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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Systemic lupus erythematosus &#40;SLE&#41; is a complex&#44; chronic autoimmune disorder&#44; characterised by a broad spectrum of manifestations with a variable and unpredictable relapsing-remitting course&#46; Despite an improvement in SLE management and prognosis&#44; a considerable proportion of patients still experience suboptimal disease control&#44; and increased morbidity and mortality&#44; exacerbated by long-term SLE-related medications such as corticosteroids&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#8211;4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Enhanced understanding of SLE pathogenesis has led to the emergence of a new drug class which targets specific immunologic pathways of the disease process&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#8211;7</span></a> One such approach inhibits B-lymphocyte stimulator &#40;BLyS&#41;&#44; a key cytokine for maturation and survival of B cells&#44; which is elevated in approximately 50&#37; of patients with SLE&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> Belimumab&#44; a human immunoglobulin &#40;Ig&#41;G1&#955; monoclonal antibody&#44; blocks the binding of soluble BLyS and inhibits B-lymphocyte activity and survival&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> The efficacy and safety of belimumab has been demonstrated in five Phase 3 placebo-controlled trials in autoantibody-positive patients with SLE receiving standard therapy&#44;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">10&#8211;14</span></a> and in patients with active lupus nephritis &#40;LN&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> Whilst being mindful of cross-study comparisons&#44; evidence from observational studies suggests belimumab efficacy in real-world settings could be greater than that reported in clinical trials&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16&#8211;19</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">However&#44; data from real-world clinical practice settings in Spain are limited&#44; particularly data relating to the direct healthcare costs associated with belimumab&#46; Understanding real-world treatment patterns and outcomes with belimumab may help foster best clinical practice&#44; identify barriers to patient adherence&#47;persistence&#44; and identify patients who would benefit most from belimumab treatment&#46; To gain insight into the effectiveness of belimumab in routine clinical practice and its impact on healthcare resource utilisation &#40;HCRU&#41;&#44; an observational OBSErve programme &#40;Evaluation Of use of Belimumab in clinical practice SEttings&#41; was initiated in the USA<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> and later extended to other countries&#44; including Spain&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> The OBSErve Spain study represents the biggest cohort of belimumab patients evaluated in routine clinical practice settings in Spain to date&#46; Its objective was to evaluate belimumab effectiveness following 6 months of treatment&#44; in addition to standard therapy&#44; in patients with active SLE&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Study design</span><p id="par0020" class="elsevierStylePara elsevierViewall">OBSErve Spain &#40;GSK Study 200883&#41; was a retrospective&#44; multicentre&#44; observational chart review cohort study that collected real-world data from patient medical records between December 2013 and February 2014&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The study period comprised 12 months&#44; subdivided into two periods of 6 months before and after the belimumab initiation date &#40;index&#41;&#46; Patients received belimumab at the recommended dosage of intravenous &#40;IV&#41; 10<span class="elsevierStyleHsp" style=""></span>mg&#47;kg every 4 weeks&#44; after 3 induction doses 2 weeks apart&#44; in addition to concomitant immunosuppressive medication&#44; and remained on this dose throughout the study&#46; Patients who discontinued belimumab within the first 6 months were also included&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The study was conducted in accordance with the Guidelines for Good Pharmacoepidemiology Practices &#40;GPP&#41;&#46; All study documents were approved by the competent national authority&#44; the Agencia Espa&#241;ola de Medicamentos y Productos Sanitarios&#44; for study classification and the ethics committee of the local coordinating investigator&#44; the Comit&#233; &#201;tico de Investigaci&#243;n Cl&#237;nica &#40;CEIC&#41; de l&#8217;Hospital Universitari Vall d&#8217;Hebr&#243;n&#44; de Barcelona&#46; Patient informed consent was not required&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Study population</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Clinical sites</span><p id="par0035" class="elsevierStylePara elsevierViewall">Physicians from clinical sites prescribing belimumab for &#8805;6 months in &#8805;2 patients with SLE as part of routine care qualified to recruit eligible patients&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Patient population</span><p id="par0040" class="elsevierStylePara elsevierViewall">Physicians enrolled adult patients &#40;&#8805;18 years of age&#41; with a confirmed diagnosis of SLE and active disease receiving standard therapy&#44; in whom belimumab therapy was initiated for the first time as part of their routine clinical care &#8805;6 months prior to study enrolment&#46; Medical and treatment history for &#8805;6 months prior to index had to be available&#46; Patients were excluded if they were receiving belimumab as part of a clinical trial in an interventional arm&#44; or were currently enrolled in any SLE-related trial&#46; Physicians included all eligible patients to avoid selection bias&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Data collection</span><p id="par0045" class="elsevierStylePara elsevierViewall">Data collection was performed using an electronic data capture system &#40;EDC&#41;&#46; Deidentified data from patient medical records were abstracted into electronic Case Report Forms &#40;eCRFs&#41;&#46; Automatic checks were implemented in the EDC to avoid missing answers and to provide valid and plausible data entries&#46; Clinical manifestations were assessed through clinical routine evaluations&#46; Due to the real-world&#44; and retrospective nature of this study&#44; clinical evaluation methods&#44; including criteria to classify SLE&#44; were not prospectively specified&#46; SLE disease characteristics assessed at index included time since diagnosis&#44; disease severity &#40;mild&#44; moderate and severe&#41; and clinical manifestations&#44; and were obtained from the medical records&#46; Disease activity assessments were performed retrospectively &#40;when absent&#41; and were also included in the medical records&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Study objectives</span><p id="par0050" class="elsevierStylePara elsevierViewall">The primary objective was to describe the overall patterns of SLE care and outcomes among patients receiving belimumab in clinical practice in Spain&#46; Secondary objectives were to describe the characteristics of patients receiving belimumab in clinical practice&#44; reasons for initiation and discontinuation of belimumab&#44; change in Safety of Estrogens in Systemic Lupus Erythematosus National Assessment SLE Disease Activity Index &#40;SELENA-SLEDAI&#41; score&#44; the treatment patterns with concomitant medications &#40;especially corticosteroids&#41;&#44; and to describe HCRU among patients receiving belimumab&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Study endpoints</span><p id="par0055" class="elsevierStylePara elsevierViewall">The primary efficacy endpoint was the overall clinical response&#44; as assessed by the physicians&#8217; judgment scale of response &#40;Physician Global Assessment &#91;PGA&#93;-like scale&#41;&#44; assessed at 6 months of belimumab treatment&#46; PGA reflects physicians&#8217; subjective opinion of the improvement of their patients&#8217; SLE status&#44; categorised as&#58; worse&#44; no improvement&#44; &#60;20&#37; improvement&#44; 20&#8211;49&#37; improvement&#44; 50&#8211;79&#37; improvement&#44; and &#8805;80&#37; improvement&#44; versus index&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Other endpoints &#40;assessed at 6 months post-index&#41; included&#58; reasons for belimumab initiation&#44; changes in SELENA-SLEDAI score&#44; clinical response for specific manifestations as assessed by physicians &#40;arthritis &#91;including the number of tender and swollen joints&#93;&#44; rash and fatigue&#41; and laboratory parameters &#40;complement C3 and C4 levels and anti-double-stranded DNA &#91;anti-dsDNA&#93; antibody positivity&#41;&#46; Physician-reported changes in manifestations and laboratory parameters were reported