{"title":"Vegan Glucosamine versus Crustacean Glucosamine in Osteoarthritis: Choosing the Correct One During Clinical Practice.","authors":"Hitesh Verma","doi":"10.31138/mjr.201223.vgv","DOIUrl":"https://doi.org/10.31138/mjr.201223.vgv","url":null,"abstract":"<p><p>The present commentary critically evaluates the role of glucosamine in joint health, specifically exploring the potential of vegan glucosamine as an alternative of crustacean glucosamine. While acknowledging glucosamine's established benefits in managing osteoarthritis, this commentary underscores concern regarding the limited data supporting the clinical use of vegan glucosamine. Methodological flaws in the bioequivalence study, lax quality parameters, and the absence of safety data for E. coli-derived vegan glucosamine are highlighted. The commentary calls for caution in endorsing vegan glucosamine for osteoarthritis patients, stressing the need for further research and a thorough evaluation of its efficacy and safety before widespread clinical adoption.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 2","pages":"207-209"},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112740","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":"2023 EULAR Recommendations for the Treatment of PsA: Advances and Pending Issues.","authors":"Philipp Sewerin, Xenofon Baraliakos","doi":"10.31138/mjr.050424.ert","DOIUrl":"https://doi.org/10.31138/mjr.050424.ert","url":null,"abstract":"","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 2","pages":"204-206"},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112800","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":"New-Onset, Treatment-Resistant Inflammatory Bowel Disease after Administration of Secukinumab for Plaque Psoriasis: A Case Report and Review of the Existing Literature.","authors":"Michail Krikelis, Evgenia Papathanasiou, George Leonidakis, Pavlos Pardalis, Spyridon Michopoulos, Evanthia Zampeli","doi":"10.31138/mjr.030124.ntt","DOIUrl":"10.31138/mjr.030124.ntt","url":null,"abstract":"<p><strong>Introduction: </strong>Aberrant activation of the IL-23/IL-17 axis leads to inflammatory phenotypes with overlapping clinical characteristics. Inhibition of IL-17 has mostly an anti-inflammatory effect, but sporadic cases of new-onset IBD have been reported.</p><p><strong>Case description: </strong>We present the case of a 65-year-old male patient with new-onset Crohn's-like disease after treatment with secukinumab for skin psoriasis. Discontinuation of the IL-17 inhibitor and high-dose corticosteroid treatment were efficient initially, but a relapse was noted during corticosteroid tapering. Administration of certolizumab pegol did partially relieve the patient, but disease remission was only achieved with subcutaneous risankizumab therapy.</p><p><strong>Discussion: </strong>Clinical trials and real-world data indicate sporadic cases of new-onset IBD in patients receiving IL-17 inhibitors. Interestingly, our case is a \"treatment-resistant\" one since treatment with a biologic disease-modifying drug (bDMARD) usually leads to disease remission. As such, it is crucial to investigate the special characteristics of this clinical entity.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 1","pages":"150-155"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912940","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":"EULAR 2023 Recommendations for the Management of Systemic Lupus Erythematosus: One Step Forward.","authors":"Georgia-Savina Moysidou, Antonis Fanouriakis","doi":"10.31138/mjr.130124.erm","DOIUrl":"10.31138/mjr.130124.erm","url":null,"abstract":"","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 1","pages":"63-65"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913693","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}
Eleana Bolla, George E Fragoulis, Alexios Iliopoulos
{"title":"New-Onset MDA-5 Dermatomyositis in a Patient Following COVID-19 Vaccination: A Case Report.","authors":"Eleana Bolla, George E Fragoulis, Alexios Iliopoulos","doi":"10.31138/mjr.280124.nom","DOIUrl":"10.31138/mjr.280124.nom","url":null,"abstract":"<p><p>Vaccination against Sars-CoV-2 has been proven to significantly reduce COVID-19 morbidity and mortality and is therefore recommended for the general population, and especially for seniors with impaired immunity. However, it is currently postulated that COVID-19 vaccines could rarely induce autoimmune diseases in previously healthy individuals. We report a case of new-onset anti-melanoma differentiation-associated protein 5 (anti-MDA5) antibody-positive dermatomyositis in a patient presenting with rash and fever following the third dose of COVID-19 vaccine. The laboratory testing revealed high titres of anti-MDA-5 antibody and chest computed tomography showed micronodular lesions and ground glass opacities bilaterally. The patient was promptly treated with corticosteroids, methotrexate, and azathioprine, and was later started on rituximab due to dermatomyositis rash exacerbation along with newly formed, diffuse skin ulcers. Our case highlights the potential immunogenicity of COVID-19 vaccines and the need for further reporting of rare rheumatic syndromes possibly related to COVID-19 disease and vaccination.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 1","pages":"179-183"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912935","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}
