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atingir a remiss&#227;o cl&#237;nica&#46; O tratamento padr&#227;o do p&#234;nfigo consiste em corticosteroide oral&#44; com&#47;sem medicamentos imunossupressores adjuvantes&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;8</span></a> Entretanto&#44; v&#225;rias morbidades associadas ao uso di&#225;rio prolongado de corticosteroides foram relatadas&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">9&#44;10</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">O rituximabe foi introduzido para o tratamento do p&#234;nfigo em 2001&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> Nos &#250;ltimos anos&#44; tem sido considerada a op&#231;&#227;o de primeira linha para o tratamento do p&#234;nfigo em pa&#237;ses desenvolvidos&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> Entretanto&#44; no Brasil&#44; rituximabe tem sido prescrito como op&#231;&#227;o excepcional&#44; para casos que n&#227;o respondem aos medicamentos mais comuns&#44;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">12&#8211;14</span></a> o que nos incentivou a buscar tratamento alternativo a fim de diminuir os efeitos colaterais dos corticoides quando prescritos cronicamente&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">9&#44;10</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Sabendo que as doen&#231;as autoimunes s&#227;o controladas de maneira eficaz com esquemas de pulsoterapia&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> al&#233;m do fato de trabalharmos em enfermarias para pacientes dermatol&#243;gicos e reumatol&#243;gicos em manejo cl&#237;nico compartilhado&#44; introduzimos a pulsoterapia com dexametasona&#8208;ciclofosfamida &#40;PDC&#41; ou dexametasona exclusivamente &#40;PD&#41; no tratamento do p&#234;nfigo&#44; com base no primeiro relato de Pasricha et al&#46; &#40;1998&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Tivemos por objetivo comparar os desfechos dos ciclos PDC&#47;PD em uma coorte brasileira de pacientes com PV e PF de acordo com os dados demogr&#225;ficos e cl&#237;nicos&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Materiais e m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Tipo de estudo</span><p id="par0030" class="elsevierStylePara elsevierViewall">Este &#233; um estudo anal&#237;tico retrospectivo&#44; com an&#225;lise de prontu&#225;rios na &#250;ltima d&#233;cada&#44; realizado de acordo com o <span class="elsevierStyleItalic">checklist</span> STROBE&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Popula&#231;&#227;o do estudo</span><p id="par0035" class="elsevierStylePara elsevierViewall">Os pacientes foram atendidos no Hospital Universit&#225;rio da Faculdade de Medicina de Ribeir&#227;o Preto da Universidade de S&#227;o Paulo&#44; Brasil&#46; Histopatologia&#44; caracter&#237;sticas de imunofluoresc&#234;ncia direta e&#47;ou indireta&#44; al&#233;m de sorologia anti&#8208;desmogle&#237;na 1 e 3 por ELISA com <span class="elsevierStyleItalic">kits</span> comerciais &#40;MBL&#44; Nagoya&#44; Jap&#227;o&#41; foram utilizados para confirmar o diagn&#243;stico de p&#234;nfigo e ajudaram a alocar os pacientes nos grupos PV e PF&#46; Os crit&#233;rios de inclus&#227;o consistiram em diagn&#243;stico confirmado de PV ou PF e prescri&#231;&#227;o de ciclo &#250;nico de terapia PDC&#47;PD &#40;ver Pulsoterapia&#41;&#46; Os crit&#233;rios de exclus&#227;o foram gravidez&#44; lacta&#231;&#227;o e tratamento anterior com rituximabe&#46; Os pacientes que tinham tratamentos anteriores foram transferidos para o regime de pulsoterapia devido &#224; refratariedade e efeitos colaterais do uso cr&#244;nico di&#225;rio de prednisona oral&#44; anti&#8208;inflamat&#243;rios e&#47;ou imunossupressores &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Pulsoterapia</span><p id="par0040" class="elsevierStylePara elsevierViewall">Os esquemas de pulsoterapia seguiram as recomenda&#231;&#245;es seguintes&#44; compreendendo quatro fases&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> Quando s&#227;o prescritas infus&#245;es de dexametasona &#40;DXM&#41; e ciclofosfamida &#40;CYP&#41; denomina&#8208;se terapia PDC&#44; e o esquema envolvendo infus&#227;o exclusiva de DXM &#233; denominado terapia PD&#46; A terapia PDC compreende 100<span class="elsevierStyleHsp" style=""></span>mg de DXM dissolvidos em 500<span class="elsevierStyleHsp" style=""></span>mL de glicose a 5&#37; e &#233; administrada em infus&#227;o intravenosa e repetida em tr&#234;s dias consecutivos&#46; No segundo dia&#44; os pacientes tamb&#233;m recebem infus&#227;o de CYP 500<span class="elsevierStyleHsp" style=""></span>mg&#46; Os pacientes jovens e os que desejam ter filhos s&#227;o tratados com a terapia PD&#44; infus&#227;o de DXM 100<span class="elsevierStyleHsp" style=""></span>mg exclusivamente em tr&#234;s dias consecutivos&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">A fase I compreende pulsos a cada 28 a 30 dias at&#233; que o paciente atinja a remiss&#227;o&#46; Se o paciente n&#227;o atingir a remiss&#227;o na Fase I&#44; &#233; considerada falha de tratamento&#46; A fase II consiste em nove pulsos consecutivos a cada 28 a 30 dias&#44; e CYP oral di&#225;ria de 50<span class="elsevierStyleHsp" style=""></span>mg &#233; mantida para consolidar a remiss&#227;o&#46; A Fase III compreende CYP oral di&#225;ria de 50<span class="elsevierStyleHsp" style=""></span>mg exclusivamente por nove meses&#46; A Fase IV consiste na remiss&#227;o sem medica&#231;&#227;o&#44; considerada como seguimento p&#243;s&#8208;tratamento&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Na terapia PDC&#44; o esquema posol&#243;gico de prednisona prescrito anteriormente foi mantido na fase I&#46; Quando ocorre a remiss&#227;o&#44; a redu&#231;&#227;o gradual da dose de prednisona &#233; realizada na fase II&#46; Na terapia PD&#44; a dose de prednisona &#233; administrada nas fases I&#8208;III&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">H&#225; um protocolo de exames cl&#237;nicos e laboratoriais para eleger o paciente para receber pulsoterapia&#44; incluindo exame dent&#225;rio&#44; e exames para excluir doen&#231;as oncol&#243;gicas&#46; Antes de cada pulso ser prescrito nas enfermarias&#44; s&#227;o realizados exames gerais cl&#237;nicos e laboratoriais&#44; principalmente hematol&#243;gicos&#44; fun&#231;&#227;o hep&#225;tica e de urina&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">A remiss&#227;o consiste na resolu&#231;&#227;o das les&#245;es antigas sem aparecimento de novas les&#245;es na fase I&#46; Durante as fases II e III&#44; os pacientes devem permanecer livres de novas les&#245;es bolhosas&#46; Se novas bolhas surgirem&#44; a fase I deve ser reiniciada&#46; Quando novas les&#245;es surgem nas fases II&#8208;IV&#44; &#233; considerada falha de tratamento&#46; Abandono foi considerado quando o paciente n&#227;o retornou em tr&#234;s meses&#46; O seguimento consistiu em pelo menos 12 meses de consultas m&#233;dicas semanais com pacientes que atingiram a fase IV&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">An&#225;lise estat&#237;stica</span><p id="par0065" class="elsevierStylePara elsevierViewall">Dados discretos e cont&#237;nuos foram expressos como contagem &#40;porcentagem&#41; e mediana &#40;varia&#231;&#227;o&#41;&#44; respectivamente&#46; O teste de Mann&#8208;Whitney foi utilizado para vari&#225;veis cont&#237;nuas&#44; como apropriado&#46; Vari&#225;veis categ&#243;ricas foram comparadas utilizando o teste exato de Fisher&#46; A an&#225;lise estat&#237;stica foi realizada com o <span class="elsevierStyleItalic">software</span> Prism GraphPad 9 &#40;La Jolla&#44; CA&#44; EUA&#41;&#46; O n&#237;vel de signific&#226;ncia adotado foi &#945;<span class="elsevierStyleHsp" style=""></span>&#62; 5&#37;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">&#201;tica</span><p id="par0070" class="elsevierStylePara elsevierViewall">Os pacientes assinaram o Termo de Consentimento Livre e Esclarecido&#44; e os pacientes menores de 18 anos tiveram seu termo de consentimento assinado pelos pais ou respons&#225;veis legais&#46; O estudo foi aprovado pelo Comit&#234; de &#201;tica local &#40;n&#176; 10&#8208;51729&#8208;2 e n&#176; 8063&#8208;2015&#41; de acordo com os padr&#245;es &#233;ticos da Declara&#231;&#227;o de Helsinque da Associa&#231;&#227;o M&#233;dica Mundial&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="par0075" class="elsevierStylePara elsevierViewall">O estudo incluiu 78 pacientes com p&#234;nfigo&#44; 37 com PV e 41 com PF&#46; Informa&#231;&#245;es sobre sexo&#44; idade&#44; dura&#231;&#227;o da doen&#231;a e tratamentos pr&#233;vios antes da prescri&#231;&#227;o da pulsoterapia e aloca&#231;&#227;o nos esquemas PDC e PD est&#227;o descritas na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; Ambos os grupos apresentaram diferen&#231;as estat&#237;sticas quanto &#224; idade e dura&#231;&#227;o da doen&#231;a&#59; os pacientes com PV eram mais idosos do que os com PF&#44; e tempo de doen&#231;a do PF foi maior que o do PV &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001 para ambos&#41;&#46; A aloca&#231;&#227;o de pacientes com PV e PF em esquemas de PDC ou PD foi semelhante &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;235&#41;&#46; Portanto&#44; os resultados foram analisados abrangendo ambos os esquemas&#44; denominada terapia PDC&#47;PD&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Cinco pacientes com PV foram alocados no esquema de pulsoterapia como primeira op&#231;&#227;o em virtude da gravidade da doen&#231;a&#46; Os dados sobre os resultados da pulsoterapia nas fases I&#8208;IV para os grupos PV e PF est&#227;o expressos na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados da PDC&#47;PD em 37 pacientes com PV</span><p id="par0085" class="elsevierStylePara elsevierViewall">Dos 37 pacientes com PV&#44; 25 &#40;67&#44;6&#37;&#41; atingiram remiss&#227;o na fase I ap&#243;s mediana de seis &#40;1&#8211;18&#41; pulsos e prosseguiram para a fase II&#46; A falha &#40;13&#44;5&#37;&#41; foi determinada ap&#243;s mediana de 13 &#40;11&#8211;24&#41; pulsos&#59; esses pacientes foram alocados em outras modalidades terap&#234;uticas&#44; como rituximabe&#46; Dois &#40;5&#44;4&#37;&#41; pacientes apresentaram intercorr&#234;ncias cl&#237;nicas&#58; um recebeu tratamento para tuberculose latente e o outro apresentou c&#226;ncer renal&#46; De fato&#44; o diagn&#243;stico do paciente que morreu de c&#226;ncer renal foi revisado&#59; ele apresentava p&#234;nfigo paraneopl&#225;sico&#46; Vinte e um &#40;84&#37;&#41; pacientes da fase II prosseguiram para a fase III&#46; Na fase II&#44; um &#40;4&#37;&#41; paciente teve recorr&#234;ncia e outro &#40;4&#37;&#41; apresentou idea&#231;&#227;o suicida como intercorr&#234;ncia cl&#237;nica&#44; atribu&#237;da aos corticoides&#46; Na fase III&#44; dois pacientes &#40;9&#44;5&#37;&#41; abandonaram o tratamento e um &#40;4&#44;8&#37;&#41; apresentou recorr&#234;ncia&#46; Dos 17 pacientes na fase IV&#44; 14 &#40;82&#44;4&#37;&#41; mantiveram a remiss&#227;o sem terapia com seguimento m&#233;dio de 12 &#40;8 a 44&#41; meses&#44; e tr&#234;s pacientes &#40;17&#44;6&#37;&#41; tiveram recorr&#234;ncia em dois a tr&#234;s meses&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">PDC foi prescrita como primeiro tratamento para quatro pacientes com PV&#44; devido &#224; gravidade da doen&#231;a &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#58; dois pacientes apresentaram falha na fase I e rituximabe foi prescrito&#59; um estava na fase I e outro na fase IV&#46; PD foi prescrita como primeiro tratamento para um paciente com PV&#44; que apresentou recorr&#234;ncia ap&#243;s dois meses na fase IV&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a> mostra uma compara&#231;&#227;o dos dados demogr&#225;ficos e cl&#237;nicos de 14 pacientes com PV em remiss&#227;o sem terapia e cinco pacientes que apresentaram falha na fase I&#46; Os pacientes com PV mais jovens apresentaram maior frequ&#234;ncia de falha &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;031&#41;&#59; o n&#250;mero de pulsos e a dura&#231;&#227;o da fase I foram menores nos pacientes que apresentaram remiss&#227;o &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002 para ambos&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Resultados da PDC&#47;PD em 41 pacientes com PF</span><p id="par0100" class="elsevierStylePara elsevierViewall">Dos 41 pacientes com PF&#44; 23 &#40;56&#44;1&#37;&#41; entraram em remiss&#227;o na fase I ap&#243;s mediana de 10 &#40;2&#8208;33&#41; pulsos e prosseguiram para a fase II&#46; Falha foi observada em seis &#40;14&#44;6&#37;&#41; pacientes&#44; ap&#243;s mediana de 25 &#40;16&#8208;34&#41; pulsos&#46; Cinco &#40;12&#44;2&#37;&#41; pacientes abandonaram o tratamento e quatro &#40;9&#44;7&#37;&#41; apresentaram intercorr&#234;ncias cl&#237;nicas &#40;artrite s&#233;ptica e infec&#231;&#245;es de pele&#41; e foram removidos do estudo&#46; Dezenove &#40;82&#44;6&#37;&#41; pacientes prosseguiram para a fase III&#44; um &#40;4&#44;4&#37;&#41; paciente foi removido do estudo em virtude de tratamento odontol&#243;gico e outro &#40;5&#44;3&#37;&#41; apresentou recorr&#234;ncia&#46; Dos 18 pacientes na fase IV&#44; 14 &#40;77&#44;8&#37;&#41; mantiveram a remiss&#227;o sem terapia com mediana de 26 &#40;8&#8208;56&#41; meses&#46; Ainda&#44; a recorr&#234;ncia ocorreu em quatro pacientes &#40;22&#44;2&#37;&#41;&#44; ap&#243;s mediana de tr&#234;s &#40;1&#8208;47&#41; meses&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Os dados cl&#237;nicos comparando 14 pacientes com PF que obtiveram remiss&#227;o livre de terapia e seis pacientes que apresentaram falha na fase I s&#227;o apresentados na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#46; As vari&#225;veis cujos resultados diferiram estatisticamente foram&#58; o n&#250;mero de pulsos e a dura&#231;&#227;o da fase I&#44; que foram menores em pacientes que apresentaram remiss&#227;o &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004 e p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#44; respectivamente&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Compara&#231;&#227;o dos resultados de PDC&#47;PD em pacientes com PV e PF que alcan&#231;aram remiss&#227;o sem terapia &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a>&#41;</span><p id="par0110" class="elsevierStylePara elsevierViewall">Os resultados da PDC&#47;PD foram semelhantes em ambos os grupos&#46; Em resumo&#44; 14 &#40;37&#44;8&#37;&#41; de 37 pacientes com PV e 14 &#40;34&#44;1&#37;&#41; de 41 pacientes com PF entraram em remiss&#227;o&#44; considerados livres de doen&#231;a na Fase IV &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;815&#41;&#46; Falha ocorreu em cinco &#40;13&#44;5&#37;&#41; de 37 casos de PV e em seis &#40;14&#44;6&#37;&#41; de 41 casos de PF na fase I &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;0&#41;&#46; Recorr&#234;ncia nas fases II a IV ocorreu em cinco &#40;13&#44;5&#37;&#41; de 37 pacientes com PV e em cinco &#40;12&#44;2&#37;&#41; de 41 pacientes com PF &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;0&#41;&#46; Pacientes mais jovens com PV apresentaram maior frequ&#234;ncia de falha&#46; Os pacientes com PF eram mais jovens&#44; apresentavam maior dura&#231;&#227;o da doen&#231;a e necessitavam de maior n&#250;mero de pulsos para atingir a remiss&#227;o na fase I&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Ciclos n&#227;o completados da pulsoterapia</span><p id="par0115" class="elsevierStylePara elsevierViewall">Em geral&#44; a pulsoterapia foi bem tolerada&#44; mas efeitos colaterais menores &#40;infec&#231;&#227;o cut&#226;nea e urin&#225;ria&#44; n&#225;useas e v&#244;mitos&#44; cefaleia e hemat&#250;ria&#41; ocorreram em tr&#234;s &#40;8&#44;1&#37;&#41; de 37 pacientes com PV e em cinco &#40;12&#44;2&#37;&#41; de 41 com PF &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;715&#41;&#46; Foi registrado um caso de adenocarcinoma prost&#225;tico&#44; diagnosticado sete meses ap&#243;s a suspens&#227;o da pulsoterapia&#46; Nenhum paciente morreu em decorr&#234;ncia do tratamento&#46; Abandono ocorreu em sete &#40;18&#44;9&#37;&#41; de 37 pacientes com PV e em cinco &#40;12&#44;2&#37;&#41; de 41 pacientes com PF &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;534&#41;&#46; No total&#44; abandono do tratamento foi observado em 10 &#40;27&#37;&#41; de 37 pacientes com PV e em 10 &#40;24&#44;4&#37;&#41; de 41 pacientes com PF &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;802&#41;&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discuss&#227;o</span><p id="par0120" class="elsevierStylePara elsevierViewall">Nas &#250;ltimas d&#233;cadas&#44; a pulsoterapia tornou&#8208;se op&#231;&#227;o segura para o tratamento do p&#234;nfigo&#44; pois evita os efeitos colaterais em longo prazo do tratamento oral di&#225;rio com corticosteroides e&#47;ou medicamentos imunossupressores&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">9&#44;10&#44;16&#8211;21</span></a> As principais modalidades relatadas de pulsoterapia compreendem PDC e pulso de dexametasona com azatioprina oral&#44; resultando em controle semelhante da doen&#231;a&#44; mas maior frequ&#234;ncia de recorr&#234;ncia no regime com azatioprina&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> No Brasil&#44; um &#250;nico relato sobre pulsoterapia para p&#234;nfigo foi encontrado na literatura&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">PDC foi prescrita para mais de 300 pacientes com p&#234;nfigo na &#205;ndia&#44; dos quais 190 &#40;84&#37;&#41; dos 227 pacientes que completaram o tratamento estavam livres da doen&#231;a &#40;25&#44;3&#37; com seguimento de mais de cinco anos&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> A compara&#231;&#227;o do uso de adjuvantes com efeito poupador de esteroides demonstrou que PDC e ciclosporina s&#227;o os melhores medicamentos em termos de taxas de recorr&#234;ncia&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">No presente estudo&#44; foram comparados os resultados de PDC&#47;PD nas duas principais formas cl&#237;nicas de p&#234;nfigo em uma regi&#227;o brasileira com preval&#234;ncia de PV e PF&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> Considerando a amostra total dos grupos PV e PF&#44; que completaram um ciclo de PDC&#47;PD&#44; as frequ&#234;ncias de remiss&#227;o foram semelhantes para ambos &#40;14 &#91;37&#44;8&#37;&#93; de 37 casos de PV e 14 &#91;34&#44;1&#37;&#93; de 41 casos de PF&#41;&#46; Se forem considerados os pacientes que prosseguiram para a fase IV&#44; 14 &#40;82&#44;4&#37;&#41; dos 17 pacientes com PV e 14 &#40;77&#44;8&#37;&#41; dos 18 com PF apresentaram remiss&#227;o com mediana de seguimento de 12 meses e 26 meses&#44; respectivamente&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">A dura&#231;&#227;o da fase I determina a dura&#231;&#227;o da pulsoterapia completa&#46; Os fatores que influenciam a fase I s&#227;o importantes para estabelecer o progn&#243;stico da resposta &#224; PDC&#47;PD&#46; Na fase I&#44; 25 &#40;67&#44;7&#37;&#41; de 37 pacientes com PV e 23 &#40;56&#44;1&#37;&#41; dos pacientes com PF atingiram frequ&#234;ncias de remiss&#227;o semelhantes&#46; &#201; digno de nota que&#44; embora o PF seja considerado como tendo melhor progn&#243;stico que o PV&#44; o grupo PF demorou mais para atingir a remiss&#227;o quando comparado ao PV&#44; com mediana de 10 e seis pulsos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41; e 11 e cinco meses&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#46; Roga&#44; Augustine &#40;2018&#41; descreveram 10 meses para PV e oito meses para PF&#44; mas o grupo com PF necessitou mais ciclos do que o grupo com PV para alcan&#231;ar o controle&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> Mundakkat&#44; Sridharan &#40;2018&#41; associaram a dura&#231;&#227;o mais longa da fase de indu&#231;&#227;o &#40;fase I&#41; com a gravidade do escore oral e cut&#226;neo e com a dura&#231;&#227;o da doen&#231;a&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> &#201; importante ressaltar que a terapia PDC&#47;PD&#44; com exce&#231;&#227;o de cinco casos de PV&#44; foi prescrita para pacientes que n&#227;o apresentaram resposta ao tratamento anterior&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">De fato&#44; o tempo da doen&#231;a antes da prescri&#231;&#227;o da pulsoterapia foi maior no grupo PF do que no PV &#40;mediana<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>69 meses e 14 meses&#44; respectivamente&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; O comportamento epidemiol&#243;gico e cl&#237;nico do PF poderia explicar esse achado &#8208; o PF geralmente come&#231;a em idade precoce&#44; cursa com baixa gravidade&#44; permitindo um longo per&#237;odo sem o uso de qualquer agente terap&#234;utico agressivo&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> Esses fatos podem justificar o grande n&#250;mero de pulsos para atingir a remiss&#227;o no grupo PF visto na fase I&#46; Embora a gravidade do PV seja maior do que o PF&#44; os pacientes com PV iniciaram a pulsoterapia mais precocemente ap&#243;s um per&#237;odo mais curto de doen&#231;a em compara&#231;&#227;o com o PF&#44; o que poderia justificar a resposta mais r&#225;pida e o menor n&#250;mero de pulsos necess&#225;rios para atingir a remiss&#227;o na Fase I&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">22&#44;24</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">As frequ&#234;ncias de falha na fase I foram semelhantes nos grupos PV e PF &#40;13&#44;5&#37; e 14&#44;6&#37;&#44; respectivamente&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; O n&#250;mero de pulsos considerados para falha foi maior para o grupo PF&#44; comparado ao PV &#40;mediana<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25 e 13&#44; respectivamente&#41;&#46; Nas fases II e III&#44; poucos pacientes apresentaram recorr&#234;ncia &#40;dois pacientes com PV e um com PF&#41;&#46; Na fase IV&#44; quando os pacientes n&#227;o utilizam nenhum corticoide ou agente imunossupressor&#44; houve recorr&#234;ncia em tr&#234;s &#40;17&#44;6&#37;&#41; dos 17 pacientes com PV e em quatro &#40;22&#44;2&#37;&#41; dos 18 pacientes com PF&#46; Ao buscar fatores que pudessem influenciar os resultados da remiss&#227;o livre de terapia na fase IV e falha na fase I &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41;&#44; o n&#250;mero de pulsos na fase I foi maior no subgrupo de falha tanto em PV quanto em PF&#46; Em termos de idade&#44; os pacientes com PV mais jovens apresentaram maior frequ&#234;ncia de falha em compara&#231;&#227;o com a remiss&#227;o livre de terapia &#40;mediana de 36 anos e 