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Gaggiano C, Gupta V, Agrawal R, De Smet MD, Frediani B, Tosi GM, Paroli MP, Sridharan S, Pavesio CE, Pleyer U, Denisova EV, Babu K, de-la-Torre A, Yang P, Davis JL, Cunningham ET, Carreño E, Goldstein D, Fonollosa A, Cantarini L, Sobrin L, Fabiani C. Knowledge and Current Practices in Monogenic Uveitis: An International Survey by IUSG and AIDA Network. Ophthalmol Ther 2024; 13:127-147. [PMID: 37924480 PMCID: PMC10776548 DOI: 10.1007/s40123-023-00839-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 10/19/2023] [Indexed: 11/06/2023] Open
Abstract
INTRODUCTION This study aims to explore awareness, knowledge, and diagnostic/therapeutic practices in monogenic uveitis (mU) among uveitis experts. METHODS This is an explorative, cross-sectional survey study. An anonymous, semi-structured, electronic survey was delivered to uveitis experts from the Autoinflammatory Diseases Alliance (AIDA) Network and International Uveitis Study Group (IUSG). We included respondents answering ≥ 50% of the survey. RESULTS Seventy-seven participants rated their knowledge of mU as proficient (3.9%), adequate (15.6%), sufficient (16.9%), or poor (63.6%). When asked about the first mU gene they thought of, 60.4% mentioned NOD2, 3.9% mentioned NLRP3 or MEFV, and 49.4% provided incorrect or no answers. Success rates in clinical scenarios varied from 15.6% to 55.8% and were higher for ophthalmologists working in multidisciplinary teams (p < 0.01). Genetic testing was ordered for suspected mU by 41.6% of physicians. The availability of molecular techniques did not significantly differ based on geography (p > 0.05). The public healthcare system ensured a higher percentage of tests prescribed were obtained by patients compared to private insurances (p < 0.00). In terms of disease-modifying anti-rheumatic drugs (DMARDs), tumor necrosis factor-α inhibitors were the most familiar to uveitis experts. The difficulties with off-label therapy procedures were the primary barrier to DMARDs prescription for patients with mU and correlated inversely with the obtained/prescribed drug ratio for interleukin-1 (p < 0.01) and interleukin-6 (p < 0.01) inhibitors. CONCLUSIONS This survey identifies proficiency areas, gaps, and opportunities for targeted improvements in patients care. The comprehensive outputs may inform evidence-based guidelines, empowering clinicians with standardized approaches, and drive an AIDA Network-IUSG unified effort to advance scientific knowledge and clinical practice.
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Affiliation(s)
- Carla Gaggiano
- Department of Medical Sciences, Surgery and Neurosciences, Rheumatology Unit, University of Siena and Azienda Ospedaliero-Universitaria Senese (European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA) Center), Policlinico "Le Scotte", Viale Bracci 16, 53100, Siena, Italy
| | - Vishali Gupta
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, QQ7H+JW3, Vidya Path, Sector 12, Chandigarh, 160012, India
| | - Rupesh Agrawal
- 11 Jalan Tan Tock Seng, Level 1, TTSH Medical Centre, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, 308433, Singapore
- Lee Kong Chian School of Medicine, 11 Mandalay Rd, #17-01, Singapore, 308232, Singapore
- Singapore Eye Research Institute, Level 6 Discovery Tower, The Academia, 20 College Rd, Singapore, 169856, Singapore
- Duke NUS Medical School, 8 College Rd, Singapore, 169857, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore
| | - Marc D De Smet
- MicroInvasive Ocular Surgery Clinic, Av. du Léman 32, 1005, Lausanne, Switzerland
| | - Bruno Frediani
- Department of Medical Sciences, Surgery and Neurosciences, Rheumatology Unit, University of Siena and Azienda Ospedaliero-Universitaria Senese (European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA) Center), Policlinico "Le Scotte", Viale Bracci 16, 53100, Siena, Italy
| | - Gian Marco Tosi
- Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena and Azienda Ospedaliero-Universitaria Senese, (European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory, and Autoimmune Diseases (RITA) Center), Policlinico "Le Scotte", Viale Bracci 16, 53100, Siena, Italy
| | - Maria Pia Paroli
- Department of Sense Organs, Eye Clinic, Uveitis Unit, Sapienza University of Rome, Policlinico Umberto I University Hospital, Via Giovanni Maria Lancisi, 2, 00161, Rome, Italy
| | - Sudharshan Sridharan
- Department of Uvea, Medical and Vision Research Foundations, Sankara Nethralaya, No. 41, College Road, Chennai, Tamil Nadu, 600 006, India
| | - Carlos E Pavesio
- Moorfields Eye Hospital, NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK
| | - Uwe Pleyer
