Discordance between doctor and patient assessments and non-adherence to subcutaneous biological drugs
AbstractTo estimate the agreement level between patient and physician assessment of disease activity and to explore whether agreement is associated with adherence to subcutaneous (SC) biological drugs in rheumatoid arthritis (RA). Cross-sectional study of RA patients who had been prescribed a SC biological drug in the past 12 –18 months was performed. Patients and physicians global disease activity on visual analogue scale (VAS) were collected. Disagreement was defined as an absolute difference ≥ 3 points between VAS scores. Adherence was assessed by the Medication Possession Ratio (MPR), consider...
Source: Rheumatology International - April 16, 2019 Category: Rheumatology Source Type: research

Use of high-resolution vessel wall magnetic resonance imaging in the diagnosis of temporal arteritis
(Source: Rheumatology International)
Source: Rheumatology International - April 16, 2019 Category: Rheumatology Source Type: research

Adalimumab in the treatment of pediatric Beh çet’s disease: case-based review
AbstractBeh çet’s disease (BD) is a systemic vasculitis affecting prominently the veins, which is usually diagnosed in adulthood, but can occur in children younger than 16 years in about 4–26% of cases. The therapy is based on several immune-suppressive drugs; in case of inadequate control and/or complica tions, the biologic therapy with anti-TNF drugs has been successfully used in adults. Here, we reported one pediatric case of BD with systemic (persistent/recurrent high fever), skin and mucosal manifestations (recurrent aphthous stomatitis, anal/penile ulcers, erythema nodosum and papulo-pustules)...
Source: Rheumatology International - April 11, 2019 Category: Rheumatology Source Type: research

Successful arthroscopic treatment of refractory and complicated popliteal cyst associated with rheumatoid arthritis in combination with osteoarthritis: case series and literature review
The objective of this study was to report four patients with RA (six knees) in combination with OA with a brief review of literature of previous similar published cases. This is a retrospective review of case records of patients with refractory and/or complicated popliteal cysts, who have successfully treated with arthroscopic intervention. We suggest that arthroscopic interventions such as radical debridement, synovectomy, biomechanical valve excision, and/or cystectomy should be considered in patients with refractory and complicated popliteal cysts associated with RA or RA in combination with OA. (Source: Rheumatology International)
Source: Rheumatology International - April 11, 2019 Category: Rheumatology Source Type: research

Clinical use of anti-DFS70 autoantibodies
AbstractThe dense fine speckled (DFS) nuclear pattern is one of the most common indirect immunofluorescence (IIF) patterns detected during routine anti-nuclear antibody (ANA) screening. There is a negative association between anti-DFS70 status and systemic autoimmune rheumatic disease (SARD), especially in the absence of concomitant SARD-specific autoantibodies. The purpose of this study was to determine the need for confirming anti-DFS70 status when a DFS pattern is observed in IIF-ANA. The frequency of anti-DFS70 detection on Western blot and the positive rate of connective tissue disease (CTD)-related autoantibody scree...
Source: Rheumatology International - April 10, 2019 Category: Rheumatology Source Type: research

Correction to: Systemic vasculitis involving the breast: a case report and literature review
The article “Systemic vasculitis involving the breast: a case report and literature review” written by Jinxia Zhao, was originally published electronically on the publisher’s internet portal (currently SpringerLink) on March 14, 2019 with open access. With the author(s) decision to step back from Open Cho ice, the copyright of the article changed to ©Springer-Verlag GmbH Germany, part of Springer Nature 2019 and the article is forthwith distributed under the terms of copyright.The original article has been corrected. (Source: Rheumatology International)
Source: Rheumatology International - April 10, 2019 Category: Rheumatology Source Type: research

Evaluation of serum fibroblast growth factor-23 in patients with axial spondyloarthritis and its association with sclerostin, inflammation, and spinal damage
AbstractThe mechanisms underlying new bone formation in individuals with axial spondyloarthritis (axSpA) remain unclear; however, low levels of sclerostin (SOST) may be associated with development of syndesmophytes in those with ankylosing spondylitis (AS). Expression of fibroblast growth factor-23 (FGF-23), another osteocyte factor, is high in those with osteoporosis and chronic renal failure, but levels in those with axSpA are unknown. To evaluate serum FGF-23 and SOST levels in axSpA patients, and to assess their relationship with inflammation and structural damage. In total, 109 axSpA patients (55 with AS and 54 with...
Source: Rheumatology International - April 9, 2019 Category: Rheumatology Source Type: research

