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Gisondi P, Geat D, Idolazzi L, Girolomoni G. Relapse of psoriatic arthritis in patients with active psoriasis switched from tumour necrosis factor‐α to interleukin‐17A inhibitor. Br J Dermatol 2019; 181:624-626. [DOI: 10.1111/bjd.17837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- P. Gisondi
- Department of Medicine Section of Dermatology and Venereology University of Verona Verona Italy
| | - D. Geat
- Department of Medicine Section of Dermatology and Venereology University of Verona Verona Italy
| | - L. Idolazzi
- Section of Rheumatology University of Verona Verona Italy
| | - G. Girolomoni
- Department of Medicine Section of Dermatology and Venereology University of Verona Verona Italy
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Fassio A, Adami G, Benini C, Vantaggiato E, Saag KG, Giollo A, Lippolis I, Viapiana O, Idolazzi L, Orsolini G, Rossini M, Gatti D. Changes in Dkk-1, sclerostin, and RANKL serum levels following discontinuation of long-term denosumab treatment in postmenopausal women. Bone 2019; 123:191-195. [PMID: 30910600 DOI: 10.1016/j.bone.2019.03.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/12/2019] [Accepted: 03/16/2019] [Indexed: 02/01/2023]
Abstract
PURPOSE The positive effects of denosumab (DMAb) on bone mineral density (BMD) are quickly reversible after its discontinuation. We investigated whether this rebound was associated with dysregulation of the Wnt canonical pathway and/or by the increase in the receptor-activator of nuclear factor-kappa B ligand (RANKL) serum levels. METHODS The study included patients (n = 15) with postmenopausal osteoporosis to whom DMAb was administered for 78 months and then discontinued. We collected BMD data at baseline/month 0 (M0), M60, M84 (6 months after last DMAb administration, coinciding when the next DMAb dose would typically be due), and after 3 and 12 months of follow-up (FU-M3 and FU-M12, respectively). Serum C-terminal telopeptide of type 1 collagen (CTX-I), Dickkopf-1 (Dkk-1), and sclerostin were measured at M0, M60, M84, FU-M3, and FU-M12. Serum N-terminal propeptide of type 1 procollagen (PINP) and RANKL were dosed at M60, M84, FU-M3, and FU-12. RESULTS We found a significant decrease in the T-score at all sites at FU-M12, when compared to M84 (-0.51 ± 0.91 at the lumbar spine; -0.72 ± 0.33 at the total hip; and -0.42 ± 0.27 at the femoral neck, p < 0.05). After DMAb discontinuation (M84 vs FU M12) CTX-I, PINP increased already at FU-M3 (+0.921 ± 0.482 ng/mL, +126.60 ± 30.36 ng/mL, respectively, p < 0.01), RANKL increased at FU-M12 (+0.041 ± 0.062 ng/mL, p < 0.05), while Dkk-1 and sclerostin decreased at FU-M12 (-10.90 ± 11.80 and - 13.00 ± 10.52 pmol/L, respectively, p < 0.01). No changes in BMD or any of the markers were found between M60 and M84. CONCLUSIONS RANKL serum levels progressively increased after discontinuation of long-term DMAb while Dkk-1 and sclerostin serum levels decreased. The increase in RANKL serum levels supports the hypothesis of a sudden loss of inhibition of the resting osteoclast line after DMAb clearance, with a hyperactivation of these cells. Our results suggest that the changes in serum Wnt inhibitors after DMAb suspension might represent a mere feedback response to the increased bone turnover.
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Affiliation(s)
- A Fassio
- Rheumatology Unit, University of Verona, Piazzale A. Scuro, 10, 37134 Verona, Italy.
| | - G Adami
- Rheumatology Unit, University of Verona, Piazzale A. Scuro, 10, 37134 Verona, Italy; Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, 510 20th Street South, Faculty Office Tower 820D, Birmingham, AL 35294, USA
| | - C Benini
- Rheumatology Unit, University of Verona, Piazzale A. Scuro, 10, 37134 Verona, Italy
| | - E Vantaggiato
- Rheumatology Unit, University of Verona, Piazzale A. Scuro, 10, 37134 Verona, Italy
| | - K G Saag
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, 510 20th Street South, Faculty Office Tower 820D, Birmingham, AL 35294, USA
| | - A Giollo
- Rheumatology Unit, University of Verona, Piazzale A. Scuro, 10, 37134 Verona, Italy
| | - I Lippolis
- Rheumatology Unit, University of Verona, Piazzale A. Scuro, 10, 37134 Verona, Italy
| | - O Viapiana
- Rheumatology Unit, University of Verona, Piazzale A. Scuro, 10, 37134 Verona, Italy
| | - L Idolazzi
- Rheumatology Unit, University of Verona, Piazzale A. Scuro, 10, 37134 Verona, Italy
| | - G Orsolini
- Rheumatology Unit, University of Verona, Piazzale A. Scuro, 10, 37134 Verona, Italy
| | - M Rossini
- Rheumatology Unit, University of Verona, Piazzale A. Scuro, 10, 37134 Verona, Italy
| | - D Gatti
- Rheumatology Unit, University of Verona, Piazzale A. Scuro, 10, 37134 Verona, Italy
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Giollo A, Rossini M, Gatti D, Adami G, Orsolini G, Fassio A, Caimmi C, Idolazzi L, Viapiana O. Amino-Bisphosphonates and Cardiovascular Risk: A New Hypothesis Involving the Effects on Gamma-Delta T Cells. J Bone Miner Res 2019; 34:570-571. [PMID: 30715760 DOI: 10.1002/jbmr.3660] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 12/04/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Alessandro Giollo
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Maurizio Rossini
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Davide Gatti
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Giovanni Adami
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Giovanni Orsolini
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Angelo Fassio
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Cristian Caimmi
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Luca Idolazzi
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Ombretta Viapiana
- Rheumatology Section, Department of Medicine, University of Verona, Verona, Italy
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Ariani A, Silva M, Bravi E, Parisi S, Saracco M, De Gennaro F, Caimmi C, Girelli F, De Santis M, Volpe A, Lumetti F, Hax V, Bredemeier M, Alfieri V, Santilli D, Bodini FC, Lucchini G, Mozzani F, Seletti V, Bacchini E, Arrigoni E, Giuggioli D, Chakr R, Idolazzi L, Bertorelli G, Imberti D, Michieletti E, Paolazzi G, Fusaro E, Chetta AA, Scirè CA, Sverzellati N. Overall mortality in combined pulmonary fibrosis and emphysema related to systemic sclerosis. RMD Open 2019; 5:e000820. [PMID: 30886735 PMCID: PMC6397433 DOI: 10.1136/rmdopen-2018-000820] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 09/09/2018] [Revised: 11/13/2018] [Accepted: 12/17/2018] [Indexed: 12/02/2022] Open
Abstract
Objectives This multicentre study aimed to investigate the overall mortality of combined pulmonary fibrosis and emphysema (CPFE) in systemic sclerosis (SSc) and to compare CPFE-SSc characteristics with those of other SSc subtypes (with interstitial lung disease—ILD, emphysema or neither). Methods Chest CTs, anamnestic data, immunological profile and pulmonary function tests of patients with SSc were retrospectively collected. Each chest CT underwent a semiquantitative assessment blindly performed by three radiologists. Patients were clustered in four groups: SSc-CPFE, SSc-ILD, SSc-emphysema and other-SSc (without ILD nor emphysema). The overall mortality of these groups was calculated by Kaplan-Meier method and compared with the stratified log-rank test; Kruskal-Wallis test, t-Student test and χ² test assessed the differences between groups. P<0.05 was considered statistically significant. Results We enrolled 470 patients (1959 patient-year); 15.5 % (73/470) died during the follow-up. Compared with the SSc-ILD and other-SSc, in SSc-CPFE there was a higher prevalence of males, lower anticentromere antibodies prevalence and a more reduced pulmonary function (p<0.05). The Kaplan-Meier survival analysis demonstrates a significantly worse survival in patients with SSc-CPFE (HR vs SSc-ILD, vs SSc-emphysema and vs other-SSc, respectively 1.6 (CI 0.5 to 5.2), 1.6 (CI 0.7 to 3.8) and 2.8 (CI 1.2 to 6.6). Conclusions CPFE increases the mortality risk in SSc along with a highly impaired lung function. These findings strengthen the importance to take into account emphysema in patients with SSc with ILD.
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Affiliation(s)
- Alarico Ariani
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Mario Silva
- Department of Medicine and Surgery (DiMeC), Unit of Surgical Sciences, Section of Radiology, University of Parma, Parma, Italy
| | - Elena Bravi
- Department of Medicine, Internal Medicine and Rheumatology Unit, Ospedale G. Da Saliceto, Piacenza, Italy
| | - Simone Parisi
- Rheumatology Department, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Marta Saracco
- Rheumatology Unit, Ospedale Mauriziano - Umberto I di Torino, Torino, Italy
| | - Fabio De Gennaro
- Rheumatology Unit, Azienda Ospedaliera "Istituti Ospitalieri" di Cremona, Cremona, Italy
| | - Cristian Caimmi
- Department of Medicine, Rheumatology Unit, University of Verona, Azienda Ospedaliera di Verona, Verona, Italy
| | - Francesco Girelli
- Department of Medicine, Rheumatology Unit, Ospedale GB Morgagni - L Pierantoni, Forlì, Italy
| | - Maria De Santis
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center, Rozzano, Italy
| | | | - Federica Lumetti
- Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy
| | - Vanessa Hax
- Division of Rheumatology, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Markus Bredemeier
- Rheumatology Service, Hospital Nossa Senhora da Conceição - Grupo Hospitalar Conceição, Porto Alegre, Brazil
| | - Veronica Alfieri
- Department of Medicine and Surgery (DiMeC), Respiratory Disease Unit, University of Parma, Parma, Italy
| | - Daniele Santilli
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | | | - Gianluca Lucchini
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Flavio Mozzani
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Valeria Seletti
- Department of Medicine and Surgery (DiMeC), Unit of Surgical Sciences, Section of Radiology, University of Parma, Parma, Italy
| | - Emanuele Bacchini
- Department of Medicine and Surgery (DiMeC), Unit of Surgical Sciences, Section of Radiology, University of Parma, Parma, Italy
| | - Eugenio Arrigoni
- Department of Medicine, Internal Medicine and Rheumatology Unit, Ospedale G. Da Saliceto, Piacenza, Italy
| | - Dilia Giuggioli
- Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy
| | - Rafael Chakr
- Rheumatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Luca Idolazzi
- Department of Medicine, Rheumatology Unit, University of Verona, Azienda Ospedaliera di Verona, Verona, Italy
| | - Giuseppina Bertorelli
- Department of Medicine and Surgery (DiMeC), Respiratory Disease Unit, University of Parma, Parma, Italy
| | - Davide Imberti
- Department of Medicine, Internal Medicine and Rheumatology Unit, Ospedale G. Da Saliceto, Piacenza, Italy
| | | | | | - Enrico Fusaro
- Rheumatology Department, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Alfredo Antonio Chetta
- Department of Medicine and Surgery (DiMeC), Respiratory Disease Unit, University of Parma, Parma, Italy
| | - Carlo Alberto Scirè
- Epidemiology Unit, Italian Society for Rheumatology (SIR), Milano, Italy.,Department of Medical Sciences, Section of Rheumatology, AOU Sant'Anna, University of Ferrara, Ferrara, Italy
| | - Nicola Sverzellati
- Department of Medicine and Surgery (DiMeC), Unit of Surgical Sciences, Section of Radiology, University of Parma, Parma, Italy
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Fassio A, Gatti D, Rossini M, Idolazzi L, Giollo A, Adami G, Gisondi P, Girolomoni G, Viapiana O. Secukinumab produces a quick increase in WNT signalling antagonists in patients with psoriatic arthritis. Clin Exp Rheumatol 2019; 37:133-136. [PMID: 30418122] [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: 04/03/2018] [Accepted: 07/02/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Interleukin-17 (IL-17) is an important cytokine involved in the pathogenesis of bone lesions of psoriatic arthritis (PsA). The aim of our study was to explore the short-term effects (≤6 months) of secukinumab (an anti-IL-17 antibody) on the serum levels of bone turnover markers (BTMs) and on the inhibitors of the WNT signalling pathway. METHODS The study sample consisted of patients with PsA starting treatment with secukinumab 150 mg every month, and healthy controls (HCs). For the PsA group, the DAS28 score was recorded, and serum samples were collected at baseline, and then at Month 1, 3 and 6 of therapy. As for the HCs, a single observation was performed, with the relevant serum collection. Intact N-terminal propeptide of type I collagen (PINP), C-terminal telopeptide of type I collagen (CTX-I-I), Dickkopf-related protein-1 (Dkk-1) and sclerostin were administered. RESULTS 28 patients with PsA and 43 HCs were enrolled. Neither PINP nor CTX-I serum levels showed any significant variation during the observation period. Baseline mean Dkk-1 serum levels for the PsA arm were significantly lower than in the HC (p<0.05). Dkk-1 and sclerostin serum levels increased at Month 6 during the treatment with secukinumab (p<0.05 vs. baseline). When the PsA arm was compared to the HC, the difference between the serum levels of Dkk-1 lost significance at Month 6. CONCLUSIONS Treatment with secukinumab does not have any significant short-term effect on BTMs, but may influence some fine regulators of the bone cell activity, such as the WNT inhibitors.
