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  1. Home
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Browsing by Author "Iannone, F"

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    Musculoskeletal manifestations in children with Behcet's syndrome: data from the AIDA Network Behcet's Syndrome Registry
    Gaggiano, C; Maselli, A; Sfikakis, PP; Laskari, K; Ragab, G; Hegazy, MT; Laymouna, AH; Lopalco, G; Almaghlouth, IA; Asfina, KN; Alahmed, O; Mayrink, HAG; Antonelli, IPD; Cattalini, M; Piga, M; Sota, J; Gentileschi, S; Maggio, MC; Opris-Belinski, D; Hatemi, G; Insalaco, A; Olivieri, AN; Tufan, A; Karadeniz, H; Kardas, RC; La Torre, F; Cardinale, F; Marino, A; Guerriero, S; Ruscitti, P; Tarsia, M; Vitale, A; Caggiano, V; Telesca, S; Iannone, F; Parretti, V; Frassi, M; Aragona, E; Ciccia, F; Wiesik-Szewczyk, E; Ionescu, R; Sahin, A; Akkoç, N; Hinojosa-Azaola, A; Tharwat, S; Hernández-Rodríguez, J; Espinosa, G; Conti, G; Del Giudice, E; Govoni, M; Emmi, G; Fabiani, C; Balistreri, A; Frediani, B; Rigante, D; Cantarini, L
    This study aims to describe musculoskeletal manifestations (MSM) in children with Behcet's syndrome (BS), their association with other disease manifestations, response to therapy, and long-term prognosis. Data were retrieved from the AIDA Network Behcet's Syndrome Registry. Out of a total of 141 patients with juvenile BS, 37 had MSM at disease onset (26.2%). The median age at onset was 10.0 years (IQR 7.7). The median follow-up duration was 21.8 years (IQR 23.3). Recurrent oral (100%) and genital ulcers (67.6%) and pseudofolliculitis (56.8%) were the most common symptoms associated with MSM. At disease onset, 31 subjects had arthritis (83.8%), 33 arthralgia (89.2%), and 14 myalgia (37.8%). Arthritis was monoarticular in 9/31 cases (29%), oligoarticular in 10 (32.3%), polyarticular in 5 (16.1%), axial in 7 (22.6%). Over time, arthritis became chronic-recurrent in 67.7% of cases and 7/31 patients had joint erosions (22.6%). The median Behcet's Syndrome Overall Damage Index was 0 (range 0-4). Colchicine was inefficacious for MSM in 4/14 cases (28.6%), independently from the type of MSM (p = 0.46) or the concomitant therapy (p = 0.30 for cDMARDs, p = 1.00 for glucocorticoids); cDMARDs and bDMARDs were inefficacious for MSM in 6/19 (31.4%) and 5/12 (41.7%) cases. The presence of myalgia was associated with bDMARDs inefficacy (p = 0.014). To conclude, MSM in children with BS are frequently associated with recurrent ulcers and pseudofolliculitis. Arthritis is mostly mono- or oligoarticular, but sacroiliitis is not unusual. Prognosis of this subset of BS is overall favorable, though the presence of myalgia negatively affects response to biologic therapies. ClinicalTrials.gov Identifier: NCT05200715 (registered on December 18, 2021).
