Correction to: Measuring treatment effect on psoriatic arthritis-related domains: insights from the SPIRIT-H2H study at weeks 24 and 52

Clinical Rheumatology -     

Cost evolution of biological drugs in rheumatoid arthritis patients in a tertiary hospital: Influential factors on price

ObjectiveTo assess the evolution of cost per patient/year and the cost per patient/year/drug in patients with rheumatoid arthritis (RA) receiving biological treatments. To analyze and quantify the factors influencing this evolution, such as the optimization of the biological drugs, the use of biosimilars, and official discounts and discounts obtained after negotiated procedures. In addition, to assess specific clinical parameters of disease activity in these patients.MethodsRetrospective, observational study conducted in a Spanish tertiary hospital. Adult patients diagnosed with RA under treatment from 2009 to 2017 were included.Results320, 270 and 389 patients were included in 2009, 2013 and 2017, respectively. The patient/year cost decreased from 10,789€ in 2009, 7491€ in 2013 to 7116€ in 2017. In 2017, due to the established competition, discounts of 14% and 29.5% were achieved on etanercept and its biosimilar; 11.5%, 17.8%, 17.9%, 17.3% on adalimumab, certolizumab, golimumab and tocilizumab IV respectively, and 24.6% and 43.1% on infliximab and its biosimilar. The percentage of patients optimized in 2017 was 35.2%. The annual saving in 2017 was 1,288,535€ (830,000€ due to dose optimization and/or administration regimens, 249,666€ corresponding to 7.5% of the official discount and 208,868€ after negotiated procedures).ConclusionThe annual cost per patient in RA decreased considerably due to different factors, such as discounts on the purchase of drugs due to official discounts and negotiated procedures, together with the optimization of therapies, the latter being the factor that contributed most to this decrease.     

Diagnóstico microbiológico de las infecciones intraabdominales

Intra-abdominal infections represent a large and wide group of diseases which include intra- and retro-peritoneal infections. Some of them could be defined as uncomplicated, where the infectious process is limited to the organ or tissue of origin (appendicitis, diverticulitis, cholecystitis…). Complications occur when the infection spreads to the peritoneum, triggering localised peritonitis and abdominal abscesses.     

Proposal of new regression formulae for the estimation of age in infant skeletal remains from the metric study of the pars basilaris

In the context of physical and forensic anthropology, when a child’s skeleton is damaged or in poor condition, which is common, many of the metric methods for the estimation of skeletal age cannot be used. In these circumstances, those more resistant bones, such as the pars basilaris, will be most useful. The aims of this study were to test existing methods for estimating skeletal age from the metric study of the pars basilaris and to propose new regression formulae. One hundred fourteen individuals aged between 5 months of gestation and 6 years were analyzed; seven measures were taken from each pars basilaris using a digital caliper. The chronological age was compared with the estimated age using the methods published by Fazekas and Kósa in 1978 and by Scheuer and MacLaughlin in 1994. New regression formulae are proposed, obtained by classical calibration, which include confidence intervals at 50 and 97.5 % to express the error. With both methods, significant differences were observed; the method of Fazekas and Kósa shows a tendency to underestimate the age, and the method of Scheuer and MacLaughlin tends to overestimate it. The proposed formulae represent a good tool for estimating age in many different contexts because they are relatively easy to apply, although other analysis systems, such as Bayesian approach or geometric morphometry, offer more robust and effective results.