A dermatologic perspective on autoinflammatory diseases.
Authors: Marzano AV, Damiani G, Genovese G, Gattorno M Abstract Autoinflammatory diseases (AIDs) encompass a heterogeneous group of disorders pathogenetically related to an abnormal activation of the innate immunity and clinically characterised by aseptic inflammation in the affected organs in the absence of high titer of circulating autoantibodies or autoreactive T cells. In classic monogenic AIDs, the skin is frequently involved with a wide range of cutaneous lesions. Monogenic AIDs result from different mutations in a single gene, which regulates the innate immunity. These mutations cause an uncontrolled activat...
Source: Clinical and Experimental Rheumatology - May 11, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

The eye involvement in monogenic autoinflammatory diseases: literature review and update.
Authors: Sota J, Vitale A, Fabiani C, Frediani B, Rigante D, Tosi GM, Zannin ME, Cantarini L Abstract Monogenic autoinflammatory diseases (AIDs) are rare entities characterised by improper activation of the innate immune system. This in turn determines recurrent episodes of systemic inflammation characterised by fever, which is variously combined with a wide range of inflammatory manifestations involving the skin, joints, serous membranes, gastrointestinal tract, and central nervous system. As shown by research efforts conducted during the last decade, the eye is not exempt from the systemic inflammatory process an...
Source: Clinical and Experimental Rheumatology - May 11, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Neurological manifestations in autoinflammatory diseases.
Authors: Uccelli A, Gattorno M Abstract Autoinflammatory diseases (AIDs) are a distinct group of diseases characterised by a dysregulation of the innate immune response leading to systemic inflammation. The clinical spectrum of these conditions is extremely variable and possibly every system and tissue can be involved, including the central nervous system (CNS). Indeed, neurological manifestations may dominate the clinical picture from disease onset in some rare conditions. However, the involvement of the CNS in AIDs is not a disease in itself, but represents a rare complication which is consequent to a systemic or...
Source: Clinical and Experimental Rheumatology - May 11, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Autoinflammatory diseases as a cause of acute abdominal pain in the emergency department.
Authors: Maconi G, Obici L, Carmagnola S, Guzzetti S Abstract Autoinflammatory diseases (AIDs) usually present with acute abdominal pain and fever, both of which are also the main causes of referral in the emergency department. As some patients with acute abdominal pain may be discharged from the emergency department without a definitive diagnosis, it is not surprising that, due to their rarity, most cases of AID remain undiagnosed or are misdiagnosed as acute appendicitis. Indeed, the diagnosis of familial Mediterranean fever and autoinflammatory syndromes requires a high index of suspicion and careful assessment ...
Source: Clinical and Experimental Rheumatology - May 11, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Renal involvement in autoinflammatory diseases and inflammasome-mediated chronic kidney damage.
Authors: Scarpioni R, Obici L Abstract Unprovoked activation of innate immune pathways and increased secretion of interleukin (IL)-1β and IL-18 are responsible for the protean clinical manifestations and the marked inflammatory response that characterise most hereditary autoinflammatory disorders. The kidney is a major target organ of this inflammatory process. The deposition of the acute-phase reactant serum amyloid A (SAA) as amyloid causes progressive glomerular and vascular damage and leads to organ failure. In this review we focus on the potential impact of hereditary autoinflammatory diseases on renal fu...
Source: Clinical and Experimental Rheumatology - May 11, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

High prevalence of metabolic syndrome in antisynthetase syndrome.
Authors: Araujo PAO, Silva MG, Borba EF, Shinjo SK Abstract OBJECTIVES: A high frequency of metabolic syndrome (MetS) has been recently described in different idiopathic inflammatory myopathies, but not in antisynthetase syndrome (ASS). Therefore, the aim of the present study was to determine the prevalence of MetS in ASS and also its possible association with cardiovascular the risk factors and ASS-related disease characteristics. METHODS: A cross-sectional single centre study of 42 consecutive ASS patients was conducted from 2012 to 2015 and compared to 84 healthy individuals matched for gender, age, ethnicit...
Source: Clinical and Experimental Rheumatology - May 3, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

One year in review 2018: pathogenesis of rheumatoid arthritis.
Authors: Calabresi E, Petrelli F, Bonifacio AF, Puxeddu I, Alunno A Abstract Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that primarily affects joints. The several mechanisms involved in the development of the disease are not completely understood. It has been proposed that different environmental factors, such as cigarette smoking, occupational and atmospheric agents act as trigger stimuli for the development of RA in genetically predisposed individuals, leading to synovial hyperplasia and bone destruction. The initial disease stage of RA is associated with alteration of innate and adapt...
