Pub Date : 2022-07-01DOI: 10.5152/eujrheum.2022.20236
Stefanie D Wade, Jonathan S Hausmann, Jason A Freed
Social distancing during the COVID-19 pandemic has led to unprecedented challenges in medical education, including for rheumatology training programs. Many programs have adapted by transitioning educational curricula into virtual classrooms. Herein, we review strategies to optimize learning within the virtual classroom. We introduce the flipped virtual classroom as a framework for facilitating higher-order thinking and improving long-term learning. We provide recommendations to maximize interactions between learners, elevate group discussions, and encourage problem solving. Once implemented, these techniques can lead to more productive teaching and learning experiences while maintaining a sense of community for rheumatology training programs.
{"title":"Engaging trainees within the virtual classroom: Teaching strategies for rheumatologists in a pandemic.","authors":"Stefanie D Wade, Jonathan S Hausmann, Jason A Freed","doi":"10.5152/eujrheum.2022.20236","DOIUrl":"https://doi.org/10.5152/eujrheum.2022.20236","url":null,"abstract":"<p><p>Social distancing during the COVID-19 pandemic has led to unprecedented challenges in medical education, including for rheumatology training programs. Many programs have adapted by transitioning educational curricula into virtual classrooms. Herein, we review strategies to optimize learning within the virtual classroom. We introduce the flipped virtual classroom as a framework for facilitating higher-order thinking and improving long-term learning. We provide recommendations to maximize interactions between learners, elevate group discussions, and encourage problem solving. Once implemented, these techniques can lead to more productive teaching and learning experiences while maintaining a sense of community for rheumatology training programs.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"9 3","pages":"148-152"},"PeriodicalIF":1.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39778541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.5152/eujrheum.2022.21132
Ahmet Karataş, Hakan Artaş, Kader Uğur, Süleyman Serdar Koca
Objectives: Achilles tendinopathy can be noticed in both acromegaly and ankylosing spondylitis (AS). Acromegaly patients presenting with tendinopathy findings may be confused with AS findings. In this study, sonoelastrographic findings of Achilles tendon are explored in patients with AS and acromegaly.
Methods: 25 patients with AS, 30 patients with acromegaly, and 18 healthy controls were enrolled in the study. Achilles tendon was evaluated by sonoelastography in all the study participants.
Results: The thickness of Achilles tendon in neutral positions was higher in acromegaly patients than those in AS patients. The sonoelastography measurement of Achilles tendon was increased in acromegaly patients when compared to the control group and AS patients.
Conclusion: The thickness of Achilles tendon can increase in patients with acromegaly and AS. However, the sonoelastographic features of Achilles tendon can be similar in patients with AS and acromegaly.
{"title":"Sonoelastrographic finding of Achilles tendon in patients with ankylosing spondylitis and acromegaly.","authors":"Ahmet Karataş, Hakan Artaş, Kader Uğur, Süleyman Serdar Koca","doi":"10.5152/eujrheum.2022.21132","DOIUrl":"https://doi.org/10.5152/eujrheum.2022.21132","url":null,"abstract":"<p><strong>Objectives: </strong>Achilles tendinopathy can be noticed in both acromegaly and ankylosing spondylitis (AS). Acromegaly patients presenting with tendinopathy findings may be confused with AS findings. In this study, sonoelastrographic findings of Achilles tendon are explored in patients with AS and acromegaly.</p><p><strong>Methods: </strong>25 patients with AS, 30 patients with acromegaly, and 18 healthy controls were enrolled in the study. Achilles tendon was evaluated by sonoelastography in all the study participants.</p><p><strong>Results: </strong>The thickness of Achilles tendon in neutral positions was higher in acromegaly patients than those in AS patients. The sonoelastography measurement of Achilles tendon was increased in acromegaly patients when compared to the control group and AS patients.</p><p><strong>Conclusion: </strong>The thickness of Achilles tendon can increase in patients with acromegaly and AS. However, the sonoelastographic features of Achilles tendon can be similar in patients with AS and acromegaly.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"9 3","pages":"122-125"},"PeriodicalIF":1.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39778540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.5152/eujrheum.2022.20184
Fernanda Mendonça Rodrigues, Ana Beatriz Bacchiega, Bruno Cesar Bacchiega, Manuella Lima Gomes Ochtrop, Roger Abramino Levy
Objective: Endothelial dysfunction is an initial stage of the atherogenic process, which can be evaluated by a noninvasive method (flow-mediated dilation - FMD) and has a well-established prognostic value for cardiovascular (CV) risk. Currently, there is no evidence of increased CV mortality in Behc¸et's disease (BD), although its association with endothelial dysfunction has been described. There are still doubts in the literature whether the presence of chronic vascular inflammation might trigger the development of atherosclerosis, despite BD remission, which is why this study was conducted.