as the proportion of patients with worse&#44; no improvement&#44; &#60;20&#37; improvement&#44; 20&#8211;49&#37; improvement&#44; 50&#8211;79&#37; improvement&#44; and &#8805;80&#37; improvement&#46; Use of concomitant SLE medications&#44; and corticosteroid &#40;prednisone-equivalent&#41; use &#40;reduction of corticosteroid dose and switch from &#8805;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day to &#60;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#41; were included&#46; For HCRU&#44; proportions of patients with&#44; and change in the number of&#44; scheduled and unscheduled physician office visits&#44; hospitalisations and emergency room &#40;ER&#41; visits were reported&#46; Additionally&#44; reasons for belimumab discontinuation and occurrence of adverse events &#40;AEs&#41; were collected&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Except for HCRU&#44; all data were collected at index and at 6 months post-index&#46; HCRU data were collected during the 6 months prior to index and at 6 months post-index&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Safety measures</span><p id="par0070" class="elsevierStylePara elsevierViewall">Given the retrospective&#44; observation nature of the study&#44; AEs were not systematically collected&#46; However&#44; deaths&#44; hospitalisations or AEs&#44; which may have been belimumab-related&#44; were included in the eCRF and reported to the GSK AE reporting system&#46; Belimumab dose modifications or discontinuations were included in the eCRF&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Statistical analysis</span><p id="par0075" class="elsevierStylePara elsevierViewall">The analysis included all patients fulfilling eligibility criteria who had completed CRFs &#40;full analysis set&#41;&#46; Given the descriptive nature of the study&#44; no sample size calculations were performed&#46; The target sample size was 70&#8211;80 patients&#46; For categorical data&#44; absolute and relative frequencies of categories&#47;items for each variable were calculated&#46; For continuous data&#44; mean&#44; standard deviation &#40;SD&#41;&#44; minimum&#44; median and maximum were calculated&#46; For the analysis of concomitant corticosteroid doses&#44; values of continuous variables were grouped into two categories&#58; &#8805;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day and &#60;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#44; as defined previously&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a></p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Results</span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Patient population</span><p id="par0080" class="elsevierStylePara elsevierViewall">The full analysis set included 64 patients documented by 25 physicians at 25 clinical sites&#59; demographic and clinical data for these patients at index are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Most patients were female &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>57&#44; 89&#46;1&#37;&#41; and of Caucasian origin &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63&#44; 98&#46;4&#37;&#41;&#44; with a mean &#40;SD&#41; age of 42&#46;7 &#40;12&#46;1&#41; years &#40;range&#58; 19&#8211;72 years&#41;&#46; Half of the patients received their SLE diagnosis longer than 10 years ago &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>32&#44; 50&#46;0&#37;&#41;&#59; disease severity was moderate for 39 &#40;60&#46;9&#37;&#41; patients and severe for 16 &#40;25&#46;0&#37;&#41; patients at index&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Of the 64 patients&#44; 12 &#40;18&#46;8&#37;&#41; had LN within a median time of 5&#46;5 years &#40;range&#58; 0&#46;2&#8211;17 years&#41; prior to index&#46; Of the patients with LN&#44; 1 had Class V LN&#44; 5 had Class IV LN&#44; 5 had Class III LN and 1 had Class II LN&#46; At the time of belimumab initiation&#44; 5 &#40;41&#46;7&#37;&#41; patients with LN were in remission&#44; 5 &#40;41&#46;7&#37;&#41; were experiencing persistent activity&#44; and 2 &#40;16&#46;7&#37;&#41; were experiencing flare&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The most common reasons for initiation of belimumab were previous medication being ineffective &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#44; 78&#46;1&#37;&#41;&#44; intent to decrease corticosteroid use &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>37&#44; 57&#46;8&#37;&#41;&#44; and worsening condition &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>35&#44; 54&#46;7&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Overall clinical response</span><p id="par0095" class="elsevierStylePara elsevierViewall">After 6 months of belimumab treatment&#44; 47 &#40;73&#46;4&#37;&#41; patients experienced &#8805;20&#37; improvement in their overall clinical condition and 33 &#40;51&#46;6&#37;&#41; patients experienced a clinical improvement of &#8805;50&#37;&#44; versus index&#46; During this period&#44; 6 &#40;9&#46;4&#37;&#41; patients experienced no clinical improvement and 2 &#40;3&#46;1&#37;&#41; patients worsened &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Disease activity assessment</span><p id="par0100" class="elsevierStylePara elsevierViewall">The mean &#40;SD&#41; SELENA-SLEDAI score&#44; documented for 57 patients&#44; showed a marked reduction&#44; from 10&#46;1 &#40;6&#46;2&#41; at index to 4&#46;5 &#40;3&#46;7&#41; at 6 months post-index &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Evaluation of clinical manifestations</span><p id="par0105" class="elsevierStylePara elsevierViewall">Clinical manifestations are shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> and <a class="elsevierStyleCrossRef" href="#sec0130">Supplementary Table 1</a>&#46; At belimumab initiation&#44; the most common clinical and immunological manifestations were arthritis &#40;56&#46;3&#37;&#41;&#44; low complement levels &#40;53&#46;1&#37;&#41;&#44; increased anti-dsDNA antibody levels &#40;48&#46;4&#37;&#41;&#44; fatigue &#40;43&#46;8&#37;&#41; and inability to taper steroids &#40;42&#46;2&#37;&#41;&#44; which were rated as moderate or severe in the majority of patients&#46; Clinical improvements were observed after 6 months of belimumab treatment&#46; For example&#44; of 36 patients with arthritis at index&#44; 33 &#40;91&#46;7&#37;&#41; patients showed &#8805;20&#37; improvement in their condition at 6 months post-index&#44; of whom 25 &#40;69&#46;5&#37;&#41; showed &#8805;50&#37; improvement &#40;as assessed by physicians&#41;&#46; For patients with arthritis in whom the 28-joint count was evaluated&#44; a significant reduction in the mean &#40;SD&#41; number of tender joints &#40;8&#46;1 &#91;3&#46;6&#93; at index &#91;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26&#93; to 2&#46;4 &#91;3&#46;0&#93; at 6 months post-index &#91;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>28&#93;&#41; and swollen joints &#40;3&#46;6 &#91;3&#46;6&#93; at index &#91;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27&#93; to 0&#46;5 &#91;1&#46;1&#93; at 6 months post-index &#91;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>28&#93;&#41; was observed&#46; Fatigue was present in 28 &#40;43&#46;8&#37;&#41; patients at index&#44; and belimumab treatment resulted in an improvement of &#8805;20&#37; for 22 &#40;78&#46;6&#37;&#41; of these patients&#46; Rashes were present in 17 &#40;26&#46;6&#37;&#41; patients at index&#44; 12 &#40;70&#46;6&#37;&#41; of whom experienced improvement of &#8805;20&#37; 6 months post-index&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Similarly&#44; clinical improvements were observed for most of the assessed laboratory parameters after 6 months of belimumab treatment compared with index &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Concomitant medication</span><p id="par0115" class="elsevierStylePara elsevierViewall">At index&#44; 59 &#40;93&#46;8&#37;&#41; patients were receiving oral corticosteroids&#44; at a mean &#40;SD&#41; dose of 14&#46;5 &#40;12&#46;5&#41;<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#46; After 6 months of belimumab treatment&#44; the mean &#40;SD&#41; corticosteroid dose decreased to 6&#46;4 &#40;5&#46;1&#41;<span class="elsevierStyleHsp" style=""></span>mg&#47;day &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>59&#59; <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; Of 48 &#40;75&#46;0&#37;&#41; patients who received &#8805;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day corticosteroids at index&#44; 32 &#40;66&#46;7&#37;&#41; decreased their dose to &#60;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day and 2 &#40;4&#46;2&#37;&#41; discontinued corticosteroids&#44; with a corresponding mean &#40;SD&#41; dose reduction from 16&#46;8 &#40;12&#46;7&#41;<span class="elsevierStyleHsp" style=""></span>mg&#47;day at index to 6&#46;8 &#40;5&#46;6&#41;<span class="elsevierStyleHsp" style=""></span>mg&#47;day at 6 months post-index&#46; For