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    The clinical assessment of lung involvement in patients with Still's disease, results from the multicentre international AIDA Network Still's Disease Registry
    Ruscitti, P; Vitale, A; Di Cola, I; Caggiano, V; Palumbo, P; Di Cesare, E; Hinojosa-Azaola, A; Torres-Ruiz, J; Guaracha-Basañez, GA; Martín-Nares, E; Lopalco, G; Morrone, M; Iannone, F; Giardini, HAM; Cordeiro, RA; Antonelli, IPD; Berardicurti, O; Navarini, L; Ciccia, F; Visconti, MC; Iacono, D; Direskeneli, H; Erten, S; Yao, HH; Thabet, M; Tharwat, S; Ragab, G; Gómez-Caverzaschi, V; Sfikakis, PP; Fotis, L; La Torre, F; Maier, A; Karamanakos, A; Almaghlouth, IA; Frassi, M; Tufan, A; Govoni, M; Sota, J; Simonini, G; Emmi, G; Li Gobbi, F; Parronchi, P; Costi, S; Sarzi-Puttini, P; Opris-Belinski, D; Sfriso, P; Tarsia, M; Maggio, MC; Monti, S; Gündüz, OS; Rigante, D; Bartoloni, E; Verrecchia, E; Iagnocco, A; Viapiana, O; Bargagli, E; Batu, ED; Sebastiani, GD; Del Giudice, E; Conti, G; Breda, L; Gidaro, A; Gicchino, MF; Gaggiano, C; Brucato, AL; Triggianese, P; Makowska, J; Carubbi, F; Farina, N; Guggino, G; De Paulis, A; Mazzei, MA; Di Meglio, N; Lo Gullo, A; Conforti, A; Ogunjimi, B; Calabrese, L; Rubegni, P; Giardina, A; Wiesik-Szewczyk, E; Balistreri, A; Fabiani, C; Frediani, B; Dagna, L; Giacomelli, R; Cantarini, L
    Objectives To assess the lung involvement in patients with Still's disease, an inflammatory disease assessing both children and adults. To exploit possible associated factors for parenchymal lung involvement in these patients.Methods A multicentre observational study was arranged assessing consecutive patients with Still's disease characterized by the lung involvement among those included in the AIDA (AutoInflammatory Disease Alliance) Network Still's Disease Registry. Still's disease-lung involvement was defined by the presence of pleuritis, parenchymal features, acute respiratory distress syndrome (ARDS) and/or pulmonary arterial hypertension.Results In total, 90 patients with Still's disease and lung involvement were assessed (mean age 36.3 +/- 17.8 years, 35.6% male sex). Among them, 13.3% of patients were paediatrics. These patients with lung involvement mainly showed pleuritis in 72.2% of cases, parenchymal features in 34.4%, ARDS in 9.5% and pulmonary arterial hypertension in 2.3%. After that we focused on patients characterised by parenchymal lung involvement, which is an emergent issue of clinical concern. These patients with parenchymal lung disease were significantly characterized by sore throat, pericarditis and higher values of systemic score than others. Finally, the administration of both IL-1 or IL-6 inhibitors was not associated with the presence of parenchymal lung involvement.Conclusion The clinical characteristics of patients with Still's disease and lung involvement were described in the AIDA network. We also provided a clinical profile of patients with parenchymal lung involvement considering its prognostic relevance. Although providing a clinical landscape of these patients, further studies are needed to fully clarify this issue.
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    Impact of HLA-B51 on Uveitis and Retinal Vasculitis: Data from the AIDA International Network Registries on Ocular Inflammatory Disorders
    Sota, J; Guerriero, S; Lopalco, G; Tufan, A; Ragab, G; Almaglouth, I; Govoni, M; Sfikakis, PP; Frassi, M; Vitale, A; Kardas, RC; Triggianese, P; Chimenti, MS; Aboabat, AA; Piga, M; Monti, S; Sebastiani, GD; Yildirim, D; Conforti, A; Gentileschi, S; Dammacco, R; Hinojosa-Azaola, A; Kawakami-Campos, PA; Ruffilli, F; Torres-Ruiz, J; Thabet, M; Atig, A; Ruscitti, P; Cataldi, G; Viapiana, O; Hatemi, G; Karakoç, A; Costi, S; Iagnocco, A; Crisafulli, F; Fragoulis, G; Del Giudice, E; Hegazy, MT; Paroli, MP; Sahin, A; Morrone, M; Iannone, F; Opris-Belinski, D; Asfina, KN; Barone, P; Gaggiano, C; Kucuk, H; Gicchino, MF; Carubbi, F; Caggiano, V; Laskari, K; Tharwat, S; Direskeneli, H; Alibaz-Oner, F; Sevik, G; Maier, A; Laymouna, AH; Emmi, G; Akkoç, N; Tarsia, M; Sbalchiero, J; Conti, G; Spinella, R; La Torre, F; Tombetti, E; Amin, RH; Mauro, A; Karamanakos, A; Carreño, E; Fonollosa, A; Cattalini, M; Breda, L; de-la-Torre, A; Wiesik-Szewczyk, E; Cifuentes-González, C; Ozen, S; Mazzei, MA; Tosi, GM; Frediani, B; Balistreri, A; Batu, ED; Gupta, V; Cantarini, L; Fabiani, C
