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Caporali R, Taylor PC, Aletaha D, Sanmartí R, Takeuchi T, Mo D, Haladyj E, Bello N, Zaremba-Pechmann L, Fang Y, Dougados M. Efficacy Of Baricitinib in Patients With Moderate-To-Severe Rheumatoid Arthritis Up to 6.5 Years Of Treatment: Results Of A Long-Term Study. Rheumatology (Oxford) 2024:keae012. [PMID: 38258434 DOI: 10.1093/rheumatology/keae012] [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: 08/24/2023] [Revised: 12/14/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVES To evaluate the long-term efficacy of once-daily baricitinib 4 mg or 2 mg in patients with active rheumatoid arthritis who had inadequate response (IR) to MTX, csDMARDs, or bDMARDs. METHODS Data from three completed phase III studies, RA-BEAM (MTX-IR), RA-BUILD (csDMARD-IR), and RA-BEACON (bDMARD-IR), and one completed long-term extension study (RA-BEYOND) were analyzed up to 6.5 years (340 weeks [RA-BEAM] and 336 weeks [RA-BUILD and RA-BEACON]). Low disease activity (LDA) (Simplified Disease Activity Index [SDAI] ≤11), clinical remission (SDAI ≤3.3), and physical function (Health Assessment Questionnaire Disability Index [HAQ-DI] ≤0.5) were the main outcomes assessed. Completer and non-responder imputation (NRI) analyses were conducted on each population. RESULTS At week 340 or 336, LDA was achieved in 37%/83% of MTX-IR, 35%/83% of csDMARD-IR, and 23%/73% of bDMARD-IR patients treated with baricitinib 4 mg, assessed by NRI/completer analyses, respectively. Remission was achieved in 20%/40% of MTX-IR, 13%/32% of csDMARD-IR, and 9%/30% of bDMARD-IR patients treated with baricitinib 4 mg, assessed by NRI/completer analyses, respectively. HAQ-DI ≤0.5 was reached in 31%/51% of MTX-IR, 25%/46% of csDMARD-IR, and 24%/38% of bDMARD-IR patients treated with baricitinib 4 mg, assessed by NRI/completer analyses, respectively. CONCLUSION Treatment with baricitinib 4 mg or 2 mg demonstrated efficacy up to 6.5 years with maintained LDA/remission results across SDAI, CDAI and DAS28-hsCRP consistent with previously reported data, and was well tolerated.
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Affiliation(s)
- Roberto Caporali
- Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano and ASST Gaetano Pini CTO, Milano, Italy
| | - Peter C Taylor
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Daniel Aletaha
- Department of Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Raimon Sanmartí
- Rheumatology Department, Hospital Clínic de Barcelona and IDIBAPS, Barcelona, Spain
| | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo and Saitama Medical University, Saitama, Japan
| | - Daojun Mo
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Ewa Haladyj
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | | | - Ying Fang
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Maxime Dougados
- Rheumatology Department, Cochin Hospital, APHP, Paris and INSERM U-1153, CRESS Paris-Sorbonne, Paris, France
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Bello N, Meyers KJ, Workman J, Hartley L, McMahon M. Cardiovascular events and risk in patients with systemic lupus erythematosus: Systematic literature review and meta-analysis. Lupus 2023; 32:325-341. [PMID: 36547368 PMCID: PMC10012401 DOI: 10.1177/09612033221147471] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is an autoimmune disease that typically affects women aged 16-55 years. Cardiovascular disease (CVD) is a well-recognized complication of SLE. This systematic literature review and meta-analysis evaluated the relative risk (RR; compared with non-SLE controls), absolute risk (AR; as incidence proportion, n/N), and incidence rate (IR) of CVD events (including stroke, myocardial infarction [MI], and CVD [composite or undefined]) in adult patients with SLE. The RR of CV risk factors (including hypertension, diabetes, and metabolic syndrome [MetS]) was also examined. METHODS PubMed and Embase were searched on September 10, 2020. Observational studies published between January 2010 and September 2020 that reported RR, AR, and/or IR of CVD events, or RR of CV risk factors, were eligible. Pooled risk estimates were calculated using a random-effects model. RESULTS Forty-six studies (16 cross-sectional, 15 retrospective cohort, 14 prospective cohort, and 1 case-control) were included in meta-analyses. Most studies were considered high quality (Critical Appraisal Skills Programme checklists). Compared with adults without SLE, patients with SLE had statistically significantly higher RRs (95% CIs) of stroke (2.51 [2.03-3.10]; 12 studies), MI (2.92 [2.45-3.48]; 11 studies), CVD (2.24 [1.94-2.59]; 8 studies), and hypertension (2.70 [1.48-4.92]; 7 studies). RRs of diabetes (1.24 [0.78-1.96]; 3 studies) and MetS (1.49 [0.95-2.33]; 7 studies) were elevated but not significant. RRs of stroke and MI were generally higher in younger versus older patients with SLE. In patients with SLE, the pooled estimate of AR (95% CI) was 0.03 (0.02-0.05), 0.01 (0.00-0.02), and 0.06 (0.03-0.10) for stroke (7 studies), MI (6 studies), and CVD (8 studies), respectively. The pooled estimate of IR per 1000 person-years (95% CI) was 4.72 (3.35-6.32), 2.81 (1.61-4.32), and 11.21 (8.48-14.32) for stroke (10 studies), MI (6 studies), and CVD (8 studies), respectively. Although heterogeneity (based on I2 value) was high in most analyses, sensitivity analyses confirmed the robustness of the pooled estimates. CONCLUSIONS This meta-analysis found an increased risk of stroke, MI, CVD, and hypertension in patients with SLE compared with the general population, despite substantial heterogeneity across the included studies.
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Affiliation(s)
| | | | | | | | - Maureen McMahon
- Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, 8783University of California Los Angeles, Los Angeles, CA, USA
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Di Diego Garcia F, Cabrerizo G, Paletta A, Prez PS, Varese A, Geffner J, Bello N, Fridman V, Stecher D, Ceballos A, Remes Lenicov F. Resistance to Prostaglandin E2 Promotes Monocyte Activation During Chronic HIV Infection. J Infect Dis 2023; 227:423-433. [PMID: 36482781 DOI: 10.1093/infdis/jiac480] [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: 08/25/2022] [Revised: 11/28/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Monocyte activation is a driver of inflammation in the course of chronic HIV infection. Prostaglandin E2 (PGE2) is known to mediate anti-inflammatory effects, notably the inhibition of tumor necrosis factor- (TNF-) production by monocytes. We aim to investigate the effects of PGE2 on activation of monocytes in chronic HIV infection and the mechanisms through which PGE2 modulates their inflammatory signature. METHODS We recruited a group of people with HIV (PWH) and matched healthy uninfected persons. We compared plasma levels of PGE2, monocyte activation, and sensitivity of monocytes to the inhibitory actions mediated by PGE2. RESULTS We found increased plasma levels of PGE2 in PWH, and an activated phenotype in circulating monocytes, compared with uninfected individuals. Monocytes from PWH showed a significant resistance to the inhibitory actions mediated by PGE2; the concentration of PGE2 able to inhibit 50 of the production of TNF- by lipopolysaccharide-stimulated monocytes was 10 times higher in PWH compared with uninfected controls. Furthermore, the expression of phosphodiesterase 4B, a negative regulator of PGE2 activity, was significantly increased in monocytes from PWH. CONCLUSIONS Resistance to the inhibitory actions mediated by PGE2 could account, at least in part, for the inflammatory profile of circulating monocytes in PWH.
