European journal of rheumatology最新文献

{"title":"A comparison of rituximab with cyclophosphamide in terms of efficacy and complications as induction therapy for treating granulomatosis with polyangiitis: A three-center study.","authors":"Maryam Tavakoli Chaleshtori,&nbsp;Ziba Farajzadegan,&nbsp;Mansour Salesi","doi":"10.5152/eurjrheum.2022.21063","DOIUrl":"https://doi.org/10.5152/eurjrheum.2022.21063","url":null,"abstract":"<p><strong>Objective: </strong>Granulomatosis with polyangiitis (GPA), formerly known as Wegner's granulomatosis, is a rare vasculitic syndrome classified under Anti-Neutrophilic Cytoplasmic Autoantibody (ANCA)-associ- ated vasculitides, which is fatal if untreated. The mainstay of treatment consists of immunosuppression using a combination of corticosteroids with either rituximab (RTX) or cyclophosphamide (CYC). We aimed to compare the 4-year clinical outcomes between patients with GPA receiving CYC and RTX as remission induction.</p><p><strong>Methods: </strong>In this retrospective cohort, we used patient data from 92 patients with GPA at two large teaching hospitals and a private clinic in Isfahan, Iran. The patients were classified based on the medi- cation they received for remission induction into RTX and CYC groups. The main outcomes were rate of death and relapse, disease activity assessed based on the Birmingham Vasculitis Activity Score (BVAS), disease-related complications, laboratory markers, and adverse-drug-reactions.</p><p><strong>Results: </strong>Fifty-three (57.6%) patients received CYC, whereas 39 (42.4%) received RTX. The mean duration of follow-up was 3.6 (62) years. Most of patients (70%) had a successful remission, while 20.7% experi- enced a relapse and 8.7% of patients died. The rate of death and relapse did not differ between the RTX and CYC groups. Disease-related complications involved an insignificantly higher proportion of patients in the CYC (12/53) group than the RTX (4/39) group. Patients in both groups showed a signifi- cant decrease in BVAS during follow-ups irrespective of the medication exposure. The rate of adverse events was similarly low (n 1⁄4 1) in both groups.</p><p><strong>Conclusion: </strong>RTX and CYC were similar in inducing remission and reducing adverse clinical outcomes among patients with GPA with acceptable side effect profiles.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b3/4b/ejr-9-2-88.PMC10176214.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9447635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A real-life analysis of patients with rheumatologic diseases on biological treatments: Data from TURKBIO Registry.","authors":"Fatoş Önen,&nbsp;Gerçek Can,&nbsp;Sedat Çapar,&nbsp;Ediz Dalkılıç,&nbsp;Yavuz Pehlivan,&nbsp;Soner Şenel,&nbsp;Servet Akar,&nbsp;Süleyman Serdar Koca,&nbsp;Abdurrahman Tufan,&nbsp;Ayten Yazıcı,&nbsp;Sema Yılmaz,&nbsp;Nevsun İnanç,&nbsp;İsmail Sarı,&nbsp;Merih Birlik,&nbsp;Dilek Solmaz,&nbsp;Ayşe Cefle,&nbsp;Mehmet Akif Öztürk,&nbsp;Servet Yolbaş,&nbsp;Niels Steen Krogh,&nbsp;Neslihan Yılmaz,&nbsp;Şükran Erten,&nbsp;Cemal Bes,&nbsp;Özgül Soysal Gündüz,&nbsp;Berna Göker,&nbsp;Seminur Haznedaroğlu,&nbsp;Şule Yavuz,&nbsp;Gözde Yildirim Çetin,&nbsp;Fatih Yıldız,&nbsp;Haner Direskeneli,&nbsp;Nurullah Akkoç","doi":"10.5152/eurjrheum.2022.21060","DOIUrl":"https://doi.org/10.5152/eurjrheum.2022.21060","url":null,"abstract":"<p><strong>Objective: </strong>TURKBIO registry, established in 2011, is the first nationwide biological database in Turkey. This study aimed to provide an overview of TURKBIO data collected by June 2018.</p><p><strong>Methods: </strong>The registry included adult patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), nonradiographic axial spondyloarthritis (nr-AxSpA), and psoriatic arthritis (PsA). Demographic and clinical features, disease activity markers, and other follow-up parameters, current and previous treat- ments, and adverse events were registered electronically at each visit using open-source software. The registration of patient-reported outcome measures was carried out electronically by the patients using touch screens.