Publications by authors named "Emilia Sato"

Background/objectives: The effectiveness of COVID-19 vaccine in patients with immune-mediated inflammatory diseases (IMID) depends on the underlying disease, immunosuppression degree and the vaccine regimens. We evaluate the safety and immunogenicity of different COVID-19 vaccine schedules.

Methods: The SAFER study: "Safety and effectiveness of the COVID-19 Vaccine in Rheumatic Disease", is a Brazilian multicentric prospective observational phase IV study in the real-life.

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Breakthrough COVID-19 (occurring in fully vaccinated people) has been described. Data on its characteristics among immune-mediated rheumatic disease (IMRD) patients are scarce. This study describes breakthrough COVID-19 occurring in IMRD patients participating in the SAFER-study, a Brazilian multicentric cohort evaluating the safety, effectiveness, and immunogenicity of SARS-CoV-2 vaccines in patients with autoimmune diseases.

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Objectives: To identify the predictive factors of first hospitalization and associated variables to the main causes of hospitalizations in lupus patients from a Latin American cohort.

Methods: The first hospitalization after entry into the cohort during these patients' follow-up due to either lupus disease activity and/or infection was examined. Clinical and therapeutic variables were those occurring prior to the first hospitalization.

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Background: Patients with immune-mediated rheumatic diseases (IMRDs) have been prioritized for COVID-19 vaccination to mitigate the infection severity risks. Patients with rheumatoid arthritis (RA) are at a high risk of severe COVID-19 outcomes, especially those under immunosuppression or with associated comorbidities. However, few studies have assessed the safety of the COVID-19 vaccine in patients with RA.

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Article Synopsis
  • A new consensus guideline by the Brazilian Society of Rheumatology was created to enhance the diagnosis and treatment of lupus nephritis (LN) through collaboration among 20 rheumatologists and methodologists, using systematic reviews and specific research questions.
  • The guideline emphasizes essential testing for all systemic lupus erythematosus (SLE) patients, with kidney biopsy as the gold standard for LN diagnosis, and outlines 14 key recommendations including a defined target renal response (TRR) for monitoring treatment effectiveness.
  • Hydroxychloroquine is recommended for all SLE patients unless contraindicated, and glucocorticoids are advised for managing LN based on effective grading strategies.
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Article Synopsis
  • - The study investigates the characteristics and effects of the time taken to diagnose systemic lupus erythematosus (SLE) in a Latin American cohort, noting that diagnosis can often be delayed and that SLE may resemble other diseases.
  • - Patients with longer diagnosis times (over 6 months) were often older, female, of Mestizo descent, uninsured, and displayed atypical symptoms, but this delayed diagnosis did not seem to affect their disease progression or mortality rates significantly.
  • - Overall, the research concludes that within this cohort, waiting up to 24 months for an SLE diagnosis, with a median of 6 months, did not lead to worse health outcomes.
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Considerable variability exists in the way health-care providers treat patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis in Latin America. The most frequently used treatments for ANCA-associated vasculitis are cyclophosphamide and prolonged glucocorticoid tapers; however, randomised controlled trials conducted over the past 30 years have led to the development of several evidence-based treatment alternatives for these patients. Latin America faces socioeconomic challenges that affect access to care, and the use of certain costly medications with proven efficacy ANCA-associated vasculitis is often restricted.

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To measure left ventricular (LV) global longitudinal strain (GLS) using speckle tracking echocardiography in idiopathic inflammatory myopathy (IIM) patients and to determine whether the LV GLS predicts outcomes in those patients. Prospective study consisted of a cross-sectional phase with 61 IIM patients and 32 individuals without IIM and longitudinal phase, in which patients were divided into two subgroups: 26 with reduced LV GLS and 35 with normal LV GLS; patients were followed for a mean of 25 months, and the occurrence of cardiovascular events and criteria for IIM activity were compared. The mean LV GLS (18.

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Article Synopsis
  • The objective was to create the first evidence-based treatment guidelines for Takayasu arteritis (TAK) by the Pan American League of Associations for Rheumatology (PANLAR).
  • A panel of experts used a structured approach (PICO format) to develop key treatment questions, conducted a systematic literature review, and assessed evidence quality using GRADE methodology.
  • Eleven recommendations were made, including conditional support for oral glucocorticoids, certain immunosuppressants, and tumor necrosis factor inhibitors depending on the severity of the disease, along with recommendations for low-dose aspirin and surgical interventions during remission.
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Objectives: To compare the correlations of histological class inferences based on clinical manifestations and laboratory tests between rheumatologists and nephrologists, to determine the associations of clinical and laboratory data with histological classes and to develop an instrument that can assist histological class identification in lupus nephritis (LN).

Methods: Retrospective study based on medical records of 80 systemic lupus erythematosus patients (SLICC criteria classification, 2012) who underwent kidney biopsy between 2010 and 2017. Two rheumatologists and two nephrologists received clinical and laboratory data and answered questions regarding which histological class was expected on kidney biopsy.

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Inflammatory T lymphocyte cytokines contribute to tissue damage in SLE patients. Vitamin D (Vit D) has a well-established immunomodulatory action, but few studies have addressed the effect of 1,25 dihydroxyvitamin D3 (1,25 (OH)2D3) on peripheral blood mononuclear cells (PBMCs) in SLE patients. The aim of this study was to evaluate the immnunomodulatory effect of 1,25 (OH)2D3 on T lymphocyte-related cytokines.