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Affiliation(s)
- Facundo Di Diego Garcia
- Instituto de Investigaciones Biomdicas en Retrovirus y SIDA, Universidad de Buenos Aires/CONICET, Buenos Aires, Argentina
| | - Gonzalo Cabrerizo
- Instituto de Investigaciones Biomdicas en Retrovirus y SIDA, Universidad de Buenos Aires/CONICET, Buenos Aires, Argentina
| | - Ana Paletta
- Instituto de Investigaciones Biomdicas en Retrovirus y SIDA, Universidad de Buenos Aires/CONICET, Buenos Aires, Argentina
| | - Paula S Prez
- Instituto de Investigaciones Biomdicas en Retrovirus y SIDA, Universidad de Buenos Aires/CONICET, Buenos Aires, Argentina
| | - Augusto Varese
- Instituto de Investigaciones Biomdicas en Retrovirus y SIDA, Universidad de Buenos Aires/CONICET, Buenos Aires, Argentina
| | - Jorge Geffner
- Instituto de Investigaciones Biomdicas en Retrovirus y SIDA, Universidad de Buenos Aires/CONICET, Buenos Aires, Argentina
| | - Natalia Bello
- Divisin Infectologa, Hospital de Clnicas Jos de San Martn, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Vanesa Fridman
- Divisin Infectologa, Hospital de Clnicas Jos de San Martn, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Daniel Stecher
- Divisin Infectologa, Hospital de Clnicas Jos de San Martn, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Ana Ceballos
- Instituto de Investigaciones Biomdicas en Retrovirus y SIDA, Universidad de Buenos Aires/CONICET, Buenos Aires, Argentina
| | - Federico Remes Lenicov
- Instituto de Investigaciones Biomdicas en Retrovirus y SIDA, Universidad de Buenos Aires/CONICET, Buenos Aires, Argentina
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Bello N, Meyers KJ, Workman J, Marcano Belisario J, Cervera R. Systematic Literature Review and Meta-analysis of Venous Thromboembolism Events in Systemic Lupus Erythematosus. Rheumatol Ther 2023; 10:7-34. [PMID: 36471199 PMCID: PMC9931974 DOI: 10.1007/s40744-022-00513-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
The objective of this work was to conduct a systematic literature review (SLR) and meta-analysis (MA) to evaluate the relative risk (RR) of venous thromboembolism (VTE) events, including deep vein thrombosis (DVT) and pulmonary embolism (PE), in patients with systemic lupus erythematosus (SLE) compared with patients without SLE, as well as the absolute risk (AR) (measured by incidence proportion) and incidence rate (IR) of VTE events in patients with SLE. The SLR was conducted using Embase, MEDLINE, and MEDLINE In-Process to identify observational studies evaluating the risk of VTE, DVT, and PE events in adult patients with SLE compared with the general population, published January 2000 to September 2020. Random-effects models were used as the primary approach in the MA. Heterogeneity was assessed on the basis of the I2 value. Sensitivity analyses were performed to assess the robustness of results to various conditions, and subgroup analysis was performed for the AR of VTE by antiphospholipid status (aPLs) and antiphospholipid syndrome (APS). Of the 50 publications included for data extraction, 44 contained data for consideration in the MA of any one of the measures of interest (RR, AR, or IR) for VTE, DVT, or PE. The pooled RR indicates statistically significantly higher risk of VTE (RR 4.38, 95% confidence interval 2.63-7.29) in patients with SLE compared with the general population. Considerable heterogeneity was present in nearly all MA (I2 = 75-100%). Moreover, a higher pooled AR of VTE was estimated in patients with SLE with aPLs (n/N = 0.13) and APS (n/N = 0.63) compared with patients with SLE without aPLs/APS (n/N = 0.07). Overall, there was evidence of an increased risk of VTE, DVT, and PE in patients with SLE compared with the general population.
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Affiliation(s)
| | | | | | | | - Ricard Cervera
- Department of Autoimmune Diseases, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Catalonia, Spain
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Barcia RE, Keller GA, Bello N, Azzato F, Diez RA, Giunti G. Polypharmacy and Drug Interactions in the COVID-19 Pandemic. Prague Med Rep 2023; 124:392-412. [PMID: 38069645 DOI: 10.14712/23362936.2023.30] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
The COVID-19 pandemic generated a great impact on health systems. We compared evolution, polypharmacy, and potential drug-drug interactions (P-DDIs) in COVID-19 and non-COVID-19 hospitalizations during first wave of pandemic. Prescriptions for hospitalized patients ≥ 18 years (COVID-19 and non-COVID-19 rooms) between April and September 2020 were included. The computerized medical decision support system SIMDA and the physician order entry system Hdc.DrApp.la were used. Patients in COVID-19 rooms were divided into detectable and non-detectable, according to real-time reverse transcription polymerase chain reaction (RT-PCR). Number of drugs, prescribed on day 1, after day 1, and total; polypharmacy, excessive polypharmacy, and P-DDIs were compared. 1,623 admissions were evaluated: 881 COVID-19, 538 detectable and 343 non-detectable, and 742 non-COVID-19. Mortality was 15% in COVID-19 and 13% in non-COVID-19 (RR [non-COVID-19 vs. COVID-19]: 0.84 [95% CI] [0.66-1.07]). In COVID-19, mortality was 19% in detectable and 9% in non-detectable (RR: 2.07 [1.42-3.00]). Average number of drugs was 4.54/patient (SD ± 3.06) in COVID-19 and 5.92/patient (±3.24) in non-COVID-19 (p<0.001) on day 1 and 5.57/patient (±3.93) in COVID-19 and 9.17/patient (±5.27) in non-COVID-19 (p<0.001) throughout the hospitalization. 45% received polypharmacy in COVID-19 and 62% in non-COVID-19 (RR: 1.38 [1.25-1.51]) and excessive polypharmacy 7% in COVID-19 and 14% in non-COVID-19 (RR: 2.09 [1.54-2.83]). The frequency of total P-DDIs was 0.31/patient (±0.67) in COVID-19 and 0.40/patient (±0.94) in non-COVID-19 (p=0.022). Hospitalizations in the COVID-19 setting are associated with less use of drugs, less polypharmacy and less P-DDIs. Detectable patients had higher mortality.
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Affiliation(s)
- Ricardo Enrique Barcia
- 6° Cátedra de Medicina Interna, Hospital de Clínicas "José de San Martín", Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.
- DrApp, Empresa de Desarrollos Informáticos para Medicina, Buenos Aires, Argentina.
| | - Guillermo Alberto Keller
- Centro de Vigilancia y Seguridad de Medicamentos, Departamento de Toxicología y Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Natalia Bello
- División Infectología, Hospital de Clínicas "José de San Martín", Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Francisco Azzato
- 6° Cátedra de Medicina Interna, Hospital de Clínicas "José de San Martín", Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Roberto Alejandro Diez
- Centro de Vigilancia y Seguridad de Medicamentos, Departamento de Toxicología y Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Guido Giunti
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- University of Oulu, Oulu, Finland
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Hayden C, Motta J, Bello N, Sala R, Absalon-Medina V, Ross P, Moreno J, Garcia-Guerra A. 153 Assessment of methods to synchronise follicle wave emergence in pregnant heifers. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab153] [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: 12/12/2022] Open
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Taylor PC, Takeuchi T, Burmester G, Durez P, Smolen J, Deberdt W, Zhong J, Terres JR, Bello N, Winthrop K. P196 Safety profile of baricitinib for the treatment of rheumatoid arthritis up to 9.3 years: an updated integrated safety analysis. Rheumatology (Oxford) 2022. [DOI: 10.1093/rheumatology/keac133.195] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Aims
Baricitinib (BARI) is an oral selective Janus kinase (JAK)1/JAK2 inhibitor approved for the treatment of adult patients with moderate-to-severe rheumatoid arthritis (RA).
Objective
Reporting BARI’s safety profile with data up to 9.3 years of treatment.
Methods
Pooled data from nine randomized (five Phase 3, three Phase 2, one Phase 1b) and one long-term-extension (LTE) study were assessed. Incidence rates (IR)/100 patient-years at risk (PYR) were calculated for all patients treated with ≥1 dose of BARI (All-BARI-RA). Adverse events (AEs) of interest were assessed in 48-month intervals. Major adverse cardiovascular events (MACE) were adjudicated in five Phase 3 studies and the LTE, and incidence rates evaluated in subgroups of patients aged ≥50 years and presenting with ≥1 cardiovascular risk factor (current smoker, hypertension, high-density lipoprotein cholesterol <40 mg/dL, diabetes, or arteriosclerotic cardiovascular disease). To account for aging of the cohort, a standardized incidence ratio (SIR) for malignancy (excluding non-melanoma skin cancer [NMSC]) was estimated using SEER17, 2013-2017 US population cancer rates, and a standardized mortality ratio (SMR) was estimated using 2019 US population mortality calculated compared to the general US population with the same age distribution. Exposure-adjusted IRs (EAIRs) for deep vein thrombosis (DVT), pulmonary embolism (PE), and DVT and/or PE (DVT/PE) were also calculated for patient groups while receiving BARI 2-mg/4-mg within All-BARI-RA.
Results
A total of 3770 patients received BARI for 14,744.4 PYE with a median exposure of 4.6 years and a maximum exposure of 9.3 years; 80.5% of PYE were BARI 4-mg and 18.1% of PYE were BARI 2-mg. Overall, EAIRs/100 PYE for any treatment-emergent AE and serious AE (including death) were 22.6 and 7.4. Overall IRs/100 PYR were 2.58 for serious infections; 0.35 for DVT, 0.26 for PE, 0.49 for DVT/PE, 0.51 for MACE, and 0.92 for malignancy; IRs remained stable over time. The IR (95%CI) of MACE for patients aged ≥50 years was 0.68 (0.52, 0.88). In patients aged ≥50 with ≥1 of the cardiovascular risk factors, IR (95%CI) of MACE was 0.77 (0.56, 1.04). The SIR (95%CI) for malignancies excluding NMSC based on the SEER17 standard was 1.07 (0.90, 1.26); the SMR (95%CI) was 0.74 (0.59, 0.92) showing that the incidence of malignancy and death in patients treated with BARI appear similar to the general US population. EAIRs (95%CI) for patients while receiving BARI 2-mg (PYE=2678) and BARI 4-g (PYE=11,872) were DVT 2-mg 0.41 (0.21, 0.73) and 4-mg 0.35 (0.25, 0.48); PE 2-mg 0.26 (0.11, 0.54) and 4-mg 0.27 (0.18, 0.38); and DVT/PE 2-mg 0.49 (0.26, 0.83) and 4-mg 0.51 (0.39, 0.66).
Conclusion
In this report with 14,744 PYE, BARI maintained a safety profile similar to that previously reported, with no increase of IRs across safety events through exposures up to 9.3 years.
