Egyptian Rheumatologist最新文献

{"title":"Cardiovascular involvement in Behçet’s disease patients: Carotid atherosclerosis, neutrophil–lymphocyte ratio, platelet-lymphocyte ratio, and serum asymmetric dimethylarginine","authors":"Omima A. Sayed ,&nbsp;Rasha A. Abdel-Magied ,&nbsp;Hazem M.A. Farrag ,&nbsp;Mostafa A. Abu Elela ,&nbsp;Abdallah M.M. Safwat ,&nbsp;Ahmed M. Abdel-Nasser","doi":"10.1016/j.ejr.2025.07.004","DOIUrl":"10.1016/j.ejr.2025.07.004","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To assess the frequency of subclinical atherosclerosis in Behçet’s disease (BD) and the influence of neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and serum asymmetric dimethylarginine (ADMA) compared to traditional cardiovascular risk factors and their relation to the disease characteristics.</div></div><div><h3>Patients and methods</h3><div>This study included 60 BD patients and 30 age and sex matched healthy controls. The BD current activity form (BDCAF) was scored. Traditional cardiovascular risk factors were evaluated. Complete blood count was assessed and both NLR and PLR were calculated. Serum ADMA level was measured. Radiological evaluation of carotid intima media thickness (CIMT) was performed.</div></div><div><h3>Results</h3><div>The mean age of patients was 36.5 ± 10 years and were 48 males and 12 females (M:F 4:1). BD patients had significantly higher CIMT and carotid atherosclerotic plaques compared to the control (0.53 ± 0.14 versus 0.41 ± 0.09, p &lt; 0.001 and 21.7 % versus 0 % respectively) despite similar rate of traditional cardiovascular risk factors. CIMT of BD patients correlated with age (r = 0.38,p = 0.003), disease duration (r = 0.3,p = 0.02), presence of ocular manifestation (r = 0.31,p = 0.02), waist/hip ratio (WHR)(r = 0.29,p = 0.03), NLR (r = 0.42, p = 0.001), PLR (r = 0.27, p = 0.04) and ADMA (r = 0.5,p &lt; 0.001). Only serum ADMA level was found to be a significant determinant of CIMT in BD (p &lt; 0.001), contributing in 37.9 % of the variance of CIMT. NLR, PLR and ADMA can differentiate BD with subclinical atherosclerosis at cut-off values 2.36, 125.51 and 1.27 umol/L respectively.</div></div><div><h3>Conclusion</h3><div>BD is associated with an increased rate of subclinical atherosclerosis, which is best determined by increased hematological indices and serum ADMA level rather than traditional cardiovascular risk factors.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 201-206"},"PeriodicalIF":1.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Class V membranous nephropathy in patients with systemic lupus erythematosus: Clinical characteristics, outcome and prognosis","authors":"Nermeen Samy,&nbsp;Sherin H. Hamza,&nbsp;Fatma I. Mabrouk,&nbsp;Duaa F. Atyaallah,&nbsp;Mohammed M. Mohammed","doi":"10.1016/j.ejr.2025.07.003","DOIUrl":"10.1016/j.ejr.2025.07.003","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To study the clinical presentation, course, outcome and prognostic factors of membranous lupus nephritis (MLN) in systemic lupus erythematosus (SLE) patients.</div></div><div><h3>Patients and methods</h3><div>Ninty-six SLE patients with MLN were studied. The SLE disease activity index (SLEDAI) and SLE International Collaborating Clinics damage index (SLICC-DI) were assessed. 48 patients had pure MLN (Class V) and another 48 mixed (membranous plus proliferative classes III/IV) were recruited. The median follow-up was 24 months after the initial renal biopsy.</div></div><div><h3>Results</h3><div>Out of 96 patients, 86 were females and 10 were males with a mean age of 34.9 ± 10.6 years and disease duration of 8.85 ± 1.7 years. 43 (44.8 %) had nephrotic and 25 (26 %) nephritic syndrome.The mean SLICC-DI was 2.46 ± 1.2 while SLEDAI was 12.6 ± 4.3.76 (79.2 %) achieved complete remission, and 20 (20.8 %) partial remission. 