Leveraging Google Trends to investigate the global public interest in rheumatoid arthritis
This study aims to investigate the global public interest in rheumatoid arthritis by evaluating search term popularity changes of the disease over a decade. Google Trends was applied to retrieve search popularity scores for the term ‘rheumatoid arthritis’ between January 2004 and December 2017, utilizing the category of “health”. Overall, relative searches volume for rheumatoid arthritis steadily decreased from January 2004 to December 2010, and then slowly rose from January 2011 to December 2017. There were significant seasonal variations in relative searches volume for the term ‘rheumatoid a...
Source: Rheumatology International - April 6, 2019 Category: Rheumatology Source Type: research

Secretory factors produced by adipose mesenchymal stem cells downregulate Th17 and increase Treg cells in peripheral blood mononuclear cells from rheumatoid arthritis patients
AbstractWe aimed to assess the immunoregulatory effects of secretory factors produced by adipose tissue-derived MSC (AT-MSC) on Th17 and Treg subsets from patients with rheumatoid arthritis (RA). 17 patients with active disease matching the ACR/EULAR 2010 criteria for RA were included. Patients ’ peripheral blood mononuclear cells (PBMC) were cultured in AT-MSC-conditioned medium (AT-MSCcm) and in control medium. The cytokine production of AT-MSC and PBMC was quantified by ELISA. Th17 and Treg were determined by flow cytometry. AT-MSCcm contained: IL-6, IL-17, IL-21, CCL2, CCL5, IL-8, sV EGF-A and PGE2. Cultivation o...
Source: Rheumatology International - April 3, 2019 Category: Rheumatology Source Type: research

Translation, cross-cultural adaptation and validation of the Osteoarthritis Quality of Life (OAQoL) questionnaire for use in Portugal
AbstractOsteoarthritis (OA) is the most prevalent rheumatic disease and is a leading cause of decreased quality of life (QoL). The OA Quality of Life questionnaire (OAQoL) is an OA-specific patient-reported outcome measures. The aim of this study was to translate and validate the original UK English version of the Osteoarthritis Quality of Life (OAQoL) questionnaire into European Portuguese. The translation of the questionnaire was carried out according to a dual panel methodology (bilingual panel followed by lay panel). This was followed by cognitive debriefing interviews (CDIs) with OA patients to assess comprehension an...
Source: Rheumatology International - March 27, 2019 Category: Rheumatology Source Type: research

Disability due to rheumatic diseases in the city of Jun ín, Argentina
AbstractThe aim of the study is to analyze the characteristics of patients with rheumatic diseases applying for a Disability Certificate (DC). Every application for DC filed by patients of 16 years of age and older in the Health Secretariat of Junin, between 2012 and 2016, was analyzed regarding age, gender, rheumatic disease as the cause of disability, employment status, and health insurance coverage. Applications were examined as per two elements: inflammatory articular or systemic disease (IASD) versus degenerative diseases, regional or generalized pain syndromes (non-IASD). Based on the DCs accepted, a Disability Preva...
Source: Rheumatology International - March 27, 2019 Category: Rheumatology Source Type: research

Stress proteins in the pathogenesis of spondyloarthritis
AbstractSpondyloarthritis is an autoinflammatory rheumatic disease in which arthritis and osteoproliferation lead the patients who suffer from it to chronic disability. This disease is associated with the expression of class I MHC molecule HLA-B27, which tends to be misfolded in the endoplasmic reticulum and, therefore, expressed in aberrant forms. This phenomena lead to endoplasmic reticulum stress, which in time, evokes a whole response to cellular injury. Under these conditions, the molecules involved in restoring cell homeostasis play a key role. Such is the case of the “heat-shock proteins”, which usually ...
Source: Rheumatology International - March 27, 2019 Category: Rheumatology Source Type: research

Early arthritis clinic is effective for rheumatoid and psoriatic arthritides
We examined whether EACs provide better outcomes irrespective of final arthritis diagnosis.MethodsA 52-week prospective observational study of all inflammatory arthritis patients presenting to early arthritis service at our secondary care hospital in 2016 was undertaken. A protocolised approach to the early initiation of therapy (within 3  weeks) and 6-weekly review of treatment outcomes was embedded irrespective of the arthritis diagnosis. Statistical analysis was undertaken using Mann–WhitneyU test for disease activity scores to ascertain the significance of outcomes.ResultsOf 1884 patients referred, 482 (25.5...
Source: Rheumatology International - March 27, 2019 Category: Rheumatology Source Type: research