50&#44;5 anos&#44; respectivamente&#41;&#46; Tratamento incompleto ou irregular e&#47;ou pulsoterapia com medica&#231;&#227;o &#250;nica podem levar &#224; recorr&#234;ncia ou falha terap&#234;utica&#46; Para Pasricha et al&#46;&#44; o sucesso da pulsoterapia depende de protocolo e seguimento rigorosos do paciente&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> Os pacientes mais jovens com PV foram tratados com o esquema PD&#44; o que poderia justificar a maior frequ&#234;ncia de falha terap&#234;utica&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Os pacientes com PV e PF n&#227;o diferiram quanto ao abandono do tratamento ou intercorr&#234;ncias cl&#237;nicas&#46; O abandono ocorreu em sete &#40;18&#44;9&#37;&#41; dos 37 pacientes com PV e em cinco &#40;12&#44;2&#37;&#41; dos 41 pacientes com PF&#46; Intercorr&#234;ncias cl&#237;nicas foram observadas em tr&#234;s &#40;8&#44;1&#37;&#41; de 37 pacientes com PV e em cinco &#40;12&#44;2&#37;&#41; de 41 pacientes com PF&#46; Considerando o abandono do tratamento&#44; 27&#37; do grupo com PV e 24&#44;4&#37; do grupo com PF n&#227;o finalizaram o tratamento&#46; Mahajan et al&#46; &#40;2022&#41; relataram taxa de abandono de 41&#44;5&#37; em pacientes com p&#234;nfigo tratados com PDC&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> Foi poss&#237;vel identificar n&#227;o apenas a dificuldade de transporte de outras cidades at&#233; o centro de refer&#234;ncia e problemas pessoais e familiares como os principais motivos do abandono&#44; mas tamb&#233;m o abandono sem justificativa registrada em prontu&#225;rio m&#233;dico&#46; Manter a ades&#227;o dos pacientes &#224; pulsoterapia &#233; certamente um desafio para os m&#233;dicos que trabalham com esse esquema terap&#234;utico&#46; Antecedendo as consultas cl&#237;nicas&#44; agendamos reuni&#245;es com os pacientes para explicar a modalidade terap&#234;utica&#44; o que poderia justificar a melhor ades&#227;o ao tratamento&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">Por fim&#44; a pulsoterapia n&#227;o &#233; isenta de efeitos colaterais&#44; sendo astenia&#44; fadiga&#44; mialgia&#44; artralgia&#44; rubor&#44; palpita&#231;&#245;es&#44; ins&#244;nia&#44; cefaleia&#44; anorexia e n&#225;useas e v&#244;mitos os mais comumente descritos &#40;ver Ref&#46; 26 para revisar as modalidades de pulsoterapia&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">21&#44;26</span></a> A maioria dos pacientes do presente estudo tolerou bem a pulsoterapia e apresentou efeitos colaterais menores&#46; N&#227;o obstante&#44; houve um caso de adenocarcinoma prost&#225;tico&#44; diagnosticado sete meses ap&#243;s a suspens&#227;o da pulsoterapia&#46; Esse paciente de 60 anos fazia uso de CYP havia 4&#44;5 anos&#44; com dose cumulativa de 20<span class="elsevierStyleHsp" style=""></span>g Efeitos colaterais graves relatados para esse medicamento&#44; como doen&#231;as linfoproliferativas&#44; cistite hemorr&#225;gica e c&#226;ncer de bexiga&#44; podem ocorrer ap&#243;s 30&#8208;100<span class="elsevierStyleHsp" style=""></span>g de dose cumulativa de CYP&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a> Al&#233;m disso&#44; n&#227;o h&#225; relatos at&#233; o momento relacionando CYP e c&#226;ncer de pr&#243;stata&#46; Portanto&#44; n&#227;o &#233; poss&#237;vel atribuir diretamente este caso de c&#226;ncer de pr&#243;stata ao uso da terapia PDC&#46; De qualquer modo&#44; os m&#233;dicos devem monitorar o surgimento desse tipo de evento&#46; Embora mortes durante a pulsoterapia tenham sido descritas&#44; nenhuma morte foi registrada no presente estudo&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">Antes da era dos corticosteroides&#44; a letalidade do p&#234;nfigo chegava a 70&#37;&#46; Ap&#243;s a introdu&#231;&#227;o de corticosteroides e terapia adjuvante&#44; essa letalidade caiu para menos de 10&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a> Desde sua introdu&#231;&#227;o em 1982 por Pasricha et al&#46;&#44; a terapia PDC vem revolucionando o tratamento do p&#234;nfigo&#46; Essa modalidade proporciona n&#227;o apenas o controle&#44; mas tamb&#233;m a remiss&#227;o do p&#234;nfigo&#44; com menos efeitos colaterais graves associados&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16&#44;19&#44;21&#44;24&#44;29</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">Nos pa&#237;ses em desenvolvimento&#44; sem o rituximabe como agente poupador de primeira linha para o tratamento do p&#234;nfigo&#44; a PDC&#47;PD deve ser considerada uma modalidade segura para tratamento do p&#234;nfigo&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> Como o presente estudo mostrou uma associa&#231;&#227;o de maior falha terap&#234;utica com a dura&#231;&#227;o da doen&#231;a antes da pulsoterapia&#44; recomenda&#8208;se o in&#237;cio imediato da pulsoterapia no PV leve a grave e no PF&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Os resultados do presente estudo possibilitam melhor compreens&#227;o sobre a pulsoterapia e podem ser &#250;teis para novos estudos visando esclarecer a associa&#231;&#227;o do perfil gen&#233;tico de pacientes com p&#234;nfigo com o tratamento PDC&#47;PD&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclus&#245;es</span><p id="par0175" class="elsevierStylePara elsevierViewall">Os grupos PV e PF apresentaram frequ&#234;ncias semelhantes de desfecho da PDC&#47;PD&#58; remiss&#227;o&#44; falha terap&#234;utica&#44; recorr&#234;ncia e abandono do tratamento&#46; Em compara&#231;&#227;o com o grupo PV&#44; os pacientes com PF necessitaram de maior n&#250;mero de pulsos para atingir a remiss&#227;o durante a fase I&#44; o que pode estar relacionado &#224; maior dura&#231;&#227;o da doen&#231;a antes da prescri&#231;&#227;o da pulsoterapia&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Suporte financeiro</span><p id="par0180" class="elsevierStylePara elsevierViewall">Este estudo foi parcialmente financiado pela Funda&#231;&#227;o de Amparo &#224; Pesquisa do Estado de S&#227;o Paulo &#40;FAPESP&#59; &#35;2010&#8208;51729&#8208;2&#41; e Funda&#231;&#227;o de Apoio ao Ensino&#44; Assist&#234;ncia e Pesquisa &#40;FAEPA&#41;&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Contribui&#231;&#227;o dos autores</span><p id="par0185" class="elsevierStylePara elsevierViewall">Ludmilla Figueiredo Vale Fontenelle&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; an&#225;lise estat&#237;stica&#59; reda&#231;&#227;o do manuscrito&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Roberto Bueno&#8208;Filho&#58; An&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Sebasti&#225;n Vernal&#58; An&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Renata Delfino&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Giovanna Stefanne L&#243;pes Barbosa&#58; An&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Eduardo Antonio Donadi&#58; An&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Ana Maria Roselino&#58; Concep&#231;&#227;o e planejamento do estudo&#59; revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflito de interesses</span><p id="par0220" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pulsos de dexametasona&#8208;ciclofosfamida &#40;PDC&#41; e de dexametasona &#40;PD&#41; t&#234;m sido utilizados com sucesso para tratar p&#234;nfigo&#44; mas os relatos de PDC&#47;PD comparando p&#234;nfigo vulgar &#40;PV&#41; e p&#234;nfigo foli&#225;ceo &#40;PF&#41; s&#227;o escassos&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Comparar o desfecho de PDC&#47;PD em uma coorte brasileira de pacientes com PV e PF de acordo com dados demogr&#225;ficos e cl&#237;nicos&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudo de coorte anal&#237;tico retrospectivo&#44; com revis&#227;o de prontu&#225;rios de pacientes com PV e PF &#40;para as fases I&#8208;IV dos ciclos DCP&#47;DP&#44; consultar Pasricha et al&#46;<span class="elsevierStyleSup">16&#8208;18</span>&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Trinta e sete pacientes com PV e 41 com PF&#44; que n&#227;o responderam aos tratamentos usuais&#44; foram inclu&#237;dos similarmente na terapia com PDC ou PD&#46; A dura&#231;&#227;o da doen&#231;a era maior entre os pacientes com PF antes da prescri&#231;&#227;o de PDC&#47;PD &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#59; PF exigiu maior n&#250;mero de pulsos mensais para atingir a remiss&#227;o na fase I &#40;mediana de 10 e seis pulsos&#44; respectivamente&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41;&#46; Os resultados de PDC&#47;PD foram semelhantes em ambos os grupos&#58; remiss&#227;o em 37&#44;8&#37; dos casos de PV e 34&#44;1&#37; de PF ap&#243;s completar o ciclo de PDC&#47;PD com mediana de 13 meses &#40;1&#8208;56 meses de seguimento&#41;&#59; falha ocorreu em 13&#44;5&#37; do grupo PV e 14&#44;6&#37; do PF na fase I&#59; recidiva em 13&#44;5&#37; do grupo PV e 12&#44;2&#37; do PF&#44; e abandono em 27&#37; do PV e 24&#44;4&#37; do PF nas fases II a IV&#46; Efeitos colaterais leves foram documentados&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#245;es do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A gravidade do PV e do PF n&#227;o foi avaliada por &#237;ndices de escore&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#245;es</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Pacientes com PV e PF apresentaram desfechos semelhantes ap&#243;s PDC&#47;PD&#46; PDC&#47;PD deve ser iniciado mais precocemente em pacientes com PF em virtude da longa dura&#231;&#227;o da doen&#231;a&#44; a fim de diminuir o n&#250;mero de pulsos e a dura&#231;&#227;o da fase I para obter remiss&#227;o&#46;</p></span>"
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Dura&#231;&#227;o da doen&#231;a antes da pulsoterapia &#40;meses&#41; mediana &#40;m&#237;n&#8208;m&#225;x&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14 &#40;2&#8208;92&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;13&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \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
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \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
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \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
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;83&#44;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">40 &#40;97&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Dapsona&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">15 &#40;40&#44;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">12 &#40;29&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Hidroxicloroquina&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&#44;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">14 &#40;34&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Azatioprina&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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                  """