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Fassio A, Adami G, Gatti D, Orsolini G, Giollo A, Idolazzi L, Benini C, Vantaggiato E, Rossini M, Viapiana O. Inhibition of tumor necrosis factor-alpha (TNF-alpha) in patients with early rheumatoid arthritis results in acute changes of bone modulators. Int Immunopharmacol 2018; 67:487-489. [PMID: 30599401 DOI: 10.1016/j.intimp.2018.12.050] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/17/2018] [Accepted: 12/22/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Dicckopf-1 (Dkk-1) is a potent inhibitor of the Wnt canonical pathway. In rheumatoid arthritis (RA), Dkk-1 is upregulated by tumor necrosis factor-α (TNF). Certolizumab pegol (CMZ) is a biologic TNF-inhibitor (TNFi) effective in RA and slows radiographic progression. Data on the immediate effects (≤1-8 weeks) of TNFi on Wnt modulators are lacking. This study investigated the acute influence of TNFi treatment on Wnt modulators (Dkk-1 and sclerostin) and bone turnover markers (BTM), including intact N-terminal propeptide of collagen type I (PINP) and C-terminal telopeptide of type I collagen (CTX-I). METHODS This longitudinal, uncontrolled study involved female RA patients with inadequate response to conventional methotrexate who underwent treatment with CMZ. ESR, Dkk-1, sclerostin, BTM, parathyroid hormone (PTH), and 25OH-vitamin D levels were evaluated at baseline, week 1, week 4, and week 8. Radiographs of the hands and feet were obtained at baseline and the total and erosion scores were assessed using the Simple Erosion Narrowing Score method (SENS). RESULTS Seventeen patients were enrolled. Dkk-1 and CTX-I significantly decreased after one week of treatment with CMZ (-49.1 ± 17.1% and -25.0 ± 20.6%, respectively, p < 0.01), whereas PINP increased (+43.2 ± 31.5%, p < 0.01). These changes persisted at week 4 and 8. CONCLUSIONS Our study showed that TNF-alpha inhibition with CMZ promptly results in a rapid decline of serum Dkk-1 levels, alongside decreased bone resorption and increased bone formation.
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Affiliation(s)
- A Fassio
- Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134 Verona, Italy.
| | - G Adami
- Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134 Verona, Italy
| | - D Gatti
- Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134 Verona, Italy
| | - G Orsolini
- Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134 Verona, Italy
| | - A Giollo
- Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134 Verona, Italy
| | - L Idolazzi
- Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134 Verona, Italy
| | - C Benini
- Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134 Verona, Italy
| | - E Vantaggiato
- Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134 Verona, Italy
| | - M Rossini
- Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134 Verona, Italy
| | - O Viapiana
- Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134 Verona, Italy
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Caimmi C, Bertoldo E, Venturini A, Caramaschi P, Frulloni L, Ciccocioppo R, Brunelli S, Idolazzi L, Gatti D, Rossini M, Viapiana O. Relationship Between Increased Fecal Calprotectin Levels and Interstitial Lung Disease in Systemic Sclerosis. J Rheumatol 2018; 46:274-278. [PMID: 30442820 DOI: 10.3899/jrheum.171445] [Citation(s) in RCA: 6] [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] [Accepted: 08/15/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To evaluate the relationship between fecal calprotectin (FC) and interstitial lung disease (ILD) in systemic sclerosis (SSc). METHODS The study enrolled 129 outpatients with SSc. Data about disease characteristics, in particular lung involvement, were collected and FC was measured. RESULTS Patients with ILD (35, 27.1%) had higher values of FC (p < 0.001). In multivariate analysis, these variables were associated with increased risk of ILD: diffuse disease subset, higher modified Rodnan skin score, longer disease duration, higher severity scores, steroid treatment, and higher FC levels, while diverticulosis was protective. CONCLUSION ILD is independently associated with increased FC levels in SSc.
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Affiliation(s)
- Cristian Caimmi
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy. .,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi.
| | - Eugenia Bertoldo
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Anna Venturini
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Paola Caramaschi
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Luca Frulloni
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Rachele Ciccocioppo
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Sabrina Brunelli
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Luca Idolazzi
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Davide Gatti
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Maurizio Rossini
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Ombretta Viapiana
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
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Giollo A, Rossini M, Bettili F, Ghellere F, Fracassi E, Idolazzi L, Gatti D, Viapiana O. Permanent Discontinuation of Glucocorticoids in Polymyalgia Rheumatica Is Uncommon but May Be Enhanced by Amino Bisphosphonates. J Rheumatol 2018; 46:318-322. [PMID: 30385701 DOI: 10.3899/jrheum.180324] [Citation(s) in RCA: 8] [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] [Accepted: 08/08/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The duration of treatment with glucocorticoids (GC) in polymyalgia rheumatica (PMR) is often longterm. Amino bisphosphonates (N-BP) are used in PMR for the prevention of GC-induced osteoporosis, but they coulsd also have immunomodulatory properties. Whether they can be effective as an adjuvant treatment in PMR is unknown. We aimed to establish whether the use of N-BP in our PMR cohort may be associated with GC discontinuation. METHODS We conducted a retrospective review of all patients diagnosed with PMR recorded in our electronic medical notes. Cox regression analyses were used to examine the association between the use of N-BP and discontinuation of GC. RESULTS Data were retrieved for 385 patients (mean age 71 ± 10 yrs, 64% females, mean initial prednisone dose 19 ± 9 mg/day). The median followup time was 38 months (range 9-57); more than 60% of patients were exposed to N-BP. GC were discontinued in 47% of patients after a median time of 20 months (range 14-27), but subsequently restarted in 39%. Overall, 276/385 patients (72%) were actively treated at their last available evaluation (mean prednisone dose 4.9 ± 5.5 mg/day), while 123/205 (60%) were still receiving GC after 24 months of followup. The use of N-BP was associated with the discontinuation of GC (adjusted HR 0.66, 95% CI 0.50-0.88), independent of age, initial GC dose, and osteoporosis. CONCLUSION Unlike current guidelines, longterm treatment with GC is often necessary. These preliminary data suggest that N-BP may be involved in the management of PMR.
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Affiliation(s)
- Alessandro Giollo
- From the Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy. .,A. Giollo, MD, Rheumatology Unit, Department of Medicine, University of Verona; M. Rossini, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; F. Bettili, MD, Rheumatology Unit, Department of Medicine, University of Verona; F. Ghellere, MD, Rheumatology Unit, Department of Medicine, University of Verona; E. Fracassi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; L. Idolazzi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; D. Gatti, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; O. Viapiana, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona.
| | - Maurizio Rossini
- From the Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.,A. Giollo, MD, Rheumatology Unit, Department of Medicine, University of Verona; M. Rossini, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; F. Bettili, MD, Rheumatology Unit, Department of Medicine, University of Verona; F. Ghellere, MD, Rheumatology Unit, Department of Medicine, University of Verona; E. Fracassi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; L. Idolazzi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; D. Gatti, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; O. Viapiana, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona
| | - Francesco Bettili
- From the Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.,A. Giollo, MD, Rheumatology Unit, Department of Medicine, University of Verona; M. Rossini, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; F. Bettili, MD, Rheumatology Unit, Department of Medicine, University of Verona; F. Ghellere, MD, Rheumatology Unit, Department of Medicine, University of Verona; E. Fracassi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; L. Idolazzi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; D. Gatti, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; O. Viapiana, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona
| | - Francesco Ghellere
- From the Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.,A. Giollo, MD, Rheumatology Unit, Department of Medicine, University of Verona; M. Rossini, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; F. Bettili, MD, Rheumatology Unit, Department of Medicine, University of Verona; F. Ghellere, MD, Rheumatology Unit, Department of Medicine, University of Verona; E. Fracassi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; L. Idolazzi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; D. Gatti, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; O. Viapiana, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona
| | - Elena Fracassi
- From the Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.,A. Giollo, MD, Rheumatology Unit, Department of Medicine, University of Verona; M. Rossini, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; F. Bettili, MD, Rheumatology Unit, Department of Medicine, University of Verona; F. Ghellere, MD, Rheumatology Unit, Department of Medicine, University of Verona; E. Fracassi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; L. Idolazzi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; D. Gatti, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; O. Viapiana, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona
| | - Luca Idolazzi
- From the Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.,A. Giollo, MD, Rheumatology Unit, Department of Medicine, University of Verona; M. Rossini, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; F. Bettili, MD, Rheumatology Unit, Department of Medicine, University of Verona; F. Ghellere, MD, Rheumatology Unit, Department of Medicine, University of Verona; E. Fracassi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; L. Idolazzi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; D. Gatti, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; O. Viapiana, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona
| | - Davide Gatti
- From the Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.,A. Giollo, MD, Rheumatology Unit, Department of Medicine, University of Verona; M. Rossini, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; F. Bettili, MD, Rheumatology Unit, Department of Medicine, University of Verona; F. Ghellere, MD, Rheumatology Unit, Department of Medicine, University of Verona; E. Fracassi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; L. Idolazzi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; D. Gatti, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; O. Viapiana, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona
| | - Ombretta Viapiana
- From the Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.,A. Giollo, MD, Rheumatology Unit, Department of Medicine, University of Verona; M. Rossini, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; F. Bettili, MD, Rheumatology Unit, Department of Medicine, University of Verona; F. Ghellere, MD, Rheumatology Unit, Department of Medicine, University of Verona; E. Fracassi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; L. Idolazzi, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; D. Gatti, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona; O. Viapiana, MD, PhD, Rheumatology Unit, Department of Medicine, University of Verona
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Orsolini G, Adami G, Rossini M, Fassio A, Giollo A, Caimmi C, Idolazzi L, Gatti D, Viapiana O. Correction to: Is the exposure to bisphosphonates or osteoporosis the predictor of spinal radiographic progression in ankylosing spondylitis? Arthritis Res Ther 2018; 20:248. [PMID: 30396370 PMCID: PMC6235198 DOI: 10.1186/s13075-018-1753-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 11/26/2022] Open
Affiliation(s)
- Giovanni Orsolini
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy.
| | - Giovanni Adami
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Maurizio Rossini
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Angelo Fassio
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Alessandro Giollo
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Cristian Caimmi
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Luca Idolazzi
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Davide Gatti
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Ombretta Viapiana
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
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Orsolini G, Adami G, Rossini M, Fassio A, Giollo A, Caimmi C, Idolazzi L, Gatti D, Viapiana O. Is the exposure to bisphosphonates or osteoporosis the predictor of spinal radiographic progression in ankylosing spondylitis? Arthritis Res Ther 2018; 20:233. [PMID: 30336776 PMCID: PMC6235229 DOI: 10.1186/s13075-018-1730-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Giovanni Orsolini
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy.
| | - Giovanni Adami
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Maurizio Rossini
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Angelo Fassio
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Alessandro Giollo
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Cristian Caimmi
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Luca Idolazzi
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Davide Gatti
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
| | - Ombretta Viapiana
- University of Verona, Rheumatology Unit, piazzale L. Scuro 10, 37134, Verona, Italy
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Veraldi GF, Mezzetto L, Scorsone L, Sacco M, Eccher A, Idolazzi L. Surgical Treatment of Symptomatic Aortic Aneurysm in a Patient with Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis: Case Report and Review of the Literature. Ann Vasc Surg 2018; 53:270.e17-270.e21. [PMID: 30092440 DOI: 10.1016/j.avsg.2018.05.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 11/16/2022]
Abstract
Vasculitis is an heterogeneous group of syndromes, which shares inflammation of blood vessel wall as the main feature. Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a necrotizing vasculitis, with few or no immune deposits, predominantly affecting small vessels (i.e., capillaries, venules, arterioles, and small arteries), associated with ANCAs specific for myeloperoxidase or proteinase 3. Clinical manifestations may be heterogeneous but an involvement of lungs and kidneys frequently occurs. AAV of large vessels is a very rare condition whose standard therapy is medical approach. Surgical revascularization has been described in selected patients after medical failure or in emergent settings. We report the case of a patient affected by symptomatic infrarenal aortic aneurysm related to AAV, who underwent in-situ reconstruction by means of cryopreserved homograft.
