Nikolaos Kougkas, Elpida Skouvaklidou, Konstantinos Tsafis, Dimitrios Deligeorgakis, Vasileios Skepastianos, Christina Adamichou, Evdokia Papadimitriou, Afroditi Mpitouli, Maria Boutel, Fotis Dimitriadis, George Spagos, Ioannis Zarifis, Theodoros Dimitroulas, Adam Tsaousidis
{"title":"Cardiac strain in patients on Janus Kinase inhibitors for rheumatic diseases: a 1-year echocardiographic study.","authors":"Nikolaos Kougkas, Elpida Skouvaklidou, Konstantinos Tsafis, Dimitrios Deligeorgakis, Vasileios Skepastianos, Christina Adamichou, Evdokia Papadimitriou, Afroditi Mpitouli, Maria Boutel, Fotis Dimitriadis, George Spagos, Ioannis Zarifis, Theodoros Dimitroulas, Adam Tsaousidis","doi":"10.55563/clinexprheumatol/al5kv6","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/al5kv6","url":null,"abstract":"<p><strong>Objectives: </strong>Janus kinase inhibitors (JAKi) are increasingly used to treat autoimmune rheumatic diseases (ARDs), despite concerns regarding their potential cardiovascular risks. Cardiac strain, a sensitive marker for subclinical myocardial dysfunction, can predict the risk of heart failure. This study aims to evaluate the effect of JAKi on cardiac strain and function in patients with ARDs in routine clinical practice.</p><p><strong>Methods: </strong>This prospective Greek cohort study enrolled patients diagnosed with RA, PsA, or axSpA initiating treatment with a JAKi (baricitinib, tofacitinib, or upadacitinib). Comprehensive assessments were performed at baseline, 6 months, and 12 months including disease-specific scores and laboratory tests. Transthoracic speckle-tracking echocardiography was used to assess global longitudinal strain (GLS), left ventricular ejection fraction (EF), and right ventricular function (including RV GLS, TAPSE, and S'RV). Diastolic function was evaluated through the E/A and E/E' ratios.</p><p><strong>Results: </strong>Thirty patients completed the study: 12 with axSpA, 10 with RA, and 8 with PsA. Disease activity significantly improved across all cohorts. No significant changes in GLS, EF, E/A, E/E', TAPSE, S'RV or heart rate were observed from baseline to 12 months. Additionally, the GLS of the left ventricle did not show a decline.</p><p><strong>Conclusions: </strong>In this cohort, JAKi did not result in significant changes in cardiac strain or function over one year in patients with ARDs, suggesting that JAKi may not have a detrimental impact on cardiac function in the short term. However, longer-term studies with larger cohorts are necessary to evaluate potential delayed effects and confirm the cardiovascular safety of JAKi.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hua Ye, Shengyun Liu, Yongjun Mei, Jieruo Gu, Min Yang, Li Zhang, Guoqin Wang, Zhimei He, Feiyan Wu, Yuyan Zheng, Michelle Xia, Baiyong Li, Zhanguo Li
{"title":"Efficacy and safety of monoclonal antibody AK111 in the treatment of active ankylosing spondylitis: a randomised, double-blind, placebo-controlled, multicentre phase II clinical study.","authors":"Hua Ye, Shengyun Liu, Yongjun Mei, Jieruo Gu, Min Yang, Li Zhang, Guoqin Wang, Zhimei He, Feiyan Wu, Yuyan Zheng, Michelle Xia, Baiyong Li, Zhanguo Li","doi":"10.55563/clinexprheumatol/2t27x9","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/2t27x9","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective of the study was to evaluate the efficacy and safety of the monoclonal antibody AK111 in participants with active ankylosing spondylitis (AS).</p><p><strong>Methods: </strong>Adult participants who met the Modified New York Criteria for Ankylosing Spondylitis revised in 1984 were randomly assigned to the AK111 75 mg, 150 mg, 300 mg group or placebo group with the ratio of 1:1:1:1. Each participant received 5 subcutaneous (SC) injections of the study drug (week 0/1/4/8/12). The primary efficacy endpoint of this study was the percentage of participants who reached the Assessment of SpondyloArthritis International Society (ASAS) 20 response at week 16. The key secondary endpoint was the percentage of participants who reached the ASAS 40 response at week 16.</p><p><strong>Results: </strong>A total of 125 participants were randomly enrolled in this study. The ASAS 20 response rates at week 16 in the AK111 75 mg, 150 mg, and 300 mg groups were 80.6%, 71.9%, and 66.7%, respectively, each of which was higher than the placebo group (37.5%). The overall response rate of ASAS 40 in the AK111 group was also better than the placebo group. The incidence rate of treatment emergent adverse events (TEAEs) after receiving AK111 75 mg, 150 mg, 300 mg, and placebo group was 93.5% (29/31), 75.0% (24/32), 73.3% (22/30), and 75.0% (24/32), respectively; the incidence of drug-related AEs was 58.1% (18/31), 50% (16/32), 50% (15/30) and 43.8% (14/32), respectively. The majority of the TEAEs were grade 1 and 2 in severity. No neutralising antibody positivity was found during the study.</p><p><strong>Conclusions: </strong>The humanised monoclonal antibody AK111 was safe and well tolerated in treating AS and showed a good efficacy by improved ASAS 20/ASAS 40 response.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauri Weman, Henri Salo, Vappu Rantalaiho, Johanna Huhtakangas, Laura Kuusalo, Paula Vähäsalo, Maria Backström, Tuulikki Sokka-Isler