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PV &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>37&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">37 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">41 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Remiss&#227;o&#44; progrediu para fase II&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">25 &#40;67&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;56&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;355&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Falha terap&#234;utica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;13&#44;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">6 &#40;14&#44;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">1&#44;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Abandono do tratamento&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;10&#44;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">5 &#40;12&#44;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">1&#44;0&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>Intercorr&#234;ncias cl&#237;nicas&nbsp;\t\t\t\t\t\t\n
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                  \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&#44;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">4 &#40;9&#44;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&#44;678&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>Terapia continuada<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \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&#44;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">3 &#40;7&#44;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">N&#46;A&#46;&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>Pulsos at&#233; remiss&#227;o&#44; mediana &#40;m&#237;n&#8211;m&#225;x&#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;1&#8211;18&#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">10 &#40;2&#8211;33&#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&#44;005&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>Meses at&#233; remiss&#227;o&#44; mediana &#40;m&#237;n&#8208;m&#225;x&#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;1&#8208;19&#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">11 &#40;2&#8208;33&#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&#44;002&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>Pulsos at&#233; falha terap&#234;utica&#44; mediana &#40;m&#237;n&#8211;m&#225;x&#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">13 &#40;11&#8211;24&#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">25 &#40;16&#8211;34&#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&#44;074&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">Fase II</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;100&#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">23 &#40;100&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Manteve remiss&#227;o&#44; progrediu para fase III&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">21 &#40;84&#44;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">19 &#40;82&#44;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">1&#44;0&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>Recorr&#234;ncia&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;4&#44;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">Nenhum&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&#44;0&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>Abandono do tratamento&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;4&#44;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">Nenhum&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&#44;0&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>Intercorr&#234;ncias cl&#237;nicas&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;4&#44;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;4&#44;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&#44;0&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>Terapia continuada<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&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;4&#44;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">3 &#40;13&#44;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">N&#46;A&#46;&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">Fase III</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;100&#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">19 &#40;100&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Manteve remiss&#227;o&#44; progrediu para fase IV&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">18 &#40;85&#44;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">19 &#40;100&#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&#44;0&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>Abandono do tratamento&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;9&#44;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">Nenhum&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&#44;493&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>Intercorr&#234;ncias cl&#237;nicas&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">Nenhum&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">Nenhum&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&#44;0&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>Recorr&#234;ncia&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;4&#44;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;5&#44;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&#44;0&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>Terapia continuada<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&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;4&#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">Nenhum&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">N&#46;A&#46;&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">Fase IV</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;100&#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">18 &#40;100&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Remiss&#227;o sem terapia&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">14 &#40;82&#44;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">14 &#40;77&#44;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&#44;0&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>Recorr&#234;ncia&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&#44;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">4 &#40;22&#44;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">1&#44;0&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>Tempo at&#233; recorr&#234;ncia &#40;meses&#41;&#44; mediana &#40;m&#237;n&#8211;m&#225;x&#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;2&#8211;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;1&#8211;47&#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&#44;971&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>Dura&#231;&#227;o do seguimento &#40;meses&#41;&#44; mediana &#40;m&#237;n&#8211;m&#225;x&#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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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Idade &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dura&#231;&#227;o da doen&#231;a antes da pulsoterapia &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dura&#231;&#227;o do seguimento na fase IV &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">26 &#40;8&#8211;56&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Compara&#231;&#227;o de dados demogr&#225;ficos&#44; cl&#237;nicos e n&#250;mero de pulsos e dura&#231;&#227;o da fase I entre os grupos de p&#234;nfigo vulgar &#40;PV&#41; e p&#234;nfigo foli&#225;ceo &#40;PF&#41; que atingiram remiss&#227;o livres de terapia</p>"
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    "bibliografia" => array:2 [
      "titulo" => "Refer&#234;ncias"
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                0 => array:2 [
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                      "titulo" => "Autoimmune pemphigus&#58; latest advances and emerging therapies"
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                            0 => "Y&#46;L&#46; Lim"
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                      "doi" => "10.3389/fmolb.2021.808536"
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                        "tituloSerie" => "Front Mol Biosci&#46;"
                        "fecha" => "2022"
                        "volumen" => "8"
                        "paginaInicial" => "808536"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35187073"
                            "web" => "Medline"
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                      "titulo" => "Common denominators in the immunobiology of IgG4 autoimmune diseases&#58; what do glomerulonephritis&#44; pemphigus vulgaris&#44; myasthenia gravis&#44; thrombotic thrombocytopenic purpura and autoimmune encephalitis have in common&#63;"
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                      "titulo" => "Spatial distribution of pemphigus occurrence over five decades in Southeastern Brazil"
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                        "link" => array:1 [
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                      "titulo" => "Herpes simplex virus 1 and cytomegalovirus are associated with pemphigus vulgaris but not with pemphigus foliaceus disease"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Trace element profile in pemphigus foliaceus and in pemphigus vulgaris patients from Southeastern Brazil"
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                        "paginaInicial" => "958"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "class I and class II associations in pemphigus foliaceus and pemphigus vulgaris patients from a prevalent Southeastern Brazilian region"
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                      "titulo" => "Severe multi&#8208;resistant pemphigus vulgaris&#58; prolonged remission with a single cycle of rituximab"
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                      "titulo" => "Cyclophosphamide pulses in the treatment of rheumatic diseases&#58; an update"
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                        "paginaInicial" => "179"
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                        "fecha" => "1988"
                        "volumen" => "119"
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                        "paginaFinal" => "77"
                        "link" => array:1 [
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                    0 => array:2 [
                      "titulo" => "Pulse therapy as a cure for autoimmune diseases"
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                        "paginaInicial" => "323"
                        "paginaFinal" => "328"
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                      "titulo" => "Dexamethasone&#8208;cyclophosphamide pulse therapy for pemphigus"
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                        "paginaFinal" => "882"
                        "link" => array:1 [
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Artigo original
Desfechos da pulsoterapia com dexametasona‐ciclofosfamida comparando grupos de pênfigo vulgar e pênfigo foliáceo em estudo de coorte brasileiro
Ludmilla Figueiredo Fontenellea,b, Roberto Bueno‐Filhoa, Sebastián Vernala, Renata Delfinoa, Giovanna Stefanne Lópes Barbosab, Eduardo Antonio Donadic, Ana Maria Roselinoa,
Corresponding author
amfrosel@fmrp.usp.br

Autor para correspondência.