Mexican rheumatology: where do we stand?
AbstractThe aim of this review was to provide an overall overview of the past, present, and future situations and main challenges that are facing Mexican Rheumatology as a medical subspecialty in the context of their national healthcare system, where a deficit of workforce at the national level coexists with a shortage of specialists in the less-developed southern states of the country and a great surplus of professionals within large metropolitan areas. We also analyzed the prevalence and burden of Rheumatic and Musculoskeletal Diseases (RMDs), the structural composition and distribution of Mexican Rheumatology, and the c...
Source: Rheumatology International - March 27, 2019 Category: Rheumatology Source Type: research

Parameters of arterial stiffness in patients with Beh çet’s disease and their relationship with disease duration
AbstractThe results of investigations of arterial stiffness in Beh çet’s disease (BD) are contradictory and the reason for this contradictory situation is not clear. The lack of studies in homogenous groups according to the duration of the disease may be the cause of conflicting results. To compare arterial stiffness by assessing pulse wave velocity (PWV) and au gmentation index (AIx) measurements in healthy controls (HC) and patients diagnosed with BD with short and long disease duration. This cross-sectional study was conducted between August-November 2017 and 54 patients with BD and 34 HC were included. Pat...
Source: Rheumatology International - March 26, 2019 Category: Rheumatology Source Type: research

Evidence synthesis of types and intensity of therapeutic land-based exercises to reduce pain in individuals with knee osteoarthritis
The objective of this study is to construct an evidence synthesis to identify the types of land-based exercises most investigated in the current literature, the intervention duration, frequency of the programs and the exercises which are most frequently implemented. A search was performed on the reference list of included and excluded studies of one systematic review, on land-based exercises for knee osteoarthritis and, an updated search of The Cochrane Library, Embase, CINAHL and PEDro was completed. Two authors independently selected the studies and a third author was consulted for an additional opinion. The inclusion cr...
Source: Rheumatology International - March 26, 2019 Category: Rheumatology Source Type: research

Modifiable risk factors in knee osteoarthritis: treatment implications
The objectives of the present narrative review were to identify, summarize, and cluster all the potentially modifiable risk factors that influence the course of KOA, and discuss their susceptibility to alteration via personal, clinical, and public strategy. For this purpose, Pubmed and Scopus databases were queried using the terms “knee osteoarthritis”, “risk factors” and “improvement”. Six main categories of modifiable risk factors were identified: (1) obesity and overweight, (2) comorbidity, (3) occupational factors, (4) physical activity, (5) biomechanical factors, (6) dietary exposur...
Source: Rheumatology International - March 25, 2019 Category: Rheumatology Source Type: research

Retrospective study of the course, treatment and long-term follow-up of Kawasaki disease: a single-center experience from Poland
AbstractKawasaki disease (KD) is an acute, self-limited, systemic vasculitis and the most common cause of acquired coronary artery disease in pediatric population in the developed countries. It occurs mostly in Asian countries; however, due to better access to diagnostic and imaging tests, it is more frequently diagnosed among pediatric patients in Poland. The aim of this study was to describe the clinical course with special interest in cardiac involvement, treatment and follow-up of Polish patients with KD. It is a single-center retrospective study. Clinical features (including coronary involvement), laboratory results a...
Source: Rheumatology International - March 22, 2019 Category: Rheumatology Source Type: research

The impact of physical activity on serum levels of inflammatory markers in rheumatoid arthritis: a systematic literature review
AbstractThis review aims to determine the specific effects of PA on systemic levels of interleukins and inflammatory markers. A systematic literature search was conducted in three computerized bibliographic databases (Medline, Embase, CENTRAL) to identify randomized controlled trials and matched case studies. Applied key words were: RA and PA including the terms exercise, exercise therapy, gymnastics and exercise movement techniques. Inclusion criteria were data on all types of proinflammatory interleukins (IL), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). For data synthesis, the populations, interven...
Source: Rheumatology International - March 21, 2019 Category: Rheumatology Source Type: research

