Browsing by Author "Sari I."

Now showing 1 - 9 of 9
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    The cost of care of rheumatoid arthritis and ankylosing spondylitis patients in tertiary care rheumatology units in Turkey
    (2012) Malhan S.; Pay S.; Ataman S.; Dalkilic E.; Dinc A.; Erken E.; Ertenli I.; Ertugrul E.; Gogus F.; Hamuryudan V.; Inanc M.; Karaaslan Y.; Karadag O.; Karakoc Y.; Keskin G.; Kisacik B.; Kiraz S.; Oksel F.; Oksuz E.; Pirildar T.; Sari I.; Soy M.; Senturk T.; Taylan A.
    Objectives: To determine the direct and indirect costs due to rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients in Turkey. Methods: An expert panel was convened to estimate the direct and indirect costs of care of patients with RA and AS in Turkey. The panel was composed of 22 experts chosen from all national tertiary care rheumatology units (n=53). To calculate direct costs, the medical management of RA and AS patients was estimated using "cost-of-illness" methodology. To measure indirect costs, the number of days of sick leave, the extent of disability, and the levels of early retirement and early death were also evaluated. Lost productivity costs were calculated using the "human capital approach", based on the minimum wage. Results: The total annual direct costs were 2,917.03 Euros per RA patient and 3,565.9 Euros for each AS patient. The direct costs were thus substantial, but the indirect costs were much higher because of extensive morbidity and mortality rates. The total annual indirect costs were 7,058.99 Euros per RA patient and 6,989.81 for each AS patient. Thus, the total cost for each RA patient was 9,976.01 Euros and that for an AS patient 10,555.72 Euros, in Turkey. Conclusion: From the societal perspective, both RA and AS have become burden in Turkey. The cost of lost productivity is higher than the medical cost. Another important conclusion is that indirect costs constitute 70% and 66% of total costs in patients with RA and AS, respectively. © Clinical and Experimental Rheumatology 2012.
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    Primary central nervous system lymphoma in daily practice and the role of autologous stem cell transplantation in relapsed disease: A retrospective multicenter study
    (Elsevier Ltd, 2016) Erkurt M.A.; Berber I.; Tekgündüz E.; Dogu M.H.; Korkmaz S.; Demir C.; Yilmaz M.; Akay O.M.; Pala C.; Bilen Y.; Kaya E.; Sari I.; Sencan M.; Kuku I.; Altuntaş F.; Dal M.S.; Aydogdu I.
    We investigated the course of 54 patients presenting with primary central nervous system lymphoma, who were treated in daily practice. The patients were treated with chemotherapy and/or radiotherapy and/or intrathecal chemotherapy. At a median follow-up period of 23 months (range 1-71), median relapse-free survival (RFS) and overall survival (OS) were not reached. Estimated 2-year RFS and OS rates were 42% and 48%, respectively. Ten relapsed PCNSL patients underwent ASCT. Complete remission rate of these patients was 40%, with 20% treatment-related mortality. Estimated 2-year RFS and OS rates were 37% and 40%, respectively. The prognosis of patients with PCNSL, who received off-study treatment, is still dismal. © 2016 Elsevier Ltd.
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    A multicenter experience of thrombotic microangiopathies in Turkey: The Turkish Hematology Research and Education Group (ThREG)-TMA01 study
    (Elsevier Ltd, 2018) Tekgündüz E.; Yılmaz M.; Erkurt M.A.; Kiki I.; Kaya A.H.; Kaynar L.; Alacacioglu I.; Cetin G.; Ozarslan I.; Kuku I.; Sincan G.; Salim O.; Namdaroglu S.; Karakus A.; Karakus V.; Altuntas F.; Sari I.; Ozet G.; Aydogdu I.; Okan V.; Kaya E.; Yildirim R.; Yildizhan E.; Ozgur G.; Ozcebe O.I.; Payzin B.; Akpinar S.; Demirkan F.