Source: Clinical and Experimental Rheumatology - May 3, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Prediction of organ involvement in systemic sclerosis by serum biomarkers and peripheral endothelial function.
CONCLUSIONS: This is the first study to inclusively investigate the relationships among biomarkers, EndoPAT-RHI and organ involvement in patients with SSc. Our data suggest a complex pathological progression of SSc through fibrotic impairment and microvascular damage. PMID: 29652651 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 16, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Circulating follicular helper T cells (CD4+CXCR5+ICOS+) decrease in patients with rheumatoid arthritis treated with abatacept.
Authors: Piantoni S, Regola F, Scarsi M, Tincani A, Airò P PMID: 29652652 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 16, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Role of foetal umbilical artery Doppler on prediction of adverse pregnancy outcomes in patients with systemic lupus erythematosus.
CONCLUSIONS: Pregnancies in lupus still had an increased risk of APOs in terms of pre-term birth. Third-trimester umbilical artery Doppler was useful in predicting pre-term birth, SGA, and composite APOs in lupus pregnancies. PMID: 29652653 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 16, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Patients with juvenile idiopathic arthritis become adults: the role of transitional care.
Authors: Conti F, Pontikaki I, D'Andrea M, Ravelli A, De Benedetti F Abstract Most juvenile idiopathic arthritis (JIA) patients need to attend adult rheumatology centres to continue the clinical management of their disease and to receive adequate long-term treatment. Transition from the paediatric to the adult health care team is a critical moment in the clinical history of these patients, but unfortunately, about 50% of the transfer processes to adult rheumatology are not successful, putting these patients at high risk of unfavourable outcomes. There are several obstacles to the success of transitional care for JI...
Source: Clinical and Experimental Rheumatology - April 16, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Effect of tumour necrosis factor-alpha inhibitors on renal function in patients with rheumatoid arthritis from the KOBIO registry from 2012 to 2016.
CONCLUSIONS: TNF inhibitors did not influence the change of renal function during RA treatment. TNF inhibitors may be a safe treatment option irrespective of renal function. PMID: 29652655 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 16, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Electrocardiogram abnormalities related to anti-malarials in systemic lupus erythematosus.
CONCLUSIONS: This study suggests an association between cumulative AM dose above the median (1207 g) and structural ECG abnormalities. More importantly, cumulative AM decreases the odds of ECG conduction abnormalities. PMID: 29652656 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 16, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Detection of anti-neutrophil cytoplasmic and antinuclear autoantibodies favoring misdiagnoses in 5 cases of Erdheim-Chester disease.
Authors: Özden F, Schinke S, Thorns C, Eckey T, Dalhoff K, Münte TF, Tronnier V, Humrich JY, Riemekasten G, Lamprecht P PMID: 29652657 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 16, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Bcl-XL and Mcl-1 upregulation by calreticulin promotes apoptosis resistance of fibroblast-like synoviocytes via activation of PI3K/Akt and STAT3 pathways in rheumatoid arthritis.
CONCLUSIONS: This study showed that upregulation of Bcl-XL and Mcl-1 expression in RA FLS by CRT were PI3K/Akt and STAT3 signal pathways dependent, and promoted the anti-apoptosis of RA FLS. Therefore, this may represent a therapeutic target for the treatment of RA. PMID: 29652658 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 16, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Efficiency of dose reduction strategy of etanercept in patients with axial spondyloarthritis.
CONCLUSIONS: It is feasible to slowly increase the dosing interval and transit to the lowest effective dosing interval for some patients in remission/LDA. Prolonging the time under remission before tapering help to improve the outcome. Tapering 25% of the etanercept dose every 3 months may be a pragmatic approach for more cost-effective use of the drug. PMID: 29652659 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 16, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Cognitive function of patients with rheumatoid arthritis is associated with disease activity but not carotid atherosclerotic changes.
This study investigated cognitive function in patients with RA and evaluated whether cognitive function was affected by carotid arterial atherosclerosis. METHODS: We examined 70 RA patients and 40 healthy controls. RA activity was assessed by disease activity score with 28 joint-erythrocyte sedimentation rate (DAS28-ESR). Cognitive function was assessed by the Korean version of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K) neuropsychological battery. Carotid arteries were scanned for the presence of plaques and to assess intima-media thickness (IMT). We assessed potential risk factors of cogn...
