Pub Date : 2023-11-01DOI: 10.1142/s266134172374019x
Ping-Hung Kuo
Eosinophilic Granulomatosis with Polyangiitis (EGPA), formerly known as Churg-Strauss syndrome, is a rare systemic vasculitis characterized by asthma, eosinophilia, and vasculitic organ involvement. This rare disease poses diagnostic challenges within the domain of severe asthma. Recognizing EGPA within the asthmatic cohort is therefore crucial for appropriate management and improved patient outcomes. Moreover, effective collaboration between rheumatologists and respiratory physicians is vital for the comprehensive care of EGPA patients. This scientific lecture aims to discuss the identification of EGPA in individuals with asthma and highlight the importance of co-care between rheumatology and respiratory medicine. This lecture will begin by providing an overview of EGPA, its clinical manifestations, and the challenges associated with differentiating it from severe asthma. The crucial identification of distinctive clinical features, such as refractory asthma, peripheral eosinophilia, and systemic symptoms, which serve as beacons for the presence of EGPA, will be discussed. Diagnostic tools encompassing imaging, laboratory tests, and biopsy techniques are explored, focusing on their utility in distinguishing EGPA from asthma. Concomitantly, the lecture will then shift its focus to the collaborative efforts required from rheumatologists and respiratory physicians in managing EGPA patients. The complementary roles of both specialties in achieving optimal patient outcomes will be discussed. Rheumatologists play a crucial role in the diagnosis and treatment of systemic vasculitis, including EGPA, while respiratory physicians provide expertise in managing asthma and respiratory complications. The case will highlight the importance of open communication, shared decision-making, and coordinated treatment plans to ensure comprehensive care for EGPA patients, addressing both their rheumatologic and respiratory needs. Real-life case will be shared to illustrate successful co-management models between rheumatology and respiratory medicine. These examples will underscore the benefits of a multidisciplinary approach, including improved disease management, reduced treatment-related complications, and enhanced patient satisfaction. In conclusion, identifying EGPA within the asthma population is crucial for appropriate management, and effective collaboration between rheumatology and respiratory physicians is essential for comprehensive care. This scientific lecture aims to provide insights into spotting EGPA among asthma patients and emphasize the significance of co-care between these specialties, ultimately improving patient outcomes and quality of life.
{"title":"Symposium 10: Spotting EGPA from Asthma Populations and How Co-Care Works Between Rheumatology and Respiratory Physicians: A Case Sharing","authors":"Ping-Hung Kuo","doi":"10.1142/s266134172374019x","DOIUrl":"https://doi.org/10.1142/s266134172374019x","url":null,"abstract":"Eosinophilic Granulomatosis with Polyangiitis (EGPA), formerly known as Churg-Strauss syndrome, is a rare systemic vasculitis characterized by asthma, eosinophilia, and vasculitic organ involvement. This rare disease poses diagnostic challenges within the domain of severe asthma. Recognizing EGPA within the asthmatic cohort is therefore crucial for appropriate management and improved patient outcomes. Moreover, effective collaboration between rheumatologists and respiratory physicians is vital for the comprehensive care of EGPA patients. This scientific lecture aims to discuss the identification of EGPA in individuals with asthma and highlight the importance of co-care between rheumatology and respiratory medicine. This lecture will begin by providing an overview of EGPA, its clinical manifestations, and the challenges associated with differentiating it from severe asthma. The crucial identification of distinctive clinical features, such as refractory asthma, peripheral eosinophilia, and systemic symptoms, which serve as beacons for the presence of EGPA, will be discussed. Diagnostic tools encompassing imaging, laboratory tests, and biopsy techniques are explored, focusing on their utility in distinguishing EGPA from asthma. Concomitantly, the lecture will then shift its focus to the collaborative efforts required from rheumatologists and respiratory physicians in managing EGPA patients. The complementary roles of both specialties in achieving optimal patient outcomes will be discussed. Rheumatologists play a crucial role in the diagnosis and treatment of systemic vasculitis, including EGPA, while respiratory physicians provide expertise in managing asthma and respiratory complications. The case will highlight the importance of open communication, shared decision-making, and coordinated treatment plans to ensure comprehensive care for EGPA patients, addressing both their rheumatologic and respiratory needs. Real-life case will be shared to illustrate successful co-management models between rheumatology and respiratory medicine. These examples will underscore the benefits of a multidisciplinary approach, including improved disease management, reduced treatment-related complications, and enhanced patient satisfaction. In conclusion, identifying EGPA within the asthma population is crucial for appropriate management, and effective collaboration between rheumatology and respiratory physicians is essential for comprehensive care. This scientific lecture aims to provide insights into spotting EGPA among asthma patients and emphasize the significance of co-care between these specialties, ultimately improving patient outcomes and quality of life.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139299066","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 : 2023-11-01DOI: 10.1142/s2661341723740255
S. Tomo, Maya Gopalakrishnan, Mithu Banerjee
Background Sphingolipids are major components of the plasma membrane which are acted upon by various enzymes to generate signaling molecules. The metabolites of the sphingolipid pathway have been identified to play a major regulatory role in various cellular processes. Sphingosine-1-phosphate (S1P) is one of the major intermediary molecules of the sphingolipid pathway. Sphingosine-1-phosphate, formed in the cell can be dephosphorylated by S1P-phosphatase (SGPP1 and SGPP2), which is a reversible process. Dysregulation of the sphingolipid pathway has been associated with multiple connective tissue disorders. The current study aimed to assess and compare differential gene expressions of SGPP1 and SGPP2 in patients with SLE when compared with other connective tissue diseases. Methods The current bioinformatics analytic study was conducted using publicly available datasets. Existing datasets from the ADEx: Autoimmune Diseases Explorer Database pertaining to connective tissue disorders were used to explore differentially expressed genes involved in sphingolipid pathways in patients with SLE when compared with other CTD. The differential expression of SGPP1 and SGPP2 genes of the sphingolipid pathway will be identified from datasets. Results The differential expression of SGPP1 and SGPP2 has been identified from the ADEx database. A total of 51 datasets, comprising 17 datasets of RA, 9 datasets of Sjogren Syndrome, 20 datasets of SLE, and 5 datasets of Systemic Sclerosis were used for analysis. An FDR filter of 0.01 was used during the analysis. On analysis, we observed an increased expression of SGPP1 in 2 RA datasets, 1 Sjogren Syndrome, and an increased expression of SGPP2 in 1 Systemic sclerosis dataset. However, in SLE datasets, the SGPP1 and SGPP2 were observed to have decreased expression. Conclusion Our study demonstrates a unique trend of SGPP1 and SGPP1 downregulated in SLE patients when compared with other CTD. This provides additional insight into the widely explored Sphingosine-1-phosphate-related dysregulation in SLE and will enable in devising of novel targeted therapy.