Disclosure
P.C. Taylor: Consultancies; AbbVie, Biogen, Bristol Myers Squibb, Celgene, Eli Lilly and Company, Fresenius Medical Care, Galapagos NV, Gilead Sciences, GlaxoSmithKline, Janssen, Nordic Pharma, Pfizer, Roche, Sanofi, UCB Pharma. Grants/research support; AbbVie, Biogen, Bristol Myers Squibb, Celgene, Eli Lilly and Company, Fresenius Medical Care, Galapagos NV, Gilead Sciences, GlaxoSmithKline, Janssen, Nordic Pharma, Pfizer, Roche, Sanofi, UCB Pharma. T. Takeuchi: Consultancies; AbbVie, Asahi Kasei Pharma, Astellas, AstraZeneca, Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo, Eisai, Eli Lilly and Company, GlaxoSmithKline, Janssen, Mitsubishi Tanabe Pharma, Nippon Kayaku, Novartis, Pfizer Japan, Taiho Pharmaceutical, Taisho Toyama Pharmaceutical, Takeda, and UCB Japan. Member of speakers’ bureau; AbbVie, Asahi Kasei Pharma, Astellas, AstraZeneca, Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo, Eisai, Eli Lilly and Company, GlaxoSmithKline, Janssen, Mitsubishi Tanabe Pharma, Nippon Kayaku, Novartis, Pfizer Japan, Taiho Pharmaceutical, Taisho Toyama Pharmaceutical, Takeda, and UCB Japan. G. Burmester: Consultancies; Eli Lilly and Company, Janssen, Novartis, and Pfizer. Grants/research support; Eli Lilly and Company. P. Durez: Member of speakers’ bureau; Bristol Myers Squibb, Celltrion, Eli Lilly and Company, and Sanofi. J. Smolen: Consultancies; AbbVie, Amgen, AstraZeneca, Astro Pharma, Bristol Myers Squibb, Celgene, Celltrion, Chugai Pharmaceutical, Eli Lilly and Company, Gilead Sciences, GlaxoSmithKline, ILTOO Pharma, Janssen, MedImmune, Merck Sharp & Dohme, Novartis-Sandoz, Pfizer, Roche, Samsung, Sanofi, and UCB Pharma. Member of speakers’ bureau; AbbVie, Amgen, AstraZeneca, Astro Pharma, Bristol Myers Squibb, Celgene, Celltrion, Chugai Pharmaceutical, Eli Lilly and Company, Gilead Sciences, GlaxoSmithKline, ILTOO Pharma, Janssen, MedImmune, Merck Sharp & Dohme, Novartis-Sandoz, Pfizer, Roche, Samsung, Sanofi, and UCB Pharma. Grants/research support; AbbVie, Amgen, AstraZeneca, Astro Pharma, Bristol Myers Squibb, Celgene, Celltrion, Chugai Pharmaceutical, Eli Lilly and Company, Gilead Sciences, GlaxoSmithKline, ILTOO Pharma, Janssen, MedImmune, Merck Sharp & Dohme, Novartis-Sandoz, Pfizer, Roche, Samsung, Sanofi, and UCB Pharma. W. Deberdt: Shareholder/stock ownership; Eli Lilly and Company. J. Zhong: Other; current employee of: IQVIA. J. Ross Terres: Shareholder/stock ownership; Eli Lilly and Company. N. Bello: Shareholder/stock ownership; Eli Lilly and Company. K. Winthrop: Consultancies; AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly and Company, Pfizer, and UCB Pharma. Grants/research support; Bristol Myers Squibb and Pfizer.
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Affiliation(s)
- Peter C Taylor
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UNITED KINGDOM
| | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JAPAN
| | - Gerd Burmester
- Department of Rheumatology and Clinical Immunology, Charité-University Medicine Berlin, Free University, and Humboldt University Berlin, Berlin, GERMANY
| | - Patrick Durez
- Division of Rheumatology, Cliniques Universitaires Saint-Luc, Brussels, BELGIUM
| | - Josef Smolen
- Division of Rheumatology, Department of Medicine, Medical University of Vienna, Vienna, AUSTRIA
| | - Walter Deberdt
- Department of Rheumatology, Eli Lilly and Company, Indianapolis, IN
| | | | | | - Natalia Bello
- Department of Rheumatology, Eli Lilly and Company, Indianapolis, IN
| | - Kevin Winthrop
- Department of Rheumatology, Oregon Health Sciences University, Portland, OR, USA
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Dörner T, Vital EM, Ohrndorf S, Alten R, Bello N, Haladyj E, Burmester G. A Narrative Literature Review Comparing the Key Features of Musculoskeletal Involvement in Rheumatoid Arthritis and Systemic Lupus Erythematosus. Rheumatol Ther 2022; 9:781-802. [PMID: 35359260 PMCID: PMC9127025 DOI: 10.1007/s40744-022-00442-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/08/2022] [Indexed: 12/14/2022] Open
Abstract
Although the clinical approach to the management of musculoskeletal manifestations in systemic lupus erythematosus (SLE) is often similar to that of rheumatoid arthritis (RA), there are distinct differences in immunopathogenesis, structural and imaging phenotypes and therapeutic evidence. Additionally, there are few published comparisons of these diseases. The objective of this narrative literature review is to compare the immunopathogenesis, structural features, magnetic resonance imaging (MRI) and musculoskeletal ultrasound (MSUS) studies and management of joint manifestations in RA and SLE. We highlight the key similarities and differences between the two diseases. Overall, the literature evaluated indicates that synovitis and radiographical progression are the key features in RA, while inflammation without swelling, tendinitis and tenosynovitis are more prominent features in SLE. In addition, the importance of defining patients with RA by the presence or absence of autoantibodies and categorizing patients with SLE by synovitis detected by musculoskeletal ultrasound and by structural phenotype (non-deforming, non-erosive arthritis, Jaccoud’s arthropathy and ‘Rhupus’) with respect to joint manifestations will also be discussed. An increased understanding of the joint manifestations in RA and SLE may inform evidence-based clinical decisions for both diseases.
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Affiliation(s)
- Thomas Dörner
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Germany.
| | - Edward M Vital
- Faculty of Medicine and Health, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- Leeds Biomedical Research Centre, National Institute for Health Research, Leeds Teaching Hospitals, Leeds, UK
| | - Sarah Ohrndorf
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Rieke Alten
- Department of Internal Medicine and Rheumatology, Schlosspark-Klinik, Teaching Hospital of the Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Ewa Haladyj
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Gerd Burmester
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Germany
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Taylor PC, Alten R, Álvaro Gracia JM, Kaneko Y, Walls C, Quebe A, Jia B, Bello N, Terres JR, Fleischmann R. Achieving pain control in early rheumatoid arthritis with baricitinib monotherapy or in combination with methotrexate versus methotrexate monotherapy. RMD Open 2022; 8:rmdopen-2021-001994. [PMID: 35264432 PMCID: PMC8915362 DOI: 10.1136/rmdopen-2021-001994] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives This post hoc analysis assessed speed, magnitude and maintenance of pain improvement in patients with early rheumatoid arthritis (RA) receiving baricitinib, baricitinib and methotrexate (MTX), or MTX over 1 year. Cumulative pain and quality of life benefits were also assessed. Methods Randomised, double-blind, phase 3 study RA-BEGIN (NCT01711359) compared baricitinib 4 mg (N=159), baricitinib 4 mg +MTX (N=215) and MTX (N=210) in patients with RA who had no or limited prior disease-modifying antirheumatic drug treatment. Pain was assessed on a 0–100 mm Visual Analogue Scale (VAS). Proportion of patients with ≥30%, ≥50% and ≥70% pain improvement from baseline; ≤20 mm and ≤10 mm on the pain VAS; and time to achieve pain improvement thresholds were assessed over 52 weeks, as were Patient Global Assessment (PtGA) and 36-Item Short Form Health Survey Physical Component Score (SF-36 PCS) outcomes. Results Baricitinib monotherapy or combination with MTX provides greater (least square mean changes (LSM) from baseline −40 mm and −43 mm, respectively) and more rapid (median 12 and 8 weeks to ≥70% improvement, respectively) pain relief than MTX alone (LSM −31 mm, median 20 weeks to ≥70% improvement) over 52 weeks. Baricitinib, alone or combination, provides 9–10 additional weeks of limited to no pain, similar gain in achievable wellness measured through PtGA, and 5–7 additional weeks with change in SF-36 PCS ≥5 vs MTX over 1 year. Conclusions Patients treated with baricitinib reported significantly greater and more rapid pain relief, more weeks with limited to no pain, and clinically meaningful improvements in physical health than patients treated with MTX alone over 1 year.