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Affiliation(s)
- Gian Franco Veraldi
- Department of Vascular Surgery, University Hospital of Verona, Verona, Italy
| | - Luca Mezzetto
- Department of Vascular Surgery, University Hospital of Verona, Verona, Italy.
| | - Lorenzo Scorsone
- Department of General and Upper Gastrointestinal Surgery, University Hospital of Verona, Verona, Italy
| | - Michele Sacco
- Department of General and Upper Gastrointestinal Surgery, University Hospital of Verona, Verona, Italy
| | - Albino Eccher
- Department of Diagnostic and Pathology, University Hospital of Verona, Verona, Italy
| | - Luca Idolazzi
- Department of Rheumatology, University Hospital of Verona, Verona, Italy
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Sarzi-Puttini P, Filippucci E, Adami S, Meroni PL, Batticciotto A, Idolazzi L, De Lucia O, Talavera P, Kumke T, Grassi W. Clinical, Ultrasound, and Predictability Outcomes Following Certolizumab Pegol Treatment (with Methotrexate) in Patients with Moderate-to-Severe Rheumatoid Arthritis: 52-Week Results from the CZP-SPEED Study. Adv Ther 2018; 35:1153-1168. [PMID: 30043210 PMCID: PMC6096970 DOI: 10.1007/s12325-018-0751-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Indexed: 12/12/2022]
Abstract
Introduction To assess the impact of certolizumab pegol (CZP) treatment on clinical, patient-reported, and musculoskeletal ultrasound outcomes and to determine the treatment response time point most predictive of long-term outcomes in Italian patients with rheumatoid arthritis (RA). Methods CZP-SPEED (NCT01443364) was a 52-week, open-label, prospective, interventional, multicenter study. Biologic-naïve patients with moderate-to-severe active RA, who had failed at least one DMARD treatment, received CZP (400 mg at weeks 0, 2, and 4, then 200 mg every 2 weeks) concomitantly with methotrexate. The primary objective was to identify the time point of clinical response {decrease in 28-joint Disease Activity Score [DAS28(ESR)] ≥ 1.2} most predictive of a clinical response at week 52. Additional clinical and patient-reported outcomes were measured. Power Doppler (PD) ultrasound was used to assess synovial effusion, synovial proliferation, PD signal, cartilage damage, and bone erosion according to international guidelines. Results A total of 132 patients were enrolled and received CZP; 91/132 (69%) completed to week 52. Predicted 52-week responses for early responders (week 2 onwards) were between 65% and 70%. Rapid improvements in joint cavity widening and PD signal were observed to week 8 and maintained to week 52. Cartilage damage and bone erosion were stable over 52 weeks. No new safety signals were identified. Conclusion In Italian CZP-treated patients with moderate-to-severe RA, week 12 clinical responses may be predictive of long-term response at week 52. Rapid improvements in clinical, patient-reported, and musculoskeletal ultrasound outcomes were maintained to week 52. These data may aid rheumatologists to make earlier treatment decisions. Trial Registration ClinicalTrials.gov identifier, NCT01443364. Funding UCB Pharma. Electronic supplementary material The online version of this article (10.1007/s12325-018-0751-8) contains supplementary material, which is available to authorized users.
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Orsolini G, Adami G, Rossini M, Ghellere F, Caimmi C, Fassio A, Idolazzi L, Gatti D, Viapiana O. Parathyroid hormone is a determinant of serum Dickkopf-1 levels in ankylosing spondylitis. Clin Rheumatol 2018; 37:3093-3098. [PMID: 29995219 DOI: 10.1007/s10067-018-4205-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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] [Received: 04/25/2018] [Revised: 06/12/2018] [Accepted: 07/09/2018] [Indexed: 12/15/2022]
Abstract
Available studies reported contradictory results about serum levels Dickkopf-1 (DKK1), an inhibitor of Wnt signaling in patients with ankylosing spondylitis (AS). In previous studies, we observed in other conditions that parathyroid hormone (PTH) serum levels were an important determinant of DKK1 serum levels. The aim of the present study was to investigate it in patients with AS. We recruited 71 patients diagnosed with AS. Levels of C-reactive protein (CRP), DKK1, PTH, 25OH-vitamin D, and bone turnover markers (intact N-propeptide of type I collagen, P1NP, and C-terminal telopeptide of type I collagen, CTX) were measured and compared to healthy controls (HC). Dual X-ray absorptiometry at lumbar spine and proximal femoral site was used for bone mineral density (BMD) assessment and spine X-rays were also performed. PTH serum levels were found to be significantly higher in AS patients than in HC (33.8 ± 14.11 vs 24.8 ± 13 pg/ml, p = 0.002), while mean DKK1 serum levels were lower than in HC (23.3 ± 13.1 vs 29.8 ± 15.9 pmol/l, p = 0.009). A positive correlation between DKK1 and PTH (correlation coefficient + 0.25, p = 0.03) was observed; it remained significant in a multivariate analysis. In patients with longer disease duration, DKK1 was also positively correlated with CTX (coefficient 0.42, p = 0.01), and PTH was higher in those patients with low BMD (Z-score ≤ - 1) at any site (p = 0.04). Also in AS, PTH is an important determinant of DKK1 serum levels and should be evaluated in studies on DKK1. PTH might have a role in bone involvement in AS, also through the Wnt pathway.
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Affiliation(s)
- Giovanni Orsolini
- University of Verona, Rheumatology Unit, Piazzale L. Scuro 10, 37134, Verona, Italy.
| | - Giovanni Adami
- University of Verona, Rheumatology Unit, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - Maurizio Rossini
- University of Verona, Rheumatology Unit, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - Francesco Ghellere
- University of Verona, Rheumatology Unit, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - Cristian Caimmi
- University of Verona, Rheumatology Unit, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - Angelo Fassio
- University of Verona, Rheumatology Unit, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - Luca Idolazzi
- University of Verona, Rheumatology Unit, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - Davide Gatti
- University of Verona, Rheumatology Unit, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - Ombretta Viapiana
- University of Verona, Rheumatology Unit, Piazzale L. Scuro 10, 37134, Verona, Italy
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Filippou G, Sakellariou G, Scirè CA, Carrara G, Rumi F, Bellis E, Adinolfi A, Batticciotto A, Bortoluzzi A, Cagnotto G, Caprioli M, Canzoni M, Cavatorta FP, De Lucia O, Di Sabatino V, Draghessi A, Farina I, Focherini MC, Gabba A, Gutierrez M, Idolazzi L, Luccioli F, Macchioni P, Massarotti MS, Mastaglio C, Menza L, Muratore M, Parisi S, Picerno V, Piga M, Ramonda R, Raffeiner B, Rossi D, Rossi S, Rossini P, Scioscia C, Venditti C, Volpe A, Iagnocco A. The predictive role of ultrasound-detected tenosynovitis and joint synovitis for flare in patients with rheumatoid arthritis in stable remission. Results of an Italian multicentre study of the Italian Society for Rheumatology Group for Ultrasound: the STARTER study. Ann Rheum Dis 2018; 77:1283-1289. [PMID: 29886430 DOI: 10.1136/annrheumdis-2018-213217] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [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: 02/09/2018] [Revised: 05/13/2018] [Accepted: 05/14/2018] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To define the role of ultrasound (US) for the assessment of patients with rheumatoid arthritis (RA) in clinical remission, including joint and tendon evaluation. METHODS A multicentre longitudinal study has been promoted by the US Study Group of the Italian Society for Rheumatology. 25 Italian centres participated, enrolling consecutive patients with RA in clinical remission. All patients underwent complete clinical assessment (demographic data, disease characteristics, laboratory exams, clinical assessment of 28 joints and patient/physician-reported outcomes) and Power Doppler (PD) US evaluation of wrist, metacarpalphalangeal joints, proximal interphalangeal joints and synovial tendons of the hands and wrists at enrolment, 6 and 12 months. The association between clinical and US variables with flare, disability and radiographic progression was evaluated by univariable and adjusted logistic regression models. RESULTS 361 patients were enrolled, the mean age was 56.20 (±13.31) years and 261 were women, with a mean disease duration of 9.75 (±8.07) years. In the 12 months follow-up, 98/326 (30.1%) patients presented a disease flare. The concurrent presence of PD positive tenosynovitis and joint synovitis predicted disease flare, with an OR (95% CI) of 2.75 (1.45 to 5.20) in crude analyses and 2.09 (1.06 to 4.13) in adjusted analyses. US variables did not predict the worsening of function or radiographic progression. US was able to predict flare at 12 months but not at 6 months. CONCLUSIONS PD positivity in tendons and joints is an independent risk factor of flare in patients with RA in clinical remission. Musculoskeletal ultrasound evaluation is a valuable tool to monitor and help decision making in patients with RA in clinical remission.
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Affiliation(s)
- Georgios Filippou
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Garifallia Sakellariou
- Chair and Division of Rheumatology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Carlo Alberto Scirè
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Epidemiology Unit, Italian Society for Rheumatology (SIR), Milan, Italy
| | - Greta Carrara
- Epidemiology Unit, Italian Society for Rheumatology (SIR), Milan, Italy
| | - Federica Rumi
- Epidemiology Unit, Italian Society for Rheumatology (SIR), Milan, Italy
| | | | - Antonella Adinolfi
- Department of Medicine, Surgery and Neurosciences, Rheumatology Section, University of Siena, Siena, Italy
| | | | - Alessandra Bortoluzzi
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Cagnotto
- Department of Clinical Sciences, Rheumatology, Skane University Hospital, Lund University, Lund, Sweden
| | - Marta Caprioli
- Division of Rheumatology and Clinical Immunology, Humanitas Research Hospital, Rozzano, Italy
| | - Marco Canzoni
- Rheumatology Unit, Azienda Ospedaliera Sant'Andrea, Rome, Italy
| | | | - Orazio De Lucia
- Department of Rheumatology, ASST Centro Traumatologico Ortopedico G. Pini-CTO, Milan, Italy
| | - Valentina Di Sabatino
- Department of Medicine, Surgery and Neurosciences, Rheumatology Section, University of Siena, Siena, Italy
| | - Antonella Draghessi
- Department of Rheumatology, Clinica Reumatologica, Universita` Policlinica delle Marche, Jesi, Italy
| | - Ilaria Farina
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Alessandra Gabba
- Rheumatology Unit, A.O.U. University Clinic Cagliari, Monserrato, Italy
| | | | - Luca Idolazzi
- Rheumatology Unit, Ospedale Civile Maggiore, Verona, Italy
| | - Filippo Luccioli
- Rheumatology Unit, A.O.S. Maria della Misericordia, Perugia, Italy
| | - Pierluigi Macchioni
- Rheumatology Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Marco Sergio Massarotti
- Department of Rheumatology, University Hospitals of Morecambe Bay NHS Foundation Trust, Royal Lancaster Infirmary, Lancaster, UK
| | | | - Luana Menza
- Rheumatology Unit, Moriggia-Pelascini Hospital, Gravedona, Italy
| | | | - Simone Parisi
- SC Reumatologia, A.O.U.Citta` della Salute e della Scienza di Torino, Turin, Italy
| | - Valentina Picerno
- Rheumatology Unit, Azienda Ospedaliera Regionale San Carlo, Potenza, Basilicata, Italy
| | - Matteo Piga
- Rheumatology Unit, A.O.U. University Clinic Cagliari, Monserrato, Italy
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine, DIMED, University of Padova, Padua, Italy
| | | | - Daniela Rossi
- SS Immunoreumatologia, G. Bosco Hospital, Turin, Italy
| | - Silvia Rossi
- Chair and Division of Rheumatology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Paola Rossini
- Rheumatology Unit, P. O. Destra Secchia, Pieve di Coriano, Italy
| | | | - Carlo Venditti
- Rheumatology Unit, A.O. Rummo di Benevento, Benevento, Italy
| | | | - Annamaria Iagnocco
- Dipartimento di Scienze Cliniche e Biologiche, Universita` degli Studi di Torino, Turin, Italy
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Abstract
Unfortunately, the author's first name and the family name were swapped and published in the original publication.
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Affiliation(s)
- Angelo Fassio
- Rheumatology Unit, University of Verona, Policlinico G.B. Rossi, piazzale A. Scuro, 37134, Verona, Italy.
| | - Luca Idolazzi
- Rheumatology Unit, University of Verona, Policlinico G.B. Rossi, piazzale A. Scuro, 37134, Verona, Italy
| | - Maurizio Rossini
- Rheumatology Unit, University of Verona, Policlinico G.B. Rossi, piazzale A. Scuro, 37134, Verona, Italy
| | - Davide Gatti
- Rheumatology Unit, University of Verona, Policlinico G.B. Rossi, piazzale A. Scuro, 37134, Verona, Italy
| | - Giovanni Adami
- Rheumatology Unit, University of Verona, Policlinico G.B. Rossi, piazzale A. Scuro, 37134, Verona, Italy
| | - Alessandro Giollo
- Rheumatology Unit, University of Verona, Policlinico G.B. Rossi, piazzale A. Scuro, 37134, Verona, Italy
| | - Ombretta Viapiana
- Rheumatology Unit, University of Verona, Policlinico G.B. Rossi, piazzale A. Scuro, 37134, Verona, Italy
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Idolazzi L, Gisondi P, Fassio A, Viapiana O, Giollo A, Rossini M, Girolomoni G, Gatti D. Ultrasonography of the nail unit reveals quantitative and qualitative alterations in patients with psoriasis and psoriatic arthritis. Med Ultrason 2018; 20:177-184. [PMID: 29730684 DOI: 10.11152/mu-1327] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIMS The nail unit is a matter of interest both for dermatologist and rheumatologist. The nail is considered one of the possible targets of assessment, especially when ultrasonography is performed. The aim of the study is to highlight peculiar features and alterations of the nail unit in patients affected by psoriasis and psoriatic arthritis versus healthy controls using ultrasonography. MATERIALS AND METHODS The study sample included 82 patients affected by psoriasis and/or psoriatic arthritis and 50 healthy controls. The patients were consecutively enrolled during their routine visit in the outpatient clinic and they performed clinical and ultrasonographic evaluation of the nail. The evaluationof disease activity was done using Disease Activity in Psoriatic Arthritis (DAPSA), Psoriasis Activity Severity Index (PASI), and Nail Psoriasi Severity Index (NAPSI). RESULTS Multivariate analysis of variance was performed between groups. Post hoc analysis underlined the differences between healthy and affected regarding nail plate thickness (0.063±0.011 cm for patients with psoriasis, 0.065±0.014 cm for patients with psoriatic arthritis and 0.051±0.006 cm for healthy controls, p<0.05). Elementary lesions of nail plate and nail bed were compared using Pearson's chi square test between patients in psoriasis and psoriatic arthritis groups, with no differences except for a trend for onycholisis and crumbling (p=0.07 and 0.06, respectively) in the psoriatic arthritis group. ROC curves were calculated (AUC = 0.68) obtaining also quantitative cut offs for nail plate andnail bed thickness in the affected vs healthy patients. CONCLUSIONS Our study shows that ultrasonography may be a potential advantage in clinical practice. Our results strengthen the information already available in the literature and add quantitative parameters for ultrasonography of the nail.
