The perennial search for alternatives to corticosteroids in rheumatology: is there light at the end of the tunnel?
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 12, 2020 Category: Rheumatology Source Type: research

Biosimilars for vasculitis: promise requires validation by quality studies
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 12, 2020 Category: Rheumatology Source Type: research

Distinct gene network in skin lesion of patients with diffuse cutaneous systemic sclerosis
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 12, 2020 Category: Rheumatology Source Type: research

Is it time to say goodbye to weekly rituximab in ANCA vasculitis?
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 12, 2020 Category: Rheumatology Source Type: research

Correction to: Comparison of 8-year knee osteoarthritis progression in 2 siblings: a case-based review
The original version of this article was revised due to a retrospective Open Access order. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 12, 2020 Category: Rheumatology Source Type: research

Diplopia and ocular pain due to orbital myositis
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 12, 2020 Category: Rheumatology Source Type: research

Things left unsaid: important topics that are not discussed between patients with systemic sclerosis, their carers and their healthcare professionals —a discourse analysis
ConclusionKey topics, including mortality and prognosis, are rarely openly discussed, leaving patients uncertain and anxious about the future. By communicating about difficult but important topics, physicians and nurses could help patients and carers manage and plan their lives. This study shows that a multi-professional team-based communication approach is likely to better address patient needs and priorities.Key Points•Key topics in SSc or SSc-ILD, such as mortality and prognosis, are rarely openly discussed in clinical consultations.•By communicating difficult but important topics, physicians and nurses could ...
Source: Clinical Rheumatology - September 11, 2020 Category: Rheumatology Source Type: research

Anaplastic large cell lymphoma in a patient with MAGIC syndrome: a case and review of the literature
In this report, we present a case in which a patient developed anaplastic large cell lymphoma 1 year after the diagnosis of MAGIC syndrome. Additionally, we review the clinical manifestations, mana gement, and prognosis of MAGIC syndrome. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 11, 2020 Category: Rheumatology Source Type: research

Maintenance to target was associated with radiological outcomes in patients with rheumatoid arthritis: a real-world observational cohort study
AbstractObjectiveTo investigate the effect of different maintenance to target on radiologic outcomes in patients with rheumatoid arthritis (RA) in real-world setting.MethodsRA patients enrolled were screened from a longitudinal cohort. The radiographies were evaluated at baseline, after 1 –2 years and thereafter every 2 years. An increase of mTSS> 3 from baseline was taken as the primary outcome and accelerated annual radiological progression as the secondary outcome of radiological progression. The maintenance rate (MR) to target was calculated as the proportion of the year fulfilling preset criteria of target ov...
Source: Clinical Rheumatology - September 8, 2020 Category: Rheumatology Source Type: research

Managing rheumatic diseases during COVID-19
This article is an attempt to review and understand COVID-19 and its impact on the immune system with special emphasis on managing medications used for autoimmune rheumatic diseases. We have provided general guidance about decision making, in regards to the immunosuppressive agents used in rheumatology practice with an understanding that this may change in near future. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 8, 2020 Category: Rheumatology Source Type: research

Multiple nodules under the pericardium in a patient with IgG4-related disease
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 7, 2020 Category: Rheumatology Source Type: research

Managing rheumatoid arthritis during COVID-19
AbstractThe outbreak of coronavirus in the world has led to an uncertainty about treatment of patients with autoimmune disorders because of their weakened immune system coupled with immunosuppressive agents they take which predisposes them to a host of infections. Data on COVID-19 patients with underlying rheumatological diseases has been emerging mostly in the form of small case series and one global registry. From these data, it seems like our patients, although immunosuppressed, are not particularly susceptible to the coronavirus infection and if infected, do not have significantly worse outcomes than other patients. In...
Source: Clinical Rheumatology - September 6, 2020 Category: Rheumatology Source Type: research

Prevalent vertebral fractures incur high risk of future fractures in inflammatory myositis
ConclusionPatients with IIM with a prior VF incurred a five times risk of subsequent VF irrespective of disease activity and glucocorticoids.Key Points•Patients with inflammatory myositis are at a high risk of asymptomatic vertebral fractures.•Patients with baseline vertebral fractures incur a high risk of future fractures on follow-up.•Number of fractures is negatively correlated with age, BMD values at lower end of radius, L4, and damage. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 6, 2020 Category: Rheumatology Source Type: research

