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  • 1
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    Characterization and outcomes of 414 patients with primary SS who developed haematological malignancies
    Oxford University Press (OUP) ; 2022
    In:  Rheumatology Vol. 62, No. 1 ( 2022-12-23), p. 243-255
    Details
    In: Rheumatology, Oxford University Press (OUP), Vol. 62, No. 1 ( 2022-12-23), p. 243-255
    Abstract: To characterize 414 patients with primary SS who developed haematological malignancies and to analyse how the main SS- and lymphoma-related features can modify the presentation patterns and outcomes. Methods By January 2021, the Big Data Sjögren Project Consortium database included 11 966 patients fulfilling the 2002/2016 classification criteria. Haematological malignancies diagnosed according to the World Health Organization (WHO) classification were retrospectively identified. Results There were 414 patients (355 women, mean age 57 years) with haematological malignancies (in 43, malignancy preceded at least one year the SS diagnosis). A total of 376 (91%) patients had mature B-cell malignancy, nearly half had extranodal marginal zone lymphoma (MZL) of mucosa-associated lymphoid tissue (MALT lymphoma) (n = 197), followed by diffuse large B-cell lymphoma (DLBCL) (n = 67), nodal MZL lymphoma (n = 29), chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) (n = 19) and follicular lymphoma (FL) (n = 17). Rates of complete response, relapses and death were 80%, 34% and 13%, respectively, with a 5-year survival rate of 86.5% after a mean follow-up of 8 years. There were significant differences in age at diagnosis (younger in MALT, older in CLL/SLL), predominant clinical presentation (glandular enlargement in MALT lymphoma, peripheral lymphadenopathy in nodal MZL and FL, constitutional symptoms in DLBCL, incidental diagnosis in CLL/SLL), therapeutic response (higher in MALT lymphoma, lower in DLBCL) and survival (better in MALT, nodal MZL and FL, worse in DLBCL). Conclusion In the largest reported study of haematological malignancies complicating primary SS, we confirm the overwhelming predominance of B-cell lymphomas, especially MALT, with the salivary glands being the primary site of involvement. This highly-specific histopathological scenario is linked with the overall good prognosis with a 5-year survival rate of nearly 90%.
    Type of Medium: Online Resource
    ISSN: 1462-0324 , 1462-0332
    URL: Article
    DOI: 10.1093/rheumatology/keac205
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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  • 2
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    Roadmap for cardiovascular education across the European Society of Cardiology: inspiring better knowledge and skills, now and for the future
    Oxford University Press (OUP) ; 2019
    In:  European Heart Journal Vol. 40, No. 21 ( 2019-06-01), p. 1728-1738
    Details
    In: European Heart Journal, Oxford University Press (OUP), Vol. 40, No. 21 ( 2019-06-01), p. 1728-1738
    Abstract: The provision of high-quality education allows the European Society of Cardiology (ESC) to achieve its mission of better cardiovascular practice and provides an essential component of translating new evidence to improve outcomes. Methods and results The 4th ESC Education Conference, held in Sophia Antipolis (December 2016), brought together ESC education leaders, National Directors of Training of 43 ESC countries, and representatives of the ESC Young Community. Integrating national descriptions of education and cardiology training, we discussed innovative pathways to further improve knowledge and skills across different training programmes and health care systems. We developed an ESC roadmap supporting better cardiology training and continued medical education (CME), noting: (i) The ESC provides an excellent framework for unbiased and up-to-date cardiovascular education in close cooperation with its National Societies. (ii) The ESC should support the harmonization of cardiology training, curriculum development, and professional dialogue and mentorship. (iii) ESC congresses are an essential forum to learn and discuss the latest developments in cardiovascular medicine. (iv) The ESC should create a unified, interactive educational platform for cardiology training and continued cardiovascular education combining Webinars, eLearning Courses, Clinical Cases, and other educational programmes, along with ESC Congress content, Practice Guidelines and the next ESC Textbook of Cardiovascular Medicine. (v) ESC-delivered online education should be integrated into National and regional cardiology training and CME programmes. Conclusion These recommendations support the ESC to deliver excellent and comprehensive cardiovascular education for the next generation of specialists. Teamwork between international, national and local partners is essential to achieve this objective.
