José Luis Andreu

Hospital Universitario Puerta de Hierro-Majadahonda · Departamento de Reumatología

To verify, via a survey, the experience and needs of patients receiving methotrexate (MTX), their general management and the quality of the information provided by the rheumatologist. We conducted a 51-item online survey between May and July 2020 addressed to persons diagnosed with an immune-mediated disease and treated with MTX (regardless of the...

Copy number (CN) polymorphisms of complement C4 play distinct roles in many conditions, including immune-mediated diseases. We investigated the association of C4 CN with systemic sclerosis (SSc) risk. Imputed total C4, C4A, C4B, and HERV-K CN were analyzed in 26,633 individuals and validated in an independent cohort. Our results showed that higher...

Purpose To analyze the causes and identify predictive factors of mortality of Systemic Lupus Erythematosus (SLE), and to assess the time evolution and chronological changes in Spain. Methods We performed a cross-sectional and retrospective study analyzing data from the RELESSER cohort (Spanish Registry of SLE of the Spanish Society of Rheumatology...

Introduction Nerve conduction studies (NCS) have been considered as the gold standard in carpal tunnel syndrome (CTS) diagnosis, despite correlation between clinical symptomatology and NCS severity has shown to be poor. In fact, clinical symptoms precede NCS changes in months or years. Few papers have been published about the clinical response to t...

Background Sjögren syndrome (SS) is a chronic systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands, which alters their function producing dryness of the mouth, eyes and other mucous membranes. The method used to quantify glandular hypofunction is by whole saliva flow stimulated and unstimulated (UWSF) [1], wh...

Background The development of targeted biologic (bDMARDs) and targeted synthetic disease-modifying drugs (tsDMARDS) has made a substantial change in the control of our patients, and has allowed an increasing number of patients to achieve clinical remission. Objectives To gain understanding of patients’ experiences of starting treatment with b/tsDM...

Background Non-alcoholic fatty liver disease (NAFLD), the most common cause of liver disease, has a prevalence of about 25% in the general population. It increases mortality and comorbidity in patients with immune-mediated inflammatory diseases. Objectives The main objective is to estimate the prevalence of NAFLD in three of the most common rheuma...

Background The classification system for Sjögren’s syndrome (SS) proposed by the American-European Consensus Group (AECG) and the revised diagrams proposed by the American College of Rheumatology (ACR) include an altered minor salivary gland biopsy (MSGB) or positive antiRo, among other findings. Thus, an altered MSGB is a particularly important fi...

Background Tocilizumab (TCZ) has shown to be effective for large vessel vasculitis including giant cell arteritis (GCA) and Takayasu arteritis (TAK) (1-5 ). However, LVV-GCA and TAK show different demographic and clinical features that may influence on TCZ therapeutic response. Objectives To compare the effectiveness of TCZ in patients with LVV-G...

Background The therapeutic management of Sjögren’s Syndrome remains challenging in clinical practice. Randomized clinical trials with rituximab (RTX) fail to submit primary outcomes; nevertheless, some case series show improvement with this treatment. Objectives To evaluate the effectiveness of therapy with RTX in patients with primary Sjögren’s S...

Background The rate of psoriatic arthritis progression is increased in those patients presenting with established disease greater than 2 years duration, so it is necessary to find tools that allow early diagnosis to prevent joint damage ¹ . Prevalence of psoriatic arthritis varies according to the screening strategies used. The COMPAQ study compare...

Background Ocular and Neurobehçet’s Disease (NBD) are the most severe manifestations of Behcet’s disease (1-4 ). NBD can be classified as A ) primary neural parenchymal lesions, also known as parenchymal NBD (p-NBD) or B ) secondary to vascular involvement or non-parenchymal NBD (np-NBD) (4 ). Response to biologic therapy (BT) in these two refr...

Background Anti-transcriptional intermediary factor 1γ (anti-TIF 1γ) antibody is robustly linked with cancer-associated dermatomyositis (DM) in adults, but its specificity varies widely between series. TIF 1γ can act either as a tumor promoter or suppressor and may behave as an autoantigen. Objectives Investigate the association between anti-TIF 1...

