Browsing by Author "Aksu K."

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    Platelet-activating factor and P-selectin activities in thrombotic and nonthrombotic Behçet's patients
    (2005) Tunc S.E.; Aksu K.; Keser G.; Oksel F.; Doganavsargil E.; Pirildar T.; Turk T.; Terzioglu E.; Huseyinov A.
    Objective: The aim of this study was to compare plasma Platelet-activating factor (PAF) and P-selectin (CD62P) activities in Behçet's disease patients with and without thrombosis. Methods: In this cross-sectional and descriptive study, 30 consecutive Behçet's patients were included, 15 of them with venous thrombosis. All patients were also divided into two subgroups according to the presence or absence of clinical activity. Plasma PAF levels, basal and Ca++ ionophore (A23187)-induced leukocyte (cellular) PAF activities, and platelet-rich plasma ΔCD62P activity (the mean fluorescent density difference between CD62P phycoerythrin-positive and -negative stains) were evaluated. Results: In the thrombotic group, plasma PAF (P=0.001), basal leukocyte PAF (P=0.017), induced leukocyte PAF (P=0.024), and ΔCD62P (P=0.023) levels were significantly higher than in the nonthrombotic group. In the whole group of Behçet's patients, there was a positive correlation between plasma PAF and ΔCD62P levels (r=0.533, P=0.002). When we compared clinically active and inactive patients with respect to the above parameters, there was no significant difference, irrespective of thrombosis. Plasma PAF (P=0.001), basal leukocyte PAF (P=0.004), and ΔCD62P (P=0.038) levels were significantly higher in the presence of both clinical activity and thrombosis than of clinical activity alone. Conclusion: Platelet-activating factor and CD62P may contribute to endothelial injury and thrombosis development in Behçet's disease. These two parameters seem related to the presence of thrombosis rather than clinical activity. © Springer-Verlag 2004.
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    Comparison of 18F-FDG PET/CT findings with current clinical disease status in patients with takayasu's arteritis
    (2013) Karapolat I.; Kalfa M.; Keser G.; Yalçin M.; Inal V.; Kumanlioǧlu K.; Pirildar T.; Aksu K.
    Objective. 18F-fluorodeoxyglucosepositron emission tomography/computed tomography (18F-FDG PET/CT) scanning has been proposed as a new tool to assess disease activity in Takayasu arteritis (TA). We investigated whether 18F-FDG PET/CT findings were consistent with current clinical disease status in patients with TA. Methods. In this cross sectional study, 22 patients with TA were enrolled. Clinical disease activity was assessed by the combination of National Institutes of Health (NIH) criteria, Disease Extent Index-Takayasu (DEI-Tak) score, physician global assessment and 18F-FDG PET/CT scans. Results. At the time 18F-FDG PET/CT scans were taken, the majority of the patients (17/22) were using immunosuppressive (IS) drugs, and only four patients had clinically active disease. 18F-FDG PET/CT scans confirmed the presence of active vasculitic lesions in those four patients. In 16 out of 18 patients who were accepted to be in clinical remission, 18F-FDG PET/ CT scans were also normal. There were only two patients with discordant results, i.e. active 18F-FDG PET/CT findings despite the lack of clinical activity. Interestingly, clinical exacerbation occurred four weeks later in one of them. Overall sensitivity and specificity of 18F-FDG PET/CT findings for clinical activity were 100% and 88.9%, respectively. Conclusion. We found that 18F-FDG PET/CT findings were generally consistent with clinical disease status in TA. Although use of IS drugs certainly impairs diagnostic accuracy of 18FFDG PET/CT in TA, this imaging method may still have a potential for confirming remission or detecting disease activity in patients with TA receiving treatment. © CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 2013.
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    Identification of susceptibility loci for Takayasu arteritis through a large multi-ancestral genome-wide association study
    (Cell Press, 2021) Ortiz-Fernández L.; Saruhan-Direskeneli G.; Alibaz-Oner F.; Kaymaz-Tahra S.; Coit P.; Kong X.; Kiprianos A.P.; Maughan R.T.; Aydin S.Z.; Aksu K.; Keser G.; Kamali S.; Inanc M.; Springer J.; Akar S.; Onen F.; Akkoc N.; Khalidi N.A.; Koening C.; Karadag O.; Kiraz S.; Forbess L.; Langford C.A.; McAlear C.A.; Ozbalkan Z.; Yavuz S.; Çetin G.Y.; Alpay-Kanitez N.; Chung S.; Ates A.; Karaaslan Y.; McKinnon-Maksimowicz K.; Monach P.A.; Ozer H.T.E.; Seyahi E.; Fresko I.; Cefle A.; Seo P.; Warrington K.J.; Ozturk M.A.; Ytterberg S.R.; Cobankara V.; Onat A.M.; Duzgun N.; Bıcakcıgil M.; Yentür S.P.; Lally L.; Manfredi A.A.; Baldissera E.; Erken E.; Yazici A.; Kısacık B.; Kaşifoğlu T.; Dalkilic E.; Cuthbertson D.; Pagnoux C.; Sreih A.; Reales G.; Wallace C.; Wren J.D.; Cunninghame-Graham D.S.; Vyse T.J.; Sun Y.; Chen H.; Grayson P.C.; Tombetti E.; Jiang L.; Mason J.C.; Merkel P.A.; Direskeneli H.; Sawalha A.H.