{"title":"Does different administration method of methotrexate matter in early rheumatoid arthritis? An exploratory register-based study.","authors":"Lauri Weman, Henri Salo, Vappu Rantalaiho, Johanna Huhtakangas, Laura Kuusalo, Paula Vähäsalo, Maria Backström, Tuulikki Sokka-Isler","doi":"10.55563/clinexprheumatol/tg7hxr","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/tg7hxr","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to study the course of disease activity and pain over two years in patients with early rheumatoid arthritis who began subcutaneous (SC) or peroral (PO) methotrexate (MTX) as part of their first treatment strategy. Treatment failures and drug survival were analysed.</p><p><strong>Methods: </strong>Patients who received a new reimbursement for RA between 1.1.2016 to 31.12.2023 were identified in the Reimbursement Register; purchases of DMARDs were available in the Drug Purchase Register. Clinical and demographic data were extracted from the Finnish Rheumatology Quality Register. Locally estimated scatterplot smoothing (LOESS) trajectories were used to illustrate the development of disease activity and pain for two years. Treatment failures, defined as the probability to avoid bDMARDs, were analysed with Cox regression, adjusted for age and sex. The proportion of patients taking MTX at two years were calculated.</p><p><strong>Results: </strong>From the database, we identified 4,655 patients (mean age 60 years, 64% female, 80% seropositive) who started MTX as part of the initial medication for early RA. MTX SC was purchased by 1076(23.1%) and MTX PO by 3579(76.9%) patients. At baseline, the mean (SD) DAS28 was 3.8(1.2) for MTX SC starters and 3.9(1.2) for MTX PO starters. The trajectories for disease activity and pain were more favourable for two years in patients with initial MTX SC versus PO. The probability (95%CI) to avoid bDMARDs was 0.87(0.85 to 0.89) for MTX SC and 0.91(0.90 to 0.92) for MTX PO starters (p<0.001). At two years, MTX was purchased by 80% and 79% of patients who started with MTX SC versus PO, respectively.</p><p><strong>Conclusions: </strong>Our study provides real-world evidence of the use MTX SC and PO as part of the first treatment strategy for RA. Starting with MTX, SC may be more favourable for patients, in terms of disease activity and pain, over the following two years.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"MXRA5 is identified and validated as a key gene related to epithelial-mesenchymal transition in rheumatoid arthritis fibroblast-like synoviocytes.","authors":"Haiguang Lv, Yanju Li, Ruiqiang Wang, Yang Gao","doi":"10.55563/clinexprheumatol/dt5mf6","DOIUrl":"10.55563/clinexprheumatol/dt5mf6","url":null,"abstract":"<p><strong>Objectives: </strong>The invasion of fibroblasts is a major cause of cartilage destruction in rheumatoid arthritis (RA). The epithelial-to-mesenchymal transition (EMT) is a key factor that enhances the proliferation, invasion and migration abilities of cells. This study aims to identify important EMT-related genes in the synovial cells of RA using single-cell analysis and various machine learning methods, followed by functional validation.</p><p><strong>Methods: </strong>The RA-related single-cell dataset SDY 998 was employed to investigate the heterogeneity of EMT across different cell types using the AUCcell and AddModuleScore algorithms. By intersecting the high EMT-related genes with the differentially expressed genes (DEGs), we obtained the EMT-related DEGs for subsequent correlation analysis. We then used five machine learning algorithms: Xtreme Gradient Boosting (XGBoost), Boruta, Random Forest (RF), Least Absolute Shrinkage and Selection Operator (LASSO), and Support Vector Machine Recursive Feature Elimination (SVM-RFE) to identify the optimal feature genes in the bulk RNA datasets. To validate the accuracy of our analysis, we conducted functional experiments on MH7A cells.