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Affiliation(s)
- Luca Idolazzi
- Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Verona, Italy.
| | - Paolo Gisondi
- Dermatology Clinic , Department of Medicine, University of Verona, Verona, Italy
| | - Angelo Fassio
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Ombretta Viapiana
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Alessandro Giollo
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Maurizio Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Giampiero Girolomoni
- Dermatology Clinic , Department of Medicine, University of Verona, Verona, Italy.
| | - Davide Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
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Idolazzi L, El Ghoch M, Dalle Grave R, Bazzani PV, Calugi S, Fassio S, Caimmi C, Viapiana O, Bertoldo F, Braga V, Rossini M, Gatti D. Bone metabolism in patients with anorexia nervosa and amenorrhoea. Eat Weight Disord 2018; 23:255-261. [PMID: 27787773 DOI: 10.1007/s40519-016-0337-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 10/17/2016] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Aim of this study is focusing on bone metabolism in AN patients with amenorrhoea and related estrogen deficiency effects. METHODS AN patients were compared both with healthy females and with postmenopausal women (reference model for estrogen deficiency). The study sample included 81 females with AN. Laboratory tests [25-OH vitamin D, bone turnover markers, intact parathyroid hormone, sclerostin (SOST) and dickkopf-related protein (DKK1)] and dual energy X-ray absorptiometry (DXA) were taken into account. RESULTS AN patients had higher levels of C-terminal telopeptide of type I collagen (CTX) than both control groups. AN adolescents had CTX higher than AN young adults. In postmenopausal women, intact N-propeptide of type I collagen was higher if compared with each other group. In AN groups, Dickkopf-related protein 1 was significantly lower than the two control groups. No differences were found in sclerostin except in adolescents. In AN adolescents, DXA values at femoral sites were higher than in AN young adults and a positive correlation was found with body weight (p < 0.01) and with fat mass evaluated using DXA (p < 0.01). CONCLUSIONS AN women with amenorrhoea have an increased bone resorption like postmenopausal women but bone formation is depressed. The consequent remodeling uncoupling is considerably more severe than that occurring after menopause.
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Affiliation(s)
- L Idolazzi
- Unit of Rheumatology, University of Verona, P.le L. Scuro 2, 37134, Verona, Italy.
| | - M El Ghoch
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, Garda, 37016, Verona, Italy
| | - R Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, Garda, 37016, Verona, Italy
| | - P V Bazzani
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, Garda, 37016, Verona, Italy
| | - S Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, Garda, 37016, Verona, Italy
| | - S Fassio
- Unit of Rheumatology, University of Verona, P.le L. Scuro 2, 37134, Verona, Italy
| | - C Caimmi
- Unit of Rheumatology, University of Verona, P.le L. Scuro 2, 37134, Verona, Italy
| | - O Viapiana
- Unit of Rheumatology, University of Verona, P.le L. Scuro 2, 37134, Verona, Italy
| | - F Bertoldo
- Internal Medicine, University of Verona, P.le L. Scuro 2, 37134, Verona, Italy
| | - V Braga
- Unit of Rheumatology, University of Verona, P.le L. Scuro 2, 37134, Verona, Italy
| | - M Rossini
- Unit of Rheumatology, University of Verona, P.le L. Scuro 2, 37134, Verona, Italy
| | - D Gatti
- Unit of Rheumatology, University of Verona, P.le L. Scuro 2, 37134, Verona, Italy
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Fassio A, Rossini M, Viapiana O, Idolazzi L, Vantaggiato E, Benini C, Gatti D. New Strategies for the Prevention and Treatment of Systemic and Local Bone Loss; from Pathophysiology to Clinical Application. Curr Pharm Des 2018; 23:6241-6250. [DOI: 10.2174/1381612823666170713104431] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 06/04/2017] [Accepted: 06/19/2017] [Indexed: 11/22/2022]
Affiliation(s)
- Angelo Fassio
- Unit of Rheumatology, University of Verona, piazzale A. Scuro, Verona, Italy
| | - Maurizio Rossini
- Unit of Rheumatology, University of Verona, piazzale A. Scuro, Verona, Italy
| | - Ombretta Viapiana
- Unit of Rheumatology, University of Verona, piazzale A. Scuro, Verona, Italy
| | - Luca Idolazzi
- Unit of Rheumatology, University of Verona, piazzale A. Scuro, Verona, Italy
| | | | - Camilla Benini
- Unit of Rheumatology, University of Verona, piazzale A. Scuro, Verona, Italy
| | - Davide Gatti
- Unit of Rheumatology, University of Verona, piazzale A. Scuro, Verona, Italy
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Adami G, Rossini M, Viapiana O, Fassio A, Idolazzi L, Orsolini G, Gatti D. Lack of Effect of Teriparatide on Joint Erosions in Rheumatoid Arthritis Is an Expected Result: Comment on the Article by Solomon et al. Arthritis Rheumatol 2018; 70:475-476. [PMID: 29193862 DOI: 10.1002/art.40385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Gisondi P, Altomare G, Ayala F, Conti A, Dapavo P, De Simone C, Foti C, Idolazzi L, Lubrano E, Malara G, Marchesoni A, Olivieri I, Parodi A, Peris K, Piaserico S, Salvarani C, Scarpa R, Girolomoni G. Consensus on the management of patients with psoriatic arthritis in a dermatology setting. J Eur Acad Dermatol Venereol 2018; 32:515-528. [PMID: 29220551 DOI: 10.1111/jdv.14741] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 11/22/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis (PsO). Early diagnosis and prompt therapeutic intervention are crucial for limiting PsA progression and prevention of disability. Dermatologists are in a privileged position to detect early PsA. The management of patients with PsA in the dermatology setting is widely variable. OBJECTIVE To provide practical recommendations for the management of patients with PsA in the dermatology setting including early diagnosis and treatment. METHODS A consensus document was written by an expert panel composed by dermatologists (n = 12) and rheumatologists (n = 6). Eleven highly relevant questions were selected and elaborated with answers/statements based on a narrative literature review. The resulting document was discussed in a face-to-face meeting adopting a nominal group technique to reach consensus (i.e. 100% agreement) using the Delphi method. RESULTS A consensus was achieved in defining the following: the clinical characteristics differentiating inflammatory and non-inflammatory signs and symptoms of joint disease; the most important differential diagnoses of PsA in clinical practice; the most useful screening questionnaires, serum laboratory tests and imaging techniques for the detection of early PsA; the criteria for dermatologist to refer patients with PsO to rheumatologist; the criteria for the diagnosis of PsA; the selection of the indices that the dermatologist could use for measuring the activity and severity of PsA in clinical practice; when systemic steroids and/or intra-articular steroid injections are indicated in the treatment of PsA. Finally, systemic treatments including synthetic and biologic disease-modifying antirheumatic drugs to be considered for the treatment of PsA have been reported. CONCLUSIONS The implementations of these practical recommendations could be very helpful for the management of patients with PsA in the dermatology setting including early diagnosis and treatment.
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Affiliation(s)
- P Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - G Altomare
- I.R.C.C.S Istituto Ortopedico Galeazzi, Division of Dermatology and Venereology, University of Milan, Milan, Italy
| | - F Ayala
- Department of Dermatology, University of Naples Federico II, Naples, Italy
| | - A Conti
- Department of Head and Neck Surgery, Section of Dermatology, Azienda Ospedaliero Universitaria Policlinico di Modena, Modena, Italy
| | - P Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - C De Simone
- Dermatology Department, Catholic University of the Sacred Heart, Rome, Italy
| | - C Foti
- Department of Biomedical Science and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - L Idolazzi
- Department of Medicine, Section of Rheumatology, University of Verona, Verona, Italy
| | - E Lubrano
- Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università degli Studi del Molise, Campobasso, Italy
| | - G Malara
- Unit of Dermatology, Azienda Ospedaliera Papardo, Messina, Italy
| | - A Marchesoni
- Department of Rheumatology, ASST Gaetano Pini-CTO, Milano, Italy
| | - I Olivieri
- Division of Rheumatology, Azienda Ospedaliera San Carlo, Potenza, Italy
| | - A Parodi
- Section of Dermatology, University of Genoa, Genoa, Italy
| | - K Peris
- Dermatology Department, Catholic University of the Sacred Heart, Rome, Italy
| | - S Piaserico
- Department of Medicine, Section of Dermatology, University of Padua, Padua, Italy
| | - C Salvarani
- Division of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, University of Modena and Reggio Emilia, Modena, Reggio Emilia, Italy
| | - R Scarpa
- Department of Medicine, Section of Rheumatology, University of Naples Federico II, Naples, Italy
| | - G Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
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Idolazzi L. Secukinumab treatment in psoriatic patients: Italian experiences. J DERMATOL TREAT 2018; 29:1-2. [PMID: 30919722 DOI: 10.1080/09546634.2018.1534364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Luca Idolazzi
- a Ospedale Civile Maggiore , Rheumatology Unit, University of Verona , Verona , Italy
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Zabotti A, Idolazzi L, Batticciotto A, De Lucia O, Scirè CA, Tinazzi I, Iagnocco A. Enthesitis of the hands in psoriatic arthritis: an ultrasonographic perspective. Med Ultrason 2017; 19:438-443. [PMID: 29197921 DOI: 10.11152/mu-1172] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Psoriatic arthritis is a systemic inflammatory disease in which enthesitis and dactylitis are two of the main hallmarks of the disease. In the last years, ultrasonography is increasingly playing a key role in the diagnosis of psoriatic arthritis and ultrasonography of the entheses, particularly of the lower limbs, is commonly used to assess patients with that disease. New advancements in ultrasound equipment using high frequencies probes allowed us also to identify and characterize the involvementof the entheses of the hand in psoriatic arthritis, confirming the results of the experimental models of the disease and the theory of the sinovial-entheseal complex, even in small joints.
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Affiliation(s)
- Alen Zabotti
- Rheumatology Clinic, University of Udine, Italy.
| | - Luca Idolazzi
- Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Verona, Italy.
| | | | - Orazio De Lucia
- Department of Rheumatology, ASST Centro traumatologico ortopedico G. Pini - CTO, Milan.
| | - Carlo Alberto Scirè
- Department of Medical Sciences, Section of Rheumatology, University of Ferrara, Ferrara, Italy.
| | - Ilaria Tinazzi
- Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy.
| | - Annamaria Iagnocco
- Dipartimento di Scienze Cliniche e Biologiche, Università degli Studi di Torino, Turin, Italy.
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Batticciotto A, Idolazzi L, De Lucia O, Tinazzi I, Iagnocco A. Could nail and joint alterations make the difference between psoriatic arthritis and osteoarthritis during the ultrasonographic evaluation of the distal interphalangeal joints? Med Ultrason 2017; 19:347-348. [PMID: 29197909 DOI: 10.11152/mu-1266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | - Luca Idolazzi
- Unit of Rheumatology, Ospedale Civile Maggiore, University of Verona, Italy.
| | - Orazio De Lucia
- Department of Rheumatology, ASST Centro traumatologico ortopedico G. Pini - CTO, Milan,Italy
| | - Ilaria Tinazzi
- Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy
| | - Annamaria Iagnocco
- Dipartimento di Scienze Cliniche e Biologiche, Università degli Studi di Torino, Turin, Italy
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Caporali R, Idolazzi L, Bombardieri S, Ferraccioli G, Gerli R, Govoni M, Matucci Cerinic M, Pomponio G, Salaffi F, Tirri R, Benaglio F, Bianchino L, Sarzi-Puttini P. Tocilizumab in the treatment of patients with rheumatoid arthritis in real clinical practice: results of an Italian observational study. Clin Exp Rheumatol 2017; 35:919-928. [PMID: 28516890] [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: 03/31/2015] [Accepted: 03/08/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To describe the effectiveness and safety of tocilizumab (TCZ), an interleukin-6 receptor inhibitor, in a cohort of patients with rheumatoid arthritis (RA) recruited in clinical practice. METHODS TRUST was an observational study in RA patients who started treatment with TCZ in the 6 months prior to site activation and were still on treatment at start of study; patients were followed up to 12 months after the first TCZ infusion. RESULTS 322 RA patients were enrolled in 59 Italian centres (mean age: 55.8 years; mean disease duration: 120.5 months; baseline DAS28: 5.3). After 6 months of TCZ treatment, patients achieving low disease activity (DAS28 ≤3.2; 57.52%) or disease remission (DAS28 <2.6; 38.05%) were 216 out of 226 patients with available DAS28 (p<0.001). No statistically significant differences were found in mean DAS28 and HAQ score changes from baseline (start of TCZ treatment) to study end between patients previously inadequately responding to disease-modifyinganti-rheumatic drugs (DMARD-IR) or to DMARDs plus tumour necrosis factor inhibitors (DMARD +TNFi-IR): both patient populations responded to TCZ. A statistically significant decrease in mean VAS Fatigue score (48.4 vs. 34.7; p=0.0025) at month 6 was observed. In patients treated with TCZ as monotherapy (32.61%), DAS28, VAS fatigue and HAQ scores decreased from baseline to any post-baseline time point. Overall, 62 patients (19.3%) prematurely discontinued TCZ treatment, 24 (7.5%) for safety reasons. Drug-related adverse events occurred in 92 patients (28.6%) (mostly 3 hypercholesterolaemia and leucopenia) and drug-related serious adverse events in 11 patients (3.4%). CONCLUSIONS This study confirms the good effectiveness and safety profile of TCZ in real life RA patient care.