</p><p><strong>Results: </strong>TURKBIO registry included a total of 41,145 treatment series with biologicals. There were 2,588 patients with axSpA (2,459 AS and 129 nr-axSpA), 2,036 with RA, and 428 with PsA. The total number of patients, including those with other diagnoses, was 5,718. In the follow-up period, the number of patients and also visits steadily increased by years. The yearly mean number of visits per patient was found to be 2.3. Significant improvements in disease activity and health assessment parameters were observed following the biological treatments. Biologics were often given in combination with a con- ventional synthetic disease-modifying antirheumatic drug in patients with RA. Infections were the most commonly seen adverse events, followed by allergic reactions. Tuberculosis was observed in 12 patients, malignancy in 18, and treatment-related mortality in 31.</p><p><strong>Conclusion: </strong>TURKBIO provided a valuable real-life experience with the use of biologics in rheumatic diseases in Turkey.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/02/ejr-9-2-82.PMC10176217.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9447689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pigmented villus fragments on synovial fluid examination.","authors":"Ufuk İlgen,&nbsp;Hakan Emmungil","doi":"10.5152/eurjrheum.2021.20152","DOIUrl":"https://doi.org/10.5152/eurjrheum.2021.20152","url":null,"abstract":"A 55-year-old woman with no systemic disease presented to our hospital with unilateral knee swelling for 3 years. The swelling was progressive in nature, with acute exacerbations. Physical examination revealed painless moderate joint effusion with no accompanying arthritic features clinically. Aspiration yielded a slightly turbid yellow fluid, with 3,500 white blood cells/mm3 (60% polymorphonuclear cells). No crystals were found in the sediment examination, and no bacteria were identified on Gram staining. Bacterial cultures were also negative. She had moderate effusion and synovial hypertrophy with no Doppler signal in the suprapatellar recess on ultrasonography. Plain radiography was unremarkable. Acute-phase reactants were normal, and she was negative for rheumatoid factor, anti-cyclic citrullinated peptide, and anti-nuclear antibodies. A dose of triamcinolone hexacetonide 40 mg was administered intra-articularly for a diagnosis of chronic undifferentiated monoarthritis. She presented with a huge effusion in the same joint 2 months later. Synovial fluid examination was similar, except that she had pigmented synovial villus fragments on microscopy (Figure 1). Magnetic resonance imaging showed effusion and synovial thickening with villus-like projections primarily localized in the suprapatellar recess, iso/hypointense T1and T2-weighted images with hypointense foci, and diffuse gadolinium enhancement (Figure 2). These findings were suggestive of pigmented villonodular synovitis. An open synovectomy was performed. Pathological examination revealed hyperplastic synovium with papillary projections containing hemosiderin-laden macrophages, foamy histiocytes, and multinucleated giant cells, which confirmed the diagnosis. The patient is being followed up with no relapse. Ufuk İlgen, Hakan Emmungil Images in Rheumatology","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/47/ejr-9-2-104.PMC10176224.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9799911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Next-Generation Sequencing Analysis of MVK, NLRP3, TNFRSF1A, and PSTPIP1 Genes in Patients without MEFV Gene Variation and Genotype-Phenotype Correlation.","authors":"Gamze Vuran,&nbsp;Afig Berdeli","doi":"10.5152/eurjrheum.2022.21049","DOIUrl":"https://doi.org/10.5152/eurjrheum.2022.21049","url":null,"abstract":"<p><p>Objective: In this study, we aimed to evaluate other interleukin-1b-mediated monogenic autoinflam- matory diseases (AIDs) (tumor necrosis factor receptor-1-associated periodic syndrome, hyperimmuno- globulin D syndrome, cryopyrin-associated periodic syndrome (CAPS), pyogenic arthritis, pyoderma gangrenosum, and acne syndrome) by the next-generation sequencing method (NGS) in cases with clinical Familial Mediterranean Fever symptoms, and no variant detected in the MEFV gene.