    Type of Medium: Online Resource
    ISSN: 0195-668X , 1522-9645
    URL: Article
    DOI: 10.1093/eurheartj/ehy058
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
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  • 3
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    POS1274 A SINGLE CENTER COVID-19 VACCINE EXPERIENCE IN FAMILIAL MEDITERRANEAN FEVER PATIENTS
    BMJ ; 2022
    In:  Annals of the Rheumatic Diseases Vol. 81, No. Suppl 1 ( 2022-06), p. 973.3-974
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 81, No. Suppl 1 ( 2022-06), p. 973.3-974
    Abstract: To prevent COVID-19 disease SARS-CoV 2 vaccines put into use worldwide with emergency use authorizations despite ongoing safety concerns. Since pyrin mediated inflammasome response is dysregulated in FMF, exposure to SARS-CoV 2 proteins via vaccination may potentially trigger inflammation, leading to attacks and/or increased rate of adverse events (AE). Objectives Aim of this study to investigate frequency of adverse events and attacks related to vaccination in recipients of CoronaVac and BNT162b2 comparatively in our FMF patients. Methods Data regarding, number of vaccine doses, types of vaccines (CoronaVac or BNT162b2), presence of AEs and/or FMF attacks after any vaccine dose within a month, history of COVID-19 infection before or after vaccination, adherence to FMF treatment during vaccination were collected from hospital database or via telephone. Results A total of 161 vaccinated FMF patients were included. Mean ± SD age was 40.5 ± 11.7 years. 57.1% was female. 10.6% of the patients had chronic kidney disease and 9.3% had amyloidosis. Most common MEFV mutations were M694V heterozygous (27%) and M694V homozygous (21.6%). 93.2% of the patients were under colchicine, 21.8% under anti-interleukin 1 agents, 2.5% under TNF-a inhibitors. 96.3% of the patients adhered to FMF treatment during vaccination. Vaccination properties and data regarding adverse events are presented in Table 1. 57.8% of patients reported to suffer from an AE/attack after a vaccine dose. Number of patients with AE after BNT162b2 was significantly higher (p 〈 0.001). None of the patients had severe AEs. 39 patients had COVID-19 infection prior to primary vaccination. 61.5% of these suffered from an adverse reaction/attack after vaccination, in comparison to 56.6% of the patients without prior COVID-19 infection (p=0.584). When patients with and without AEs/attacks were compared, no significant differences were observed regarding age, gender, body mass index, comorbidities, FMF treatments and total vaccine doses. Table 1. Adverse events and FMF attacks in a total of 161 vaccine recipients BNT162b2 CoronaVac p Total vaccine doses, n 213 140 Patients ever vaccinated with BNT162b2 and CoronaVac, n (% ) 117 (72.7) 67 (41.6) Dose per patient, median (min-max ) 2 (1-4) 2 (1-4) Patients with primary vaccination completed with BNT162b2 or CoronaVac, n (%)* 88 (54.7) 57 (35.4) Patients with a booster with BNT162b2 or CoronaVac, n (% ) 23 (14.2) 14 (8.6) Patients vaccinated with BNT162b2 or CoronaVac alone, n(% ) 94 (58.4) 44 (27.3) Patients with an adverse event after any vaccine dose of n (% ) ¶ 64/117 (54.7) 20/67 (29.9) 〈 0.001 Adverse events, n (% ) ¶  Fever 13 (11.1) 6 (9.0) 0.644  Malaise 21 (17.9) 4 (6.0) 0.023  Local pain/arm pain 17 (14.5) 4 (6.0) 0.079  Arthralgia 19 (16.2) 4 (6.0) 0.043  Myalgia 6 (5.1) 0 (0.0) 0.059  Headache 11 (9.4) 0 (0.0) 0.010  Nausea 6 (5.1) 1 (1.5) 0.215  Vomiting 4 (3.4) 1 (1.5) 0.439  Others 22 (18.9) 7 (10.4) Patients with FMF attack within one month after any vaccine dose, n (% ) ¶ 26 (22.2) 13 (19.4) 0.653 Time from vaccine dose to FMF attack, days, median (IQR ) 7.0 (12.5) 10.0 (13.5) 0.758 *9.9 % of the patients had only single dose of either vaccine, ¶ Over 117 ever vaccinated with BNT162b2 and 67 ever with CoronaVac Conclusion We observed considerable number of FMF patients suffered from vaccine related AEs/attacks, particularly with BNT162b2. However, no serious AE was detected. Demographics, clinical characteristics and prior history of vaccination did not significantly affect AE/attack occurrence. Acknowledgements I have no acknowledgements to declare. Disclosure of Interests None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2022-eular.4920
