Gestion Des Dmards Conventionnels Dans La Polyarthrite Rhumatoïde Au Bénin : Quid De La Biothérapie - Zavier, Zomalhèto; Calixte, Assogba; Hilaire, Dossou-yovo (European Scientific Journal, ESJ, 2020)
Objectif : Evaluer la gestion et lâ€™efficacitÃ© des DMARDs conventionnels chez les patients souffrant de PR au BÃ©nin. Patients et MÃ©thode : Etude transversale et analytique portant sur les patients suivis pour une PR et traitÃ©e par DMARDs. Le diagnostic de PR a Ã©tÃ© retenu sur la base des critÃ¨res EULAR/ACR 2010. Les donnÃ©es recueillies ont Ã©tÃ© analysÃ©es grÃ¢ce au logiciel SPSS17.0 RÃ©sultats : 156 patients souffrant de PR ont Ã©tÃ© Ã©valuÃ©s. L’Ã¢ge moyen des patients Ã©tait de 44,6 Â± 14,1 [15-69] ans et le sex- ratio Ã©tait de 0,14. Le facteur rhumatoÃ¯de Ã©tait prÃ©sent chez 88%, les anticorps anti-CCP Ã©taient prÃ©sents chez 69.20%. Lâ€™Ã¢ge moyen de dÃ©but de la maladie Ã©tait 32,7 Â± 7.03 [18-50]. La durÃ©e moyenne dâ€™Ã©volution Ã©tait de 10,3 Â± 7,1 [0,5-25] ans. Le DAS28 moyen au dÃ©but Ã©tait 5,71Â± 2.04. Au plan radiologique, le score moyen de Larsen Ã©tait de 38,55 Â± 16,94. La dose moyenne de Prednisone Ã©tait de 15 mg/jour. Les DMARDs utilisÃ©s Ã©taient : MÃ©thotrexate 15 Ã 20mg/semaine (150 cas), le lÃ©flunomide (6 cas), la salazopyrine 2g/j (27cas), hydroxychloroquine 400 mg / jour (24 cas). A 24 mois, le DAS28 moyen Ã©tait de 3, 91Â±2,01 et 23,7% des patients avaient une PR active. Conclusion : La disponibilitÃ© des DMARDs pose un problÃ¨me dans notre pays. Leur utilisation rationnelle associÃ©e Ã une faible dose de prednisone permet dâ€™Ã©pargner aux patients une biothÃ©rapie dont le coÃ»t reste hors de la portÃ©e des patients de notre pays Ã faible revenu. Aim: To evaluate the management and efficacy of conventional DMARDs in RA patients in Benin. Patients and Method: Transversal and analytical study of patients followed for RA and treated with DMARDs. The diagnosis of RA was selected on the basis of EULAR/ACR 2010 criteria. The data collected were analysed using SPSS17.0 software. Results: 156 RA patients were evaluated. The mean age of the patients was 44.6 Â± 14.1 [15-69] years and the sex ratio was 0.14. The mean age of the patients was 44.6 Â± 14.1 [15-69] and the sex ratio was 0.14. Rheumatoid factor was present in 88%, anti-CCP antibodies were present in 69.20%. The mean age of disease onset was 10.3 Â± 7.1 [0.5-25] years. The mean time to progression was 8.9 Â± 7.7 [1-30]. The mean DAS28 at onset was 5.71Â± 2.04 [1-30]. Radiologically, the mean feedback score was 38.55 Â± 16.94 [1-30]. The mean dose of Prednisone was 15 mg/day. The DMARDs used were: methotrexate 15-20 mg/week (150 cases), leflunomide (6 cases), salazopyrin 2g/day (27 cases), hydroxychloroquine 400 mg/day (24 cases). At 24 months, mean DAS28 was 3.91Â±2.01 and 23.7% of patients had active RA. Conclusion: Availability of DMARDs is a problem in our country. Their rational use associated with a low dose of prednisone saves patients from biotherapy, the cost of which remains out of reach for low-income patients in our country.