Source: Clinical and Experimental Rheumatology - April 16, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Combined brain and heart magnetic resonance imaging in systemic vasculitides: fiction or real need?
Authors: Mavrogeni SI, Kitas G, Lamb HJ, Psychoyios K, Dimitroulas T, Koutsogeorgopoulou L, Boki K, Vartela V, Kolovou G, Markousis-Mavrogenis G, Kallenberg CG, Guillevin L, Vassilopoulos D Abstract Systemic vasculitides (SVs) is a group of diseases characterised by inflammation/necrosis of the blood vessel wall in various organs. Simultaneous brain and heart involvement is a cause of increased morbidity/mortality in SV. We aimed to present evidence of concurrent brain/heart involvement in SV and the role of a combined brain/heart magnetic resonance imaging (MRI) in their risk stratification. Cerebral vasculitis (C...
Source: Clinical and Experimental Rheumatology - April 16, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Effects of biologic disease-modifying anti-rheumatic drugs on the radiographic progression of rheumatoid arthritis: a systematic literature review.
CONCLUSIONS: There is evidence from RCTs with a range of bDMARDs that improvement in radiographic outcomes for patients with early or established RA, when used in combination with MTX and to a lesser extent as monotherapy, are significantly greater than MTX alone. There was no evidence of a difference between bDMARDs on inhibition of radiographic progression. PMID: 29600931 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Dermoscopy as a supportive tool in differential diagnosis of psoriatic arthritis: another reason to include such a technique in rheumatology fellow curriculum.
Authors: Zabotti A, De Vita S, Stinco G, Errichetti E PMID: 29600932 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Retention and clinical response to abatacept in patients with rheumatoid arthritis: an Italian perspective.
Authors: Galeazzi M, Alten R, Chartier M, Elbez Y, Fusaro E, Le Bars M, Lorenz HM, Pagano Mariano G, Muratore M, Nüßlein HG, Patanè G PMID: 29600933 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Autoimmune or infectious disease? That is the question.
Authors: Constantinou CA, Fragoulis GE, Gakiopoulou Η, Tzioufas AG, Sipsas NV PMID: 29600934 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Rheumatoid arthritis patients achieved better quality of life than systemic lupus erythematosus patients at sustained remission.
CONCLUSIONS: RA patients in sustained remission achieved better quality of life than SLE patients. PMID: 29600935 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Association between primary Sj ögren's syndrome, cardiovascular and cerebrovascular disease: a systematic review and meta-analysis.
Association between primary Sjögren's syndrome, cardiovascular and cerebrovascular disease: a systematic review and meta-analysis. Clin Exp Rheumatol. 2018 Mar 19; Authors: Yong WC, Sanguankeo A, Upala S Abstract OBJECTIVES: Acute systemic inflammation and chronic systemic vasculitis are associated with endothelial dysfunction and atherosclerotic plaque formation. Studies on cardiovascular or cerebrovascular events in primary Sjögren's syndrome (pSS) are limited, with conflicting results. This meta-analysis aimed to explore the risk of cardiovascular and cerebrovascular disease in pSS. ME...
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Low dose of simvastatin reduces disease activity and improves endothelial function in patients with SLE.
Authors: Kotyla P PMID: 29600937 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Detection of human T lymphotropic virus type-I bZIP factor and tax in the salivary glands of Sj ögren's syndrome patients.
Detection of human T lymphotropic virus type-I bZIP factor and tax in the salivary glands of Sjögren's syndrome patients. Clin Exp Rheumatol. 2018 Mar 20; Authors: Nakamura H, Hasegawa H, Sasaki D, Takatani A, Shimizu T, Kurushima S, Horai Y, Nakashima Y, Nakamura T, Fukuoka J, Kawakami A Abstract OBJECTIVES: To detect HTLV-I bZIP factor (HBZ), tax and relevant molecules in labial salivary glands (LSGs) from patients with Sjögren's syndrome (SS). METHODS: The expressions of HBZ and tax in T cell lines and LSGs were analysed by in situ hybridization (ISH) or real time PCR. The expressions ...
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Chinese registry of rheumatoid arthritis (CREDIT): Introduction and prevalence of remission in Chinese patients with rheumatoid arthritis.