{"title":"Abstract 9 — Sphingosine-1-Phosphate Phosphatase Expression in SLE when Compared with Other Connective Tissue Disorders: A Bioinformatic Analysis","authors":"S. Tomo, Maya Gopalakrishnan, Mithu Banerjee","doi":"10.1142/s2661341723740255","DOIUrl":"https://doi.org/10.1142/s2661341723740255","url":null,"abstract":"Background Sphingolipids are major components of the plasma membrane which are acted upon by various enzymes to generate signaling molecules. The metabolites of the sphingolipid pathway have been identified to play a major regulatory role in various cellular processes. Sphingosine-1-phosphate (S1P) is one of the major intermediary molecules of the sphingolipid pathway. Sphingosine-1-phosphate, formed in the cell can be dephosphorylated by S1P-phosphatase (SGPP1 and SGPP2), which is a reversible process. Dysregulation of the sphingolipid pathway has been associated with multiple connective tissue disorders. The current study aimed to assess and compare differential gene expressions of SGPP1 and SGPP2 in patients with SLE when compared with other connective tissue diseases. Methods The current bioinformatics analytic study was conducted using publicly available datasets. Existing datasets from the ADEx: Autoimmune Diseases Explorer Database pertaining to connective tissue disorders were used to explore differentially expressed genes involved in sphingolipid pathways in patients with SLE when compared with other CTD. The differential expression of SGPP1 and SGPP2 genes of the sphingolipid pathway will be identified from datasets. Results The differential expression of SGPP1 and SGPP2 has been identified from the ADEx database. A total of 51 datasets, comprising 17 datasets of RA, 9 datasets of Sjogren Syndrome, 20 datasets of SLE, and 5 datasets of Systemic Sclerosis were used for analysis. An FDR filter of 0.01 was used during the analysis. On analysis, we observed an increased expression of SGPP1 in 2 RA datasets, 1 Sjogren Syndrome, and an increased expression of SGPP2 in 1 Systemic sclerosis dataset. However, in SLE datasets, the SGPP1 and SGPP2 were observed to have decreased expression. Conclusion Our study demonstrates a unique trend of SGPP1 and SGPP1 downregulated in SLE patients when compared with other CTD. This provides additional insight into the widely explored Sphingosine-1-phosphate-related dysregulation in SLE and will enable in devising of novel targeted therapy.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139294053","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 : 2023-11-01DOI: 10.1142/s2661341723740334
Mohd Haidir Mohd Yusof, Marcel Jinih, Nur Aishah Che Roos, Ahmad Asmadi Yusof
Background There is an ongoing controversy surrounding whether tofacitinib increases the risk of infections in patients with rheumatoid arthritis (RA). To address this issue, we conducted a meta-analysis using data from randomized clinical trials (RCTs) to assess the overall risk of infection in these patients. Methods We conducted a comprehensive systematic search in EMBASE, MEDLINE, and CENTRAL from their inception until December 2022 to identify relevant RCTs reporting the occurrence of infections in patients with RA who were treated with the standard clinical therapeutic dosage of tofacitinib (5mg twice daily orally). The primary outcomes of the included studies in this review focused on the incidence of total infections, serious infections, non-serious infections, and opportunistic infections (including herpes zoster and tuberculosis). Additionally, we examined secondary outcomes related to the incidence of various sites of infections, including the upper respiratory tract, lower respiratory tract, gastrointestinal tract, hepatobiliary system, urinary tract, skin and soft tissue, blood, dental and oral soft tissue, genital, reproductive tract, bone and joint, and central nervous system infections. Due to the expected anticipation of clinical and methodological heterogeneity across studies, the effect estimate was pooled with a random-effects model, to obtain the RRs and 95% CIs, using Mantel-Haenszel statistical method. Results Twelve eligible RCTs, involving a total of 6,056 patients, were included in the analysis. In comparison to the control group (placebo and other active treatments), tofacitinib exhibited a significant increase in the risk of total infections (RR, 1.21; 95% CI, 1.07-1.37; I2, 28%), serious infections (RR, 1.23; 95% CI, 1.02-1.48; I2, 0%), non-serious infections (RR, 1.20; 95% CI, 1.05-1.36; I2, 29%), and opportunistic infections (RR, 1.66; 95% CI, 1.40-1.97; I2, 0%). Secondary outcomes analyses revealed a significant increase in the risk of lower respiratory infections with tofacitinib (RR, 1.27; 95% CI, 1.10–1.47; I2, 0%). Conclusion Compared with placebo and other active treatments, tofacitinib significantly increased the overall risk of infections (total infections, serious infections, non-serious infections, and opportunistic infections). These findings can help clinicians assess the risk of infections in RA patients treated with tofacitinib.