- Klinik Für Augenheilkunde, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - Ekaterina V Denisova
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, 105062, Russia
| | - Kalpana Babu
- Department of Uvea and Ocular Inflammation, Prabha Eye Clinic and Research Centre, Vittala International Institute of Ophthalmology, 504, 40Th Cross Rd, 8Th Block, Jayanagar, Bengaluru, Karnataka, 560070, India
| | - Alejandra de-la-Torre
- Neuroscience Research Group (NEUROS), Neurovitae Center for Neuroscience, Institute of Translational Medicine (IMT), School of Medicine and Health Sciences, Universidad del Rosario, Cra 27 #63 C 39, Bogotá, Colombia
| | - Peizeng Yang
- Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, The First Affiliated Hospital of Chongqing Medical University, Youyi Road 1, Yuzhong District, 400016, Chongqing, People's Republic of China
| | - Janet L Davis
- Department of Ophthalmology, University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, 900 NW 17Th St, Miami, FL, 33136, USA
| | - Emmett T Cunningham
- The Department of Ophthalmology, California Pacific Medical Center, 711 Van Ness Ave #250, San Francisco, CA, 94102, USA
- The Department of Ophthalmology, Stanford University School of Medicine, 291 Campus Drive, Li Ka Shing Building, Stanford, CA, 94305, USA
- The Francis I. Proctor Foundation, UCSF School of Medicine, 490 Illinois St, San Francisco, CA, 94158, USA
| | - Ester Carreño
- Hospital Universitario Fundacion Jimenez Diaz, Av. de los Reyes Católicos, 2, 28040, Madrid, Spain
| | - Debra Goldstein
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, 645 N. Michigan Ave. Suite 440, Chicago, IL, 60611, USA
| | - Alex Fonollosa
- Department of Ophthalmology, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Cruces Plaza, 48903, Barakaldo, Bizkaia, Spain
- Department of Retina, Instituto Oftalmológico Bilbao, Berástegui 4, 1º Izq, 48001, Bilbao, Spain
| | - Luca Cantarini
- Department of Medical Sciences, Surgery and Neurosciences, Rheumatology Unit, University of Siena and Azienda Ospedaliero-Universitaria Senese (European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA) Center), Policlinico "Le Scotte", Viale Bracci 16, 53100, Siena, Italy.
| | - Lucia Sobrin
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles St, Boston, MA, 02114, USA
| | - Claudia Fabiani
- Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena and Azienda Ospedaliero-Universitaria Senese, (European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory, and Autoimmune Diseases (RITA) Center), Policlinico "Le Scotte", Viale Bracci 16, 53100, Siena, Italy.
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Mansfield LM, Lapidus SK, Romero SN, Moorthy LN, Adler-Shohet FC, Hollander M, Cherian J, Twilt M, Lionetti G, Mohan S, DeLaMora PA, Durrant KL, Muskardin TW, Correia Marques M, Onel KB, Dedeoglu F, Gutierrez MJ, Schulert G. Increase in pediatric recurrent fever evaluations during the first year of the COVID-19 pandemic in North America. Front Pediatr 2023; 11:1240242. [PMID: 37601132 PMCID: PMC10435740 DOI: 10.3389/fped.2023.1240242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Abstract
The impact of the COVID-19 pandemic on new diagnoses of recurrent fevers and autoinflammatory diseases is largely unknown. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) PFAPA/AID Working Group aimed to investigate the impact of the COVID-19 pandemic on the number of pediatric patients evaluated for recurrent fevers and autoinflammatory diseases in North America. The absolute number of new outpatient visits and the proportion of these visits attributed to recurrent fever diagnoses during the pre-pandemic period (1 March 2019-29 February 2020) and the first year of the COVID-19 pandemic (1 March 2020-28 February 2021) were examined. Data were collected from 27 sites in the United States and Canada. Our results showed an increase in the absolute number of new visits for recurrent fever evaluations in 21 of 27 sites during the COVID-19 pandemic compared to the pre-pandemic period. The increase was observed across different geographic regions in North America. Additionally, the proportion of new visits to these centers for recurrent fever in relation to all new patient evaluations was significantly higher during the first year of the pandemic, increasing from 7.8% before the pandemic to 10.9% during the pandemic year (p < 0.001). Our findings showed that the first year of the COVID-19 pandemic was associated with a higher number of evaluations by pediatric subspecialists for recurrent fevers. Further research is needed to understand the reasons behind these findings and to explore non-infectious triggers for recurrent fevers in children.