a Departamento de Clínica Médica, Hospital Universitário, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
b Departamento de Medicina, Universidade Federal do Delta do Parnaíba, Parnaíba, PI, Brasil
c Departamento de Clínica Médica, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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atingir a remiss&#227;o cl&#237;nica&#46; O tratamento padr&#227;o do p&#234;nfigo consiste em corticosteroide oral&#44; com&#47;sem medicamentos imunossupressores adjuvantes&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;8</span></a> Entretanto&#44; v&#225;rias morbidades associadas ao uso di&#225;rio prolongado de corticosteroides foram relatadas&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">9&#44;10</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">O rituximabe foi introduzido para o tratamento do p&#234;nfigo em 2001&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> Nos &#250;ltimos anos&#44; tem sido considerada a op&#231;&#227;o de primeira linha para o tratamento do p&#234;nfigo em pa&#237;ses desenvolvidos&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> Entretanto&#44; no Brasil&#44; rituximabe tem sido prescrito como op&#231;&#227;o excepcional&#44; para casos que n&#227;o respondem aos medicamentos mais comuns&#44;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">12&#8211;14</span></a> o que nos incentivou a buscar tratamento alternativo a fim de diminuir os efeitos colaterais dos corticoides quando prescritos cronicamente&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">9&#44;10</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Sabendo que as doen&#231;as autoimunes s&#227;o controladas de maneira eficaz com esquemas de pulsoterapia&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> al&#233;m do fato de trabalharmos em enfermarias para pacientes dermatol&#243;gicos e reumatol&#243;gicos em manejo cl&#237;nico compartilhado&#44; introduzimos a pulsoterapia com dexametasona&#8208;ciclofosfamida &#40;PDC&#41; ou dexametasona exclusivamente &#40;PD&#41; no tratamento do p&#234;nfigo&#44; com base no primeiro relato de Pasricha et al&#46; &#40;1998&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Tivemos por objetivo comparar os desfechos dos ciclos PDC&#47;PD em uma coorte brasileira de pacientes com PV e PF de acordo com os dados demogr&#225;ficos e cl&#237;nicos&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Materiais e m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Tipo de estudo</span><p id="par0030" class="elsevierStylePara elsevierViewall">Este &#233; um estudo anal&#237;tico retrospectivo&#44; com an&#225;lise de prontu&#225;rios na &#250;ltima d&#233;cada&#44; realizado de acordo com o <span class="elsevierStyleItalic">checklist</span> STROBE&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Popula&#231;&#227;o do estudo</span><p id="par0035" class="elsevierStylePara elsevierViewall">Os pacientes foram atendidos no Hospital Universit&#225;rio da Faculdade de Medicina de Ribeir&#227;o Preto da Universidade de S&#227;o Paulo&#44; Brasil&#46; Histopatologia&#44; caracter&#237;sticas de imunofluoresc&#234;ncia direta e&#47;ou indireta&#44; al&#233;m de sorologia anti&#8208;desmogle&#237;na 1 e 3 por ELISA com <span class="elsevierStyleItalic">kits</span> comerciais &#40;MBL&#44; Nagoya&#44; Jap&#227;o&#41; foram utilizados para confirmar o diagn&#243;stico de p&#234;nfigo e ajudaram a alocar os pacientes nos grupos PV e PF&#46; Os crit&#233;rios de inclus&#227;o consistiram em diagn&#243;stico confirmado de PV ou PF e prescri&#231;&#227;o de ciclo &#250;nico de terapia PDC&#47;PD &#40;ver Pulsoterapia&#41;&#46; Os crit&#233;rios de exclus&#227;o foram gravidez&#44; lacta&#231;&#227;o e tratamento anterior com rituximabe&#46; Os pacientes que tinham tratamentos anteriores foram transferidos para o regime de pulsoterapia devido &#224; refratariedade e efeitos colaterais do uso cr&#244;nico di&#225;rio de prednisona oral&#44; anti&#8208;inflamat&#243;rios e&#47;ou imunossupressores &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Pulsoterapia</span><p id="par0040" class="elsevierStylePara elsevierViewall">Os esquemas de pulsoterapia seguiram as recomenda&#231;&#245;es seguintes&#44; 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que o paciente atinja a remiss&#227;o&#46; Se o paciente n&#227;o atingir a remiss&#227;o na Fase I&#44; &#233; considerada falha de tratamento&#46; A fase II consiste em nove pulsos consecutivos a cada 28 a 30 dias&#44; e CYP oral di&#225;ria de 50<span class="elsevierStyleHsp" style=""></span>mg &#233; mantida para consolidar a remiss&#227;o&#46; A Fase III compreende CYP oral di&#225;ria de 50<span class="elsevierStyleHsp" style=""></span>mg exclusivamente por nove meses&#46; A Fase IV consiste na remiss&#227;o sem medica&#231;&#227;o&#44; considerada como seguimento p&#243;s&#8208;tratamento&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Na terapia PDC&#44; o esquema posol&#243;gico de prednisona prescrito anteriormente foi mantido na fase I&#46; Quando ocorre a remiss&#227;o&#44; a redu&#231;&#227;o gradual da dose de prednisona &#233; realizada na fase II&#46; Na terapia PD&#44; a dose de prednisona &#233; administrada nas fases I&#8208;III&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">H&#225; um protocolo de exames cl&#237;nicos e laboratoriais para eleger o paciente para receber pulsoterapia&#44; incluindo exame dent&#225;rio&#44; e exames para excluir doen&#231;as oncol&#243;gicas&#46; Antes de cada pulso ser prescrito nas enfermarias&#44; s&#227;o realizados exames gerais cl&#237;nicos e laboratoriais&#44; principalmente hematol&#243;gicos&#44; fun&#231;&#227;o hep&#225;tica e de urina&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">A remiss&#227;o consiste na resolu&#231;&#227;o das les&#245;es antigas sem aparecimento de novas les&#245;es na fase I&#46; Durante as fases II e III&#44; os pacientes devem permanecer livres de novas les&#245;es bolhosas&#46; Se novas bolhas surgirem&#44; a fase I deve ser reiniciada&#46; Quando novas les&#245;es surgem nas fases II&#8208;IV&#44; &#233; considerada falha de tratamento&#46; Abandono foi considerado quando o paciente n&#227;o retornou em tr&#234;s meses&#46; O seguimento consistiu em pelo menos 12 meses de consultas m&#233;dicas semanais com pacientes que atingiram a fase IV&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">An&#225;lise estat&#237;stica</span><p id="par0065" class="elsevierStylePara elsevierViewall">Dados discretos e cont&#237;nuos foram expressos como contagem &#40;porcentagem&#41; e mediana &#40;varia&#231;&#227;o&#41;&#44; respectivamente&#46; O teste de Mann&#8208;Whitney foi utilizado para vari&#225;veis cont&#237;nuas&#44; como apropriado&#46; Vari&#225;veis categ&#243;ricas foram comparadas utilizando o teste exato de Fisher&#46; A an&#225;lise estat&#237;stica foi realizada com o <span class="elsevierStyleItalic">software</span> Prism GraphPad 9 &#40;La Jolla&#44; CA&#44; EUA&#41;&#46; O n&#237;vel de signific&#226;ncia adotado foi &#945;<span class="elsevierStyleHsp" style=""></span>&#62; 5&#37;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">&#201;tica</span><p id="par0070" class="elsevierStylePara elsevierViewall">Os pacientes assinaram o Termo de Consentimento Livre e Esclarecido&#44; e os pacientes menores de 18 anos tiveram seu termo de consentimento assinado pelos pais ou respons&#225;veis legais&#46; O estudo foi aprovado pelo Comit&#234; de &#201;tica local &#40;n&#176; 10&#8208;51729&#8208;2 e n&#176; 8063&#8208;2015&#41; de acordo com os padr&#245;es &#233;ticos da Declara&#231;&#227;o de Helsinque da Associa&#231;&#227;o M&#233;dica Mundial&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="par0075" class="elsevierStylePara elsevierViewall">O estudo incluiu 78 pacientes com p&#234;nfigo&#44; 37 com PV e 41 com PF&#46; Informa&#231;&#245;es sobre sexo&#44; idade&#44; dura&#231;&#227;o da doen&#231;a e tratamentos pr&#233;vios antes da prescri&#231;&#227;o da pulsoterapia e aloca&#231;&#227;o nos esquemas PDC e PD est&#227;o descritas na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; Ambos os grupos apresentaram diferen&#231;as estat&#237;sticas quanto &#224; idade e dura&#231;&#227;o da doen&#231;a&#59; os pacientes com PV eram mais idosos do que os com PF&#44; e tempo de doen&#231;a do PF foi maior que o do PV &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001 para ambos&#41;&#46; A aloca&#231;&#227;o de pacientes com PV e PF em esquemas de PDC ou PD foi semelhante &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;235&#41;&#46; Portanto&#44; os resultados foram analisados abrangendo ambos os esquemas&#44; denominada terapia PDC&#47;PD&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Cinco pacientes com PV foram alocados no esquema de pulsoterapia como primeira op&#231;&#227;o em virtude da gravidade da doen&#231;a&#46; Os dados sobre os resultados da pulsoterapia nas fases I&#8208;IV para os grupos PV e PF est&#227;o expressos na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados da PDC&#47;PD em 37 pacientes com PV</span><p id="par0085" class="elsevierStylePara elsevierViewall">Dos 37 pacientes com PV&#44; 25 &#40;67&#44;6&#37;&#41; atingiram remiss&#227;o na fase I ap&#243;s mediana de seis &#40;1&#8211;18&#41; pulsos e prosseguiram para a fase II&#46; A falha &#40;13&#44;5&#37;&#41; foi determinada ap&#243;s mediana de 13 &#40;11&#8211;24&#41; pulsos&#59; esses pacientes foram alocados em outras modalidades terap&#234;uticas&#44; como rituximabe&#46; Dois &#40;5&#44;4&#37;&#41; pacientes apresentaram intercorr&#234;ncias cl&#237;nicas&#58; um recebeu tratamento para tuberculose latente e o outro apresentou c&#226;ncer renal&#46; De fato&#44; o diagn&#243;stico do paciente que morreu de c&#226;ncer renal foi revisado&#59; ele apresentava p&#234;nfigo paraneopl&#225;sico&#46; Vinte e um &#40;84&#37;&#41; pacientes da fase II prosseguiram para a fase III&#46; Na fase II&#44; um &#40;4&#37;&#41; paciente teve recorr&#234;ncia e outro &#40;4&#37;&#41; apresentou idea&#231;&#227;o suicida como intercorr&#234;ncia cl&#237;nica&#44; atribu&#237;da aos corticoides&#46; Na fase III&#44; dois pacientes &#40;9&#44;5&#37;&#41; abandonaram o tratamento e um &#40;4&#44;8&#37;&#41; apresentou recorr&#234;ncia&#46; Dos 17 pacientes na fase IV&#44; 14 &#40;82&#44;4&#37;&#41; mantiveram a remiss&#227;o sem terapia com seguimento m&#233;dio de 12 &#40;8 a 44&#41; meses&#44; e tr&#234;s pacientes &#40;17&#44;6&#37;&#41; tiveram recorr&#234;ncia em dois a tr&#234;s meses&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">PDC foi prescrita como primeiro tratamento para quatro pacientes com PV&#44; devido &#224; gravidade da doen&#231;a &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#58; dois pacientes apresentaram falha na fase I e rituximabe foi prescrito&#59; um estava na fase I e outro na fase IV&#46; PD foi prescrita como primeiro tratamento para um paciente com PV&#44; que apresentou recorr&#234;ncia ap&#243;s dois meses na fase IV&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a> mostra uma compara&#231;&#227;o dos dados demogr&#225;ficos e cl&#237;nicos de 14 pacientes com PV em remiss&#227;o sem terapia e cinco pacientes que apresentaram falha na fase I&#46; Os pacientes com PV mais jovens apresentaram maior frequ&#234;ncia de falha &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;031&#41;&#59; o n&#250;mero de pulsos e a dura&#231;&#227;o da fase I foram menores nos pacientes que apresentaram remiss&#227;o &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002 para ambos&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Resultados da PDC&#47;PD em 41 pacientes com PF</span><p id="par0100" class="elsevierStylePara elsevierViewall">Dos 41 pacientes com PF&#44; 23 &#40;56&#44;1&#37;&#41; entraram em remiss&#227;o na fase I ap&#243;s mediana de 10 &#40;2&#8208;33&#41; pulsos e prosseguiram para a fase II&#46; Falha foi observada em seis &#40;14&#44;6&#37;&#41; pacientes&#44; ap&#243;s mediana de 25 &#40;16&#8208;34&#41; pulsos&#46; Cinco &#40;12&#44;2&#37;&#41; pacientes abandonaram o tratamento e quatro &#40;9&#44;7&#37;&#41; apresentaram intercorr&#234;ncias cl&#237;nicas &#40;artrite s&#233;ptica e infec&#231;&#245;es de pele&#41; e foram removidos do estudo&#46; Dezenove &#40;82&#44;6&#37;&#41; pacientes prosseguiram para a fase III&#44; um &#40;4&#44;4&#37;&#41; paciente foi removido do estudo em virtude de tratamento odontol&#243;gico e outro &#40;5&#44;3&#37;&#41; apresentou recorr&#234;ncia&#46; Dos 18 pacientes na fase IV&#44; 14 &#40;77&#44;8&#37;&#41; mantiveram a remiss&#227;o sem terapia com mediana de 26 &#40;8&#8208;56&#41; meses&#46; Ainda&#44; a recorr&#234;ncia ocorreu em quatro pacientes &#40;22&#44;2&#37;&#41;&#44; ap&#243;s mediana de tr&#234;s &#40;1&#8208;47&#41; meses&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Os dados cl&#237;nicos comparando 14 pacientes com PF que obtiveram remiss&#227;o livre de terapia e seis pacientes que apresentaram falha na fase I s&#227;o apresentados na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#46; As vari&#225;veis cujos resultados diferiram estatisticamente foram&#58; o n&#250;mero de pulsos e a dura&#231;&#227;o da fase I&#44; que foram menores em pacientes que apresentaram remiss&#227;o &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004 e