Clinical relevance of monitoring serum adalimumab levels in axial spondyloarthritis
AbstractOur aim was  to assess the relationship between serum adalimumab levels, anti-drug antibodies (ADA) and disease activity in patients with axial spondylarthritis (SpA). We have carried out a single-centre cross-sectional study. adalimumab and ADA levels were analysed with ELISA and correlated with SpA activity using BASDAI and ASDAS scores. Adalimumab cut-off value was calculated to discriminate inactive disease/low disease activity (BASDAI 
Source: Rheumatology International - March 21, 2019 Category: Rheumatology Source Type: research

ESSDAI activity index of the SJ ÖGRENSER cohort: analysis and comparison with other European cohorts
The objective of the study was to assess the ESSDAI index characteristics in the SJ ÖGRENSER cohort (Spanish Rheumatology Association’s registry of patients with Primary Sjögren Syndrome [PSS]). SJÖGRENSER is a prospective multicentric study on a cohort of Spanish patients with PSS who meet the 2002 American–European consensus from rheumatology units. 298 variables were stud ied in patients for the inclusion of the study from an anonymous list from each department. The ESSDAI (EULAR Sjögren’s syndrome disease activity index) includes 12 domains and measures systematic activity in PSS p...
Source: Rheumatology International - March 19, 2019 Category: Rheumatology Source Type: research

Rheumatology practice in Japan: challenges and opportunities
This article aims to and describes the characteristics of rheumatology practice in Japan, focusing on the medical environment for the treatment of rheumatoid arthritis (RA). In Japan, the introduction of biological disease-modifying anti-rheumatic drugs (bDMARDs) has led to a significant paradigm shift in medical care; satisfactory safety outcomes have been demonstrated by periodic analysis, post-market surveillance and the development of guidelines via an industry –academia–government collaboration. Drug discontinuation is also considered an option, as well as medical economic analysis of any increase in the f...
Source: Rheumatology International - March 19, 2019 Category: Rheumatology Source Type: research

Clinical course of abdominal aortic aneurysms in Beh çet disease: a retrospective analysis
This study aimed to investigate the clinical course of BD patients with abdominal aortic aneurysms (AAA). We retrospectively searched charts of BD patients, followed up between 1988 and 2011, to identify those with AAA with at least 6-month clinic al and radiological follow-up data. Chart review revealed 12 patients (11 males) with AAA amongst 1224 patients; follow-up data from 11 patients were available. The most common symptoms were lower back and abdominal pain. The only pre-treatment complication was a spontaneous rupture. All but one pat ient received corticosteroid and cyclophosphamide pulses for the induction, and c...
Source: Rheumatology International - March 19, 2019 Category: Rheumatology Source Type: research

Correction to: Diagnostic utility of a targeted next-generation sequencing gene panel in the clinical suspicion of systemic autoinflammatory diseases: a multi-center study
The second affiliation of the corresponding author Eda Tahir Turanl ı was incorrectly published as İstanbul Medeniyet University instead of Istanbul Technical University. (Source: Rheumatology International)
Source: Rheumatology International - March 18, 2019 Category: Rheumatology Source Type: research

Should nasal biopsy inevitably be performed for classifying granulomatosis with polyangiitis in patients with rhinosinusitis? A retrospective chart review study
In conclusion, PR3-ANCA (or C-ANCA) positivity, GPA-specific lung lesions and cartilaginous involvement could help physicians in charge make a final diagnosis of GPA in cases unable for nasal biopsy. (Source: Rheumatology International)
Source: Rheumatology International - March 18, 2019 Category: Rheumatology Source Type: research

Progression of atherosclerosis versus arterial stiffness with age within and between arteries in systemic lupus erythematosus
AbstractThe progression of atherosclerosis versus arterial stiffness with age within and between arteries has not been defined. Systemic lupus erythematosus (SLE) is a human model of accelerated arterial disease that may permit this determination. 76 SLE patients (69 women, age 37  ± 12 years) and 26 age-and-sex-matched controls (22 women, age 34 ± 11 years) underwent transesophageal echocardiography and carotid ultrasonography for assessment of atherosclerosis [plaques and intima–media thickening (IMT)] and arterial stiffness [increased pressure-strain elastic modu...
Source: Rheumatology International - March 16, 2019 Category: Rheumatology Source Type: research