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Affiliation(s)
- Leanne M. Mansfield
- Department of Pediatric Rheumatology, Hospital for Special Surgery, New York, NY, United States
- Department of Pediatrics, Weill Cornell Medicine, New York, NY, United States
| | - Sivia K. Lapidus
- Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center and Hackensack Meridian Health, Hackensack, NJ, United States
| | - Samira Nazzar Romero
- Department of Rheumatology, Nemours Children’s Hospital, Orlando, FL, United States
| | - Lakshmi N. Moorthy
- Department of Pediatrics, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | | | - Matthew Hollander
- Department of Pediatrics, University of Vermont Larner College of Medicine, Burlington, VT, United States
| | - Julie Cherian
- Department of Pediatrics, Stony Brook Children's Hospital, Stony Brook, NY, United States
| | - Marinka Twilt
- Alberta Children’s Hospital, University of Calgary, Calgary, AB, Canada
| | - Geraldina Lionetti
- Department of Pediatrics, University of California San Francisco, Benioff Children's Hospitals, San Francisco, CA, United States
| | - Smriti Mohan
- Department of Pediatrics, University of Michigan, CS Mott Children’s Hospital, Ann Arbor, MI, United States
| | | | | | | | - Mariana Correia Marques
- National Institute for Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Karen B. Onel
- Department of Pediatric Rheumatology, Hospital for Special Surgery, New York, NY, United States
- Department of Pediatrics, Weill Cornell Medicine, New York, NY, United States
| | - Fatma Dedeoglu
- Division of Immunology, Department of Medicine, Boston Children’s Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Maria J. Gutierrez
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Grant Schulert
- Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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3
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Kobak S. VEXAS syndrome: Current clinical, diagnostic and treatment approaches. Intractable Rare Dis Res 2023; 12:170-179. [PMID: 37662628 PMCID: PMC10468411 DOI: 10.5582/irdr.2023.01020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/30/2023] [Accepted: 08/15/2023] [Indexed: 09/05/2023] Open
Abstract
VEXAS syndrome, is a hemato-inflammatory chronic disease characterized with predominantly rheumatic and hematologic systemic involvement. It was first described in 2020 by a group of researchers in the United States. VEXAS syndrome is a rare condition that primarily affects adult males and is caused by a mutation in the UBA1 gene located on the X chromosome. Its pathogenesis is related to the somatic mutation affecting methionine-41 (p.Met41) in UBA1, the major E1 enzyme that initiates ubiquitylation. Mutant gene lead to decreased ubiquitination and activated innate immune pathways and systemic inflammation occur. The specific mechanism by which the UBA1 mutation leads to the clinical features of VEXAS syndrome is not yet fully understood. VEXAS is a newly define adult-onset inflammatory syndrome manifested with treatment-refractory fevers, arthritis, chondritis, vasculitis, cytopenias, typical vacuoles in hematopetic precursor cells, neutrophilic cutaneous and pulmonary inflammation. Diagnosing VEXAS syndrome can be challenging due to its rarity and the overlap of symptoms with other inflammatory conditions. Genetic testing to identify the UBA1 gene mutation is essential for definitive diagnosis. Currently, there is no known cure for VEXAS syndrome, and treatment mainly focuses on managing the symptoms. This may involve the use of anti-inflammatory medications, immunosuppressive drugs, and supportive therapies tailored to the individual patient's needs. Due to the recent discovery of VEXAS syndrome, ongoing research is being conducted to better understand its pathogenesis, clinical features, and potential treatment options. In this review article, the clinical, diagnostic and treatment approaches of VEXAS syndrome were evaluated in the light of the latest literature data.
