Comment on: Epidemiology of biopsy-confirmed giant cell arteritis in southern Sweden —an update on incidence and first prevalence estimate: reply
Dear Editor, We thank Yanget al. [1] for their letter and their interest in our article entitled ‘Epidemiology of biopsy-confirmed GCA in southern Sweden—an update on incidence and first prevalence estimate’ [2]. (Source: Rheumatology)
Source: Rheumatology - July 16, 2021 Category: Rheumatology Source Type: research
Comment on: Epidemiology of biopsy-confirmed giant cell arteritis in southern Sweden —an update on incidence and first prevalence estimate
Dear Editor, We commend Stamatiset al., who identified a pattern of seasonal variation in the incidence of GCA in a Swedish cohort with positive temporal artery biopsy (TAB) [1]. Over a 23-year study period, more diagnoses were made in the spring and summer. There was also a fall in the incidence of 2% per year. Proposed explanations regarding environmental risk factors for GCA, including the latitude and altitude of study populations, remain unproven. The present paper adds to a growing literature of conflicting findings in the epidemiological landscape of GCA. Other studies, including some within Scandinavia, report more...
Source: Rheumatology - July 15, 2021 Category: Rheumatology Source Type: research
Diagnosing giant cell arteritis: a comprehensive practical guide for the practicing rheumatologist
AbstractGCA is the most common large vessel vasculitis in the elderly population. In recent years, advanced imaging has changed the way GCA can be diagnosed in many locations. The GCA fast-track clinic approach combined with US examination allows prompt treatment and diagnosis with high certainty. Fast-track clinics have been shown to improve prognosis while being cost effective. However, all diagnostic modalities are highly operator dependent, and in many locations expertise in advanced imaging may not be available. In this paper, we review the current evidence on GCA diagnostics and propose a simple algorithm for diagnos...
Source: Rheumatology - July 13, 2021 Category: Rheumatology Source Type: research
Efficacy of baricitinib for refractory large-vessel vasculitis
Rheumatology key messageBaricitinib could be an efficient alternative option in refractory large-vessel vasculitis. (Source: Rheumatology)
Source: Rheumatology - July 11, 2021 Category: Rheumatology Source Type: research
Delayed diagnosis in axial spondyloarthritis —how can we do better?
The wide-reaching benefits of prompt diagnosis and treatment have long been demonstrated in RA [1,2]. A ‘window of opportunity’ for treatment initiation is reflected in clinical guidelines and drives efforts to reduce iagnostic delay, for example by establishing early arthritis services. Although international guidelines have advocated prompt referral and treatment initiation in axial spondyloarth ritis (axSpA) [3], this approach has been severely hampered by a number of unique challenges. A recent systematic review and metanalysis undertaken by Zhao and colleagues confirms a mean delay of 6.7 years, which did not i...