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Affiliation(s)
- Peter C Taylor
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Rieke Alten
- Internal Medicine II, Rheumatology, SCHLOSSPARK-KLINIK, University Medicine Berlin, Berlin, Germany
| | - Jose María Álvaro Gracia
- Rheumatology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Yuko Kaneko
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Chad Walls
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Amanda Quebe
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Bochao Jia
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | | | | | - Roy Fleischmann
- Metroplex Clinical Research Center, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
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10
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Taylor PC, Takeuchi T, Burmester GR, Durez P, Smolen JS, Deberdt W, Issa M, Terres JR, Bello N, Winthrop KL. Safety of baricitinib for the treatment of rheumatoid arthritis over a median of 4.6 and up to 9.3 years of treatment: final results from long-term extension study and integrated database. Ann Rheum Dis 2021; 81:335-343. [PMID: 34706874 PMCID: PMC8862028 DOI: 10.1136/annrheumdis-2021-221276] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/07/2021] [Indexed: 12/30/2022]
Abstract
Objective To report long-term safety from the completed extension trial of baricitinib, an oral selective Janus kinase inhibitor, in patients with active rheumatoid arthritis (RA). Methods Treatment-emergent adverse events are summarised from an integrated database (9 phase III/II/Ib and 1 long-term extension) of patients who received any baricitinib dose (All-bari-RA). Standardised incidence ratio (SIR) for malignancy (excluding non-melanoma skin cancer (NMSC)) and standardised mortality ratio (SMR) were estimated. Additional analysis was done in a subset of patients who had ever taken 2 mg or 4 mg baricitinib. Results 3770 patients received baricitinib (14 744 patient-years of exposure (PYE)). All-bari-RA incidence rates (IRs) per 100 patient-years at risk were 2.6, 3.0 and 0.5 for serious infections, herpes zoster and major adverse cardiovascular events (MACE), respectively. In patients aged ≥50 with ≥1 cardiovascular risk factor, the IR for MACE was 0.77 (95% CI 0.56 to 1.04). The IR for malignancy (excluding NMSC) during the first 48 weeks was 0.6 and remained stable thereafter (IR 1.0). The SIR for malignancies excluding NMSC was 1.07 (95% CI 0.90 to 1.26) and the SMR was 0.74 (95% CI 0.59 to 0.92). All-bari-RA IRs for deep vein thrombosis (DVT)/pulmonary embolism (PE), DVT and PE were 0.5 (95% CI 0.38 to 0.61), 0.4 (95% CI 0.26 to 0.45) and 0.3 (95% CI 0.18 to 0.35), respectively. No clear dose differences were noted for exposure-adjusted IRs (per 100 PYE) for deaths, serious infections, DVT/PE and MACE. Conclusions In this integrated analysis including long-term data of baricitinib from 3770 patients (median 4.6 years, up to 9.3 years) with active RA, baricitinib maintained a similar safety profile to earlier analyses. No new safety signals were identified. Trial registration number NCT01185353, NCT00902486, NCT01469013, NCT01710358, NCT02265705, NCT01721044, NCT01721057, NCT01711359 and NCT01885078.
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Affiliation(s)
- Peter C Taylor
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan
| | - Gerd R Burmester
- Rheumatology and Clinical Immunology, Charitė - Universitätsmedizin Berlin, Berlin, Germany
| | - Patrick Durez
- Division of Rheumatology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Josef S Smolen
- Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | | | - Maher Issa
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | | | | | - Kevin L Winthrop
- Schools of Medicine and Public Health, Oregon Health & Sciences University, Portland, Oregon, USA
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Birt JA, Wu J, Griffing K, Bello N, Princic N, Winer I, Lew CR, Costenbader KH. Corticosteroid dosing and opioid use are high in patients with SLE and remain elevated after belimumab initiation: a retrospective claims database analysis. Lupus Sci Med 2021; 7:7/1/e000435. [PMID: 33361460 PMCID: PMC7759957 DOI: 10.1136/lupus-2020-000435] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/24/2020] [Accepted: 11/29/2020] [Indexed: 12/21/2022]
Abstract
Objectives To investigate corticosteroid and opioid use among patients with SLE and to examine the impact of belimumab initiation on the use of other SLE therapies. Methods We identified adult patients with SLE (International Classification of Diseases, 9th Revision/10th Revision 710.0 and M32) between 1 January 2012 and 31 May 2018 (earliest SLE diagnosis=index date) within MarketScan administrative claims data. Patients were followed from index date for a minimum of 12 months and until the earlier of disenrolment in their health plan or study end (31 May 2018). Corticosteroid utilisation, corticosteroid dose (in prednisone equivalents) and opioid utilisation (overall, by strength (weak, strong) and by duration (chronic use defined as >90 days of cumulative drug supply)) were measured during follow-up. Oral corticosteroid and opioid use were compared in the 6 months before and after initiation of belimumab. Results There were 49 413 patients with SLE eligible for analysis (mean (SD) age: 50.1 (14.0) years, 90.2% female). Of these, 68.5% received corticosteroids, and the average number of prescriptions was 4.59 (4.11) over the first 12 months of follow-up. Among patients with oral corticosteroids, average daily dose was 19.4 (14.2) mg and 59.6% had an average daily dose of ≥15 mg. Half (52.6%) had at least one opioid prescription and of these, 34.6% had chronic use over the first 12 months of follow-up. Among patients initiating belimumab during follow-up (n=1710), oral corticosteroid use decreased by 9.1% (p=0.001), and average daily dose decreased from 14.5 (18.4) mg to 11.9 (18.0) mg (p<0.001) in the 6 months after initiation compared with the 6 months prior. Initiation of belimumab had no impact on prevalence of opioid use. Conclusions A high proportion of patients with SLE are treated with corticosteroids to control SLE and opioid therapy to manage chronic pain. While there was no change in opioid use, oral corticosteroid use and dose intensity decreased following initiation of belimumab.
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Affiliation(s)
- Julie A Birt
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Jianmin Wu
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | | | | | | | | | | | - Karen H Costenbader
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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Birt JA, Hadi MA, Sargalo N, Brookes E, Swinburn P, Hanrahan L, Tse K, Bello N, Griffing K, Silk ME, Delbecque LA, Kamen D, Askanase AD. Patient Experiences, Satisfaction, and Expectations with Current Systemic Lupus Erythematosus Treatment: Results of the SLE-UPDATE Survey. Rheumatol Ther 2021; 8:1189-1205. [PMID: 34164800 PMCID: PMC8380609 DOI: 10.1007/s40744-021-00328-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/27/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To provide information on systemic lupus erythematosus (SLE) patients' experiences, satisfaction, and expectations with treatments and examine the association between treatment satisfaction and patient-reported outcomes (PRO). METHODS A cross-sectional, non-interventional, online survey of US adult patients with SLE was conducted in 2019. The survey consisted of 104 questions about SLE and the following PRO instruments: LupusPRO™, Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue, Work Productivity and Activity Impairment (WPAI), an 11-point Worst Pain Numerical Rating scale (NRS), and an 11-point Worst Joint Pain NRS. RESULTS Five hundred participants (75% female, 76% White/Caucasian, mean age 42.6 ± 12.7 years, 63% with an associate degree or higher) completed the survey. Most participants were "completely" or "somewhat satisfied" with their treatments, although satisfaction rates were lower for corticosteroids (65%), immunosuppressants (71%), and anti-malarials (55%) than for belimumab (intravenous or subcutaneous) (86%) and rituximab (94%). Treatments were more often considered "burdensome" or "very burdensome" for belimumab (67%) and rituximab (63%) than for corticosteroids (48%), immunosuppressants (49%), and anti-malarials (30%). Pain and productivity assessments supported substantial impairment for the majority of participants, even those who indicated that they were completely satisfied with treatments. The treatment goals most commonly reported as "very important" were reducing fatigue, pain, and the frequency or severity of flares. Three-quarters of participants (76.6%) indicated that their physician's goals for their therapy matched their own goals "very" or "somewhat closely." Despite high levels of satisfaction, most participants (63.0%) indicated that their physicians had not asked about their treatment goals during the past 3 months. CONCLUSION SLE patients reported high rates of satisfaction with current therapies despite identifying substantial treatment burdens, residual pain, and fatigue. Reduced fatigue, pain, and flares were the most important treatment goals for these patients.
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Affiliation(s)
- Julie A Birt
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Monica A Hadi
- Evidera, The Ark, 2nd floor, 201 Talgarth Road, London, UK.
| | | | - Ella Brookes
- Evidera, The Ark, 2nd floor, 201 Talgarth Road, London, UK
| | - Paul Swinburn
- Evidera, The Ark, 2nd floor, 201 Talgarth Road, London, UK
| | | | - Karin Tse
- Lupus Foundation of America, Washington, DC, USA
| | - Natalia Bello
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Kirstin Griffing
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Maria E Silk
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | | | - Diane Kamen
- Medical University of South Carolina Health, Charleston, SC, USA
| | - Anca D Askanase
- Columbia University College of Physicians and Surgeons, New York, USA
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13
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Bello N, Calvo-Medina R, Mora-Ramírez MD, Ramos-Fernández JM. [Epileptic status in paediatric patients: its developmental consequences and an epidemiological update]. Rev Neurol 2020; 71:365-372. [PMID: 33145747 DOI: 10.33588/rn.7110.2020306] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Epileptic status represents the most frequent neurological emergency in pediatrics. Prolonged febrile seizures represent the most common etiology. Our objective is to update its epidemiology and analyze its evolutionary consequences. PATIENTS AND METHODS Observational analytical study of retrospective cohorts of children seen in the emergency department with epileptic status between January-2014 and December-2018. Demographic variables, personal history, clinical characteristics, complementary tests and the etiology of the epileptic status followed in our hospital were collected. The evolutionary consequences in terms of neurodevelopment and subsequent epilepsy were analyzed. RESULTS Of a total of 525,000 emergencies attended during the study, epileptic status cases were 79 in 68 patients (16 cases/100,000 children/year). The symptomatic etiology was the most frequent (35.4%). 20.6% of the patients had a history of prematurity, 30.8% had a deficit of previous neurodevelopment, this being more frequent in case of symptomatic etiology, and 44% were diagnosed with epilepsy. The median duration of seizures was 50 minutes. An acute brain trigger was identified in seven patients. The subsequent neurodevelopmental deficit attributable to epileptic status was 9.1% of patients related to symptomatic etiology and/or a history of prematurity. The development of epilepsy occurred in 10.7%. CONCLUSIONS The neurodevelopmental disorder attributable to epileptic status affects one in 11 cases. Prematurity was a risk factor per se. Post-epileptic status epilepsy developed in one in 10 cases.