</p><p><strong>Results: </strong>After analysing the scRNA-seq dataset with various algorithms, we found that fibroblast cells exhibited significantly high EMT activity. Fifty genes were identified as high EMT-related DEGs for subsequent analysis. The five machine learning algorithms revealed that MXRA5 and LRRC15 were significantly upregulated in RA fibroblast cells. Functional experiments confirmed that knockdown of MXRA5 significantly reduced the proliferation, migration, and invasion capabilities of the cells.</p><p><strong>Conclusions: </strong>MXRA5 was identified as a key gene related to EMT in fibroblast-like synoviocytes of RA patients. Knockdown of MXRA5 could suppress the proliferation, migration, and invasion capabilities of MH7A cells.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Li Wan, Jun Guo, Anbang Sun, Huixin Chen, Bicheng Hu, Chengyu Liu
{"title":"The application value of peripheral plasmablasts in the assessment of disease activity and treatment response in systemic lupus erythematosus.","authors":"Li Wan, Jun Guo, Anbang Sun, Huixin Chen, Bicheng Hu, Chengyu Liu","doi":"10.55563/clinexprheumatol/xsjjih","DOIUrl":"10.55563/clinexprheumatol/xsjjih","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the significance of peripheral plasmablasts as biomarkers for assessing disease activity and predicting treatment response in systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 108 SLE patients hospitalised at Wuhan Hospital of Traditional Chinese and Western Medicine from September 2023 to December 2024, focusing on their peripheral blood B cell subsets.</p><p><strong>Results: </strong>Based on the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) scores, SLE patients were categorised into mild (69 cases), moderate (27 cases), and severe (12 cases) groups. Plasmablast proportions differed significantly among SLE disease activity (mild vs. moderate: 4.06%±2.43% vs. 10.91%±6.03%, p<0.001; mild vs. severe: 4.06%±2.43% vs. 14.68%±6.41%, p<0.001; moderate vs. severe: 10.91%±6.03% vs. 14.68%±6.41%, p=0.080). Plasmablast proportions positively correlated with SLEDAI-2K, anti-dsDNA antibodies, and erythrocyte sedimentation rate, and negatively correlated with C3, C4, white blood cell and platelet counts. The AUC value for predicting SLE disease activity using plasmablast proportions was 0.885. With a cut-off value of 6.06%, the sensitivity and specificity were 87.2% and 85.5%, respectively. Moreover, in 17 patients undergoing dynamic B-cell subset monitoring, those achieving remission after treatment, whether newly diagnosed or relapsed, showed decreasing plasmablast proportions and counts over time. In contrast, refractory patients displayed poor response and persistently high plasmablast proportions and counts despite treatment.</p><p><strong>Conclusions: </strong>Peripheral plasmablasts is intricately linked with the disease activity in SLE; sustained elevated levels of plasmablasts may serve as a prognostic indicator of suboptimal therapeutic response.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The potential role of neutrophils in connective tissue disease-associated interstitial lung disease.","authors":"Haolong Wang, Yilin Lu, Jing Liu, Zhihan Sang, Wenqiang Fan, Yanli Liu, Juntang Lin","doi":"10.55563/clinexprheumatol/su8rvb","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/su8rvb","url":null,"abstract":"<p><p>Connective tissue disease-associated interstitial lung disease (CTD-ILD) is a subtype of ILD that arises due to autoimmune disorders. Unlike other ILDs, CTD-ILD is strongly linked to genetic predisposition, environmental factors, and dysfunction of the immune system. The primary pathogenesis involves immune cells erroneously attacking lung tissues in the context of autoimmune diseases; however, the precise pathogenic mechanisms remain elusive. As core driving factor of autoimmune diseases, immune cells play a pivotal role in the development of CTD-ILD. Neutrophils, key components of the innate immune system, are responsible for defending against infections and are critical in orchestrating immune responses. Notably, neutrophils can combat infections through phagocytosis or by releasing neutrophil extracellular traps (NETs).Recent studies have revealed significant dynamic changes in the quantity and function of neutrophils during the progression of CTD-ILD, highlighting their crucial role in this process. This review not only summarises the clinical manifestations of ILD associated with autoimmune diseases but also investigates the role of neutrophils in autoimmune diseases and inflammation, offering insights into the development of novel therapeutic strategies targeting abnormal neutrophil activity in CTD-ILD.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesco Belli, Francesca Bandinelli, Roberto Bandinelli, Mario Pagano