p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#44; respectivamente&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Compara&#231;&#227;o dos resultados de PDC&#47;PD em pacientes com PV e PF que alcan&#231;aram remiss&#227;o sem terapia &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a>&#41;</span><p id="par0110" class="elsevierStylePara elsevierViewall">Os resultados da PDC&#47;PD foram semelhantes em ambos os grupos&#46; Em resumo&#44; 14 &#40;37&#44;8&#37;&#41; de 37 pacientes com PV e 14 &#40;34&#44;1&#37;&#41; de 41 pacientes com PF entraram em remiss&#227;o&#44; considerados livres de doen&#231;a na Fase IV &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;815&#41;&#46; Falha ocorreu em cinco &#40;13&#44;5&#37;&#41; de 37 casos de PV e em seis &#40;14&#44;6&#37;&#41; de 41 casos de PF na fase I &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;0&#41;&#46; Recorr&#234;ncia nas fases II a IV ocorreu em cinco &#40;13&#44;5&#37;&#41; de 37 pacientes com PV e em cinco &#40;12&#44;2&#37;&#41; de 41 pacientes com PF &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;0&#41;&#46; Pacientes mais jovens com PV apresentaram maior frequ&#234;ncia de falha&#46; Os pacientes com PF eram mais jovens&#44; apresentavam maior dura&#231;&#227;o da doen&#231;a e necessitavam de maior n&#250;mero de pulsos para atingir a remiss&#227;o na fase I&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Ciclos n&#227;o completados da pulsoterapia</span><p id="par0115" class="elsevierStylePara elsevierViewall">Em geral&#44; a pulsoterapia foi bem tolerada&#44; mas efeitos colaterais menores &#40;infec&#231;&#227;o cut&#226;nea e urin&#225;ria&#44; n&#225;useas e v&#244;mitos&#44; cefaleia e hemat&#250;ria&#41; ocorreram em tr&#234;s &#40;8&#44;1&#37;&#41; de 37 pacientes com PV e em cinco &#40;12&#44;2&#37;&#41; de 41 com PF &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;715&#41;&#46; Foi registrado um caso de adenocarcinoma prost&#225;tico&#44; diagnosticado sete meses ap&#243;s a suspens&#227;o da pulsoterapia&#46; Nenhum paciente morreu em decorr&#234;ncia do tratamento&#46; Abandono ocorreu em sete &#40;18&#44;9&#37;&#41; de 37 pacientes com PV e em cinco &#40;12&#44;2&#37;&#41; de 41 pacientes com PF &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;534&#41;&#46; No total&#44; abandono do tratamento foi observado em 10 &#40;27&#37;&#41; de 37 pacientes com PV e em 10 &#40;24&#44;4&#37;&#41; de 41 pacientes com PF &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;802&#41;&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discuss&#227;o</span><p id="par0120" class="elsevierStylePara elsevierViewall">Nas &#250;ltimas d&#233;cadas&#44; a pulsoterapia tornou&#8208;se op&#231;&#227;o segura para o tratamento do p&#234;nfigo&#44; pois evita os efeitos colaterais em longo prazo do tratamento oral di&#225;rio com corticosteroides e&#47;ou medicamentos imunossupressores&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">9&#44;10&#44;16&#8211;21</span></a> As principais modalidades relatadas de pulsoterapia compreendem PDC e pulso de dexametasona com azatioprina oral&#44; resultando em controle semelhante da doen&#231;a&#44; mas maior frequ&#234;ncia de recorr&#234;ncia no regime com azatioprina&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> No Brasil&#44; um &#250;nico relato sobre pulsoterapia para p&#234;nfigo foi encontrado na literatura&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">PDC foi prescrita para mais de 300 pacientes com p&#234;nfigo na &#205;ndia&#44; dos quais 190 &#40;84&#37;&#41; dos 227 pacientes que completaram o tratamento estavam livres da doen&#231;a &#40;25&#44;3&#37; com seguimento de mais de cinco anos&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> A compara&#231;&#227;o do uso de adjuvantes com efeito poupador de esteroides demonstrou que PDC e ciclosporina s&#227;o os melhores medicamentos em termos de taxas de recorr&#234;ncia&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">No presente estudo&#44; foram comparados os resultados de PDC&#47;PD nas duas principais formas cl&#237;nicas de p&#234;nfigo em uma regi&#227;o brasileira com preval&#234;ncia de PV e PF&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> Considerando a amostra total dos grupos PV e PF&#44; que completaram um ciclo de PDC&#47;PD&#44; as frequ&#234;ncias de remiss&#227;o foram semelhantes para ambos &#40;14 &#91;37&#44;8&#37;&#93; de 37 casos de PV e 14 &#91;34&#44;1&#37;&#93; de 41 casos de PF&#41;&#46; Se forem considerados os pacientes que prosseguiram para a fase IV&#44; 14 &#40;82&#44;4&#37;&#41; dos 17 pacientes com PV e 14 &#40;77&#44;8&#37;&#41; dos 18 com PF apresentaram remiss&#227;o com mediana de seguimento de 12 meses e 26 meses&#44; respectivamente&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">A dura&#231;&#227;o da fase I determina a dura&#231;&#227;o da pulsoterapia completa&#46; Os fatores que influenciam a fase I s&#227;o importantes para estabelecer o progn&#243;stico da resposta &#224; PDC&#47;PD&#46; Na fase I&#44; 25 &#40;67&#44;7&#37;&#41; de 37 pacientes com PV e 23 &#40;56&#44;1&#37;&#41; dos pacientes com PF atingiram frequ&#234;ncias de remiss&#227;o semelhantes&#46; &#201; digno de nota que&#44; embora o PF seja considerado como tendo melhor progn&#243;stico que o PV&#44; o grupo PF demorou mais para atingir a remiss&#227;o quando comparado ao PV&#44; com mediana de 10 e seis pulsos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41; e 11 e cinco meses&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#46; Roga&#44; Augustine &#40;2018&#41; descreveram 10 meses para PV e oito meses para PF&#44; mas o grupo com PF necessitou mais ciclos do que o grupo com PV para alcan&#231;ar o controle&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> Mundakkat&#44; Sridharan &#40;2018&#41; associaram a dura&#231;&#227;o mais longa da fase de indu&#231;&#227;o &#40;fase I&#41; com a gravidade do escore oral e cut&#226;neo e com a dura&#231;&#227;o da doen&#231;a&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> &#201; importante ressaltar que a terapia PDC&#47;PD&#44; com exce&#231;&#227;o de cinco casos de PV&#44; foi prescrita para pacientes que n&#227;o apresentaram resposta ao tratamento anterior&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">De fato&#44; o tempo da doen&#231;a antes da prescri&#231;&#227;o da pulsoterapia foi maior no grupo PF do que no PV &#40;mediana<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>69 meses e 14 meses&#44; respectivamente&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; O comportamento epidemiol&#243;gico e cl&#237;nico do PF poderia explicar esse achado &#8208; o PF geralmente come&#231;a em idade precoce&#44; cursa com baixa gravidade&#44; permitindo um longo per&#237;odo sem o uso de qualquer agente terap&#234;utico agressivo&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> Esses fatos podem justificar o grande n&#250;mero de pulsos para atingir a remiss&#227;o no grupo PF visto na fase I&#46; Embora a gravidade do PV seja maior do que o PF&#44; os pacientes com PV iniciaram a pulsoterapia mais precocemente ap&#243;s um per&#237;odo mais curto de doen&#231;a em compara&#231;&#227;o com o PF&#44; o que poderia justificar a resposta mais r&#225;pida e o menor n&#250;mero de pulsos necess&#225;rios para atingir a remiss&#227;o na Fase I&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">22&#44;24</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">As frequ&#234;ncias de falha na fase I foram semelhantes nos grupos PV e PF &#40;13&#44;5&#37; e 14&#44;6&#37;&#44; respectivamente&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; O n&#250;mero de pulsos considerados para falha foi maior para o grupo PF&#44; comparado ao PV &#40;mediana<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25 e 13&#44; respectivamente&#41;&#46; Nas fases II e III&#44; poucos pacientes apresentaram recorr&#234;ncia &#40;dois pacientes com PV e um com PF&#41;&#46; Na fase IV&#44; quando os pacientes n&#227;o utilizam nenhum corticoide ou agente imunossupressor&#44; houve recorr&#234;ncia em tr&#234;s &#40;17&#44;6&#37;&#41; dos 17 pacientes com PV e em quatro &#40;22&#44;2&#37;&#41; dos 18 pacientes com PF&#46; Ao buscar fatores que pudessem influenciar os resultados da remiss&#227;o livre de terapia na fase IV e falha na fase I &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41;&#44; o n&#250;mero de pulsos na fase I foi maior no subgrupo de falha tanto em PV quanto em PF&#46; Em termos de idade&#44; os pacientes com PV mais jovens apresentaram maior frequ&#234;ncia de falha em compara&#231;&#227;o com a remiss&#227;o livre de terapia &#40;mediana de 36 anos e 50&#44;5 anos&#44; respectivamente&#41;&#46; Tratamento incompleto ou irregular e&#47;ou pulsoterapia com medica&#231;&#227;o &#250;nica podem levar &#224; recorr&#234;ncia ou falha terap&#234;utica&#46; Para Pasricha et al&#46;&#44; o sucesso da pulsoterapia depende de protocolo e seguimento rigorosos do paciente&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> Os pacientes mais jovens com PV foram tratados com o esquema PD&#44; o que poderia justificar a maior frequ&#234;ncia de falha terap&#234;utica&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Os pacientes com PV e PF n&#227;o diferiram quanto ao abandono do tratamento ou intercorr&#234;ncias cl&#237;nicas&#46; O abandono ocorreu em sete &#40;18&#44;9&#37;&#41; dos 37 pacientes com PV e em cinco &#40;12&#44;2&#37;&#41; dos 41 pacientes com PF&#46; Intercorr&#234;ncias cl&#237;nicas foram observadas em tr&#234;s &#40;8&#44;1&#37;&#41; de 37 pacientes com PV e em cinco &#40;12&#44;2&#37;&#41; de 41 pacientes com PF&#46; Considerando o abandono do tratamento&#44; 27&#37; do grupo com PV e 24&#44;4&#37; do grupo com PF n&#227;o finalizaram o tratamento&#46; Mahajan et al&#46; &#40;2022&#41; relataram taxa de abandono de 41&#44;5&#37; em pacientes com p&#234;nfigo tratados com PDC&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> Foi poss&#237;vel identificar n&#227;o apenas a dificuldade de transporte de outras cidades at&#233; o centro de refer&#234;ncia e problemas pessoais e familiares como os principais motivos do abandono&#44; mas tamb&#233;m o abandono sem justificativa registrada em prontu&#225;rio m&#233;dico&#46; Manter a ades&#227;o dos pacientes &#224; pulsoterapia &#233; certamente um desafio para os m&#233;dicos que trabalham com esse esquema terap&#234;utico&#46; Antecedendo as consultas cl&#237;nicas&#44; agendamos reuni&#245;es com os pacientes para explicar a modalidade terap&#234;utica&#44; o que poderia justificar a melhor ades&#227;o ao tratamento&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">Por fim&#44; a pulsoterapia n&#227;o &#233; isenta de efeitos colaterais&#44; sendo astenia&#44; fadiga&#44; mialgia&#44; artralgia&#44; rubor&#44; palpita&#231;&#245;es&#44; ins&#244;nia&#44; cefaleia&#44; anorexia e n&#225;useas e v&#244;mitos os mais comumente descritos &#40;ver Ref&#46; 26 para revisar as modalidades de pulsoterapia&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">21&#44;26</span></a> A maioria dos pacientes do presente estudo tolerou bem a pulsoterapia e apresentou efeitos colaterais menores&#46; N&#227;o obstante&#44; houve um caso de adenocarcinoma prost&#225;tico&#44; diagnosticado sete meses ap&#243;s a suspens&#227;o da pulsoterapia&#46; Esse paciente de 60 anos fazia uso de CYP havia 4&#44;5 anos&#44; com dose cumulativa de 20<span class="elsevierStyleHsp" style=""></span>g Efeitos colaterais graves relatados para esse medicamento&#44; como doen&#231;as linfoproliferativas&#44; cistite hemorr&#225;gica e c&#226;ncer de bexiga&#44; podem ocorrer ap&#243;s 30&#8208;100<span class="elsevierStyleHsp" style=""></span>g de dose cumulativa de CYP&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a> Al&#233;m disso&#44; n&#227;o h&#225; relatos at&#233; o momento relacionando CYP e c&#226;ncer de pr&#243;stata&#46; Portanto&#44; n&#227;o &#233; poss&#237;vel atribuir diretamente este caso de c&#226;ncer de pr&#243;stata ao uso da terapia PDC&#46; De qualquer modo&#44; os m&#233;dicos devem monitorar o surgimento desse tipo de evento&#46; Embora mortes durante a pulsoterapia tenham sido descritas&#44; nenhuma morte foi registrada no presente estudo&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">Antes da era dos corticosteroides&#44; a letalidade do p&#234;nfigo chegava a 70&#37;&#46; Ap&#243;s a introdu&#231;&#227;o de corticosteroides e terapia adjuvante&#44; essa letalidade caiu para menos de 10&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a> Desde sua introdu&#231;&#227;o em 1982 por Pasricha et al&#46;&#44; a terapia PDC vem revolucionando o tratamento do p&#234;nfigo&#46; Essa modalidade proporciona n&#227;o apenas o controle&#44; mas tamb&#233;m a remiss&#227;o do p&#234;nfigo&#44; com menos efeitos colaterais graves associados&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16&#44;19&#44;21&#44;24&#44;29</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">Nos pa&#237;ses em desenvolvimento&#44; sem o rituximabe como agente poupador de primeira linha para o tratamento do p&#234;nfigo&#44; a PDC&#47;PD deve ser considerada uma modalidade segura para tratamento do p&#234;nfigo&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> Como o presente estudo mostrou uma associa&#231;&#227;o de maior falha terap&#234;utica com a dura&#231;&#227;o da doen&#231;a antes da