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Affiliation(s)
- N Bello
- Hospital Regional Universitario Materno Infantil Málaga, Málaga, España
| | - R Calvo-Medina
- Hospital Regional Universitario Materno Infantil Málaga, Málaga, España
| | - M D Mora-Ramírez
- Hospital Regional Universitario Materno Infantil Málaga, Málaga, España
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14
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Suleiman HM, Aliyu IS, Abubakar SA, Isa MS, El-Bashir JM, Adamu R, Ibrahim MZ, Mohammed A, Yusuf R, Manu M, Dogara AB, Mustapha SK, Bello N, Ozovehe SA. Cardiac Troponin T and creatine kinase MB fraction levels among patients with acute ischemic stroke in Nigeria. Niger J Clin Pract 2018; 20:1618-1621. [PMID: 29378996 DOI: 10.4103/njcp.njcp_78_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Stroke has been a global burden, with increasing morbidity and mortality. Serum cardiac troponin t (cTnT) and creatine kinase (CK-MB) fraction are reported to be elevated in patients admitted with acute ischaemic stroke and high level of these biomarkers indicated more severe stroke and neurologic deficit in some of the patients. OBJECTIVE To evaluate the serum levels cardiac troponin t (cTnT) and creatine kinase MB fraction (CK-MB) in patients with acute ischaemic stroke and relate the analytes to severity of stroke. METHOD Patients with clinical diagnosis of ischaemic stroke diagnosed, confirmed by brain Computerized Tomography scan and equal number of apparently healthy age and sex-matched were recruited. Serum cardiac troponin t (cTnT) and creatine kinase MB fraction (CK-MB) were analysed using ELISA method and Stroke severity was determined using National Institute of Health Stroke Score (NIHSS). RESULTS Mean serum cardiac troponin t (cTnT) and creatine kinase MB fraction (CK-MB) in stroke patients were found to be higher than age sex matched control (p<0.05). NIHS Score of 12.2 ± 5.43 and 9.78 ± 3.97 were observed in Patients with elevated and normal cTnT respectively (p=0.009) while NIHS Score were similar in patients with elevated and normal CK-MB (p = 0.772). CONCLUSION The mean values of serum cTnT and CK-MB were higher in acute ischaemic stroke patients compared to controls. Serum cardiac Troponin t level may be a significant biomarker of the severity of stroke.
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Affiliation(s)
- H M Suleiman
- Department of Chemical Pathology, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - I S Aliyu
- Department of Chemical Pathology, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - S A Abubakar
- Department of Medicine, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - M S Isa
- Department of Chemical Pathology, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - J M El-Bashir
- Department of Chemical Pathology, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - R Adamu
- Department of Chemical Pathology, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - M Z Ibrahim
- Department of Radiology, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - A Mohammed
- Department of Chemical Pathology, FMC, Bida, Nigeria
| | - R Yusuf
- Department of Chemical Pathology, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - M Manu
- Department of Chemical Pathology, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - A B Dogara
- Department of Chemical Pathology, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - S K Mustapha
- Department of Medicine, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - N Bello
- Department of Radiology, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - S A Ozovehe
- Department of Chemical Pathology, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
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Murphy M, Hodgson D, Bello N. The accuracy and precision of oxygen therapy flowmeters in a veterinary teaching hospital. Vet Anaesth Analg 2017. [DOI: 10.1016/j.vaa.2017.09.016] [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: 10/18/2022]
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16
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Mastaglia S, Watson D, Bello N, Fridman V, Stecher D, Oliveri B. Vitamin D levels and their impact on mineral metabolism in HIV infected patients: an exploratory study. ACTA ACUST UNITED AC 2017; 14:18-22. [PMID: 28740520 DOI: 10.11138/ccmbm/2017.14.1.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Vitamin D has immunomodulating properties. The nuclear receptor for vitamin D is expressed in several immune cells, which convert 25-hydroxyvitamin D (25OHD) to the active form 1,25 hydroxyvitamin D [1,25(OH)2 D]. Under conditions of infection, 1,25(OH)2 D promotes production of cathelicidin (an antimicrobial peptide) in monocytes and activated macrophages. In vitro studies have shown the ability of cathelicidin to inhibit replication of human immunodeficiency virus (HIV-1) in T CD4 lymphocytes and macrophages. OBJECTIVE To evaluate vitamin D levels and their impact on mineral metabolism in HIV infected patients. MATERIALS AND METHODS Seventy-four clinical records of HIV/AIDS patients seen at the outpatients clinic were reviewed. The following data were collected: age, sex, time since diagnosis of HIV, HIV-1 viral load, CD4 counts (absolute value and percentage), and mineral metabolism determinations: 25OHD, intact parathormone (iPTH); serum calcium (sCa); serum phosphorus (sP) and serum crosslaps (sCTX). Vitamin D levels were stratified as follows: optimal: ≥30ng/ml; insufficient: 21-29ng/ml; moderately deficient: 20≥ -25OHD- >10 ng/ml and severely deficient ≤10 ng/ml. RESULTS Fifty-five clinical records were included; 82% of patients had 25OHD levels below 30ng/ml (insufficient: 23.6%, moderately deficient: 36.4%; and severely deficient: 21.8%). A significantly higher serum PTH levels in the moderately and severely deficient groups than in the optimal and insufficient groups was observed (p<0.05 and p<0.03 respectively). A weak negative correlation was observed between serum 25OHD and PTH levels (r=-0.268; p<0.004). CONCLUSION Sub-optimal vitamin D levels are frequently observed in HIV/AIDS patients on antiretroviral therapy (ART). Systematic assessment of mineral metabolism is considered necessary in HIV/AIDS positive patients.
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Affiliation(s)
- Silvina Mastaglia
- Osteoporosis and Metabolic Bone Diseases Laboratory, Institute of Immunology, Genetics, and Metabolism (INIGEM) CONICET - UBA, Buenos Aires, Argentina.,Researcher of the National Council for Scientific and Technologic Research (CONICET), Buenos Aires, Argentina
| | - Dana Watson
- Osteoporosis and Metabolic Bone Diseases Laboratory, Institute of Immunology, Genetics, and Metabolism (INIGEM) CONICET - UBA, Buenos Aires, Argentina
| | - Natalia Bello
- Infectology Division, Department of Internal Medicine, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina
| | - Vanesa Fridman
- Infectology Division, Department of Internal Medicine, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina
| | - Daniel Stecher
- Infectology Division, Department of Internal Medicine, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina
| | - Beatriz Oliveri
- Osteoporosis and Metabolic Bone Diseases Laboratory, Institute of Immunology, Genetics, and Metabolism (INIGEM) CONICET - UBA, Buenos Aires, Argentina.,Researcher of the National Council for Scientific and Technologic Research (CONICET), Buenos Aires, Argentina
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Taylor PC, Krogulec M, Dudek A, Dudler J, Drescher E, Cseuz R, Kausiene R, Andersone D, Unikiene D, Burson JS, Alonso RB, Dvořák Z, Ghizdavescu A, Irto I, Larsson E, Bello N, Barry J, Durand F, Holzkämper T, Otawa S, de Bono S, Keystone EC, Rubbert-Roth A, Combe B, De La Torre I. Rheumatoid arthritis oral abstractsO01. Efficacy and Safety of Baricitinib Versus Placebo and Adalimumab in Patients with Moderately to Severely Active Rheumatoid Arthritis and Inadequate Response to Methotrexate: Summary Results from the 52-Week Phase 3 RA-Beam Study. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex061] [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: 11/14/2022] Open
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18
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Taylor PC, Krogulec M, Dudek A, Dudler J, Drescher E, Cseuz R, Kausiene R, Andersone D, Unikiene D, Burson JS, Alonso RB, Dvořák Z, Ghizdavescu A, Irto I, Larsson E, Bello N, Barry J, Durand F, Holzkämper T, Otawa S, de Bono S, Keystone EC, Rubbert-Roth A, Combe B, De La Torre I. Rheumatoid arthritis oral abstractsO01. Efficacy and Safety of Baricitinib Versus Placebo and Adalimumab in Patients with Moderately to Severely Active Rheumatoid Arthritis and Inadequate Response to Methotrexate: Summary Results from the 52-Week Phase 3 RA-Beam Study. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex061.001] [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: 11/12/2022] Open
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Taylor P, Krogulec M, Dudek A, Dudler J, Drescher E, Cseuz R, Kausiene R, Andersone D, Unikiene D, Burson J, Alonso R, Dvořák Z, Ghizdavescu A, Irto I, Larsson E, Bello N, Barry J, Durand F, Holzkämper T, Otawa S, de Bono S, Keystone E, Rubbert-Roth A, Combe B, De La Torre I, Gonçalves L. BARICITINIBE VS. PBO E ADALIMUMABE NA ARTRITE REUMATOIDE MOD A GRAVE ‐ RESULTADOS DO RA‐BEAM. Revista Brasileira de Reumatologia 2017. [DOI: 10.1016/j.rbr.2017.07.536] [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: 11/17/2022] Open
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20
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Serrano-Benavente B, Bello N, Nieto-González J, Ovalles-Bonilla J, Janta I, González-Benítez R, Mata C, Hernández-Flόrez D, Lόpez-Longo F, Naredo E, González-Fernández C, Monteagudo I. AB0406 Clinical Experience from Abatacept Use in Systemic Lupus Erythematosus: Effectiveness and Safety: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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Di Gregorio S, Fernandez S, Perazzi B, Bello N, Famiglietti A, Mollerach M. Increase in IS256 transposition in invasive vancomycin heteroresistant Staphylococcus aureus isolate belonging to ST100 and its derived VISA mutants. Infect Genet Evol 2016; 43:197-202. [PMID: 27154328 DOI: 10.1016/j.meegid.2016.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 04/28/2016] [Accepted: 05/01/2016] [Indexed: 11/17/2022]
Abstract
In Staphylococcus aureus, transposition of IS256 has been described to play an important role in biofilm formation and antibiotic resistance. This study describes the molecular characterization of two clinical heterogeneous vancomycin-intermediate S. aureus (hVISA) isolates recovered from the same patient (before and after antibiotic treatment) and two VISA derivatives obtained by serial passages in the presence of vancomycin. Our results showed that antibiotic treatment (in vivo and in vitro) could enhance IS256 transposition, being responsible for the eventual loss of agr function. As far as we know this is the first study that reports the increase of IS256 transposition in isogenic strains after antibiotic treatment in a clinical setting.