patients who were receiving &#60;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day corticosteroids at index &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#44; 15&#46;6&#37;&#41;&#44; the mean &#40;SD&#41; dose remained stable&#58; 4&#46;7 &#40;0&#46;9&#41;<span class="elsevierStyleHsp" style=""></span>mg&#47;day at index and 4&#46;4 &#40;1&#46;2&#41;<span class="elsevierStyleHsp" style=""></span>mg&#47;day at 6 months post-index&#46; One patient started corticosteroid therapy &#40;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#41; during belimumab treatment&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">The number of patients receiving other concomitant medications&#44; including immunosuppressants&#44; decreased after 6 months of belimumab treatment&#44; as did most mean doses &#40;<a class="elsevierStyleCrossRef" href="#sec0130">Supplementary Table 2</a>&#41;&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Healthcare resource utilisation</span><p id="par0125" class="elsevierStylePara elsevierViewall">A total of 63 &#40;98&#46;4&#37;&#41; patients reported &#8805;1 scheduled rheumatologist visit in the 6 months before index&#44; versus 64 &#40;100&#37;&#41; patients in the 6 months post-index&#46; The mean &#40;SD&#41; number of scheduled visits was similar between these two time periods &#40;6 months prior to index&#58; 3&#46;5 &#91;2&#46;2&#93;&#59; 6 months post-index&#58; 3&#46;3 &#91;1&#46;9&#93;&#41;&#46; Fewer patients required &#8805;1 unscheduled rheumatologist visit in the 6 months post-index &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>16&#44; 15&#46;0&#37;&#41; at a mean &#40;SD&#41; number of 0&#46;3 &#40;0&#46;7&#41; visit per patient&#44; versus 6 months prior to index &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>34&#44; 53&#46;1&#37;&#59; mean &#91;SD&#93; number of visits&#58; 1&#46;0 &#91;1&#46;3&#93;&#59; <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; Over half of the patients &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>34&#44; 53&#46;1&#37;&#41; consulted other specialists for SLE-related reasons at index&#44; falling to 27 &#40;42&#46;2&#37;&#41; patients in the 6 months post-index &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; There was also a reduction in the number of patients requiring an SLE-related ER visit &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#44; 23&#46;4&#37;&#44; reducing to <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#44; 9&#46;4&#37;&#44; respectively&#41;&#44; and in the mean &#40;SD&#41; number of visits per patient &#40;1&#46;6 &#91;1&#46;1&#93; visits reducing to 0&#46;4 &#91;0&#46;6&#93;&#44; respectively&#41; from the 6 months prior to index versus 6 months post-index&#46; In the 6 months prior to index&#44; 7 &#40;10&#46;9&#37;&#41; patients were hospitalised &#40;mean &#91;SD&#93; length of stay&#58; 6&#46;7 &#91;4&#46;3&#93; days&#41;&#59; 5 &#40;7&#46;8&#37;&#41; patients were hospitalised once&#44; and 2 &#40;3&#46;1&#37;&#41; patients experienced &#8805;2 hospitalisations&#46; In the 6 months post-index&#44; 3 &#40;4&#46;7&#37;&#41; patients were hospitalised once &#40;mean &#91;SD&#93; length of stay&#58; 6&#46;7 &#91;3&#46;5&#93; days&#41;&#46; No hospitalisations were related to belimumab use&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Belimumab discontinuation</span><p id="par0130" class="elsevierStylePara elsevierViewall">No patient required a belimumab dose modification during the study and 1 patient required a dose interruption of 1 month due to a pilonidal cyst&#46; Belimumab was discontinued in 2 patients during the first 6 months of therapy&#44; 1 patient due to an AE &#40;inflammatory pelvic disease&#44; suspected to be treatment-related and for which the sponsor did not receive evaluation&#41; after 82 days of exposure&#44; and 1 patient due to lack of efficacy after 154 days of exposure&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Adverse events</span><p id="par0135" class="elsevierStylePara elsevierViewall">Two AEs were reported that led to belimumab discontinuation &#40;see &#8220;Belimumab discontinuation&#8221; section for details&#41;&#46; No deaths were reported&#46;</p></span></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Discussion</span><p id="par0140" class="elsevierStylePara elsevierViewall">This observational real-world cohort study conducted in Spain shows early and sustained effectiveness of belimumab during the first 6 months of treatment when added to standard SLE therapy&#44; with a corresponding reduction in HCRU&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">The most common reasons selected for initiating belimumab were lack of efficacy of other drug regimens&#44; inability to taper corticosteroids&#44; and persistent disease activity&#46; After 6 months of belimumab treatment&#44; over half of patients achieved a &#62;50&#37; improvement in their SLE activity&#44; as indicated by physician-assessed clinical response&#44; while the mean SELENA-SLEDAI score decreased substantially&#46; These results are in line with those from other OBSErve studies&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> and several independent academic observational studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16&#44;18&#44;19</span></a> The prior OBSErve studies showed a similar clinical response after 6 months of belimumab treatment&#44; with an improvement in disease activity for 99&#46;0&#37; &#40;USA<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a>&#41;&#44; 98&#46;1&#37; &#40;Canada<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a>&#41;&#44; 95&#37; &#40;Argentina<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a>&#41;&#44; 92&#46;7&#37; &#40;Germany<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a>&#41;&#44; and 83&#46;0&#37; &#40;Switzerland<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a>&#41; of patients&#44; compared with 87&#46;5&#37; of patients from Spain&#46; When the data from all six countries were pooled&#44; the overall clinical response was 95&#46;3&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> A larger proportion of Spanish patients experienced &#8805;80&#37; improvement in SLE compared with other countries&#44; which ranged from 9 to 21&#37;&#44; and was 13&#37; in the pooled analysis&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> This is perhaps related to the high proportion of patients with severe disease at index in Spain &#40;33&#37; vs 21&#37; in the pooled analysis&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> However&#44; it is difficult to interpret between-country comparisons due to the subjective nature of physician assessments&#44; and differences in patient populations between countries&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Consistent with previous studies<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">13&#44;18&#44;19&#44;21&#8211;25</span></a> and with the OBSErve pooled analysis&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> belimumab treatment was associated with a reduction in corticosteroid use&#46; This was particularly evident for patients receiving &#8805;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day of corticosteroids&#44; of whom 66&#46;7&#37; switched to &#60;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day after 6 months of belimumab treatment&#44; a slightly larger proportion than that in the OBSErve pooled analysis &#40;52&#46;6&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> Corticosteroids were reinitiated in just 1 patient&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Fatigue is a common complaint of patients with SLE and is associated with diminished ability to function&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">26&#44;27</span></a> In most cases&#44; the cause of fatigue is unexplained&#59; indeed&#44; the accumulation of many factors may lead to SLE fatigue&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a> Until recently&#44; clinical trials have not routinely assessed fatigue&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a> In the belimumab Phase 3 trials&#44; Functional Assessment of Chronic Illness Therapy &#8211; Fatigue &#40;FACIT-F&#41; score improved significantly from baseline to Week 52 with belimumab treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">10&#44;11</span></a> In our study&#44; a marked improvement in fatigue after 6 months of belimumab treatment was observed&#46; However&#44; these results should be interpreted cautiously&#44; as it was a subjective evaluation by the treating physician and no objective or patient-reported measurements like FACIT-F score were performed&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">The HCRU data from Spain were consistent with those for the USA&#44; showing an overall reduction in HCRU after 6 months of belimumab treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> Both studies recorded a reduction