pulsoterapia&#44; recomenda&#8208;se o in&#237;cio imediato da pulsoterapia no PV leve a grave e no PF&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Os resultados do presente estudo possibilitam melhor compreens&#227;o sobre a pulsoterapia e podem ser &#250;teis para novos estudos visando esclarecer a associa&#231;&#227;o do perfil gen&#233;tico de pacientes com p&#234;nfigo com o tratamento PDC&#47;PD&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclus&#245;es</span><p id="par0175" class="elsevierStylePara elsevierViewall">Os grupos PV e PF apresentaram frequ&#234;ncias semelhantes de desfecho da PDC&#47;PD&#58; remiss&#227;o&#44; falha terap&#234;utica&#44; recorr&#234;ncia e abandono do tratamento&#46; Em compara&#231;&#227;o com o grupo PV&#44; os pacientes com PF necessitaram de maior n&#250;mero de pulsos para atingir a remiss&#227;o durante a fase I&#44; o que pode estar relacionado &#224; maior dura&#231;&#227;o da doen&#231;a antes da prescri&#231;&#227;o da pulsoterapia&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Suporte financeiro</span><p id="par0180" class="elsevierStylePara elsevierViewall">Este estudo foi parcialmente financiado pela Funda&#231;&#227;o de Amparo &#224; Pesquisa do Estado de S&#227;o Paulo &#40;FAPESP&#59; &#35;2010&#8208;51729&#8208;2&#41; e Funda&#231;&#227;o de Apoio ao Ensino&#44; Assist&#234;ncia e Pesquisa &#40;FAEPA&#41;&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Contribui&#231;&#227;o dos autores</span><p id="par0185" class="elsevierStylePara elsevierViewall">Ludmilla Figueiredo Vale Fontenelle&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; an&#225;lise estat&#237;stica&#59; reda&#231;&#227;o do manuscrito&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Roberto Bueno&#8208;Filho&#58; An&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Sebasti&#225;n Vernal&#58; An&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Renata Delfino&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Giovanna Stefanne L&#243;pes Barbosa&#58; An&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Eduardo Antonio Donadi&#58; An&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Ana Maria Roselino&#58; Concep&#231;&#227;o e planejamento do estudo&#59; revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflito de interesses</span><p id="par0220" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pulsos de dexametasona&#8208;ciclofosfamida &#40;PDC&#41; e de dexametasona &#40;PD&#41; t&#234;m sido utilizados com sucesso para tratar p&#234;nfigo&#44; mas os relatos de PDC&#47;PD comparando p&#234;nfigo vulgar &#40;PV&#41; e p&#234;nfigo foli&#225;ceo &#40;PF&#41; s&#227;o escassos&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Comparar o desfecho de PDC&#47;PD em uma coorte brasileira de pacientes com PV e PF de acordo com dados demogr&#225;ficos e cl&#237;nicos&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudo de coorte anal&#237;tico retrospectivo&#44; com revis&#227;o de prontu&#225;rios de pacientes com PV e PF &#40;para as fases I&#8208;IV dos ciclos DCP&#47;DP&#44; consultar Pasricha et al&#46;<span class="elsevierStyleSup">16&#8208;18</span>&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Trinta e sete pacientes com PV e 41 com PF&#44; que n&#227;o responderam aos tratamentos usuais&#44; foram inclu&#237;dos similarmente na terapia com PDC ou PD&#46; A dura&#231;&#227;o da doen&#231;a era maior entre os pacientes com PF antes da prescri&#231;&#227;o de PDC&#47;PD &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#59; PF exigiu maior n&#250;mero de pulsos mensais para atingir a remiss&#227;o na fase I &#40;mediana de 10 e seis pulsos&#44; respectivamente&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41;&#46; Os resultados de PDC&#47;PD foram semelhantes em ambos os grupos&#58; remiss&#227;o em 37&#44;8&#37; dos casos de PV e 34&#44;1&#37; de PF ap&#243;s completar o ciclo de PDC&#47;PD com mediana de 13 meses &#40;1&#8208;56 meses de seguimento&#41;&#59; falha ocorreu em 13&#44;5&#37; do grupo PV e 14&#44;6&#37; do PF na fase I&#59; recidiva em 13&#44;5&#37; do grupo PV e 12&#44;2&#37; do PF&#44; e abandono em 27&#37; do PV e 24&#44;4&#37; do PF nas fases II a IV&#46; Efeitos colaterais leves foram documentados&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#245;es do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A gravidade do PV e do PF n&#227;o foi avaliada por &#237;ndices de escore&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#245;es</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Pacientes com PV e PF apresentaram desfechos semelhantes ap&#243;s PDC&#47;PD&#46; PDC&#47;PD deve ser iniciado mais precocemente em pacientes com PF em virtude da longa dura&#231;&#227;o da doen&#231;a&#44; a fim de diminuir o n&#250;mero de pulsos e a dura&#231;&#227;o da fase I para obter remiss&#227;o&#46;</p></span>"
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Feminino&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">23 &#40;62&#44;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">24 &#40;58&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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">Idade &#40;anos&#41; mediana &#40;m&#237;n&#8208;m&#225;x&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;16&#8208;69&#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">21 &#40;11&#8208;85&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">Pacientes com idade &#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">18 anos&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;5&#44;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">10 &#40;24&#44;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">0&#44;028&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">Dura&#231;&#227;o da doen&#231;a antes da pulsoterapia &#40;meses&#41; mediana &#40;m&#237;n&#8208;m&#225;x&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;2&#8208;92&#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">69 &#40;2&#8208;528&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">Pulsoterapia como primeiro tratamento&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;13&#44;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">Nenhum&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&#44;055&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>PDC&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;10&#44;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">Nenhum&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>PD&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&#44;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">Nenhum&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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">Tratamento anterior&#44; n &#40;&#37;&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&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">32 &#40;86&#44;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">41 &#40;100&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Prednisona&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">31 &#40;83&#44;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">40 &#40;97&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Dapsona&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">15 &#40;40&#44;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">12 &#40;29&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Hidroxicloroquina&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&#44;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">14 &#40;34&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Azatioprina&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">7 &#40;18&#44;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">9 &#40;22&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Metotrexato&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&#44;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">8 &#40;19&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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">Esquema de pulsoterapia&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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&#44;235&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>PDC&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">27 &#40;73&#44;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">24 &#40;58&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>PD&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">10 &#40;27&#44;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">17 &#40;41&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&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">PV &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>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">PF &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>41&#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">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#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">n &#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="" 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></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">Fase I</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;100&#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">41 &#40;100&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Remiss&#227;o&#44; progrediu para fase II&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">25 &#40;67&#44;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">23 &#40;56&#44;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&#44;355&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>Falha terap&#234;utica&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;13&#44;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">6 &#40;14&#44;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">1&#44;0&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>Abandono do tratamento&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;10&#44;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">5 &#40;12&#44;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">1&#44;0&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>Intercorr&#234;ncias cl&#237;nicas&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&#44;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">4 &#40;9&#44;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&#44;678&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>Terapia continuada<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&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&#44;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">3 &#40;7&#44;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">N&#46;A&#46;&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>Pulsos at&#233; remiss&#227;o&#44; mediana &#40;m&#237;n&#8211;m&#225;x&#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;1&#8211;18&#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">10 &#40;2&#8211;33&#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&#44;005&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>Meses at&#233; remiss&#227;o&#44; mediana &#40;m&#237;n&#8208;m&#225;x&#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;1&#8208;19&#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">11 &#40;2&#8208;33&#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&#44;002&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>Pulsos at&#233; falha terap&#234;utica&#44; mediana &#40;m&#237;n&#8211;m&#225;x&#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">13 &#40;11&#8211;24&#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">25 &#40;16&#8211;34&#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&#44;074&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">Fase II</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;100&#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">23 &#40;100&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Manteve remiss&#227;o&#44; progrediu para fase III&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">21 &#40;84&#44;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">19 &#40;82&#44;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">1&#44;0&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>Recorr&#234;ncia&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;4&#44;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">Nenhum&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&#44;0&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>Abandono do tratamento&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;4&#44;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">Nenhum&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&#44;0&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>Intercorr&#234;ncias cl&#237;nicas&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;4&#44;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;4&#44;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&#44;0&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>Terapia continuada<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&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;4&#44;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">3 &#40;13&#44;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">N&#46;A&#46;&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">Fase