Unmet needs in the treatment of ankylosing spondylitis: a long-term observational study from a single university center
AbstractDespite the progress in the treatment of ankylosing spondylitis (AS), a significant number of patients do not achieve low disease activity (LDA). The aim of the study is to estimate the size of unmet needs in the treatment of AS in a long-term observational study. Between January 2003 and December 2017, 220 patients with radiographic SpA were evaluated fulfilling the ASAS criteria. They were followed up at predefined times and were naive to biological treatment with anti-tumor necrosis factor agents (anti-TNFs) and the interleukin (IL)-17 inhibitor. NSAIDs, all anti-TNFs and the IL-17 inhibitor secukinumab were use...
Source: Rheumatology International - March 15, 2019 Category: Rheumatology Source Type: research

Is it required to routinely check fibrinogen level in patients with rheumatic diseases on tocilizumab? Case-based review
AbstractTocilizumab (TCZ) may rarely cause hematological side effects including neutropenia and thrombocytopenia. TCZ is essentially expected to lower the fibrinogen levels to stay within the normal range, but TCZ-induced hypofibrinogenemia has been rarely reported in literature. Although it may remain asymptomatic, hypofibrinogenemia has clinical significance owing to the tendency of the condition to result in bleeding. A 65-year-old female patient with known polymyositis was, approximately 20  years after the diagnosis was made, examined due to elevated acute phase reactants leading to the diagnosis of giant cell ar...
Source: Rheumatology International - March 14, 2019 Category: Rheumatology Source Type: research

Systemic vasculitis involving the breast: a case report and literature review
We report a case of PAN affecting the right breast in a young woman. A retrospective review was performed by searching Medline, Embase, Web of Science, the Cochrane Library, and Scopus for cases of systemic vasculitis involving the breast written in English up to June 1st, 2018. A 27-year-old woman presented with a painful mass in the right breast was diagnosed as PAN by the biopsy. She was treated with prednisone and methotrexate for 6  months, at which time her condition had stabilized and inflammatory markers had normalized. A total of 66 cases were identified, with granulomatosis with polyangiitis (GPA), giant cel...
Source: Rheumatology International - March 14, 2019 Category: Rheumatology Source Type: research

Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio as predictors of 12-week treatment response and drug persistence of anti-tumor necrosis factor- α agents in patients with rheumatoid arthritis: a retrospective chart review analysis
AbstractData are scarce regarding the association of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with treatment response and persistence of anti-TNF- α agents in patients with rheumatoid arthritis (RA). Thus, we investigated whether baseline NLR and PLR could predict 12-week treatment response and long-term persistence of anti-TNF-α agents in RA patients. This is a retrospective chart review analysis of 82 women with RA who started anti-TNF-α agents as the first-line biologic therapy and 328 healthy age-matched women. RA patients were divided into high and low baseline NLR ...
Source: Rheumatology International - March 14, 2019 Category: Rheumatology Source Type: research

Analysis of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and mean platelet volume to platelet count ratio in children with acute stage of immunoglobulin A vasculitis and assessment of their suitability for predicting the course of the disease
AbstractImmunoglobulin A vasculitis (IgAV) is the most common systemic vasculitis in developmental age. The disease is most often characterized by a self-limiting course and good prognosis, but sometimes serious complications, like gastrointestinal bleeding or glomerulonephritis, may develop. The neutrophil to lymphocyte (NLR) and the platelet to lymphocyte (PLR) ratios are indicators related to clinical outcome in various inflammatory diseases. The mean platelet volume to platelet count ratio (MPR) has not been evaluated in patients with IgAV. The aim of this study was to analyze the values of the NLR, PLR and MPR in pati...
Source: Rheumatology International - March 13, 2019 Category: Rheumatology Source Type: research

Color Doppler imaging of ocular hemodynamic changes in patients with rheumatoid arthritis unrelated to disease activity
AbstractWe aimed to investigate how orbital blood flow rates in patients with rheumatoid arthritis (RA) are affected by the active and remission phase of the disease. This prospective study included a total of 56 patients with RA (study group) and 24 control individuals (control group). All RA patients were divided into two groups, as active (Group 1) and remission (Group 2) according to the disease activity index (DAS 28) score. For each eye, retrobulbar vascular structures were evaluated [central retinal artery (CRA), posterior ciliary artery (PCA), and ophthalmic artery (OA)], respectively. The peak systolic velocity (P...
Source: Rheumatology International - March 12, 2019 Category: Rheumatology Source Type: research