Authors: Yu C, Li M, Duan X, Fang Y, Li Q, Wu R, Liu S, Wang Y, Wu Z, Shi X, Jiang Z, Wang Y, Hsieh ED, Jin S, Jiang N, Wang Q, Zhao Y, Tian X, Zeng X, and the co-authors of CREDIT Abstract OBJECTIVES: To introduce the Chinese Registry of rhEumatoiD arthrITis (CREDIT), which is the first nationwide, multicentre, online rheumatoid arthritis (RA) registry in China, and to depict major cross-sectional data and treatment strategies of Chinese RA patients. METHODS: RA patients who fulfilled the 2010 ACR/EULAR classification criteria for rheumatoid arthritis were recruited into the registry by their rheumatologists f...
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

The burden of systemic juvenile idiopathic arthritis for patients and caregivers: an international survey and retrospective chart review.
CONCLUSIONS: SJIA patients on biologic therapy experience HRQOL impairment, caregivers' mental well-being suffers and productivity losses and expenses are incurred. Therapeutic interventions that reduce the burden of SJIA are required. PMID: 29600940 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Adalimumab biosimilar in rheumatoid arthritis: a total-evidence assessment to evaluate equivalence with the originator based on network meta-analysis.
Authors: Mengato D, Messori A PMID: 29600941 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Serum Epstein-Barr virus DNA, detected by droplet digital PCR, correlates with disease activity in patients with rheumatoid arthritis.
CONCLUSIONS: Active RA is associated with a lytic EBV infection which may have a role in the pathogenesis of RA. PMID: 29600942 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Silent arterial inflammation during the apparent remission state of Takayasu's arteritis. What do cytokines tell us?
CONCLUSIONS: A smoldering inflammatory response with predominantly cytokines involved in Th17 response seems to be ongoing in TAK patients in remission with extensive disease or with previous ischaemic events. PMID: 29600943 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Investigation of serum biomarkers in primary gout patients using iTRAQ-based screening.
Authors: Ying Y, Chen Y, Zhang S, Huang H, Zou R, Li X, Chu Z, Huang X, Peng Y, Gan M, Geng B, Zhu M, Ying Y, Huang Z Abstract OBJECTIVES: Primary gout is a major disease that affects human health; however, its pathogenesis is not well known. The purpose of this study was to identify biomarkers to explore the underlying mechanisms of primary gout. METHODS: We used the isobaric tags for relative and absolute quantitation (iTRAQ) technique combined with liquid chromatography-tandem mass spectrometry to screen differentially expressed proteins between gout patients and controls. We also identified proteins potenti...
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

L öfgren syndrome as secondary autoimmune disease in a patient with B-cell depletion following rituximab treatment.
Löfgren syndrome as secondary autoimmune disease in a patient with B-cell depletion following rituximab treatment. Clin Exp Rheumatol. 2018 Mar 21; Authors: Kronbichler A, Luger AK, Loacker L, Pizzini A, Löffler-Ragg J, Peschel I PMID: 29600945 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Diagnosis of deficiency of adenosine deaminase 2 with early onset polyarteritis nodosa in an adult patient with a novel compound heterozygous CECR1 mutation.
Authors: Lamprecht P, Humrich JY, Diebold I, Riemekasten G PMID: 29600946 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Disease activity, overweight, physical activity and screen time in a cohort of patients with juvenile idiopathic arthritis.
CONCLUSIONS: Physical activity, obesity rates and screen time hours were similar between JIA patients and controls. This lack of difference could be attributed to clinical remission following early, aggressive, treat-to-target therapy. PMID: 29600947 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Intraarticular infliximab therapy in patients with juvenile idiopathic arthritis: the role of musculoskeletal ultrasound and disease activity scores in monitoring therapy response.
Authors: Vidovic M, Lamot L, Lamot M, Harjacek M Abstract OBJECTIVES: Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children, with heterogeneous clinical features. Although therapeutic options are wide and in the majority of children symptoms improve with the combination of non-steroidal anti-inflammatory and disease-modifying drugs, there are a number of patients who do not respond to conventional therapy and who do not meet the criteria for systemic biologics, namely anti TNF-alpha. Those patients are potential candidates for intraarticular therapy with biologics and in this ...
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Clinical remission in rheumatoid arthritis and psoriatic arthritis.
Authors: Lubrano E, Mesina F, Caporali R Abstract It is currently recognised that remission can be an achievable target for several rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients by a treat-to-target approach. For RA different remission criteria have been proposed, depending on the disease activity scores used, on the importance given to the inclusion of patients' perspective into the definition of remission, and on their applicability in clinical practice, that generate highly different remission rates. Conversely, for PsA, remission is still insufficiently defined and represents a partially unme...