Background The EPISER study is the first Spanish epidemiological study that has confirmed the great burden of rheumatic diseases in the general population: they consume a large quantity of health resources (doctor visits, medical products) and imply a high social impact in terms of work absenteeism. Rheumatic diseases represent almost 30% of Primar...

Objective To analyse the efficacy, adherence, patient satisfaction, safety, pharmacodynamics and cost-effectiveness of parenteral methotrexate (MTX) in patients with rheumatic diseases. Methods A systematic review of literature was carried out in Medline, Embase and Cochrane Central from the beginning until June 2019. Studies including adult patie...

Objectives To assess efficacy and safety of biologic therapy (BT) in Neurobehçet’s disease (NBD) refractory to glucocorticoids and at least one conventional immunosuppressive drug. Methods Open-label, national, multicenter study. NBD diagnosis was based on the International Consensus Recommendation criteria. Outcome variables were efficacy and saf...

Background/objectives Factors associated with chronic heart failure (CHF) in patients with systemic lupus erythematosus (SLE) have received little attention. Recent data on the use of hydroxychloroquine in the treatment of SARS-CoV-2 infection have cast doubt on its cardiac safety. The factors associated with CHF, including therapy with antimalaria...

Objective To investigate the barriers and facilitators of adherence to methotrexate (MTX) in people with rheumatic diseases and to explore the experience of shared decision-making. Methods A qualitative study was carried out. People diagnosed with inflammatory arthritides or systemic autoimmune diseases and who were treated with MTX were invited t...

Background Neuro-Behçet’s disease (NBD) is a severe complication of Behcet’s disease (BD). Despite well-established therapies with glucocorticoids and conventional immunosuppressants (cIS), a significant proportion of patients are refractory. Objectives To assess efficacy and safety of biologic therapy (BT) in NBD refractory to glucocorticoids and...

Background Factors associated with the development of chronic heart failure (CHF) in systemic lupus erythematosus (SLE) have received little attention. On the other hand, recent data from the use of hydroxychloroquine in the treatment of SARS-CoV-2 infection during the COVID19 pandemic have cast some doubts on its cardiological safety. Objectives...

Background Giant cell arteritis (GCA) may be divided into cranial, and extracranial GCA. Tocilizumab (TCZ) has shown efficacy and safety in GCA and other large-vessel vasculitis (LVV) (1-5). Objectives To compare the efficacy of TCZ in cranial and extracranial GCA. Methods Multicenter observational study of 312 patients with GCA treated with TCZ....

Background SARS-CoV-2 virus is a novel coronavirus that causes COVID-19 disease, which in its most severe form produces life-threatening atypical pneumonia and ARDS. Coronaviruses induce dysregulation of the immune system resulting in a cytokine storm syndrome with activation of the macrophage mediated mainly by IL-1 and IL-6. Although there is no...

Background Visual involvement is one of the most feared complication of Giant Cell Arteritis (GCA).Tocilizumab (TCZ) has shown efficacy and safety in large-vessel vasculitis (LVV) including GCA (1-4). Objectives To assess the efficacy of TCZ to: a ) prevent the appearance of new ocular involvement, and b ) to improve visual symptoms if present. M...

Introduction Nerve conduction studies (NCS) have been considered as the gold standard in carpal tunnel syndrome (CTS) diagnosis, despite correlation between clinical symptomatology and NCS severity has shown to be poor. In fact, clinical symptoms precede NCS changes in months or years. Few papers have been published about the clinical response to t...

Background: Systemic lupus erythematosus (SLE) can affect any part of the gastrointestinal (GI) tract. GI symptoms are reported to occur in more than 50% of SLE patients. Aims: To describe the GI manifestations of SLE in the RELESSER (Registry of Systemic Lupus Erythematosus Patients of the Spanish Society of Rheumatology) cohort and to determin...

Introduction The current paradigm of the management of rheumatoid arthritis (RA) recommends achieving a state of remission or low disease activity through the treat-to-target strategy. Our study assesses adherence to this strategy. Method Patients with RA (ACR-EULAR 2010 criteria) were included. From each centre, 19 patients were randomly selected...