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Affiliation(s)
- Roberto Caporali
- Division of Rheumatology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | | | | | - Gianfranco Ferraccioli
- Division of Rheumatology, Institute of Rheumatology and Affine Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Roberto Gerli
- Rheumatology Unit, Department of Medicine, University of Perugia, Italy
| | - Marcello Govoni
- Department of Medical Sciences, UOC of Rheumatology, Azienda Ospedaliero-Universitaria S. Anna-Ferrara, University of Ferrara, Cona, Italy
| | - Marco Matucci Cerinic
- Division of Rheumatology AOUC, Department of Experimental and Clinical Medicine, University of Florence, Italy
| | | | - Fausto Salaffi
- Department of Rheumatology, Polytechnic University of the Marche, Ancona, Italy
| | - Rossella Tirri
- Rheumatology Unit, Università della Campania, "Luigi Vanvitelli", Caserta, Italy
| | - Francesca Benaglio
- Division of Rheumatology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
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Rossini M, Adami G, Viapiana O, Idolazzi L, Fassio A, Giollo A, Caimmi C, Orsolini G, Gatti D. Rheumatoid arthritis, γδ T cells and bisphosphonates. Ann Rheum Dis 2017; 77:e57. [DOI: 10.1136/annrheumdis-2017-212510] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 10/11/2017] [Indexed: 11/03/2022]
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76
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Idolazzi L, Fassio A, Viapiana O, Rossini M, Adami G, Bertoldo F, Antoniazzi F, Gatti D. Treatment with neridronate in children and adolescents with osteogenesis imperfecta: Data from open-label, not controlled, three-year Italian study. Bone 2017; 103:144-149. [PMID: 28684193 DOI: 10.1016/j.bone.2017.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 06/30/2017] [Accepted: 07/01/2017] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The present study assessed the long-term efficacy and safety of intravenous (i.v.) neridronate in children and adolescents affected by osteogenesis imperfecta (OI). METHODS 55 young patients (mean age 12.6±3.9years) affected by OI were included in the study. Neridronate was administered by i.v. infusion at a dose of 2mg/kg (maximum dose of 100mg) at intervals of three-months for three years. Dual X-ray absorptiometry of the lumbar spine, hip and ultradistal and proximal radius were evaluated every 6months. Blood calcium, phosphate, albumin, fasting urinary calcium/creatinine ratio were obtained at baseline and every 3months. Serum bone turnover markers total and bone alkaline phosphatase were performed every 12months in a proportion of patients. RESULTS Mean lumbar spine and total hip bone mineral density (BMD) and bone mineral content significantly increased from baseline compared to all subsequent time points (p<0.001). Mean ultradistal radius BMD significantly increased from month 18 (p=0.026). Levels of bone turnover markers significantly decreased from baseline to all post-baseline observation time points. There was no statistically significant effect on fracture risk (p=0.185), although a significant reduction was observed in the mean number of fractures occurring during treatment compared to pre-treatment values. The most frequent adverse events were arthralgia, fever, joint sprain. An acute phase reaction was reported in 26 (22.8%) patients. None of the reported serious adverse events was considered as treatment-related. CONCLUSION Long-term i.v. neridronate treatment has positive effects on BMD, bone turnover markers and fracture risk with a good safety profile.
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Affiliation(s)
- L Idolazzi
- Rheumatology Unit, Department of Medicine, University of Verona, Italy.
| | - A Fassio
- Rheumatology Unit, Department of Medicine, University of Verona, Italy
| | - O Viapiana
- Rheumatology Unit, Department of Medicine, University of Verona, Italy
| | - M Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, Italy
| | - G Adami
- Rheumatology Unit, Department of Medicine, University of Verona, Italy
| | - F Bertoldo
- Internal Medicine Unit, Department of Medicine, University of Verona, Italy
| | - F Antoniazzi
- Pediatric Clinic, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy
| | - D Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Italy
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Rossini M, Adami G, Viapiana O, Idolazzi L, Orsolini G, Fassio A, Giollo A, Gatti D. Osteoporosis: an Independent Determinant of Bone Erosions in Rheumatoid Arthritis? J Bone Miner Res 2017; 32:2142-2143. [PMID: 28670771 DOI: 10.1002/jbmr.3209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Maurizio Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Giovanni Adami
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Ombretta Viapiana
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Luca Idolazzi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Giovanni Orsolini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Angelo Fassio
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Alessandro Giollo
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Davide Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
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Fassio A, Gatti D, Gisondi P, Girolomoni G, Viapiana O, Giollo A, Zamboni M, Rossini M, Idolazzi L. Effects of secukinumab on serum adipocytokines: preliminary data. Reumatismo 2017; 69:105-110. [PMID: 28933132 DOI: 10.4081/reumatismo.2017.953] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 08/02/2017] [Accepted: 07/04/2017] [Indexed: 11/23/2022] Open
Abstract
Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects joints, connective tissues and the axial skeleton. Metabolic syndrome is an independent risk factor for psoriasis (Pso) development and is associated with more severe forms of Pso. Adipocytokines are secreted by white adipose tissue and are thought to link obesity with the development of metabolic and cardiovascular diseases. Secukinumab is a new monoclonal antibody with a different mechanism of action. This antibody selectively binds to and neutralizes interleukin-17 (IL-17) and it has shown efficacy in the treatment of PsA. The aim of this study was to evaluate the possible interferences of secukinumab on different adipocytokines. We enrolled 28 patients with PsA, classified with the CASPAR criteria. Serum samples were stored at baseline and then at the first, the third and the sixth month of therapy. Resistin, chemerin, adiponectin and C-reactive protein (CRP) were dosed. When tested globally, none of the adipokine tested showed any statistically significant variation. However, when the male group was tested, both resistin and chemerin at M6 showed a significant decrease from baseline. CRP did not show any variation at any time point. Our study demonstrated that treatment with secukinumab has little influence on the levels of adipokines tested within the first six months of treatment even though it might exert different influence between males and females from a metabolic perspective. Further studies with greater numbers of patients are needed to determine whether these preliminary results have clinical relevance.
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Affiliation(s)
- A Fassio
- Unit of Rheumatology, University of Verona.
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79
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Giollo A, Idolazzi L, Caimmi C, Fassio A, Bertoldo F, Dalle Grave R, El Ghoch M, Calugi S, Bazzani PV, Viapiana O, Rossini M, Gatti D. Vitamin D levels strongly influence bone mineral density and bone turnover markers during weight gain in female patients with anorexia nervosa. Int J Eat Disord 2017; 50:1041-1049. [PMID: 28593655 DOI: 10.1002/eat.22731] [Citation(s) in RCA: 20] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 05/09/2017] [Accepted: 05/17/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The aim of the study was to investigate a potential role for vitamin D status on bone mineral density (BMD) during weight gain in patients with anorexia nervosa (AN). METHOD Spine and hip BMD assessed by dual-energy X-ray absorptiometry (DXA), serum vitamin D (25-OH-D), N-propeptide of type I collagen (P1NP), C-terminal telopeptide of type I collagen (CTX), and intact parathyroid hormone (PTH) were measured before and after a 20-week intensive weight-restoration program in ninety-one female patients with AN and secondary amenorrhoea. RESULTS Ninety-one consecutive female patients (age 13-45 years; weight 39.4 ± 5.6 kg, body mass index [BMI] 15.1 ± 1.6 kg m-2 ) were included in the study. Although weight and BMI significantly increased in all patients during treatment, mean BMD only significantly increased at the spine (1.0% ± 3.6%, p = .009). The increase in spine BMD was significantly higher only above post-treatment 25-OH-D levels of 30 ng mL-1 (2.5% vs. 0.5%, respectively, for 25-OH-D ≥ and < 30 ng mL-1 , p = .026). There was a significant decrease in bone resorption (CTX; p = .043) and increased bone formation (P1NP; p < .001) after weight restoration. Nevertheless, a significant increase in PTH was also found, which was inversely correlated with decreased post-treatment 25-OH-D levels (R2 = .153, p < .001). DISCUSSION Hypovitaminosis D may counteract the efficacy of refeeding in AN through increased bone resorption mediated by secondary hyperparathyroidism, which strongly supports the use of vitamin D supplements for bone health in AN.
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Affiliation(s)
- Alessandro Giollo
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Luca Idolazzi
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Cristian Caimmi
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Angelo Fassio
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Francesco Bertoldo
- Department of Medicine, Internal Medicine Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo 89, Garda, 37016, Italy
| | - Marwan El Ghoch
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo 89, Garda, 37016, Italy
| | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo 89, Garda, 37016, Italy
| | | | - Ombretta Viapiana
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Maurizio Rossini
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
| | - Davide Gatti
- Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy
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Ariani A, Silva M, Seletti V, Bravi E, Saracco M, Parisi S, De Gennaro F, Idolazzi L, Caramaschi P, Benini C, Bodini FC, Scirè CA, Carrara G, Lumetti F, Alfieri V, Bonati E, Lucchini G, Aiello M, Santilli D, Mozzani F, Imberti D, Michieletti E, Arrigoni E, Delsante G, Pellerito R, Fusaro E, Chetta A, Sverzellati N. Quantitative chest computed tomography is associated with two prediction models of mortality in interstitial lung disease related to systemic sclerosis. Rheumatology (Oxford) 2017; 56:922-927. [PMID: 28160007 DOI: 10.1093/rheumatology/kew480] [Citation(s) in RCA: 26] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Indexed: 11/14/2022] Open
Abstract
Objective In this multicentre study, we aimed to evaluate the capacity of a computer-assisted automated QCT method to identify patients with SSc-associated interstitial lung disease (SSc-ILD) with high mortality risk according to validated composite clinical indexes (ILD-Gender, Age, Physiology index and du Bois index). Methods Chest CT, anamnestic data and pulmonary function tests of 146 patients with SSc were retrospectively collected, and the ILD-Gender, Age, Physiology score and DuBois index were calculated. Each chest CT underwent an operator-independent quantitative assessment performed with a free medical image viewer (Horos). The correlation between clinical prediction models and QCT parameters was tested. A value of P < 0.05 was considered statistically significant. Results Most QCT parameters had a statistically different distribution in patients with diverging mortality risk according to both clinical prediction models (P < 0.01). The cut-offs of QCT parameters were calculated by receiver operating characteristic curve analysis, and most of them could discriminate patients with different mortality risk according to clinical prediction models. Conclusion QCT assessment of SSc-ILD can discriminate between well-defined different mortality risk categories, supporting its prognostic value. These findings, together with the operator independence, strengthen the validity and clinical usefulness of QCT for assessment of SSc-ILD.