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Diagnostic and predictive evaluation using salivary gland ultrasonography in primary Sj ögren's syndrome.
Diagnostic and predictive evaluation using salivary gland ultrasonography in primary Sjögren's syndrome. Clin Exp Rheumatol. 2018 Mar 16; Authors: Lee KA, Lee SH, Kim HR Abstract OBJECTIVES: We aimed to assess the diagnostic accuracy of salivary gland ultrasonography (SGUS) as a single test for the detection of primary Sjögren's syndrome (pSS) and examine the prognostic factors for severe structural damage of the salivary glands based on SGUS score. METHODS: Patients with pSS (n=94) and idiopathic sicca syndrome (n=44) were evaluated using the SGUS 0-48 scoring system, which comprises fiv...
Source: Clinical and Experimental Rheumatology - April 1, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Guidelines for prophylaxis of Pneumocystis pneumonia cannot rely solely on CD4-cell count in autoimmune and inflammatory diseases.
Authors: Baulier G, Issa N, Gabriel F, Accoceberry I, Camou F, Duffau P Abstract OBJECTIVES: Guidelines for preventing Pneumocystis pneumonia (PCP) in HIV patients are based on CD4 below 200/mm3. Such cut-off value is suggested to guide prophylaxis in non-HIV conditions (NHIV) especially in autoimmune and inflammatory diseases (AD). We aimed to determine if CD4 could be used to guide PCP prophylaxis in AD. METHODS: CD4 and lymphocyte-count were retrospectively studied in patients diagnosed with PCP between January 2013 and February 2016. RESULTS: 129 patients were included. The median CD4-count was 302/mm3 ...
Source: Clinical and Experimental Rheumatology - March 14, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Chikungunya virus: a rheumatologist's perspective.
Authors: Runowska M, Majewski D, Niklas K, Puszczewicz M Abstract Chikungunya virus (CHIKV) is an arthropod-borne alphavirus, transmitted by Aedes aegypti and Aedes albopictus mosquitoes. It is responsible for a febrile illness, typically accompanied by maculopapular rash and severe, incapacitating arthralgia. The disease, although generally self-limiting, frequently evolves into a long-lasting, debilitating rheumatic disorder, which shares many clinical features with rheumatoid arthritis (RA). The underlying mechanism by which CHIKV induces persistent arthritis remains under investigation, however, currently, atte...
Source: Clinical and Experimental Rheumatology - March 14, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

In early arthritis patients, high HAQ at baseline and DAS28 at three months predict suboptimal outcomes at two years: a retrospective cohort study.
Authors: Fanouriakis A, Papalopoulos I, Gergianaki I, Spyrou G, Erden A, Rapsomaniki P, Terizaki M, Avgoustidis N, Repa A, Kougkas N, Bertsias G, Boumpas DT, Sidiropoulos PI Abstract OBJECTIVES: Early arthritis clinics (EAC) aim to improve rheumatoid arthritis (RA) outcomes by tailoring treatment targeting to remission. Our aim was to analyse disease course and relevant predictors over 2 years in early arthritis; we also assessed the applicability of the "treat-to-target approach" in a real-life EAC. METHODS: Patients with early arthritis recruited at the EAC of the University Hospital of Heraklion we...
Source: Clinical and Experimental Rheumatology - March 14, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Comorbidity of PFAPA (periodic fever, aphthous stomatitis, pharyngitis and adenitis) patients: a case control study.
Authors: Lantto U, Kettunen S, Tapiainen T, Koivunen P, Uhari M, Renko M Abstract OBJECTIVES: To compare the long-term morbidity of patients with periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome treated by tonsillectomy (TE) in childhood to that of matched controls. METHODS: We identified 132 PFAPA patients from the medical records treated by TE in 1987-2007 in Oulu University Hospital, Finland. Altogether 119 patients participated the follow-up study and 94 were clinically examined on average 9.0 years after TE. The controls consisted of 230 randomly selected age-, sex-, and birt...
Source: Clinical and Experimental Rheumatology - March 14, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Prevalence and validity of ACR/EULAR remission in four European early rheumatoid arthritis cohorts.
CONCLUSIONS: In clinical practice, a minority of patients with early RA achieves remission in the first 6 months of treatment. Remission at 6 months is predictive for good HAQ outcome between year 1 and 2 after inclusion, but not radiographic stability. PMID: 29533752 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - March 14, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Successful sequential therapy with rituximab and belimumab in patients with active systemic lupus erythematosus: a case series.