Background/objectives: Immune-mediated inflammatory diseases (IMIDs) are prevalent diseases. There is, however, a lack of understanding of the link between diet and IMIDs, how much dietary patterns vary between them and if there are food groups associated with a worsening of the disease. Subjects/methods: To answer these questions we analyzed a...

Benign rheumatoid nodules are subcutaneous nodules, identical in morphology and histology to the nodules that develop over the course of rheumatoid arthritis (RA); they present in individuals with no symptoms of arthritis and with negative rheumatoid factor (RF). This article introduces the case of a 46-year-old caucasian male who consulted for a t...

Objective To evaluate the efficacy and safety of belimumab in patients with Primary Sjögren's syndrome (pSS). Methods The search included manuscripts assessing the efficacy or safety of belimumab in patients with pSS (American-European Consensus Criteria 2002) published between 2004 and 2017 in MEDLINE, EMBASE or Cochrane databases. Two reviewers...

Objective: To analyse the efficacy, adherence, patient satisfaction, safety, pharmacodynamics and cost-effectiveness of parenteral methotrexate (MTX) in patients with rheumatic diseases. Methods: A systematic review of literature was carried out in Medline, Embase and Cochrane Central from the beginning until June 2019. Studies including adult p...

Background: In a previous paper, we have demonstrated that: (1) local injection of corticosteroids for carpal tunnel syndrome (CTS) is as effective as decompressive surgery, at 1-year follow-up; and (2) surgery has an additional benefit in the 2-year follow-up. In this study, we assess the long-term outcomes of both therapies in an observational ex...

Long-term Outcome of Local Steroid Injections Versus Surgery in Carpal Tunnel Syndrome: Observational Extension of a Randomized Clinical Trial Domingo Ly-Pen1 , José Luis Andreu2, Isabel Millán2, Gema de Blas3, and Alberto Sánchez-Olaso3† Abstract Background: In a previous paper, we have demonstrated that: (1) local injection of corticosteroids for...

This study aimed at determining socio-demographic and clinical factors of primary Sjögren syndrome (pSS) associated with osteoporosis (OP) and fragility fracture. SJOGRENSER is a cross-sectional study of patients with pSS, classified according to American European consensus criteria developed in 33 Spanish rheumatology departments. Epidemiological,...

Introduction: Mucopolysaccharidosis type I (MPS-I: Hurler/Scheie´s disease) is a rare disease with a wide spectrum of severity. This results in underdiagnosis and delayed diagnosis. Prognosis greatly depends upon early diagnosis. The availability of reliable diagnostic tests and the existence of enzyme replacement therapy and/or hematopoietic stem...

Resumen Los nódulos reumatoides benignos son nódulos subcutáneos, idénticos en su morfología e histología a los que ocurren en el transcurso de la artritis reumatoide (AR), que aparecen en personas sin síntomas de artritis y con factor reumatoide (FR) negativo. Se presenta el caso de un varón de 46 años de raza caucasiana que consultó por tumoració...

Objectives: Digestive involvement (DI) has been reported in 10-30% of primary Sjögren's syndrome (pSS) patients, and few studies have systematically analysed the prevalence of DI in pSS patients. The aim of this study was to describe DI prevalence in pSS patients from the Sjögrenser Study, and to analyse its clinical associations. Methods: All p...

Objectives: To investigate the prevalence, associated factors, and effects of primary overt renal disease on morbidity in patients with primary Sjögren's syndrome (pSS). Methods: All patients in the Sjögrenser (registry of adult pSS patients of the Spanish Society of Rheumatology) cohort were retrospectively investigated for the presence of clin...

The lupus register of the Spanish Society of Rheumatology (RELESSER) is a multicentre register of patients with systemic lupus erythematosus (SLE) under follow-up by Spanish Rheumatology Services. It contains data on a total of 4024 patients with SLE. So far, 14 studies have been published from the transversal phase of RELESSER. Here we report the...

Background The mortality in Systemic Lupus Erythematosus (SLE) varies largely across different countries most probably due to social, healthcare and ethnic differences. Objectives To analyze the causes and identify predictive factors of mortality of SLE in Spain in the present century. Methods We performed a cross-sectional and retrospective stud...

