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Ersözlü ED, Ekici M, Coşkun BN, Badak SÖ, Bilgin E, Kalyoncu U, Yağız B, Pehlivan Y, Küçükşahin O, Erden A, Solmaz D, Atagündüz P, Kimyon G, Beş C, Çolak S, Mercan R, Kaşifoğlu T, Emmungil H, Alpay Kanıtez N, Ateş A, Koca SS, Kiraz S, Ertenli İ. Epidemiological characteristics of hepatitis B and C in patients with inflammatory arthritis: Implications from treasure database. Arch Rheumatol 2023; 38:347-357. [PMID: 38046251 PMCID: PMC10689007 DOI: 10.46497/archrheumatol.2023.9504] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 08/19/2022] [Indexed: 12/05/2023] Open
Abstract
Objectives This study aimed to evaluate the hepatitis B (HBV) and C (HCV) frequency and clinical characteristics among patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) who receive biological treatments. Patients and methods The observational study was conducted with patients from the TReasure database, a web-based prospective observational registry collecting data from 17 centers across Türkiye, between December 2017 and June 2021. From this database, 3,147 RA patients (2,502 males, 645 females; median age 56 years; range, 44 to 64 years) and 6,071 SpA patients (2,709 males, 3,362 females; median age 43 years; range, 36 to 52 years) were analyzed in terms of viral hepatitis, patient characteristics, and treatments used. Results The screening rate for HBV was 97% in RA and 94.2% in SpA patients. Hepatitis B surface antigen (HBsAg) positivity rates were 2.6% and 2%, hepatitis B surface antibody positivity rates were 32.3% and 34%, hepatitis B core antibody positivity rates were 20.3% and 12.5%, HBV DNA (deoxyribonucleic acid) positivity rates were 3.5% and 12.5%, and antibody against HCV positivity rates were 0.8% and 0.3% in RA and SpA patients, respectively. The HBsAg-positive patients were older and had more comorbidities, including hypertension, diabetes, and coronary artery disease. In addition, rheumatoid factor (RF) positivity was more common in HBsAg-positive cases. The most frequently prescribed biologic disease-modifying antirheumatic drugs were adalimumab (28.5%), etanercept (27%), tofacitinib (23.4%), and tocilizumab (21.5%) in the RA group and adalimumab (48.1%), etanercept (31.4%), infliximab (22.6%), and certolizumab (21.1%) in the SpA group. Hepatitis B reactivation was observed in one RA patient during treatment, who received rituximab and prophylaxis with tenofovir. Conclusion The epidemiological characteristics of patients with rheumatic diseases and viral hepatitis are essential for effective patient management. This study provided the most recent epidemiological characteristics from the prospective TReasure database, one of the comprehensive registries in rheumatology practice.
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Affiliation(s)
- Emine Duygu Ersözlü
- Department of Internal Medicine, Division of Rheumatology, Adana City Training and Research Hospital, Adana, Türkiye
| | - Mustafa Ekici
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Türkiy
| | - Belkis Nihan Coşkun
- Department of Internal Medicine, Division of Rheumatology, Uludağ University, Bursa, Türkiye
| | - Suade Özlem Badak
- Department of Internal Medicine, Division of Rheumatology, Adana City Training and Research Hospital, Adana, Türkiye
| | - Emre Bilgin
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Türkiy
| | - Umut Kalyoncu
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Türkiy
| | - Burcu Yağız
- Department of Internal Medicine, Division of Rheumatology, Afyonkarahisar Hospital, Afyonkarahisar, Türkiye
| | - Yavuz Pehlivan
- Department of Internal Medicine, Division of Rheumatology, Uludağ University, Bursa, Türkiye
| | - Orhan Küçükşahin
- Department of Internal Medicine, Division of Rheumatology, Ankara Yıldırım Beyazıt Üniversitesi, Ankara, Türkiye
| | - Abdulsamet Erden
- Department of Internal Medicine, Division of Rheumatology, Ankara City Hospital, Ankara, Türkiye
| | - Dilek Solmaz
- Department of Internal Medicine, Division of Rheumatology, Katip Çelebi University, Atatürk Eğitim ve Araştırma Hospital, Izmir, Türkiye
| | - Pamir Atagündüz
- Department of Internal Medicine, Division of Rheumatology, Marmara University, Istanbul, Türkiye
| | - Gezmiş Kimyon
- Department of Internal Medicine, Division of Rheumatology, Mustafa Kemal University, Hatay, Türkiye
| | - Cemal Beş
- Department of Internal Medicine, Division of Rheumatology, University of Health Sciences, Istanbul Başakşehir Cam and Sakura City Hospital, Istanbul, Türkiye
| | - Seda Çolak
- Department of Internal Medicine, Division of Rheumatology, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
| | - Rıdvan Mercan
- Department of Internal Medicine, Division of Rheumatology, Namık Kemal University, Tekirdağ, Türkiye
| | - Timuçin Kaşifoğlu
- Department of Internal Medicine, Division of Rheumatology, Osmangazi University, Eskişehir, Türkiye
| | - Hakan Emmungil
