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Rheumatology;biologics

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https://www.readbyqxmd.com/read/27919202/body-mass-index-is-related-with-the-presence-of-syndesmophyte-in-axial-spondyloarthritis-data-from-the-korean-college-of-rheumatology-biologics-kobio-registry
#1
Seong-Kyu Kim, Jung-Yoon Choe, Shin-Seok Lee, Kichul Shin
OBJECTIVE: We investigated whether body mass index (BMI) is associated with parameters of disease activity and clinical manifestations in axial spondyloarthritis (axSpA). METHODS: Demographic, clinical, and radiological features and disease activity indexes from 789 axSpA patients (619 males and 170 females) were obtained from the Korean College of Rheumatology Biologics (KOBIO) registry. BMI (kg/m(2)) was classified into normal (BMI < 23.0), overweight (23.0 ≤ BMI < 25...
December 6, 2016: Modern Rheumatology
https://www.readbyqxmd.com/read/27913894/use-and-effectiveness-of-tocilizumab-among-patients-with-rheumatoid-arthritis-an-observational-study-from-the-british-society-for-rheumatology-biologics-register-for-rheumatoid-arthritis
#2
Mari Kihara, Rebecca Davies, Lianne Kearsley-Fleet, Kath D Watson, Mark Lunt, Deborah P M Symmons, Kimme L Hyrich
The aims of the present study are to describe the characteristics of rheumatoid arthritis (RA) patients selected for tocilizumab (TCZ), compare the "real-world" effectiveness of TCZ and tumour necrosis factor inhibitors (TNFi) when used as a first biologic and assess the influence of past biologic exposure/concurrent methotrexate (MTX) therapy on post-TCZ treatment outcomes. The British Society for Rheumatology Biologics Register (BSRBR-RA) is a prospective cohort study following RA patients starting biologics in the UK...
December 2, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27912794/a-genetic-risk-score-composed-of-rheumatoid-arthritis-risk-alleles-hla-drb1-haplotypes-and-response-to-tnfi-therapy-results-from-a-swedish-cohort-study
#3
Xia Jiang, Johan Askling, Saedis Saevarsdottir, Leonid Padyukov, Lars Alfredsson, Sebastien Viatte, Thomas Frisell
BACKGROUND: To prevent debilitating and irreversible joint damage, rheumatoid arthritis (RA) is often treated with tumor necrosis factor inhibitor (TNFi), but many patients do not respond to this costly therapy. Few predictors for response are known, and it has been proposed that genetic factors which influence the development of RA may also influence disease severity and response to therapy. Several previous studies have attempted to confirm this but results remain inconclusive. We expand on previous studies by including more RA risk alleles, and maximize power by combining them into a genetic risk score...
December 3, 2016: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/27903264/adult-onset-still-s-disease-evaluation-of-prognostic-tools-and-validation-of-the-systemic-score-by-analysis-of-100-cases-from-three-centers
#4
Piero Ruscitti, Paola Cipriani, Francesco Masedu, Daniela Iacono, Francesco Ciccia, Vasiliki Liakouli, Giuliana Guggino, Francesco Carubbi, Onorina Berardicurti, Paola Di Benedetto, Marco Valenti, Giovanni Triolo, Gabriele Valentini, Roberto Giacomelli
BACKGROUND: Adult-onset Still's disease (AOSD) is rare inflammatory disease of unknown etiology that usually affects young adults. The more common clinical manifestations are spiking fevers, arthritis, evanescent rash, elevated liver enzymes, lymphadenopathy, hepatosplenomegaly, and serositis. The multi-visceral involvement of the disease and the different complications, such as macrophage activation syndrome, may strongly decrease the life expectancy of AOSD patients. METHODS: This study aimed to identify the positive and negative features correlated with the outcome of patients...
December 1, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27896522/tapering-biologics-in-rheumatoid-arthritis-a-pragmatic-approach-for-clinical-practice
#5
Aleksander Lenert, Petar Lenert
Optimal rheumatoid arthritis (RA) therapy in daily clinical practice is based on the treat-to-target strategy. Quicker escalation of therapy and earlier introduction of biological disease-modifying anti-rheumatic drugs have led to improved outcomes in RA. However, chronic immunosuppressive therapy is associated with adverse events and higher costs. In addition, our patients frequently express a desire for lower dosing and drug holidays. Current clinical practice guidelines from the American College of Rheumatology and European League Against Rheumatism suggest that rheumatologists consider tapering treatment after achieving remission...