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Affiliation(s)
- Sabrina Di Gregorio
- Cátedra de Microbiología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, CABA, Argentina
| | - Silvina Fernandez
- Cátedra de Microbiología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, CABA, Argentina
| | - Beatriz Perazzi
- Laboratorio de Bacteriología Clínica, Hospital de Clínicas José de San Martín, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, CABA, Argentina
| | - Natalia Bello
- División Infectología, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, CABA, Argentina
| | - Angela Famiglietti
- Laboratorio de Bacteriología Clínica, Hospital de Clínicas José de San Martín, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, CABA, Argentina
| | - Marta Mollerach
- Cátedra de Microbiología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, CABA, Argentina.
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Janta I, Stanciu D, Hinojosa M, Nieto-González JC, Valor L, Bello N, Serrano B, Mata-Martínez C, Martínez-Barrio J, Ovalles-Bonilla JG, González CM, López-Longo FJ, Monteagudo I, Naredo E, Carreño L. Structural damage in rheumatoid arthritis: comparison between tendon damage evaluated by ultrasound and radiographic damage. Rheumatology (Oxford) 2016; 55:1042-6. [PMID: 26945055 DOI: 10.1093/rheumatology/kew020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 06/08/2015] [Accepted: 01/26/2016] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To compare structural damage assessed by conventional radiography and tendon damage assessed by musculoskeletal US (MSUS) at wrist and ankle in RA patients. METHODS We evaluated 72 consecutive patients [56 (77.8%) females] with RA. The MSUS evaluation consisted in a B-mode examination of bilateral extensor carpi ulnaris and tibialis posterior tendons. Tendon damage was defined and scored according to OMERACT. A total score for the tendon damage score (TDS) was calculated by summing the grades for each tendon. For the radiographic evaluations we used the van der Heijde score; a total radiographic score (RTS) was calculated by summing a bone erosion score (ERS) and a joint space narrowing score (JSNS). RESULTS We evaluated 288 tendons. The mean (s.d.) of TDS was 2.3 (1.8). Fifty-four (75%) patients presented tendon damage of at least one tendon. From all evaluated tendons, 134 (46.5%) had no tendon damage, 146 (50.7%) had grade 1 and 8 (2.8%) had grade 2 tendon damage. The mean (s.d.) for RTS was 91.4 (97), for ERS was 47.3 (61.9) and for JSNS was 44.1 (37.2). We found a significant correlation between disease duration and both TDS and RTS (r = 0.413 and r = 0.560, respectively; P < 0.0001). We found a good significant correlation between TDS and all variables of radiographic structural damage (RTS, r = 0.65; ERS, r = 0.637; JSNS, r = 0.618; P < 0.001). CONCLUSION The MSUS assessment of only four tendons can be an additional feasible method to assess structural damage in RA patients.
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Affiliation(s)
- Iustina Janta
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and
| | - Denisa Stanciu
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and Clinical Center of Rheumatic Diseases 'Dr Ion Stoia', Bucharest, Romania
| | - Michelle Hinojosa
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and
| | | | - Lara Valor
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and
| | - Natalia Bello
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and
| | - Belen Serrano
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and
| | - Carmen Mata-Martínez
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and
| | - Julia Martínez-Barrio
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and
| | | | - Carlos Manuel González
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and
| | | | - Indalecio Monteagudo
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and
| | - Esperanza Naredo
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and
| | - Luis Carreño
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain and
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Bello N, Etcheto A, Béal C, Dougados M, Moltó A. Evaluation of the impact of fibromyalgia in disease activity and treatment effect in spondyloarthritis. Arthritis Res Ther 2016; 18:42. [PMID: 26860612 PMCID: PMC4748456 DOI: 10.1186/s13075-016-0943-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [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] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 01/29/2016] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Fibromyalgia (FM) can coexist with Spondyloarthritis (SpA) leading to diagnostic and treatment dilemmas, especially in the presence of enthesitis. With this study we aimed to estimate the prevalence of FM in SpA and to compare the clinical/disease features and TNF inhibitors (TNFi) in patients with/without FM. METHOD FM was defined by a score = > 5/6 of the Fibromyalgia Rapid Screening Tool (FiRST). SpA patients (according to the rheumatologist) and consecutively consulting in the day care hospital but also in the outpatient clinic at the rheumatology department of a tertiary care university hospital were included. Demographics, disease characteristics, activity and severity and TNFi treatment were compared in patients with and without FM; retention rate of the first TNFi and associated factors were explored (Kaplan Meier and Cox regression). RESULTS Of the 196 enrolled SpA patients, 42 (21.4 %) were positively screened for FM. No statistically significant differences in the prevalence of FM were found with regard to the fulfillment of the ASAS criteria for peripheral/axial SpA, nor with regard to the fulfillment of the imaging vs. clinical arm of the ASAS criteria. However, patients with coexisting FM presented significantly with more enthesitis, higher disease activity (BASDAI and VAS) and poorer function scores (BASFI). No differences were found with regard to the initiation of TNFi treatment (79.0 % vs. 70.0 %, respectively), but the retention rate of the first TNFi after 2 years was shorter in the group of patients with FM (28.1 % (95 % CI 12.5-44.0) vs. 41.7 % (95 % CI 32.2-51.3), p = 0.01). CONCLUSION This study confirms that coexistent FM in SpA might impact the patient-reported outcome indices for disease activity and function, and the retention rate of TNFi treatment.
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Affiliation(s)
- Natalia Bello
- Rheumatology Department, Cochin Hospital, AP-HP, París, France.
- Rheumatology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Adrien Etcheto
- Rheumatology Department, Cochin Hospital, AP-HP, París, France.
- INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbornne Paris-Cité, Paris, France.
| | - Caroline Béal
- Rheumatology Department, Cochin Hospital, AP-HP, París, France.
| | - Maxime Dougados
- Rheumatology Department, Cochin Hospital, AP-HP, París, France.
- INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbornne Paris-Cité, Paris, France.
| | - Anna Moltó
- Rheumatology Department, Cochin Hospital, AP-HP, París, France.
- INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbornne Paris-Cité, Paris, France.
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Martínez-Barrio J, Ovalles-Bonilla JG, López-Longo FJ, González CM, Montoro M, Valor L, Martínez LP, Nieto JC, Hinojosa-Dávila MC, Bello N, Monteagudo I, Naredo E, Carreño L. Juvenile, adult and late-onset systemic lupus erythematosus: a long term follow-up study from a geographic and ethnically homogeneous population. Clin Exp Rheumatol 2015; 33:788-794. [PMID: 26575830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 03/23/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES This paper aims to identify clinical and serological differences, damage accrual and mortality, in juvenile, adult and late-onset SLE. METHODS We conducted our study with patients fulfilling SLE classification criteria taken from the Hospital Gregorio Marañon Autoimmune Systemic Rheumatic Diseases' Registry (1986 to 2012). Clinical characteristics, laboratory data and therapies used during the course of the disease were analysed with patients divided into 3 groups: juvenile-onset (≤ 18 years), adult-onset (19-50) and late onset (>50 years). RESULTS Four hundred and forty-five patients were included. Renal disease and cutaneous manifestations were more frequent in the juvenile-onset group at disease onset. During follow-up, juvenile-onset group presented a higher incidence of renal disease, malar rash, Raynaud's phenomenon, cutaneous vasculitis, and neuropsychiatric manifestations than the other two groups. Arthritis and lymphopoenia were more frequent in the adult-onset group. Arterial hypertension and neoplasm were more frequent in the late-onset group. Low serum complement, anti-dsDNA, anti-U1RNP and anti-Sm antibodies were more common in the juvenile-onset group. Patients with late-onset SLE had more damage accrual. Thirty-seven patients (8.3%) died during the study. All-cause mortality was significantly higher in the late-onset group. Age at disease onset >50 years was an independent risk factor for damage accrual (OR, 2.2; 95%CI, 1.1-4.6; p=0.029) and mortality (OR, 2.6; 95%CI, 1.1-6.3; p=0.03). CONCLUSIONS We found significant differences in clinical and serological profiles between juvenile, adult and late-onset SLE. The most significant of which was a higher prevalence of neuropsychiatric and renal complications as well as different autoantibody signatures for the juvenile-onset group.