{"title":"Red wine antioxidant properties implications in rheumatic diseases: exploring clonal variations in resveratrol and other bioactive compounds.","authors":"Francesco Belli, Francesca Bandinelli, Roberto Bandinelli, Mario Pagano","doi":"10.55563/clinexprheumatol/pybjjj","DOIUrl":"10.55563/clinexprheumatol/pybjjj","url":null,"abstract":"<p><p>Resveratrol (RS), a non-flavonoid polyphenol, is a well-recognised anti-inflammatory compound of red wine. This narrative review aims to explore the mechanisms underlying its potential antioxidant properties in osteoarthritis (OA), rheumatoid arthritis (RA), spondyloarthritis (SpA), and osteoporosis (OP), as well as its clonal variation in red wine and future perspectives for clinical applications.Although human data remain limited and sometimes controversial, recent studies in animal models have demonstrated that RS can reduce inflammation by interacting with various cellular pathways, including the activation of sirtuins, which regulate oxidative stress and bone density in OA and OP, and modulating gut microbiota, as central inflammatory trigger for SpA and RA.While RS effects and toxicity are dosedependent, its concentration in red wine may vary depending on grape clone selection and maceration time, potentially increasing its levels and associated health benefits. Additionally, pterostilbene, a compound structurally related to RS, has shown greater bioavailability and promising antioxidant effects. The rapid metabolism of RS in the human body remains a limitation for its therapeutic use, which might be improved through combination with other antioxidants such as vitamins C and E, curcumin, and quercetin, offering synergistic anti-inflammatory effects.Moreover, advanced delivery systems, including nanotechnology, have been developed to enhance RS absorption and stability. Continued research is essential to better understand the role of RS and other antioxidants, and to optimise their therapeutic potential in the near future.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Elena Soto, Gabriela Meléndez-Ramírez, Mary Carmen Herrera Zarza, Aloha Meave, Miguel Ángel Cruz-Marmolejo, Aurelio Mendez-Dominguez, Juan Salvador Arias-Fernandez, Miguel Ángel Aguirre-Delfin
{"title":"Comprehensive magnetic resonance imaging evaluation in a cohort of 145 patients with Takayasu's arteritis. Proposal for a standardised and systematic reporting format.","authors":"Maria Elena Soto, Gabriela Meléndez-Ramírez, Mary Carmen Herrera Zarza, Aloha Meave, Miguel Ángel Cruz-Marmolejo, Aurelio Mendez-Dominguez, Juan Salvador Arias-Fernandez, Miguel Ángel Aguirre-Delfin","doi":"10.55563/clinexprheumatol/4bmcp0","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/4bmcp0","url":null,"abstract":"<p><strong>Objectives: </strong>Takayasu's arteritis (TAK) is a rare disease affecting the aorta and its branches. Magnetic resonance imaging (MRI) can assess vascular lesions, disease progression, activity, and the impact on different organs. Comprehensive MRI study including whole-body angiography (WBA) and target-organ assessment is not performed in all patients with suspected TAK. The aim of this study is to evaluate vascular and organic lesions in a cohort of patients with TAK who underwent MRI and to propose a standardised and systematic reporting format of the findings.</p><p><strong>Methods: </strong>Patients with ≥4 TAK criteria who underwent MRI between 2003-2024, were included. With a standardised format, angiographic analysis of the presence and type of vascular lesion by segment was performed, including cerebral, cardiac, lower limbs, and visceral arteries, as well as the impact on the target organ.</p><p><strong>Results: </strong>A total of 145 patients with mean age 36±15 years, 128 (88%) women were included. Type V of the angiographic classification was the most frequent. Involvement of cerebral 27 (18%), coronary 12 (8.2%), pulmonary 25 (17%), right renal 50 (34%) and left 42 (39%), lower limb arteries 48 (33%), stroke 27 (19%) was found. Cardiac MRI was done in 108 patients, any cardiac abnormality 70 (65%), myocardial infarction 10 (9.3 %), aortic regurgitation 26 (17%), mitral regurgitation 14 (8.3%) and complete AV-Block 1 (0.7%) was found.