Treatment of chronic inflammatory rheumatism by biotherapy in Gabon : eligibility and follow-up of the first 8 patients in sub-Saharan Africa
| Autor: | L. Missounga, I.R. Nseng Nseng Ondo, J. B. Boguikouma, J. Iba Ba, M.I.C. Nziengui Madjinou, D. Mwenpindi Malekou, E.G. Mouendou Mouloungui |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Tuberculosis Etanercept Arthritis Rheumatoid Internal medicine medicine Adalimumab Humans Gabon Africa South of the Sahara business.industry Patient Selection Public Health Environmental and Occupational Health Middle Aged medicine.disease Golimumab Infliximab Biological Therapy Infectious Diseases Rheumatoid arthritis Antirheumatic Agents Rituximab Female business Rheumatism medicine.drug Follow-Up Studies |
| Zdroj: | Medecine et sante tropicales. 28(2) |
| ISSN: | 2261-2211 |
| Popis: | Objective to clarify the eligibility criteria for biotherapies in patients with chronic inflammatory rheumatism (CIR) in sub-Saharan Africa and to describe the characteristics of the first 8 patients treated with biotherapy in Gabon. Materials and methods Patients who responded inadequately to treatments by cDMARDs (EULAR criteria) had a face-to-face interview to inform them about and obtain their consent to biotherapy for at least 3 months, with details of the cost and side effects of each available biotherapy and a certificate of "necessity of biotherapy". The inclusion and follow-up of patients took place in the outpatient rheumatology consultations at the University Hospital of Libreville (Gabon) between January 2010 and December 2016. Results Of the 30 patients who failed cDMARDs and required biologic treatment, 8 (26.6%) were able to start a biotherapy: 4 men and 4 women with rheumatoid arthritis (n = 4.50%), spondyloarthritis or psoriatic rheumatism (n = 2.25% each). The biotherapy was etanercept (n = 4, 50%), adalimumab, golimumab, infliximab and rituximab (n = 1, 12.5% each). The average duration of the biotherapy was 27.4 months (9-54). Biotherapy was stopped in 4 cases (50%), one each (12.5%) for multifocal tuberculosis, pregnancy, financial reasons, and remission. Conclusion Our study shows that biotherapies, which are currently very expensive, can be prescribed in Africa provided that the usual recommendations are followed strictly. Here, access to biotherapies is only possible through private insurance and the rheumatologist must play the role of facilitator for needy and consenting patients. |
| Databáze: | OpenAIRE |
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