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2022
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  • 4
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    AB0579 INSTRUMENTS FOR SCREENING PSORIATIC ARTHRITIS AMONG PATIENTS WITH PSORIASIS: A SYSTEMATIC LITERATURE REVIEW
    BMJ ; 2021
    In:  Annals of the Rheumatic Diseases Vol. 80, No. Suppl 1 ( 2021-06), p. 1327.1-1327
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 80, No. Suppl 1 ( 2021-06), p. 1327.1-1327
    Abstract: Timely diagnosis is essential for the optimal management of psoriatic arthritis (PsA). Several instruments have been developed for screening PsA among patients with psoriasis. However, a delay in diagnosis is still frequently reported, possibly due to the lack of a wide use of these instruments. Objectives: We aimed to identify and compare the reported performance of these instruments with special emphasis on the PsA phenotypes. Methods: We conducted a systematic literature search on PubMed until 15 August 2020 using the keyword ‘psoriatic arthritis’. Two independent reviewers identified all studies published in English, that report on the validation, psychometric evaluation or use of an instrument for screening PsA. Any disagreements were resolved by the third investigator. Data on sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were extracted or calculated for each instrument. Additionally, instruments were assessed for their performance in patients with different disease phenotypes. Results: A total of 10754 references were screened, and 42 were identified that reported on 15 different screening instruments. Psoriatic Arthritis Screening and Evaluation (PASE), Psoriasis Epidemiology Screening Tool (PEST), Early Arthritis for Psoriatic Patients questionnaire (EARP) were the most commonly used instruments. There was important variability across studies regarding the sensitivity, specificity, PPV and NPV of these instruments based on the cut-offs for positivity, setting, patient population and disease phenotypes (Table 1). Specificity was higher when patients with a previous diagnosis of other rheumatic diseases were excluded. Lower sensitivity was reported among patients with shorter disease duration and when patients with a prior diagnosis of PsA were excluded from the study, whereas higher sensitivity was reported among patients with prior NSAID use. Screening tools showed differences in sensitivity in different domains (Figure 1). Figure 1. Performance Among Patients with Each Domain Conclusion: This systematic literature review revealed wide variability in the diagnostic estimates of currently available questionnaire-based screening instruments for identifying PsA among psoriasis patients, depending on study populations and disease phenotypes. There is an unmet need for a screening instrument with a better performance in all disease domains. Table 1. Diagnostic estimates of screening tools in different studies Instrument Number of studies Sensitivity % Specificity % PPV % NPV % PASE 18 24-91 38-95 18-88 13-96 PEST 11 40 – 85 37.2-98.6 23-96 47.1-99.3 EARP 9 41-97.2 34-97.2 14-93.3 57.5-100 TOPAS 6 41-89.1 29.7-90 25.7-91.8 68-81.6 TOPAS-II 4 44-95.8 80.5-98 63.4-95.8 91-98 PsA-Disk questionnaire 1 87.2 46.4 58.6 78.5 CONTEST 2 70-76.5 56.5-91 16-89 68-95 STRIPP 1 91.5 93.3 79.6 97.5 SiPAS 1 79 87 73 90 PASQ 2 67-92.7 64-81.8 43 83 GEPARD 2 77 70 66 80 Swedish- Psoriasis Assessment Questionnaire 1 63 72 45 85 PAQ 1 60 62 26 87.5 SiPAT 1 69 69 91 69 A novel, short, and simple screening questionnaire 1 86.9 71.3 53 93.6 PASE: Psoriatic Arthritis Screening and Evaluation, PEST: Psoriasis Epidemiology Screening Tool, EARP: Early Arthritis for Psoriatic Patients questionnaire, TOPAS: Toronto Psoriatic Arthritis Screening Questionnaire, STRIPP: Screening Tool for Rheumatologic Investigation, SIPAS: Simple Psoriatic Arthritis Screening questionnaire, PASQ: Psoriasis and Arthritis Screening Questionnaire, GEPARD: German Psoriatic Arthritis Diagnostic Questionnaire, PAQ: Psoriatic and Arthritic Questionnaire, SiPAT: Siriraj Psoriatic Arthritis Screening Tool Disclosure of Interests: None declared.
