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Hamar A, Szekanecz Z, Pusztai A, Czókolyová M, Végh E, Pethő Z, Bodnár N, Gulyás K, Horváth Á, Soós B, Bodoki L, Bhattoa HP, Nagy G, Tajti G, Panyi G, Szekanecz É, Domján A, Hodosi K, Szántó S, Szűcs G, Szamosi S. Effects of one-year tofacitinib therapy on bone metabolism in rheumatoid arthritis. Osteoporos Int 2021; 32:1621-1629. [PMID: 33559714 PMCID: PMC8376736 DOI: 10.1007/s00198-021-05871-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 02/01/2021] [Indexed: 12/22/2022]
Abstract
UNLABELLED Janus kinase (JAK) inhibitors are used to treat rheumatoid arthritis (RA). We assessed the effects of tofacitinib on bone density and bone markers in association with clinical and laboratory parameters in RA. Tofacitinib stabilized bone density and resulted in a positive balance of bone turnover. INTRODUCTION Janus kinase (JAK) inhibitors emerged as new therapeutic options in rheumatoid arthritis (RA). We have little information on how it affects areal and volumetric bone mineral density (BMD) and bone turnover markers. The aim of this study was to assess the effects of 1-year tofacitinib therapy on bone metabolism in RA. METHODS Thirty RA patients with active disease were treated with either 5 mg bid or 10 mg bid tofacitinib for 12 months. We determined DAS28, CRP, IgM rheumatoid factor (RF), and anti-cyclic citrullinated peptide (CCP) levels, as well as serum levels of sclerostin, osteocalcin (OC), P1NP, DKK-1, OPG, RANKL, and 25-hydroxy-vitamin D3. Areal and volumetric BMD were assessed by DXA and peripheral quantitative CT (QCT), respectively. RESULTS Twenty-six patients (13 on each arm) completed the study. Tofacitinib was clinically effective by suppressing DAS28, CRP, and HAQ. This was accompanied by the attenuation of further bone loss. Tofacitinib therapy significantly increased OC, OPG, and vitamin D3, while decreased CTX levels (p < 0.05). Age and multiple bone markers (OC, CTX, P1NP, RANKL) inversely correlated with L2-4 and femoral neck BMD by DXA. CRP, DAS28, and RANKL inversely determined volumetric BMD by QCT. Age, CRP, anti-CCP, and DKK-1 influenced the effects of tofacitinib therapy on BMD changes. CONCLUSIONS One-year tofacitinib treatment stabilized BMD in RA patients and resulted in a positive balance of bone turnover as indicated by bone biomarkers. Further studies are needed to evaluate the potential beneficial effects of JAK inhibitors on inflammatory bone loss.
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Affiliation(s)
- A Hamar
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Z Szekanecz
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | - A Pusztai
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - M Czókolyová
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - E Végh
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Z Pethő
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - N Bodnár
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - K Gulyás
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Á Horváth
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - B Soós
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - L Bodoki
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - H P Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - G Nagy
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - G Tajti
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - G Panyi
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - É Szekanecz
- Department of Oncology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - A Domján
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - K Hodosi
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - S Szántó
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Department of Sports Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - G Szűcs
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - S Szamosi
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Juhász B, Gulyás K, Horváth Á, Pethő Z, Bhattoa HP, Váncsa A, Szekanecz É, Horváth C, Kocsis J, Horváth Z, Hodosi K, Szántó S, Szűcs G, Szekanecz Z. Comparison of peripheral quantitative computed tomography forearm bone density versus DXA in rheumatoid arthritis patients and controls. Osteoporos Int 2017; 28:1271-1277. [PMID: 27942777 DOI: 10.1007/s00198-016-3850-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 11/21/2016] [Indexed: 01/01/2023]
Abstract
UNLABELLED Rheumatoid arthritis (RA) has been associated with osteoporosis. Quantitative computed tomography (QCT) is capable of assessing bone density and composition. We found lower bone density in RA compared to controls. Age and RA duration influenced bone density. QCT may be useful to assess bone metabolism in RA. INTRODUCTION RA is associated with generalized and periarticular osteoporosis. In addition to DXA that determines areal bone mineral density (BMD), peripheral QCT also detects volumetric BMD. QCT differentiates between total, trabecular, and cortical BMD. Here, we compared DXA and QCT in RA patients and healthy controls. METHODS BMD of 57 female RA patients and 32 age-matched healthy female controls were assessed by DXA. QCT of the forearm ultradistal region was also performed. Densitometry data were correlated with age, disease duration, disease activity, serum CRP, and anti-CCP levels. RESULTS Total bone density (310.4 ± 79.7 versus 354.0 ± 54.1 mg/cm3; p = 0.007) and attenuation (0.37 ± 0.05 versus 0.40 ± 0.03 1/cm; p = 0.001), trabecular density (157.6 ± 57.0 versus 193.8 ± 48.7 mg/cm3; p = 0.005) and attenuation (0.28 ± 0.03 