4.2 % developed renal or extra-renal flare, 13.5 % had chronic kidney disease. Patients with mixed-type had a significantly higher SLEDAI (p &lt; 0.0001), anti-double-stranded deoxyribonucleic acid (anti-dsDNA) titre (p = 0.028), serum creatinine (p = 0.016), chronicity index of renal biopsy (p = 0.001) and longer duration to achieve nephritis remission (p = 0.001) together with lower creatinine clearance (p = 0.009) in comparison with pure type. SLICC-DI &gt; 3 (p = 0.002), SLEDAI &gt; 14 (p &lt; 0.001), Albumin/ Creatinine &gt; 4.5 g/day (p = 0.013), serum creatinine &gt; 1.36 mg/dl (p &lt; 0.001), creatinine clearance &lt; 84.3 mL/min (p = 0.002), urinary casts (p &lt; 0.0001) and chronicity index &gt; 6 (p = 0.003) were the main predictors of poor outcome among patients with MLN.</div></div><div><h3>Conclusion</h3><div>Mixed MLN had more severe clinical and histological presentations and a longer time to achieve complete and partial remission than the pure MLN.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 207-211"},"PeriodicalIF":1.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymptomatic hyperuricemia and the risk of colistin-induced acute kidney injury in critically-ill patients with ventilator-associated pneumonia","authors":"Alia H. Abd El Fatah,&nbsp;Mohamed M.Y. Khaled,&nbsp;Mohammed S. Sayed,&nbsp;Mohamed A. Fakher,&nbsp;Sherif R.A. Mohamed","doi":"10.1016/j.ejr.2025.07.001","DOIUrl":"10.1016/j.ejr.2025.07.001","url":null,"abstract":"<div><h3>Background</h3><div>Hyperuricemia has been associated with many chronic metabolic diseases, such as cardiovascular disease, chronic kidney disease, and metabolic syndrome.</div></div><div><h3>Aim of the work</h3><div>To reveal the risk of hyperuricemia and its association with development of acute kidney injury (AKI) during treatment with colistin incritically-illpatients with multidrug and extensive drug resistant ventilator-associated pneumonia not known to be hyperuricemic.</div></div><div><h3>Patients and methods</h3><div>This study included 60 patients with ventilator-associated pneumonia admitted to the intensive care unit (ICU): 23 with hyperuricemia and 37with normal serum uric acid (SUA) levels. The APACHE II (Acute Physiology And Chronic Health Evaluation) and Sequential Organ Failure Assessment (SOFA) were scored. All patients were receiving intravenous colistin 2.5–5 mg/kg/d in 2–4 divided doses.</div></div><div><h3>Results</h3><div>The mean age of the patients was 61.3 ± 14.4 years, 17 females (F:M 1:2.19), the APACHE II and SOFA were lower in those with hyperuricemia (20.5 ± 6.3 and 16.0 ± 4.9) compared to those with normal SUA (24.8 ± 9.3 and 8.7 ± 5.6; p = 0.0.04 and p = 0.001). 12 (52.1 %) patients with hyperuricemia developed AKI and 11 (47.8 %) died while 5 (13.5 %) developed AKI and 17 (45.9 %) died in those with normal SUA (p = 0.001 and p = 0.89 respectively). The area under the curve (AUC) for SUA levels predicting AKI was 0.77 (95 %CI:0.62–0.9) at &gt; 7 mg/dL (sensitivity 71 %, specificity 77 %) (p = 0.001).</div></div><div><h3>Conclusion</h3><div>Asymptomatic hyperuricemia is a potential risk factor for AKI in critically-ill patients with multidrug resistant ventilator-associated pneumonia. It may play a role in the development of sepsis-related AKI, and managing hyperuricemia could potentially serve as an effective strategy to prevent its development.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 197-200"},"PeriodicalIF":1.