Methods: We analyzed 24 subjects in this cross-sectional study (12 patients with BD in remission and 12 subjects matched by gender age). Endothelial function was analyzed via FMD.
Results: The lowest median for FMD was presented by the BD group (2.025% - interquartile range (IQR) 7.785 versus 5.46% - IQR 3.625, P ¼ .18). The median total cholesterol in the BD group was lower than the controls (168 mg dL-1 - IQR 46 and 216.5 mg dL-1 - IQR 54, respectively, P ¼ .0193). In the right carotid artery, the intima-media thickness was equal to 0.740 - IQR 0.16 for the patients and 0.740 - IQR 0.11 for the controls (P ¼ .9473); on the left, 0.725 - IQR 0.13 and 0.745 - IQR 0.120 (P ¼ .4333), respectively.
Conclusion: The lower median trend of FMD in patients with BD suggests endothelial dysfunction, despite clinical remission of the inflammatory disease, although our study is limited by the sample size and greater use of statins in BD group.
{"title":"Evaluation of endothelial function in patients with Behçet's disease in remission: A cross-sectional study.","authors":"Fernanda Mendonça Rodrigues, Ana Beatriz Bacchiega, Bruno Cesar Bacchiega, Manuella Lima Gomes Ochtrop, Roger Abramino Levy","doi":"10.5152/eujrheum.2022.20184","DOIUrl":"https://doi.org/10.5152/eujrheum.2022.20184","url":null,"abstract":"<p><strong>Objective: </strong>Endothelial dysfunction is an initial stage of the atherogenic process, which can be evaluated by a noninvasive method (flow-mediated dilation - FMD) and has a well-established prognostic value for cardiovascular (CV) risk. Currently, there is no evidence of increased CV mortality in Behc¸et's disease (BD), although its association with endothelial dysfunction has been described. There are still doubts in the literature whether the presence of chronic vascular inflammation might trigger the development of atherosclerosis, despite BD remission, which is why this study was conducted.</p><p><strong>Methods: </strong>We analyzed 24 subjects in this cross-sectional study (12 patients with BD in remission and 12 subjects matched by gender age). Endothelial function was analyzed via FMD.</p><p><strong>Results: </strong>The lowest median for FMD was presented by the BD group (2.025% - interquartile range (IQR) 7.785 versus 5.46% - IQR 3.625, P ¼ .18). The median total cholesterol in the BD group was lower than the controls (168 mg dL-1 - IQR 46 and 216.5 mg dL-1 - IQR 54, respectively, P ¼ .0193). In the right carotid artery, the intima-media thickness was equal to 0.740 - IQR 0.16 for the patients and 0.740 - IQR 0.11 for the controls (P ¼ .9473); on the left, 0.725 - IQR 0.13 and 0.745 - IQR 0.120 (P ¼ .4333), respectively.</p><p><strong>Conclusion: </strong>The lower median trend of FMD in patients with BD suggests endothelial dysfunction, despite clinical remission of the inflammatory disease, although our study is limited by the sample size and greater use of statins in BD group.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"9 3","pages":"139-143"},"PeriodicalIF":1.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39792800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.5152/eurjrheum.2022.21033
Nurbanu Hindioğlu, Mahmut Bilal Doğan, Meryem Can
Concurrent use of tumor necrosis factor inhibitor and tyrosine kinase inhibitor in ankylosing spondylitis and myeloid neoplasm.