背景 关于托法替尼是否会增加类风湿性关节炎（RA）患者的感染风险一直存在争议。为了解决这一问题，我们利用随机临床试验（RCT）的数据进行了一项荟萃分析，以评估这些患者的总体感染风险。方法 我们在 EMBASE、MEDLINE 和 CENTRAL 中进行了一次全面的系统性检索，检索时间为 EMBASE、MEDLINE 和 CENTRAL 的起始时间至 2022 年 12 月，目的是找出报告接受托法替尼标准临床治疗剂量（5 毫克，每日口服两次）治疗的 RA 患者感染发生情况的相关 RCT。本综述所纳入研究的主要结果集中于总感染、严重感染、非严重感染和机会性感染（包括带状疱疹和结核病）的发生率。此外，我们还研究了与不同部位感染发生率相关的次要结果，包括上呼吸道、下呼吸道、胃肠道、肝胆系统、泌尿道、皮肤和软组织、血液、牙科和口腔软组织、生殖器、生殖道、骨关节和中枢神经系统感染。由于预计各研究在临床和方法上存在异质性，因此采用随机效应模型对效应估计值进行了汇总，并利用曼特尔-汉斯泽尔统计方法得出了RRs和95% CIs。结果 12 项符合条件的研究被纳入分析，共涉及 6,056 名患者。与对照组（安慰剂和其他活性疗法）相比，托法替尼显著增加了总感染风险（RR，1.21；95% CI，1.07-1.37；I2，28%）。37；I2，28%）、严重感染（RR，1.23；95% CI，1.02-1.48；I2，0%）、非严重感染（RR，1.20；95% CI，1.05-1.36；I2，29%）和机会性感染（RR，1.66；95% CI，1.40-1.97；I2，0%）的风险显著增加。次要结果分析显示，使用托法替尼会显著增加下呼吸道感染的风险（RR，1.27；95% CI，1.10-1.47；I2，0%）。结论 与安慰剂和其他活性疗法相比，托法替尼会显著增加感染（总感染、严重感染、非严重感染和机会性感染）的总体风险。这些发现有助于临床医生评估接受托法替尼治疗的RA患者的感染风险。
{"title":"Abstract 17 — Overall Infection Risks of Tofacitinib in Patient with Rheumatoid Arthritis: A Meta-Analysis of Randomized Clinical Trials","authors":"Mohd Haidir Mohd Yusof, Marcel Jinih, Nur Aishah Che Roos, Ahmad Asmadi Yusof","doi":"10.1142/s2661341723740334","DOIUrl":"https://doi.org/10.1142/s2661341723740334","url":null,"abstract":"Background There is an ongoing controversy surrounding whether tofacitinib increases the risk of infections in patients with rheumatoid arthritis (RA). To address this issue, we conducted a meta-analysis using data from randomized clinical trials (RCTs) to assess the overall risk of infection in these patients. Methods We conducted a comprehensive systematic search in EMBASE, MEDLINE, and CENTRAL from their inception until December 2022 to identify relevant RCTs reporting the occurrence of infections in patients with RA who were treated with the standard clinical therapeutic dosage of tofacitinib (5mg twice daily orally). The primary outcomes of the included studies in this review focused on the incidence of total infections, serious infections, non-serious infections, and opportunistic infections (including herpes zoster and tuberculosis). Additionally, we examined secondary outcomes related to the incidence of various sites of infections, including the upper respiratory tract, lower respiratory tract, gastrointestinal tract, hepatobiliary system, urinary tract, skin and soft tissue, blood, dental and oral soft tissue, genital, reproductive tract, bone and joint, and central nervous system infections. Due to the expected anticipation of clinical and methodological heterogeneity across studies, the effect estimate was pooled with a random-effects model, to obtain the RRs and 95% CIs, using Mantel-Haenszel statistical method. Results Twelve eligible RCTs, involving a total of 6,056 patients, were included in the analysis. In comparison to the control group (placebo and other active treatments), tofacitinib exhibited a significant increase in the risk of total infections (RR, 1.21; 95% CI, 1.07-1.37; I2, 28%), serious infections (RR, 1.23; 95% CI, 1.02-1.48; I2, 0%), non-serious infections (RR, 1.20; 95% CI, 1.05-1.36; I2, 29%), and opportunistic infections (RR, 1.66; 95% CI, 1.40-1.97; I2, 0%). Secondary outcomes analyses revealed a significant increase in the risk of lower respiratory infections with tofacitinib (RR, 1.27; 95% CI, 1.10–1.47; I2, 0%). Conclusion Compared with placebo and other active treatments, tofacitinib significantly increased the overall risk of infections (total infections, serious infections, non-serious infections, and opportunistic infections). These findings can help clinicians assess the risk of infections in RA patients treated with tofacitinib.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":"186 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139294328","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 : 2023-11-01DOI: 10.1142/s2661341723740243
Ho Yin Chung, S. C. Chan, Christina Sze Man Wong
Objectives To assess the associations of hepatic injury and fibrosis in patients with psoriasis (PsO) and rheumatoid arthritis (RA). Methods A total of 318 patients attending dermatology and/or rheumatology out-patient clinics in Queen Mary Hospital, with clinical diagnosis of PsO, psoriatic arthritis (PsA) or RA were consecutively recruited from July 2020 to August 2022. Demographic data, comorbidities, and medications were recorded. Body mass index (BMI) was measured. Serum biomarkers for hepatic injury including autotaxin, matrix metalloproteinase (MMP) 3, MMP 8, and MMP 9 were determined. Transient elastography (TE) was performed to determine liver stiffness measure (LSM) and controlled attenuation parameter (CAP). Regression models were built to determine the association between methotrexate and leflunomide cumulative dosage, serum biomarkers and TE scores. Results A total of 67 (20.4%) patients had LSM>7.1 kPa. Multivariate linear regression showed methotrexate cumulative dosage was associated with autotaxin level (B=4.77, 95% CI 1.39; 8.15, p=0.001). There was no association between methotrexate cumulative dosage and MMP 3, MMP 8, MMP 9, LSM, CAP. There was also no association between leflunomide cumulative dosage and autotaxin, MMP 3, MMP 8, MMP 9, LSM, CAP. BMI (B=6.18, 95% CI 4.95; 7.41, p<0.001), hypertension (B=18.98, 95% CI 4.15; 31.82, p=0.01), hyperlipidaemia (B=20.21, 95% CI 3.50; 36.92, p=0.02) were associated with CAP. Conclusion Methotrexate and leflunomide have minimal hepatic risk in patient with PsO and RA. Metabolic risk factors had strong associations with hepatic injury.