Rheumatologists in the COVID-19 era: will there be a new role for the rheumatologist in the care of rheumatic patients?
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 5, 2020 Category: Rheumatology Source Type: research

The potential similarities of COVID-19 and autoimmune disease pathogenesis and therapeutic options: new insights approach
AbstractCytokine pathways and their signaling disorders can be the cause of onset and pathogenesis of many diseases such as autoimmune diseases and COVID-19 infection. Autoimmune patients may be at higher risk of developing infection due to the impaired immune responses, the use of immunosuppressive drugs, and damage to various organs. Increased secretion of inflammatory cytokines and intolerance of the patient ’s immune system to COVID-19 infection are the leading causes of hospitalization of these patients. The content used in this paper has been taken from English language articles (2005–2020) retrieved from...
Source: Clinical Rheumatology - September 3, 2020 Category: Rheumatology Source Type: research

Influence of smoking and obesity on treatment response in patients with axial spondyloarthritis: a systematic literature review
AbstractTo assess whether smoking and obesity are predictors of poor treatment response in patients with axial spondyloarthritis (axSpA). A systematic literature review was performed by searching in MEDLINE and EMBASE up to June 2019 with a strategy based on the PICO approach: Population: patients with axSpA; Intervention or exposure: smoking or obesity; Comparison: non-smokers (for smoking) and normal-weight individuals (for obesity); and Outcome: any response criteria currently validated for axSpA. The 2009 Oxford Centre for Evidence-based Medicine levels were used for assessing the studies quality. Out of 1873 reference...
Source: Clinical Rheumatology - September 3, 2020 Category: Rheumatology Source Type: research

Longitudinal change during follow-up of systemic sclerosis: correlation between high-resolution computed tomography and pulmonary function tests
In conclusion, change in radiological extent of SSc-ILD was correlated to functional decline in a limited time-frame. Repeated HRCT after 12 –24 months may be useful for the longitudinal characterization of ILD evolution in patients with stable pulmonary function. Conversely, functional changes are suggestive of a concurrent radiological progression only after this interval.Key Points• In SSc patients, chest HRCT performed every 12–24 months can detect minimal but significant changes in ILD extent, even in subjects with stable pulmonary function.• PFT changes in 12–24 months are related to the r...
Source: Clinical Rheumatology - September 3, 2020 Category: Rheumatology Source Type: research

Gout of ankle and foot: DECT versus US for crystal detection
AbstractObjectiveTo compare dual-energy computed tomography (DECT) and ultrasound (US) in detecting monosodium urate (MSU) crystals in the ankle and foot in patients with acute gouty arthritis.MethodsBilateral ankle and foot were examined by DECT and US and the differences between the findings were compared.ResultsA total of 50 patients underwent DECT and US examinations. At the patient level, the overall positivity of crystal deposition detected by DECT was higher than that by US (92% vs 68%,P = 0.005). The agreement of detecting crystal deposition between DECT and US was not very strong (К = ...
Source: Clinical Rheumatology - September 3, 2020 Category: Rheumatology Source Type: research

The usefulness and validity of English-language videos on YouTube as an educational resource for spondyloarthritis
ConclusionsMajority of YouTube videos have useful information on SpA and are important educational sources to patients. However, rheumatologists should be aware that misleading patient opinions on alternative therapies can contain inaccurate information and should hence actively correct these misinformation during their clinic consultsKey Points•The majority of videos on Spondyloarthritis found on YouTube are deemed useful and are uploaded by healthcare professionals.•The majority of misleading videos were uploaded by patients and the main theme of misinformation was on clinical features and treatment of spondylo...
Source: Clinical Rheumatology - September 2, 2020 Category: Rheumatology Source Type: research

Systematic review of recommendations on the use of methotrexate in rheumatoid arthritis
ConclusionExisting recommendations do not uniformly address all aspects related to the use of MTX and disagree in relevant aspects of MTX use. Adaptations to these recommendations are needed to facilitate their implementation in LDCs.Key Points• This paper summarizes current recommendations on the use of methotrexate for the treatment of rheumatoid arthritis.• Areas of agreement between recommendations include the following: pre-methotrexate patient assessment, need for folic acid supplementation, and toxicity monitoring.• Areas of disagreement relate to methotrexate starting and maximal dose, titration, and...
Source: Clinical Rheumatology - September 2, 2020 Category: Rheumatology Source Type: research