Christina Antoniadou, Nikolaos Fytanidis, Vasileios Devetzis, Konstantia Kantartzi, Charalampos Papagoras
{"title":"Anakinra for Refractory Pseudogout in Patients with End-stage Renal Disease on Haemodialysis.","authors":"Christina Antoniadou, Nikolaos Fytanidis, Vasileios Devetzis, Konstantia Kantartzi, Charalampos Papagoras","doi":"10.31138/mjr.261123.afr","DOIUrl":"https://doi.org/10.31138/mjr.261123.afr","url":null,"abstract":"<p><p>Calcium pyrophosphate deposition (CPPD) arthritis is the second most common type of crystal-induced arthritis after gout. Acute flares are commonly treated with non-steroidal anti-inflammatory drugs, intra-articular or short-term systemic glucocorticoids or colchicine. However, since there is no pharmacological treatment to reduce CPPD crystal burden, relapsing or chronic CPPD arthritis may be challenging to treat, particularly in patients with end-stage renal disease who are at risk for toxicity of the above medications. Since IL-1β appears to be driving CPPD arthritis, we treated two patients with chronic CPPD arthritis and end-stage renal disease on haemodialysis with the IL-1β receptor antagonist anakinra. In both patients, arthritis resolved quickly, while continuation of anakinra maintained remission and allowed complete glucocorticoid withdrawal. Therefore, anakinra may be a safe and effective option both for short and long-term treatment of CPPD arthritis in patients on chronic renal replacement therapy.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 Suppl 1","pages":"58-62"},"PeriodicalIF":0.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11094439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140958427","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}
Apostolos Kontzias, Olga Petryna, Priscila Nakasato, Petros Efthimiou
{"title":"Diagnosing and Treating Systemic Juvenile Idiopathic Arthritis and Adult-Onset Still's Disease as Part of the Still's Disease Continuum.","authors":"Apostolos Kontzias, Olga Petryna, Priscila Nakasato, Petros Efthimiou","doi":"10.31138/mjr.290323.dat","DOIUrl":"https://doi.org/10.31138/mjr.290323.dat","url":null,"abstract":"<p><strong>Aim: </strong>We have summarised the existing evidence supporting the concept that systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still's disease (AOSD) are part of the same Still's disease spectrum.</p><p><strong>Methods: </strong>A PubMed/Embase database search was conducted using specific search strings and free text words to screen for relevant articles. The search was limited to studies in humans, published up to June 2023, in English-language.</p><p><strong>Summary: </strong>sJIA and AOSD are rare autoinflammatory disorders that have similar pathophysiological and clinical features. The clinical presentations of sJIA and AOSD are highly variable, with differential diagnoses that include a broad range of malignancies, infectious diseases, and autoimmune disorders, which contribute to delays in diagnosis. Several sets of classification exist to help diagnose patients in clinical practice; the International League of Associations for Rheumatology criteria for sJIA and the Yamaguchi and Fautrel criteria for AOSD are the most-used criteria. The therapeutic strategy for Still's disease aims to relieve signs and symptoms, prevent irreversible joint damage and potentially life-threatening complications, and avoid deleterious side effects of treatment. Recently, targeted therapies such as interleukin (IL)-1 and IL-6 inhibitors have become available for the treatment of sJIA and AOSD. While these biologics were originally largely reserved for patients in whom non-steroidal anti-inflammatory drugs, corticosteroids and conventional synthetic disease-modifying anti-rheumatic drugs had failed, they are increasingly used earlier in the treatment paradigm. Among IL-1 inhibitors, canakinumab is the only biologic approved in the US for the treatment of both sJIA and AOSD.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 Suppl 1","pages":"45-57"},"PeriodicalIF":0.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11094444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140958881","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}
Konstantinos D Vassilakis, Konstantina Magiouf, Stefan Siebert, George E Fragoulis