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2021-eular.3275
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2021
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  • 5
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    SAT0443 CONCOMITANT PSORIATIC ARTHRITIS AND INFLAMMATORY BOWEL DISEASE IN THE PSA BIOLOGICAL REGISTRY: HUR-BIO REAL LIFE RESULTS
    BMJ ; 2020
    In:  Annals of the Rheumatic Diseases Vol. 79, No. Suppl 1 ( 2020-06), p. 1178-1179
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 79, No. Suppl 1 ( 2020-06), p. 1178-1179
    Abstract: Patients with spondyloarthritis (SpA) have 3 important extra-articular involvement; psoriasis, uveitis and inflammatory bowel disease (IBD). Psoriatic arthritis (PsA) patients may have IBD, as well, and clinical features of PsA + IBD patients do not assess comprehensively, yet. Objectives: The purpose of this study is to determine the frequency and clinical features of concomitant PSA and IBD in a PsA biological DMARD cohort. Methods: Hacettepe University Rheumatology Biologic (HUR-BIO) is a single center biologic registry since 2005 and include 469 psoriatic arthritis patients to date. Demographics, clinical features, co-morbidities, laboratory and disease activity parameters collected from the database. The diagnosis of IBD was accepted with colonoscopy findings and pathology. Results: Overall, 469 PsA patients (70% females) with the mean age 47.7±12.4 years and [median (IQR)] disease duration 7 (3-11) years included in the study. Overall, 10/469 (5 male) PsA patients (2.1%) had IBD (7 (70%) with ulcerative colitis and 3 (30%) Crohn’s disease). Mean age of the patients was 53.3±10.0 years and mean disease duration was 9.0 ± 6.1 years. Six of ten patients were diagnosed with IBD before PsA and 4 of them were diagnosed with PsA first. Patients were followed-up for 3.7±2.8 years and bDMARD switch were made in 4 patients mostly due to primary inefficacy. bDMARD was discontinued in 2 patients (one for Crohn disease with fistula and one for drug induced SLE). According to DAPSA score 44% of the patients had low disease activity and 56% of the patients had moderate disease activity at last visit (9 patients were available). Sacroiliitis (70%) and severe radiographic hip (20%) involvement were common in PsA patients with IBD. Disease characteristics and demographic data are given in table 1. Table 1. Disease characteristics and demographic data of PsA patients with IBD Age (years) /sex Disease duration (years) IBD type Sacroiliitis Last visit treatments 61/M 16 Crohn’s disease (+) Azathioprine, GC 50/M 5 Ulcerative colitis (+), hip Adalimumab, GC 59/F 3 Ulcerative colitis (+) Certolizumab, methotrexate 40/F 10 Ulcerative colitis - Adalimumab, methotrexate 71/M 19 Ulcerative colitis - Infliximab 62/M 13 Crohn’s disease (+), hip Azathioprine, GC, sulphasalazine 50/F 1 Ulcerative colitis - Adalimumab, GC 59/M 12 Crohn’s disease (+) Secukinumab, GC 45/F 9 Ulcerative colitis (+) Adalimumab, methotrexate, GC 36/F 5 Ulcerative colitis (+) Infliximab, methotrexate, GC Conclusion: In our single center biological registry, relatively small portion of PsA patients had concomitant IBD, however, those cases may have severe axial involvement, particularly in hip involvement, and further studies needed for these subgroup. Physician should be aware those SpA subgroup, because treatment choices, particularly IL-17 inhibitors may have some cautions patients with PsA and IBD. Disclosure of Interests: Gözde Kübra Yardimci: None declared, Bayram Farisoğullari: None declared, Berkan Armagan: None declared, Emre Bilgin: None declared, Ertugrul Cagri Bolek: None declared, Emine Duran: None declared, Levent Kiliç: None declared, Omer Karadag: None declared, Ali Akdoğan: None declared, Şule Apraş Bilgen: None declared, Ali İhsan Ertenli: None declared, Sedat Kiraz: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2020-eular.6135