    PurposeThe clinical relevance of human leukocyte antigen (HLA) subtypes such as HLA-B51 on Beh & ccedil;et's disease (BD)-related uveitis and non-infectious uveitis (NIU) unrelated to BD remains largely unknown.MethodsData were prospectively collected from the International AIDA Network Registry for BD and for NIU. We assessed differences between groups (NIU unrelated to BD and positive for HLA-B51, BD-related uveitis positive for HLA-B51 and BD-related uveitis negative for HLA-B51) in terms of long-term ocular complications, visual acuity (VA) measured by best corrected visual acuity (BCVA), anatomical pattern, occurrence of retinal vasculitis (RV) and macular edema over time.ResultsRecords of 213 patients (341 eyes) were analyzed. No differences in complications were observed (p = 0.465). With regard to VA, a significant difference was detected in median BCVA (p = 0.046), which was not maintained after Bonferroni correction (p = 0.060). RV was significantly more prevalent in NIU-affected patients who tested positive for HLA-B51, irrespective of the systemic diagnosis of BD (p = 0.025). No differences emerged in the occurrence of macular edema (p = 0.99).ConclusionsPatients with NIU testing positive for HLA-B51 exhibit an increased likelihood of RV throughout disease course, irrespective of a systemic diagnosis of BD. The rate of complications as well as VA are comparable between NIU cases unrelated to BD testing positive for HLA-B51 and uveitis associated with BD. Therefore, it is advisable to perform the HLA-B typing in patients with NIU or retinal vasculitis, even in the absence of typical BD features.
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    The Systemic Score May Identify Life-Threatening Evolution in Still Disease: Data from the GIRRCS AOSD-Study Group and the AIDA Network Still Disease Registry
    Ruscitti, P; Masedu, F; Vitale, A; Caggiano, V; Di Cola, I; Cipriani, P; Valenti, M; Giardini, HAM; Antonelli, IPDB; Dagostin, MA; Lopalco, G; Iannone, F; Maria, M; Almaghlouth, IA; Asfina, KN; Ali, HH; Ciccia, F; Iacono, D; Pantano, I; Mauro, D; Sfikakis, PP; Tektonidou, M; Laskari, K; Berardicurti, O; Dagna, L; Tomelleri, A; Tufan, A; Kardas, RC; Hinojosa-Azaola, A; Martín-Nares, E; Kawakami-Campos, PA; Ragab, G; Hegazy, MT; Direskeneli, H; Alibaz-Oner, F; Fotis, L; Sfriso, P; Govoni, M; La Torre, F; Maggio, MC; Montecucco, C; De Stefano, L; Bugatti, S; Rossi, S; Makowska, J; Del Giudice, E; Emmi, G; Bartoloni, E; Hernández-Rodríguez, J; Conti, G; Olivieri, AN; Lo Gullo, A; Simonini, G; Viapiana, O; Wiesik-Szewczyk, E; Erten, S; Carubbi, F; De Paulis, A; Maier, A; Tharwat, S; Costi, S; Iagnocco, A; Sebastiani, GD; Gidaro, A; Brucato, AL; Karamanakos, A; Akkoç, N; Caso, F; Costa, L; Prete, M; Perosa, F; Atzeni, F; Guggino, G; Fabiani, C; Frediani, B; Giacomelli, R; Cantarini, L
    Objective. We aimed to evaluate the clinical usefulness of the systemic score in the prediction of life-threatening evolution in Still disease. We also aimed to assess the clinical relevance of each component of the systemic score in predicting life-threatening evolution and to derive patient subsets accordingly. Methods. A multicenter, observational, prospective study was designed including patients included in the Gruppo Italiano Di Ricerca in Reumatologia Clinica e Sperimentale Adult-Onset Still Disease Study Group and the Autoinflammatory Disease Alliance Network Still Disease Registry. Patients were assessed to see if the variables to derive the systemic score were available. The life-threatening evolution was defined as mortality, whatever the clinical course, and/or macrophage activation syndrome, a secondary hemophagocytic lymphohistiocytosis associated with a poor prognosis. Results. A total of 597 patients with Still disease were assessed (mean +/- SD age 36.6 +/- 17.3 years; male 44.4%). The systemic score, assessed as a continuous variable, significantly predicted the life-threatening evolution (odds ratio [OR] 1.24; 95% confidence interval [CI] 1.07-1.42; P = 0.004). A systemic score >= 7 also significantly predicted the likelihood of a patient experiencing life-threatening evolution (OR 3.36; 95% CI 1.81-6.25; P < 0.001). Assessing the clinical relevance of each component of the systemic score, liver involvement (OR 1.68; 95% CI 1.48-2.67; P = 0.031) and lung disease (OR 2.12; 95% CI 1.14-4.49; P = 0.042) both significantly predicted life-threatening evolution. The clinical characteristics of patients with liver involvement and lung disease were derived, highlighting their relevance in multiorgan disease manifestations. Conclusion. The clinical utility of the systemic score was shown in identifying Still disease at a higher risk of life-threatening evolution in a large cohort. Furthermore, the clinical relevance of liver involvement and lung disease was highlighted.