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Affiliation(s)
- Senol Kobak
- Department of Internal Medicine and Rheumatology, Istinye University Faculty of Medicine, Liv Hospital, WASOG Sarcoidosis Clinic, Istanbul,Turkey
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4
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Rigante D. Febrile children with breaches in the responses of innate immunity. Expert Rev Clin Immunol 2023; 19:1293-1298. [PMID: 37480327 DOI: 10.1080/1744666x.2023.2240960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 07/21/2023] [Indexed: 07/24/2023]
Affiliation(s)
- Donato Rigante
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica Sacro Cuore, Rome, Italy
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5
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Alunno A, Wincup C, Jani M, Roccatello D, Rodríguez-Carrio J. Editorial: Global excellence in rheumatology: Europe. Front Med (Lausanne) 2023; 10:1242449. [PMID: 37457566 PMCID: PMC10343954 DOI: 10.3389/fmed.2023.1242449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023] Open
Affiliation(s)
- Alessia Alunno
- University of L'Aquila, MeSVA Department, Internal Medicine and Nephrology Division, ASL 1 Avezzano-Sulmona-L'Aquila, L'Aquila, Italy
| | - Chris Wincup
- King's College Hospital NHS Trust, London, United Kingdom
- Department of Rheumatology, University College London, London, United Kingdom
| | - Meghna Jani
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, The University of Manchester, Manchester, United Kingdom
| | - Dario Roccatello
- University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net, ERN-Reconnect and RITA-ERN Member), Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley (North-West Italy), Department of Clinical and Biological Sciences, University of Turin and San Giovanni Bosco Hub Hospital, ASL Città di Torino, Turin, Italy
| | - Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
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6
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Staus P, Rusch S, El-Helou S, Müller G, Krausz M, Geisen U, Caballero-Oteyza A, Krüger R, Bakhtiar S, Lee-Kirsch MA, Fasshauer M, Baumann U, Hoyer BF, Farela Neves J, Borte M, Carrabba M, Hauck F, Ehl S, Bader P, von Bernuth H, Atschekzei F, Seppänen MRJ, Warnatz K, Nieters A, Kindle G, Grimbacher B. The GAIN Registry - a New Prospective Study for Patients with Multi-organ Autoimmunity and Autoinflammation. J Clin Immunol 2023:10.1007/s10875-023-01472-0. [PMID: 37084016 PMCID: PMC10119522 DOI: 10.1007/s10875-023-01472-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/06/2023] [Indexed: 04/22/2023]
Abstract
Patient registries are a very important and essential tool for investigating rare diseases, as most physicians only see a limited number of cases during their career. Diseases of multi-organ autoimmunity and autoinflammation are especially challenging, as they are characterized by diverse clinical phenotypes and highly variable expressivity. The GAIN consortium (German multi-organ Auto Immunity Network) developed a dataset addressing these challenges. ICD-11, HPO, and ATC codes were incorporated to document various clinical manifestations and medications with a defined terminology. The GAIN dataset comprises detailed information on genetics, phenotypes, medication, and laboratory values. Between November 2019 and July 2022, twelve centers from Europe have registered 419 patients with multi-organ autoimmunity or autoinflammation. The median age at onset of symptoms was 13 years (IQR 3-28) and the median delay from onset to diagnosis was 5 years (IQR 1-14). Of 354 (84.5%) patients who were genetically tested, 248 (59.2%) had a defined monogenetic cause. For 87 (20.8%) patients, no mutation was found and for 19 (4.5%), the result was pending. The most common gene affected was NFkB1 (48, 11.5%), and the second common was CTLA4 (40, 9.5%), both genetic patient groups being fostered by specific research projects within GAIN. The GAIN registry may serve as a valuable resource for research in the inborn error of immunity community by providing a platform for etiological and diagnostic research projects, as well as observational trials on treatment options.