{"title":"Tracheobronchopathia osteochondroplastica and cervical spine involvement in rheumatoid arthritis.","authors":"Nurbanu Hindioğlu, Mahmut Bilal Doğan, Meryem Can","doi":"10.5152/eurjrheum.2022.21033","DOIUrl":"https://doi.org/10.5152/eurjrheum.2022.21033","url":null,"abstract":"Concurrent use of tumor necrosis factor inhibitor and tyrosine kinase inhibitor in ankylosing spondylitis and myeloid neoplasm.","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"9 3","pages":"182-183"},"PeriodicalIF":1.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39623309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.5152/eurjrheum.2022.21135
Mariana Correia Marques, Buğra Han Egeli, Holly Wobma, Claudio Ribeiro, Edwin Anderson, Jonathan S Hausmann, Fatma Dedeoğlu
Objective: Patients with undefined systemic autoinflammatory diseases (uSAIDs) are challenging to manage, as there are no guidelines or recommendations for targeted therapy. We aimed to evaluate the efficacy of empiric treatment with colchicine in our single-center uSAID population in the United States, as well as the patient characteristics associated with the most robust colchicine response.
Methods: Children with uSAID 18 years old at initial evaluation during 2000-2019 were included if they received 3 months of colchicine therapy. Data on demographics, clinical features, laboratory/ genetic studies, and treatment responses were collected. Most statistics were based on chi-square analyses for categorical data. Complete response to colchicine was defined as resolution of episodes or the presence of minor residual symptoms that did not require any further therapy. A partial response was defined as a decrease in the frequency, severity, or length of episodes but still necessitating additional therapy. Patients were considered nonresponders if they did not experience any improvement with colchicine at target therapeutic dosing.
Results: We identified 133 children diagnosed with uSAID who met our inclusion criteria. The median time to starting empiric colchicine was 5 months from the diagnosis of autoinflammatory disease. 92.5% (n = 123) of patients had a beneficial response to colchicine, including 46.6% (n = 62) partial responders and 45.9% (n = 61) complete responders. The presence of a nonurticarial rash was associated with an incomplete colchicine response (29.2% (n = 21) vs 13.1% (n = 8), P = .025). The presence of a heterozygous MEFV mutation in patients who did not fit Familial Mediterranean Fever diagnostic criteria (n = 25) appeared to be associated with a greater likelihood of complete colchicine response, although this was not statistically significant (62.5% (n = 14) vs 42.6% (n =11), P = .08). In MEFV mutation-negative patients, a nonurticarial rash was even more strongly associated with incomplete colchicine response, with an OR of 27.53 (CI [1.59-477], P = .023). The presence of oral ulcers also corresponded to incomplete colchicine response, although this did not reach clinical significance (38.9% (n = 28) vs 24.6% (n = 15), P = .08). There was no significant association between episode duration or frequency and colchicine response.
Conclusion: Colchicine leads to clinical benefits in most children with uSAID. We, thus, recommend an early trial of colchicine in newly diagnosed patients with uSAID.