CONCLUSIONS: The modulation of plasma BLyS kinetics in patients undergoing sequential treatment with rituximab and belimumab may represent a possible rationale behind the effectiveness of this combined therapy. PMID: 29533753 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - March 14, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Trends in the activity of rheumatoid arthritis as the consequence of treat-to-target strategy: eight-year data from 2009 to 2016.
Authors: Xie W, Li J, Zhang X, Li G, Hao Y, Zhao J, Wang L, Sun X, Fan Y, Zhang Z Abstract OBJECTIVES: To investigate the trends in the activity of rheumatoid arthritis (RA) over the past 8 years and evaluate the value of treat-to target (T2T) strategy in daily practice. METHODS: All the medical records of RA patients from 2009 to 2016 were retrospectively reviewed. Disease activity scores at obtained visits were measured by DAS28-CRP, DAS28-ESR, SDAI and CDAI. To display trends over years, both mean and time-adjusted methods were applied in calculation of annual disease activity and remission rate. Disease act...
Source: Clinical and Experimental Rheumatology - March 14, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Efficacy and safety of canakinumab in patients with Still's disease: exposure-response analysis of pooled systemic juvenile idiopathic arthritis data by age groups.
Authors: Feist E, Quartier P, Fautrel B, Schneider R, Sfriso P, Efthimiou P, Cantarini L, Lheritier K, Leon K, Karyekar CS, Speziale A Abstract OBJECTIVES: To describe the efficacy, safety, and exposure-response relationship of canakinumab in a subgroup of patients with systemic juvenile idiopathic arthritis (SJIA) aged ≥16 years, representative of adult-onset Still's disease (AOSD) patients, and to compare this subgroup with those of children and young adolescents with SJIA by pooling clinical data collected during the development programme of canakinumab. METHODS: Safety and efficacy data on canakinumab-tr...
Source: Clinical and Experimental Rheumatology - March 14, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Comprehensive evaluation of finger flexor tendon entheseal soft tissue and bone changes by ultrasound can differentiate psoriatic arthritis and rheumatoid arthritis.
Authors: Tinazzi I, McGonagle D, Zabotti A, Chessa D, Marchetta A, Macchioni P Abstract OBJECTIVES: To determine whether a detailed sonographic evaluation of the hand flexor tendon compartment could help differentiate between psoriatic arthritis (PsA) and rheumatoid arthritis (RA). METHODS: Thirty-seven patients with PsA, 47 with RA and 10 healthy controls (HC) had flexor tendon (FT) compartment imaging of the dominant hand 2nd to 4th tendons using grey scale (GS) and power Doppler (PD) ultrasound (US) with evaluation for tenosynovitis, peri-tendinous lesions, soft tissue oedema and bony changes at FT insertion...
Source: Clinical and Experimental Rheumatology - March 14, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Cause-specific mortality in a large population-based cohort of patients with rheumatoid arthritis in Italy.
CONCLUSIONS: In our study, a 42% excess risk of death was observed among subjects with RA compared with the general population. Cardiovascular disease is the primary cause of premature death in RA. Adverse effects of therapy and comorbidities should be adequately monitored in RA subjects. PMID: 29533757 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - March 14, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

Association of TLR7 gene copy number variations with ankylosing spondylitis in a Chinese population: a case control study.
CONCLUSIONS: We conclude that the lower copy number (=1) of TLR7 gene confers a risk factor for AS susceptibility in males but protective factor in females. PMID: 29533758 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Rheumatology)
Source: Clinical and Experimental Rheumatology - March 14, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research

IL-6 receptor inhibition modulates type III collagen and C-reactive protein degradation in rheumatoid arthritis patients with an inadequate response to anti-tumour necrosis factor therapy: analysis of connective tissue turnover in the tocilizumab RADIATE.
The objective of this study was to examine the tissue degradation in response to anti-IL6 receptor treatment in rheumatoid arthritis (RA) patients which are anti-TNF-α inadequate responders. METHODS: RADIATE was a randomised, double-blinded, placebo-controlled, parallel-group, phase III trial. RA patients with previous inadequate response to anti-TNFα therapy (n=299) were randomly assigned to tocilizumab 4 or 8 mg/kg with methotrexate (10-25 mg weekly) or placebo with methotrexate. Type III collagen degradation (C3M) and CRP degradation (CRPM) were analysed in serum samples at baseline and 16 weeks. RES...
Source: Clinical and Experimental Rheumatology - February 24, 2018 Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research