in unscheduled rheumatologist and ER visits&#46; OBSErve Spain also documented a decrease in hospitalisations&#44; similar to that shown in OBSErve US study&#46; Furthermore&#44; belimumab was generally well tolerated&#44; with a low number of AEs and discontinuations in this study&#44; similar to the OBSErve pooled analysis&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">This study has some limitations&#44; including a lack of a control group and a strict protocol&#46; Furthermore&#44; there were no formal statistical analyses and only descriptive data are presented&#46; Patient populations and treatment regimens may have varied across sites and may not be representative of non-participating sites&#46; Clinical response was evaluated based on physicians&#8217; judgement&#44; which is subjective&#44; and the applied scale might be conceived differently by another cohort of physicians&#46; Data were collected and validated electronically&#44; and verification was not performed&#46; It should also be noted that the observation period ended in 2014&#44; and thus patient profile data may not be fully aligned to the current clinical care and to the management and classification of SLE published in 2019&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">28&#8211;30</span></a> Finally&#44; the short observation period may miss treatment-related AEs or flares that may occur after prolonged treatment&#46; A longer observational period may be required to fully capture longitudinal treatment effect&#46; Indeed&#44; in the OBSErve Argentina study&#44; which evaluated belimumab treatment up to 24 months post-index&#44; 26&#37; of patients experienced a clinical improvement of &#8805;80&#37; after 6 months of belimumab treatment&#44; rising to 80&#37; of patients after 24 months of treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> Therefore&#44; future studies should include a longer observation period and formal statistical analyses&#44; in which further improvements may be detected and quantified&#46;</p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Conclusion</span><p id="par0170" class="elsevierStylePara elsevierViewall">In this study evaluating belimumab treatment in real-world clinical practice settings in Spain&#44; a notable improvement in SLE disease activity&#44; based on clinical and serological manifestations and improvement in SELENA-SLEDAI score&#44; was observed among patients with SLE receiving belimumab for 6 months&#44; which was accompanied by a decrease in HCRU&#46; In addition&#44; in this short treatment period&#44; a significant reduction of concomitant corticosteroids was observed&#46; The low number of belimumab discontinuations due to AEs indicates that&#44; in general&#44; belimumab was well tolerated&#46; These findings support the continued use of belimumab for the management of SLE in Spain across different SLE manifestations&#46; However&#44; further observational studies&#44; particularly with subcutaneous formulations of belimumab&#44; are required to fully elucidate the effectiveness potential of this biological agent on patient outcomes&#44; adherence and impact on healthcare systems&#46;</p></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0180">Conflicts of interest</span><p id="par0175" class="elsevierStylePara elsevierViewall">J&#46; Cort&#233;s-Hern&#225;ndez received consulting fees from GSK&#46; C&#46; Marras received consulting fees from GSK&#46; J&#46;L&#46; Andreu received consulting fees from Eli Lilly&#44; Sanofi&#44; UCB and AstraZeneca&#46; J&#46; Calvo received consulting fees from GSK&#44; Eli Lilly and MSD&#46; A&#46;M&#46; Garcia received consulting fees from AbbVie&#44; GSK and BMS&#46; E&#46; Diez declares to have no conflict of interest&#46; F&#46;J&#46; Hidalgo and A&#46; Perna were full-time employees of GSK at the time of the study and held stock options in GSK&#46; C&#46; Coronell was employed by GSK at the time of the study&#46; J&#46; Ordi received consulting fees from GSK&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">OBSErve Spain study &#40;GSK Study 200883&#41; was funded by <span class="elsevierStyleGrantSponsor" id="gs1">GSK</span>&#44; and conducted by Kantar Health GmbH&#44; Munich&#44; Germany &#40;including support for study design and statistical analyses&#41; and Kantar Health Spain &#40;study sites management&#41;&#46; Medical writing support was provided by Nicholas Thomas&#44; PhD&#44; of Fishawack Indicia Ltd&#44; UK&#44; part of Fishawack Health&#44; and was funded by GSK&#46;</p></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0185">Funding</span><p id="par0185" class="elsevierStylePara elsevierViewall">This study &#40;GSK Study 200883&#41; was funded by GSK and conducted by Kantar Health GmbH&#44; Munich&#44; Germany &#40;including support for study design and statistical analyses&#41; and Kantar Health Spain &#40;study sites management&#41;&#46; The sponsor &#40;GSK&#41; contributed to the design&#44; collection&#44; analysis and interpretation of the data&#44; and the decision to submit the manuscript for publication&#44; and supported the authors in development of the manuscript&#46; Medical writing support was provided by Nicholas Thomas&#44; PhD&#44; of Fishawack Indicia Ltd&#44; UK&#44; part of Fishawack Health&#44; and was funded by GSK&#46;</p></span></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction and objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">This OBSErve Spain study&#44; a part of the international OBSErve programme&#44; evaluated belimumab real-world use and effectiveness following 6 months of treatment in patients with active systemic lupus erythematosus &#40;SLE&#41; in clinical practice in Spain&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">In this retrospective&#44; observational study &#40;GSK Study 200883&#41;&#44; eligible patients with SLE receiving intravenous belimumab &#40;10<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#41; had their disease activity &#40;physician assessed&#41;&#44; SELENA-SLEDAI scores&#44; corticosteroid use&#44; and healthcare resource utilisation &#40;HCRU&#41;&#44; assessed after 6 months of treatment versus index &#40;belimumab initiation&#41; or 6 months pre-index&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Overall&#44; 64 patients initiated belimumab&#44; mainly due to ineffectiveness of previous treatments &#40;78&#46;1&#37;&#41; and to reduce corticosteroid use &#40;57&#46;8&#37;&#41;&#46; Following 6 months of treatment&#44; 73&#46;4&#37; of patients achieved &#8805;20&#37; overall clinical improvement&#44; while only 3&#46;1&#37; of patients worsened&#46; Mean &#40;standard deviation&#44; SD&#41; SELENA-SLEDAI score decreased from 10&#46;1 &#40;6&#46;2&#41; at index to 4&#46;5 &#40;3&#46;7&#41; 6 months post-index&#46; HCRU decreased from 6 months pre-index to 6 months post-index&#44; with fewer hospitalisations &#40;10&#46;9&#37; vs 4&#46;7&#37; patients&#41; and ER visits &#40;23&#46;4&#37; vs 9&#46;4&#37; patients&#41;&#46; Mean &#40;SD&#41; corticosteroid dose decreased from 14&#46;5 &#40;12&#46;5&#41;<span class="elsevierStyleHsp" style=""></span>mg&#47;day at index to 6&#46;4 &#40;5&#46;1&#41;<span class="elsevierStyleHsp" style=""></span>mg&#47;day 6 months post-index&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Patients with SLE receiving belimumab for 6 months in real-world clinical practice in Spain experienced clinical improvements and a reduction in HCRU and corticosteroid dose&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducci&#243;n y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El estudio OBSErve Espa&#241;a&#44; que forma parte del programa internacional OBSErve&#44; evalu&#243; el uso y la eficacia de belimumab en la pr&#225;ctica cl&#237;nica real espa&#241;ola tras seis meses de tratamiento en pacientes con lupus eritematoso sist&#233;mico &#40;LES&#41; activo&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Materiales y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">En este estudio observacional y retrospectivo &#40;GSK Study 200883&#41; fue evaluada la respuesta cl&#237;nica&#44; la actividad de la enfermedad &#40;puntuaci&#243;n SELENA-SLEDAI&#41;&#44; el uso de corticosteroides y los recursos sanitarios utilizados de los pacientes con LES que recibieron belimumab intravenoso &#40;10<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#41;&#44; al inicio y tras seis meses de tratamiento&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">En total 64 pacientes iniciaron belimumab&#44; principalmente por ineficacia de los tratamientos previos &#40;78&#44;1&#37;&#41; y para reducir los corticoides &#40;57&#44;8&#37;&#41;&#46; Despu&#233;s de seis meses de tratamiento&#44; 73&#44;4&#37; de los pacientes lograron una mejor&#237;a cl&#237;nica general de &#8805;20&#37;&#44; mientras que solo 3&#44;1&#37; de los pacientes empeor&#243;&#46; La puntuaci&#243;n media &#40;desviaci&#243;n est&#225;ndar&#44; DE&#41; de SELENA-SLEDAI disminuy&#243; de 10&#44;1 &#40;6&#44;2&#41; a 4&#44;5 &#40;3&#44;7&#41;&#46; Los recursos sanitarios utilizados disminuyeron con menos hospitalizaciones &#40;10&#44;9 vs&#46; 4&#44;7&#37;&#41; y visitas a urgencias &#40;23&#44;4 vs&#46; 9&#44;4&#37;&#41;&#46; La dosis media &#40;DE&#41; de corticosteroides disminuy&#243; de 14&#44;5 &#40;12&#44;5<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#41; a 6&#44;4 &#40;5&#44;1<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#41;&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los pacientes con LES que recibieron belimumab durante seis meses en la pr&#225;ctica cl&#237;nica real en Espa&#241;a experimentaron mejoras cl&#237;nicas y una reducci&#243;n de la dosis de corticosteroides y recursos sanitarios utilizados&#46;</p></span>"
