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Athanasios Tragiannidis, Ioannis Kyriakidis, Ilse Zündorf, Andreas H Groll
Macromolecular immunosuppressive monoclonal antibodies and fusion proteins directed against molecules or cells involved in inflammation and immunity represent a recent and important addition to our therapeutic armamentarium. Tumor necrosis alpha (TNFα) is a cytokine involved in systemic inflammation and clinical utilization of its antagonists has revolutionized treatment of juvenile rheumatoid and psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, and plaque psoriasis. Clinical utility has also been demonstrated for use against steroid-refractory graft-vs-host disease and other immune-mediated conditions...
October 21, 2016: Mycoses
Insa Joost, Johannes Steinfurt, Philipp T Meyer, Winfried V Kern, Siegbert Rieg
BACKGROUND: Ustekinumab (Stelara®), a human monoclonal antibody targeting the p40-subunit of interleukin (IL)-12 and IL-23, is indicated for moderate to severe plaque psoriasis and psoriatic arthritis. In large multicenter, prospective trials assessing efficacy and safety of ustekinumab increased rates of severe infections have not been observed so far. CASE PRESENTATION: Here, we report the case of a 64-year old woman presenting with chills, pain and swelling of her right foot with dark maculae at the sole, and elevated inflammatory markers...
October 20, 2016: BMC Infectious Diseases
Joel M Kremer
The Corrona US national registry collects data concerning patient status from both the rheumatologist and patient at routine clinical encounters. Corrona has functioning disease registries in rheumatoid arthritis, psoriatic arthritis, spondyloarthropathies, psoriasis and inflammatory bowel disease. Corrona merges data concerning long-term effectiveness and safety, as well as comparative and cost effectiveness of agents to treat these autoimmune diseases.
September 2016: Clinical and Experimental Rheumatology
Laura C Coates
As in rheumatoid arthritis, treating to target in psoriatic arthritis (PsA) has been shown to improve outcomes over standard therapy. As a result of this, the European League Against Rheumatism (EULAR) updated recommendations for the management of PsA now recommend a treat-to-target approach for all patients with PsA. However, translating the results of this research remains challenging in clinical practice. Prolonged consultation time associated with implementing this into practice can be minimised using a simple to calculate but inclusive target for treatment and assessing this within information technology (IT) systems...
September 2016: Clinical and Experimental Rheumatology
Choua Thao, Amir Lagstein, Tadashi Allen, Huseyin Erhan Dincer, Hyun Joo Kim
Respiratory involvement in Crohn's disease (CD) is a rare manifestation known to involve the large and small airways, lung parenchyma, and pleura. The clinical presentation is nonspecific, and diagnostic tests can mimic other pulmonary diseases, posing a diagnostic challenge and delay in treatment. We report a case of a 60-year-old female with a history of CD and psoriatic arthritis who presented with dyspnea, fever, and cough with abnormal radiological findings. Diagnostic testing revealed an elevated CD4:CD8 ratio in the bronchoalveolar lavage fluid, and cryoprobe lung biopsy results showed non-necrotizing granulomatous inflammation...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Tao Gu, Neel Shah, Gaurav Deshpande, Derek H Tang, Debra F Eisenberg
BACKGROUND: The relative cost of biologics in the treatment of autoimmune disorders, including rheumatoid arthritis, psoriatic arthritis, psoriasis, and ankylosing spondylitis, is a key consideration for managed care payers. OBJECTIVES: Our objective was to estimate biologic costs and treatment patterns in US managed care patients with rheumatoid arthritis, psoriatic arthritis, psoriasis, and/or ankylosing spondylitis. METHODS: This retrospective study used administrative claims data from the HealthCore Integrated Research Database (HIRD(SM)) for adults with rheumatoid arthritis, psoriatic arthritis, psoriasis, and/or ankylosing spondylitis who received abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab, or ustekinumab between 1 July 2009 and 31 January 2013...
October 18, 2016: Drugs—Real World Outcomes
Jordi Gratacos-Masmitja, Jesus Luelmo-Aguilar, Pedro Zarco-Montejo, Rafael Botella-Estrada, Ana Maria Carrizosa-Esquivel, Maria Luz Garcia-Vivar, Silvia Perez-Barrio, Jose Antonio Roman-Ivorra, Maria Dolores Ruiz-Montesino, Jose Luis Lopez-Estebaranz
INTRODUCTION: In numerous clinical practice guidelines, emphasis is placed on the need for coordinated care of psoriatic arthritis (PsA) between rheumatologists and the objective was to develop experience-based points to consider facilitating the implementation of multidisciplinary units (Dermatology/Rheumatology) for the management of patients with PsA. METHODS: A scientific committee of rheumatology and dermatology experts in the management of PsA, and with experience in joint care, discussed the critical aspects of multidisciplinary PsA Units...