Background Methotrexate (MTX) is currently a mainstream drug in the treatment of rheumatic diseases. However, the response to MTX is not universal and may be conditioned by a number of factors, among which adherence could be crucial. Objectives The aim of this study is to explore adherence to MTX in patients with rheumatic diseases, facilitators a...

Background Interstitial Lung Disease (ILD) is an extra-articular complication of rheumatoid arthritis (RA) that is associated with increased morbidity and mortality. Conventional disease-modifying drugs (DMARDs) such as methotrexate (MTX) have been implicated in the development and exacerbation of a pre-existing ILD. Objectives The aim of our stud...

Objectives To investigate the prevalence, risk factors, and effects of primary renal disease on morbidity and mortality in patients with primary Sjögren’s syndrome (pSS). Methods All patients in the SJÖGRENSER (registry of adult SSp patients of the Spanish Society of Rheumatology, cross-sectional phase) cohort were retrospectively investigated for...

Background Interstitial Lung Disease (ILD) is a severe complication of Rheumatoid Arthritis (RA). Several conventional disease-modifying anti-rheumatic drugs (cDMARDs) and biologic (b) DMARDs may induce or impaired ILD-RA. Abatacept (ABA) may be useful in ILD-RA (1). Objectives To assess the efficacy and safety of ABA in a large series of ILD-RA f...

Background Fecal calprotectin (FC) is a biomarker of bowel inflammation widely spread in diagnosis and follow-up of inflammatory bowel disease (IBD). It is classically estimated that 5% of patients with axial spondyloarthritis (SpA) also have IBD; coexistence of both conditions has definite impact in clinical decisions. Proactive detection of both...

Background Interstitial Lung Disease (ILD) is a severe extraarticular manifestation of rheumatoid arthritis (RA). In this line, several radiological patterns of RA-ILD have been described: i) usual interstitial pneumonia (UIP), ii) nonspecific interstitial pneumonia (NSIP), iii) obliterating bronchiolitis, iv) organized pneumonia and mixed patterns...

Objectives Primary Sjögren´s Syndrome (pSS) is characterized by hyperactivity of the B cell, with the consequent production of autoantibodies. The presence of anti-Ro and anti-La has been associated with extraglandular manifestations and lymphoma development. The aim of this study is to evaluate the frequency of different serological profiles in pa...

Management of systemic autoimmune diseases is challenging for physicians in their clinical practice. Although not common, they affect thousands of patients in Spain. The family doctor faces patients with symptoms and non-specific cutaneous, mucous, joint, vascular signs or abnormal laboratory findings at the start of the disease process and has to...

Objective To evaluate the efficacy and safety of belimumab in patients with Primary Sjögren's syndrome (pSS). Methods The search included manuscripts assessing the efficacy or safety of belimumab in patients with pSS (American-European Consensus Criteria 2002) published between 2004 and 2017 in MEDLINE, EMBASE or Cochrane databases. Two reviewers...

OBJECTIVE To assess the incidence of serious infection (SI) and associated factors in a large juvenile-onset systemic lupus erythematosus (jSLE) retrospective cohort. METHODS All patients in the Spanish Rheumatology Society Lupus Registry (RELESSER) who meet ≥4 ACR-97 SLE criteria and disease onset <18 years old (jSLE), were retrospectively invest...

Resumen El registro de lupus de la Sociedad Española de Reumatología (RELESSER) es un registro multicéntrico de pacientes con lupus eritematoso sistémico seguidos en servicios de reumatología españoles, que contiene cuantiosa información sobre 4.024 pacientes. Hasta la fecha han sido publicados 14 análisis sobre la fase transversal del registro. Se...

In 2015 the Spanish Society of Rheumatology (SER) published its position paper on biosimilar drugs. In this update, the SER, continues to manifest its unequivocal commitment to the sustainability of the health system of our country and is aligned with the measures that, without reducing quality of care, are aimed at ensuring its continuity. Since t...