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    Development and implementation of the AIDA International Registry for patients with Behcet's disease
    Vitale, A; Della Casa, F; Ragab, G; Almaghlouth, IA; Lopalco, G; Pereira, RM; Guerriero, S; Govoni, M; Sfikakis, PP; Giacomelli, R; Ciccia, F; Monti, S; Ruscitti, P; Piga, M; Lomater, C; Tufan, A; Opris-Belinski, D; Emmi, G; Hernández-Rodríguez, J; Karkas, B; Sebastiani, GD; Bartoloni, E; Akkoç, N; Cattalini, M; Conti, G; Hatemi, G; Maier, A; Parronchi, P; Del Giudice, E; Erten, S; Insalaco, A; Li Gobbi, F; Maggio, MC; Shahram, F; Caggiano, V; Hegazy, MT; Asfina, KN; Morrone, M; Prado, LL; Dammacco, R; Ruffilli, F; Arida, A; Navarini, L; Pantano, I; Cavagna, L; Conforti, A; Cauli, A; Marucco, EM; Kucuk, H; Ionescu, R; Mattioli, I; Espinosa, G; Araújo, O; Canofari, C; Sota, J; Laymouna, AH; Bedaiwi, AA; Colella, S; Giardini, HAM; Albano, V; Lo Monaco, A; Fragoulis, GE; Kardas, RC; Berlengiero, V; Hussein, MA; Ricci, F; La Torre, F; Rigante, D; Wiesik-Szewczyk, E; Frassi, M; Gentileschi, S; Tosi, GM; Dagostin, MA; Mahmoud, AAMA; Tarsia, M; Alessio, G; Cimaz, R; Giani, T; Gaggiano, C; Iannone, F; Cipriani, P; Mourabi, M; Spedicato, V; Barneschi, S; Aragona, E; Balistreri, A; Frediani, B; Fabiani, C; Cantarini, L
    Purpose of the present paper is to point out the design, development and deployment of the AutoInflammatory Disease Alliance (AIDA) International Registry dedicated to pediatric and adult patients with Behcet's disease (BD). The Registry is a clinical physician-driven non-population- and electronic-based instrument implemented for the retrospective and prospective collection of real-life data about demographics, clinical, therapeutic, laboratory, instrumental and socioeconomic information from BD patients; the Registry is based on the Research Electronic Data Capture (REDCap) tool, which is thought to collect standardised information for clinical real-life research, and has been realised to change over time according to future scientific acquisitions and potentially communicate with other existing and future Registries dedicated to BD. Starting from January 31st, 2021, to February 7th, 2022, 110 centres from 23 countries in 4 continents have been involved. Fifty-four of these have already obtained the approval from their local Ethics Committees. Currently, the platform counts 290 users (111 Principal Investigators, 175 Site Investigators, 2 Lead Investigators, and 2 data managers). The Registry collects baseline and follow-up data using 5993 fields organised into 16 instruments, including patient's demographics, history, clinical manifestations and symptoms, trigger/risk factors, therapies and healthcare access. The development of the AIDA International Registry for BD patients will facilitate the collection of standardised data leading to real-world evidence, enabling international multicentre collaborative research through data sharing, international consultation, dissemination of knowledge, inclusion of patients and families, and ultimately optimisation of scientific efforts and implementation of standardised care. Trial registration NCT05200715 in 21/01/2022.