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            "Ancho" => 1258
            "Tamanyo" => 55591
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Physician-assessed clinical response to belimumab treatment at 6 months &#40;<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>64&#41;&#42;&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#42;Two patients discontinued belimumab treatment within the first 6 months but were included in the analysis&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 578
            "Ancho" => 1258
            "Tamanyo" => 29764
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">SELENA-SLEDAI score at index versus 6 months post-index &#40;<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>57&#41;&#42;&#46;</p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">&#42;SELENA-SLEDAI score data were unavailable for 7 patients at index or 6 months post-index&#46;</p> <p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">SELENA-SLEDAI&#44; Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Fig&#46; 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 969
            "Ancho" => 1675
            "Tamanyo" => 92422
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Change in mean oral corticosteroid dose from index following 6 months of treatment with belimumab for patients with known corticosteroid use at index &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>58&#41; and at 6 months post-index &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>59&#41; and for patients stratified by corticosteroid dose at index &#40;&#60;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day vs &#8805;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#41;&#46;</p> <p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">&#42;Two patients discontinued corticosteroids &#40;mean dose at index 10&#46;0<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#41;&#44; 32 patients switched to &#60;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day &#40;from mean 14&#46;1<span class="elsevierStyleHsp" style=""></span>mg&#47;day at index to 4&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day at 6 months post-index&#41;&#44; and 14 patients remained on &#8805;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day &#40;mean dose at index 23&#46;9<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#44; mean dose at 6 months post-index 13&#46;2<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#41; during belimumab treatment&#59; all these patients were included in the mean dose calculations presented here&#59; <span class="elsevierStyleSup">&#8224;</span>one patient initiated corticosteroids during belimumab treatment at a prednisone-equivalent dose of 5&#46;0<span class="elsevierStyleHsp" style=""></span>mg&#47;day &#40;at 6 months post-index&#41;&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Anti-dsDSN&#44; anti-double-stranded DNA&#59; C&#44; complement&#59; NSAID&#44; non-steroidal anti-inflammatory drug&#59; SD&#44; standard deviation&#59; SELENA-SLEDAI&#44; Safety of Estrogens in Lupus Erythematosus National Assessment-SLE Disease Activity Index&#59; SLE&#44; systemic lupus erythematosus&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Characteristic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Age &#40;years&#41;&#44; mean &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#46;7 &#40;12&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Female&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57 &#40;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Race&#47;ethnicity&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Caucasian&#47;white&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63 &#40;98&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Asian&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Time since SLE diagnosis&#44; mean &#40;SD&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#60;1 year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#8211;5 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;21&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>6&#8211;10 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;26&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62;10 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;50&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Severity of SLE disease&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mild&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;10&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;60&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Severe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;25&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Unknown&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">SELENA-SLEDAI score</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a><span class="elsevierStyleItalic">&#44; mean &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;1 &#40;6&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">High anti-dsDNA level&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;68&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Low C3 &#40;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;56&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Low C4 &#40;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;57&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Immunosuppressant use&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Azathioprine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;21&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mycophenolate Mofetil&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;23&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Methotrexate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;10&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tacrolimus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antimalarial use&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;60&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">NSAID use&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;14&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Oral corticosteroid use&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;92&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62;7&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#8224;</span></a>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;81&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dose &#40;mg&#47;day&#41;&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;5 &#40;12&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3327180.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Calculated for 57 patients&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "&#8224;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Calculated as a percentage of patients receiving corticosteroids &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>59&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Patient demographics and clinical characteristics at index&#44; unless otherwise stated &#40;<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>64&#41;&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Previous treatment regimen not effective&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;78&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Decrease use of corticosteroids &#40;steroid-sparing&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;57&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient condition worsening&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;54&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Previous treatment regimen not well tolerated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;20&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Previous treatment regimen inconvenient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient request&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vasculitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Osteonecrosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3327179.