Objective The aim of this study is to describe the findings of a protocolised odontological evaluation of patients with primary Sjögren’s syndrome (pSS) treated in rheumatology units in the Community of Madrid. Methods Multicentric descriptive study in which pSS patients classified according to the American-European consensus of 2002 criteria were...

Introduction One of the missions of the Spanish Society of Rheumatology is to provide the necessary tools for excellence in health care. Currently, there is no reference point to quantify medical actions in this specialty, and this is imperative. Material and method A list of actions was drawn up and a hierarchical classification system was establ...

Objectives: This article estimates the frequency of polyautoimmunity and associated factors in a large retrospective cohort of patients with SLE. Methods: RELESSER (Spanish Society of Rheumatology Lupus Registry) is a nationwide multicentre, hospital-based registry of SLE patients. This is a cross-sectional study. The main variable was polyautoi...

Background Systemic lupus erythematosus (SLE) is regarded as a prototype autoimmune disease because it can serve as a means for studying differences between ethnic minorities and sex. Traditionally, all Hispanics have been bracketed within the same ethnic group, but there are differences between Hispanics from Spain and those from Latin America, no...

Introduction: The current paradigm of the management of rheumatoid arthritis (RA) recommends achieving a state of remission or low disease activity through the treat-to-target strategy. Our study assesses adherence to this strategy. Method: Patients with RA (ACR-EULAR 2010 criteria) were included. From each centre, 19 patients were randomly sele...

Objective The AR Excellence project evaluates clinical monitoring in patients with rheumatoid arthritis (RA) in Spain. The aim of the study was to analyse the use of methotrexate (MTX) in the AR Excellence cohort and to compare it with current recommendations. Patients and methods We collected data from RA patients who initiated treatment with MTX...

Objective: To formulate SER recommendations for the use of biological agents in primary Sjögren's syndrome (pSS). Methods: Relevant clinical research questions were identified on the use of biological agents in pSS. The clinical questions were reformulated into 4PICO questions. A search strategy was designed and a review of the scientific eviden...

Management of systemic autoimmune diseases is challenging for physicians in their clinical practice. Although not common, they affect thousands of patients in Spain. The family doctor faces patients with symptoms and non-specific cutaneous, mucous, joint, vascular signs or abnormal laboratory findings at the start of the disease process and has to...

Objective To formulate SER recommendations for the use of biological agents in primary Sjögren's syndrome (pSS). Methods Relevant clinical research questions were identified on the use of biological agents in pSS. The clinical questions were reformulated into 4 PICO questions. A search strategy was designed and a review of the scientific evidence...

Systemic sclerosis (SSc) is an autoimmune disease that shows one of the highest mortality rates among rheumatic diseases. We perform a large genome-wide association study (GWAS), and meta-analysis with previous GWASs, in 26,679 individuals and identify 27 independent genome-wide associated signals, including 13 new risk loci. The novel associations...

Objectives: To explore the remission concept in rheumatoid arthritis (RA) and the implications of the existing definitions when applied to clinical practice among rheumatologists with different profiles. Methods: A qualitative study through focus groups was conducted. Three focus groups were organised from February to March 2016. Each group was...

Objective: To estimate the incidence and analyze any cancer-associated factors in patients with Systemic Lupus Erythematosus (SLE) differentiating between hormone-sensitive (HS) and non-HS cancers. Methods: Retrospective multicentric study of a patient cohort from the SLE Registry of the Spanish Society of Rheumatology (RELESSER - Spanish acrony...

The objective of the study was to assess the ESSDAI index characteristics in the SJÖGRENSER cohort (Spanish Rheumatology Association’s registry of patients with Primary Sjögren Syndrome [PSS]). SJÖGRENSER is a prospective multicentric study on a cohort of Spanish patients with PSS who meet the 2002 American–European consensus from rheumatology unit...

Background Primary Sjögren’s syndrome (pSS) is characterized by lymphocytic infiltration of the exocrine glands. These patients have a higher risk than the general population of developing non-Hodgkin lymphoma (NHL). This risk also increases with the time of evolution of the disease. pSS is also associated with the development of non-hematological...