November 28, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27894239/do-the-biologic-agents-increase-the-risk-of-infection-in-patients-undergoing-lower-limb-arthroplasty-surgery
#6
N A Sandiford
BACKGROUND: Biologic agents have contributed significantly to the management of patients with in rheumatoid arthritis (RA). A significant proportion of patients with RA still require arthroplasty procedures however. It is unclear whether these agents increase the risk of post operative infection after lower limb arthroplasty . The aim of this review is to review the contemporary literature about this topic along with the recommendations from specialist societies. METHOD: A literature search was performed for articles published over the last 10 years in the English language examining the association between anti-tumour necrosis factor inhibitors and the incidence of post operative infection in patients with RA undergoing hip and knee arthroplasty procedures...
November 27, 2016: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/27889300/tofacitinib-versus-biologic-treatments-in-patients-with-active-rheumatoid-arthritis-who-have-had-an-inadequate-response-to-tumor-necrosis-factor-inhibitors-results-from-a-network-meta-analysis
#7
Maria-Cecilia Vieira, Samuel H Zwillich, Jeroen P Jansen, Brielan Smiechowski, Dean Spurden, Gene V Wallenstein
PURPOSE: Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). This analysis compared the efficacy and safety of tofacitinib with biologic disease-modifying antirheumatic drugs in patients with RA and a prior inadequate response (IR) to tumor necrosis factor inhibitors (TNFi). METHODS: A systematic literature review identified 5 randomized placebo-controlled trials that evaluated tofacitinib or biologic disease-modifying antirheumatic drugs (bDMARDs) against placebo in patient populations with RA with a prior IR to TNFi...
November 23, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27886693/gaps-in-aging-research-as-it-applies-to-rheumatologic-clinical-care
#8
REVIEW
Una E Makris, Devyani Misra, Raymond Yung
The incidence and prevalence of rheumatologic conditions are increasing and the rheumatology workforce must be aware of aging-specific issues. This article reviews specific barriers to understanding the biology of aging and aging-related mechanisms that may underlie development of rheumatologic diseases in older adults. It summarizes gaps in the assessment, outcomes measurement, and treatment of these diseases in this unique population. It also highlights potential solutions to these barriers and suggests possible ways to bridge the gap, from a research and education standpoint, so that clinicians can be better prepared to effectively manage older adults with rheumatologic conditions...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27883001/psoriasis
#9
Jacqueline E Greb, Ari M Goldminz, James T Elder, Mark G Lebwohl, Dafna D Gladman, Jashin J Wu, Nehal N Mehta, Andrew Y Finlay, Alice B Gottlieb
Psoriasis is a chronic, immune-mediated disorder with cutaneous and systemic manifestations and substantial negative effects on patient quality of life. Psoriasis has a strong, albeit polygenic, genetic basis. Whereas approximately half of the accountable genetic effect of psoriasis maps to the major histocompatibility complex, >70 other loci have been identified, many of which implicate nuclear factor-κB, interferon signalling and the IL-23-IL-23 receptor axis. Psoriasis pathophysiology is characterized by abnormal keratinocyte proliferation and immune cell infiltration in the dermis and epidermis involving the innate and adaptive immune systems, with important roles for dendritic cells and T cells, among other cells...
November 24, 2016: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/27863807/head-to-head-comparison-of-certolizumab-pegol-versus-adalimumab-in-rheumatoid-arthritis-2-year-efficacy-and-safety-results-from-the-randomised-exxelerate-study
#10
Josef S Smolen, Gerd-Rüdiger Burmester, Bernard Combe, Jeffrey R Curtis, Stephen Hall, Boulos Haraoui, Ronald van Vollenhoven, Christopher Cioffi, Cécile Ecoffet, Leon Gervitz, Lucian Ionescu, Luke Peterson, Roy Fleischmann
BACKGROUND: To date, head-to-head trials comparing the efficacy and safety of biological disease-modifying antirheumatic drugs within the same class, including TNF inhibitors, in patients with active rheumatoid arthritis despite methotrexate therapy are lacking. We aimed to compare the efficacy and safety of two different TNF inhibitors and to assess the efficacy and safety of switching to the other TNF inhibitor without a washout period after insufficient primary response to the first TNF inhibitor at week 12...