\u0000Methods: The cases included in this study and their parents were interviewed and filled in a survey form. The targeted genetic panel for interleukin-1b-mediated AIDs covering four genes (MVK, NLRP3,TNFRSF1A, and PSTPIP1) was studied for cases with a negative result from the MEFV gene analysis. The genetic analysis was conducted using the targeted NGS method.\u0000Results: Variants were found in 16 out of the 40 patients in the study sample. These variants were pri- orly reported in variant databases, and three of them were identified as definitely pathogenic (V377I of the MVK gene, C52Y of the TNFRSF1A gene, and I313V of the NLRP3 gene), four as a variant of uncer- tain significance (VUS) (R92Q of the TNFRSF1A, A372V of the PSTPIP1, and V198M and Q703K of the NLRP3), and one as benign polymorphism (S52N of the MVK gene). The median age of onset among variant-positive cases was 10.5 (3.5-18) years. The most common clinical findings in the variant-positive group were arthralgia, fever, and abdominal pain. While three out of 40 patients met the classification criteria before genetic analysis, only one patient was diagnosed with CAPS as a result of genetic analy- sis, and other patients were considered as nonspecific phenotype.\u0000Conclusion: The use of NGS gene panels seems beneficial in diseases with heterogeneous clinical manifestations such as systemic AIDs. Although the number of variants detected is high, clinical diag- nosis rates remain low. The genotype–phenotype relationship in these diseases is still unclear.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dc/48/ejr-9-2-62.PMC10176221.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adalimumab-Induced Lupus Nephritis: Case Report and Review of the Literature.","authors":"Brigitte Kazzi,&nbsp;Brent Gudenkauf,&nbsp;Derek Fine,&nbsp;Jose Manuel Monroy-Trujillo,&nbsp;Antoine Azar,&nbsp;Gabriel Giannini,&nbsp;Homa Timlin","doi":"10.5152/eurjrheum.2022.21059","DOIUrl":"https://doi.org/10.5152/eurjrheum.2022.21059","url":null,"abstract":"<p><p>Tumor necrosis factor-alpha inhibitors are known causative agents of systemic lupus erythemato- sus but have rarely been implicated in lupus nephritis. A patient with Crohn's disease on long-term adalimumab treatment presented with new-onset Raynaud's phenomenon and was found to have hematuria and proteinuria. Elevated antinuclear, anti-dsDNA, and MPO antibodies were found. A renal biopsy confirmed the diagnosis of lupus nephritis. Adalimumab was discontinued ensuing improvement in urine studies and resolution of dsDNA and MPO antibodies. Adalimumab can induce systemic lupus erythematosus and lupus nephritis.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/1c/ejr-9-2-108.PMC10176219.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for Leishmania specific antibodies among patients with rheumatic diseases treated with biological therapy.","authors":"Fruzsina Szabados,&nbsp;Henrik Vedel Nielsen,&nbsp;Kurt Fuursted,&nbsp;Asta Linauskas,&nbsp;Claus Rasmussen,&nbsp;Peter Derek Christian Leutscher","doi":"10.5152/eurjrheum.2022.20105","DOIUrl":"https://doi.org/10.5152/eurjrheum.2022.20105","url":null,"abstract":"We have read with interest the recent Letter to the Editor: “Remembering visceral leishmaniasis as a potential trigger of haemophagocytic lymphohistiocytosis in individuals treated with anti-TNF-alpha therapy” by Nardo-Marino et al., 1 and we would like to add some comments to the letter. This letter refers to a case report by Burka et al. 2 describing a Scandinavian male patient developing hemophagocytic lymphohistiocytosis 28days after the onset of infliximab treatment. The bone marrow examination revealed the presence of Leishmania amastiotes, which was a quite surprising finding, because the patient did not have any recent travel history to leishmaniasis-endemic areas at the onset of the symptoms and had never traveled to any endemic areas outside of Europe. The majority of visceral leishmaniasis (VL) cases worldwide occur in endemic areas of Brazil, Nepal, India, and in some East African countries. In Europe, the parasitic disease is seen in the Mediterranean region. 3 As highlighted by Nardo-Marino et al., 1 VL progression induced by biologic therapy has been reported on several occasions among patients from VL endemic areas. We have recently conducted a travel questionnaire survey among arthritis patients treated with biologics in our out-patient clinic. 