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Affiliation(s)
- Alarico Ariani
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero
| | - Mario Silva
- Department of Clinical Sciences, Section of Radiology, University of Parma, Parma
| | - Valeria Seletti
- Department of Clinical Sciences, Section of Radiology, University of Parma, Parma
| | - Elena Bravi
- Department of Medicine, Internal Medicine and Rheumatology Unit, Ospedale G. Da Saliceto, Piacenza
| | - Marta Saracco
- Rheumatology Unit, Ospedale Mauriziano - Umberto I di Torino, Turin
| | - Simone Parisi
- Rheumatology Department, Azienda Ospedaliera Cittá della Salute e della Scienza di Torino, Turin
| | - Fabio De Gennaro
- Rheumatology Unit, Azienda Ospedaliera 'Istituti Ospitalieri' di Cremona, Cremona
| | - Luca Idolazzi
- Rheumatology Section, Department of Medicine, University of Verona, Azienda Ospedaliero Universitaria Integrata, Verona
| | - Paola Caramaschi
- Rheumatology Section, Department of Medicine, University of Verona, Azienda Ospedaliero Universitaria Integrata, Verona
| | - Camilla Benini
- Rheumatology Section, Department of Medicine, University of Verona, Azienda Ospedaliero Universitaria Integrata, Verona
| | | | | | - Greta Carrara
- Epidemiology Unit, Italian Society for Rheumatology, Milano
| | - Federica Lumetti
- Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena
| | - Veronica Alfieri
- Department of Clinical and Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Elisa Bonati
- Department of Clinical and Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Gianluca Lucchini
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero
| | - Marina Aiello
- Department of Clinical and Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Daniele Santilli
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero
| | - Flavio Mozzani
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero
| | - Davide Imberti
- Department of Medicine, Internal Medicine and Rheumatology Unit, Ospedale G. Da Saliceto, Piacenza
| | | | - Eugenio Arrigoni
- Department of Medicine, Internal Medicine and Rheumatology Unit, Ospedale G. Da Saliceto, Piacenza
| | - Giovanni Delsante
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero
| | | | - Enrico Fusaro
- Rheumatology Department, Azienda Ospedaliera Cittá della Salute e della Scienza di Torino, Turin
| | - Alfredo Chetta
- Department of Clinical and Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Nicola Sverzellati
- Department of Clinical Sciences, Section of Radiology, University of Parma, Parma
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Orsolini G, Caimmi C, Viapiana O, Idolazzi L, Fracassi E, Gatti D, Adami G, Rossini M. Titer-Dependent Effect of Anti-Citrullinated Protein Antibodies On Systemic Bone Mass in Rheumatoid Arthritis Patients. Calcif Tissue Int 2017; 101:17-23. [PMID: 28246933 DOI: 10.1007/s00223-017-0253-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 02/06/2017] [Indexed: 01/09/2023]
Abstract
Bone loss in rheumatoid arthritis (RA) is a key feature both local and systemic. Anti-citrullinated protein antibodies (ACPA) have recently been found to directly induce differentiation and activation of osteoclasts and therefore contribute to periarticular bone loss. The aim of this study was to analyze the effect of ACPA on systemic bone mineral density (BMD) in patients with established RA. This is a cross-sectional study with a single-center RA population. BMD was measured with Dual X-ray absorptiometry at lumbar and femoral sites. ACPA were measured by EIA. Multivariate analysis was performed adjusting for the main confounding variables. One hundred twenty-seven RA patients were enrolled. In univariate analysis, ACPA-positive patients showed lower BMD Z-score (SD below the age- and gender-matched mean reference value) at femoral sites (p < 0.01). A negative correlation between ACPA titer and BMD Z-score at all sites was observed (p < 0.01). The multivariate analysis adjusted for the main confounding variables confirmed the negative effect of ACPA at femoral sites (p < 0.05), but not at lumbar spine BMD. No significant effect of rheumatoid factor has been observed. ACPA have a negative titer-dependent effect on BMD at femoral sites, mainly constituted by cortical bone. ACPA-positive patients, especially if at high titer, should undergo bone investigations and be treated with bone protecting agents. Disease-modifying anti-rheumatic drugs lowering ACPA titer might have positive effects on systemic bone mass.
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Affiliation(s)
- Giovanni Orsolini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.
| | - Cristian Caimmi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Ombretta Viapiana
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Luca Idolazzi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Elena Fracassi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Davide Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Giovanni Adami
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Maurizio Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
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Fassio A, Idolazzi L, Viapiana O, Benini C, Vantaggiato E, Bertoldo F, Rossini M, Gatti D. In psoriatic arthritis Dkk-1 and PTH are lower than in rheumatoid arthritis and healthy controls. Clin Rheumatol 2017. [PMID: 28634697 DOI: 10.1007/s10067-017-3734-2] [Citation(s) in RCA: 35] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Psoriatic Arthritis (PsA) is characterized by bone erosive damage often associated with exuberant bone formation especially in enthesial sites. Dkk-1 and sclerostin are the main inhibitors of the WNT/β-catenin signaling pathway and play a key role in the regulation of both bone formation and resorption. We performed this study in order to compare the serum levels of the WNT-pathway regulators along with bone turnover markers (BTM) and parathyroid hormone (PTH) between three different groups: one group of female patients affected by PsA, one group of female patients affected by rheumatoid arthritis (RA), and healthy female controls (HC). This is a cross-sectional study including 33 patients with PsA classified with the CASPAR criteria, 35 HC, and 28 patients with RA classified with the ACR/EULAR 2010 criteria. Intact N-propeptide of type I collagen (PINP), C-terminal telopeptide of type I collagen (CTX-I), Dickkopf-related-protein 1 (Dkk-1), sclerostin, PTH, and 25OH-vitamin D serum levels were dosed. The PsA group showed significantly lower Dkk-1 levels when compared to the HC and RA groups. Dkk-1 in the RA group was significantly higher than HC. A similar trend was documented for PTH. In the PsA group, CTX-I was found to be lower than in both the RA and HC groups. This study demonstrated for the first time that Dkk-1 levels in PsA are lower than HC, in contrast with RA, in which they are increased. These results might contribute to explain the different bone involvement of the two different diseases.
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Affiliation(s)
- Angelo Fassio
- Unit of Rheumatology, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134, Verona, Italy.
| | - Luca Idolazzi
- Unit of Rheumatology, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134, Verona, Italy
| | - Ombretta Viapiana
- Unit of Rheumatology, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134, Verona, Italy
| | - Camilla Benini
- Unit of Rheumatology, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134, Verona, Italy
| | - Elisabetta Vantaggiato
- Unit of Rheumatology, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134, Verona, Italy
| | - Francesco Bertoldo
- Department of Internal Medicine, University of Verona, Piazzale A. Scuro, 37134, Verona, Italy
| | - Maurizio Rossini
- Unit of Rheumatology, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134, Verona, Italy
| | - Davide Gatti
- Unit of Rheumatology, University of Verona, Ospedale Civile Maggiore, Piazzale A. Scuro, 37134, Verona, Italy
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Orsolini G, Gavioli I, Tripi G, Viapiana O, Gatti D, Idolazzi L, Zanotti R, Rossini M. Denosumab for the Treatment of Mastocytosis-Related Osteoporosis: A Case Series. Calcif Tissue Int 2017; 100:595-598. [PMID: 28229176 DOI: 10.1007/s00223-017-0241-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 01/17/2017] [Indexed: 12/19/2022]
Abstract
The purpose of this study was to investigate the therapeutic effect of denosumab, an anti-RANKL monoclonal antibody for the treatment of bone loss in indolent systemic mastocytosis (ISM) patients intolerant to bisphosphonates. Four patients underwent upon informed consent a treatment with denosumab 60 mg administered subcutaneously every 6 months with the same regimen used for postmenopausal osteoporosis. Bone mineral density (BMD) was measured at lumbar and femoral sites at baseline and after 1 year. C-terminal telopeptide of collagen type I (CTX), bone alkaline phosphatase (bALP) and tryptase serum level were determined at baseline and after 12 months with fasting blood samples withdrawals. BMD increased significantly at both sites during the 12 months; all the patients had an important decrease of serum CTX and of lesser extent of bALP serum levels. After denosumab treatment, a decrease in serum tryptase level was observed in all the patients. No adverse events or new fractures occurred. Denosumab seems to be a valid alternative for the treatment of bone loss in ISM. RANKL might be of key importance in the pathogenesis of ISM bone involvement.
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Affiliation(s)
- Giovanni Orsolini
- Rheumatology Section, Department of Medicine, University of Verona, Piazzale L. Scuro 10, 37134, Verona, Italy.
| | - Irene Gavioli
- Rheumatology Section, Department of Medicine, University of Verona, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - Gaia Tripi
- Rheumatology Section, Department of Medicine, University of Verona, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - Ombretta Viapiana
- Rheumatology Section, Department of Medicine, University of Verona, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - Davide Gatti
- Rheumatology Section, Department of Medicine, University of Verona, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - Luca Idolazzi
- Rheumatology Section, Department of Medicine, University of Verona, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - Roberta Zanotti
- Hematology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Maurizio Rossini
- Rheumatology Section, Department of Medicine, University of Verona, Piazzale L. Scuro 10, 37134, Verona, Italy
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Fassio A, Bertoldo F, Idolazzi L, Viapiana O, Rossini M, Gatti D. Drug-induced osteonecrosis of the jaw: the state of the art. Reumatismo 2017; 69:9-15. [PMID: 28535616 DOI: 10.4081/reumatismo.2017.983] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/06/2017] [Accepted: 04/05/2017] [Indexed: 11/23/2022] Open
Abstract
Osteonecrosis of the jaw (ONJ) is a rare adverse event of antiresorptive drugs such as bisphosphonates (BP) and denosumab (DMAb). The diagnosis of ONJ is considered in cases where exposed bone in the maxillofacial region does not heal within 8 weeks in a patient previously treated with an antiresorptive agent. In patients with osteoporosis, ONJ is reported as a very rare adverse event while in oncologic patients with bone metastases or malignant hypercalcemia the incidence is significantly higher (up to the 1-10% of the patients). The pathophysiology of ONJ is still not completely understood but it is multi-factorial. ONJ is a condition associated with poor oral health, oral surgery, and use of antiresorptive agents. Prevention is of paramount importance especially in cancer patients, in whom the large majority of cases of ONJ (>90%) are reported, but it should also be considered in osteoporotic patients, especially during dental surgical procedure. Some simple prevention procedures are effective in reducing the risk of its appearance. When ONJ unfortunately occurs, the large majority of patients can be managed conservatively. In conclusion, ONJ is a rare condition associated with antiresorptive drugs. Both osteoporotic and oncologic patients should be well informed about its low absolute risk and regarding the fact that the benefits of antiresorptive therapy far outweigh this potential risk of ONJ.
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Affiliation(s)
- A Fassio
- Department of Medicine, Rheumatology Unit, University of Verona.
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85
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Caimmi C, Rossini M, Viapiana O, Idolazzi L, Adami G, Gatti D. Could γ/δ T Cells Explain Adverse Effects of Zoledronic Acid? Comment on the Article by Reinhardt et al. Arthritis Rheumatol 2017; 69:1339. [DOI: 10.1002/art.40048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 01/12/2017] [Indexed: 11/12/2022]
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86
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Giollo A, Gatti D, Viapiana O, Idolazzi L, Fassio A, Adami G, Rossini M. Comment on: clinical efficacy of oral alendronate in ankylosing spondylitis: a randomised placebo-controlled trial. Clin Exp Rheumatol 2017; 35:548. [PMID: 28421998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 02/20/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Alessandro Giollo
- Department of Medicine, Rheumatology Unit, University of Verona, Italy.
| | - Davide Gatti
- Department of Medicine, Rheumatology Unit, University of Verona, Italy
| | - Ombretta Viapiana
- Department of Medicine, Rheumatology Unit, University of Verona, Italy
| | - Luca Idolazzi
- Department of Medicine, Rheumatology Unit, University of Verona, Italy
| | - Angelo Fassio
- Department of Medicine, Rheumatology Unit, University of Verona, Italy
| | - Giovanni Adami
- Department of Medicine, Rheumatology Unit, University of Verona, Italy
| | - Maurizio Rossini
- Department of Medicine, Rheumatology Unit, University of Verona, Italy
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87
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Cioffi G, Viapiana O, Ognibeni F, Dalbeni A, Giollo A, Gatti D, Idolazzi L, Faganello G, Di Lenarda A, Rossini M. Prognostic Role of Subclinical Left Ventricular Systolic Dysfunction Evaluated by Speckle-Tracking Echocardiography in Rheumatoid Arthritis. J Am Soc Echocardiogr 2017; 30:602-611. [PMID: 28391000 DOI: 10.1016/j.echo.2017.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Speckle-tracking echocardiography allows early detection of subclinical left ventricular systolic dysfunction (LVSD) in patients with rheumatoid arthritis (RA). In this prospective study, we assessed the prevalence and the prognostic role of subclinical LVSD detected by speckle-tracking echocardiography in RA patients. METHODS Two-dimensional global longitudinal strain (GLS) and global circumferential strain (GCS) were measured in 209 RA patients without overt cardiac disease. LVSD was defined as low GLS (> -16.0%), low GCS (> -17.8%), or both. The primary end point was all-causes hospitalization; the coprimary end point was hospitalization for cardiovascular causes. RESULTS The study population had a mean age of 58 ± 11 years; 67% were female, 52% had hypertension, and the RA duration was 14 ± 10 years. Low GLS was detected in 51 patients (24%), low GCS in 42 patients (20%), and combined low GLS and GCS in 18 patients (9%). During a median follow-up time of 16 months (range, 10-21 months), a primary end point occurred in 50 patients (24%), and 25 patients were hospitalized for a cardiovascular event. Multiple Cox regression analyses revealed that combined low GLS and GCS was independently associated with the end point defined as all-causes hospitalization together with higher aortic stiffness. Examined individually, neither low GCS nor low GLS showed an independent association with this typology of clinical outcome. Conversely, both low GCS and low GLS (examined individually or as combined low GLS and GCS) emerged as strong independent prognosticators of cardiovascular events. CONCLUSIONS Subclinical LVSD defined as low GLS, GCS, or both is common in RA patients without overt cardiac disease and provides additional prognostic information in these individuals.