Source: Rheumatology - July 9, 2021 Category: Rheumatology Source Type: research
Impact of the COVID-19 pandemic on treat-to-target strategies and physical consultations in & gt;7000 patients with inflammatory arthritis
ConclusionIn this nationwide study performed during the first 8 months of the pandemic, patient satisfaction was high and the PROs and remission rates remained stable despite the remarkable reduction in physical consultations, as well as in patients with early disease. Characteristics of patients with/without physical consultations appeared similar. (Source: Rheumatology)
Source: Rheumatology - June 19, 2021 Category: Rheumatology Source Type: research
Ticagrelor added to methotrexate improves rheumatoid arthritis disease severity
AstraZeneca10.13039/100004325American Heart Association Career Development18CDA34080540National Institutes of Health10.13039/100000002K23 Career Development AwardHL152013-01A1 (Source: Rheumatology)
Source: Rheumatology - June 17, 2021 Category: Rheumatology Source Type: research
Cryoglobulinaemic vasculitis diagnostic and treatment recommendations
Rheumatology key messagesIt is important to exclude an underlying haematological malignancy/plasma cell dyscrasia.When deciding on therapy, it is important to assess if organ-threatening disease is present.Plasma exchange and rituximab are effective for severe disease.Rituximab without plasma exchange can cause a flare which may need additional steroid. (Source: Rheumatology)
Source: Rheumatology - June 16, 2021 Category: Rheumatology Source Type: research
Extracorporeal membrane oxygenation for life-threatening ANCA-associated vasculitis with pulmonary haemorrhage
Rheumatology key messagesPlasma exchange remains an intervention that should be considered in patients with respiratory failure secondary to ANCA-associated pulmonary haemorrhage.ECMO may also be life-saving in patients with life-threatening ANCA-associated pulmonary haemorrhage. (Source: Rheumatology)
Source: Rheumatology - June 16, 2021 Category: Rheumatology Source Type: research
Pneumocystis jirovecii following rituximab
Rheumatology key messagesPneumocystis jirovecii pneumonia is an important differential in the immunosuppressed patient with new onset breathlessness.The onset ofPneumocystis jirovecii pneumonia may rapidly follow commencement of immunosuppression.With increasing use of prophylaxis againstPneumocystis jirovecii pneumonia, clinicians should be aware of potential drug toxicities. (Source: Rheumatology)
Source: Rheumatology - June 16, 2021 Category: Rheumatology Source Type: research
Therapeutic dilemmas in relapsing renal ANCA-associated vasculitis
Rheumatology key messagesEarly withdrawal of immunosuppression/steroids, persistent ANCA positivity and the use of cyclophosphamide- sparing induction regimens may increase relapse risk.Renal biopsies may identify more than one pathology, and are particularly valuable when AAV treatment response is suboptimal.PLEX should be considered for severe or refractory renal AAV. (Source: Rheumatology)
Source: Rheumatology - June 16, 2021 Category: Rheumatology Source Type: research
An 80-year-old man with headache, orbital pain and elevated ESR: challenges in the diagnosis of a patient with suspected giant cell arteritis
Rheumatology key messagesThe diagnosis of GCA exclusively based on clinical judgment may have substantial pitfalls.Optimal approach to diagnosis may require combination of clinical, serological, imaging and histopathological data. (Source: Rheumatology)
Source: Rheumatology - June 16, 2021 Category: Rheumatology Source Type: research
Aggressive vasculitis after lung transplantation for cystic fibrosis
Rheumatology key messagesAggressive medium- and large-vessel vasculitis can occur in association with advanced cystic fibrosis post-lung transplantation.Chronic infection in cystic fibrosis may drive inflammation and vasculitis.CYC can be used to treat life-threatening vasculitis in cystic fibrosis patients provided adequate antimicrobial cover is given. (Source: Rheumatology)
Source: Rheumatology - June 16, 2021 Category: Rheumatology Source Type: research
Acute renal allograft failure in a patient with vasculitis
Rheumatology key messagesRecurrence of AAV after renal transplant is rare but can occur.Concomitant pathologies can coexist, emphasizing the importance of approaching each case with an open mind and a high index of suspicion and obtaining all objective data available.sCD163 is a novel non-invasive urine biomarker for the detection of glomerular inflammation (e.g. AAV relapse).The use of molecular analysis in conjunction with machine learning algorithms, through MMDx-Kidney, can augment the standard of care in the workup of renal transplant dysfunction. (Source: Rheumatology)
Source: Rheumatology - June 16, 2021 Category: Rheumatology Source Type: research
A rare life-threatening presentation of Takayasu arteritis
Rheumatology key messagesMyocarditis is a rare life-threatening complication of Takayasu arteritis, while subclinical myocarditis may be more common.Cardiac MRI is a sensitive, non-invasive imaging modality used to aid the diagnosis of myocarditis.Treatment of life-threatening Takayasu arteritis involves high-dose prednisolone, cyclophosphamide and increasingly, biologic therapies.Surgical interventions, either endovascular or open, should be conducted once disease is in remission wherever possible. (Source: Rheumatology)
Source: Rheumatology - June 16, 2021 Category: Rheumatology Source Type: research