{"title":"Selective JAK-Inhibitors in Spondyloarthritis.","authors":"Konstantinos D Vassilakis, Konstantina Magiouf, Stefan Siebert, George E Fragoulis","doi":"10.31138/mjr.311023.sji","DOIUrl":"https://doi.org/10.31138/mjr.311023.sji","url":null,"abstract":"<p><p>As our research interest and knowledge increases in the field of Spondyloarthritis, new aspects also emerge as regards to their therapeutic approach. JAK inhibitors (JAKi) are a relatively new treatment option, aiming molecules in the JAK-STAT pathway, which has a leading role in the pathophysiology of both Psoriatic Arthritis and Axial Spondyloarthritis. JAKi exhibit different selectivity towards the four different members of the JAK family (namely JAK1, JAK2, JAK3, and TYK2), possibly reflecting different efficacy and safety profile. Although knowledge is more consolidated for rheumatoid arthritis in which JAKi are being used for more than 10 years, data are still accumulating for PsA/SpA. In this review we aim to present and assess current knowledge about the efficacy of JAKi (with a focus on selective JAKi) in the treatment of patients with SpA and evaluate their safety profile as some concerns may arise around this therapeutic option.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 Suppl 1","pages":"27-36"},"PeriodicalIF":0.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11094441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959246","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}
Elpida Skouvaklidou, Dimitrios Deligeorgakis, Anastasia Skalkou, Vasileios Skepastianos, Konstantinos Tsafis, Evdokia Papadimitriou, Eleni Pagkopoulou, Paraskevi Avgerou, Maria G Mytilinaiou, Maria Tzitiridou-Chatzopoulou, Nikolaos Kougkas, Christina Adamichou
{"title":"Focus on Filgotinib in Rheumatoid Arthritis: A Trial-Based Review.","authors":"Elpida Skouvaklidou, Dimitrios Deligeorgakis, Anastasia Skalkou, Vasileios Skepastianos, Konstantinos Tsafis, Evdokia Papadimitriou, Eleni Pagkopoulou, Paraskevi Avgerou, Maria G Mytilinaiou, Maria Tzitiridou-Chatzopoulou, Nikolaos Kougkas, Christina Adamichou","doi":"10.31138/mjr.281123.fof","DOIUrl":"https://doi.org/10.31138/mjr.281123.fof","url":null,"abstract":"<p><p>Janus kinases (JAK)/Signal Transducer and Activator of Transcription (STAT) pathway is involved in pathophysiologic cascade of a notable number of rheumatic diseases. The development of JAK inhibitors has expanded treatment choices in rheumatoid arthritis (RA) with a sustained class-effect efficacy. Filgotinib is a novel selective inhibitor of JAK1 isoform licensed for use in RA and ulcerative colitis. In this review we aim to present an analysis of filgotinib's efficacy and drug-specific safety warnings. Patients with RA with or without concomitant conventional synthetic Disease-Modifying Antirheumatic Drugs (csDMARDs) (naïve or experienced) and those who have failed biologic Disease-Modifying Antirheumatic Drugs (bDMARDs) were examined in randomised clinical trials. Filgotinib was also tested against placebo, methotrexate, or adalimumab. Long-term extension trials provide insights for up to four years of continuous filgotinib administration. Beneficial effects are depicted in both disease activity parameters and quality of life indexes in moderate or severe RA with a longitudinal efficacy. In head-to-head comparison with adalimumab, filgotinib 200 mg was non-inferior. Adverse effects alerts are marked by the elevated risk of infectious adverse effects with the exception of herpes zoster infection, which has a low incidence.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 Suppl 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11094443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959190","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}
Sotirios G Tsiogkas, Carlo Perricone, Dimitrios P Bogdanos
{"title":"The Effect of JAK Inhibitors on Patient-Reported Outcomes in Psoriatic Arthritis.","authors":"Sotirios G Tsiogkas, Carlo Perricone, Dimitrios P Bogdanos","doi":"10.31138/mjr.171223.tej","DOIUrl":"https://doi.org/10.31138/mjr.171223.tej","url":null,"abstract":"<p><strong>Objective: </strong>Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects the joints and skin of patients with psoriasis. In this review we aimed to summarise the available evidence regarding the effect of Janus kinase inhibitors (JAKi) on patient-reported outcomes (PROs) when used for the management of PsA.</p><p><strong>Methods: </strong>We utilised a narrative review approach as we searched the available literature for articles to be included in our study.</p><p><strong>Results: </strong>JAKi have been found to be effective in inducing better PRO responses compared to placebo. These findings have been consistent across various patient populations, including those with active PsA, those with an inadequate response to conventional therapies, and those with comorbidities. The evidence supporting the benefits of JAKi on PROs in PsA is compelling, demonstrating consistent improvements in pain, physical function, fatigue, and quality of life.</p><p><strong>Conclusion: </strong>Numerous studies have demonstrated the the efficacy of JAKi in improving PROs in patients with PsA.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 Suppl 1","pages":"20-26"},"PeriodicalIF":0.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11094440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959260","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}