目的:不明全身性自身炎症性疾病(uSAIDs)患者的治疗具有挑战性,因为没有针对靶向治疗的指南或建议。我们的目的是评估秋水仙碱经验性治疗在美国uSAID单中心人群中的疗效,以及与秋水仙碱反应最强相关的患者特征。方法:纳入2000-2019年初始评估时患有uSAID的18岁儿童,如果他们接受了3个月的秋水仙碱治疗。收集了人口统计学、临床特征、实验室/遗传学研究和治疗反应的数据。大多数统计是基于卡方分析的分类数据。秋水仙碱完全缓解被定义为不需要任何进一步治疗的发作缓解或轻微残留症状的存在。部分缓解被定义为发作频率、严重程度或时间减少,但仍需要额外治疗。如果在目标治疗剂量下秋水仙碱没有任何改善,则认为患者无反应。结果:我们确定了133名被诊断患有uSAID的儿童,他们符合我们的纳入标准。从诊断为自身炎症性疾病到开始使用秋水仙碱的中位时间为5个月。92.5% (n = 123)的患者对秋水仙碱有有益反应,其中46.6% (n = 62)的患者部分缓解,45.9% (n = 61)的患者完全缓解。非荨麻疹的出现与秋水仙碱反应不完全相关(29.2% (n = 21) vs 13.1% (n = 8), P = 0.025)。在不符合家族性地中海热诊断标准的患者(n = 25)中存在杂合MEFV突变似乎与更大的秋水草碱完全反应的可能性相关,尽管这没有统计学意义(62.5% (n = 14) vs 42.6% (n =11), P = 0.08)。在MEFV突变阴性的患者中,非荨麻疹皮疹与秋水仙碱不完全反应的相关性更强,OR为27.53 (CI [1.59-477], P = 0.023)。口腔溃疡的存在也与秋水仙碱反应不完全相关,尽管这没有达到临床意义(38.9% (n = 28) vs 24.6% (n = 15), P = 0.08)。发作持续时间或频率与秋水仙碱反应之间无显著关联。结论:秋水仙碱对大多数患有uSAID的儿童有临床益处。因此,我们建议在新诊断的uSAID患者中进行秋水仙碱的早期试验。
{"title":"Features predicting colchicine efficacy in treatment of children with undefined systemic autoinflammatory disease: A retrospective cohort study.","authors":"Mariana Correia Marques, Buğra Han Egeli, Holly Wobma, Claudio Ribeiro, Edwin Anderson, Jonathan S Hausmann, Fatma Dedeoğlu","doi":"10.5152/eurjrheum.2022.21135","DOIUrl":"https://doi.org/10.5152/eurjrheum.2022.21135","url":null,"abstract":"<p><strong>Objective: </strong>Patients with undefined systemic autoinflammatory diseases (uSAIDs) are challenging to manage, as there are no guidelines or recommendations for targeted therapy. We aimed to evaluate the efficacy of empiric treatment with colchicine in our single-center uSAID population in the United States, as well as the patient characteristics associated with the most robust colchicine response.</p><p><strong>Methods: </strong>Children with uSAID 18 years old at initial evaluation during 2000-2019 were included if they received 3 months of colchicine therapy. Data on demographics, clinical features, laboratory/ genetic studies, and treatment responses were collected. Most statistics were based on chi-square analyses for categorical data. Complete response to colchicine was defined as resolution of episodes or the presence of minor residual symptoms that did not require any further therapy. A partial response was defined as a decrease in the frequency, severity, or length of episodes but still necessitating additional therapy. Patients were considered nonresponders if they did not experience any improvement with colchicine at target therapeutic dosing.</p><p><strong>Results: </strong>We identified 133 children diagnosed with uSAID who met our inclusion criteria. The median time to starting empiric colchicine was 5 months from the diagnosis of autoinflammatory disease. 92.5% (n = 123) of patients had a beneficial response to colchicine, including 46.6% (n = 62) partial responders and 45.9% (n = 61) complete responders. The presence of a nonurticarial rash was associated with an incomplete colchicine response (29.2% (n = 21) vs 13.1% (n = 8), P = .025). The presence of a heterozygous MEFV mutation in patients who did not fit Familial Mediterranean Fever diagnostic criteria (n = 25) appeared to be associated with a greater likelihood of complete colchicine response, although this was not statistically significant (62.5% (n = 14) vs 42.6% (n =11), P = .08). In MEFV mutation-negative patients, a nonurticarial rash was even more strongly associated with incomplete colchicine response, with an OR of 27.53 (CI [1.59-477], P = .023). The presence of oral ulcers also corresponded to incomplete colchicine response, although this did not reach clinical significance (38.9% (n = 28) vs 24.6% (n = 15), P = .08). There was no significant association between episode duration or frequency and colchicine response.</p><p><strong>Conclusion: </strong>Colchicine leads to clinical benefits in most children with uSAID. We, thus, recommend an early trial of colchicine in newly diagnosed patients with uSAID.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"9 3","pages":"116-121"},"PeriodicalIF":1.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39623313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.5152/eurjrheum.2021.21071
Graeme J Carroll
Physical activity and psychosomatic status in patients with Behçet's disease during coronavirus disease pandemic.