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
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  • 6
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    AB0562 Demographic Characteristics and Distribution of The Vasculitides Frequencies: A Real- Life Experience of Vasculitis Center from Eastern Mediterranean
    BMJ ; 2016
    In:  Annals of the Rheumatic Diseases Vol. 75, No. Suppl 2 ( 2016-06), p. 1096.4-1097
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 75, No. Suppl 2 ( 2016-06), p. 1096.4-1097
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2016-eular.4789
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2016
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  • 7
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    AB0745 REAL-LIFE EXPERIENCE FOR SECUKINUMAB IN PSORIATIC ARTHRITIS FROM HURBio-PsA DATABASE
    BMJ ; 2020
    In:  Annals of the Rheumatic Diseases Vol. 79, No. Suppl 1 ( 2020-06), p. 1669-1670
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 79, No. Suppl 1 ( 2020-06), p. 1669-1670
    Abstract: Biologic disease modifying anti-rheumatic drugs (bDMARD) are revolutionary treatment options for management of inflammatory arthritis. Secukinumab (SEC), anti-interleukin-17A monoclonal antibody, is a new alternative choice to anti-TNFs and IL-12/23 blocking agents in the therapy of psoriatic arthritis (PsA). In Turkey, government health insurance system covers secukinumab for at bDMARD-refractory PsA patients. Objectives: In this study, analyzing of parameters that related with effectiveness and drug survival rates for patients using SEC from Hacettepe University Rheumatology Biologic Registry (HURBio-PsA) were aimed. Methods: HURBio-PsA is a monocentric biologic database including 470 PsA by December 2020. Sixty-two PsA patients that recorded with prescribed SEC in the database were evaluated. Sixteen patients have no control clinical-visit were excluded. Descriptives and demographics were recorded and Kaplan-Meier analysis was used to estimate SEC drug-retention rates. Results: Fourty-two (26.1% male) PsA patients treated with SEC) were included. Characteristics of the patients at the baseline and the last visit were shown in Table. Last visit scores of DKYI, Patient VAS Global, VAS Fatigue, VAS Pain and BASDAI showed statistically significant improvements in comparison with first visit values. Median duration of SEC usage was 5.4 (Min-Max: 0.18-18.6) months. SEC drug-retention rate at 12 months were 69% and 54.4% for two PsA groups that were used previously 1 and ≥2 bDMARDs, respectively (p=0.743, Figure). Conclusion: In this real-world study derived from single center experience; there is no statistically significant difference for drug survival rates of SEC therapy in the patient groups used 1 and ≥2 bDMARDs. Effectiveness and drug-survival shoul be obviously verified by data derived from multicenter large cohorts. Table 1. Baseline characteristics of PsA patients with treated with Secukiumab All Patients (n=62) 1 bDMARD exposed (n=18) ≥ 2 bDMARD exposed (n=44) p Gender, Female, n(%) 47 (75.8) 12 (66.7) 35 (79.5) 0.334 Age at the disease diagn osis, years, mean±SD 42 ± 11.65 35 ± 5.65 38.6 ± 10.7 0.721 Age at SEC starting, years, mean±SD 