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Affiliation(s)
- J Martínez-Barrio
- Department of Rheumatology, Gregorio Marañón General Hospital, Madrid, Spain.
| | - J G Ovalles-Bonilla
- Department of Rheumatology, Gregorio Marañón General Hospital, Madrid, Spain
| | - F J López-Longo
- Department of Rheumatology, Gregorio Marañón General Hospital; and Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - C M González
- Department of Rheumatology, Gregorio Marañón General Hospital, Madrid, Spain
| | - M Montoro
- Department of Rheumatology, Gregorio Marañón General Hospital, Madrid, Spain
| | - L Valor
- Department of Rheumatology, Gregorio Marañón General Hospital, Madrid, Spain
| | - L P Martínez
- Department of Rheumatology, Gregorio Marañón General Hospital, Madrid, Spain
| | - J C Nieto
- Department of Rheumatology, Gregorio Marañón General Hospital, Madrid, Spain
| | - M C Hinojosa-Dávila
- Department of Rheumatology, Gregorio Marañón General Hospital, Madrid, Spain
| | - N Bello
- Department of Rheumatology, Gregorio Marañón General Hospital, Madrid, Spain
| | - I Monteagudo
- Unit of Paediatric Rheumatology, Gregorio Marañón General Hospital, Madrid, Spain
| | - E Naredo
- Department of Rheumatology, Gregorio Marañón General Hospital, Madrid, Spain
| | - L Carreño
- Department of Rheumatology, Gregorio Marañón General Hospital; and Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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Ovalles-Bonilla J, Nieto J, Martinez-Barrio J, Lopez-Longo F, Janta I, Naredo E, Gonzalez C, Hinojosa M, Bello N, Serrano B, Mata-Martinez C, Gonzalez R, Saenz C, Monteagudo I, Hernandez D, Valor L, Carreño L. SAT0509 Clinical and Serological Profile of Children with Positive SSA-Ro/SSB-La Antibodies. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4474] [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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26
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Bello N, Ghraizi M, Adetona SO. Standalone General Purpose Data Logger Design and Implementation. Nig J Tech 2015. [DOI: 10.4314/njt.v34i2.18] [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: 11/17/2022] Open
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27
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Naredo E, Valor L, De la Torre I, Montoro M, Bello N, Martínez-Barrio J, Martínez-Estupiñán L, Nieto JC, Ovalles-Bonilla JG, Hernández-Flórez D, González CM, López-Longo FJ, Monteagudo I, Carreño L. Predictive value of Doppler ultrasound-detected synovitis in relation to failed tapering of biologic therapy in patients with rheumatoid arthritis. Rheumatology (Oxford) 2015; 54:1408-14. [DOI: 10.1093/rheumatology/kev006] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Indexed: 12/20/2022] Open
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28
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Janta I, Martínez-Estupiñán L, Valor L, Montoro M, Baniandres Rodriguez O, Hernández Aragüés I, Bello N, Hernández-Flórez D, Hinojosa M, Martínez-Barrio J, Nieto-González JC, Ovalles-Bonilla JG, González CM, López-Longo FJ, Monteagudo I, Naredo E, Carreño L. Comparison between full and tapered dosages of biologic therapies in psoriatic arthritis patients: clinical and ultrasound assessment. Clin Rheumatol 2015; 34:935-42. [DOI: 10.1007/s10067-015-2880-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 01/18/2015] [Accepted: 01/18/2015] [Indexed: 12/28/2022]
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Quigley M, Bello N, Jho D, Fuhrer R, Karlovits S, Buchinsky F. BM-27 * ESTIMATING THE ADDITIONAL BENEFIT OF SURGICAL EXCISION TO STEREOTACTIC RADIOSURGERY IN THE MANAGEMENT OF METASTATIC BRAIN DISEASE. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou240.27] [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: 11/14/2022] Open
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Quigley M, Bello N, Jho D, Fuhrer R, Karlovits S, Buchinsky F. The Utility of Surgical Excision in the Contemporary Treatment of Metastatic Brain Disease. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.663] [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: 10/24/2022]
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31
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Tanshi F, Bello N. A Basic Approach to Designing Embedded Systems Using a Simple Calculator and C Programming Language. Nig J Tech 2014. [DOI: 10.4314/njt.v33i3.14] [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: 11/17/2022] Open
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32
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Nieto-González JC, Monteagudo I, Bello N, Martínez-Estupiñan L, Naredo E, Carreño L. Salivary gland ultrasound in children: a useful tool in the diagnosis of juvenile Sjögren's syndrome. Clin Exp Rheumatol 2014; 32:578-580. [PMID: 24847722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 01/10/2014] [Indexed: 06/03/2023]
Abstract
Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease uncommon in children, clinically characterized by recurrent parotitis at the onset, which is a common disorder in childhood, most of them of infectious origin. Juvenile pSS diagnosis is based on clinical symptoms and presence of autoantibodies, after exclusion of infectious or lymphoproliferative diseases. However, salivary gland ultrasound (SGU) shows typical features of pSS that can add useful information for the diagnosis of this disorder. We describe three patients who presented with recurrent parotitis in which characteristic autoantibodies and typical SGU pattern allow us to make the diagnosis of juvenile pSS. We suggest that in children with recurrent parotitis SGU and autoantibodies should be routinely performed.
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33
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Egwaile JO, Bello N. Design and Implementation of GSM Based Transformer Phase Monitoring System. Nig J Tech 2014. [DOI: 10.4314/njt.v33i3.10] [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: 11/17/2022] Open
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34
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Naredo E, Hinojosa M, Valor L, Hernández-Flórez D, Mata-Martínez C, Serrano-Benavente B, Del Río T, Bello N, Montoro M, Nieto-González JC, González CM, López-Longo FJ, Monteagudo I, Carreño L. Does ultrasound-scored synovitis depend on the pharmacokinetics of subcutaneous anti-TNF agents in patients with rheumatoid arthritis? Rheumatology (Oxford) 2014; 53:2088-94. [PMID: 24939676 DOI: 10.1093/rheumatology/keu248] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the influence of the pharmacokinetics of s.c. anti-TNF agents on the grade of US-detected synovitis in RA patients. METHODS Fifty RA patients were prospectively recruited from the Biologic Therapy Unit of our hospital. Inclusion criteria were being in treatment with s.c. anti-TNF agents and having had neither changes in therapy nor local corticosteroid injections in the previous 3 months. Patients underwent clinical, laboratory [28-joint DAS (DAS28) and Simplified Disease Activity Index (SDAI)] and US assessment at two time points, i.e. at peak plasma drug concentration and at trough plasma drug concentration. US assessments were performed blindly to the anti-TNF agent, the administration time and the clinical and laboratory data. Twenty-eight joints were investigated for the presence and grade (0-3) of B-mode synovitis and synovial power Doppler signal. Global indices for B-mode synovitis (BSI) and Doppler synovitis (DSI) were calculated for 12 joints and for wrist-hand-ankle-foot joints. B-mode US remission was defined as a BSI <1 and Doppler US remission as a DSI <1. RESULTS There were no significant differences between the clinical, laboratory and B-mode and Doppler US parameters at peak time and trough time (P = 0.132-0.986). There were no significant differences between the proportion of patients with active disease and those in remission according to DAS28, SDAI, B-mode US and Doppler US at peak time and trough time assessments (P = 0.070-1). CONCLUSION Our results suggested that s.c. anti-TNF pharmacokinetics do not significantly influence US-scored synovitis in RA patients.