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving role of long non-coding (lnc) RNA RP11-273G15.2, mRNA-RSAD2 and mRNA-IFI44 in systemic lupus erythematosus patients","authors":"Basma R. Sakr ,&nbsp;Neama M Abdelazim ,&nbsp;Olfat G. Shaker ,&nbsp;Mona G. Nada ,&nbsp;Marwa Mamdouh","doi":"10.1016/j.ejr.2025.07.002","DOIUrl":"10.1016/j.ejr.2025.07.002","url":null,"abstract":"<div><div><strong><em>Aim of the work:</em></strong> To assess expression level of long non-coding (lnc) RNA RP11-273G15.2, microRNA (mRNA) RSAD2, and mRNAIFI44 in systemic lupus erythematosus (SLE) patients and to study their relationship with clinical manifestations, hematological indices, and disease activity. <strong><em>Patients and methods</em>:</strong> This study recruited 40 SLE patients and 40 controls. SLE disease activity index (SLEDAI) was assessed. Quantitative analysis by real-time polymerized-chain reaction was accomplished for lncRNA RP11-273G15.2, mRNA-RSAD2 and mRNA-IFI44. <strong><em>Results:</em></strong> The mean age of the patients was 33.4 ± 8.1 years, 36 females (F:M 9:1) and disease duration 7.4 ± 6.2 years. The mRNA IFI44 was significantly upregulated in patients (p = 0.004), while lnc RNA RP11-273G15.2 and mRNA-RSAD2 were comparable between patients and controls. The lnc RNA RP11-273G15.2, mRNA IFI44 and mRNA RSAD2 were similar between patients with and without musculoskeletal, cardiac, pulmonary, mucocutaneous, central nervous system, or renal manifestations. The mRNA RSAD2 exhibited significantly lower expression level in patients with history of thrombosis (p = 0.03). The lnc RNA RP11-273G15.2, mRNA-IFI44 and mRNA-RSAD2 were comparable in relation to the other blood indices anti-dsDNA positivity and complement consumption. There was no association of any of the studied parameters with SLEDAI. <strong><em>Conclusion:</em></strong> The mRNA IFI44 was significantly upregulated in SLE patients signifying its role in the molecular pathophysiology of SLE, while lncRNA RP11-273G15.2, and mRNA-RSAD2 were comparable between patients and controls. The lncRNA RP11-273G15.2, mRNA-IFI44 and mRNA-RSAD2 were not related to clinical manifestations, hematological indices, immune profile, or disease activity of SLE patients, apart from significant down regulation of mRNA-RSAD2 in patients with history of thrombosis.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 192-196"},"PeriodicalIF":1.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinical characteristics of patients with Behҫet’s disease in two different geographical areas in the United States","authors":"Hamdy Ahmed ,&nbsp;Sebastian E. Sattui ,&nbsp;Dongmei Sun ,&nbsp;Ammar Alkassm ,&nbsp;Angelo Gaffo","doi":"10.1016/j.ejr.2025.06.002","DOIUrl":"10.1016/j.ejr.2025.06.002","url":null,"abstract":"<div><h3>Aim of the work</h3><div>The current data regarding regional differences in the characteristics of Behҫet disease (BD) within the United States are scarce. The aim of the study is to explore these differences in two distinct regions of the United States: Northeast and Southeast.</div></div><div><h3>Patients and Methods</h3><div>This chart review study was conducted at three medical centers. Medical records from patients with ICD-9/10 (136.1/M25.2) codes for BD between 2012 and 2019 were reviewed. Cases included fulfilled the international criteria for BD (ICBD) and International Study Group (ISG) criteria. Data on demographics, clinical and laboratory features was collected. Characteristics were compared by geographic region, sex, and race/ethnicity.</div></div><div><h3>Results</h3><div>A total of 153 patients met ICBD criteria; 77 Northeast and 76 Southeast. The majority of the patients were female (73 %), and white race (73 %), with and median age at diagnosis of 31 years. There was a greater proportion of White non-Hispanic patients in southeast US (85.3 % vs 61 %) and more Hispanic in Northeast (11 % vs 0 %). Females had a higher incidence of genital ulcers (92.5 % vs 69 %, p = 0.01) and arthralgia (34.2 % vs 14.3 %, p = 0.03). Similar trends of race/ethnicity were found using ISG criteria, but no differences in clinical characteristics. Males were more frequent in patients with positive HLA-B51 (50 %) vs negative (22.6 %) (p = 0.048), associated with fewer genital ulcers (55.6 % vs 87 %, p = 0.013), and more gastrointestinal involvement (50 % vs 16.1 %, p = 0.01).