versus 0.32 ± 0.04 1/cm; p < 0.0001), and cortical density (434.3 ± 115.8 versus 492.5 ± 64.0 mg/cm3; p = 0.006) and attenuation (0.44 ± 0.07 versus 0.47 ± 0.04 1/cm; p = 0.004) were significantly lower in RA. Both lumbar and femoral neck BMD, as well as T-scores, were significantly lower in RA versus controls (p < 0.001 in all cases). In RA, total and cortical QCT attenuation and density were associated with age, the presence of RA, and their combination. In contrast, trabecular density and attenuation were only affected by the presence of the disease but not by age. Also in RA, total trabecular and cortical density as determined by QCT significantly correlated with lumbar and/or femoral neck BMD as measured by DXA. Finally, anti-CCP seropositivity was associated with lower trabecular density and attenuation. CONCLUSIONS Both DXA and QCT may be suitable to study bone metabolism in RA. Areal BMD determined by DXA may correlate with volumetric bone density measured by QCT. Moreover, trabecular osteoporosis may be associated by the underlying autoimmune-inflammatory disease, while cortical osteoporosis may rather be age-related.
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Affiliation(s)
- B Juhász
- Department of Oncology, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - K Gulyás
- Department of Rheumatology, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - Á Horváth
- Department of Rheumatology, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - Z Pethő
- Department of Rheumatology, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - H P Bhattoa
- Department of Laboratory Medicine, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - A Váncsa
- Department of Rheumatology, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - É Szekanecz
- Department of Oncology, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - C Horváth
- First Department of Medicine, Semmelweis University, Budapest, Hungary
| | - J Kocsis
- Department of Oncology, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - Z Horváth
- Department of Oncology, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - K Hodosi
- Department of Rheumatology, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - S Szántó
- Department of Rheumatology, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - G Szűcs
- Department of Rheumatology, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - Z Szekanecz
- Department of Rheumatology, University of Debrecen Faculty of Medicine, Debrecen, Hungary.
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van Steenbergen H, Aletaha D, Beaart-van de Voorde L, Brouwer E, Codreanu C, Combe B, Fonseca J, Hetland M, Humby F, Kvien T, Landewé R, Niedermann K, Nuño L, Oliver S, Rantapää-Dahlqvist S, Raza K, van Schaardenburg D, Schett G, De Smet L, Szűcs G, Vencovský J, Wiland P, van der Helm-van Mil A. THU0127 Development of Draft Criteria for Arthralgia that is Clinically Suspect for Progression to Rheumatoid Arthritis; Results of Phase 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pusztai A, Végh E, Váncsa A, Bodnár N, Szamosi S, Nagy G, Szöllösi I, Csomor P, Lopez L, Matsuura E, Szűcs G, Szántó S, Nagy Z, Shoenfeld Y, Szekanecz Z. A6.13 Effects of anti-tnf therapy on circulating oxLDL-BETA2GPI complex levels in arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Balogh E, Végh E, Kerekes G, Váncsa A, Csomor P, Pogácsás L, Balázs F, McCormick J, Biniecka M, Szántó S, Szűcs G, Fearon U, Veale DJ, Szekanecz Z. A6.12 Effects of anti-tnf therapy on markers of angiogenesis and vascular pathology in arthritis: a comparative approach. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Á H, Pusztai A, Gulyás K, Váncsa A, Végh E, Bodnár N, Csomor P, Pethő Z, Juhász B, Szentpétery Á, Szamosi S, Bhattoa H, Szántó S, Szűcs G, Nagy Z, Szekanecz Z. A4.3 Effects of anti-TNF therapy on markers of bone homeostasis in rheumatoid arthritis and ankylosing spondylitis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.85] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Poliska S, Végh E, Váncsa A, Bodnár N, Szamosi S, Csumita M, Kerekes G, Szabó Z, Szűcs G, Szántó S, Zahuczky G, Soltész P, Nagy L, Szekanecz Z. A6.15 Genetic signatures may be associated with vascular pathology in rheumatoid arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Combe B, Veale D, Burgos-Vargas R, Szűcs G, Leirisalo-Repo M, Yao R, Huyck S, Lyu R, Govoni M, Vastesaeger N, Weng H. AB0373 Integrating Treatment Goals of Physicians, Patients, and Payers during Treatment with Golimumab in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Németh A, Szamosi S, Horváth A, Schönherr J, Nicksch E, Szekanecz Z, Szűcs G. [Systemic sclerosis and pregnancy. A review of the current literature]. Z Rheumatol 2013; 73:175-9. [PMID: 24306839 DOI: 10.1007/s00393-013-1267-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Pregnancy in women diagnosed with systemic sclerosis generally has a favorable outcome according to most recent studies. Women with systemic sclerosis who wish to become pregnant should achieve low disease activity for at least 6 months prior to conception. Regular follow-up of pregnant scleroderma patients by an interdisciplinary medical team including gynaecologists and rheumatologists is necessary to control disease activity and avoid possible complications. Severe organ involvement, early diffuse systemic sclerosis with rapid onset, and pulmonary hypertension ought to discourage patients from pregnancy, as these situations are at high risk of complications for both mother and fetus during pregnancy.