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    Predicting ASDAS Inactive Disease After 6 Months of TNFi Treatment in Bio-Naive Axial Spondyloarthritis Patients Treated in Clinical Practice - Results from the EuroSpA Collaboration
    Ornbjerg, LM; Georgiadis, S; Lindström, U; Loft, AG; Ciurea, A; Mann, H; Akkoç, N; Iannone, F; Kristianslund, E; Hokkanen, AM; Santos, MJ; Codreanu, C; Sánchez-Piedra, C; Tomsic, M; Gudbjornsson, B; van der Horst-Bruinsma, I; Askling, J; Nissen, MJ; Pavelka, K; Gunduz, O; Atzeni, F; Sexton, J; Nordström, D; Santos, H; Ionescu, R; Pombo-Suarez, M; Rotar, Z; Geirsson, AJ; van de Sande, M; Macfarlane, G; Michelsen, B; Hetland, ML; Ostergaard, M
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    The impact of a csDMARD in combination with a TNF inhibitor on drug retention and clinical remission in axial spondyloarthritis
    Nissen, M; Delcoigne, B; Di Giuseppe, D; Jacobsson, L; Hetland, ML; Ciurea, A; Nekvindova, L; Iannone, F; Akkoc, N; Sokka-Isler, T; Fagerli, KM; Santos, MJ; Codreanu, C; Pombo-Suarez, M; Rotar, Z; Gudbjornsson, B; Van der Horst-Bruinsma, I; Loft, AG; Möller, B; Mann, H; Conti, F; Cetin, GY; Relas, H; Michelsen, B; Ribeiro, PA; Ionescu, R; Sanchez-Piedra, C; Tomsic, M; Geirsson, AJ; Askling, J; Glintborg, B; Lindström, U
    Objectives Many axial spondylarthritis (axSpA) patients receive a conventional synthetic DMARD (csDMARD) in combination with a TNF inhibitor (TNFi). However, the value of this co-therapy remains unclear. The objectives were to describe the characteristics of axSpA patients initiating a first TNFi as monotherapy compared with co-therapy with csDMARD, to compare one-year TNFi retention and remission rates, and to explore the impact of peripheral arthritis. Methods Data was collected from 13 European registries. One-year outcomes included TNFi retention and hazard ratios (HR) for discontinuation with 95% CIs. Logistic regression was performed with adjusted odds ratios (OR) of achieving remission (Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP < 1.3 and/or BASDAI < 2) and stratified by treatment. Inter-registry heterogeneity was assessed using random-effect meta-analyses, combined results were presented when heterogeneity was not significant. Peripheral arthritis was defined as >= 1 swollen joint at baseline (=TNFi start). Results Amongst 24 171 axSpA patients, 32% received csDMARD co-therapy (range across countries: 13.5% to 71.2%). The co-therapy group had more baseline peripheral arthritis and higher CRP than the monotherapy group. One-year TNFi-retention rates (95% CI): 79% (78, 79%) for TNFi monotherapy vs 82% (81, 83%) with co-therapy (P < 0.001). Remission was obtained in 20% on monotherapy and 22% on co-therapy (P < 0.001); adjusted OR of 1.16 (1.07, 1.25). Remission rates at 12 months were similar in patients with/without peripheral arthritis. Conclusion This large European study of axial SpA patients showed similar one-year treatment outcomes for TNFi monotherapy and csDMARD co-therapy, although considerable heterogeneity across countries limited the identification of certain subgroups (e.g. peripheral arthritis) that may benefit from co-therapy.
