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Ibáñez, Sebastián

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Ibáñez

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Sebastián

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    Pan American League of Associations for Rheumatology recommendations for the management of axial spondyloarthritis
    (2023) Bautista-Molano, Wilson; Fernández-Avila, Daniel G.; Brance, María Lorena; Avila Pedretti, María Gabriela; Burgos-Vargas, Ruben; Corbacho, Inés; Cosentino, Vanesa Laura; Díaz Coto, José Francisco; Giraldo Ho, Enrique; Gomes Resende, Gustavo; Gutiérrez, Luis Arturo; Gutiérrez, Marwin; Ibáñez, Sebastián; Jáuregui, Edwin; Ocampo, Vanessa; Palleiro Rivero, Daniel Ruben; Palominos, Penélope Esther; Pacheco Tena, Cesar; Quiceno, Guillermo Andrés; Saldarriaga-Rivera, Lina María; Sommerfleck, Fernando Andrés; Sariego Goecke, Anelisse; Vera Barrezueta, Claudia; Vega Espinoza, Luis Enrique; Vega Hinojosa, Oscar; Citera, Gustavo; Lozada, Carlos; Sampaio-Barros, Percival D.; Schneeberger, Emilce; Soriano, Enrique R.
    Axial spondyloarthritis (axSpA) comprises a spectrum of chronic inflammatory manifestations affecting the axial skeleton and represents a challenge for diagnosis and treatment. Our objective was to generate a set of evidence-based recommendations for the management of axSpA for physicians, health professionals, rheumatologists and policy decision makers in Pan American League of Associations for Rheumatology (PANLAR) countries. Grading of Recommendations, Assessment, Development and Evaluation-ADOLOPMENT methodology was used to adapt existing recommendations after performing an independent systematic search and synthesis of the literature to update the evidence. A working group consisting of rheumatologists, epidemiologists and patient representatives from countries within the Americas prioritized 13 topics relevant to the context of these countries for the management of axSpA. This Evidence-Based Guideline article reports 13 recommendations addressing therapeutic targets, the use of NSAIDs and glucocorticoids, treatment with DMARDs (including conventional synthetic, biologic and targeted synthetic DMARDs), therapeutic failure, optimization of the use of biologic DMARDs, the use of drugs for extra-musculoskeletal manifestations of axSpA, non-pharmacological interventions and the follow-up of patients with axSpA.
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    Reactivation of adult-onset Still's disease after use of the COVID-19 ChAdOx1-S vaccine
    (2022) Ibáñez, Sebastián; Morales Murillo, Luis; Rivera Vergara, Matías de la; Saldías Martínez, Roberto
    A woman in her 60s with a history of adult-onset Still's disease (AOSD) in remission for 14 years received the ChAdOx1-S vaccine as a booster to her initial vaccination schedule (two doses of CoronaVac vaccine 6 months apart). Two weeks later, she consulted for symptoms suggestive of AOSD reactivation. This was confirmed during hospitalisation, where renal and cardiac involvement were also observed. Despite using high-dose corticosteroids, troponin T and N-terminal pro hormone B-type natriuretic peptide (NT-proBNP) were persistently elevated. Tocilizumab was used, with which the patient achieved complete remission of her symptoms and normalised her laboratory tests.
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    Características clínicas, tratamientos y su impacto en la calidad de vida y productividad laboral en pacientes chilenos con espondiloartritis: Un estudio basado en encuestas web
    (2025) Ibáñez, Sebastián; Díaz, Pamela; Zúniga, Leana
    RESUMEN Objetivo: Describir las características clínicas, los tratamientos utilizados y el impacto de la espondiloartritis (EspA) en la calidad de vida y la productividad laboral de los pacientes en Chile. Méto­dos: Estudio transversal basado en una encuesta web autoadminis- trada dirigida a pacientes con diagnóstico de EspA. Se utilizaron instrumentos validados como BASDAI, BASFI, ASAS-HI, WPAI y FiRST. Se compararon los resultados entre usuarios y no usua­rios de terapias biológicas o inhibidores de JAK. Resultados: Se incluyeron 346 pacientes, con una mediana de edad de 43 años; el 70,8% eran mujeres. El retraso diagnóstico tuvo una mediana de 4 años. El 41,9% reportó ser HLA-B27 positivo. El diagnóstico más frecuente fue EspA axial radiográfica (71,1%). En cuanto a tratamientos, el 76,3% usaba AINE, 44,8% FAME, 33,5% terapias biológicas o JAKi y 30,9% opiáceos. El 78% presentó un BASDAI > 4 y el 27,8% un ASAS-HI > 12. El impacto en la productividad laboral fue significativo: el presentismo y la pérdida total de pro­ductividad alcanzaron medianas de 50%, mientras que el impacto en actividades generales fue del 60%. Los usuarios de biológicos o JAKi mostraron menor actividad de la enfermedad (BASDAI 5,1 vs 6,2; p = 0,0004), mejor capacidad funcional (BASFI 4,4 vs 5,6; p = 0,0206), menor nivel de afectación subjetiva y menor pérdida de productividad laboral (46,3% vs 50%; p = 0,0151), en comparación con los no usuarios. Conclusión: Los resultados una alta carga de enfermedad en los pacientes con EspA en Chile, asociada a un uso limitado de terapias avanzadas y a barreras en el acceso al tratamiento. Se destaca la necesidad de estrategias diagnósticas y terapéuticas más efectivas y accesibles, así como una mejor comprensión del impacto de la enfermedad en la vida laboral y social de los pacientes. ABSTRACT Objective: To describe the clinical characteristics, treatments used, and the impact of spondyloarthritis (SpA) on the quality of life and work productivity of patients in Chile. Methods: A cross-sectional study based on a self-administered web survey targeting patients with a diagnosis of SpA. Validated instruments such as BASDAI, BASFI, ASAS-HI, WPAI, and FiRST were used. Results were compared between users and non-users of biological therapies or JAK inhibitors. Results: A total of 346 patients were included, with a median age of 43 years; 70.8% were women. The median diagnostic delay was 4 years. A total of 41.9% reported being HLA-B27 positive. The most frequent diagnosis was radiographic axial SpA (71.1%). Regarding treatments, 76.3% used NSAIDs, 44.8% synthetic DMARDs, 33.5% biological or JAK inhibitor therapies, and 30.9% opioids. High disease activity (BASDAI > 4) was found in 78% of patients, and 27.8% had an ASAS-HI > 12. The WPAI indicated a substantial work impact: median presenteeism and total work productivity loss were both 50%, and impairment in general activities reached 60%. Users of biologics or JAK inhibitors had lower disease activity (BASDAI 5.1 vs 6.2; p = 0.0004), better functional capacity (BASFI 4.4 vs 5.6; p = 0.0206), lower subjective disease impact, and reduced productivity loss (46.3% vs 50%; p = 0.0151) compared to non-users. Conclusion: The findings reveal a high disease burden among Chilean patients with SpA, associated with limited use of advanced therapies and barriers to treatment access. These results underscore the need for more effective and accessible diagnostic and therapeutic strategies, and greater awareness of the social and occupational impact of the disease.

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