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Affiliation(s)
- A Németh
- Department of Rheumatology, University of Debrecen Medical and Health Sciences Center, Debrecen, Hungary,
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Combe B, Veale D, Burgos-Vargas R, Szűcs G, Leirisalo-Repo M, Yao R, Govoni M, Vastesaeger N, Weng HH. THU0178 Comprehensive Disease Control with Golimumab in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bakondi G, Pór Á, Kovács I, Szűcs G, Rusznák Z. Hyperpolarization-activated, cyclic nucleotide-gated, cation non-selective channel subunit expression pattern of guinea-pig spiral ganglion cells. Neuroscience 2009; 158:1469-77. [DOI: 10.1016/j.neuroscience.2008.10.056] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Revised: 10/29/2008] [Accepted: 10/30/2008] [Indexed: 11/26/2022]
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Bányai K, Martella V, Bogdán Á, Forgách P, Jakab F, Meleg E, Bíró H, Melegh B, Szűcs G. Genogroup I picobirnaviruses in pigs: evidence for genetic diversity and relatedness to human strains. J Gen Virol 2008; 89:534-539. [DOI: 10.1099/vir.0.83134-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Picobirnaviruses (PBVs) are small, non-enveloped viruses with a bisegmented double-stranded RNA genome. Their pathogenic potential, ecology, and evolutionary features are largely unexplored. Here, we describe the molecular analysis of porcine PBVs identified in the intestinal content of dead pigs. Six of 13 positive samples were cloned and then subjected to single-strand conformation polymorphism analysis and nucleotide sequencing. All clones belonged to genogroup I PBVs and almost all clones clustered on separate branches from human strains. A single strain shared a notably close genetic relationship with a Hungarian human PBV strain (89.9 nt and 96.4 % aa identity). Genetic diversity was also observed among strains identified in mixed infections. Single point mutations and deleterious mutations within highly related strains suggested that PBVs exist as quasispecies in the swine alimentary tract. Clones with complete sequence identities originating from different animals suggested effective animal-to-animal transmission of the virus. Our findings indicate that infection with genogroup I PBVs is common in pigs.
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Affiliation(s)
- K. Bányai
- Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Regional Laboratory of Virology, Baranya County Institute of State Public Health Service, Szabadság út 7, H-7623 Pécs, Hungary
| | - V. Martella
- Department of Animal Health and Well-Being, University of Bari, Sp Casamassima Km 3, I-70010 Valenzano, Bari, Italy
| | - Á. Bogdán
- Regional Laboratory of Virology, Baranya County Institute of State Public Health Service, Szabadság út 7, H-7623 Pécs, Hungary
| | - P. Forgách
- Department of Microbiology and Infectious Diseases, Faculty of Veterinary Science, Szent István University, István u. 2, H-1078 Budapest, Hungary
| | - F. Jakab
- Regional Laboratory of Virology, Baranya County Institute of State Public Health Service, Szabadság út 7, H-7623 Pécs, Hungary
| | - E. Meleg
- Regional Laboratory of Virology, Baranya County Institute of State Public Health Service, Szabadság út 7, H-7623 Pécs, Hungary
| | - H. Bíró
- AKA-HYB Ltd, Tompa M. u. 15, H-7700 Mohács, Hungary
| | - B. Melegh
- Department of Medical Genetics and Child Development, Faculty of Medicine, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - G. Szűcs
- Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Regional Laboratory of Virology, Baranya County Institute of State Public Health Service, Szabadság út 7, H-7623 Pécs, Hungary
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