Behaviour change interventions targeting physical activity in adults with fibromyalgia: a systematic review
AbstractPhysical activity (PA) and exercise programmes are recommended for the management of fibromyalgia. Despite positive effects on symptoms and function, PA promotion remains a significant clinical challenge. Behaviour change theories and techniques are recommended as part of complex health interventions; their integration into interventions aimed at PA behaviour in people with fibromyalgia is not known. This review explored behaviour change interventions targeting PA in adults with fibromyalgia. A systematic review was conducted; randomized and quasi-randomized controlled trials with at least one behaviour change inte...
Source: Rheumatology International - March 12, 2019 Category: Rheumatology Source Type: research

Fatty infiltration in the thigh muscles in knee osteoarthritis: a systematic review and meta-analysis
The objective of this study is to systematically review the literature comparing the amount of fatty infiltration between people with knee osteoarthritis and healthy controls. A literature search on the databases MEDLINE, Embase, CINAHL SPORTDiscuss, Web of Science and Scopus from insertion to December 2018, resulted in 1035 articles, from which 7 met inclusion/exclusion criteria and were included in the review. All included studies analyzed the difference in intermuscular fat and only one study analyzed intramuscular fat. A meta-analysis (random effects model) transforming data into standardized mean difference was perfor...
Source: Rheumatology International - March 9, 2019 Category: Rheumatology Source Type: research

Real-world incidence and prevalence of low back pain using routinely collected data
AbstractLow back pain (LBP) is a common health problem among adults of working age population, and its prevalence or incidence increases with increasing in age. The purpose of this review was to examine the real-world prevalence or incidence of LBP. A systematic review of the literature was conducted in accordance to the PRISMA guideline. Allied and Complementary Medicine Database, Cumulative Index of Nursing and Allied Health Literature, MEDLINE, SportDiscuss and Scopus electronic databases were searched using specifically developed search strategies to identify studies using patients ’ electronic medical records pu...
Source: Rheumatology International - March 8, 2019 Category: Rheumatology Source Type: research

Association between disease activity measured by RAPID3 and health-related quality of life in patients with rheumatoid arthritis
AbstractRoutine assessment of patient index data 3 (RAPID3) is a simple, valid and reliable tool designed to measure disease activity in patients with rheumatoid arthritis (RA). RA causes significant disability and diminishes health-related quality of life (HR-QoL). The aim of this study was to investigate how RAPID3 is related to HR-QoL in patients with RA. In this cross-sectional study performed at the tertiary outpatient clinic 68 consecutive patients (58 females, and 10 males) with established RA were enrolled. RAPID3 and EuroQoL-5D-3L (EQ-5D-3L) were used to measure disease activity and quality of life, respectively. ...
Source: Rheumatology International - March 7, 2019 Category: Rheumatology Source Type: research

Accuracy, completeness and accessibility of online information on fibromyalgia
AbstractFibromyalgia is a multi-factorial illness primarily characterised by widespread chronic pain and fatigue, with several symptoms and associated conditions. Due to a lack of clinical awareness and an absence of objective diagnostic measures, fibromyalgia patients often engage with online health information. The aim is to investigate the completeness and trustworthiness of the information available online on fibromyalgia. Google.co.uk was searched for ‘fibromyalgia’, the first 200 webpages were imported and 148 were analysed for standard health information quality criteria (JAMA score, HONcode) as well as ...
Source: Rheumatology International - March 6, 2019 Category: Rheumatology Source Type: research

Challenges in the diagnosis and treatment of disabling pansclerotic morphea of childhood: case-based review
We describe the challenges in treating a previously well 5-year-old male who has refractory symptoms of DPMC. Over the 29  months, since his initial presentation, we trialed over ten therapies. There was subjective improvement with prednisolone and mycophenolate mofetil (MMF). However, other therapies including biologics and tyrosine kinase inhibitors (TKI) were ineffective. The patient has been referred for hematopoi etic stem cell transplant given ongoing disease progression. We conducted a literature search focusing on English articles with keywords including DPMC. Publications with limited information or describin...
Source: Rheumatology International - March 5, 2019 Category: Rheumatology Source Type: research