目的 评估银屑病（PsO）和类风湿性关节炎（RA）患者肝损伤和肝纤维化的相关性。方法 在 2020 年 7 月至 2022 年 8 月期间，连续招募了 318 名在玛丽医院皮肤科和/或风湿病门诊就诊、临床诊断为银屑病、银屑病关节炎（PsA）或类风湿性关节炎（RA）的患者。研究人员记录了人口统计学数据、合并症和用药情况。测量了体重指数（BMI）。测定了肝损伤的血清生物标志物，包括自体免疫球蛋白、基质金属蛋白酶（MMP）3、MMP 8 和 MMP 9。通过瞬态弹性成像（TE）测定肝脏硬度（LSM）和受控衰减参数（CAP）。建立回归模型以确定甲氨蝶呤和来氟米特累积剂量、血清生物标记物和 TE 评分之间的关联。结果 共有 67 例（20.4%）患者的 LSM>7.1 kPa。多变量线性回归显示，甲氨蝶呤累积用量与自体表皮生长因子水平相关（B=4.77，95% CI 1.39; 8.15，P=0.001）。甲氨蝶呤累积剂量与 MMP 3、MMP 8、MMP 9、LSM 和 CAP 之间没有关联。来氟米特（leflunomide）的累积剂量与自旋霉素、MMP 3、MMP 8、MMP 9、LSM、CAP之间也没有关联。BMI（B=6.18，95% CI 4.95；7.41，p<0.001）、高血压（B=18.98，95% CI 4.15；31.82，p=0.01）、高脂血症（B=20.21，95% CI 3.50；36.92，p=0.02）与 CAP 相关。结论 甲氨蝶呤和来氟米特对PsO和RA患者的肝脏风险极小。代谢风险因素与肝损伤密切相关。
{"title":"Abstract 8 — Risk of Liver Injury in Psoriasis and Rheumatoid Arthritis is Associated with Metabolic Risk Factors Rather than Methotrexate and Leflunomide","authors":"Ho Yin Chung, S. C. Chan, Christina Sze Man Wong","doi":"10.1142/s2661341723740243","DOIUrl":"https://doi.org/10.1142/s2661341723740243","url":null,"abstract":"Objectives To assess the associations of hepatic injury and fibrosis in patients with psoriasis (PsO) and rheumatoid arthritis (RA). Methods A total of 318 patients attending dermatology and/or rheumatology out-patient clinics in Queen Mary Hospital, with clinical diagnosis of PsO, psoriatic arthritis (PsA) or RA were consecutively recruited from July 2020 to August 2022. Demographic data, comorbidities, and medications were recorded. Body mass index (BMI) was measured. Serum biomarkers for hepatic injury including autotaxin, matrix metalloproteinase (MMP) 3, MMP 8, and MMP 9 were determined. Transient elastography (TE) was performed to determine liver stiffness measure (LSM) and controlled attenuation parameter (CAP). Regression models were built to determine the association between methotrexate and leflunomide cumulative dosage, serum biomarkers and TE scores. Results A total of 67 (20.4%) patients had LSM>7.1 kPa. Multivariate linear regression showed methotrexate cumulative dosage was associated with autotaxin level (B=4.77, 95% CI 1.39; 8.15, p=0.001). There was no association between methotrexate cumulative dosage and MMP 3, MMP 8, MMP 9, LSM, CAP. There was also no association between leflunomide cumulative dosage and autotaxin, MMP 3, MMP 8, MMP 9, LSM, CAP. BMI (B=6.18, 95% CI 4.95; 7.41, p<0.001), hypertension (B=18.98, 95% CI 4.15; 31.82, p=0.01), hyperlipidaemia (B=20.21, 95% CI 3.50; 36.92, p=0.02) were associated with CAP. Conclusion Methotrexate and leflunomide have minimal hepatic risk in patient with PsO and RA. Metabolic risk factors had strong associations with hepatic injury.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":"113 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139306053","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 : 2023-11-01DOI: 10.1142/s266134172374005x
Ho Yin Chung
Magnetic resonance imaging (MRI) of the spine is a frequent investigation for low back pain (LBP). Applications in axial spondyloarthritis (SpA) include diagnosis and assessment of disease activity. Sacroiliitis on MRI is a known diagnostic criterion. Other MRI lesions such as corner inflammatory lesions (CIL) and fatty corner lesions (FCL) may have potential roles in aiding diagnosis 1 , 2 and in predicting the formation of syndesmophytes. Facet joint and costovertebral lesions are associated with limited spinal mobility and functional impairment 3 . Other lesions described include discovertebral lesions (DVL), Modic type I and II lesions. Identification of individual lesions helps rheumatologists to understand disease progression and guide treatment.