III</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;100&#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">19 &#40;100&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Manteve remiss&#227;o&#44; progrediu para fase IV&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">18 &#40;85&#44;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">19 &#40;100&#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&#44;0&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>Abandono do tratamento&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;9&#44;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">Nenhum&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&#44;493&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>Intercorr&#234;ncias cl&#237;nicas&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">Nenhum&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">Nenhum&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&#44;0&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>Recorr&#234;ncia&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;4&#44;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;5&#44;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&#44;0&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>Terapia continuada<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&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;4&#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">Nenhum&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">N&#46;A&#46;&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">Fase IV</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;100&#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">18 &#40;100&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Remiss&#227;o sem terapia&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">14 &#40;82&#44;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">14 &#40;77&#44;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&#44;0&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>Recorr&#234;ncia&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&#44;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">4 &#40;22&#44;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">1&#44;0&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>Tempo at&#233; recorr&#234;ncia &#40;meses&#41;&#44; mediana &#40;m&#237;n&#8211;m&#225;x&#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;2&#8211;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;1&#8211;47&#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&#44;971&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>Dura&#231;&#227;o do seguimento &#40;meses&#41;&#44; mediana &#40;m&#237;n&#8211;m&#225;x&#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">12 &#40;8&#8211;44&#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">26 &#40;8&#8208;56&#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&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3303783.png"
              ]
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            0 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Pacientes que ainda estavam nas Fases I&#44; II ou III no momento da coleta de dados&#46;</p> <p class="elsevierStyleNotepara" id="npar0015">N&#46;A&#46;&#44; n&#227;o aplic&#225;vel&#46;</p>"
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Resultados da pulsoterapia de acordo com a fase dos esquemas PDC&#47;PD nos grupos p&#234;nfigo vulgar &#40;PV&#41; e p&#234;nfigo foli&#225;ceo &#40;PF&#41;</p>"
        ]
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        "identificador" => "tbl0015"
        "etiqueta" => "Tabela 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabela "
            "rol" => "short"
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        "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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&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="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P&#234;nfigo vulgar</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P&#234;nfigo foli&#225;ceo</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">&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">Remiss&#227;o livre de terapia&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">Falha na Fase I&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">p&#8208;valor&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">Remiss&#227;o livre de terapia&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">Falha na Fase I&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">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&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">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&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
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Mediana &#40;m&#237;n&#8211;m&#225;x&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Idade &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
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                  \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">50&#44;5 &#40;18&#8211;61&#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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                  \t\t\t\t">23 &#40;11&#8211;45&#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
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                  \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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dura&#231;&#227;o da doen&#231;a antes da pulsoterapia &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">14 &#40;3&#8211;45&#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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                  \t\t\t\t">81 &#40;8&#8211;528&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;006&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
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                  \t\t\t\t">6&#44;5 &#40;2&#8211;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10&#44;5 &#40;3&#8211;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;026&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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dura&#231;&#227;o da fase I &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#44;5 &#40;2&#8211;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">12 &#40;4&#8211;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;015&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dura&#231;&#227;o do seguimento na fase IV &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12 &#40;8&#8211;44&#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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                  \t\t\t\t">26 &#40;8&#8211;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;070&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Compara&#231;&#227;o de dados demogr&#225;ficos&#44; cl&#237;nicos e n&#250;mero de pulsos e dura&#231;&#227;o da fase I entre os grupos de p&#234;nfigo vulgar &#40;PV&#41; e p&#234;nfigo foli&#225;ceo &#40;PF&#41; que atingiram remiss&#227;o livres de terapia</p>"
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                          "autores" => array:5 [
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                            4 => "T&#46;L&#46; Lenz"
                            5 => "S&#46; Tzartos"
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                      ]
                    ]
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                    0 => array:2 [
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                        "fecha" => "2021"
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                        "link" => array:1 [
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                      "titulo" => "Consensus on the treatment of autoimmune bullous dermatoses&#58; pemphigus vulgaris and pemphigus foliaceus &#8208; Brazilian Society of Dermatology"
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                      "titulo" => "Prevalence of Metabolic Syndrome and its components in a Brazilian sample of pemphigus patients"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35262797"
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                        "paginaInicial" => "269"
                        "paginaFinal" => "272"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11255323"
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                      "titulo" => "Refractory pemphigus vulgaris treated with rituximab and mycophenolate mofetil"
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                      "titulo" => "Off&#8208;label use of rituximab in dermatology&#58; pemphigus treatment"
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                          "etal" => false
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                            4 => "A&#46;C&#46; Gripp"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24068154"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Severe multi&#8208;resistant pemphigus vulgaris&#58; prolonged remission with a single cycle of rituximab"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
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                            2 => "R&#46;T&#46; Aquino"
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                            4 => "M&#46;E&#46; Magliari"
                            5 => "H&#46; Muller"
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                    0 => array:2 [
                      "doi" => "10.1590/abd1806-4841.20131990"
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                        "paginaFinal" => "642"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24068143"
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                    0 => array:2 [
                      "titulo" => "Cyclophosphamide pulses in the treatment of rheumatic diseases&#58; an update"
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                          "etal" => false
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                            0 => "S&#46; De Vita"
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                        "tituloSerie" => "Clin Exp Rheumatol&#46;"
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                        "volumen" => "9"
                        "paginaInicial" => "179"
                        "paginaFinal" => "193"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2060164"
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                0 => array:2 [
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                      "titulo" => "Intermittent high&#8208;dose dexamethasone&#8208;cyclophosphamide therapy for pemphigus"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
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                            2 => "U&#46;K&#46; Khan"
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                    0 => array:2 [
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                        "tituloSerie" => "Br J Dermatol&#46;"
                        "fecha" => "1988"
                        "volumen" => "119"
                        "paginaInicial" => "73"
                        "paginaFinal" => "77"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3408666"
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              "identificador" => "bib0235"
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                    0 => array:2 [
                      "titulo" => "Pulse therapy as a cure for autoimmune diseases"
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                        "paginaInicial" => "323"
                        "paginaFinal" => "328"
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              "identificador" => "bib0240"
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                0 => array:2 [
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                      "titulo" => "Dexamethasone&#8208;cyclophosphamide pulse therapy for pemphigus"
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                        "paginaFinal" => "882"
                        "link" => array:1 [
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                      "titulo" => "Pulse intravenous cyclophosphamide therapy for dermatologic disorders"
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                            2 => "S&#46; Hore"
                            3 => "S&#46; Sen"
                            4 => "S&#46; Maity"
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                      "titulo" => "Incidence and prevention of bladder toxicity from cyclophosphamide in the treatment of rheumatic diseases&#58; a data&#8208;driven review"
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                      "titulo" => "Factors affecting the duration of phase I of dexamethasone &#8208; cyclophosphamide pulse therapy"
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                          "autores" => array:4 [
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Article information
ISSN: 26662752
Original language: Portuguese
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