    Thrombotic microangiopathies (TMAs) are rare, but life-threatening disorders characterized by microangiopathic hemolytic anemia and thrombocytopenia (MAHAT) associated with multiorgan dysfunction as a result of microvascular thrombosis and tissue ischemia. The differentiation of the etiology is of utmost importance as the pathophysiological basis will dictate the choice of appropriate treatment. We retrospectively evaluated 154 (99 females and 55 males) patients who received therapeutic plasma exchange (TPE) due to a presumptive diagnosis of TMA, who had serum ADAMTS13 activity/anti-ADAMTS13 antibody analysis at the time of hospital admission. The median age of the study cohort was 36 (14-84). 67 (43.5%), 32 (20.8%), 27 (17.5%) and 28 (18.2%) patients were diagnosed as thrombotic thrombocytopenic purpura (TTP), infection/complement-associated hemolytic uremic syndrome (IA/CA-HUS), secondary TMA and TMA-not otherwise specified (TMA-NOS), respectively. Patients received a median of 18 (1­75) plasma volume exchanges for 14 (153) days. 81 (52.6%) patients received concomitant steroid therapy with TPE. Treatment responses could be evaluated in 137 patients. 90 patients (65.7%) achieved clinical remission following TPE, while 47 (34.3%) patients had non-responsive disease. 25 (18.2%) non-responsive patients died during follow-up. Our study present real-life data on the distribution and follow-up of patients with TMAs who were referred to therapeutic apheresis centers for the application of TPE. © 2018 Elsevier Ltd
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    Apoptotic and cytotoxic effect of origanum minutiflorum on NB2A neuroblastoma cells; [ORIGANUM MINUTIFLORUM'UN NB2A NÖROBLASTOMA HÜCRELERINE APOPTOTIK VE SITOTOKSIK ETKISI]
    (University of Ankara, 2020) Sari I.; Donmez Arat G.; Ozkan O.; Aydemir I.; Ozbey C.; Tuǧlu M.I.
    Objective: The aim of the present study is to investigate the cytotoxic and apoptotic effects of oregano oil from Origanum minutiflorum, which is an endemic medicinal plant in Turkey, on NB2a neuroblastoma cells. Material and Method: Cell proliferation, apoptosis, and expression of inducible and endothelial nitric oxide synthase have been determined by MTT, TUNEL, and immunohistochemistry, respectively. Result and Discussion: The cell viability was significantly decreased gradually in NB2a cells when the concentrations of both oregano oil and doxorubicin were increased. IC50doses were found to be10.75 μl/ml for oregano oil and 5μM for doxorubicin. Furthermore, expression of inducible and endothelial nitric oxide synthase, also the number of apoptotic cells was significantly enhanced in NB2a cells after treatment with oregano oil and doxorubicin. There was a remarkable increase in inducible and endothelial nitric oxide synthase expression levels and in the number of apoptotic cells by the dual application of these agents. In addition, oregano oil enhanced the apoptotic effect of doxorubicin. In conclusion, our results indicated that oregano oil of O. minutiflorum has a cytotoxic and apoptotic effect on NB2a cells and these effects may be related to its enhancing effects on inducible and endothelial nitric oxide synthase levels. © 2020 University of Ankara. All rights reserved.
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    Unintentional Monotherapy in Rheumatoid Arthritis Patients Receiving Tofacitinib and Drug Survival Rate of Tofacitinib
    (Lippincott Williams and Wilkins, 2023) Inanc N.; Abacar K.Y.; Ozturk M.A.; Tufan A.; Karadeniz H.; Sari I.; Can G.; Erez Y.; Pehlivan Y.; Dalkilic H.E.; Ocak T.; Cefle A.; Yazici A.; Senel A.S.; Akar S.; Durak-Ediboǧlu E.; Koca S.S.; Piskin-Sagir R.; Yilmaz S.; Gulcemal S.; Soysal-Gunduz O.; Basibuyuk C.S.; Alkan S.; Cesur T.Y.; Onen F.