</div></div><div><h3>Conclusion</h3><div>In the US, few differences in demographic and clinical features were observed among patients with BD in two different geographical regions.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 187-191"},"PeriodicalIF":1.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of dose-dependent methotrexate therapy on renal functions in patients with rheumatoid arthritis","authors":"Dalia M. Gamal ,&nbsp;Ghada Maged ,&nbsp;Marwa Abdo ,&nbsp;Reem M. Elsharabasy ,&nbsp;Sara F. Samaan","doi":"10.1016/j.ejr.2025.06.004","DOIUrl":"10.1016/j.ejr.2025.06.004","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To study the dose-dependent effects of methotrexate (MTX) on renal functions and estimated glomerular filtration rate (eGFR<strong>)</strong> after 1 and 3 years of MTX therapy in rheumatoid arthritis (RA) patients.</div></div><div><h3>Patients and methods</h3><div>Medical records of 360 RA patients were reviewed. Disease activity score (DAS28) was recorded. Doses of MTX, concomitant therapies, and estimated glomerular filtration rate (eGFR) were reviewed at baseline, after 1 and 3 years of therapy.</div></div><div><h3>Results</h3><div>The mean age of patients was 44.6 ± 13.7 years, 80.6 % were females and disease duration was 9.9 ± 6.5 years. 36.4 % had moderate disease activity, 26.1 % high, 21.4 % low and 16.1 % in remission. There was a significant decline in eGFR after 1and 3 years of MTX therapy (p &lt; 0.001) where at baseline it was 100.2 ± 22.6, after 1 year 91.5 ± 23.7 and after 3 years 82 ± 18.7. eGFR was similar in patients receiving MTX doses &lt; 10 mg, 10–15 and &gt; 15 mg/week (after 1 year p = 0.1, after 3 years p = 0.36). On regression, after 3 years, age and MTX therapy were significantly associated with decline in eGFR (p = 0.001 and p = 0.034) respectively. Seventeen patients (4.7 %) developed renal impairment (eGFR &lt; 60 ml/min) after 1 year of MTX versus 9 (3.4 %) after 3 years. At cut off dose 18 mg/week, sensitivity 70.6 % and specificity 53.4 %, MTX could predict renal impairment after 1 year (p = 0.102) and at 15 mg/week after 3 years, sensitivity 82.4 % and specificity 36.1 % (p = 0.068).</div></div><div><h3>Conclusion</h3><div>Low dose MTX has a potential nephrotoxic effect, mandating close monitoring of renal functions for patients on MTX therapy.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 182-186"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of fibrinogen to albumin ratio in patients with systemic lupus erythematosus: Relation with disease characteristics","authors":"Noha H. Shedid,&nbsp;Hanan M. Farouk,&nbsp;Esraa M. Ahmed,&nbsp;Mohammed M. Mohammed","doi":"10.1016/j.ejr.2025.06.006","DOIUrl":"10.1016/j.ejr.2025.06.006","url":null,"abstract":"<div><h3>Aim of the work</h3><div>to investigate the role of fibrinogen to albumin ratio (FAR) in systemic lupus erythematosus (SLE) patients and its relationship with disease characteristics.</div></div><div><h3>Patients and methods</h3><div>This study included 45 SLE patients with activity and another 45 without as well as 45 controls. The clinical, laboratory data including FAR measurement and SLE disease activity index 2000 (SLEDAI-2K) were assessed.</div></div><div><h3>Results</h3><div>The patients were 83.3% females, with a median (IQR) age of 30.5 (23–41) years and disease duration of 4 (2–7) years. The median FAR value was significantly higher in patients (1.4, 0.6–1.8) compared to control (0.6, 0.5–0.8) and in active (1.6, 1.2–2.1) compared to inactive (0.7, 0.5–1.7) patients (both p&lt; 0.0001). Higher FAR values were significantly associated with receiving disease modifying antirheumatic drugs (DMARDs) (n= 82) (1.4, 0.7–2 vs 0.4, 0.15–1.1) (p= 0.01). FAR significantly correlated with the erythrocyte sedimentation rate (ESR) (r= 0.3, p= 0.004), anti-double stranded deoxyribonucleic acid (anti-dsDNA) (r= 0.28, p= 0.008) and urinary protein/creatinine (r= 0.48, p&lt; 0.0001) while inversely with complement (C3: r= -0.41, p&lt; 0.0001 and C4: r= -0.31, p= 0.003). Anti-dsDNA was the most significant factor affecting the values of FAR (β= 0.24, p= 0.04). The best cut-off value of FAR to discriminate SLE from controls and active from inactive patients were 1.1 and 0.8, with a diagnostic sensitivity of 58.9% and 86.7% and specificity of 95.6% and 55.6%, p&lt; 0001 and p&lt; 0.001, respectively.