Use of systemic glucocorticoids in patients with psoriatic arthritis by Argentinian and other Latin-American rheumatologists
AbstractTo analyse the administration of systemic glucocorticoids (SGC) to patients with Psoriatic arthritis (PsA). Online, anonymous, multiple-choice, closed-ended survey on SGC use in PsA, dose, duration of therapy, and the reason for administration. One hundred and twenty rheumatologists from Argentina (ARG) and 75 from other countries in Latin-America (LAT) completed the survey. Only 6% of the respondents indicated that they did not prescribe SGC, and 65% claimed that they administered them to less than 10% of their patients. Among those physicians who used SGC, 71% prescribed between 5 and 10  mg/day of prednison...
Source: Rheumatology International - March 4, 2019 Category: Rheumatology Source Type: research

Factors associated with long-term retention of treatment with golimumab in a real-world setting: an analysis of the Spanish BIOBADASER registry
AbstractThe retention rate of a biological drug (percentage of patients remaining on treatment over time) provides an index of a drug ’s overall effectiveness. The golimumab retention rate as first-line biological therapy was high in clinical trial extensions lasting 5 years. Real-world studies also indicate good retention rates but have been of shorter duration. The probability of retention with golimumab treatment was assesse d, as any line of anti-tumor necrosis factor-alpha therapy, for up to 5 years in patients with rheumatoid arthritis (RA), axial spondyloarthritis (SpA) or psoriatic arthritis (PsA), ...
Source: Rheumatology International - February 12, 2019 Category: Rheumatology Source Type: research

Self-reported disease severity in women with systemic lupus erythematosus
AbstractSystemic lupus erythematosus (SLE), pathology with net feminine predominance, is one of the most complex autoimmune diseases and has major impact on patients ’ life. The aim is to identify patient and disease-related factors associated with self-perceived disease severity in female SLE patients. This cross-sectional study enrolled 73 women fulfilling the 2012 Systemic Lupus International Collaborating Clinic (SLICC) criteria. SLE disease activity was a ssessed by the Systemic Lupus Activity Measure (SLAM) score and overall damage by the SLICC/American College of Rheumatology (ACR) index. Patients’ gener...
Source: Rheumatology International - February 12, 2019 Category: Rheumatology Source Type: research

Factors related to alexithymia in patients with systemic sclerosis: a tight relationship with facial image dissatisfaction
AbstractTo assess clinical and psychosocial factors related to alexithymia in systemic sclerosis (SSc). We enrolled 40 consecutive SSc patients in a cross-sectional study evaluating alexithymia with Toronto Alexithymia scale (TAS-20). We measured Beck Depression inventory (BDI), Hamilton Anxiety rating scale (HAM-H), 36-Items Short-Form Healthy Survey (SF-36), Functional Assessment of Chronic Illness Therapy (FACIT) —Fatigue, Visual Analog Scale (VAS) pain, Pittsburgh Sleep Quality Index (PSQI), Satisfaction with Appearance Scale (SWAP), and Mouth Handicap in Systemic Sclerosis (MHISS). The prevalence of alexithymia ...
Source: Rheumatology International - February 12, 2019 Category: Rheumatology Source Type: research

Persistence with biological drugs in patients treated in rheumatology practices in Germany
This study included patients diagnosed with rheumatoid arthritis (RA), psoriatic arthritis (PA), or ankylosing spondylitis (AS) who received a first prescription of biological drugs between 2008 and 2016 (index date) in 21 rheumatology practices in Germany (n = 4925; Disease Analyzer database). The main outcome measure was the rate of persistence within 5 years of the index date. Kaplan–Meier analyses were performed to study treatment persistence as a function of diagnosis, gender and age. A Cox proportional hazards regression model was used to e stimate the relationship between non-persistence and...
Source: Rheumatology International - February 12, 2019 Category: Rheumatology Source Type: research

Bulgarian rheumatology: science and practice in a cost-constrained environment
AbstractOur aim was to appraise publications from Bulgaria, to assess their global impact, and to describe features and challenges unique to the rheumatology practice in Bulgaria characterized by stringent cost constraints. The Scopus database was queried on 25th July 2018 and data on the number of published documents, their Hirsch-indices and citations number were extracted. Published Bulgarian guidelines for the management of rheumatic diseases and the presented data on Bulgarian Rheumatology Society were identified based on prior knowledge of the authors. From all the identified 1082 document the most extensively resear...
Source: Rheumatology International - February 12, 2019 Category: Rheumatology Source Type: research