    Objective To determine the rate of unintentional monotherapy (UM; switching to monotherapy from combination therapy of patients' own volition) in rheumatoid arthritis patients receiving tofacitinib and to evaluate tofacitinib survival rate. Methods This national, multicenter study included patients' data from the TURKBIO Registry. Demographics, clinical characteristics, disease duration and activity, comorbidities, and treatments were analyzed. Results Data of 231 rheumatoid arthritis patients (84.8% female, median age, 56 years) were included; 153 were initially prescribed combination therapy and continued to their therapies; 31 were initially prescribed combination therapy but switched to monotherapy on their own volition (UM); 21 were initially prescribed monotherapy and switched to combination therapy; 26 were initially prescribed monotherapy and continued to their therapies. The rate of comorbidities at the time of data retrieval was higher in the UM group than in the combination group (83.3% vs. 60.3%, p = 0.031). Presence of comorbidities was a significant factor affecting switching to monotherapy (p = 0.039; odds ratio, 3.29; 95% confidence interval, 1.06-10.18). The combination and UM groups did not differ regarding remission rate assessed by Disease Activity Score 28-joint count C-reactive protein (60.5% and 70%, respectively; p = 0.328). Drug survival rates of the UM and combination groups did not differ. The median drug survival duration of tofacitinib was 27+ months with 1- and 4-year drug survival rates of 89.6% and 60.2%, respectively, in the UM group. Conclusions Although 13.4% of the study population started monotherapy unintentionally, drug survival and remission rates of the UM and combination groups were not different. Comorbidity was a factor affecting transition from combination therapy to monotherapy. © Wolters Kluwer Health, Inc. All rights reserved.
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    Fabry disease in familial Mediterranean fever according to the severity of the disease; [Enfermedad de Fabry en la fiebre mediterránea familiar según la gravedad de la enfermedad]
    (Ediciones Doyma, S.L., 2024) Uslu S.; Kabadayi G.; Teke Kısa P.; Yüce Inel T.; Arslan Z.; Arslan N.; Akar S.; Onen F.; Sari I.
    Objectives: Mutations in the α-galactosidase A (GLA) gene result in Fabry disease (FD), a rare metabolic condition. FD patients present with heterogeneous clinical manifestations, which may overlap with systemic diseases including familial Mediterranean fever (FMF). The aim of this study was to determine the frequency of FD in patients with mild and severe FMF and to prevent misdiagnosis by increasing clinicians’ awareness. Methods: Based on Tel-Hashomer criteria, the study included a total of 91 FMF patients. Patients were divided into two groups according to the number of recurrent clinical episodes or failure to respond to maximum therapy: those with mild and severe forms of the disease. GLA gene mutations and α-GLA enzyme activity were assessed. Records of MEFV mutations, therapies and demographic characteristics were kept. Results: FD testing was performed on a cohort of 91 FMF patients, 54.9% had mild FMF, 45.1% had severe FMF, and only one patient in the mild FMF subgroup tested positive for FD. The patient was a 39-year-old woman with a history of recurrent abdominal pain, distal limb pain and fever. She had low GLA enzyme activity and a heterozygous GLA gene mutation. Conclusions: Our findings suggest that FD should be considered in the differential diagnosis of FMF, especially in individuals with unusual symptoms. © 2024 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología
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    Assessing safety and efficacy of TNFi treatment in late onset ankylosing spondylitis: a TURKBIO registry study
    (Nature Research, 2024) Uslu S.; Gulle S.; Sen G.; Cefle A.; Yilmaz S.; Kocaer S.B.; Yuce Inel T.; Koca S.S.; Yolbas S.; Ozturk M.A.; Senel S.; Inanc N.; Dalkilic H.E.; Soysal Gunduz O.; Tufan A.; Akar S.; Birlik A.M.; Sari I.; Akkoc N.; Onen F.
    Clinical data on the use of tumour necrosis factor inhibitors (TNFi) in late-onset ankylosing spondylitis (LoAS) are limited. The present study aimed to evaluate efficacy, safety, and treatment adherence associated with the initial use of TNFi therapy in biologic naive patients diagnosed with LoAS. Patients whose age of onset was ≥ 45 years and < 45 years were classified as having LoAS and YoAS, respectively, based on the age of symptom onset. There were 2573 patients with YoAS and 281 LoAS. Baseline disease activity measures were similar between the groups. No significant differences were seen between the two groups in response to treatment and in remaining on the first TNFi at 6, 12 and 24 months. In the LoAS group, the analysis showed that TNFi discontinuation was linked to VAS pain score (HR 1.04; 95% CI 1.01–1.06). Patient groups had similar rates of adverse events (YoAS: 8.7% vs. LoAS: 11.7%). In both biologic naive LoAS and YoAS patients, the study showed that the initial TNFi therapy was equally effective and safe. © The Author(s) 2024.