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Reasons for belimumab initiation &#40;<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>64&#41;&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Anti-dsDNA&#44; anti-double-stranded DNA&#59; C&#44; complement&#59; CH50&#44; total haemolytic complement&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Clinical manifestation and laboratory parameters<a class="elsevierStyleCrossRef" href="#tblfn0015">&#42;</a>&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Index&#40;<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>64&#44; <span class="elsevierStyleItalic">n</span> &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="6" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Improvement from index after 6 months&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;<span class="elsevierStyleSup">&#43;</span>&#41;</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Worse&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No improvement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#60;20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">20&#8211;49&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">50&#8211;79&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#8805;80&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Arthritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;56&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;22&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;30&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;39&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fatigue&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;43&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;17&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;17&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;42&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;17&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Low complement&#40;C3&#44; C4 or CH50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;53&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;11&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;35&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Increased anti-dsDNA antibody levels&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;48&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;6&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;16&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;25&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;6&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;22&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;22&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Inability to taper corticosteroids&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;42&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;14&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;14&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;22&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;22&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;25&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rash&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;26&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;11&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;11&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;41&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Leukopenia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;23&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;13&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;40&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;13&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;20&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Proteinuria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;18&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;8&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;25&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;8&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;25&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Thrombocytopenia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;10&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;28&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;28&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;28&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mucosal ulcers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;10&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;28&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;28&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alopecia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;10&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                      "titulo" => "Treatment of lupus with corticosteroids"
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                            0 => "W&#46;W&#46; Chatham"
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                          "autores" => array:2 [
                            0 => "R&#46; Sabahi"
                            1 => "J&#46;H&#46; Anolik"
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                    0 => array:2 [
                      "doi" => "10.2165/00003495-200666150-00004"
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                        "tituloSerie" => "Drugs"
                        "fecha" => "2006"
                        "volumen" => "66"
                        "paginaInicial" => "1933"
                        "paginaFinal" => "1948"
                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Manipulating B cell homeostasis&#58; a key component in the advancement of targeted strategies"
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                          "etal" => false
                          "autores" => array:5 [
                            0 => "L&#46;S&#46; Treml"
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                            2 => "J&#46;F&#46; Treml"
                            3 => "J&#46;L&#46; Scholz"
                            4 => "M&#46;P&#46; Cancro"
                          ]
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                    0 => array:2 [
                      "doi" => "10.1007/s00005-008-0017-2"
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                        "tituloSerie" => "Arch Immunol Ther Exp"
                        "fecha" => "2008"
                        "volumen" => "56"
                        "paginaInicial" => "153"
                        "paginaFinal" => "164"
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0185"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of lupus erythematosus&#58; recent insights"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;J&#46; Wallace"
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                    0 => array:2 [
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                        "tituloSerie" => "Curr Opin Rheumatol"
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                        "volumen" => "14"
                        "paginaInicial" => "212"
                        "paginaFinal" => "219"
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673622003671"
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                          "issn" => "01406736"
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                ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of plasma B lymphocyte stimulator levels and disease activity in systemic lupus erythematosus"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Petri"
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                            2 => "W&#46; Chatham"
                            3 => "W&#46;J&#46; McCune"
                            4 => "M&#46; Chevrier"
                            5 => "J&#46; Ryel"
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                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "doi" => "10.1002/art.23678"
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                        "tituloSerie" => "Arthritis Rheum"
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                        "volumen" => "58"
                        "paginaInicial" => "2453"
                        "paginaFinal" => "2459"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18668552"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0195"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Generation and characterization of LymphoStat-B&#44; a human monoclonal antibody that antagonizes the bioactivities of B lymphocyte stimulator"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "B&#46;M&#46; Edwards"
                            2 => "S&#46;H&#46; Main"
                            3 => "G&#46;H&#46; Choi"
                            4 => "R&#46;E&#46; Wager"
                            5 => "W&#46;G&#46; Halpern"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.11299"