{"title":"Undetectable mannose binding lectin confers increased risk for serious infection in rheumatoid arthritis.","authors":"Graeme J Carroll","doi":"10.5152/eurjrheum.2021.21071","DOIUrl":"https://doi.org/10.5152/eurjrheum.2021.21071","url":null,"abstract":"Physical activity and psychosomatic status in patients with Behçet's disease during coronavirus disease pandemic.","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"9 3","pages":"184"},"PeriodicalIF":1.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39623310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.5152/eurjrheum.2021.21102
Cemal Bes, Gizem Köybaşı, Ozan Cemal İçaçan, Melek Yalçın Mutlu, Fatih Yıldırım
Interstitial lung disease (ILD) is one of the common extra-articular manifestations of rheumatoid arthritis (RA) and it is associated with high mortality rate. The usual interstitial pneumonia (UIP) pattern of RA associated ILD (RA-ILD) shows some similarities to idiopathic pulmonary fibrosis, suggesting that antifibrotic therapies may have potential positive affects. In this review, we discuss the effectiveness of antifibrotic therapy for RA-ILD.
{"title":"Antifibrotic therapies in rheumatoid arthritis associated interstitial lung disease.","authors":"Cemal Bes, Gizem Köybaşı, Ozan Cemal İçaçan, Melek Yalçın Mutlu, Fatih Yıldırım","doi":"10.5152/eurjrheum.2021.21102","DOIUrl":"https://doi.org/10.5152/eurjrheum.2021.21102","url":null,"abstract":"<p><p>Interstitial lung disease (ILD) is one of the common extra-articular manifestations of rheumatoid arthritis (RA) and it is associated with high mortality rate. The usual interstitial pneumonia (UIP) pattern of RA associated ILD (RA-ILD) shows some similarities to idiopathic pulmonary fibrosis, suggesting that antifibrotic therapies may have potential positive affects. In this review, we discuss the effectiveness of antifibrotic therapy for RA-ILD.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"9 3","pages":"176-179"},"PeriodicalIF":1.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39623312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Granulomatosis with polyangiitis (GPA), formerly known as Wegner's granulomatosis, is a rare vasculitic syndrome classified under Anti-Neutrophilic Cytoplasmic Autoantibody (ANCA)-associ- ated vasculitides, which is fatal if untreated. The mainstay of treatment consists of immunosuppression using a combination of corticosteroids with either rituximab (RTX) or cyclophosphamide (CYC). We aimed to compare the 4-year clinical outcomes between patients with GPA receiving CYC and RTX as remission induction.
Methods: In this retrospective cohort, we used patient data from 92 patients with GPA at two large teaching hospitals and a private clinic in Isfahan, Iran. The patients were classified based on the medi- cation they received for remission induction into RTX and CYC groups. The main outcomes were rate of death and relapse, disease activity assessed based on the Birmingham Vasculitis Activity Score (BVAS), disease-related complications, laboratory markers, and adverse-drug-reactions.