4 A total of 273 patients completed the questionnaire. A history of traveling to dif-ferent countries in the Mediterranean region was reported by 13%, including Portugal, Spain, Italy,","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/81/ejr-9-2-114.PMC10176213.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9459623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rituximab-associated hypogammaglobulinemia in ANCA-associated vasculitis: Incidence and time course.","authors":"Anam Tariq,&nbsp;Ayobami Akenroye,&nbsp;Antoine Azar,&nbsp;Philip Seo,&nbsp;Duvuru Geetha","doi":"10.5152/eujrheum.2022.20258","DOIUrl":"https://doi.org/10.5152/eujrheum.2022.20258","url":null,"abstract":"<p><strong>Objective: </strong>Rituximab (RTX) is approved for remission induction and maintenance of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV). Observational studies demonstrate decline in immunoglobulin (IgG) in AAV post-RTX. The time course for the onset of hypogammaglobulinemia (Hypo-IgG) post-RTX is unknown. This is a key determinant in deciding whether to continue RTX for reinduction or maintenance of remission for AAV. We evaluated the trends of Hypo-IgG among AAV patients post-RTX therapies.</p><p><strong>Methods: </strong>An observational single-tertiary-center study of AAV patients treated with RTX for remission induction or maintenance (induction therapy, maintenance therapy, and combined induction and maintenance therapy) between 1998 and 2018. Poisson regression was used to compare the inciden- ces of Hypo-IgG: mild (450-700 mg dL-1), moderate (200-450 mg dL-1), and severe (􏰃200 mg dL-1). Ig levels were measured every 3-6 months after RTX use.</p><p><strong>Results: </strong>Mean (SD) age at last visit was 59 (16) years, 93% were Caucasians, 64% were females, and 71 (63%) had granulomatosis with polyangiitis (GPA). Hypo-IgG occurred in 47 patients: one (2%) severe, 13 (28%) moderate, and 33 (70%) mild. Lower incidences of mild Hypo-IgG post-RTX were seen during induction compared to maintenance (IR 5.04 per 100 000 days vs 5.45 per 100 000 days, incidence rate ratio (IRR) 1.08, 95% CI 0.34, 3.19). Moderate Hypo-IgG occurred at 2.29 per 100 000 days during induc- tion and 1.82 per 100 000 days during maintenance (IRR 0.79, 95% CI 0.08, 4.84).</p><p><strong>Conclusion: </strong>Hypo-IgG is common among AAV treated with RTX, occurring in 42% of patients in this single-center cohort. The nadir IgG levels occur during remission induction, and the IgG levels remain relatively stable or increase over time in those receiving RTX for remission maintenance.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/49/cd/ejr-9-2-93.PMC10176222.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9459624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mönckeberg sclerosis with giant cells as a masquerade of giant cell arteritis.","authors":"Andrew Johannemann,&nbsp;Alan D Proia,&nbsp;Lisa Criscione-Schreiber","doi":"10.5152/eurjrheum.2021.20134","DOIUrl":"https://doi.org/10.5152/eurjrheum.2021.20134","url":null,"abstract":"<p><p>Giant cell arteritis (GCA) is the most common type of vasculitis in adults, which is classified as a large/medium vessel vasculitis. It has a predilection for the ophthalmic circulation and extracranial carotid system. Temporal artery biopsy specimens can show the presence of inflammatory multinucleated giant cells. Here, we report just the third case of Mönckeberg sclerosis with multinucleated giant cells affecting the temporal artery and mimicking GCA. This rare finding in the evaluation of a common vasculitis is important for rheumatologists to be aware of and emphasizes close collaboration between clinicians and pathologists.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/94/ce/ejr-8-2-105.PMC8133881.