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    Efficacy and Safety of CT-P13 as First- and Second-Line Treatment in Patients with Ankylosing Spondylitis
    (Multidisciplinary Digital Publishing Institute (MDPI), 2024) Uslu S.; Gülle S.; Sen G.; Capar S.; Senel S.; Dalkılıc E.; Akar S.; Koca S.S.; Tufan A.; Yazici A.; Yilmaz S.; Inanc N.; Birlik M.; Solmaz D.; Cefle A.; Goker B.; Direskeneli H.; Yolbas S.; Steen Krogh N.; Yilmaz N.; Erten S.; Bes C.; Soysal Gündüz O.; Oztürk M.A.; Haznedaroglu S.; Yavuz S.; Onen F.; Sari I.
    Background/Objectives: CT-P13 is a biosimilar version of infliximab, a monoclonal antibody. In individuals with ankylosing spondylitis (AS), CT-P13 has been shown to be effective and to have a well-tolerated safety profile. The aim of this study was to evaluate the long-term drug persistence, safety, and efficacy of infliximab biosimilar CT-P13 in patients with AS undergoing first-line (1st-line) and later (≥2nd-line) treatment in clinical practice. Methods: We performed an observational cohort study that included AS patients based on the biological drug database in the TURKBIO Registry between 2014 and 2021. The patients were divided into two groups: those receiving CT-P13 as first-line treatment or as a switch (≥2nd-line) from another TNF inhibitor (TNFi). Standard disease activity metrics were used to assess the effectiveness of CT-P13, and drug retention rates were investigated. Results: There were 179 AS patients using CT-P13 (47.4% male, mean age: 42.9 ± 11.3 years). Of these patients, 123 (68.7%) were receiving CT-P13 as a first-line treatment. The mean length of treatment was 3.5 years. CT-P13 drug retention rates in the general patient population were 58.6% and 48.2% in the first-line and ≥second-line treatment, respectively, after 3 years of follow-up. The most common reason for CT-P13 treatment discontinuation was lack of efficacy. The first-line CT-P13 group had statistically substantially higher ASAS20/40 response rates at three and six months. Nonetheless, both groups’ response rates at one year were comparable. Conclusions: In this real-world data analysis, AS patients who were TNFi naïve (1st-line) and subsequently treated (≥2nd-line) with CT-P13 showed encouraging drug retention rates with acceptable long-term effectiveness and safety. © 2024 by the authors.
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    Does obesity affect treatment response to secukinumab and survival in ankylosing spondylitis? Real-life data from the TURKBIO Registry
    (Oxford University Press, 2024) Karakaş A.; Gulle S.; Can G.; Dalklllc E.; Akar S.; Koca S.S.; Pehlivan Y.; Senel S.; Tufan A.; Ozturk M.A.; Yilmaz S.; Yazici A.; Cefle A.; Yüce Inel T.; Erez Y.; Sari I.; Birlik M.; Direskeneli H.; Akkoc N.; Onen F.
    Objectives: The aim of this study was to evaluate the impact of obesity on the treatment response to secukinumab and drug survival rate in patients with ankylosing spondylitis (AS). Methods: We performed an observational cohort study that included AS patients based on the biological drug database in Turkey (TURKBIO) Registry between 2018 and 2021. The patients were divided into three groups: normal [body mass index (BMI) < 25 kg/m2], overweight (BMI: 25-30 kg/m2), and obese (BMI ≥ 30 kg/m2). Disease activity was evaluated at baseline, 3, 6, and 12 months. Drug retention rates at 12 months were also investigated. Results: There were 166 AS patients using secukinumab (56.6% male, mean age: 44.9 ± 11.6 years). The median follow-up time was 17.2 (3-33.2) months. Forty-eight (28.9%) patients were obese. The mean age was higher in the obese group than in others (P =. 003). There was no statistically significant difference in Bath Ankylosing Spondylitis Disease Activity Index 50, Assessment of SpondyloArthritis international Society 20 (ASAS20), ASAS40, Ankylosing Spondylitis Disease Activity Score (ASDAS) low disease activity, and ASDAS clinically important improvement responses between the three groups at 3, 6, and 12 months, although they were numerically lower in obese patients. Drug retention rates at 12 months were similar in all groups (P >. 05). Conclusions: This study suggested that obesity did not affect secukinumab treatment response and drug retention in AS patients. © 2023 Japan College of Rheumatology. Published by Oxford University Press. All rights reserved.