October 18, 2016: Advances in Therapy
Ying Ying Leung, Julian Thumboo, Matthew Rouse, Stephen P McKenna
BACKGROUND: To develop Singapore Chinese and English versions of the Psoriatic Arthritis Quality of Life (PsAQoL) scale that were equivalent to and met the same psychometric and acceptability standards as the original UK measure. METHODS: Translation of the original PsAQoL into contextualised English and Chinese versions for use in Singapore was performed by professional and lay translation panels. Ten Chinese speaking and ten English speaking local patients were interviewed to assess face and content validity...
October 18, 2016: BMC Musculoskeletal Disorders
Sean Yiu, Brian Tom
Multistate processes provide a convenient framework when interest lies in characterising the transition intensities between a set of defined states. If, however, there is an unobserved event of interest (not known if and when the event occurs), which when it occurs stops future transitions in the multistate process from occurring, then drawing inference from the joint multistate and event process can be problematic. In health studies, a particular example of this could be resolution, where a resolved patient can no longer experience any further symptoms, and this is explored here for illustration...
October 17, 2016: Statistics in Medicine
Filipa Oliveira-Ramos, Mónica Eusébio, Fernando M Martins, Ana Filipa Mourão, Carolina Furtado, Raquel Campanilho-Marques, Inês Cordeiro, Joana Ferreira, Marcos Cerqueira, Ricardo Figueira, Iva Brito, Helena Canhão, Maria José Santos, José A Melo-Gomes, João Eurico Fonseca
OBJECTIVES: To determine how adult juvenile idiopathic arthritis (JIA) patients fulfil classification criteria for adult rheumatic diseases, evaluate their outcomes and determine clinical predictors of inactive disease, functional status and damage. METHODS: Patients with JIA registered on the Rheumatic Diseases Portuguese Register ( older than 18 years and with more than 5 years of disease duration were included. Data regarding sociodemographic features, fulfilment of adult classification criteria, Health Assessment Questionnaire, Juvenile Arthritis Damage Index-articular (JADI-A) and Juvenile Arthritis Damage Index-extra-articular (JADI-E) damage index and disease activity were analysed...
2016: RMD Open
Pedro David Carvalho, Cátia Duarte, Elsa Vieira-Sousa, Luís Cunha-Miranda, Pedro Avila-Ribeiro, Helena Santos, Miguel Bernardes, Maria José Santos, Marcos Cerqueira, Margarida Mateus, Patrícia Nero, Ana Águeda, José António Pereira da Silva, Pedro Machado
Psoriatic arthritis (PsA) is a chronic inflammatory rheumatic disease with a broad clinical spectrum. PsA can affect the axial skeleton, peripheral joints, entheses, synovial sheaths of tendons, skin, nails and extra-articular organs. Tumour necrosis factor alpha blockers (TNF blockers) were a breakthrough development in the treatment of PsA. Identifying predictors of response to biological therapies in patients with PsA is of utmost importance, especially in view of the costs and potential side effects of these agents...
August 17, 2016: Acta Reumatológica Portuguesa
Giovanni Ciancio, Manuela Ferracin, Elena Saccenti, Valentina Bagnari, Ilaria Farina, Federica Furini, Elisa Galuppi, Barbara Zagatti, Francesco Trotta, Massimo Negrini, Marcello Govoni
OBJECTIVES: To evaluate the micro-RNA (miRNA) expression profile in patients with early psoriatic arthritis (PsA) in order to assess the role of miRNAs as potential PsA biomarkers. METHODS: The expression of 723 mature miRNAs in peripheral blood mononuclear cells of early PsA patients in comparison with early-rheumatoid arthritis (ERA) patients and healthy controls (HC) was evaluated using a miRNA microarray. All patients had active disease and were naïve from treatment...