Characteristics, evolution, and outcome of patients with non-infectious uveitis referred for rheumatologic assessment and management: an Egyptian multicenter retrospective study
AbstractObjectiveTo investigate the characteristics, evolution, and visual outcome of non-infectious uveitis.MethodologyRecords of 201 patients with non-infectious uveitis (136 (67.7%) males and 84 (41.8%) juvenile-onset ( ≤ 16 years)) were retrospectively reviewed. Data were analyzed through Kruskal–Wallis and Mann–Whitney, chi-square (χ2) tests, and logistic regression.ResultsThe median disease and follow-up durations were 36 (interquartile range (IQR) 24 –70) and 24 (IQR 10–36) months, respectively. Fifty-eight (28.9%) patients had persistently idiopathic uveitis, and 143 ...
Source: Clinical Rheumatology - September 2, 2020 Category: Rheumatology Source Type: research

African League Against Rheumatism (AFLAR) preliminary recommendations on the management of rheumatic diseases during the COVID-19 pandemic
ConclusionsThe preliminary statements of recommendations will serve to guide the clinical practice of rheumatology across Africa amidst the changing practices and uncertainties in the current era of COVID-19. It is recognized that further updates to the recommendations will be needed as more evidence emerges.Key Points• AFLAR has developed preliminary recommendations for the management of RMDs in the face of the COVID-19 pandemic.• COVID-19 is an unprecedented experience which has brought new concerns regarding the use of some disease-modifying anti-rheumatic drugs (DMARDs), and these recommendations seek to prov...
Source: Clinical Rheumatology - September 2, 2020 Category: Rheumatology Source Type: research

Efficacy and safety results from a randomized double-blind study comparing proposed biosimilar ABP 798 with rituximab reference product in subjects with moderate-to-severe rheumatoid arthritis
ConclusionsClinical equivalence in terms of efficacy, safety, and immunogenicity was established between ABP 798 and rituximab RP in this comparative clinical trial in patients with moderate-to-severe RA.Key Points• ABP 798 provided similar efficacy as rituximab reference product (RP) in patients with moderate-severe rheumatoid arthritis.• The safety and immunogenicity profiles for ABP 798 were similar to those for the rituximab RP.• The single transition from rituximab RP to ABP 798 did not show differences in efficacy, safety, or immunogenicity. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 2, 2020 Category: Rheumatology Source Type: research

Increasing of SIgA serum levels may reflect subclinical intestinal involvement in non-radiographic axial and peripheral spondyloarthritis
AbstractObjectiveThe evidence shows that previous infection with enteric pathogens is a requirement to develop pSpA. Based on our previous results, variances on regulation of SIgA might influence SpA activity; thus, the aim of this study was to correlate the levels of SIgA, IgA against some enteric bacteria, and IL-17, IL-21, and IL-6 with clinical features in a group of SpA patients.MethodsTwenty-six pSpA, 20 nr-axSpA, 60 healthy volunteers (HV), and 34 patients with inflammatory bowel diseases (IBD) were included. All subjects were assessed to measure SIgA, total and specific IgA for enteric bacteria, and IL-17, IL-21, a...
Source: Clinical Rheumatology - September 2, 2020 Category: Rheumatology Source Type: research

Response to: Biosimilars for vasculitis: promise requires validation by quality studies
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 2, 2020 Category: Rheumatology Source Type: research

Correction to: Tuberculosis and viral hepatitis in patients treated with certolizumab pegol in Asia-Pacific countries and worldwide: real-world and clinical trial data
The original published version of the above article contained an error. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - September 2, 2020 Category: Rheumatology Source Type: research

A complex COVID-19 case with rheumatoid arthritis treated with tocilizumab
AbstractRecurrences of COVID-19 were observed in a patient with long-term usage of hydroxychloroquine, leflunomide, and glucocorticoids due to her 30-year history of rheumatoid arthritis (RA). Tocilizumab was applied and intended to target both COVID-19 and RA. However, disease of this patient aggravated after usage of tocilizumab. After the discussion of a multiple disciplinary team (MDT) including rheumatologists, antimicrobial treatments were applied to target the potential opportunistic infections (Pneumocystis jirovecii andAspergillus fumigatus), which were authenticated several days later via high throughput sequenci...
Source: Clinical Rheumatology - August 13, 2020 Category: Rheumatology Source Type: research