</div></div><div><h3>Conclusion</h3><div>The FAR was significantly increased in SLE patients and was linked with disease activity particularly renal. FAR can be used as an inflammatory biomarker to monitor SLE disease activity.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 172-176"},"PeriodicalIF":1.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive impairment in radiographic axial spondyloarthritis patients and its relation to disease characteristics","authors":"Hania S. Zayed ,&nbsp;Radwa S. ELbahnasy ,&nbsp;Shirin M. El-Makawi ,&nbsp;Suzan S. Al-Adle","doi":"10.1016/j.ejr.2025.06.005","DOIUrl":"10.1016/j.ejr.2025.06.005","url":null,"abstract":"<div><h3>Aim of the work</h3><div>Cognitive involvement in patients with radiographic axial spondyloarthritis (r-axSpA) has not been sufficiently studied. This study aimed to assess cognitive functions in these patients and their relation to disease characteristics.</div></div><div><h3>Patients and methods</h3><div>Sixty r-axSpA patients and 60 age, sex- and education-matched healthy controls were enrolled. Disease activity was assessed by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and functional impairment by the Bath Ankylosing Spondylitis Functional Index (BASFI). Patients and controls were assessed by the Depression, Anxiety and Stress scale (DASS) and the Montreal Cognitive Assessment (MoCA) Basic test.</div></div><div><h3>Results</h3><div>The mean age of the patients was 35.8 ± 8.6 years, median disease duration of 10 years, 52 (86.7 %) were males and the educational attainment was 13.4 ± 4.7 years. The median BASDAI was 4.45 (3.75– 5.65) and BASFI was 5.1 (3.5–6.7). The patients experienced different grades of depression (78.4 %), anxiety (71.7 %) and stress (76.7 %) compared to 15 %, 31.7 %, and 30 % of the control, respectively (p &lt; 0.001). Eighteen (30 %) patients showed impaired cognitive functions on the MoCA B test (score &lt; 26) versus none of the controls (p &lt; 0.001). Executive function, immediate recall, fluency, abstraction and visuoperception were more frequently involved in patients (p = 0.001, p = 0.022, p = 0.011, p = 0.001 and p = 0.001, respectively). Impaired MoCA was significantly associated with older age (p = 0.029), lower education levels (p = 0.003), and higher BASFI (p = 0.003), but not with disease duration, BASDAI or DASS scores.</div></div><div><h3>Conclusion</h3><div>Cognitive impairment is frequent among r-axSpA patients and is associated with older age, lower educational attainment, and more functional limitations.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 177-181"},"PeriodicalIF":1.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologic of choice after secukinumab failure in psoriatic arthritis patient: Ixekizumab or interleukin-23 inhibitors – A retrospective study","authors":"P.S. Ong ,&nbsp;P.J. Lee ,&nbsp;C.R. Ng ,&nbsp;Fariz Yahya ,&nbsp;S.S. Chng ,&nbsp;S.A. Maulana","doi":"10.1016/j.ejr.2025.06.003","DOIUrl":"10.1016/j.ejr.2025.06.003","url":null,"abstract":"<div><h3>Aim of the work</h3><div>This study aimed to compare the clinical response to ixekizumab versus interleukin-23 inhibitors (IL23i) in psoriatic arthritis (PsA) patients who failed secukinumab treatment.