Results: Fifty-three (57.6%) patients received CYC, whereas 39 (42.4%) received RTX. The mean duration of follow-up was 3.6 (62) years. Most of patients (70%) had a successful remission, while 20.7% experi- enced a relapse and 8.7% of patients died. The rate of death and relapse did not differ between the RTX and CYC groups. Disease-related complications involved an insignificantly higher proportion of patients in the CYC (12/53) group than the RTX (4/39) group. Patients in both groups showed a signifi- cant decrease in BVAS during follow-ups irrespective of the medication exposure. The rate of adverse events was similarly low (n 1⁄4 1) in both groups.
Conclusion: RTX and CYC were similar in inducing remission and reducing adverse clinical outcomes among patients with GPA with acceptable side effect profiles.
{"title":"A comparison of rituximab with cyclophosphamide in terms of efficacy and complications as induction therapy for treating granulomatosis with polyangiitis: A three-center study.","authors":"Maryam Tavakoli Chaleshtori, Ziba Farajzadegan, Mansour Salesi","doi":"10.5152/eurjrheum.2022.21063","DOIUrl":"https://doi.org/10.5152/eurjrheum.2022.21063","url":null,"abstract":"<p><strong>Objective: </strong>Granulomatosis with polyangiitis (GPA), formerly known as Wegner's granulomatosis, is a rare vasculitic syndrome classified under Anti-Neutrophilic Cytoplasmic Autoantibody (ANCA)-associ- ated vasculitides, which is fatal if untreated. The mainstay of treatment consists of immunosuppression using a combination of corticosteroids with either rituximab (RTX) or cyclophosphamide (CYC). We aimed to compare the 4-year clinical outcomes between patients with GPA receiving CYC and RTX as remission induction.</p><p><strong>Methods: </strong>In this retrospective cohort, we used patient data from 92 patients with GPA at two large teaching hospitals and a private clinic in Isfahan, Iran. The patients were classified based on the medi- cation they received for remission induction into RTX and CYC groups. The main outcomes were rate of death and relapse, disease activity assessed based on the Birmingham Vasculitis Activity Score (BVAS), disease-related complications, laboratory markers, and adverse-drug-reactions.</p><p><strong>Results: </strong>Fifty-three (57.6%) patients received CYC, whereas 39 (42.4%) received RTX. The mean duration of follow-up was 3.6 (62) years. Most of patients (70%) had a successful remission, while 20.7% experi- enced a relapse and 8.7% of patients died. The rate of death and relapse did not differ between the RTX and CYC groups. Disease-related complications involved an insignificantly higher proportion of patients in the CYC (12/53) group than the RTX (4/39) group. Patients in both groups showed a signifi- cant decrease in BVAS during follow-ups irrespective of the medication exposure. The rate of adverse events was similarly low (n 1⁄4 1) in both groups.</p><p><strong>Conclusion: </strong>RTX and CYC were similar in inducing remission and reducing adverse clinical outcomes among patients with GPA with acceptable side effect profiles.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"9 2","pages":"88-92"},"PeriodicalIF":1.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b3/4b/ejr-9-2-88.PMC10176214.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9447635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.5152/eurjrheum.2022.21060
Fatoş Önen, Gerçek Can, Sedat Çapar, Ediz Dalkılıç, Yavuz Pehlivan, Soner Şenel, Servet Akar, Süleyman Serdar Koca, Abdurrahman Tufan, Ayten Yazıcı, Sema Yılmaz, Nevsun İnanç, İsmail Sarı, Merih Birlik, Dilek Solmaz, Ayşe Cefle, Mehmet Akif Öztürk, Servet Yolbaş, Niels Steen Krogh, Neslihan Yılmaz, Şükran Erten, Cemal Bes, Özgül Soysal Gündüz, Berna Göker, Seminur Haznedaroğlu, Şule Yavuz, Gözde Yildirim Çetin, Fatih Yıldız, Haner Direskeneli, Nurullah Akkoç
Objective: TURKBIO registry, established in 2011, is the first nationwide biological database in Turkey. This study aimed to provide an overview of TURKBIO data collected by June 2018.