October 7, 2016: Clinical and Experimental Rheumatology
Julio Ramírez, José Iniciarte-Mundo, Andrea Cuervo, Virginia Ruiz-Esquide, M Victoria Hernández, Raimón Sanmartí, Juan D Cañete
OBJECTIVES: To analyse clinical, serological and sonographic differences between rheumatoid arthritis (RA) and polyarticular psoriatic arthritis (PsA) patients on anti-TNF therapy in clinical remission. METHODS: Angiogenic and proinflammatory cytokine serum levels were determined by multiplex ELISA in patients with RA and PsA in clinical remission (DAS28-ESR<2.6), clinically-active RA patients (DAS28>3.2) and healthy controls. Ultrasound (US) scans were made of both wrists and hands...
October 7, 2016: Clinical and Experimental Rheumatology
Maddalena Napolitano, Nicola Balato, Francesco Caso, Luisa Costa, Matteo Megna, Teresa Cirillo, Anna Balato, Raffaele Scarpa
OBJECTIVES: To evaluate the incidence of new cases of psoriatic arthritis (PsA) in patients with plaque psoriasis receiving biologic drugs. METHODS: A retrospective study was performed on 434 psoriatic patients under biologic treatment, attending the Psoriasis Care Centre of Dermatology at the University Federico II of Naples from January 2011 to November 2015. As part of the routine clinical practice, assessment of disease activity was made at baseline, and every 3 months...
September 8, 2016: Clinical and Experimental Rheumatology
Martina Gatzka
Tumor necrosis factor alpha (TNF-α) and Interleukin 17 (IL-17) are key cytokines driving psoriasis and other inflammatory autoimmune diseases and thus represent effective targets for anti-psoriatic therapy. In a recent issue of The Journal of Pathology, Leite Dantas et al. explore a mouse model of TNF-mediated psoriasiform dermatitis and arthritis with Doxycyclin-inducible general over-expression of human TNF (ihTNFtg mice) for the contributions of macrophages and T cells in skin inflammation - with some unexpected and interesting findings...
October 17, 2016: Journal of Pathology
Vibeke Strand, Elaine Husni, Jenny Griffith, Zheng-Yi Zhou, James Signorovitch, Arijit Ganguli
INTRODUCTION: The present study aimed to evaluate clinical outcomes and costs associated with timely versus delayed use of tumor necrosis factor inhibitors (TNFis) among patients with moderately to severely active psoriatic arthritis (PsA) with and without moderate/severe psoriasis (Ps) from a US payer's perspective. METHODS: An economic model evaluated PsA patients initially treated with a TNFi (timely TNFi use) or apremilast (delayed TNFi use). Patients without joint (American College of Rheumatology 20%, [ACR20]) improvement either switched TNFis or initiated one...
September 15, 2016: Rheumatol Ther
Philip Mease, Iain B McInnes
No abstract text is available yet for this article.
July 25, 2016: Rheumatol Ther
Jason Madan, Tony Ades, Pelham Barton, Laura Bojke, Ernest Choy, Philip Helliwell, Paresh Jobanputra, Ken Stein, Andrew Stevens, Jonathan Tosh, Suzanne Verstappen, Allan Wailoo
INTRODUCTION: Biologic therapies are efficacious but costly. A number of health economic models have been developed to determine the most cost-effective way of using them in the treatment pathway. These models have produced conflicting results, driven by differences in assumptions, model structure, and data, which undermine the credibility of funding decisions based on modeling studies. A Consensus Working Party met to discuss recommendations and approaches for future models of biologic therapies...
December 2015: Rheumatol Ther
Philip Mease, Iain B McInnes
INTRODUCTION: Psoriatic arthritis (PsA) is an immune-mediated chronic inflammatory arthropathy associated with impaired physical function and reduced quality of life. Biologic therapies that target tumor necrosis factor (anti-TNF) have significantly improved clinical outcomes. Partial, non- and transient responses remain common comprising significant unmet clinical need. New therapies with novel modes of action are urgently required. OBJECTIVES: The interleukin (IL)-17 pathway has recently been attributed a critical role in the pathogenesis of spondyloarthritides...
June 2016: Rheumatol Ther
Arthur Kavanaugh, Philip Helliwell, Christopher T Ritchlin
INTRODUCTION: Psoriatic arthritis (PsA) is underdiagnosed and has a substantial impact on quality of life, disability, and work productivity. The population-based Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) survey examined the impact of PsA on patients' activities of daily living and unmet treatment needs. METHODS: This large-scale, random digit dialing, telephone survey of patients self-reporting a diagnosis of psoriasis and/or PsA was conducted in North America and Europe...
June 2016: Rheumatol Ther
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