Good response to mycophenolate mofetil on treatment of interstitial lung disease in polymyositis associated with antisynthetase syndrome positive for anti-EJ and anti-Ro52 antibodies
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - August 13, 2020 Category: Rheumatology Source Type: research

Comment on “Dysregulation of gut microbiome is linked to disease activity of rheumatic diseases”
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - August 13, 2020 Category: Rheumatology Source Type: research

Correction to: Mortality burden associated with all-cause pneumonia among adults with autoimmune inflammatory rheumatic diseases, human immunodeficiency virus infection, and malignancies: a population-based comparative study for informed decision-making in public health policies
The Table 2 in the original version of the above article was incorrectly presented. The data where misaligned during publication process.] (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - August 13, 2020 Category: Rheumatology Source Type: research

Myocarditis and intracardiac thrombus due to Henoch-Sch önlein purpura: case report and literature review
AbstractCardiac involvement is very rare in patients with Henoch-Sch önlein purpura (HSP). In this case study, we present an 8-year-old girl presenting with HSP-induced myocarditis and thrombus in the right atrium and HSP nephritis. To date, 15 cases of HSP-related cardiac involvement have been reported in the PubMed/MEDLINE, Scopus, and Google Scholar databases. Th ese cases, together with our case, are included in this review. We excluded those patients with other rheumatologic diseases (acute rheumatic fever, acute post-streptococcal glomerulonephritis, Kawasaki disease) accompanied by HSP. Three were children and ...
Source: Clinical Rheumatology - August 13, 2020 Category: Rheumatology Source Type: research

Identifying the hub gene and immune infiltration of osteoarthritis by bioinformatical methods
ConclusionIn a word, my results suggested that PRKACB played an essential role in osteoarthritis development.Key Points•Used the “sva” R package to combine the data of 59 samples from four studies to do the bioinformatical analysis.•Identifying the hub gene PRKACB as potential marker for OA and using validation sets to confirm it.•Detecting the situation of immune infiltration in synovium by CIBERSORT algorithm method. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - August 12, 2020 Category: Rheumatology Source Type: research

Clinical features and expression of type I interferon-inducible genes in systemic lupus erythematosus patients harboring rs1143679 polymorphism in China: a single-center, retrospective study
AbstractObjectiveThis case-control study aimed to analyze the clinical features and determine the expression of type I interferon-induced genes in systemic lupus erythematosus (SLE) patients harboring the CD11b rs1143679 single-nucleotide polymorphism (SNP) and elucidate whether it is involved in the relapses of SLE.MethodsOne hundred twenty-five relatively inactive SLE patients with SLEDAI scores
Source: Clinical Rheumatology - August 12, 2020 Category: Rheumatology Source Type: research

Platelet-rich plasma for hip osteoarthritis: comparing the variables in production protocol and composition
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - August 11, 2020 Category: Rheumatology Source Type: research

Kawasaki disease in siblings in close temporal proximity to each other —what are the implications?
AbstractKawasaki disease (KD) is the commonest medium vessel vasculitis in children. The etiology of KD remains an enigma despite extensive research. Infections are considered to be one of the triggers for KD, especially in genetically susceptible hosts. KD occurring within a short time interval among siblings is an important clinical observation supporting this hypothesis. In addition, siblings of children with KD are at a higher risk of developing the disease as compared with other children. Screening for KD in febrile siblings, therefore, seems prudent. This would help initiate timely therapy and prevent complications. ...
Source: Clinical Rheumatology - August 10, 2020 Category: Rheumatology Source Type: research

Clinical characteristics, treatment, and outcome of pancreatitis, panniculitis, and polyarthritis syndrome: a case-based review
AbstractA 42-year-old Caucasian female presented with lower limb panniculitis and bilateral ankle arthritis in the absence of abdominal or other localizing symptoms. Abdominal imaging revealed subacute pancreatitis with pseudocyst formation. The clinical manifestations were compatible with pancreatitis, panniculitis, and polyarthritis syndrome (PPP syndrome), a very rare complication of pancreatic disease. The patient improved with conservative treatment for the pancreatic disease and systemic corticosteroids for the cutaneous and articular manifestations. We identified 59 patients with the PPP syndrome from the literature...
Source: Clinical Rheumatology - August 10, 2020 Category: Rheumatology Source Type: research

Open-label non-mandatory transitioning from originators to biosimilars in routine clinical care
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - August 10, 2020 Category: Rheumatology Source Type: research