Methods: The registry included adult patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), nonradiographic axial spondyloarthritis (nr-AxSpA), and psoriatic arthritis (PsA). Demographic and clinical features, disease activity markers, and other follow-up parameters, current and previous treat- ments, and adverse events were registered electronically at each visit using open-source software. The registration of patient-reported outcome measures was carried out electronically by the patients using touch screens.
Results: TURKBIO registry included a total of 41,145 treatment series with biologicals. There were 2,588 patients with axSpA (2,459 AS and 129 nr-axSpA), 2,036 with RA, and 428 with PsA. The total number of patients, including those with other diagnoses, was 5,718. In the follow-up period, the number of patients and also visits steadily increased by years. The yearly mean number of visits per patient was found to be 2.3. Significant improvements in disease activity and health assessment parameters were observed following the biological treatments. Biologics were often given in combination with a con- ventional synthetic disease-modifying antirheumatic drug in patients with RA. Infections were the most commonly seen adverse events, followed by allergic reactions. Tuberculosis was observed in 12 patients, malignancy in 18, and treatment-related mortality in 31.
Conclusion: TURKBIO provided a valuable real-life experience with the use of biologics in rheumatic diseases in Turkey.
{"title":"A real-life analysis of patients with rheumatologic diseases on biological treatments: Data from TURKBIO Registry.","authors":"Fatoş Önen, Gerçek Can, Sedat Çapar, Ediz Dalkılıç, Yavuz Pehlivan, Soner Şenel, Servet Akar, Süleyman Serdar Koca, Abdurrahman Tufan, Ayten Yazıcı, Sema Yılmaz, Nevsun İnanç, İsmail Sarı, Merih Birlik, Dilek Solmaz, Ayşe Cefle, Mehmet Akif Öztürk, Servet Yolbaş, Niels Steen Krogh, Neslihan Yılmaz, Şükran Erten, Cemal Bes, Özgül Soysal Gündüz, Berna Göker, Seminur Haznedaroğlu, Şule Yavuz, Gözde Yildirim Çetin, Fatih Yıldız, Haner Direskeneli, Nurullah Akkoç","doi":"10.5152/eurjrheum.2022.21060","DOIUrl":"https://doi.org/10.5152/eurjrheum.2022.21060","url":null,"abstract":"<p><strong>Objective: </strong>TURKBIO registry, established in 2011, is the first nationwide biological database in Turkey. This study aimed to provide an overview of TURKBIO data collected by June 2018.</p><p><strong>Methods: </strong>The registry included adult patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), nonradiographic axial spondyloarthritis (nr-AxSpA), and psoriatic arthritis (PsA). Demographic and clinical features, disease activity markers, and other follow-up parameters, current and previous treat- ments, and adverse events were registered electronically at each visit using open-source software. The registration of patient-reported outcome measures was carried out electronically by the patients using touch screens.</p><p><strong>Results: </strong>TURKBIO registry included a total of 41,145 treatment series with biologicals. There were 2,588 patients with axSpA (2,459 AS and 129 nr-axSpA), 2,036 with RA, and 428 with PsA. The total number of patients, including those with other diagnoses, was 5,718. In the follow-up period, the number of patients and also visits steadily increased by years. The yearly mean number of visits per patient was found to be 2.3. Significant improvements in disease activity and health assessment parameters were observed following the biological treatments. Biologics were often given in combination with a con- ventional synthetic disease-modifying antirheumatic drug in patients with RA. Infections were the most commonly seen adverse events, followed by allergic reactions. Tuberculosis was observed in 12 patients, malignancy in 18, and treatment-related mortality in 31.</p><p><strong>Conclusion: </strong>TURKBIO provided a valuable real-life experience with the use of biologics in rheumatic diseases in Turkey.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"9 2","pages":"82-87"},"PeriodicalIF":1.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/02/ejr-9-2-82.PMC10176217.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9447689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}