Hand grip endurance moderating the effect of grip force on functional ability and disease activity in rheumatoid arthritis patients: a cross-sectional study
AbstractTo examine the effect of endurance on the relationship between grip force and measures of functional capacity and disease activity, we performed a cross-sectional study at the University Department of Rheumatology, Physical medicine and Rehabilitation from January 2017 to August 2018. Functional capacity of the hand was measured by ABILHAND-RA questionnaire and disease activity was assessed by the Disease Activity Score (DAS-28-CRP). All participants underwent dynamometric measurements of maximal grip force and hand grip endurance during repeated gripping. We analyzed the data from 34 RA patients at the median (IQR...
Source: Rheumatology International - February 12, 2019 Category: Rheumatology Source Type: research

Real-world evidence in rheumatic diseases: relevance and lessons learnt
AbstractAn emerging trend in the medical literature, including the Rheumatology literature, is that of accumulating large, multicentric, multi-national data based on registries of patients seen in real life situations. Such real-world evidence (RWE) may help provide valuable insights into the long-term outcomes of disease in unselected patients seen in daily practice, including patients belonging to vulnerable populations such as extremes of age, during pregnancy and lactation. Evidences gathered from real life practice settings can help understand drug prescription patterns, including adherence to treatment guidelines, co...
Source: Rheumatology International - February 6, 2019 Category: Rheumatology Source Type: research

Correction to: On-drug and drug-free remission by baseline symptom duration: abatacept with methotrexate in patients with early rheumatoid arthritis
The article “On-drug and drug-free remission by baseline symptom duration: abatacept with methotrexate in patients with early rheumatoid arthritis”, written by Vivian P.Bykerk, was originally published Online First without open access. (Source: Rheumatology International)
Source: Rheumatology International - February 5, 2019 Category: Rheumatology Source Type: research

Risk of hospitalization for heart failure in rheumatoid arthritis patients treated with etanercept and abatacept
AbstractTo estimate biologic influence on heart failure (HF) risk in rheumatoid arthritis. Retrospective cohort (RECORD Study of Italian Society for Rheumatology) study on administrative healthcare databases. We identified 2527 patients treated with either etanercept (n = 1690) or abatacept (n = 837). HF incidence rate was higher in the abatacept cohort than in the etanercept cohort with a 2.38 (95% CI 1.08–5.27) crude competing risk HR (SHR) for abatacept of developing HF, not confirmed after adjustment for prespecified confounders (SHR 1.43; 95% CI 0.51–3.98). Abatacept, compar ed ...
Source: Rheumatology International - February 1, 2019 Category: Rheumatology Source Type: research

Tocilizumab treatment in refractory polyarteritis nodosa: a case report and review of the literature
We present a case of a young male with refractory PAN and ongoing biopsy evidence of active vasculitis despite optimal standard therapies, who was successfully treated with interleukin-6 antagonist, tocilizumab. A 24-year-old male presented with severe immobilizing polyneuropathy and myalgias. Clinical features included fasciitis, tenosynovitis, early signs of polyneuropathy, and panniculitis, which were largely refractory to the standard therapies. The previous unsuccessful treatments included high-dose glucocorticoids, methotrexate, cyclophosphamide, rituximab, anakinra, and intravenous immunoglobulins. Magnetic resonanc...
Source: Rheumatology International - February 1, 2019 Category: Rheumatology Source Type: research

Cyclophosphamide-induced severe acute hepatitis in a rheumatic disease: case-based review
AbstractIn rheumatology practice, the risk of hepatotoxicity from medications, including non-steroidal anti-inflammatory drugs, notably, and methotrexate, sulfasalazine, leflunomide, and azathioprine is highly recognized by the rheumatologists. On the other hand, hepatotoxicity is neither a commonly expected nor a well-known side effect of cyclophosphamide (CYC) which is particularly used for vital organ involvements in systemic lupus erythematosus (SLE) and systemic vasculitis. Here we reported a 19-year-old case of SLE who, while on oral CYC treatment of 100  mg/day, was detected to have asymptomatic liver enzyme el...
Source: Rheumatology International - February 1, 2019 Category: Rheumatology Source Type: research