<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2413-4341</journal-id>
<journal-title><![CDATA[Revista Paraguaya de Reumatología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. parag. reumatol.]]></abbrev-journal-title>
<issn>2413-4341</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Reumatología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2413-43412025000200047</article-id>
<article-id pub-id-type="doi">10.18004/rpr/2025.11.02.47</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Patrones de inicio de fármacos biológicos y sintéticos dirigidos en pacientes con artritis inflamatoria: datos del Registro BIOBADAGUAY]]></article-title>
<article-title xml:lang="en"><![CDATA[Initiation patterns of biologic and synthetic disease-modifying antirheumatic drugs in patients with inflammatory arthritis: data from the BIOBADAGUAY Registry]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Trigueros]]></surname>
<given-names><![CDATA[Paloma de Abreu]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villalba]]></surname>
<given-names><![CDATA[Sonia Cabrera]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ortiz]]></surname>
<given-names><![CDATA[Angélica Amarilla]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cabrera]]></surname>
<given-names><![CDATA[Vannia Valinotti]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chávez]]></surname>
<given-names><![CDATA[Teresa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torres]]></surname>
<given-names><![CDATA[Mariela Zarza]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruíz-Díaz]]></surname>
<given-names><![CDATA[Lourdes Román]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Paniagua]]></surname>
<given-names><![CDATA[Patricia Melgarejo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Paats]]></surname>
<given-names><![CDATA[Astrid]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pineda]]></surname>
<given-names><![CDATA[Alexis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ríos]]></surname>
<given-names><![CDATA[Evelyn Leiva]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ayala]]></surname>
<given-names><![CDATA[Zoilo Morel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Campuzano]]></surname>
<given-names><![CDATA[Roger Rolón]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[Sany Gómez]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Maidana]]></surname>
<given-names><![CDATA[Santiago Ferreira]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Coronel]]></surname>
<given-names><![CDATA[Claudia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aranda]]></surname>
<given-names><![CDATA[Raquel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pusineri]]></surname>
<given-names><![CDATA[Paola]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez]]></surname>
<given-names><![CDATA[Paola Jara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cordovilla]]></surname>
<given-names><![CDATA[Darwin]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Parodi]]></surname>
<given-names><![CDATA[Clyde]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Balbuena]]></surname>
<given-names><![CDATA[Cynthia Vega]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz]]></surname>
<given-names><![CDATA[Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Consani]]></surname>
<given-names><![CDATA[Sandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Garino]]></surname>
<given-names><![CDATA[Pilar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rostan]]></surname>
<given-names><![CDATA[Sofia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Velázquez]]></surname>
<given-names><![CDATA[Pamela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Brunengo]]></surname>
<given-names><![CDATA[Cristina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Babak]]></surname>
<given-names><![CDATA[Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Maidana]]></surname>
<given-names><![CDATA[Agustina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Yinde]]></surname>
<given-names><![CDATA[Yanira]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pedretti]]></surname>
<given-names><![CDATA[Gabriela Ávila]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,aff1  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Hospital de Clínicas]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto de Previsión Social Servicio de Reumatología ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Ministerio de Salud Pública y Bienestar Social Hospital de Villa Elisa ]]></institution>
<addr-line><![CDATA[Villa Elisa ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Hospital de Villarrica  ]]></institution>
<addr-line><![CDATA[Villarrica ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Complejo Santo Domingo Departamento de Reumatología ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Ministerio de Salud pública y Bienestar Social Hospital Nacional de Itauguá ]]></institution>