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Objectives: To evaluate factors associated with COVID-19 severity outcomes in patients with systemic lupus erythematosus (SLE).

Methods: This was a cross-sectional analysis of baseline data of a prospective, multi-stage cohort study-"The ReumaCoV Brazil"-designed to monitor patients with immune-mediated rheumatologic disease (IMRD) during the SARS-CoV-2 pandemic. SLE adult patients with COVID-19 were compared with those without COVID-19.

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Autoimmune/autoinflammatory syndrome induced by adjuvants (ASIA) was first described in 2011 to cover disorders characterized by dysregulation of the immune system after exposure to an adjuvant. In the present review, the authors focus on silicone-induced ASIA. In the last two decades, there has been worldwide increase in the use of silicone breast implant (SBI) as an aesthetic procedure, raising concerns for possible effects on the immune system, especially in people who already have previous immune dysregulation.

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Background/objectives: Endothelial dysfunction and reduced number of endothelial progenitor cells (EPCs) in peripheral blood are contributing factors to cardiovascular disease in systemic lupus erythematosus (SLE) patients. Endothelial progenitor cell proliferation is regulated by vascular endothelial growth factor (VEGF). Angiotensin-converting enzyme inhibitors reduce cardiovascular mortality in patients with coronary heart disease.

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Little is known about the epidemiology of systemic vasculitis in South American countries. The aim of this study is to compare the prevalence of systemic vasculitides in two vasculitis referral centers from Brazil and Peru. A cross-sectional study was performed and all patients above 18 years of age, with at least 6 months of follow-up and who met classification or diagnosis criteria for the most common forms of vasculitis, were included.

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Background: Myostatin is a protein in the TGF-β family that negatively regulates muscle mass, and follistatin is a myostatin antagonist.

Objective: The aim of this study was to measure serum levels of myostatin and follistatin in idiopathic inflammatory myopathy patients and correlate these levels with muscle strength, fatigue, functional capacity, damage, and serum levels of muscle enzymes.

Methods: This was a multicenter cross-sectional study including 50 patients (34 dermatomyositis and 16 polymyositis [PM]) and 52 healthy individuals (control group [CG]).

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Article Synopsis
  • - The study aimed to investigate the impact of chronic hydroxychloroquine use on COVID-19 incidence among rheumatic disease patients compared to non-users in the same households during the early months of the pandemic in Brazil.
  • - Researchers analyzed data from 10,443 participants, finding no significant difference in COVID-19 symptoms between patients on hydroxychloroquine and those not taking it; however, factors like lung disease and systemic sclerosis diagnosis increased risk for COVID-19 in patients.
  • - The study highlighted that recent influenza vaccination provided a protective effect against COVID-19, reinforcing the importance of immunization for at-risk populations like those with rheumatic diseases.
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Objectives: To evaluate the incidence of COVID-19 and its main outcomes in rheumatic disease (RD) patients on hydroxychloroquine (HCQ) compared to household cohabitants (HC).

Methods: This is a 24-week nationwide prospective multi-centre cohort with a control group without RD and not using HCQ. All participants were monitored through scheduled phone interviews performed by health professionals.

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Article Synopsis
  • The study investigates factors influencing neuropsychiatric (NP) manifestations in patients with newly diagnosed Systemic Lupus Erythematosus (SLE), aiming to identify both disease-related and demographic factors.
  • A total of 1,193 patients without NP involvement at the start were analyzed using clinical and lab data, applying a multivariable regression model to find independent risk factors.
  • Key findings highlight that certain conditions like myalgias, pneumonitis, and hemolytic anemia increase the risk of NP involvement, while longer disease duration at the start is linked to a lower risk.
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Background/objective: The Latin American population living with lupus lacks reliable and culturally competent health education resources. We describe a Spanish and Portuguese online program to educate Latin American people about lupus.

Methods: An extensive network of Latin American stakeholders participated in the program design, implementation, dissemination, and evaluation.

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Aim: A decrease in proteinuria has been considered protective from renal damage in lupus nephritis (LN), but a cut-off point has yet to be established. The aim of this study was to identify the predictors of renal damage in patients with LN and to determine the best cut-off point for a decrease in proteinuria.

Methods: We included patients with LN defined clinically or histologically.

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Objectives: This study aimed to compare the clinical features, damage accrual, and survival of patients with familial and sporadic systemic lupus erythematosus (SLE).

Methods: A multi-ethnic, multinational Latin American SLE cohort was studied. Familial lupus was defined as patients with a first-degree SLE relative; these relatives were interviewed in person or by telephone.

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Hydroxychloroquine and chloroquine, also known as antimalarial drugs, are widely used in the treatment of rheumatic diseases and have recently become the focus of attention because of the ongoing COVID-19 pandemic. Rheumatologists have been using antimalarials to manage patients with chronic immune-mediated inflammatory rheumatic diseases for decades. It is an appropriate time to review their immunomodulatory and anti-inflammatory mechanisms impact on disease activity and survival of systemic lupus erythematosus patient, including antiplatelet effect, metabolic and lipid benefits.

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