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Affiliation(s)
- Paulina Staus
- Division Methods in Clinical Epidemiology, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Center, University of Freiburg, Breisacher Str. 115, 79106, Freiburg, Germany.
| | - Stephan Rusch
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Center, University of Freiburg, Breisacher Str. 115, 79106, Freiburg, Germany
| | - Sabine El-Helou
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Center, University of Freiburg, Breisacher Str. 115, 79106, Freiburg, Germany
- Department of Rheumatology and Immunology, Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hanover, Germany
| | - Gabriele Müller
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Center, University of Freiburg, Breisacher Str. 115, 79106, Freiburg, Germany
| | - Máté Krausz
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Center, University of Freiburg, Breisacher Str. 115, 79106, Freiburg, Germany
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Faculty of Biology, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Ulf Geisen
- Excellence Center for Inflammation Medicine, Clinic for Rheumatology and Clinical Immunology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Andrés Caballero-Oteyza
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Center, University of Freiburg, Breisacher Str. 115, 79106, Freiburg, Germany
- Department of Rheumatology and Immunology, Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hanover, Germany
| | - Renate Krüger
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Shahrzad Bakhtiar
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Hospital for Children and Adolescents, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Min Ae Lee-Kirsch
- Department of Pediatrics, University Hospital and Medical Faculty Carl Gustav-Carus, Technische Universität Dresden, Dresden, Germany
| | - Maria Fasshauer
- Hospital for Children & Adolescents, St. Georg Hospital, Leipzig, Germany
- Academic Teaching Hospital of the University of Leipzig, Immunodeficiency Center Leipzig (IDCL), Leipzig, Germany
| | - Ulrich Baumann
- Department of Paediatric Pulmonology, Allergy and Neonatology, Hannover Medical School, Hanover, Germany
| | - Bimba Franziska Hoyer
- Excellence Center for Inflammation Medicine, Clinic for Rheumatology and Clinical Immunology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - João Farela Neves
- Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
- CHRC, Comprehensive Health Research Centre, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
- CEDOC, Chronic Diseases Research Center, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Michael Borte
- Hospital for Children & Adolescents, St. Georg Hospital, Leipzig, Germany
- Academic Teaching Hospital of the University of Leipzig, Immunodeficiency Center Leipzig (IDCL), Leipzig, Germany
| | - Maria Carrabba
- Dipartimento di Medicina Interna, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, UOS Malattie Rare, Milan, Italy
| | - Fabian Hauck
- Department of Pediatrics, Dr von Hauner Children's Hospital, University Hospital, Ludwig Maximilians Universität München, Munich, Germany
| | - Stephan Ehl
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Center, University of Freiburg, Breisacher Str. 115, 79106, Freiburg, Germany
| | - Peter Bader
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Hospital for Children and Adolescents, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Horst von Bernuth
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Immunology, Labor Berlin GmbH, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Berlin, Germany
| | - Faranaz Atschekzei
- Department of Rheumatology and Immunology, Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hanover, Germany
| | - Mikko R J Seppänen
- The Rare Disease and Pediatric Research Centers, Hospital for Children and Adolescents and Adult Immunodeficiency Unit, Inflammation Center, University of Helsinki and HUS Helsinki, University Hospital, Helsinki, Finland
| | - Klaus Warnatz
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Center, University of Freiburg, Breisacher Str. 115, 79106, Freiburg, Germany
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Alexandra Nieters
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Center, University of Freiburg, Breisacher Str. 115, 79106, Freiburg, Germany
| | - Gerhard Kindle
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Center, University of Freiburg, Breisacher Str. 115, 79106, Freiburg, Germany
| | - Bodo Grimbacher
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Faculty of Medicine, Medical Center, University of Freiburg, Breisacher Str. 115, 79106, Freiburg, Germany.
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- DZIF - German Center for Infection Research, Satellite Center Freiburg, Freiburg, Germany.
- CIBSS - Centre for Integrative Biological Signalling Studies, Albert-Ludwigs University, Freiburg, Germany.
- RESIST - Cluster of Excellence 2155 to Hanover Medical School, Satellite Center Freiburg, Freiburg, Germany.