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                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2003"
                        "volumen" => "48"
                        "paginaInicial" => "3253"
                        "paginaFinal" => "3265"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14613291"
                            "web" => "Medline"
                          ]
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                          "issn" => "03022838"
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              ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A phase III&#44; randomized&#44; placebo-controlled study of belimumab&#44; a monoclonal antibody that inhibits B lymphocyte stimulator&#44; in patients with systemic lupus erythematosus"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Furie"
                            1 => "M&#46; Petri"
                            2 => "O&#46; Zamani"
                            3 => "R&#46; Cervera"
                            4 => "D&#46;J&#46; Wallace"
                            5 => "D&#46; Tegzov&#225;"
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                        ]
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                    0 => array:2 [
                      "doi" => "10.1002/art.30613"
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                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2011"
                        "volumen" => "63"
                        "paginaInicial" => "3918"
                        "paginaFinal" => "3930"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22127708"
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              "identificador" => "bib0205"
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                    0 => array:2 [
                      "titulo" => "Efficacy and safety of belimumab in patients with active systemic lupus erythematosus&#58; a randomised&#44; placebo-controlled&#44; phase 3 trial"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "R&#46;M&#46; Guzm&#225;n"
                            2 => "A&#46;E&#46; Gallacher"
                            3 => "S&#46; Hall"
                            4 => "R&#46;A&#46; Levy"
                            5 => "R&#46;E&#46; Jimenez"
                          ]
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                        "tituloSerie" => "Lancet"
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                        "volumen" => "377"
                        "paginaInicial" => "721"
                        "paginaFinal" => "731"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21296403"
                            "web" => "Medline"
                          ]
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                ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A pivotal phase III&#44; randomised&#44; placebo-controlled study of belimumab in patients with systemic lupus erythematosus located in China&#44; Japan and South Korea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "S&#46;C&#46; Bae"
                            2 => "D&#46; Bass"
                            3 => "M&#46; Chu"
                            4 => "S&#46; Egginton"
                            5 => "D&#46; Gordon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2017-211631"
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2018"
                        "volumen" => "77"
                        "paginaInicial" => "355"
                        "paginaFinal" => "363"
                      ]
                    ]
                  ]
                ]
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              "identificador" => "bib0215"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "OP0232 Sustained safety and efficacy over 10 years with belimumab &#40;BEL&#41; plus standard systemic lupus erythematosus &#40;SLE&#41; therapy &#40;SOC&#41; in patients with SLE"
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                            2 => "J&#46; Merrill"
                            3 => "R&#46; Furie"
                            4 => "W&#46; Stohl"
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                      "doi" => "10.1136/annrheumdis-2017-eular.6430"
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                        "tituloSerie" => "Ann Rheum Dis"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Embrace&#58; phase 3&#47;4&#44; randomized&#44; 52-Week study of belimumab efficacy and safety in patients of black African ancestry with systemic lupus erythematosus"
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                            4 => "K&#46; Maksimowicz-McKinnon"
                            5 => "J&#46; Oates"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Arthritis Rheum"
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                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "15"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Two-year&#44; randomized&#44; controlled trial of belimumab in lupus nephritis"
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                        "tituloSerie" => "N Engl J Med"
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                        "volumen" => "383"
                        "paginaInicial" => "1117"
                        "paginaFinal" => "1128"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32937045"
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              "identificador" => "bib0230"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Post-marketing experiences with belimumab in the treatment of SLE patients"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;D&#46; Askanase"
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                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25034159"
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                          ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Real-world effectiveness of belimumab in the treatment of systemic lupus erythematosus&#58; pooled analysis of multi-country data from the OBSEerve studies"
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                        0 => array:2 [
                          "etal" => true
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                            3 => "J&#46; von Kempis"
                            4 => "A&#46; Schwarting"
                            5 => "Z&#46; Touma"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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                        "tituloSerie" => "Rheumatol Ther"
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                        "volumen" => "7"
                        "paginaInicial" => "949"
                        "paginaFinal" => "965"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33206344"
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                          ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Clinical predictors of response and discontinuation of belimumab in patients with systemic lupus erythematosus in real life setting&#46; Results of a large&#44; multicentric&#44; nationwide study"
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                        0 => array:2 [
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                    0 => array:2 [
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                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28935492"
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                          ]
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                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Favorable response to belimumab in pediatric-onset systemic lupus erythematosus&#46; Abstract 672&#46; ACR 2014"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "J&#46; Taylor"
                            2 => "X&#46; Qing Li"
                            3 => "L&#46; Mariel Bermudez"
                            4 => "J&#46; Isgro"
                            5 => "A&#46;H&#46; Eichenfield"
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                    0 => array:1 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Response to belimumab among patients with systemic lupus erythematosus in clinical practice settings&#58; 24-month results from the OBSErve study in the USA"
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                        0 => array:2 [
                          "etal" => true
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                            3 => "C&#46; Macahilig"
                            4 => "C&#46; Molta"
                            5 => "V&#46; Koscielny"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:2 [
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                        "tituloSerie" => "Lupus Sci Med"
                        "fecha" => "2016"