    Takayasu arteritis is a rare inflammatory disease of large arteries. We performed a genetic study in Takayasu arteritis comprising 6,670 individuals (1,226 affected individuals) from five different populations. We discovered HLA risk factors and four non-HLA susceptibility loci in VPS8, SVEP1, CFL2, and chr13q21 and reinforced IL12B, PTK2B, and chr21q22 as robust susceptibility loci shared across ancestries. Functional analysis proposed plausible underlying disease mechanisms and pinpointed ETS2 as a potential causal gene for chr21q22 association. We also identified >60 candidate loci with suggestive association (p < 5 × 10−5) and devised a genetic risk score for Takayasu arteritis. Takayasu arteritis was compared to hundreds of other traits, revealing the closest genetic relatedness to inflammatory bowel disease. Epigenetic patterns within risk loci suggest roles for monocytes and B cells in Takayasu arteritis. This work enhances understanding of the genetic basis and pathophysiology of Takayasu arteritis and provides clues for potential new therapeutic targets. © 2020 American Society of Human Genetics
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    Short-acting β2-agonist prescription patterns in patients with asthma in Turkey: results from SABINA III
    (BioMed Central Ltd, 2022) Yorgancıoğlu A.; Aksu K.; Naycı S.A.; Ediger D.; Mungan D.; Gül U.; Beekman M.J.H.I.; Kızılırmak D.; Altıntaş N.; Bulut İ.; Çağatay T.; Gemicioğlu B.; İnce Ö.; Oğuzülgen K.; Kalpaklıoğlu F.; Baççıoğlu A.; Aksu F.; Altuntaş M.; Erkekol F.Ö.; Karakaya G.; Kalyoncu A.F.; Damadoğlu E.; Hanta İ.; Altunok E.; Özer A.; Yuluğ D.P.; Gülbaş G.; Süerdem M.; Yormaz B.; Ceylan E.; Erge D.; Çilli A.; Doğan B.C.; Erel F.; Sevinç C.; Anar C.; Pekbak G.; Erbay M.
    Background: Over-reliance on short-acting β2-agonists (SABAs) is associated with poor asthma outcomes. However, the extent of SABA use in Turkey is unclear owing to a lack of comprehensive healthcare databases. Here, we describe the demographics, disease characteristics and treatment patterns from the Turkish cohort of the SABA use IN Asthma (SABINA) III study. Methods: This observational, cross-sectional study included patients aged ≥ 12 years with asthma from 24 centres across Turkey. Data on sociodemographics, disease characteristics and asthma treatments were collected using electronic case report forms. Patients were classified by investigator-defined asthma severity (guided by the 2017 Global Initiative for Asthma [GINA]) and practice type (primary/specialist care). The primary objective was to describe SABA prescription patterns in the 12 months prior to the study visit. Results: Overall, 579 patients were included (mean age [standard deviation; SD]: 47.4 [16.1] years; 74.3% female), all of whom were treated by specialists. Most patients had moderate-to-severe asthma (82.7%, GINA steps 3–5), were overweight or obese (70.5%), had high school or university/post-graduate education (51.8%) and reported fully reimbursed healthcare (97.1%). The mean (SD) asthma duration was 12.0 (9.9) years. Asthma was partly controlled/uncontrolled in 56.3% of patients, and 46.5% experienced ≥ 1 severe exacerbation in the preceding 12 months. Overall, 23.9% of patients were prescribed ≥ 3 SABA canisters in the previous 12 months (considered over-prescription); 42.9% received no SABA prescriptions. As few patients had mild asthma, only 5.7% were prescribed SABA monotherapy. Therefore, most patients (61.5%) were prescribed SABA in addition to maintenance therapy, with 42.8% receiving ≥ 3 SABA canisters in the previous 12 months. Inhaled corticosteroids (ICS), ICS + a long-acting β-agonist fixed-dose combination and oral corticosteroids were prescribed to 14.5%, 88.3% and 28.5% of all patients, respectively. Additionally, 10.2% of patients purchased SABA over the counter, of whom 27.1% purchased ≥ 3 canisters in the preceding 12 months. Conclusions: Despite all patients being treated by specialists and most receiving fully reimbursed healthcare, nearly a quarter of patients received prescriptions for ≥ 3 SABA canisters in the previous 12 months. This highlights a public health concern and emphasizes the need to align clinical practices with the latest evidence-based recommendations. © 2022, The Author(s).