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Affiliation(s)
- Giovanni Cioffi
- Department of Cardiology, Villa Bianca Hospital, Trento, Italy.
| | - Ombretta Viapiana
- Division of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Federica Ognibeni
- Division of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Andrea Dalbeni
- Division of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Alessandro Giollo
- Division of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Davide Gatti
- Division of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Luca Idolazzi
- Division of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Giorgio Faganello
- Cardiovascular Center Health Authority n° 1 and University of Trieste, Trieste, Italy
| | - Andrea Di Lenarda
- Cardiovascular Center Health Authority n° 1 and University of Trieste, Trieste, Italy
| | - Maurizio Rossini
- Division of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
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88
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Viapiana O, Idolazzi L, Fassio A, Orsolini G, Rossini M, Adami G, Bertoldo F, Gatti D. Long-term Effects of Neridronate in Adults with Osteogenesis Imperfecta: An Observational Three-Year Italian Study. Calcif Tissue Int 2017; 100:341-347. [PMID: 28130572 DOI: 10.1007/s00223-017-0236-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 01/07/2017] [Indexed: 10/20/2022]
Abstract
The aim of this study was to assess the long-term efficacy and safety of i.v. neridronate in the treatment of osteogenesis imperfecta (OI). One hundred and fourteen patients affected by OI were included in the study. Neridronate was administered by i.v. infusion at the dosage of 2 mg/kg, up to a maximum of 100 mg at three-month intervals for 3 years. Dual X-ray absorptiometry of the lumbar spine, hip, and ultradistal and proximal radius were evaluated every 6 months. Blood calcium, phosphate, albumin, fasting urinary calcium/creatinine ratio, total serum alkaline phosphatase, and bone alkaline phosphatase were obtained at baseline and every 3 months. The mean lumbar spine and total hip BMD significantly increased from baseline to any time point (p < 0.001). The mean ultradistal radius BMD significantly increased from baseline only at month 18 (p = 0.026), 30 (p = 0.046), and 36 (p = 0.013), respectively. The mean proximal radius BMD did not change during the whole observation. The levels of bone turnover markers significantly decreased from baseline to any post-baseline observation time. The study was not able to find any statistically significant effect on fracture risk (p = 0.185). The percentage of patients with fractures was unaltered during treatment as compared to the 3-year period before treatment. The most common AEs were fragility fractures, back pain, arthralgia, fever, and joint sprain. An acute phase reaction was reported in 26 (22.8%) patients. None of the reported SAEs were considered as treatment-related. Long-term treatment with i.v. neridronate has positive effects on BMD and bone turnover markers with a good safety profile, although no significant effect on the risk of fracture was observed.
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Affiliation(s)
- O Viapiana
- Rheumatology Unit, Department of Medicine, University of Verona, p.le L Scuro 2, 37100, Verona, Italy
| | - L Idolazzi
- Rheumatology Unit, Department of Medicine, University of Verona, p.le L Scuro 2, 37100, Verona, Italy.
| | - A Fassio
- Rheumatology Unit, Department of Medicine, University of Verona, p.le L Scuro 2, 37100, Verona, Italy
| | - G Orsolini
- Rheumatology Unit, Department of Medicine, University of Verona, p.le L Scuro 2, 37100, Verona, Italy
| | - M Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, p.le L Scuro 2, 37100, Verona, Italy
| | - G Adami
- Rheumatology Unit, Department of Medicine, University of Verona, p.le L Scuro 2, 37100, Verona, Italy
| | - F Bertoldo
- Internal Medicine, Department of Medicine, University of Verona, p.le L Scuro 2, 37100, Verona, Italy
| | - D Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, p.le L Scuro 2, 37100, Verona, Italy
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89
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Idolazzi L, Ridolo E, Fassio A, Gatti D, Montagni M, Caminati M, Martignago I, Incorvaia C, Senna G. Periostin: The bone and beyond. Eur J Intern Med 2017; 38:12-16. [PMID: 27939043 DOI: 10.1016/j.ejim.2016.11.015] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/26/2016] [Accepted: 11/28/2016] [Indexed: 12/21/2022]
Abstract
In recent years the relationship between bone, metabolism and many pathophysiologic mechanisms involving other organs and the immune system, was increasingly apparent. This observation concerns vitamin D, osteopontin and periostin (PO). PO is expressed in the periosteum of long bones but also in many other tissues and organs, including heart, kidney, skin and lungs, being enhanced by mechanical stress or injury. PO has a relevant physiological function in promoting injury repair in a large number of tissues. However, its overexpression was observed in different diseases characterized by inflammation, fibrosis and tumorigenesis. Here we review the current knowledge on the role of PO in physiologic and pathologic pathways of different diseases. A specific focus regards the correlation between the level of PO and lung diseases and the identification of PO also as an inflammatory key effector in asthma, strongly associated with airways eosinophilia. In fact PO seems to be a useful biomarker of "Th2-high" asthma compared to "Th2-low" asthma phenotype and a predictor of response to therapeutic agents. Currently, a growing number of studies suggests a possible role of PO as a new diagnostic marker and/or therapeutic target for different diseases and its usefulness in clinical practice should be supported and confirmed by further and larger studies.
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Affiliation(s)
- L Idolazzi
- Rheumatology Unit, Department of Medicine, University of Verona, Italy.
| | - E Ridolo
- Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - A Fassio
- Rheumatology Unit, Department of Medicine, University of Verona, Italy
| | - D Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Italy
| | - M Montagni
- Departmental Unit of Allergology, AUSL of Piacenza,, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - M Caminati
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - I Martignago
- Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - C Incorvaia
- Allergy/Cardiac & Pulmonary Rehabilitation, ASST Gaetano Pini/CTO, Milan, Italy
| | - G Senna
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
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90
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Ceccarelli F, Massafra U, Perricone C, Idolazzi L, Giacomelli R, Tirri R, Russo R, Pistone G, Ruscitti P, Parisi S, Sainaghi PP, Cacciapaglia F, Zullo A, Marino V, Migliore A, Valesini G. Anti-TNF treatment response in rheumatoid arthritis patients with moderate disease activity: a prospective observational multicentre study (MODERATE). Clin Exp Rheumatol 2017; 35:24-32. [PMID: 27974105] [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: 09/04/2015] [Accepted: 03/07/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Rheumatoid arthritis (RA) patients with moderate disease activity show progression of joint damage and have impaired quality of life, physical function, work and daily activities. Little is known about management of patients with moderate RA. The aim of the study was to assess the 1-year response to anti-TNF in biologic-naïve RA patients with moderate (3.2 <DAS28 ≤5.1) disease activity despite DMARD treatment, in the Italian clinical practice. METHODS The MODERATE study is a multicentre prospective, cohort non-interventional study, conducted in 19 Italian rheumatology sites. Patients with moderate RA, diagnosed according to the 2010 American College of Rheumatology (ACR)/EULAR criteria, were enrolled if they also were aged ≥18 years, had disease onset after 16 years old, moderate disease at baseline (DAS28 score >3.2 and ≤5.1), and were naïve to anti-TNF treatment. RESULTS Among 157 RA patients, 93 (59%) underwent etanercept, 43 (22%) adalimumab, 26 (17%) certolizumab, 10 golimumab and 2 infliximab; 80% of patients were still in treatment after 12-month observation. One-year clinical remission was achieved by 27 RA patients (21%), reduction of DAS28 score greater than 1.2 was observed in 75 (58%) patients. Moderate and good response according to EULAR criteria was observed in 59 (46%) and 45 (35%) patients, respectively. CONCLUSIONS Results confirm the efficacy of anti-TNF alpha also in moderate RA patients, who may achieve a substantial decrease of disease activity, and improve their quality of life. The low rate of patients achieving remission may suggest that therapeutic strategies should be more timely and aggressive.
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Affiliation(s)
- Fulvia Ceccarelli
- Dipartimento di Medicina Interna e Specialità Mediche, La Sapienza Università di Roma, Italy
| | - Umberto Massafra
- U.O.S. Reumatologia, Medicina Interna, Ospedale S.Pietro Fatebenefratelli, Rome, Italy
| | - Carlo Perricone
- Dipartimento di Medicina Interna e Specialità Mediche, La Sapienza Università di Roma, Italy
| | - Luca Idolazzi
- S.S.O. Reumatologia, Ospedale Civile Maggiore Borgo Trento, Verona, Italy
| | - Roberto Giacomelli
- Chair and Clinical Unit of Rheumatology, Department of Biotechnological and Applied Clinical Science, School of Medicine, 'San Salvatore' University Hospital, University of L'Aquila, Italy
| | - Rosella Tirri
- Reumatologia, Medicina Clinica e Sperimentale, A.O.U. Seconda Università di Napoli, Italy
| | - Romualdo Russo
- Medicina III, S.S. Reumatologia A.O.R.N. A. Cardarelli, Napoli, Italy
| | - Giovanni Pistone
- II Divisione Medicina Interna, ARNAS Civico Di Cristina Benfratelli, Palermo,Italy
| | - Piero Ruscitti
- Chair and Clinical Unit of Rheumatology, Department of Biotechnological and Applied Clinical Science, School of Medicine, 'San Salvatore' University Hospital, University of L'Aquila, Italy
| | - Simone Parisi
- Struttura Complessa Reumatologia, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Italy
| | - Pier Paolo Sainaghi
- Ambulatorio Immuno-Reumatologico, Ospedale Maggiore della Carità, Novara, Italy
| | - Fabio Cacciapaglia
- U.O. di Medicina Interna, Ambulatorio di Reumatologia Ospedale Ninetto Melli, San Pietro V.co, Brindisi, Italy
| | | | | | - Alberto Migliore
- U.O.S. Reumatologia, Medicina Interna, Ospedale S.Pietro Fatebenefratelli, Rome, Italy
| | - Guido Valesini
- Dipartimento di Medicina Interna e Specialità Mediche, La Sapienza Università di Roma, Italy.
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91
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Artuso A, Caimmi C, Tripi G, Viapiana O, Bonifacio M, Idolazzi L, Gavioli I, Gatti D, Zanotti R, Rossini M. Longitudinal Evaluation of Bone Mineral Density and Bone Metabolism Markers in Patients with Indolent Systemic Mastocytosis Without Osteoporosis. Calcif Tissue Int 2017; 100:40-46. [PMID: 27743017 DOI: 10.1007/s00223-016-0198-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 10/04/2016] [Indexed: 11/24/2022]
Abstract
Systemic Mastocytosis has been long identified as a potential cause of osteoporosis; nevertheless, data regarding longitudinal variation of bone mineral density (BMD) in patients with indolent systemic mastocytosis (ISM) are missing . We studied BMD variation at lumbar spine and proximal hip after 30-month (±6 months) follow-up in a large cohort of patients (83) with ISM without osteoporosis, supplementated with vitamin D and/or calcium when needed. We also analyzed the correlation between variation of BMD, basal serum tryptase levels and bone turnover markers (BTM). Sixty-four percent of our population was male; mean age was 52.1 (±11.5) years. Vitamin D insufficiency (serum levels of 25-OH-vitamin D, 25OHD, lower than 75 nmol/L) was found in more than 70 % of patients. After a follow-up of 30 ± 6 months with only vitamin D (5000-7500 IU weekly of oral cholecalciferol) or calcium (500 mg/die) supplementation when needed, we observed 2.1 % increase in BMD at lumbar spine, with no significant changes at hip. At the end of follow-up, almost 60 % of patients showed 25OHD serum levels still lower than recommended, despite vitamin D supplementation. Reduction in BMD after follow-up significantly correlated with high C-telopeptide of type I collagen serum levels at the time of diagnosis. In patients with ISM without osteoporosis, a routinary BMD evaluation within a time <2 years is not justified, except in the presence of elevated BTM. In these patients, vitamin D supplementation is frequently needed.
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Affiliation(s)
- A Artuso
- Hematology Section, Department of Medicine, University of Verona, Verona, Italy
| | - C Caimmi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.
| | - G Tripi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - O Viapiana
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - M Bonifacio
- Hematology Section, Department of Medicine, University of Verona, Verona, Italy
| | - L Idolazzi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - I Gavioli
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - D Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - R Zanotti
- Hematology Section, Department of Medicine, University of Verona, Verona, Italy
| | - M Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
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92
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Kunnathully V, Gomez-Lira M, Bassi G, Poli F, Zoratti E, La Verde V, Idolazzi L, Gatti D, Viapiana O, Adami S, Rossini M. CD14 ++ CD16 - monocytes are the main source of 11β-HSD type 1 after IL-4 stimulation. Int Immunopharmacol 2016; 43:156-163. [PMID: 27998829 DOI: 10.1016/j.intimp.2016.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 10/16/2016] [Revised: 11/23/2016] [Accepted: 12/10/2016] [Indexed: 01/21/2023]
Abstract
The anti-inflammatory actions of IL-4 are well established through earlier findings. However, the exact mechanism it uses to downregulate the pro-inflammatory cytokine production through monocytes and macrophages is poorly understood. In this study, we examined the effect of IL-4 in the induction of 11β-HSD1 in the two main classes of monocytes, CD14++ CD16- (CD14) and CD14+ CD16+ (CD16). Peripheral Blood Mononuclear Cells (PBMCs) were isolated from 17 healthy donors and were sorted into CD14 and CD16 subpopulations using cell sorting. Effect of IL-4 on 11β-HSD1-enzyme activity was measured in sorted and unsorted monocytes using Homogeneous Time-Resolved Fluorescence (HTRF) and M1/M2 polarization analysis was performed by flow cytometry. Our results indicate that CD14 cells are the major source of 11β-HSD1 enzyme after IL-4 stimulation and that M2 phenotype is not a pre-requisite for its synthesis.