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40587290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How well are biologic and conventional DMARDs tolerated in psoriatic arthritis: A real world study.","authors":"Issrah I Jawad,&nbsp;Muhammed K Nisar","doi":"10.5152/eurjrheum.2021.21027","DOIUrl":"https://doi.org/10.5152/eurjrheum.2021.21027","url":null,"abstract":"<p><strong>Objective: </strong>Even though disease-modifying antirheumatic drugs (DMARDs) are well established in rou- tine clinical practice, longitudinal real-world data for their retention and tolerability are sparse, espe- cially in psoriatic arthritis (PsA) patients. Our objective was to describe the characteristics of our large PsA cohort including the comorbidities and evaluate real-world DMARD tolerability and discontinua- tion rates with reasons for stopping treatment.</p><p><strong>Methods: </strong>We retrospectively interrogated the electronic, multipurpose, live setting database at our uni- versity hospital to identify 335 patients diagnosed with PsA who had received conventional DMARDs (cDMARDs) and/or biologic DMARDs (bDMARDs) between 1994 up to and including April 2019.</p><p><strong>Results: </strong>In total, 170 (50.7%) patients had discontinued one or more cDMARDs prior with a mean dura- tion before discontinuation of 9.9 months. In contrast, only 28 (24.8%) patients had stopped a course of bDMARDs at some point. The mean duration before biologic therapy was discontinued was 18.2 months.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first dedicated retrospective review of a large real-world PsA cohort addressing drug survival and tolerability of DMARDs over a 20-year period. Our study shows that in reality, cDMARDs are not well tolerated. This should encourage review of international guid- ance allowing earlier employment of biologics in the treatment paradigm.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/d7/ejr-9-2-100.PMC10176215.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9456197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment with biologic DMARDs may not adversely affect lung nodules in rheumatoid arthritis patients.","authors":"Hazan Karadeniz,&nbsp;Emetullah Cindil,&nbsp;Hakan Babaoğlu,&nbsp;Aslıhan Avanoğlu Güler,&nbsp;Reyhan Bilici Salman,&nbsp;Hasan Satış,&nbsp;Nuh Ataş,&nbsp;Berna Göker,&nbsp;Şeminur Haznedaroğlu,&nbsp;Mehmet Akif Öztürk,&nbsp;Abdurrahman Tufan","doi":"10.5152/eujrheum.2022.21067","DOIUrl":"https://doi.org/10.5152/eujrheum.2022.21067","url":null,"abstract":"<p><strong>Objective: </strong>Lung nodules (LNs) impose diagnostic and therapeutic challenges in patients with rheuma- toid arthritis (RA) due to unpredictable outcomes. Potential induction of nodulosis with the use of con- ventional synthetic DMARDs (csDMARD) and lack of knowledge regarding the effect of biologic disease-modifying anti-rheumatic drugs (bDMARDs)/tofacitinib on the LN raise concerns and have an impact on treatment decisions. This study aims to evaluate the possible effects of the bDMARDs/tofa- citinib and csDMARDS on LNs observed in RA patients.</p><p><strong>Methods: </strong>Electronic health records of RA patients who had LNs detected on computed tomography (CT) between January 2015 and December 2020 were evaluated retrospectively. Patients with follow- up CT images were included in the study. Baseline and follow-up images were meticulously examined for the number, size, attenuation, and cavity formation. Clinical, histopathologic, and laboratory find- ings were analyzed.</p><p><strong>Results: </strong>Forty-two RA patients with LNs were studied, 21 were on bDMARDs/tofacitinib (11 females, mean age: 59.7 6 8.4) and 21 were on csDMARDs (12 females, mean age: 71.4 6 8.3). The proportion of patients with progressed nodules during follow-up was comparable between groups (six patients in bDMARDs/tofacitinib vs seven patients in csDMARDs). Progression of LNs was observed in six patients in the bDMARDs/tofacitinib group: three in anti-TNFa, two in rituximab, and one in abatacept users and none in tofacitinib users.</p><p><strong>Conclusion: </strong>Our results suggest that the risk of progression in LNs in RA patients with use of bDMARDs/tofacitinib might not impose a higher risk compared to csDMARDs. Moreover, bDMARDs/ tofacitinib might result in regression in LNs.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/9a/ejr-9-2-75.PMC10176220.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9456196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}