</p><p><strong>Conclusions: </strong>Comprehensive assessment of patients with TAK by MRI with a standardised and systematic reporting format is a tool that may allow better interdisciplinary communication in the study of this vasculitis.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy and safety of tocilizumab in polyarteritis nodosa and adenosine deaminase 2 deficiency: a systematic literature review.","authors":"Ege Sinan Torun, Selin Çelen","doi":"10.55563/clinexprheumatol/477rzo","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/477rzo","url":null,"abstract":"<p><strong>Objectives: </strong>There is a significant need for medications that offer improved effectiveness and safety in the treatment of polyarteritis nodosa (PAN). Research has shown that serum interleukin-6 levels were elevated in both PAN and adenosine deaminase 2 deficiency (DADA 2) patients, which supported the exploration of tocilizumab for patients with refractory cases of these conditions.</p><p><strong>Methods: </strong>A comprehensive systematic literature review was conducted to investigate the effectiveness and safety of tocilizumab in patients with PAN and DADA 2.</p><p><strong>Results: </strong>We reviewed 28 studies. Twenty-nine PAN patients received tocilizumab, resulting in favourable response for twenty-two patients. Five patients did not respond to the treatment. Tocilizumab was discontinued in two patients due to adverse effects before its effectiveness could be evaluated. Fifteen DADA 2 patients were treated with tocilizumab, with two achieving complete response, two showing a partial response, and nine not responding at all. In two cases, the assessment of effectiveness was not possible. Three patients experienced ischaemic vascular events while on tocilizumab, and ten patients transitioned to anti-tumour necrosis factor therapies. Side effects included infections, cytopenias, and hyperlipidemia, which were consistent with those observed in other rheumatic disease treatments involving tocilizumab.</p><p><strong>Conclusions: </strong>Tocilizumab appeared to be a promising and safe option for paediatric and adult PAN patients as a salvage therapy for those who did not respond to conventional and biologic immunosuppressive therapies. However, in patients with DADA 2, tocilizumab showed limited effectiveness and it generally performed worse than anti-tumour necrosis factor alpha agents in most cases.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mucahit Atasoy, Eser Kalaoglu, Ugur Takim, Hasan Gokcay
{"title":"Investigation of alexithymia levels in fibromyalgia before and after treatment.","authors":"Mucahit Atasoy, Eser Kalaoglu, Ugur Takim, Hasan Gokcay","doi":"10.55563/clinexprheumatol/45nmy7","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/45nmy7","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to investigate changes in alexithymia scores upon fibromyalgia (FM) treatment.</p><p><strong>Methods: </strong>This prospective observational cohort study was conducted at the Istanbul Physical Medicine and Rehabilitation Training and Research Hospital. Patients diagnosed with fibromyalgia syndrome (FM) according to American College of Rheumatology criteria were included. All participants received duloxetine treatment, combined aerobic exercise. FM symptoms were assessed using Visual Analog Scale (VAS) at baseline and at 6 months, while alexithymia was evaluated using Toronto Alexithymia Scale-20 (TAS-20) at baseline, 3, and 6 months. Statistical analysis included repeated measures ANOVA with Greenhouse-Geisser correction, paired t-tests, and correlation analyses, with adjustments for age, BMI, and daily medication count.</p><p><strong>Results: </strong>A total of 100 patients completed the study. VAS scores significantly decreased from the baseline (mean ± SD: 7.4±1.2) to 6 months (4.1±1.3; p<0.001). TAS-20 total scores also showed significant reductions at 3 months (57.8±7.6) and 6 months (54.2±7.1) compared to the baseline (61.5±7.9; p<0.001). Improvements in TAS-20 scores was correlated with reductions in VAS scores (r=0.41, p=0.002).</p><p><strong>Conclusions: </strong>Combined duloxetine treatment and aerobic exercise could significantly improve both alexithymia symptoms and pain levels in FMS patients over a six-month period. Higher baseline alexithymia scores were associated with greater improvements in both alexithymia and pain symptoms, suggesting that patients with more severe initial alexithymia may benefit more from this treatment.</p><p><strong>Clinical trial no: </strong>NCT06841302 (https://www.</p><p><strong>Clinicaltrials: </strong>gov/ registration date: 2025-02-18).</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}