December 3, 2016: Lancet
https://www.readbyqxmd.com/read/27860410/sarilumab-and-non-biologic-disease-modifying-antirheumatic-drugs-in-patients-with-active-ra-and-inadequate-response-or-intolerance-to-tnf-inhibitors
#11
Roy Fleischmann, Janet van Adelsberg, Yong Lin, Geraldo da Rocha Castelar-Pinheiro, Jan Brzezicki, Pawel Hrycaj, Neil M H Graham, Hubert van Hoogstraten, Deborah Bauer, Gerd R Burmester
OBJECTIVE: To evaluate efficacy and safety of sarilumab plus conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) in patients with active, moderate-to-severe rheumatoid arthritis (RA) with inadequate response or intolerance to anti-tumor necrosis factor (TNF) therapies. METHODS: Patients were randomly allocated to receive sarilumab 150 mg, sarilumab 200 mg, or placebo every 2 weeks (q2w) for 24 weeks with background csDMARD(s). Coprimary endpoints were proportion of patients achieving American College of Rheumatology 20% (ACR20) response at week 24 and change from baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) at week 12...
November 17, 2016: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/27855242/biologic-or-tofacitinib-monotherapy-for-rheumatoid-arthritis-in-people-with-traditional-disease-modifying-anti-rheumatic-drug-dmard-failure-a-cochrane-systematic-review-and-network-meta-analysis-nma
#12
REVIEW
Jasvinder A Singh, Alomgir Hossain, Elizabeth Tanjong Ghogomu, Amy S Mudano, Peter Tugwell, George A Wells
BACKGROUND: We performed a systematic review, a standard meta-analysis and network meta-analysis (NMA), which updates the 2009 Cochrane Overview, 'Biologics for rheumatoid arthritis (RA)'. This review is focused on biologic monotherapy in people with RA in whom treatment with traditional disease-modifying anti-rheumatic drugs (DMARDs) including methotrexate (MTX) had failed (MTX/other DMARD-experienced). OBJECTIVES: To assess the benefits and harms of biologic monotherapy (includes anti-tumor necrosis factor (TNF) (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab) or non-TNF (abatacept, anakinra, rituximab, tocilizumab)) or tofacitinib monotherapy (oral small molecule) versus comparator (placebo or MTX/other DMARDs) in adults with RA who were MTX/other DMARD-experienced...
November 17, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27843575/effectiveness-and-safety-of-tnf-inhibitors-in-adults-with-juvenile-idiopathic-arthritis
#13
Lianne Kearsley-Fleet, Flora McErlane, Helen E Foster, Mark Lunt, Kath D Watson, Deborah P M Symmons, Kimme L Hyrich
INTRODUCTION: Many children with juvenile idiopathic arthritis (JIA) continue to have active disease into adulthood. Adults with JIA are a heterogeneous group, and the effects of tumour necrosis factor inhibitor (TNFi) therapies are not well described. This analysis aims to describe treatment outcomes among patients with JIA starting TNFi for the first time in adulthood. METHODS: Patients with arthritis onset <16 years starting their first TNFi therapy were identified from the British Society of Rheumatology Biologics Register...
2016: RMD Open
https://www.readbyqxmd.com/read/27829672/management-of-psoriatic-arthritis-in-2016-a-comparison-of-eular-and-grappa-recommendations
#14
REVIEW
Laure Gossec, Laura C Coates, Maarten de Wit, Arthur Kavanaugh, Sofia Ramiro, Philip J Mease, Christopher T Ritchlin, Désirée van der Heijde, Josef S Smolen
Psoriatic arthritis (PsA) is a heterogeneous, potentially severe disease. Many therapeutic agents are now available for PsA, but treatment decisions are not always straightforward. To assist in this decision making, two sets of recommendations for the management of PsA were published in 2016 by international organizations - the European League Against Rheumatism (EULAR) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). In both sets of recommendations, the heterogeneity of PsA is recognized and the place of various drugs in the therapeutic armamentarium is discussed...
November 10, 2016: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/27825791/recommendations-by-the-spanish-rheumatology-society-for-the-management-of-patients-diagnosed-with-rheumatoid-arthritis-who-cannot-be-treated-with-methotrexate
#15
Rosario García-Vicuña, María Auxiliadora Martín-Martínez, María Rosa Gonzalez-Crespo, Jesús Tornero-Molina, Antonio Fernández-Nebro, Francisco Javier Blanco-García, Ricardo Blanco-Alonso, Sara Marsal-Barril
To establish a set of recommendations for the management of patients diagnosed with rheumatoid arthritis (RA) who cannot be treated with methotrexate (MTX) due to contraindications, drug toxicity or lack of adherence, and to establish therapeutic strategies more effective and safer in these RA patients. A qualitative analysis of the scientific evidence available to June 2015. The 2-round Delphi technique of consensus was used to collect and establish expert opinion based on the participants' clinical experience when only low quality evidence was available...
November 5, 2016: Reumatología Clinica
https://www.readbyqxmd.com/read/27822121/the-danish-nationwide-clinical-register-for-patients-with-rheumatoid-arthritis-danbio
#16
REVIEW
Else Helene Ibfelt, Dorte Vendelbo Jensen, Merete Lund Hetland
INTRODUCTION: DANBIO is a research register and a data source for rheumatologic diseases (rheumatoid arthritis [RA], axial spondyloarthritis, and psoriatic arthritis) for monitoring clinical quality at the national, regional, and hospital levels. STUDY POPULATION: The register includes patients with rheumatologic diseases who are treated at a hospital or a private rheumatologic clinic. Registration is mandatory for all patients with RA regardless of treatment and also for patients with other diagnoses if treated with biological disease-modifying antirheumatic drugs...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27821272/targeting-cytokine-signaling-in-autoimmunity-back-to-the-future-and-beyond
#17
REVIEW
Kiyoshi Hirahara, Daniella Schwartz, Massimo Gadina, Yuka Kanno, John J O'Shea
Cytokines represent structurally diverse soluble factors with critical roles in normal immune function and the pathogenesis of autoimmunity. The emergence of many successful biological therapies targeting cytokines and cytokine receptors exemplifies the importance of cytokines in driving human autoimmune disease; unsurprisingly, there is no paucity of reviews on this subject. Nonetheless, many patients with autoimmune disease do not respond to biologicals, and cure remains an unmet goal. Thus, targeting the intracellular pathways employed by cytokines provides new therapeutic opportunities...
November 4, 2016: Current Opinion in Immunology
https://www.readbyqxmd.com/read/27817127/the-conversion-rate-of-tuberculosis-screening-tests-during-biological-therapies-in-patients-with-rheumatoid-arthritis
#18
Giovanna Cuomo, Virginia D'Abrsca, Daniela Iacono, Ilenia Pantano
Screening for active tuberculosis (TB) and latent TB infection (LTBI) is mandatory to the initiation of biological therapy in patients with rheumatic diseases. To determine the prevalence of LTBI in patients with rheumatoid arthritis before treatment with biological therapy (anti-TNF, abatacept, and tocilizumab) and the rate of TB conversion during treatment in rheumatoid arthritis (RA) patients, we evaluated the file of 275 patients with RA treated with biological agents. We considered patients with negative baseline TB screening (tuberculin skin test (TST); quantiferon TB gold in tube (QFT-GIT); chest x-ray) and with rescreening for a TB assay every year...
November 5, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27817126/treatment-with-ustekinumab-in-a-spanish-cohort-of-patients-with-psoriasis-and-psoriatic-arthritis-in-daily-clinical-practice
#19
Miriam Almirall, Jesús Rodriguez, Lourdes Mateo, José Manuel Carrascosa, Jaime Notario, Fernando Gallardo
After approval of the use of ustekinumab for treatment of moderate to severe psoriasis, patients with psoriatic arthritis have treated with this drug in daily clinical practice. The aims of this study were to describe baseline characteristics and evolution of a cohort of patients with psoriasis and psoriatic arthritis treated with ustekinumab and to compare differences between patients who discontinued treatment and those who maintained. A retrospective multicenter observational study including patients who had received ustekinumab for a minimum of 3 months from 2009 to 2015 was performed...
November 5, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27807630/-role-of-plasmapheresis-and-immunoadsorption-in-salvage-therapy-of-rheumatological-diseases
#20
M Boser, J T Kielstein
Many rheumatological diseases are either caused by specific known proteins, such as antibodies or mediated by a plethora of cytokines. Both the unspecific immunosuppressive therapy and the specific action of biologics usually require time to be effective; therefore, extracorporeal forms of treatment are increasingly being employed in severe forms of rheumatological diseases as well as in patients who cannot tolerate pharmacological treatment or where the risk of pharmacological treatment may outweigh the potential benefits...
December 2016: Zeitschrift Für Rheumatologie
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