48.2 ± 10.8 43 ± 2.8 49.5 ± 11.3 0.182 Median duration of SEC treatment, median (min-max) 6.3 (0.9-18.6) 3.3 (3.2-3.3) 9 (4-20) 0.519 HLA-B27 positivity, n(%) 3/24 (12.5) 1 (14.3) 2 (11.8) 1 BMI, kg/m 2 , mean±SD 28.9 ± 5.9 32.6 ± 3.7 28.4 ± 6.0 0.546 Ever smokinig history, n(%) 40/61 (65.6) 13 (72.2) 27 (62.8) 0.6 Uveitis, n(%) 3 (4.8) 0 (0) 3 (6.8) 0.55 PsA/Psp family history, n(%) 22 (35.5) 2 (11.1) 20 (45.5) 0.01 Table 2. Activity parameters of PsA patients have a least clinical visit 1 bDMARD exposed (n=) ≥ 2 bDMARD exposed (n=) First Visit Last Visit p First Visit Last Visit p DAS28, Median (IQR) 2.8(1.5) 2.8 (1.8) 0.155 3.9 (1.7) 3.5 (1.4) 0.414 HAQ, Median (IQR) 0.3 (0.7) 0.05 (0.61) 0.065 0.7 (0.9) 0.5 (0.85) 0.500 DKYI, Median (IQR) 4 (4.5) 0 (3) 0.049 11 (15) 5 (9) 0.003 ESR, Median (IQR) 19 (23.2) 17.5 (18.7) 0.398 28 (38) 35 (27.9) 0.082 C-RP, Median (IQR) 0.49 (0.64) 0.41 (0.75) 0.724 0.73 (1.8) 1 (2) 0.564 BASDAI, Median (IQR) 61 (61) 27.5 (48) 0.005 58 (31) 46 (39) 0.038 BASFI, Median (IQR) 38 (50) 9.4 (54.5) 0.035 43 (53) 36 (47) 0.480 Tender Joint Count, Median (IQR) 0 (0.5) 0 (0.5) 0.180 1 (4) 0 (9) 0.720 Swollen Joint Count, Median (IQR) 0 (1.2) 0 (0) 0.357 0 (2) 0 (0) 0.635 VAS Global Patient, Median (IQR) 80 (55) 25 (45) 0.006 60 (20) 50 (50) 0.032 VAS Fatigue, Median (IQR) 65 (62.5) 40 (62.5) 0.027 60 (40) 50 (40) 0.110 VAS Pain, Median (IQR) 80 (57.5) 40 (72.5) 0.022 70 (30) 60 (50) 0.170 Figure. Drug Retention Rate for Secukinumab Disclosure of Interests: Ertugrul Cagri Bolek: None declared, Emre Bilgin: None declared, Gözde Kübra Yardimci: None declared, Bayram Farisoğullari: None declared, Emine Duran: None declared, Berkan Armagan: None declared, Levent Kiliç: None declared, Şule Apraş Bilgen: None declared, Ali İhsan Ertenli: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2020-eular.6533
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
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  • 8
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    THU0380 SECUKINUMAB IS FREQUENTLY PREFERRED IN MULTI ANTI-TNF RESISTANCE SPONDYLOARTHRITIS PATIENTS: HUR-BIO REAL LIFE RESULTS
    BMJ ; 2020
    In:  Annals of the Rheumatic Diseases Vol. 79, No. Suppl 1 ( 2020-06), p. 423.2-424
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 79, No. Suppl 1 ( 2020-06), p. 423.2-424
    Abstract: Anti-TNF agents have been used for the last two decades. However, targeting interleukin-17 (secukinumab (SEC)) is a relatively novel treatment option for spondyloarthritis (SpA). Therefore, SEC is frequently preferred after multi anti-TNF agents, in real life. Objectives: The objective of this study was to assess the retention rate and response of SEC in anti-TNF naïve and anti-TNF resistance patients in real life experience. Methods: HUR-BIO is a monocentric database of biologics including 2886 SpA patients, since 2005. SEC is approved at May 2018 in Turkey and 147 patients have used SEC by January 2020. Demographic and clinical data were obtained from HUR-BIO registry. SpA patients were classified as ankylosing spondylitis (AS) and non-radiographic SpA (nrAxSpA). Response and retention rate of SEC were determined regarding to anti-TNF naïve vs anti-TNF resistance patients. Kaplan-Meier analysis was used to estimate SEC retention rates. Results: In total, 147 axial SpA patients (96 (65.3%) AS and 51 (34.7%) nrAxSpA) were analyzed. Overall, 23/147 (15.7%) patients were anti-TNF naïve, 27 (18.4%) patients were 1 anti-TNF failure and 97 (65.9%) patients were ≥2 anti-TNF failure. Baseline characteristics of patients and