- Department of Internal Medicine, Division of Rheumatology, Trakya University, Edirne, Türkiye
| | - Nilüfer Alpay Kanıtez
- Department of Internal Medicine, Division of Rheumatology, Koç University, Istanbul, Türkiye
| | - Aşkın Ateş
- Department of Internal Medicine, Division of Rheumatology, Ankara University, Ankara, Türkiye
| | - Süleyman Serdar Koca
- Department of Internal Medicine, Division of Rheumatology, Fırat University, Elazığ, Türkiye
| | - Sedat Kiraz
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Türkiy
| | - İhsan Ertenli
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Türkiy
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Yagiz B, Coskun BN, Pehlivan Y, Dalkilic E, Kiraz S, Yazisiz V, Kucuksahin O, Erden A, Kanitez NA, Kimyon G, Emmungil H, Bilge SY, Kasifoglu T, Bes C, Bolek EC, Bilgin E, Karatas A, Kelesoglu B, Ersozlu D, Gonullu EO, Mercan R, Yilmaz S, Karadag O, Akar S, Ertenli I, Kalyoncu U. In the era of disease-modifying antirheumatic drugs, how close are we to treating rheumatoid arthritis without the use of glucocorticoids? Rheumatol Int 2021. [PMID: 34226947 DOI: 10.1007/s00296-021-04939-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
We wanted to see how close we could get to our goal of treating rheumatoid arthritis (RA) without the use of glucocorticoids (GCs) in the disease-modifying antirheumatic drugs (DMARDs) era using real-life data. Established in 2017, the TReasure database is a web-based, prospective, observational cohort for Turkey. As of May 2019, there were 2,690 RA patients recorded as receiving biologic and targeted synthetic DMARDs (bDMARDs and tsDMARDs) therapy. At the start of the bDMARDs or tsDMARDs, patients with follow-up visits of at least 3 months were registered. At the time of registration and the last visit, doses of GCs were recorded and it was determined if the target dose of ≤ 7.5 mg was achieved. During registration and follow-up, 23.4% of the patients did not receive GCs and 76.5% of the patients received GCs at any time. GCs could be stopped after 59 (25-116) months in 28.4% of these patients, but 71.6% of patients were still using GC. The target GC dose could not be achieved in 18.2% of these patients (n = 352). The rate of continuing to use GC was significantly higher in women, in the elderly, those with rheumatoid factor (RF) positive, with higher Visual Analog Scale (VAS) pain and Disease Activity Score (DAS)-28. The initial GC dose of ≥ 7.5 mg/day was found to be crucial in not reaching the GC target dose (p < 0.001, OR 39.0 (24.1-63.2)). The initial GC dose of ≥ 7.5 mg/day, female gender, age, RF positivity, high DAS28, and VAS pain level were all highly related for GC continuation. Despite the use of DMARDs, our data revealed that we are still far from achieving our goal of treating RA without using steroids.
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Kalyoncu U, Taşcılar EK, Ertenli Aİ, Dalkılıç HE, Bes C, Küçükşahin O, Kaşifoğlu T, Alpay Kanıtez N, Emmungil H, Kimyon G, Yaşar Bilge NŞ, Akar S, Atagündüz MP, Koca SS, Ateş A, Yazısız V, Terzioğlu E, Ersözlü ED, Tufan MA, Çınar M, Mercan R, Şahin A, Erten Ş, Pehlivan Y, Yılmaz S, Keleşoğlu Dinçer AB, Gerçik Ö, Coşkun BN, Yağız B, Kaymaz Tahra S, Aksoy A, Karadağ Ö, Kılıç L, Kiraz S. Methodology of a new inflammatory arthritis registry: TReasure. Turk J Med Sci 2018; 48:856-861. [PMID: 30119164 DOI: 10.3906/sag-1807-200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim The TReasure registry, created in 2017, is an observational multicenter cohort that includes inflammatory arthritis
patients. This article reviews the methodology and objectives of the TReasure registry established to collect data from rheumatoid
arthritis (RA) and spondyloarthritis (SpA) patients. Methodology Fifteen rheumatology centers in Turkey will contribute data to the TReasure database. The actual proprietor of the
database is the Hacettepe Rheumatology Association (HRD) and Hacettepe Financial Enterprises. Pharmaceutical companies that
operate in Turkey (in alphabetical or er), Abbvie, Amgen, BMS, Celltrion Healthcare, Novartis, Pfizer, Roche, and UCB, support the
TReasure registry. TReasure is a web-based database to which users connect through a URL (https://www.trials-network.org/treasure)
with their unique identifier and passwords provided for data entry and access. TReasure records demographic and clinical features,
comorbidities, radiology and laboratory results, measures of disease activity, and treatment data. Discussion TReasure will provide us with various types of data, such as a cross-sectional view of the current nationwide status of the
patients currently receiving these treatments, and retrospective data as much as allowed by the participating centers’ records. Finally, a
high-quality prospective dataset will be built over the ensuing years from patients with a new diagnosis of RA or SpA.
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