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    European bio-naive spondyloarthritis patients initiating TNF inhibitor: time trends in baseline characteristics, treatment retention and response
    Christiansen, SN; Ornbjerg, LM; Rasmussen, SH; Loft, AG; Askling, J; Iannone, F; Zavada, J; Michelsen, B; Nissen, M; Onen, F; Santos, MJ; Pombo-Suarez, M; Relas, H; Macfarlane, GJ; Tomsic, M; Codreanu, C; Gudbjornsson, B; Van der Horst-Bruinsma, I; Di Giuseppe, D; Glintborg, B; Gremese, E; Pavelka, K; Kristianslund, EK; Ciurea, A; Akkoc, N; Barcelos, A; Sánchez-Piedra, C; Peltomaa, R; Jones, GT; Rotar, Z; Ionescu, R; Grondal, G; Van de Sande, MGH; Laas, K; Ostergaard, M; Hetland, ML
    Objectives To investigate time trends in baseline characteristics and retention, remission and response rates in bio-naive axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) patients initiating TNF inhibitor (TNFi) treatment. Methods Prospectively collected data on bio-naive axSpA and PsA patients from routine care in 15 European countries were pooled. Three cohorts were defined according to year of TNFi initiation: A (1999-2008), B (2009-2014) and C (2015-2018). Retention, remission and response rates were assessed at 6, 12 and 24 months. Results In total, 27 149 axSpA and 17 446 PsA patients were included. Cohort A patients had longer disease duration compared with B and C. In axSpA, cohort A had the largest proportion of male and HLA-B27 positive patients. In PsA, baseline disease activity was highest in cohort A. Retention rates in axSpA/PsA were highest in cohort A and differed only slightly between B and C. For all cohorts, disease activity decreased markedly from 0 to 6 months. In axSpA, disease activity at 24 months was highest in cohort A, where also remission and response rates were lowest. In PsA, remission rates at 6 and 12 months tended to be lowest in cohort A. Response rates were at all time points comparable across cohorts, and less between-cohort disease activity differences were seen at 24 months. Conclusion Our findings indicate that over the past decades, clinicians have implemented more aggressive treatment strategies in spondyloarthritis. This was illustrated by shorter disease duration at treatment initiation, decreased retention rates and higher remission rates during recent years.
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    Predictors of ASDAS-CRP inactive disease in axial spondyloarthritis during treatment with TNF-inhibitors: data from the EuroSpA collaboration (vol 56, 152081, 20222)
    Ornbjerg, LM; Linde, L; Georgiadis, S; Rasmussen, SH; Lindström, U; Askling, J; Michelsen, B; Di Giuseppe, D; Wallman, JK; Pavelka, K; Závada, J; Nissen, MJ; Jones, GT; Relas, H; Pirilä, L; Tomsic, M; Rotar, Z; Geirsson, AJ; Gudbjornsson, B; Kristianslund, EK; van der Horst-Bruinsma, I; Loft, AG; Laas, K; Iannone, F; Corrado, A; Ciurea, A; Santos, MJ; Santos, H; Codreanu, C; Akkoc, N; Gunduz, OS; Glintborg, B; Ostergaard, M; Hetland, ML
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    Is there a role for TNF-α antagonists in the treatment of SSc? EUSTAR expert consensus development using the Delphi technique
    Distler, JHW; Jordan, S; Airò, P; Alegre-Sancho, JJ; Allanore, Y; Gurman, AB; Caporali, R; Caramaschi, P; Carreira, PE; Chizzolini, C; Cutolo, M; Duruöz, MT; Farge-Bancel, D; Hesselstrand, R; Iannone, F; De Keyser, F; Kucharz, EJ; Launay, D; Lefebvre, PGD; Lukacova, O; Marasini, B; Martinovic, D; Neto, JFM; Radic, M; Rednic, S; Riemekasten, G; Rovensky, J; Seidel, MF; Senel, S; Smith, V; Sunderkötter, C; Ton, E; van Laar, JM; Matucci-Cerinic, M; Müller-Ladner, U; Distler, O
    Objective: To obtain experiences and expert opinion on treatment of SSc patients with TNF-alpha antagonists. Methods: An investigation was carried out among the EUSTAR centres into their expertise on use of TNF-alpha antagonists. Assessment forms on the frequency of TNF-alpha inhibitor use were distributed to EULAR Scleroderma Trials and Research Group (EUSTAR) centres. Afterwards, a three round Delphi exercise was performed to obtain expert consensus on the use of TNF-alpha inhibitors in SSc. Results: Seventy-nine centres returned information on use of TNF-alpha antagonists in SSc patients. A total of 65 patients were treated with TNF-alpha inhibitors in 14 different centres. Forty-eight of the 65 patients treated with TNF-alpha inhibitors improved. Improvement was mainly seen in patients with arthritis, whereas the effects on fibrosis varied. In the first round of the subsequent Delphi approach, 71 out of 79 experts stated that they would use TNF-alpha antagonists in SSc. Arthritis was suggested as an indication for TNF alpha antagonists by 75% of the experts. However; after the third stage of the Delphi exercise, the acceptance for the off-label use of TNF-alpha antagonists decreased and 59% recommended that TNF-alpha antagonists should not be used or only used in clinical trials in SSc patients, while 38% of the experts suggested the use of TNF-alpha antagonists for arthritis associated with SSc. Conclusions: Most of the experts do not recommend the routine use of TNF-alpha antagonists in systemic sclerosis. Arthritis might be a potential indication in SSc, although controlled clinical trials with TNF-alpha antagonists are needed before general recommendations can be given.