the main causes of discontinuation of anti-TNF agents were shown in table. Median duration of SEC usage was 7.9 (min-max, 3.0-19.8) months in AS and 6.7 (min-max, 3.0-19.8) months in nrAxSpA group (p=0.365). SEC survival at 12 months was similar between AS and nrAxSpA patients (56% vs %52, p=0.315) (not shown).SEC survival was similar among anti-TNF naïve, one anti-TNF failure and ≥2 anti-TNF failure patients (Figure). BASDAI 50 response was reached in 61.5% of anti-TNF naïve, 42.1% of one anti-TNF failure and 43.2% of ≥2 anti-TNF failure patients at the last control (p=0.452). Patients who used ≤ 1 anti-TNF agent had a higher drug survival rate (%69 vs %46, p=0.027) at 1 year, in comparison with patients who used 〉 1 anti-TNF agents before SEC(not shown). Figure. Secukinumab survival in anti-TNF naïve, one anti-TNF failure and ≥2 anti-TNF failure patients Conclusion: For SpA, SEC is a relatively new player in biological era. When SEC launched for new treatment option, it is preferred mostly (almost 2/3) in multi anti-TNF resistance patients. Moreover, those difficult patients’ (usually female) treatment response and retention rate were not satisfactory than biological naïve patients. Table. Baseline characteristics of patients and the main causes of discontinuation of anti-TNF agents Anti-TNF naive, n=23 One anti-TNF failure, n=27 ≥2 anti-TNF failure, n=97 p Age, years, mean±SD 46.0 ± 11.2 42.4 ± 8.4 44.3 ±9.9 0.611 Female, n (%) 7 (30.4) 15 (55.6) 61 (62.9) 0.019 Disease duration, months, median (min-max) 72 (12-408) 102 (12-300) 120 (12-396) 0.054 Disease duration ≥5 years, n (%) 12 (52.2) 18 (66.7) 72 (74.2) 0.112 Secukinumab indications 〈 0.0001 -Anti-TNF inefficacy, n (%) - 9 (33.4) 80 (82.5) -Anti-TNF adverse event, n (%) - 10 (37.0) 16 (16.5) -Others, n (%) - 8 (29.6) 1 (1.0) History of smoking, n (%) 14 (60.9) 17 (63.0) 54 (55.7) 0.754 History of uveitis, n (%) 5 (21.7) 7 (25.9) 10 (10.3) 0.081 Baseline BASDAI 54 (10-96) 54.5 (0-88) 60 (0-100) 0.307 Baseline BASFI 53 (10-78) 38 (0-94) 55 (0-100) 0.142 Baseline back pain VAS 55 (0-100) 50 (0-100) 70 (0-100) 0.113 ESR, mm/h, median (min-max) 21 (2-120) 24.5 (2-107) 20 (2-84) 0.621 CRP, mg/dL, median (min-max) 0.7 (0.1-8.4) 1.3 (0.1-10.4) 0.7 (0.1-30.8) 0.439 Syndesmophytes on X-ray, n (%) 8 (66.7)* 8 (47.1) 16 (22.9)* 0.019 *p=0.007 Disclosure of Interests: Berkan Armagan: None declared, Levent Kiliç: None declared, Gözde Kübra Yardimci: None declared, Emre Bilgin: None declared, Bayram Farisoğullari: None declared, Ertugrul Cagri Bolek: None declared, Emine Duran: None declared, Omer Karadag: None declared, Ali Akdoğan: None declared, Şule Apraş Bilgen: None declared, Ali İhsan Ertenli: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB, Sedat Kiraz: None declared
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2020-eular.6044
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
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    AB0535 PRESCRIPTION PATTERNS OF THE SECOND BIOLOGIC DMARD IN PSORIATIC ARTHRITIS THROUGH THE LAST DECADE: HURBIO-PsA REAL LIFE EXPERIENCE
    BMJ ; 2021
    In:  Annals of the Rheumatic Diseases Vol. 80, No. Suppl 1 ( 2021-06), p. 1299.1-1299
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 80, No. Suppl 1 ( 2021-06), p. 1299.1-1299
    Abstract: Psoriatic arthritis (PsA) is a multi-dimensional chronic disease, which can affect joints, skin and enthesis. Extrapolation of the positive treatment results of anti-tumor necrosis factor (TNF) alpha agents on spondyloarthritis and rheumatoid arthritis to the treatment practice of PsA lead to a new era for the management of PsA. However, unmet needs in the management of PsA lead to development of several drugs targeting different molecules and cytokines. The impact of these developments on PsA patients who are intolerant/unresponsive to the first biological disease-modifying anti-rheumatic drugs (bDMARD) still needs to be defined. Objectives: To explore the second biologic agent trends on PsA patients of our 10-years of single-center experience. Methods: HURBIO-PsA (Hacettepe University Rheumatology Biologic Registry) is a single center biological disease modifying anti-rheumatic drug (DMARD) registry since 2005 on PsA patients. Until the end of the 2020, 19 different rheumatologists contributed to the development of HURBIO-PsA. Anti-TNF drugs were approved as first line bDMARD for PsA patients. Distribution of the second-line biological agents (switch from first-line biological agent because of either adverse events or unresponsiveness) was calculated according to 5-year periods starting from the 2011. Also, demographic and serologic data of RA patients were reported. Results: A total of 225 PsA (225/443, 50.8%) patients, who was prescribed a second biological agent, was registered in HURBIO-PsA by the end of 2020. Of these patients, 74.7% was female. Mean age at the starting of bDMARD was 47.1 ± 11.6 years. 90 (40.0%) and 135 (60.0%) patients were prescribed with their second bDMARD in 2011-2015 and 2016-2020, respectively. There was a trend towards the increasing prescription of non-Anti-TNF bDMARDs as second-line over time, especially for secukinumab. Table 1. Distribution of second biologic DMARDs in PsA patients according to 5-years periods 2011-2015 2016-2020 Total Adalimumab 30 (33.3) 33 (24.4) 66 (29.3) Etanercept 33 (36.7) 8 (5.9) 41 (18.2) Infliximab 9 (10) 15 (11.1) 24 (10.6) Golimumab 9 (10) 5 (3.7) 14 (6.2) Certolizumab 5 (5.6) 34 (25.2) 39 (17.3) Anti-TNF 86 (95.6) 95 (70.4) 181 (80.5) Secukinumab 0 26 (19.3) 26 (11.5) Ustekinumab 0 10 (7.4) 10 (4.4) Abatacept 4 (4.4) 2 (1.5) 6 (2.6) Tofacitinib 0 2 (1.5) 2 (0.9) Non-Anti-TNF 4 (4.4) 40 (29.6) 44 (19.5) Total 90 (100) 135 (100) 225 (100) Approval years of drugs in Turkey ; Infliximab: 2003, etanercept:2004, adalimumab: 2005, golimumab: 2013, certolizumab: 2014, secukinumab: 2018, ustekinumab: 2018; abatacept and tofacitinib were given with the permission from the Ministry of Health of Turkey for off-label use authorization Conclusion: Almost half of the PsA patients switched their anti-TNF drugs to others. Non-Anti-TNF bDMARDs, especially secukinumab, becoming more frequently used as a second-line biologic agent in PsA in recent years. These bDMARD prescription trend is appropriate to EULAR PsA recommendations. Disclosure of Interests: None declared.
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2021-eular.1222
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2021
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    Retrospective analysis of vitamin D status on ınflammatory markers and course of the disease in patients with COVID-19 infection
    Springer Science and Business Media LLC ; 2021
    In:  Journal of Endocrinological Investigation Vol. 44, No. 12 ( 2021-12), p. 2601-2607
    Details
    In: Journal of Endocrinological Investigation, Springer Science and Business Media LLC, Vol. 44, No. 12 ( 2021-12), p. 2601-2607
    Type of Medium: Online Resource
    ISSN: 1720-8386
    URL: Article
    DOI: 10.1007/s40618-021-01566-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2119482-8
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