脊柱磁共振成像（MRI）是腰背痛（LBP）的常见检查方法。轴性脊柱关节炎（SpA）的应用包括诊断和评估疾病的活动性。MRI 上的骶髂关节炎是一个已知的诊断标准。其他核磁共振成像病变，如角炎性病变（CIL）和脂肪角病变（FCL）可能在辅助诊断1、2 和预测联合骨赘的形成方面发挥潜在作用。面关节和肋骨病变与脊柱活动受限和功能障碍有关 3 。其他病变包括发现性椎体病变（DVL）、莫迪克 I 型和 II 型病变。对单个病变的鉴定有助于风湿病学家了解疾病的进展并指导治疗。
{"title":"MRI Workshop for Axial Spondyloarthritis 2023 Interpretation of MRI Spine","authors":"Ho Yin Chung","doi":"10.1142/s266134172374005x","DOIUrl":"https://doi.org/10.1142/s266134172374005x","url":null,"abstract":"Magnetic resonance imaging (MRI) of the spine is a frequent investigation for low back pain (LBP). Applications in axial spondyloarthritis (SpA) include diagnosis and assessment of disease activity. Sacroiliitis on MRI is a known diagnostic criterion. Other MRI lesions such as corner inflammatory lesions (CIL) and fatty corner lesions (FCL) may have potential roles in aiding diagnosis 1 , 2 and in predicting the formation of syndesmophytes. Facet joint and costovertebral lesions are associated with limited spinal mobility and functional impairment 3 . Other lesions described include discovertebral lesions (DVL), Modic type I and II lesions. Identification of individual lesions helps rheumatologists to understand disease progression and guide treatment.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139293106","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 : 2023-11-01DOI: 10.1142/s2661341723740036
Yingqian Mo
Sjögren’s syndrome is a chronic autoimmune disease that is estimated to affect 35 million people worldwide. Hallmarks of the disease are a loss of salivary and lacrimal gland function as well as lymphocytic infiltration, elevated proinflammatory cytokines, and circulating autoantibodies. The effective treatments are limited. However, new therapies targeting specific immune pathways associated with Sjögren’s syndrome are being developed. Gene transfer to the salivary glands has been considered a promising approach to treating the dysfunction. The application of this treatment on salivary gland injuries has been studied for decades, yet its clinical progress is delayed. This chapter provides a coup d’oeil into gene transfer methods and various gene/vector types for salivary glands. AAV2-LAMP3-treated mice developed an SS-like phenotype with progressive salivary hypofunction and autoantibody production. To confirm the role of TLR4 in the induction of BMP6 following stimulation, AAV2-LAMP3–treated mice with established salivary hypofunction were treated i.p. with the TLR4 antagonist TAK242 for 10 days, and the effect of the drug on salivary gland protein expression and function was tested. We observed that treatment with TAK242 significantly decreased BMP6 expression and increased AQP5 expression in the salivary gland tissues. In agreement with this observation, the saliva flow rate of AAV2-LAMP3–treated mice also increased compared with that in vehicle control–treated mice. Gene therapy using recombinant viruses as gene transfer vectors to deliver a water channel (aquaporin 1, AQP1) to restore membrane water permeability in the salivary gland was shown to be safe and resulted in some patients with radiation-induced xerostomia having a sustained increase in saliva flow. A clinical trial using AAV2 to transfer AQP1 to the salivary glands of radiation-induced xerostomia patients is ongoing (NCT02446249) and results from this study may support application of this treatment in Sjögren’s syndrome. Gene therapy could also be used to deliver immunomodulators locally to the salivary gland resulting in a higher local concentration within the gland that could deliver therapeutics levels of recombinant protein, while minimizing the side effects associated with the drugs. Another study investigated whether a neurturin-expressing adenovirus could be used for gene therapy in vivo to protect parasympathetic neurons and prevent gland hypofunction after irradiation. The results suggest that in vivo neurturin gene therapy prior to irradiation protects parasympathetic function and prevents irradiation-induced hypofunction.
{"title":"Hong Kong Guangdong Rheumatology Meeting","authors":"Yingqian Mo","doi":"10.1142/s2661341723740036","DOIUrl":"https://doi.org/10.1142/s2661341723740036","url":null,"abstract":"Sjögren’s syndrome is a chronic autoimmune disease that is estimated to affect 35 million people worldwide. Hallmarks of the disease are a loss of salivary and lacrimal gland function as well as lymphocytic infiltration, elevated proinflammatory cytokines, and circulating autoantibodies. The effective treatments are limited. However, new therapies targeting specific immune pathways associated with Sjögren’s syndrome are being developed. Gene transfer to the salivary glands has been considered a promising approach to treating the dysfunction. The application of this treatment on salivary gland injuries has been studied for decades, yet its clinical progress is delayed. This chapter provides a coup d’oeil into gene transfer methods and various gene/vector types for salivary glands. AAV2-LAMP3-treated mice developed an SS-like phenotype with progressive salivary hypofunction and autoantibody production. To confirm the role of TLR4 in the induction of BMP6 following stimulation, AAV2-LAMP3–treated mice with established salivary hypofunction were treated i.p. with the TLR4 antagonist TAK242 for 10 days, and the effect of the drug on salivary gland protein expression and function was tested. We observed that treatment with TAK242 significantly decreased BMP6 expression and increased AQP5 expression in the salivary gland tissues. In agreement with this observation, the saliva flow rate of AAV2-LAMP3–treated mice also increased compared with that in vehicle control–treated mice. Gene therapy using recombinant viruses as gene transfer vectors to deliver a water channel (aquaporin 1, AQP1) to restore membrane water permeability in the salivary gland was shown to be safe and resulted in some patients with radiation-induced xerostomia having a sustained increase in saliva flow. A clinical trial using AAV2 to transfer AQP1 to the salivary glands of radiation-induced xerostomia patients is ongoing (NCT02446249) and results from this study may support application of this treatment in Sjögren’s syndrome. Gene therapy could also be used to deliver immunomodulators locally to the salivary gland resulting in a higher local concentration within the gland that could deliver therapeutics levels of recombinant protein, while minimizing the side effects associated with the drugs. Another study investigated whether a neurturin-expressing adenovirus could be used for gene therapy in vivo to protect parasympathetic neurons and prevent gland hypofunction after irradiation. The results suggest that in vivo neurturin gene therapy prior to irradiation protects parasympathetic function and prevents irradiation-induced hypofunction.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139294893","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 : 2023-11-01DOI: 10.1142/s2661341723740206
Janet Wong
Autoimmune diseases are conditions of immune dysfunction, leading to inappropriate hyperactivation of the adaptive immunity and subsequent damage to various tissues of the host. Autoimmune conditions presenting in the rheumatology clinics (rheumatoid arthritis, systemic lupus erythematosus or immune mediated myositis) are often treated by immunosuppression, which are almost invariably associated with increased susceptibility to infections. However, immunosuppression can sometimes be used to conversely treat susceptibility to infections. An emerging group of autoimmune diseases which target the host’s own immune system (or associated cytokines) are becoming increasing recognized which phenotypically mimics various immunodeficiency syndromes – known as “phenocopies of PID”. One particular phenocopy of a PID known as Mendelian Susceptibility to Mycobacterial Disease (MSMD) has been increasingly recognized in our locality. This “acquired MSMD” is due to autoantibodies against anti-IFN[Formula: see text], leading to increased susceptibility to mycobacterial and other “IFN-[Formula: see text] dependent” infections. Alike other autoimmune diseases, appropriate and targeted immunosuppression can alleviate the effect of anti-IFN-[Formula: see text] antibodies and aid treatment of associated infections. During this talk, our experience in the diagnosis and management toward acquired MSMD in our locality will be discussed. We will also share findings from our novel diagnostic and functional tests, as well as outcomes of acquired MSMD patients treated with B-cell depleting therapies.
{"title":"Symposium 11","authors":"Janet Wong","doi":"10.1142/s2661341723740206","DOIUrl":"https://doi.org/10.1142/s2661341723740206","url":null,"abstract":"Autoimmune diseases are conditions of immune dysfunction, leading to inappropriate hyperactivation of the adaptive immunity and subsequent damage to various tissues of the host. Autoimmune conditions presenting in the rheumatology clinics (rheumatoid arthritis, systemic lupus erythematosus or immune mediated myositis) are often treated by immunosuppression, which are almost invariably associated with increased susceptibility to infections. However, immunosuppression can sometimes be used to conversely treat susceptibility to infections. An emerging group of autoimmune diseases which target the host’s own immune system (or associated cytokines) are becoming increasing recognized which phenotypically mimics various immunodeficiency syndromes – known as “phenocopies of PID”. One particular phenocopy of a PID known as Mendelian Susceptibility to Mycobacterial Disease (MSMD) has been increasingly recognized in our locality. This “acquired MSMD” is due to autoantibodies against anti-IFN[Formula: see text], leading to increased susceptibility to mycobacterial and other “IFN-[Formula: see text] dependent” infections. Alike other autoimmune diseases, appropriate and targeted immunosuppression can alleviate the effect of anti-IFN-[Formula: see text] antibodies and aid treatment of associated infections. During this talk, our experience in the diagnosis and management toward acquired MSMD in our locality will be discussed. We will also share findings from our novel diagnostic and functional tests, as well as outcomes of acquired MSMD patients treated with B-cell depleting therapies.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139304171","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 : 2023-11-01DOI: 10.1142/s2661341723740024
Mukeng Hong
Rheumatoid arthritis (RA) is an autoimmune disorder that has been associated with the gut microbiota. However, whether and how the gut microbiota plays a pathogenic role in RA remains unexplored. Here, we observed that Fusobacterium nucleatum is enriched in RA patients and positively associated with RA severity. F. nucleatum similarly aggravates arthritis in a mouse model of collagen-induced arthritis (CIA). F. nucleatum outer membrane vesicles (OMVs) containing the virulence determinant FadA translocate into the joints, triggering local inflammatory responses. Specifically, FadA acts on synovial macrophages, resulting in the activation of the Rab5a GTPase involved in vesicle trafficking and inflammatory pathways and YB-1, a key regulator of inflammatory mediators. OMVs containing FadA and heightened Rab5a-YB-1 expression were observed in RA patients compared with controls. These findings suggest causal role of F. nucleatum in aggravating RA and provide promising therapeutic targets for clinically ameliorating RA.
类风湿性关节炎（RA）是一种自身免疫性疾病，与肠道微生物群有关。然而，肠道微生物群是否以及如何在类风湿关节炎中发挥致病作用仍有待探索。在这里，我们观察到核酸镰刀菌富集于 RA 患者体内，并与 RA 的严重程度呈正相关。在胶原诱导的关节炎（CIA）小鼠模型中，核叉杆菌同样会加重关节炎。含有毒力决定因子 FadA 的 F. nucleatum 外膜囊泡 (OMV) 转移到关节中，引发局部炎症反应。具体来说，FadA 作用于滑膜巨噬细胞，导致参与囊泡贩运和炎症途径的 Rab5a GTPase 和炎症介质的关键调节因子 YB-1 被激活。与对照组相比，在 RA 患者中观察到了含有 FadA 的 OMV 和 Rab5a-YB-1 的高表达。这些研究结果表明，F. nucleatum 在加重 RA 病情中起着因果作用，并为临床上改善 RA 病情提供了有希望的治疗靶点。
{"title":"Hong Kong Guangdong Rheumatology Meeting","authors":"Mukeng Hong","doi":"10.1142/s2661341723740024","DOIUrl":"https://doi.org/10.1142/s2661341723740024","url":null,"abstract":"Rheumatoid arthritis (RA) is an autoimmune disorder that has been associated with the gut microbiota. However, whether and how the gut microbiota plays a pathogenic role in RA remains unexplored. Here, we observed that Fusobacterium nucleatum is enriched in RA patients and positively associated with RA severity. F. nucleatum similarly aggravates arthritis in a mouse model of collagen-induced arthritis (CIA). F. nucleatum outer membrane vesicles (OMVs) containing the virulence determinant FadA translocate into the joints, triggering local inflammatory responses. Specifically, FadA acts on synovial macrophages, resulting in the activation of the Rab5a GTPase involved in vesicle trafficking and inflammatory pathways and YB-1, a key regulator of inflammatory mediators. OMVs containing FadA and heightened Rab5a-YB-1 expression were observed in RA patients compared with controls. These findings suggest causal role of F. nucleatum in aggravating RA and provide promising therapeutic targets for clinically ameliorating RA.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139293391","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 : 2023-11-01DOI: 10.1142/s2661341723740309
Y. Kwan, Ting Hui Woon, C. Wang, Warren Fong
Background Prior studies reported conflicting results regarding differences in Assessment of SpondyloArthritis (ASAS) Health Index (HI) scores between radiographic axial spondyloarthritis (r-axSpA) and non-radiographic axial spondyloarthritis (nr-axSpA). Country-level variations in disease activity were also observed. Hence, this study aimed to compare the ASAS HI scores between r-axSpA and nr-axSpA in Singapore, and determine factors associated with poorer ASAS HI scores. Methods This was a cross-sectional evaluation of baseline data from a prospective cohort study in Singapore General Hospital, from January 2018 to March 2023. Patients aged 21 years and above who were clinically diagnosed with axial spondyloarthritis (axSpA) based on the 2009 ASAS criteria were included. Sociodemographic variables, clinical variables and patient-reported outcomes were collected. Univariable and multivariable linear regression were performed to identify variables associated with ASAS HI scores. Variables with p-value of <0.10 were included in the multivariable regression. A p-value of <0.05 was considered significant. Results Of the 331 patients, 265 (80.0%) and 66 (20.0%) had r-axSpA and nr-axSpA respectively. The median (IQR) age in r-axSpA was [40.0 (30.0-53.0) years], higher than nr-axSpA [34.0 (25.0-47.0) years], p<0.01. There was a higher proportion of males in r-axSpA (80.4%) than nr-axSpA (65.2%), p=0.01. Patients with r-axSpA had a longer disease duration [6.8 (1.8-14.0) years] than nr-axSpA [1.1 (0.2-5.4) years], p<0.01. More patients with r-axSpA (90.2%) were positive for HLA-B27 than nr-axSpA (69.7%), p<0.01. Differences in ASAS HI scores were not statistically significant between r-axSpA and nr-axSpA [4.0 (2.0-6.8) vs 5.5 (1.1-8.5), p=0.12]. Post multivariable regression, nr-axSpA ([Formula: see text]: 0.70, 95% CI: 0.09, 1.32, p=0.02), BASDAI ([Formula: see text]: 0.18, 95% CI: 0.01, 0.35, p=0.04), BASFI ([Formula: see text]: 0.47, 95% CI: 0.30, 0.65, p<0.01) and HADS-Depression scores ([Formula: see text]: 0.11, 95% CI: 0.01, 0.21, p=0.04) were positively associated with ASAS HI. Higher SF36-PCS ([Formula: see text]: −0.11, 95% CI: −0.14, −0.08, p<0.01) and SF36-MCS ([Formula: see text]: −0.07, 95% CI: −0.10, −0.04, p<0.01) were negatively associated with ASAS HI (Table 1). Conclusion Patients with nr-axSpA were associated with poorer overall health and functioning as compared to r-axSpA. Higher disease activity, poorer physical function, poorer mental health status and more depressive symptoms were associated with worse health and functioning.
背景 以前的研究报告显示，放射性轴性脊柱关节炎（r-axSpA）和非放射性轴性脊柱关节炎（nr-axSpA）之间的脊柱关节炎评估（ASAS）健康指数（HI）得分存在差异，结果相互矛盾。此外，还观察到疾病活动性的国家级差异。因此，本研究旨在比较新加坡 r-axSpA 和 nr-axSpA 的 ASAS HI 评分，并确定与较差 ASAS HI 评分相关的因素。方法 这是一项对新加坡中央医院前瞻性队列研究基线数据的横断面评估，时间为 2018 年 1 月至 2023 年 3 月。根据 2009 年 ASAS 标准临床诊断为轴性脊柱关节炎（axSpA）的 21 岁及以上患者被纳入研究。研究人员收集了社会人口学变量、临床变量和患者报告的结果。通过单变量和多变量线性回归来确定与 ASAS HI 评分相关的变量。P 值小于 0.10 的变量被纳入多变量回归。P值<0.05为显著。结果 331 名患者中，分别有 265 人（80.0%）和 66 人（20.0%）患有 r-axSpA 和 nr-axSpA。r-axSpA患者的年龄中位数（IQR）为[40.0（30.0-53.0）岁]，高于nr-axSpA患者的[34.0（25.0-47.0）岁]，P<0.01。男性在 r-axSpA 中的比例（80.4%）高于 nr-axSpA（65.2%），P=0.01。r-axSpA患者的病程[6.8（1.8-14.0）年]长于nr-axSpA[1.1（0.2-5.4）年]，P<0.01。HLA-B27阳性的 r-axSpA 患者（90.2%）多于 nr-axSpA 患者（69.7%），P<0.01。r-axSpA和nr-axSpA的ASAS HI评分差异无统计学意义[4.0 (2.0-6.8) vs 5.5 (1.1-8.5)，p=0.12]。多变量回归后，nr-axSpA（[公式：见正文]：0.70，95% CI：0.09，1.32，P=0.02）、BASDAI（[公式：见正文]：0.18，95% CI：0.01，0.35，P=0.04）、BASFI（[计算公式：见正文]：0.47，95% CI：0.30，0.65，p<0.01）和 HADS 抑郁评分（[计算公式：见正文]：0.11，95% CI：0.01，0.21，p=0.04）与 ASAS HI 呈正相关。较高的 SF36-PCS （[计算公式：见正文]：-0.11，95% CI：-0.14，-0.08，p<0.01）和 SF36-MCS （[计算公式：见正文]：-0.07，95% CI：-0.10，-0.04，p<0.01）与 ASAS HI 呈负相关（表 1）。结论 与 r-axSpA 相比，nr-axSpA 患者的整体健康和功能较差。较高的疾病活动度、较差的身体功能、较差的心理健康状况和较多的抑郁症状与较差的健康和功能相关。