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    Predictors of ASDAS-CRP inactive disease in axial spondyloarthritis during treatment with TNF-inhibitors: Data from the EuroSpA collaboration
    Ornbjerg, LM; Linde, L; Georgiadis, S; Rasmussen, SH; Lindström, U; Askling, J; Michelsen, B; Di Giuseppe, D; Wallman, JK; Pavelka, K; Závada, J; Nissen, MJ; Jones, GT; Relas, H; Pirilä, L; Tomsic, M; Rotar, Z; Geirsson, AJ; Gudbjornsson, B; Kristianslund, EK; Horst-Bruinsma, IV; Loft, AG; Laas, K; Iannone, F; Corrado, A; Ciurea, A; Santos, MJ; Santos, H; Codreanu, C; Akkoc, N; Gunduz, OS; Glintborg, B; Ostergaard, M; Hetland, ML
    Objectives: In patients with axial spondyloarthritis (axSpA) initiating their first tumor necrosis factor alpha-inhibitor (TNFi), we aimed to identify common baseline predictors of Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP) inactive disease (primary objective) and clinically important improvement (CII) at 6 months, and drug retention at 12-months across 15 European registries. Methods: Baseline demographic and clinical characteristics were collected. Outcomes were investigated per registry and in pooled data using logistic regression analyses on multiply imputed data. Results: The consistency of baseline predictors in individual registries justified pooling the data. In the pooled dataset (n = 21,196), the 6-month rates for ASDAS inactive disease and ASDAS CII were 26% and 51%, and the 12-month drug retention rate 65% in patients with available data (n = 9,845, n = 6,948 and n = 21,196, respectively). Nine common baseline predictors of ASDAS inactive disease, ASDAS CII and 12-month drug retention were identified, and the odds ratios (95%-confidence interval) for ASDAS inactive disease were: age, per year: 0.97 (0.97-0.98), men vs. women: 1.88 (1.60-2.22), current vs. non-smoking: 0.76 (0.63-0.91), HLA-B27 positive vs. negative: 1.51 (1.20-1.91), TNF start year 2015-2018 vs. 2009-2014: 1.24 (1.06-1.45), CRP > 10 vs. <= 10 mg/l: 1.49 (1.25-1.77), one unit increase in health assessment questionnaire (HAQ): 0.77 (0.58-1.03), one-millimeter (mm) increase in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) fatigue and spinal pain: 0.99 (0.99-1.00) and 0.99 (0.99-1.99), respectively Conclusion: Common baseline predictors of treatment response and adherence to TNFi could be identified across data from 15 European registries, indicating that they may be universal across different axSpA populations.
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    SECULAR TRENDS IN BASELINE CHARACTERISTICS, TREATMENT RETENTION AND RESPONSE RATES IN 27189 BIO-NAIVE AXIAL SPONDYLOARTHRITIS PATIENTS INITIATING TNFI - RESULTS FROM THE EUROSPA COLLABORATION
    Ornbjerg, LM; Christiansen, SN; Rasmussen, SH; Loft, AG; Lindstrom, U; Zavada, J; Iannone, F; Onen, F; Nissen, MJ; Michelsen, B; Santos, MJ; Macfarlane, G; Nordstrom, D; Pombo-Suarez, M; Codreanu, C; Tomsic, M; Van der Horst-Bruinsma, I; Gudbjornsson, B; Askling, J; Glintborg, B; Pavelka, K; Gremese, E; Akkoc, N; Ciurea, A; Kristianslund, E; Barcelos, A; Jones, GT; Hokkanen, AM; Sanchez-Piedra, C; Ionescu, R; Rotar, Z; Van De Sande, MGH; Geirsson, AJ; Ostergaard, M; Hetland, ML

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