Background Interstitial Lung Disease (ILD) is a severe extraarticular manifestation of rheumatoid arthritis (RA). Objectives Our aim was to assess the efficacy of abatacept (ABA) in RA patients with ILD. Methods Retrospective multicenter study of RA patients with ILD treated with ABA. ILD was diagnosed by HRCT. We have analyzed the following vari...

Background Systemic sclerosis (SE) is a serious disease of the connective tissue characterized by dysfunction of the microcirculation. Angiogenesis is a complex process regulated by both angiogenic and angiostatic factors. Normally the functions of these factors are under an adequate balance, however, under certain conditions these factors can be i...

Background Primary Sjögren’s syndrome (pSS) is a systemic autoimmune disease characterized by the involvement of the exocrine glands, mainly salivary and lacrimal glands. Approximately half of patients will experience extraglandular complications throughout their evolution. Objectives To characterize the involvement of the nervous system (NS) in p...

Background Gastric angiodysplasia and the typical “watermelon stomach” aspect is one of the most characteristic vascular manifestations in systemic sclerosis (SS). These angiodysplasias can affect the intestine ocasionally as well as the stomach. Objectives Description of a series of 5 patients with systemic sclerosis and presence of intestinal an...

Background Behçet’s disease (BD) is a variable vessel vasculitis and typically presents with mucocutaneous involvement. However, any organ can be affected, being the neurological affectation (neurobehçet, NB) one of the most serious manifestations. Objectives Our aim was to assess the efficacy and safety of biological therapy as treatment of NB....

Background Belimumab is a human IgG1l monoclonal antibody directed against BAFF, a B lymphocyte survival factor. It is indicated as adjuvant treatment in adult patients with active systemic lupus erythematosus (SLE), with positive autoantibodies and with a high degree of activity of the disease despite standard treatment. • Download figure • Open...

Background The time of rheumatoid arthritis (RA) evolution until treatment begins is key to controlling the disease. Many studies have shown that a prolonged duration of symptoms at the onset of treatment is associated with a more severe course of RA. The time from symptoms onset to first DMARD prescription is >12 weeks in Spain, because of diagnos...

Objectives To estimate the incidence of cancer in systemic lupus erythematosus (SLE) patients and to analyze factors associated with cancer differentiating between hormone-sensitive (HS) and non-HS cancers. Methods Multicenter retrospective study of a cohort of patients included in Spanish Society of Rheumatology Lupus Registry (RELESSER). The fir...

Background Primary Sjögren’s syndrome (pSS) is a systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands. Among the extraglandular manifestations, digestive involvement (DI) is frequent, and may condition the quality of life of these patients. There are few studies that systematically analyze gastrointestinal in...

Aim Tumor necrosis factor inhibitors (TNFi) are effective in controlling disease activity in spondyloarthritis (SpA). However, in a proportion of patients these treatments are ineffective or lead to adverse events. Recently, alternative therapies, such as interleukin (IL)‐17 or IL‐23 inhibitors, have emerged in the treatment of these pathologies. T...

In 2015 the Spanish Society of Rheumatology (Sociedad Española de Reumatología [SER]) published its position paper on biosimilar drugs. In this update, the SER, continues to manifest its unequivocal commitment to the sustainability of the health system of our country and is aligned with the measures that, without reducing quality of care, are aimed...

Objective To describe the incidence of bacteremia in a large multicentric cohort of SLE patients and their clinical characteristics and to identify risk factors. Methods All bacteremic episodes from the RELESSER registry were included. Clinical and laboratory characteristics concerning bacteremia and SLE status, as well as comorbidities at the tim...

Background The clinical coexistence of Systemic Lupus Erythematosus (SLE) and Sjögrens Syndrome (SS) was recognized in 1959. The prevalence of SS among patients with SLE varies considerably among the published studies (10%–30%). There is still controversy as to whether or not SLE patients with overlapping SS have a distinct and significantly milder...

Background Serious infections are included as one of the main causes of mortality in juvenile-onset systemic lupus erythematosus (jSLE) patients (Torrente-Segarra et al1) and a predictor of poor prognosis in SLE. We aimed to assess the incidence of serious infection and investigate the associated factors and clinical impact in a large jSLE retrospe...

Objective: