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Real-world clinical experience with secukinumab in psoriatic arthritis: an observational study and a literature review.
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-01-27 DOI: 10.4081/reumatismo.2025.1694
Eleonora Celletti, Giulio Gualdi, Emanuela Sabatini, Francesco Cipollone, Fabio Lobefaro, Paolo Amerio

Objective: Psoriatic arthritis (PsA) can be treated with biological drugs targeting IL-17A, such as secukinumab, with good responses and long-term positive outcomes in clinical studies.

Methods: An observational study was conducted on adult subjects with PsA and comorbidities, treated with secukinumab after prior therapy with conventional disease-modifying anti-rheumatic drugs or biological agents that were discontinued due to lack of efficacy or adverse drug reactions. Patients were followed up with clinical visits at 3, 6, 9, and 12 months and evaluated for disease activity, pain, and quality of life, with respect to values recorded at baseline. Moreover, a narrative review of the literature was performed on secukinumab's use for PsA in real life.

Results: Fifteen patients completed 6 months of follow-up, eleven patients completed 9 months, and six patients were followed for 12 months. The major comorbidities recorded were fibromyalgia (33% of patients), recurrent bilateral anterior uveitis, and autoimmune thyroiditis with hypothyroidism (both 13% of the patients). A significant improvement in Disease Activity Score-28 was recorded at 6 and 9 months, while a significant difference vs. baseline was seen at 3, 6, and 9 months for the Psoriasis Area Severity Index. The Bath Ankylosing Spondylitis Disease Activity Index showed significant differences vs. baseline at 9 and 12 months. There was an improving trend at 9 and 12 months for pain scores and a significant improvement at 6 and 9 months for the physical component and at 12 months for the social component (Short Form 36 Health Survey quality of life scores). For the review of the literature, 35 articles were identified but only 17 papers were eventually considered.

Conclusions: Secukinumab has demonstrated effectiveness for PsA treatment in several real-world studies. Both patient-oriented and clinician-oriented outcomes showed a significant improvement with this treatment. The present real-world evaluation adds further evidence of the use of secukinumab for PsA treatment, showing the rapid, safe, clinically significant, and sustained responses of PsA patients affected by co-morbidities.

{"title":"Real-world clinical experience with secukinumab in psoriatic arthritis: an observational study and a literature review.","authors":"Eleonora Celletti, Giulio Gualdi, Emanuela Sabatini, Francesco Cipollone, Fabio Lobefaro, Paolo Amerio","doi":"10.4081/reumatismo.2025.1694","DOIUrl":"https://doi.org/10.4081/reumatismo.2025.1694","url":null,"abstract":"<p><strong>Objective: </strong>Psoriatic arthritis (PsA) can be treated with biological drugs targeting IL-17A, such as secukinumab, with good responses and long-term positive outcomes in clinical studies.</p><p><strong>Methods: </strong>An observational study was conducted on adult subjects with PsA and comorbidities, treated with secukinumab after prior therapy with conventional disease-modifying anti-rheumatic drugs or biological agents that were discontinued due to lack of efficacy or adverse drug reactions. Patients were followed up with clinical visits at 3, 6, 9, and 12 months and evaluated for disease activity, pain, and quality of life, with respect to values recorded at baseline. Moreover, a narrative review of the literature was performed on secukinumab's use for PsA in real life.</p><p><strong>Results: </strong>Fifteen patients completed 6 months of follow-up, eleven patients completed 9 months, and six patients were followed for 12 months. The major comorbidities recorded were fibromyalgia (33% of patients), recurrent bilateral anterior uveitis, and autoimmune thyroiditis with hypothyroidism (both 13% of the patients). A significant improvement in Disease Activity Score-28 was recorded at 6 and 9 months, while a significant difference vs. baseline was seen at 3, 6, and 9 months for the Psoriasis Area Severity Index. The Bath Ankylosing Spondylitis Disease Activity Index showed significant differences vs. baseline at 9 and 12 months. There was an improving trend at 9 and 12 months for pain scores and a significant improvement at 6 and 9 months for the physical component and at 12 months for the social component (Short Form 36 Health Survey quality of life scores). For the review of the literature, 35 articles were identified but only 17 papers were eventually considered.</p><p><strong>Conclusions: </strong>Secukinumab has demonstrated effectiveness for PsA treatment in several real-world studies. Both patient-oriented and clinician-oriented outcomes showed a significant improvement with this treatment. The present real-world evaluation adds further evidence of the use of secukinumab for PsA treatment, showing the rapid, safe, clinically significant, and sustained responses of PsA patients affected by co-morbidities.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047640","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}
引用次数: 0
Adherence to vaccination against SARS-CoV-2 and vaccine safety in patients with immunoglobulin G4-related disease.
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-01-22 DOI: 10.4081/reumatismo.2025.1744
Linda Mastromanno, Federico Giardina, Angelica Gattamelata, Serena Colafrancesco, Simona Truglia, Francesca Romana Spinelli, Edoardo Simoncelli, Bruno Lucchino, Fabrizio Conti, Roberta Priori

Objective: To assess the adherence to the vaccination campaign against SARS-CoV-2 in patients with immunoglobulin-G4-related disease (IgG4-RD) and to evaluate the development of local and systemic adverse events (AEs) following vaccination. Additionally, to investigate the rate and outcome of SARS-CoV-2 infection in IgG4-RD patients.

Methods: Patients with IgG4-RD in follow-up before the onset of the SARS-CoV-2 pandemic were contacted by telephone and asked to answer an ad hoc questionnaire regarding their vaccination status against SARS-CoV-2 and related AEs following vaccination. The occurrence and the outcome of SARS-CoV-2 infection were also recorded. The same questionnaire was proposed to healthy controls (HC).

Results: 20 patients and 40 HC were enrolled. In the patient's cohort, 90% were vaccinated with at least one dose; among them, 9 reported AEs: 44.4% systemic and 22.2% local. Within the HC group, 100% were vaccinated with at least one dose. 13 out of 40 HC had systemic AEs (50%), and 27 (67.5%) reported local AEs. Neither in IgG4-RD nor in HC, serious adverse reactions were observed. Among the patient's cohort, 60% contracted SARS-CoV-2 infection, and 41.67% were on immunosuppressants at the time of the infection. One patient presented with severe COVID-19. No disease flares following vaccination or infection were reported.

Conclusions: Results from our study indicate a good adherence to the vaccination campaign against SARS-CoV-2 in patients with IgG4-RD and support a relatively good safety profile of this vaccine. Compared to controls, patients with IgG4-RD reported slightly more systemic AEs and fewer local AEs. A similar rate of COVID-19 development was observed between IgG4-RD patients and HC.

{"title":"Adherence to vaccination against SARS-CoV-2 and vaccine safety in patients with immunoglobulin G4-related disease.","authors":"Linda Mastromanno, Federico Giardina, Angelica Gattamelata, Serena Colafrancesco, Simona Truglia, Francesca Romana Spinelli, Edoardo Simoncelli, Bruno Lucchino, Fabrizio Conti, Roberta Priori","doi":"10.4081/reumatismo.2025.1744","DOIUrl":"https://doi.org/10.4081/reumatismo.2025.1744","url":null,"abstract":"<p><strong>Objective: </strong>To assess the adherence to the vaccination campaign against SARS-CoV-2 in patients with immunoglobulin-G4-related disease (IgG4-RD) and to evaluate the development of local and systemic adverse events (AEs) following vaccination. Additionally, to investigate the rate and outcome of SARS-CoV-2 infection in IgG4-RD patients.</p><p><strong>Methods: </strong>Patients with IgG4-RD in follow-up before the onset of the SARS-CoV-2 pandemic were contacted by telephone and asked to answer an ad hoc questionnaire regarding their vaccination status against SARS-CoV-2 and related AEs following vaccination. The occurrence and the outcome of SARS-CoV-2 infection were also recorded. The same questionnaire was proposed to healthy controls (HC).</p><p><strong>Results: </strong>20 patients and 40 HC were enrolled. In the patient's cohort, 90% were vaccinated with at least one dose; among them, 9 reported AEs: 44.4% systemic and 22.2% local. Within the HC group, 100% were vaccinated with at least one dose. 13 out of 40 HC had systemic AEs (50%), and 27 (67.5%) reported local AEs. Neither in IgG4-RD nor in HC, serious adverse reactions were observed. Among the patient's cohort, 60% contracted SARS-CoV-2 infection, and 41.67% were on immunosuppressants at the time of the infection. One patient presented with severe COVID-19. No disease flares following vaccination or infection were reported.</p><p><strong>Conclusions: </strong>Results from our study indicate a good adherence to the vaccination campaign against SARS-CoV-2 in patients with IgG4-RD and support a relatively good safety profile of this vaccine. Compared to controls, patients with IgG4-RD reported slightly more systemic AEs and fewer local AEs. A similar rate of COVID-19 development was observed between IgG4-RD patients and HC.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029558","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}
引用次数: 0
Small molecules in idiopathic inflammatory myopathies: a systematic review and a multicenter case series about Janus kinase inhibitors and apremilast. 特发性炎性肌病中的小分子:关于Janus激酶抑制剂和阿普米司特的系统回顾和多中心病例系列。
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-01-13 DOI: 10.4081/reumatismo.2025.1718
Chiara Rizzo, Silvia Grazzini, Edoardo Conticini, Hector Chinoy, Roberto D'Alessandro, Federica Camarda, Luca Cantarini, Bruno Frediani, Giuliana Guggino, Lidia La Barbera

Objective: Idiopathic inflammatory myopathies (IIM) are rare autoimmune diseases that primarily affect striated muscles; skin, joints, and lungs may be involved with different degrees of severity. Traditional treatment relies on high-dose glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs.

Methods: A growing amount of evidence is demonstrating the potential role of novel treatments in the management of IIM. We report our experience with Janus kinase inhibitors (JAKi) in these conditions and review the current evidence for the use of small molecules in real-life clinical practice.

Results: A total of 41 papers were retrieved from PubMed, 37 papers concerning IIM and JAKi, and 4 papers concerning IIM and apremilast.

Conclusions: An overall good efficacy was evidenced in IIM-associated skin lesions, including rash, ulcers, and calcinosis. If present, muscle and joint involvement demonstrated a good response to therapy, while it was not possible to draw any conclusion about dysphagia. No life-threatening adverse events were reported.

目的:特发性炎症性肌病(IIM)是一种罕见的自身免疫性疾病,主要影响横纹肌;皮肤、关节和肺部可能受到不同程度的严重影响。传统的治疗依赖于大剂量的糖皮质激素和传统的合成疾病缓解抗风湿药物。方法:越来越多的证据表明,新的治疗方法在IIM的管理中的潜在作用。我们报告了我们在这些情况下使用Janus激酶抑制剂(JAKi)的经验,并回顾了目前在现实临床实践中使用小分子药物的证据。结果:PubMed共检索到41篇论文,其中IIM与JAKi相关论文37篇,IIM与apremilast相关论文4篇。结论:iim相关的皮肤病变,包括皮疹、溃疡和钙质沉着症,总体疗效良好。如果存在,肌肉和关节受累表现出对治疗的良好反应,但不可能得出任何关于吞咽困难的结论。无危及生命的不良事件报告。
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引用次数: 0
Coexisting rheumatoid arthritis and sickle cell disease: case series and literature review. 并发类风湿关节炎和镰状细胞病:病例系列和文献回顾。
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2025-01-07 DOI: 10.4081/reumatismo.2025.1682
Abdallah Alqethami, Sabri Alsaeedi, Samera Felemban, Abdulelah Qadi

Rheumatoid arthritis (RA) is rarely reported among patients with sickle cell disease (SCD). RA treatment in these patients is believed to be more challenging due to fear of increasing the risk of infection and complications of SCD. We are reporting 7 patients with concurrent SCD and RA. The average age at the time of the diagnosis of RA was 33.3±12.6 years (ranging from 16 to 53 years), and most were women (5/7). Most of the patients were positive for rheumatoid factor (6/7) or anticyclic citrullinated peptide (6/7). Four patients were treated with hydroxyurea. The most used antirheumatic drugs were methotrexate (7/7), biologic agents (5/7), and prednisone (4/7). Two patients were in remission, four had low and one had high disease activity. Four patients (4/7) had avascular necrosis, two in the shoulders and two in the hip joints. Four patients had emergency visits or hospitalizations within one year of the diagnosis of RA, but none had blood transfusions, infections, or death. The start of antirheumatic medication was not associated with an increased risk of infection, blood transfusions, emergency visits, or hospitalizations, nor with a worsening of laboratory measures. The findings suggest that the treatment of RA in patients with SCD should follow the same strategy as in patients without SCD. However, treatment should be individualized according to the individual patient's risk of infection and SCD complications.

类风湿性关节炎(RA)在镰状细胞病(SCD)患者中很少报道。由于担心感染和SCD并发症的风险增加,这些患者的RA治疗被认为更具挑战性。我们报告了7例并发SCD和RA的患者。RA确诊时的平均年龄为33.3±12.6岁(16 ~ 53岁),以女性居多(5/7)。多数患者类风湿因子(6/7)或抗环瓜氨酸肽(6/7)阳性。4例患者用羟基脲治疗。使用最多的抗风湿药物是甲氨蝶呤(7/7)、生物制剂(5/7)和强的松(4/7)。两名患者病情缓解,四名病情低,一名病情高。4例患者(4/7)出现了缺血性坏死,2例在肩部,2例在髋关节。4名患者在诊断为类风湿性关节炎的一年内有过急诊或住院治疗,但没有输血、感染或死亡。抗风湿药物的开始与感染、输血、急诊或住院的风险增加无关,也与实验室检测结果的恶化无关。研究结果表明,治疗SCD患者的RA应遵循与非SCD患者相同的策略。然而,治疗应根据个体患者感染和SCD并发症的风险进行个体化。
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引用次数: 0
The holistic management of peripheral spondyloarthritis: focus on articular involvement in patients with inflammatory bowel disease. 外周脊柱关节炎的综合治疗:关注炎症性肠病患者的关节受累情况。
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2024-11-11 DOI: 10.4081/reumatismo.2024.1688
E Lubrano, A Armuzzi, S Scriffignano, C Felice, F M Perrotta, V Venerito, S Del Vescovo, R Ramonda, G Cassone, F Atzeni, R Caporali, F Conti, E Gremese, F Iannone, M Sebastiani, E G Favalli

Objective: To provide a comprehensive overview of peripheral spondyloarthritis (pSpA), focusing specifically on its occurrence and management in patients with inflammatory bowel disease (IBD).

Methods: An exhaustive literature search was conducted in PubMed, Embase, Cochrane Database of Systematic Reviews, and Google Scholar to identify relevant studies on pSpA in IBD patients. Titles, abstracts, and full-text articles were screened for relevance. Data on study design, patient characteristics, diagnostic criteria, main findings, and conclusions were extracted from selected articles. Study quality was assessed using appropriate checklists. Information was synthesized narratively to summarize current understanding.

Results: pSpA is the most common extraintestinal manifestation in IBD, with a median prevalence of 16%. It worsens quality of life and requires collaboration between gastroenterologists and rheumatologists for optimal diagnosis and treatment. Several "red flags" guide appropriate specialist referral of IBD patients with suspected pSpA. Once the diagnosis is confirmed, the choice of therapy depends on IBD phenotype and patterns of articular/axial involvement. Anti-tumor necrosis factor (TNF) drugs are first-line biologics, with interleukin (IL)-12/23 and IL-23 inhibitors as alternatives for anti-TNF failure. Small molecules like apremilast and Janus kinase inhibitors also have utility. Recommended treatment algorithms exist, but more randomized controlled trials are needed.

Conclusions: Early identification of pSpA is crucial in IBD patients to enable timely intervention, prevent structural damage, and minimize disability. A multidisciplinary, holistic approach addressing musculoskeletal and extra-musculoskeletal manifestations is key to optimal patient outcomes.

目的:全面概述外周脊柱关节炎(pSpA):全面概述外周脊柱关节炎(pSpA),特别关注其在炎症性肠病(IBD)患者中的发生和管理:在 PubMed、Embase、Cochrane 系统综述数据库和 Google Scholar 中进行了详尽的文献检索,以确定有关 IBD 患者中 pSpA 的相关研究。对标题、摘要和全文进行了相关性筛选。从所选文章中提取有关研究设计、患者特征、诊断标准、主要发现和结论的数据。使用适当的核对表对研究质量进行评估。结果:pSpA 是 IBD 最常见的肠外表现,中位发病率为 16%。它恶化了患者的生活质量,需要消化科医生和风湿免疫科医生合作进行最佳诊断和治疗。对于疑似 pSpA 的 IBD 患者,有几个 "警示信号 "可指导其进行适当的专科转诊。一旦确诊,治疗方法的选择取决于 IBD 表型和关节/轴受累模式。抗肿瘤坏死因子(TNF)药物是一线生物制剂,白细胞介素(IL)-12/23 和 IL-23 抑制剂是抗肿瘤坏死因子失败后的替代药物。Apremilast 和 Janus 激酶抑制剂等小分子药物也很有用。目前已有推荐的治疗算法,但还需要更多的随机对照试验:结论:对 IBD 患者而言,早期识别 pSpA 对及时干预、预防结构性损伤和减少残疾至关重要。针对肌肉骨骼和肌肉骨骼外表现的多学科综合方法是患者获得最佳治疗效果的关键。
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引用次数: 0
Conventional radiography and correlated factors of enthesopathies of the Achilles tendon and plantar fascia in patients with axial spondyloarthritis. 轴性脊柱关节炎患者跟腱和足底筋膜缠绕病的常规放射学检查和相关因素。
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2024-10-28 DOI: 10.4081/reumatismo.2024.1709
Ebru Yılmaz, Özge Pasin

Objective: This study aimed to investigate the correlated risk factors and presence of radiological enthesopathies of the Achilles tendon and plantar fascia in patients with axial spondyloarthropathy (axSpA).

Methods: 242 patients (121 female and 121 male) with axSpA were included in this study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP), the Bath Ankylosing Spondylitis Radiology Index (BASRI), the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), and CRP were evaluated in all patients. The lateral foot X-rays of the patients were assessed for enthesopathies of the Achilles tendon and plantar fascia attachments.

Results: Calcaneal spur and Achilles enthesopathies were present in 57.4% of the patients. 39.3% of patients had enthesopathies in both regions. The male and female groups differed statistically in terms of weight, height, body mass index (BMI), positive family history, and duration since diagnosis (p<0.05). The presence of calcaneal spur and Achilles enthesopathies was found to be significantly correlated with age, weight, BMI, symptom duration, and the scores of BASDAI, BASFI, ASDAS-CRP, BASRI, and MASES (p<0.05).

Conclusions: The presence of enthesopathies appears to be associated with age, weight, BMI, symptom duration, and disease activity. Conventional radiography can be used as an auxiliary tool in the evaluation of entheseal abnormalities in patients with SpA, especially in patients with advanced age, long symptom duration, and high BMI.

研究目的本研究旨在探讨轴性脊柱关节病(axSpA)患者跟腱和足底筋膜放射学粘连病变的相关风险因素。对所有患者进行了巴斯强直性脊柱炎疾病活动指数(BASDAI)、巴斯强直性脊柱炎功能指数(BASFI)、强直性脊柱炎疾病活动评分与 C 反应蛋白(ASDAS-CRP)、巴斯强直性脊柱炎放射学指数(BASRI)、马斯特里赫特强直性脊柱炎肌腱炎评分(MASES)和 CRP 评估。对患者足部外侧 X 光片进行了评估,以确定是否存在跟腱和足底筋膜附件的粘连病变:结果:57.4%的患者存在骨骨刺和跟腱粘连病。39.3%的患者同时患有这两个部位的粘连病。男性组和女性组在体重、身高、体重指数(BMI)、阳性家族史和确诊时间方面存在统计学差异(p结论:膝关节病似乎与年龄、体重、体重指数、症状持续时间和疾病活动有关。常规X光检查可作为评估SpA患者腱鞘异常的辅助工具,尤其适用于高龄、症状持续时间长和体重指数(BMI)高的患者。
{"title":"Conventional radiography and correlated factors of enthesopathies of the Achilles tendon and plantar fascia in patients with axial spondyloarthritis.","authors":"Ebru Yılmaz, Özge Pasin","doi":"10.4081/reumatismo.2024.1709","DOIUrl":"10.4081/reumatismo.2024.1709","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the correlated risk factors and presence of radiological enthesopathies of the Achilles tendon and plantar fascia in patients with axial spondyloarthropathy (axSpA).</p><p><strong>Methods: </strong>242 patients (121 female and 121 male) with axSpA were included in this study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP), the Bath Ankylosing Spondylitis Radiology Index (BASRI), the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), and CRP were evaluated in all patients. The lateral foot X-rays of the patients were assessed for enthesopathies of the Achilles tendon and plantar fascia attachments.</p><p><strong>Results: </strong>Calcaneal spur and Achilles enthesopathies were present in 57.4% of the patients. 39.3% of patients had enthesopathies in both regions. The male and female groups differed statistically in terms of weight, height, body mass index (BMI), positive family history, and duration since diagnosis (p<0.05). The presence of calcaneal spur and Achilles enthesopathies was found to be significantly correlated with age, weight, BMI, symptom duration, and the scores of BASDAI, BASFI, ASDAS-CRP, BASRI, and MASES (p<0.05).</p><p><strong>Conclusions: </strong>The presence of enthesopathies appears to be associated with age, weight, BMI, symptom duration, and disease activity. Conventional radiography can be used as an auxiliary tool in the evaluation of entheseal abnormalities in patients with SpA, especially in patients with advanced age, long symptom duration, and high BMI.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522859","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}
引用次数: 0
Sudden improvement of alopecia universalis and psoriatic arthritis while receiving upadacitinib: a case-based review. 接受奥达帕替尼治疗期间普遍性脱发和银屑病关节炎突然好转:基于病例的综述。
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2024-10-25 DOI: 10.4081/reumatismo.2024.1685
Carlo Perricone, Roberto Dal Pozzolo, Giacomo Cafaro, Santina Calvacchi, Lorenza Bruno, Francesco Tromby, Anna Colangelo, Roberto Gerli, Elena Bartoloni

Alopecia universalis (AU), an advanced form of alopecia areata (AA), is a condition characterized by the complete loss of hair over the entire skin surface. Recent progress has significantly enhanced our understanding of the pathogenesis of AU. In particular, interferon-γ (IFN-γ) and interleukin (IL)-15 seem to play a pivotal role in the pathogenesis of the disease. Nonetheless, a variety of medications has been used to treat the disease with frequently inconsistent results. Given the broad modulation of the immune system and inhibition of key molecules, including IFN-γ and IL-15, oral janus kinase (JAK) inhibitors represent a treatment option for moderate to severe cases of AA, as demonstrated in case reports supporting their efficacy and tolerability. We present the case of a patient suffering from psoriatic arthritis and AU who experienced a sudden improvement in peripheral arthritis and AU while receiving JAK1 selective treatment with upadacitinib. So far, there are very limited case reports of successful upadacitinib treatment for patients with AA, mostly in patients also suffering from atopic dermatitis. Thus, we provide evidence for the efficacy of upadacitinib in managing AU in adults, as well as in the context of inflammatory arthritis such as psoriatic arthritis.

普遍性脱发(AU)是斑秃(AA)的一种晚期形式,是一种以整个皮肤表面毛发完全脱落为特征的疾病。最近的研究进展大大提高了我们对普秃发病机制的认识。其中,干扰素-γ(IFN-γ)和白细胞介素(IL)-15似乎在该病的发病机制中起着关键作用。尽管如此,治疗该病的药物种类繁多,但效果往往不尽相同。鉴于口服破伤风激酶(JAK)抑制剂能广泛调节免疫系统并抑制包括 IFN-γ 和 IL-15 在内的关键分子,因此口服破伤风激酶(JAK)抑制剂是治疗中度至重度 AA 病例的一种选择,病例报告证明了其疗效和耐受性。我们介绍了一位患有银屑病关节炎和AU的患者的病例,该患者在接受达帕替尼(upadacitinib)的JAK1选择性治疗后,外周关节炎和AU突然得到改善。迄今为止,有关达帕替尼成功治疗AA患者的病例报道非常有限,其中大多数是同时患有特应性皮炎的患者。因此,我们为达达替尼治疗成人特应性皮炎的疗效提供了证据,而且还适用于银屑病关节炎等炎症性关节炎。
{"title":"Sudden improvement of alopecia universalis and psoriatic arthritis while receiving upadacitinib: a case-based review.","authors":"Carlo Perricone, Roberto Dal Pozzolo, Giacomo Cafaro, Santina Calvacchi, Lorenza Bruno, Francesco Tromby, Anna Colangelo, Roberto Gerli, Elena Bartoloni","doi":"10.4081/reumatismo.2024.1685","DOIUrl":"10.4081/reumatismo.2024.1685","url":null,"abstract":"<p><p>Alopecia universalis (AU), an advanced form of alopecia areata (AA), is a condition characterized by the complete loss of hair over the entire skin surface. Recent progress has significantly enhanced our understanding of the pathogenesis of AU. In particular, interferon-γ (IFN-γ) and interleukin (IL)-15 seem to play a pivotal role in the pathogenesis of the disease. Nonetheless, a variety of medications has been used to treat the disease with frequently inconsistent results. Given the broad modulation of the immune system and inhibition of key molecules, including IFN-γ and IL-15, oral janus kinase (JAK) inhibitors represent a treatment option for moderate to severe cases of AA, as demonstrated in case reports supporting their efficacy and tolerability. We present the case of a patient suffering from psoriatic arthritis and AU who experienced a sudden improvement in peripheral arthritis and AU while receiving JAK1 selective treatment with upadacitinib. So far, there are very limited case reports of successful upadacitinib treatment for patients with AA, mostly in patients also suffering from atopic dermatitis. Thus, we provide evidence for the efficacy of upadacitinib in managing AU in adults, as well as in the context of inflammatory arthritis such as psoriatic arthritis.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522860","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}
引用次数: 0
Does the volume of physical exercise influence sleep quality in patients with fibromyalgia? 运动量会影响纤维肌痛患者的睡眠质量吗?
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2024-10-16 DOI: 10.4081/reumatismo.2024.1710
Loiane Cristina De Souza, Guilherme Torres Vilarino, Alexandro Andrade

Objective: To investigate the association between the volume of exercise and the quality of sleep in patients with fibromyalgia.

Methods: This is a cross-sectional study carried out from 2010 to 2019 in patients over 18 years old from the research project at a university in Brazil. Instruments related to sociodemographic and clinical characteristics, physical exercise, and the Pittsburgh Sleep Quality Index (PSQI) were applied. Participants were classified as inactive, insufficiently active, or active. In the statistical analysis, the Kruskal-Wallis and Mann-Whitney U tests were used. Binary logistic and multinomial regression were also performed.

Results: The majority of participants were physically inactive and had poor sleep quality; 68.3% with poor sleep quality were inactive. In the analysis of the difference between the three groups, sleep latency (time it takes to fall asleep) (p=0.00) and total PSQI (p=0.04) were significantly different. When the analysis was performed between active and inactive individuals, significant differences were found in sleep latency (p=0.02), daytime dysfunction (difficulties in performing daytime tasks due to poor sleep quality) (p=0.02), and the total PSQI (p=0.02). Binary logistic regression with crude analysis showed that inactive participants are 4.3 times more likely to have poor sleep quality when compared to active participants (odds ratio = 4.311; 95% confidence interval 1.338-13.888; p=0.014). Multinomial regression analysis showed that being physically active can be a protective factor.

Conclusions: There is a high prevalence of sleep disorders and insufficient practice of physical exercise among patients with fibromyalgia. It is suggested that regular physical exercise may be related to sleep quality, and more active participants have fewer sleep disorders, with exercise being a protective factor.

目的:研究纤维肌痛患者的运动量与睡眠质量之间的关系:研究纤维肌痛患者的运动量与睡眠质量之间的关系:这是一项横断面研究,从 2010 年至 2019 年在巴西一所大学的研究项目中对 18 岁以上的患者进行了研究。研究采用了与社会人口学和临床特征、体育锻炼和匹兹堡睡眠质量指数(PSQI)相关的工具。参与者被分为不活跃、不够活跃和活跃。统计分析采用 Kruskal-Wallis 和 Mann-Whitney U 检验。此外,还进行了二元逻辑回归和多项式回归:大多数参与者缺乏运动,睡眠质量较差;68.3%的睡眠质量较差者缺乏运动。在三组差异分析中,睡眠潜伏期(入睡时间)(P=0.00)和总 PSQI(P=0.04)有显著差异。在对活跃和不活跃人群进行分析时,发现睡眠潜伏期(p=0.02)、日间功能障碍(因睡眠质量差而导致日间工作困难)(p=0.02)和 PSQI 总值(p=0.02)存在显著差异。二元逻辑回归粗分析表明,与活跃的参与者相比,不活跃的参与者睡眠质量差的可能性要高 4.3 倍(几率比 = 4.311;95% 置信区间 1.338-13.888;p=0.014)。多项式回归分析表明,积极参加体育锻炼可以成为一个保护性因素:结论:在纤维肌痛患者中,睡眠障碍和体育锻炼不足的发生率很高。结论:在纤维肌痛患者中,睡眠障碍的发生率很高,而体育锻炼不足则是一个保护因素。有研究表明,经常进行体育锻炼可能与睡眠质量有关,参加体育锻炼越多的患者睡眠障碍越少,而体育锻炼则是一个保护因素。
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引用次数: 0
Patients with anti-small ubiquitin-like modifier activating enzyme-positive dermatomyositis resembling antisynthetase syndrome with poor prognosis: a bicentric international retrospective study and literature review. 预后不良的抗小泛素样修饰激活酶阳性皮肌炎患者类似于抗合成酶综合征:一项双中心国际回顾性研究和文献综述。
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2024-10-09 DOI: 10.4081/reumatismo.2024.1686
Camila Gusmão Vicente De Carvalho, Barbara Bayeh, Fernando Henrique Carlos De Souza, Renata Miossi, Pleiades Tiharu Inaoka, Takashi Matsushita, Naoki Mugii, Samuel Katsuyuki Shinjo

Objective: This study aimed to describe adult Brazilian and Japanese patients with anti-small ubiquitin-like modifier activating enzyme (SEA)-positive dermatomyositis (DM), as there are few studies in the literature. A literature review was also conducted.

Methods: This bicentric international retrospective study, conducted between 2012 and 2023, included patients with anti-SAE-positive DM (2017 European League Against Rheumatism/ American College of Rheumatology classification criteria). All demographic features and clinical, laboratory, therapeutic, and follow-up data were collected from Brazilian and Japanese centers using pre-standardized and parameterized information.

Results: We included 17 adult patients with a median age of 65 years (56-76 years) and a predominance of females (82.4%). Constitutional symptoms at baseline were present in 58.8% of the patients. In addition to classical cutaneous DM lesions, one-third of the patients had myalgia and significant muscle weakness, whereas half presented with dysphagia, interstitial lung disease, and joint manifestations. The first-line treatment consisted of intravenous methylprednisolone and immunoglobulin pulse therapy in 41.2% and 28.6% of the patients, respectively. The median follow-up duration was 20 (13-74) months; at the last medical evaluation, half had active disease and were still using oral glucocorticoids (median dosage, 10.0 mg/day). Approximately one-fifth to one-third of the patients were diagnosed with different types of cancer, had severe infections, or died.

Conclusions: Patients with anti-SAE-positive DM not only resemble the phenotype of antisynthetase syndrome but are also associated with a poor prognosis.

研究目的本研究旨在描述抗小泛素样修饰激活酶(SEA)阳性皮肌炎(DM)的巴西和日本成年患者,因为文献中的研究很少。此外,还进行了文献综述:这项双中心国际回顾性研究在2012年至2023年期间进行,纳入了抗SEA阳性DM患者(2017年欧洲抗风湿联盟/美国风湿病学会分类标准)。所有人口统计学特征以及临床、实验室、治疗和随访数据均来自巴西和日本的中心,并使用了预先标准化和参数化的信息:我们共纳入了 17 名成年患者,中位年龄为 65 岁(56-76 岁),女性占多数(82.4%)。58.8%的患者在基线时有全身症状。除了典型的皮肤DM病变外,三分之一的患者还伴有肌痛和明显的肌无力,半数患者出现吞咽困难、间质性肺病和关节表现。分别有41.2%和28.6%的患者接受了静脉甲基强的松龙和免疫球蛋白脉冲治疗。随访时间的中位数为20(13-74)个月;在最后一次医学评估时,半数患者的病情处于活动期,仍在口服糖皮质激素(中位剂量为10.0毫克/天)。约五分之一到三分之一的患者被诊断出患有不同类型的癌症、严重感染或死亡:结论:抗SAE阳性DM患者不仅与抗异烟酸酶综合征的表型相似,而且预后较差。
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引用次数: 0
Clinical utility of lung ultrasound for the detection of interstitial lung disease in patients with rheumatoid arthritis. 肺部超声波在检测类风湿性关节炎患者肺间质疾病方面的临床实用性。
IF 1.2 Q4 RHEUMATOLOGY Pub Date : 2024-10-03 DOI: 10.4081/reumatismo.2024.1651
R Tanten Zabaleta, J Marín, J B Zacariaz Hereter, J Maritano, M Fullana, N Alvarado, E R Soriano, J E Rosa

Objective: To establish the diagnostic value of lung ultrasound (LUS) in patients with rheumatoid arthritis (RA) for the detection of interstitial lung disease (ILD).

Methods: A cross-sectional study was performed. Consecutive patients with RA (American College of Rheumatology/European League Against Rheumatism 2010 criteria) who had a chest high-resolution computed tomography (HRCT) performed within 12 months before inclusion, regardless of symptomatology, were included. Demographic, clinical, laboratory, and pharmacological data were recorded. Each patient underwent a LUS with assessment of B-lines (BL) and pleural irregularities (PI). HRCT was considered the gold standard for the confirmatory diagnosis of ILD. Receiver operating characteristic (ROC) curves were calculated to test the ability of LUS findings (BL and PI) in discriminating patients with ILD.

Results: A total of 104 RA patients were included, of which 21.8% had ILD. Patients with ILD had more BL (median 26 versus 1, p<0.001) and PI (median 16 versus 5, p<0.001) than patients without ILD. The diagnostic accuracy in ROC curves was as follows: area under the curve (AUC) 0.88 and 95% confidence interval (CI) 0.78-0.93 for BL and AUC 0.82 and 95% CI 0.74-0.89 for PI. The best cut-off points for (ILD detection) discriminating the presence of significant interstitial lung abnormalities were 8 BL and 7 PI.

Conclusions: The presence of 8 BL and/or 7 PI in the LUS showed an adequate cut-off value for discriminating the presence of significant interstitial lung abnormalities, evocative of ILD.

目的确定肺部超声波(LUS)对类风湿性关节炎(RA)患者间质性肺病(ILD)的诊断价值:进行了一项横断面研究。研究纳入了在纳入前 12 个月内进行过胸部高分辨率计算机断层扫描(HRCT)的连续性类风湿性关节炎患者(美国风湿病学会/欧洲抗风湿病联盟 2010 年标准),无论其症状如何。研究人员记录了患者的人口统计学、临床、实验室和药物学数据。每位患者都接受了LUS检查,评估了B线(BL)和胸膜不规则(PI)。HRCT 被认为是确诊 ILD 的金标准。通过计算接收者操作特征曲线(ROC)来检验 LUS 发现(BL 和 PI)在鉴别 ILD 患者方面的能力:结果:共纳入104名RA患者,其中21.8%患有ILD。ILD患者有更多的BL(中位数为26对1,P结论:LUS中出现8个BL和/或7个PI显示出足够的临界值,可用于鉴别是否存在明显的肺间质异常,从而诱发ILD。
{"title":"Clinical utility of lung ultrasound for the detection of interstitial lung disease in patients with rheumatoid arthritis.","authors":"R Tanten Zabaleta, J Marín, J B Zacariaz Hereter, J Maritano, M Fullana, N Alvarado, E R Soriano, J E Rosa","doi":"10.4081/reumatismo.2024.1651","DOIUrl":"10.4081/reumatismo.2024.1651","url":null,"abstract":"<p><strong>Objective: </strong>To establish the diagnostic value of lung ultrasound (LUS) in patients with rheumatoid arthritis (RA) for the detection of interstitial lung disease (ILD).</p><p><strong>Methods: </strong>A cross-sectional study was performed. Consecutive patients with RA (American College of Rheumatology/European League Against Rheumatism 2010 criteria) who had a chest high-resolution computed tomography (HRCT) performed within 12 months before inclusion, regardless of symptomatology, were included. Demographic, clinical, laboratory, and pharmacological data were recorded. Each patient underwent a LUS with assessment of B-lines (BL) and pleural irregularities (PI). HRCT was considered the gold standard for the confirmatory diagnosis of ILD. Receiver operating characteristic (ROC) curves were calculated to test the ability of LUS findings (BL and PI) in discriminating patients with ILD.</p><p><strong>Results: </strong>A total of 104 RA patients were included, of which 21.8% had ILD. Patients with ILD had more BL (median 26 versus 1, p<0.001) and PI (median 16 versus 5, p<0.001) than patients without ILD. The diagnostic accuracy in ROC curves was as follows: area under the curve (AUC) 0.88 and 95% confidence interval (CI) 0.78-0.93 for BL and AUC 0.82 and 95% CI 0.74-0.89 for PI. The best cut-off points for (ILD detection) discriminating the presence of significant interstitial lung abnormalities were 8 BL and 7 PI.</p><p><strong>Conclusions: </strong>The presence of 8 BL and/or 7 PI in the LUS showed an adequate cut-off value for discriminating the presence of significant interstitial lung abnormalities, evocative of ILD.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366390","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}
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Reumatismo
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