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7
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Touitou I, Jéziorski E, Al-Saleh A, Carbasse A, Piram M. Quality of life in monogenic autoinflammatory diseases. A review. Joint Bone Spine 2023; 90:105475. [PMID: 36404572 DOI: 10.1016/j.jbspin.2022.105475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Systemic autoinflammatory diseases (SAIDs) are a group of disorders related to defective regulation of the innate immune system. Recurrence of inflammation can severely affect the patients' outcomes with a direct or indirect impact on their physical and mental health and/or global quality of life (QoL). We therefore sought to identify currently available QoL studies for these diseases as well as measurement tools at our disposal. BASIC PROCEDURES A systematic literature review was carried out with a focus on monogenic SAIDs. We inventoried the study designs developed in the selected publications, grouped them into similar topics, and listed the different outcome measures used for QoL. MAIN FINDINGS We recorded 53 bibliographic references evaluating the impact of monogenic SAIDs on the patients' QoL. These publications revealed 150 different study designs and 82 outcome measures used for their assessment. The best-explored topics were the overall patients' QoL, followed by the evaluation of their psychosocial and physical functioning. We found fair coverage of familial Mediterranean fever, poor investigation of the mixed hereditary recurrent fever (HRF) group, cryopyrin-associated periodic diseases and cherubism, and almost no study of the other monogenic SAIDs. CONCLUSIONS This work revealed areas requiring further investigation such as homogenization of concepts, study of uncommon or more recent diseases, and development of more specific and validated outcome measures for SAIDs.
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Affiliation(s)
- Isabelle Touitou
- CeRéMAIA, Department of Genetics, CHU de Montpellier, Inserm, University of Montpellier, A. de Villeneuve Hospital, 371, avenue Doyen-Giraud, Montpellier, France.
| | - Eric Jéziorski
- CeRéMAIA, Department of Genetics, CHU de Montpellier, Inserm, University of Montpellier, A. de Villeneuve Hospital, 371, avenue Doyen-Giraud, Montpellier, France; CeRéMAIA, Department of Pediatrics, CHU de Montpellier, Pediatric Department, Montpellier, France
| | - Afnan Al-Saleh
- CHU de Sainte Justine Research Centre, Department of Pediatrics, CHU de Sainte Justine, University of Montreal, Montreal, QC, Canada
| | - Aurélia Carbasse
- CeRéMAIA, Department of Pediatrics, CHU de Montpellier, Pediatric Department, Montpellier, France
| | - Maryam Piram
- CHU de Sainte Justine Research Centre, Department of Pediatrics, CHU de Sainte Justine, University of Montreal, Montreal, QC, Canada; CeRéMAIA, Department of Pediatric Rheumatology, AP-HP, CHU de Bicêtre, Le Kremlin-Bicêtre, France
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Del Giudice E, Sota J, Orlando F, Picciano L, Cimaz R, Cantarini L, Mauro A. Off-label use of canakinumab in pediatric rheumatology and rare diseases. Front Med (Lausanne) 2022; 9:998281. [PMID: 36330067 PMCID: PMC9622922 DOI: 10.3389/fmed.2022.998281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/30/2022] [Indexed: 11/19/2022] Open
Abstract
Since the first success of interleukin-1 blockade in cryopyrin-associated periodic syndrome, the use of interleukin-1 inhibitors has expanded to other disorders, including off-label indications. In particular, canakinumab has been employed in an off-label fashion in several diseases such as rare monogenic autoinflammatory diseases and multifactorial autoinflammatory diseases, disclosing an excellent efficacy and good safety profile in pediatric patients unresponsive to standards of care. In addition, hyperferritinemic syndromes and complex disorders, as well as Kawasaki disease, uveitis, and other pediatric rare disorders, represent additional areas where canakinumab efficacy is worth exploring. Altogether, the results summarized below are of paramount importance in pediatric patients where a considerable proportion of treatments are prescribed off-label. This review focuses on the off-label use of canakinumab in pediatric patients affected by systemic immune-mediated diseases.
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Affiliation(s)
- Emanuela Del Giudice
- Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Jurgen Sota
- Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, University of Siena, Siena, Italy
| | - Francesca Orlando
- Pediatric Rheumatology Unit, Department of General and Emergency Pediatrics, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Ludovica Picciano
- Pediatric Emergency and Short Stay Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Rolando Cimaz
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Luca Cantarini
- Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, University of Siena, Siena, Italy
| | - Angela Mauro
- Pediatric Rheumatology Unit, Department of Childhood and Developmental Medicine, Fatebenefratelli-Sacco Hospital, Milan, Italy
- *Correspondence: Angela Mauro
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