                        "volumen" => "3"
                        "paginaInicial" => "e000118"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "21"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Belimumab use&#44; clinical outcomes and glucocorticoid reduction in patients with systemic lupus erythematosus receiving belimumab in clinical practice settings&#58; results from the OBSErve Canada Study"
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                        0 => array:2 [
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                            3 => "I&#46; Fortin"
                            4 => "M&#46; Matsos"
                            5 => "G&#46;A&#46; Ecker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00296-017-3682-9"
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                        "tituloSerie" => "Rheumatol Int"
                        "fecha" => "2017"
                        "volumen" => "37"
                        "paginaInicial" => "865"
                        "paginaFinal" => "873"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28280970"
                            "web" => "Medline"
                          ]
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                ]
              ]
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              "identificador" => "bib0260"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Evaluation of belimumab treatment in patients with systemic lupus erythematosus in a clinical practice setting&#58; results from a 24-month OBSErve study in Argentina"
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                        0 => array:2 [
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                            3 => "G&#46; Casado"
                            4 => "A&#46; Eimon"
                            5 => "H&#46; Figueredo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0961203320947814"
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                        "tituloSerie" => "Lupus"
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                        "volumen" => "29"
                        "paginaInicial" => "1385"
                        "paginaFinal" => "1396"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32791930"
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                            4 => "P&#46;M&#46; Villiger"
                            5 => "F&#46; Vallelian"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
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                        "tituloSerie" => "Swiss Med Wkly"
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                        "volumen" => "149"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30852830"
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                        0 => array:2 [
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                            2 => "C&#46; Aranow"
                            3 => "J&#46; Fettiplace"
                            4 => "B&#46; Wilson"
                            5 => "P&#46; Mistry"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.40439"
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                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2018"
                        "volumen" => "70"
                        "paginaInicial" => "868"
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                ]
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              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fatigue in systemic lupus erythematosus and rheumatoid arthritis"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Ramsey-Goldman"
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                          ]
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                    0 => array:2 [
                      "titulo" => "The prevalence and associations of fatigue in systemic lupus erythematosus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;M&#46; Tench"
                            1 => "I&#46; McCurdie"
                            2 => "P&#46;D&#46; White"
                            3 => "D&#46;P&#46; D&#8217;Cruz"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
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                        "tituloSerie" => "Rheumatology &#40;Oxford&#44; England&#41;"
                        "fecha" => "2000"
                        "volumen" => "39"
                        "paginaInicial" => "1249"
                        "paginaFinal" => "1254"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11085805"
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                  ]
                ]
              ]
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                      "titulo" => "2019 European League Against Rheumatism&#47;American College of Rheumatology classification criteria for systemic lupus erythematosus"
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                            2 => "D&#46; Daikh"
                            3 => "R&#46; Brinks"
                            4 => "M&#46; Mosca"
                            5 => "R&#46; Ramsey-Goldman"
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                        ]
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                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1002/art.40930"
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                        "volumen" => "71"
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                        "paginaFinal" => "1412"
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                      "titulo" => "2019 European League Against Rheumatism&#47;American College of Rheumatology classification criteria for systemic lupus erythematosus"
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                        "fecha" => "2019"
                        "volumen" => "78"
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                        "paginaFinal" => "1159"
                        "link" => array:1 [
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                      "titulo" => "2019 update of the EULAR recommendations for the management of systemic lupus erythematosus"
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                            3 => "M&#46; Aringer"
                            4 => "I&#46; Bajema"
                            5 => "J&#46;N&#46; Boletis"
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                      ]
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                  ]
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        "texto" => "<p id="par0190" class="elsevierStylePara elsevierViewall">This study &#40;GSK Study 200883&#41; was funded by GSK&#46; The authors would like to thank the participating patients and their families&#44; clinicians&#44; and the following OBSErve Spain study investigators&#58; Alegre Sancho J&#46;J&#46; &#40;Valencia&#41;&#44; Andreu Sanchez J&#46;L&#46; &#40;Madrid&#41;&#44; Blanco Alonso R&#46; &#40;Cantabria&#41;&#44; Calvo Alen J&#46; &#40;Cantabria&#41;&#44; Casta&#241;eda Sanz S&#46; &#40;Madrid&#41;&#44; Cortes-Hern&#225;ndez J&#46; &#40;Barcelona&#41;&#44; De Ram&#243;n Garrido E&#46; &#40;M&#225;laga&#41;&#44; D&#237;ez Alvarez E&#46; &#40;Le&#243;n&#41;&#44; Fern&#225;ndez Espartero C&#46; &#40;Madrid&#41;&#44; Galindo Izquierdo M&#46; &#40;Madrid&#41;&#44; Garc&#237;a Aparicio A&#46;M&#46; &#40;Toledo&#41;&#44; Gonz&#225;lez Fern&#225;ndez J&#46;A&#46; &#40;Alicante&#41;&#44; Gra&#241;a Gil J&#46; &#40;La Coru&#241;a&#41;&#44; Hern&#225;ndez Beriain J&#46;A&#46; &#40;Las Palmas&#41;&#44; Hern&#225;ndez Rodriguez I&#46; &#40;Pontevedra&#41;&#44; Marras Fern&#225;ndez-Cid C&#46; &#40;Murcia&#41;&#44; Mir&#243;n Trigueros P&#46; &#40;Almer&#237;a&#41;&#44; Narv&#225;ez Garc&#237;a F&#46;J&#46; &#40;Barcelona&#41;&#44; Navarro Blasco F&#46; &#40;Alicante&#41;&#44; Ordi Ros J&#46; &#40;Barcelona&#41;&#44; Paulino Huertas M&#46; &#40;Ciudad Real&#41;&#44; Pozuelo Lopez M&#46;J&#46; &#40;Valencia&#41;&#44; Rodriguez Escalera C&#46; &#40;Melilla&#41;&#44; Rodriguez Heredia J&#46;M&#46; &#40;Madrid&#41;&#44; Rosas G&#243;mez de Salazar J&#46;C&#46; &#40;Alicante&#41;&#44; Saiz Cuenca E&#46; &#40;Murcia&#41;&#46; Moreover&#44; the authors would like to acknowledge the role of Volker Koscielny&#44; former GSK Immunoinflammation Global Medical Affairs Leader&#44; in the conception and design of OBSErve Spain study&#46; Medical writing support of the first manuscript draft was provided by Claudia Kanitscheider&#44; medical writer from Kantar Health GmbH &#40;Germany&#41;&#44; and&#44; of the subsequent manuscript&#44; by Nicholas Thomas&#44; PhD&#44; of Fishawack Indicia Ltd&#44; UK&#44; part of Fishawack Health&#44; and was funded by GSK&#46;</p>"
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