</div></div><div><h3>Patients and methods</h3><div>A retrospective multi-center study included active PsA patients who experienced treatment failure with secukinumab and were subsequently treated with either ixekizumab or IL23i. Baseline demographics, including disease duration<strong>,</strong> domains involved and duration of secukinumab therapy were recorded. The disease activity in PsA (DAPSA) score and body surface area (BSA) were used to assess the effectiveness of the biologics in PsA.</div></div><div><h3>Results</h3><div>The mean age of the 25 patients was 49.4 ± 12.4 years, 15 females and 10 males with secukinumab failure were enrolled. 14 (56 %) patients switched to IL23i and 11 (44 %) to ixekizumab. The median duration of secukinumab exposure was 85.7 ± 56.2 weeks. The primary reason for switching was worsening joint and skin symptoms (52 %). Complete resolution of dactylitis (7/7) and enthesitis (5/5) was achieved with ixekizumab or IL23i. Patients with primary secukinumab failure showed PsA improvements regardless the treatment switch. Multivariate analysis identified comedication with conventional synthetic DMARDs and baseline DAPSA as predictors for achieving treatment targets in the ixekizumab group.</div></div><div><h3>Conclusion</h3><div>This study found that after secukinumab failure, the response to ixekizumab and IL23i was comparable, regardless of the type of therapeutic failure. By comparing these alternatives, it offers valuable insights into the evolving landscape of PsA management. Further prospective studies with larger sample sizes are needed to validate these findings and guide the selection of the optimal biologic therapy.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 168-171"},"PeriodicalIF":1.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calprotectin in patients with axial spondyloarthritis: Clinical features, disease activity and imaging","authors":"Noha H. Shedid,&nbsp;Noran O. El-Azizi,&nbsp;Maha A. El-Serwy,&nbsp;Zainab A. Khodary,&nbsp;Safaa A. Hussein","doi":"10.1016/j.ejr.2025.06.001","DOIUrl":"10.1016/j.ejr.2025.06.001","url":null,"abstract":"<div><h3>Aim of the work</h3><div>The aim of the current study was to examine both serum and fecal calprotectin (sCal and fCal) levels in patients with axial spondyloarthritis (axSpA) and to evaluate their potential relations to clinical features, disease activity and imaging.</div></div><div><h3>Patients and methods</h3><div>This study included 40 axSpA patients and 18 controls. Disease activity using AS disease activity score (ASDAS), sacroiliac joints radiography and magnetic resonance imaging (MRI) were assessed. sCal and fCal were measured.</div></div><div><h3>Results</h3><div>The axSpA patients were 57.5 % males, with a mean age of 39.8±11.5 years and a median disease duration (IQR) of 4.5 (1.7–11.5) years. The median sCal and fCal levels were significantly higher in axSpA patients compared to controls (p&lt; 0.001). There were no differences in median sCal and fCal levels in axSpA patients concerning demographic data, HLA-B27, extra-articular manifestations, intestinal symptoms and biologics treatment (p&gt; 0.05). A significant increase in median sCal and fCal levels along with the increase in clinical disease activity grade was found (p&lt; 0.0001 and p= 0.003, respectively). Both sCal and fCal were significantly correlating with each other (p= 0.003), with ASDAS score (p= 0.003 and p= 0.01, respectively) and negatively with hemoglobin (p= 0.01 and p= 0.009, respectively). An increase in median sCal levels was observed along with the increase in grade severity of sacroiliitis on MRI (p= 0.06).</div></div><div><h3>Conclusion</h3><div>Serum and fecal calprotectin levels were significantly increased in axSpA patients and associated with disease activity. Both were having good specificity and sensitivity as potential diagnostic biomarkers for the disease.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 161-167"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}