<addr-line><![CDATA[Itauguá ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,Hospital Evangélico Departamento de Reumatología ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af9">
<institution><![CDATA[,Hospital Pediátrico Niños de Acosta Ñu  ]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A10">
<institution><![CDATA[,Institución de Asistencia Médica Privada de Profesionales Departamento de Reumatología ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="A11">
<institution><![CDATA[,Hospital Maciel Departamento de Medicina Interna ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="A12">
<institution><![CDATA[,Hospital Escuela del Litoral Departamento de Reumatología ]]></institution>
<addr-line><![CDATA[Paysandú ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="A13">
<institution><![CDATA[,Instituto Nacional de Reumatología Departamento de Reumatología ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="A14">
<institution><![CDATA[,Hospital Regional de Encarnación  ]]></institution>
<addr-line><![CDATA[Encarnación ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<volume>11</volume>
<numero>2</numero>
<fpage>47</fpage>
<lpage>52</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2413-43412025000200047&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2413-43412025000200047&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2413-43412025000200047&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: Las artritis inflamatorias son enfermedades autoinmunes sistémicas de carácter crónico, las cuales cursan con inflamación, dolor, daño en articulaciones y otros órganos. A lo largo de los años, se han desarrollado distintas recomendaciones sobre el uso de los distintos fármacos en estas enfermedades.  Objetivos:  Describir los patrones de inicio de fármacos modificadores de la enfermedad biológicos y sintéticos dirigidos (FAMEs-b/sd) en pacientes con artritis inflamatoria en el registro BIOBADAGUAY y comparar la situación entre ellos.  Método: Se analizaron datos del registro BIOBADAGUAY. Se incluyeron pacientes con artritis inflamatoria. que habían iniciado un FAMEs-b/sd hasta finales de marzo de 2025. El análisis estadístico fue descriptivo.  Resultados: Un total de 965 pacientes y 1298 tratamientos. El 75% mujeres con una edad media al inicio de tratamiento de 43,8 (16,9 años. La artritis reumatoidea fue la más frecuente en un 69%. Los inhibidores del TNF originales (antiTNFo) fueron los primeros usados, posteriormente se van añadiendo rituximab original e inhibidores de la IL-6. En Paraguay se iniciaron los fármacos biosimilares en 2015. En 2020 en Uruguay y en 2022 se inicia el uso de inhibidores de Janus kinase. Los antiTNFo fueron los más utilizados especialmente como primera línea de tratamiento. La frecuencia de uso de antiTNFo disminuyó gradualmente desde la introducción de los nuevos fármacos en cada país  Conclusiones: La disponibilidad de fármacos en ambos países fue similar. La inclusión de nuevas dianas de tratamiento ha modificado el patrón de uso de estos fármacos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Inflammatory arthritis is a chronic, systemic autoimmune disease characterized by inflammation, pain, and damage to joints and other organs. Over the years, various recommendations have been developed regarding the use of different medications for these diseases.  Objectives: To describe the patterns of initiation of biologic and synthetic disease-modifying antirheumatic drugs (b/sDMARDs) in patients with inflammatory arthritis in the BIOBADAGUAY registry and compare the situation between them.  Method: Data from the BIOBADAGUAY registry were analyzed, including patients with inflammatory arthritis who had started a b/tsDMARDs by the end of March 2025. The statistical analysis was descriptive.  Results: A total of 965 patients and 1298 treatments were analyzed. 75% were women, with a mean age at treatment initiation of 43.8 ± 16.9 years. Rheumatoid arthritis was the most frequent condition (69%). Original TNF inhibitors (anti-TNFo) were the first used, followed by the addition of original rituximab and IL-6 inhibitors. Biosimilar drugs were introduced in Paraguay in 2015. In 2020, Janus kinase inhibitors were introduced in Uruguay, and in 2022, they were introduced in Paraguay. Anti-TNFo were the most used, especially as first-line treatment. The frequency of anti-TNFo use decreased gradually with the introduction of new drugs in each country.  Conclusions: The availability of drugs in both countries was similar. The inclusion of new treatment targets has modified the pattern of use of these drugs.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[patrones de inicio]]></kwd>
<kwd lng="es"><![CDATA[FAMEb/sd]]></kwd>
<kwd lng="es"><![CDATA[artritis inflamatoria]]></kwd>
<kwd lng="es"><![CDATA[registro]]></kwd>
<kwd lng="en"><![CDATA[initiation patterns]]></kwd>
<kwd lng="en"><![CDATA[b/sDMARDs]]></kwd>
<kwd lng="en"><![CDATA[inflammatory arthritis]]></kwd>
<kwd lng="en"><![CDATA[registry]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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