{"title":"Abstract 14 — Comparison of the ASAS Health Index Between Radiographic Axial Spondyloarthritis and Non-Radiographic Spondyloarthritis in Singapore","authors":"Y. Kwan, Ting Hui Woon, C. Wang, Warren Fong","doi":"10.1142/s2661341723740309","DOIUrl":"https://doi.org/10.1142/s2661341723740309","url":null,"abstract":"Background Prior studies reported conflicting results regarding differences in Assessment of SpondyloArthritis (ASAS) Health Index (HI) scores between radiographic axial spondyloarthritis (r-axSpA) and non-radiographic axial spondyloarthritis (nr-axSpA). Country-level variations in disease activity were also observed. Hence, this study aimed to compare the ASAS HI scores between r-axSpA and nr-axSpA in Singapore, and determine factors associated with poorer ASAS HI scores. Methods This was a cross-sectional evaluation of baseline data from a prospective cohort study in Singapore General Hospital, from January 2018 to March 2023. Patients aged 21 years and above who were clinically diagnosed with axial spondyloarthritis (axSpA) based on the 2009 ASAS criteria were included. Sociodemographic variables, clinical variables and patient-reported outcomes were collected. Univariable and multivariable linear regression were performed to identify variables associated with ASAS HI scores. Variables with p-value of <0.10 were included in the multivariable regression. A p-value of <0.05 was considered significant. Results Of the 331 patients, 265 (80.0%) and 66 (20.0%) had r-axSpA and nr-axSpA respectively. The median (IQR) age in r-axSpA was [40.0 (30.0-53.0) years], higher than nr-axSpA [34.0 (25.0-47.0) years], p<0.01. There was a higher proportion of males in r-axSpA (80.4%) than nr-axSpA (65.2%), p=0.01. Patients with r-axSpA had a longer disease duration [6.8 (1.8-14.0) years] than nr-axSpA [1.1 (0.2-5.4) years], p<0.01. More patients with r-axSpA (90.2%) were positive for HLA-B27 than nr-axSpA (69.7%), p<0.01. Differences in ASAS HI scores were not statistically significant between r-axSpA and nr-axSpA [4.0 (2.0-6.8) vs 5.5 (1.1-8.5), p=0.12]. Post multivariable regression, nr-axSpA ([Formula: see text]: 0.70, 95% CI: 0.09, 1.32, p=0.02), BASDAI ([Formula: see text]: 0.18, 95% CI: 0.01, 0.35, p=0.04), BASFI ([Formula: see text]: 0.47, 95% CI: 0.30, 0.65, p<0.01) and HADS-Depression scores ([Formula: see text]: 0.11, 95% CI: 0.01, 0.21, p=0.04) were positively associated with ASAS HI. Higher SF36-PCS ([Formula: see text]: −0.11, 95% CI: −0.14, −0.08, p<0.01) and SF36-MCS ([Formula: see text]: −0.07, 95% CI: −0.10, −0.04, p<0.01) were negatively associated with ASAS HI (Table 1). Conclusion Patients with nr-axSpA were associated with poorer overall health and functioning as compared to r-axSpA. Higher disease activity, poorer physical function, poorer mental health status and more depressive symptoms were associated with worse health and functioning.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":"190 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139304621","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 : 2023-11-01DOI: 10.1142/s2661341723740176
Mikkel Ǿstergaard
The overall objectives of this session are to understand the patient burden of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) and to reflect on the role of tailored treatment strategies in the management of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA). The presentation will initially, for each of the 3 diseases, describe key disease characteristics and the clinical responses to different types of therapy, with emphasis on biological and targeted synthetic disease modifying antirheumatic drugs (b/tsDMARDs). Subsequently, the focus will be the gap between patients’ and physicians’ perspectives on the most important aspects of the diseases, and on the main goals of treatment. Thereafter, current international recommendations for RA, PsA and axSpA and the treat-to-target concept will be introduced and discussed, followed by a discussion, disease by disease, of whether prevention of radiographic progression should be an important the goal of treatment. Finally, it will be discussed how the strategy for treating patients RA, PsA, and axSpA should be in the future, including the role of therapeutic strategies tailored for the individual patients.
{"title":"Lunch Symposium","authors":"Mikkel Ǿstergaard","doi":"10.1142/s2661341723740176","DOIUrl":"https://doi.org/10.1142/s2661341723740176","url":null,"abstract":"The overall objectives of this session are to understand the patient burden of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) and to reflect on the role of tailored treatment strategies in the management of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA). The presentation will initially, for each of the 3 diseases, describe key disease characteristics and the clinical responses to different types of therapy, with emphasis on biological and targeted synthetic disease modifying antirheumatic drugs (b/tsDMARDs). Subsequently, the focus will be the gap between patients’ and physicians’ perspectives on the most important aspects of the diseases, and on the main goals of treatment. Thereafter, current international recommendations for RA, PsA and axSpA and the treat-to-target concept will be introduced and discussed, followed by a discussion, disease by disease, of whether prevention of radiographic progression should be an important the goal of treatment. Finally, it will be discussed how the strategy for treating patients RA, PsA, and axSpA should be in the future, including the role of therapeutic strategies tailored for the individual patients.","PeriodicalId":15538,"journal":{"name":"Journal of Clinical Rheumatology and Immunology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139302779","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：