&draw=2&rank= https://clinicaltrials.gov/ct2/show/NCT04304326?term=NCT04304326&draw=2&rank (SF (DAS NCT04304 https//clinicaltrials.gov/ct2/show/NCT04304326term=NCT04304326&draw=2&rank clinicaltrialsgovct2showNCT043043 //clinicaltrials.gov/ct2/show/NCT04304 term=NCT04304326&draw=2&rank NCT0430 clinicaltrialsgovct2showNCT04304 //clinicaltrials.gov/ct2/show/NCT0430 NCT043 clinicaltrialsgovct2showNCT0430 //clinicaltrials.gov/ct2/show/NCT043 NCT04 clinicaltrialsgovct2showNCT043 //clinicaltrials.gov/ct2/show/NCT04 NCT0 clinicaltrialsgovct2showNCT04 //clinicaltrials.gov/ct2/show/NCT0 clinicaltrialsgovct2showNCT0 //clinicaltrials.gov/ct2/show/NCT clinicaltrialsgovct2showNCT

ABSTRACT BACKGROUND: Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects multiple joints. It is associated with psoriasis and treated with synthetic and biologic drugs. OBJECTIVE: The objective of this study was to assess the outcomes of patients who received biologic therapy with tumor necrosis factor (TNF) inhibitors in terms of effectiveness, safety, functionality, and quality of life. DESIGN AND SETTING: A prospective observational study was performed at a single center in Belo Horizonte, Brazil. METHODS: Patients with PsA who received their first TNF inhibitor treatment were followed up for 12 months. Disease activity was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Clinical Disease Activity Index (CDAI). Functionality was measured using the Health Questionnaire Assessment (HAQ), and quality of life was evaluated using the European Quality of Life Five Dimensions (EQ-5D). Multiple linear regression was used to identify predictors of the clinical response at 12 months. RESULTS: A total of 143 patients treated with adalimumab or etanercept were evaluated. Most of the clinical measures were significantly improved at 12 months. However, 31%–51% of the patients did not achieve good clinical control. No differences were observed between adalimumab and etanercept, except for poor functionality at 12 months among patients treated with etanercept. The main predictors of a worse clinical response were female sex, etanercept use, poor functionality, or lower quality of life at baseline. The main adverse reactions were alopecia, headache, injection site reaction, sinusitis, flu, dyslipidemia, and infections. CONCLUSION: TNF inhibitor therapy was effective and safe. However, despite improvements in clinical measures, most patients did not achieve satisfactory control of the disease.