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    Overprescription of short-acting β2-agonists is associated with poor asthma symptom control: results from five Middle Eastern countries included in the SABINA International (III) study
    (Taylor and Francis Ltd., 2022) Al Zaabi A.; Busaidi N.; Al Mutairy S.; Yorgancıoğlu A.; Aksu K.; Al-Jahdali H.; Wali S.; Elsayed M.; Beekman M.J.H.I.
    Background: Although short-acting β2-agonist (SABA) overuse is associated with poor treatment outcomes, data on SABA use in the Middle East are lacking. Research design and methods: In this cross-sectional study in patients (aged ≥12 years) with asthma, data on disease characteristics and asthma treatments were collected from the Middle Eastern cohort of the SABA use IN Asthma (SABINA) III study. Patients were classified by investigator-defined asthma severity and practice type. Multivariable regression models analyzed the association between SABA prescriptions and clinical outcomes. Results: Of 1389 patients (mean age, 46.7 years; female, 69.5%), 85.7% had moderate-to-severe asthma and 88.7% were treated by specialists. Overall, 51.3% of patients experienced ≥1 severe asthma exacerbation in the previous 12 months, with 58.2% having partly controlled or uncontrolled asthma. Notably, 47.1% of patients were prescribed ≥3 SABA canisters (considered overprescription). SABA canisters were purchased over the counter by 15.3% of patients. Higher SABA prescriptions (vs 1–2 canisters), except 3–5 canisters, were associated with increased odds of uncontrolled asthma (p < 0.05). Conclusions: SABA overprescription occurred in almost half of all patients in the Middle East, underscoring the need for healthcare providers and policymakers to adhere to the latest evidence-based recommendations to address this public health concern. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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    Economic burden of short-acting beta-2 agonist (SABA) overuse among asthma patients in Türkiye: a cost analysis with respect to the updated GINA treatment recommendations
    (BioMed Central Ltd, 2024) Yorgancıoğlu A.; Aksu K.; Cura C.; Yaman Y.; Dinç M.; Malhan S.; Erbay M.; Pekbak G.; Ediger D.; Anar C.; Sevinç C.; Erel F.; Doğan B.C.; Çilli A.; Erge D.; Ceylan E.; Yormaz B.; Süerdem M.; Gülbaş G.; Yuluğ D.P.; Naycı S.A.; Özer A.; Altunok E.; Hanta İ.; Damadoğlu E.; Kalyoncu A.F.; Karakaya G.; Erkekol F.Ö.; Altuntaş M.; Aksu F.; Baççıoğlu A.; Kalpaklıoğlu F.; Mungan D.; Oğuzülgen K.; İnce Ö.; Gemicioğlu B.; Çağatay T.; Bulut İ.; Altıntaş N.; Kızılırmak D.
    Background: This cost of illness study aimed to determine economic burden of short-acting β2-agonist (SABA) overuse in Türkiye from payer perspective with respect to the updated GINA 2022 treatment recommendations. Methods: A total of 3,034,879 asthma patients comprised the study population, via estimations extrapolated from the Türkiye arm of the global SABINA III study. The economic burden (costs related to the drug use and severe exacerbations) was compared in subgroups of overall (≥ 0 canisters/year) vs. GINA-recommended (0–2 canisters/year, hypothetical population) SABA use and in subgroups of appropriate use (0–2 canisters/year, real population) vs. overuse (≥ 3 canisters/year) of SABA with extrapolation of SABINA Türkiye data to the Türkiye asthma population. Results: Recommended SABA use was predicted to prevent 127,505 of 157,512 severe exacerbations per year in mild asthma patients and 2,668,916 of 3,262,800 severe exacerbations per year in moderate-severe asthma patients. Annual cost burden of not applying recommended SABA use (overall [≥ 0 canisters/year] vs. GINA-recommended [0–2 canisters/year] SABA use) in mild asthma and moderate-severe asthma patients was calculated to be €20.43 million and €427.65 million in terms of severe exacerbations, and to be €829,352 and €7.20 million in terms of drug costs, respectively. The total annual economic burden arising from not applying recommended SABA use was estimated to be €456.11 million. Appropriate use (0–2 canisters/year) vs. overuse (≥ 3 canisters/year) of SABA was associated with decreased frequency of severe exacerbations per year in mild asthma (from 129,878 to 27,634) and moderate-severe asthma (from 2,834,611 to 428,189) patients. SABA overuse in mild and moderate-severe asthma patients was estimated to yield an additional annual cost of €16.38 million and €385.59 million, respectively in terms of severe exacerbations, and a total €11.30 million additional drug cost. The overall annual economic burden arising from SABA overuse was estimated to be €413.27 million. Conclusions: The estimated annual total economic burden arising from not applying recommended SABA use (€456.11 million) and SABA overuse (€413.27 million) with respect to the updated GINA 2022 treatment recommendations indicates the substantial cost burden of SABA overuse to the Turkish National Health System, corresponding up to 26% of the total direct cost of asthma reported in our country. © The Author(s) 2024.