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Affiliation(s)
- Esperanza Naredo
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain.
| | - Michelle Hinojosa
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Lara Valor
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Diana Hernández-Flórez
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Carmen Mata-Martínez
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Belén Serrano-Benavente
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Tamara Del Río
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Natalia Bello
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain
| | - María Montoro
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Juan Carlos Nieto-González
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Carlos M González
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Francisco Javier López-Longo
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Indalecio Monteagudo
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Luis Carreño
- Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Faculty of Medicine, Complutense University, Madrid, Spain
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Naredo E, Valor L, De la Torre I, Montoro M, Bello N, Martínez-Barrio J, Martínez-Estupiñán L, Nieto J, Ovalles-Bonilla J, Hernández D, González C, Lόpez-Longo J, Monteagudo I, Carreño L. THU0250 Predictive Value of Doppler Ultrasound-Detected Synovitis in Relation to Successful Tapering of Biology Therapy in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3013] [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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Montoro M, Janta I, Irace R, Medina M, Serrano B, Mata C, Martinez L, Martinez J, Hinojosa M, Bello N, Ovalles J, Nieto J, Valor L, Lopez F, Monteagudo I, Gonzalez C, Naredo E, Carreño L. AB0983 Contribution of Knee Involvement Evaluated by Doppler Ultrasound and Synovial Fluid Analysis in Rheumatoid Arthritis Disease Activity Assessment: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3895] [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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Hinojosa-Dávila M, Naredo E, Valor L, Hernández D, Mata-Martínez C, Serrano-Benavente B, Bello N, Ovalles-Bonilla J, Martínez-B. J, Martínez-E. L, Nieto J, Del Río T, González C, Lόpez-Longo J, Montoro M, Monteagudo I, Carreño L. THU0187 Does Ultrasound-Scored Synovitis Depend on the Pharmacokinetics of Subcutaneous Anti-TNF Agents in Patients with Rheumatoid Arthritis?: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2966] [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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Martinez Estupiñan L, Naredo E, Valor L, Janta I, Montoro M, Del Rio T, Nieto-González J, Hinojosa M, Bello N, Martínez J, González-Fernández C, Lόpez-Longo J, Monteagudo I, Carreño-Pérez L. AB0434 Relation of Subclinical Ultrasound Detected Synovitis and Peripheral B-Cell Counts in Rheumatoid Arthritis Patients Treated with Rituximab. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4136] [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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Martínez-Barrio J, Hinojosa M, Lopez-Longo J, Ovalles-Bonilla J, Bello N, Mata Martínez C, Serrano B, Nieto Gonzalez J, Martínez Estupiñan L, Gonzalez C, Montoro M, Valor L, Monteagudo I, Naredo E, Carreño L. SAT0318 Antisynthetase Syndrome: Clinical and Serological Characteristics at Disease Onset: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3113] [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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Montoro Alvarez M, Yew Chong O, Janta I, Serrano B, Mata C, Martinez L, Martinez-Barrio J, Hinojosa M, Bello N, Ovalles J, Nieto J, Valor L, Lopez-Longo F, Monteagudo I, Gonzalez C, Garrido J, Rosman A, Ing Soo L, Naredo E, Carreño L. SAT0198 Relation of Doppler Ultrasound Synovitis versus Clinical Synovitis with Changes in Native Complement Component Levels in Rheumatoid Arthritis Patients Treated with Biologic Disease-Modifying Antirheumatic Drugs:. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4379] [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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Janta I, Naredo E, Martinez-Estupinan L, Nieto JC, De la Torre I, Valor L, Estopinan L, Bello N, Hinojosa M, Gonzalez CM, Lopez-Longo J, Monteagudo I, Montoro M, Carreno L. Patient self-assessment and physician's assessment of rheumatoid arthritis activity: which is more realistic in remission status? A comparison with ultrasonography. Rheumatology (Oxford) 2013; 52:2243-50. [DOI: 10.1093/rheumatology/ket297] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Desai AS, Claggett B, Pfeffer MA, Bello N, Finn PV, Granger C, Mcmurray JJV, Swedberg K, Yusuf S, Solomon SD. Influence of hospitalization for cardiovascular versus noncardiovascular reasons on subsequent mortality in patients with chronic heart failure across the spectrum of ejection fraction. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1480] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ovalles-Bonilla J, Martínez-Barrio J, Lόpez-Longo F, de la Torre I, González C, Valor L, Montoro-Άlvarez M, Aramburu F, Marín C, Martínez-Estupiñán L, Nieto J, Hinojosa M, Bello N, Monteagudo I, Carreño L. AB0678 Artrhitic patterns in systemic lupus erythematosus. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.678] [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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Ovalles-Bonilla JG, López-Longo FJ, Monteagudo I, Naredo E, Gonzalez CM, de la Torre I, Montoro M, Martínez-Estupiñán LP, Nieto JC, Martínez-Barrio J, Hinojosa M, Bello N, Serrano B, Mata C, Carreño L. SAT0441 Juvenile Onset Systemic Sclerosis: Clinical and Serological Features, and Mortality in Comparison with Adult Onset Disease. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2165] [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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Nieto González J, Martínez-Estupiñan L, Hernández D, Bello N, Hinojosa M, Valor L, Montoro M, García-Monforte A, Lόpez-Longo J, González C, Monteagudo I, Carreno L, de la Torre I. SAT0135 Modified antitnf dose patterns in clinical practice: Achieving clinical control with minimum effective dosages:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3082] [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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Ovalles-Bonilla J, Martínez-Barrio J, Lόpez-Longo F, de la Torre I, González C, Valor L, Montoro-Άlvarez M, Aramburu F, Marín C, Martínez-Estupiñán L, Nieto J, Hinojosa M, Bello N, Monteagudo I, Carreño L. AB0677 Late onset systemic lupus erythematosus: Is it actually a milder variant? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.677] [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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Ovalles-Bonilla J, Martínez-Barrio J, Lόpez-Longo F, de la Torre I, González C, Valor L, Montoro-Άlvarez M, Aramburu F, Marín C, Martínez-Estupiñán L, Nieto J, Hinojosa M, Bello N, Monteagudo I, Carreño L. FRI0260 Survival, causes of death and mortality risk factors in systemic sclerosis:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2717] [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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Perazzi B, Bello N, Mollerach M, Vay C, Lasala MB, Famiglietti A. Endocarditis caused by methicillin-susceptible Staphylococcus aureus with reduced susceptibility to vancomycin: a case report. J Med Case Rep 2011; 5:555. [PMID: 22114809 PMCID: PMC3236076 DOI: 10.1186/1752-1947-5-555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 11/25/2011] [Indexed: 11/10/2022] Open
Affiliation(s)
- Beatriz Perazzi
- Clinical Bacteriology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Faculty of Pharmacy & Biochemistry, University of Buenos Aires, Córdoba 2351, Capital Federal, City of Buenos Aires, Argentina.
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Perazzi B, Bello N, Mollerach M, Vay C, Lasala MB, Famiglietti A. Endocarditis caused by methicillin-susceptible Staphylococcus aureus with reduced susceptibility to vancomycin: a case report. J Med Case Rep 2011; 5:292. [PMID: 21733193 PMCID: PMC3152525 DOI: 10.1186/1752-1947-5-292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/29/2010] [Accepted: 07/07/2011] [Indexed: 11/23/2022] Open
Abstract
Introduction Staphylococcus aureus is the most common cause of acute infective endocarditis. Recent reports have described heteroresistance to vancomycin associated with methicillin-resistant Staphylococcus aureus. We present the first case report in Argentina of the failure of treatment with vancomycin in endocarditis caused by methicillin-susceptible Staphylococcus aureus containing subpopulations with reduced susceptibility to vancomycin. Case presentation We report the case of a 66-year-old Hispanic man with infective endocarditis complicated by septic emboli in the lumbosacral spine and the left iliopsoas muscle. This disease was caused by methicillin-susceptible Staphylococcus aureus containing subpopulations with reduced susceptibility to vancomycin. He was initially treated with cephalothin and gentamicin but developed a rash caused by beta-lactams and interstitial nephritis. For that reason, the treatment was subsequently switched to vancomycin but he failed to respond. The infection resolved after administration of vancomycin in combination with gentamicin and rifampin. Conclusion Our case report provides important evidence for the existence of subpopulations of methicillin-susceptible Staphylococcus aureus that have reduced susceptibility to vancomycin which would account for treatment failure. Our case raises an alert about the existence of these strains and highlights the need to determine the vancomycin minimum inhibitory concentration of Staphylococcus aureus to screen for the presence of strains that have reduced vancomycin susceptibility at different infection sites.
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Affiliation(s)
- Beatriz Perazzi
- Clinical Bacteriology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Faculty of Pharmacy & Biochemistry, University of Buenos Aires, Córdoba 2351, Capital Federal, City of Buenos Aires, Argentina.
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Heleski CR, McGreevy PD, Kaiser LJ, Lavagnino M, Tans E, Bello N, Clayton HM. Effects on behaviour and rein tension on horses ridden with or without martingales and rein inserts. Vet J 2009; 181:56-62. [PMID: 19375959 DOI: 10.1016/j.tvjl.2009.03.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Unsteady hand position can cause discomfort to the horse, potentially leading to conflict behaviours (CB) such as head tossing or tail lashing. Some instructors feel that martingales or elastic rein inserts can reduce discomfort caused by inexperienced and unsteady hands. Others consider these devices to be inappropriate 'crutches'. Four horses and nine riders were tested under three conditions in random order: plain reins, adjustable training martingales (TM), and elasticised rein inserts (RI). Rein-tension data (7s) and behavioural data (30s) were collected in each direction. Rein-tension data were collected via strain-gauge transducers. Behavioural data were assessed using an ethogram of defined behaviours. No differences in the number of CB were observed. Mean rein tension for TM was higher than that of RI or controls. Relative to the withers, the head was lower for horses ridden with martingales. Carefully fitted martingales may have a place in riding schools that teach novices.
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Affiliation(s)
- C R Heleski
- Department of Animal Science, Michigan State University, East Lansing, MI 48824, USA.
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