Pickles and warfarin interaction: a case-based review
AbstractA 36-year-old woman with a history of lupus and antiphospholipid syndrome controlled by warfarin presented to the hospital with left periorbital ecchymosis. She was found to have an INR of 9 despite maintaining her normal warfarin dose of 12.5  mg/15 mg alternating qd. The only identifiable precipitating factor was that the patient recently stopped eating dill pickles. Limiting dietary vitamin K while on warfarin therapy was once considered best practice. However, studies have demonstrated that maintaining a consistent intake of vitamin K is more important than the quantity. Still, many patients on warfar...
Source: Clinical Rheumatology - August 10, 2020 Category: Rheumatology Source Type: research

Disseminated anetoderma associated with antiphospholipid antibodies
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - August 10, 2020 Category: Rheumatology Source Type: research

Two sides on the fibromyalgia coin: physical pain and social pain (invalidation)
AbstractAlthough fibromyalgia (FM) has been traditionally defined by the extent of physical pain sites alongside other non-pain symptoms, recent evidence has highlighted the importance of social dimension in definition of pain perception. Social pain or invalidation, which denotes painful feeling following social conflicts or misunderstanding about illness legitimacy, is an important but ignored issue in the FM lexicon. While physical and social pain seem to be different and separate entities, we hypothesize that they are completely intertwined with indistinct borders in FM. Accumulating emergent neuroscience and behaviora...
Source: Clinical Rheumatology - August 9, 2020 Category: Rheumatology Source Type: research

Correction to: The IgG galactosylation ratio is higher in spondyloarthritis patients and associated with the MRI score
In the original version of the above article the References 19 and 20 were incorrect which cannot describe the development of the SPARCC score. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - August 5, 2020 Category: Rheumatology Source Type: research

Decreased sleep quality in patients with systemic lupus erythematosus: a meta-analysis
ConclusionsOur meta-analysis indicates that the sleep quality of SLE patients is worse than that of the general population; thus, more attention should be paid to the sleep status among this disease.Key Points•The sleep quality of SLE patients is worse than that of the general population.•Region, race, and disease duration are correlated with sleep quality in SLE patients. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - August 3, 2020 Category: Rheumatology Source Type: research

Tuberculosis and viral hepatitis in patients treated with certolizumab pegol in Asia-Pacific countries and worldwide: real-world and clinical trial data
ConclusionsCZP TB risk is aligned with nationwide TB rates, being slightly higher in Asia-Pacific countries excluding Japan. Overall, TB and HBV/HCV risk with CZP treatment is currently relatively low, as risk can be minimized with patient/physician education, screening, and vigilant treatment, according to international guidelines.Key Points:• TB rates were highest in eastern/central Europe, Mexico, and Asia-Pacific regions.• With the implementation of stricter TB screening and risk evaluations in 2007, especially in high TB incidence countries, there was a notable reduction TB occurrence.• Safety profile o...
Source: Clinical Rheumatology - August 1, 2020 Category: Rheumatology Source Type: research

Preconceived notions about biosimilars —a French experience
AbstractSince the arrival of the first biosimilar monoclonal antibodies into the market, many information has been circulating, leading to preconceived notions for patients and healthcare professionals. In a pressing economic context and faced with a growing number of available biosimilars, we (clinician, patient association, biologist, pharmacists, health economists) propose to take stock by trying to distinguish facts from misconceptions. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - July 6, 2020 Category: Rheumatology Source Type: research

Comment on “Colchicine may not be effective in COVID-19 infection; it may even be harmful?”
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - July 6, 2020 Category: Rheumatology Source Type: research

Colchicine as a possible therapeutic option in COVID-19 infection
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - July 6, 2020 Category: Rheumatology Source Type: research

Correction to: Anti-cyclic citrullinated peptide antibody in the cerebrospinal fluid in patients with rheumatoid arthritis who have central nervous system involvement
The authors regret that the original published version of the above article contained errors. The authors requested that these be noted. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - July 6, 2020 Category: Rheumatology Source Type: research

The rationale for the use of colchicine in COVID-19: comments on the letter by Cumhur Cure M et al.
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - July 6, 2020 Category: Rheumatology Source Type: research

Impact of anti-rheumatic drugs and steroids on clinical course and prognosis of COVID-19
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - July 6, 2020 Category: Rheumatology Source Type: research

COVID-19 and Kawasaki disease: an analysis using Google Trends
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - July 6, 2020 Category: Rheumatology Source Type: research