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Affiliation(s)
- Vidya Kunnathully
- Department of Medicine, Section of Rheumatology, University of Verona, VR 37134, Italy.
| | - Macarena Gomez-Lira
- Department of Neurological, Biomedical and Movement Sciences, Section of Biology and Genetics, University of Verona, VR 37134, Italy.
| | - Giulio Bassi
- Department of Medicine, Section of Hematology, University of Verona, VR 37134, Italy.
| | - Fabio Poli
- Department of Medicine, Section of Rheumatology, University of Verona, VR 37134, Italy.
| | - Elisa Zoratti
- Applied Research on Cancer Network, University of Verona, VR 37134, Italy.
| | - Valentina La Verde
- Department of Medicine, Section of Rheumatology, University of Verona, VR 37134, Italy.
| | - Luca Idolazzi
- Department of Medicine, Section of Rheumatology, University of Verona, VR 37134, Italy.
| | - Davide Gatti
- Department of Medicine, Section of Rheumatology, University of Verona, VR 37134, Italy.
| | - Ombretta Viapiana
- Department of Medicine, Section of Rheumatology, University of Verona, VR 37134, Italy.
| | - Silvano Adami
- Department of Medicine, Section of Rheumatology, University of Verona, VR 37134, Italy.
| | - Maurizio Rossini
- Department of Medicine, Section of Rheumatology, University of Verona, VR 37134, Italy.
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93
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Fassio A, Idolazzi L, Rossini M, Viapiana O, Gatti D. A case of mandible Paget’s disease of the bone treated with intravenous neridronate. Reumatismo 2016; 68:154-158. [PMID: 27981818 DOI: 10.4081/reumatismo.2016.917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 10/24/2016] [Accepted: 10/24/2016] [Indexed: 11/23/2022] Open
Abstract
Paget's disease of bone (PDB) is a focal disorder of osteoclasts, leading to chaotic bone remodelling, and it is characterized by the presence of focal areas of excessive bone formation alongside with areas of focal bone resorption. The typical radiographic feature is the cotton wool appearance. To date, bisphosphonates are the mainstay of the treatment. We hereby report the case of a young woman presenting with mandible PDB, with a relevant diagnostic delay and mistakenly treated for five years with chronic oral corticosteroids. After our evaluation, the patient received treatment with intravenous neridronate (an amino-bisphosphonate licensed in Italy for the treatment of this disease), with achievement of clinical remission.
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Affiliation(s)
- A Fassio
- Unit of Rheumatology, University of Verona.
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94
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Gatti D, Idolazzi L, Fassio A. Vitamin D: not just bone, but also immunity. Minerva Med 2016; 107:452-460. [PMID: 27441391] [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] [Indexed: 06/06/2023]
Abstract
Vitamin D should not be considered only as a vitamin. It has a relevant role in many functions of body regulation, both skeletal and extra skeletal and this makes vitamin D an essential element for a healthy status. This is well explained by a ubiquitous presence of vitamin D receptors. Nowadays extra skeletal effects have a more interesting impact in medical practice. The paracrine and autocrine action of vitamin D has a pivotal role for these effects. The activation of the cellular transcriptional process leads to the expression of beta-defensin and cathelicidin, activating the Th1 pathway, related to innate immunity against bacteria. The action of vitamin D is also related to adaptive immunity with a Th2 response and production of anti-inflammatory cytokines like interleukins 4 and 5, and with Th17 and B-lymphocyte suppression. Vitamin D deficiency could have an unfavorable effect on both healthy and ill subjects. It is well-known that many autoimmune diseases like systemic lupus erythematosus and rheumatoid arthritis are influenced by vitamin D deficiency, and this is especially true for disease activity. Several other pathologies are influenced by the levels of vitamin D, such as diabetes mellitus type 1: an adequate intake of vitamin D can reduce the risk to develop this disease. The same applies to asthma and multiple sclerosis. It is very important to make a point about the deficiency state and their correction, especially in those people at higher risk.
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Affiliation(s)
- Davide Gatti
- Rheumatology Unit, University of Verona, Verona, Italy -
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95
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Giollo A, Cioffi G, Ognibeni F, Dalbeni A, Gatti D, Idolazzi L, Rossini M, Viapiana O. Disease activity and left ventricular systolic function in rheumatoid arthritis: Table 1. Ann Rheum Dis 2016; 75:e83. [DOI: 10.1136/annrheumdis-2016-210482] [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] [Received: 09/07/2016] [Accepted: 09/12/2016] [Indexed: 11/04/2022]
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96
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Adami G, Rossini M, Gatti D, Orsolini G, Idolazzi L, Viapiana O, Scarpa A, Canalis E. Hajdu Cheney Syndrome; report of a novel NOTCH2 mutation and treatment with denosumab. Bone 2016; 92:150-156. [PMID: 27592446 PMCID: PMC5056853 DOI: 10.1016/j.bone.2016.08.025] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 08/12/2016] [Accepted: 08/30/2016] [Indexed: 12/28/2022]
Abstract
Notch receptors play a central role in skeletal development and homeostasis. Hajdu Cheney Syndrome (HCS) is a rare disease associated with mutations of NOTCH2 that lead to the translation of a truncated, presumably stable, NOTCH2 protein. As a consequence, a gain-of-NOTCH2 function is manifested. We report a subject presenting with HCS and her child, both harboring a new heterozygous mutation in Exon 34 of NOTCH2 upstream of the PEST domain. The subject presented with osteoporosis, fractures, acroosteolysis and splenomegaly but did not have neurological complications, cardiovascular defects or polycystic kidneys. Sequencing of genomic DNA revealed a previously unreported mutation at nucleotide 6667C>T leading to a Gln2223Ter protein product in the subject and her son. Preclinical studies have demonstrated that the bone loss in HCS is secondary to enhanced osteoclastogenesis and bone resorption, and the same mechanism may operate in humans. Accordingly, the case we report was treated and responded to therapy with denosumab with an increase in bone mineral density (BMD). However, acroosteolysis progressed and was not modified by denosumab. In conclusion, we report a case of HCS associated with a novel mutation in NOTCH2 and its response to denosumab on BMD.
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Affiliation(s)
- Giovanni Adami
- Rheumatology Unit, Department of Medicine, University of Verona, Piazzale L. Scuro 2, 37134 Verona, Italy.
| | - Maurizio Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, Piazzale L. Scuro 2, 37134 Verona, Italy
| | - Davide Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Piazzale L. Scuro 2, 37134 Verona, Italy
| | - Giovanni Orsolini
- Rheumatology Unit, Department of Medicine, University of Verona, Piazzale L. Scuro 2, 37134 Verona, Italy
| | - Luca Idolazzi
- Rheumatology Unit, Department of Medicine, University of Verona, Piazzale L. Scuro 2, 37134 Verona, Italy
| | - Ombretta Viapiana
- Rheumatology Unit, Department of Medicine, University of Verona, Piazzale L. Scuro 2, 37134 Verona, Italy
| | - Aldo Scarpa
- ARC-Net Research Centre, University and Hospital Trust of Verona, Piazzale L. Scuro 2, 37134 Verona, Italy
| | - Ernesto Canalis
- Department of Orthopaedic Surgery, the UConn Musculoskeletal Institute, UConn Health, Farmington, CT 06030, United States
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Idolazzi L, Rossini M, Viapiana O, Braga V, Fassio A, Benini C, Kunnathully V, Adami S, Gatti D. Teriparatide and denosumab combination therapy and skeletal metabolism. Osteoporos Int 2016; 27:3301-3307. [PMID: 27250971 DOI: 10.1007/s00198-016-3647-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 05/19/2016] [Indexed: 01/22/2023]
Abstract
UNLABELLED Several therapies are available for osteoporis. Understanding the bone turnover changes and their mutual realtionship gives an overall view and might lead to a target therapy INTRODUCTION: The aim of this study is to compare the changes in bone turnover markers in patients treated with either denosumab alone, teriparatide (TPTD) alone, or in a third therapeutic scheme, when TPTD was added to patients previously treated with denosumab. METHODS Fifty-nine women over 65 years old with severe postmenopausal osteoporosis (evidence of at least two moderate-severe vertebral fractures) were enrolled in the study. Serum samples were collected every 3 months. They were assayed for intact N-propeptide of type I collagen (P1NP), C-terminal telopeptide of type I collagen (CTX), intact parathyroid hormone (PTH), 25 hydroxy-vitamin D (25 OHD), Sclerostin (SOST), and Dickkopf-related protein 1 (DKK1). Bone mass density was assessed by dual-energy X-ray absorptiometry at the lumbar spine and at the total hip. RESULTS In the groups treated only with TPTD or with denosumab, bone turnover markers increased and decreased, respectively. In TPTD group, a later significant increase in DKK1 was observed, while in denosumab group, a progressive increase in SOST was associated with a progressive significant decrease in DKK1. In the group treated first with denosumab and in which TPTD was added 3 months later, both CTX and P1NP increased 3 months after the beginning of TPTD. The strong effect of denosumab on bone turnover seems to be reversed by TPTD treatment. CONCLUSIONS In this study, we showed that TPTD is able to express its biological activity even when bone turnover is fully suppressed by denosumab treatment. The combination therapy is associated with significant increases in both DKK1 and SOST.
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Affiliation(s)
- L Idolazzi
- Rheumatology Unit - Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, VR, Italy.
| | - M Rossini
- Rheumatology Unit - Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, VR, Italy
| | - O Viapiana
- Rheumatology Unit - Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, VR, Italy
| | - V Braga
- Rheumatology Unit - Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, VR, Italy
| | - A Fassio
- Rheumatology Unit - Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, VR, Italy
| | - C Benini
- Rheumatology Unit - Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, VR, Italy
| | - V Kunnathully
- Rheumatology Unit - Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, VR, Italy
| | - S Adami
- Rheumatology Unit - Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, VR, Italy
| | - D Gatti
- Rheumatology Unit - Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, VR, Italy
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Adami G, Orsolini G, Adami S, Viapiana O, Idolazzi L, Gatti D, Rossini M. Effects of TNF Inhibitors on Parathyroid Hormone and Wnt Signaling Antagonists in Rheumatoid Arthritis. Calcif Tissue Int 2016; 99:360-4. [PMID: 27307275 DOI: 10.1007/s00223-016-0161-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 06/06/2016] [Indexed: 01/01/2023]
Abstract
Tumor necrosis factor α inhibitors (TNFi) are the major class of biologic drug used for the treatment of Rheumatoid arthritis (RA). Their effects on inflammation and disease control are well established, but this is not true also for bone metabolism, especially for key factors as parathyroid hormone and Wnt pathway. Those two pathways are gaining importance in the pathogenesis RA bone damage, both systemic and local, but how the new treatment affects them is still largely unknown. We studied 54 RA patients who were starting an anti-TNFα treatment due to the failure of the conventional synthetic disease-modifying antirheumatic drugs. Serum levels of Wnt/βcatenin pathway inhibitors (Dickkopf-related protein 1, Dkk1, and Sclerostin), Parathyroid hormone (PTH), vitamin D, and bone turnover markers were measured at baseline in the morning after fasting and after 6 months of therapy. We found a significant percentage increase in serum PTH (+32 ± 55 %; p = 0.002) and a decrease in Dkk1 mean serum levels (-2.9 ± 12.1; p = 0.05). PTH percentage changes were positively correlated both with C-terminal telopeptide of type I collagen and Dkk1 percentage changes. Sclerostin serum levels showed no significant difference. TNFi treatment provokes in the short term a rise in PTH levels and a decrease in Dkk1 serum levels. The increase of PTH might promote bone resorption and blunt the normalization of Dkk1 serum levels in RA. Those data give a new insight into TNFi metabolic effects on bone and suggest new strategies to achieve better results in terms of prevention of bone erosions and osteoporosis with TNFi treatment in RA.
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Affiliation(s)
- Giovanni Adami
- Rheumatology Section, Department of Medicine, University of Verona, Policlinico G.B Rossi, Piazzale Ludovico Scuro, 10, 37134, Verona, Italy.
| | - Giovanni Orsolini
- Rheumatology Section, Department of Medicine, University of Verona, Policlinico G.B Rossi, Piazzale Ludovico Scuro, 10, 37134, Verona, Italy
| | - Silvano Adami
- Rheumatology Section, Department of Medicine, University of Verona, Policlinico G.B Rossi, Piazzale Ludovico Scuro, 10, 37134, Verona, Italy
| | - Ombretta Viapiana
- Rheumatology Section, Department of Medicine, University of Verona, Policlinico G.B Rossi, Piazzale Ludovico Scuro, 10, 37134, Verona, Italy
| | - Luca Idolazzi
- Rheumatology Section, Department of Medicine, University of Verona, Policlinico G.B Rossi, Piazzale Ludovico Scuro, 10, 37134, Verona, Italy
| | - Davide Gatti
- Rheumatology Section, Department of Medicine, University of Verona, Policlinico G.B Rossi, Piazzale Ludovico Scuro, 10, 37134, Verona, Italy
| | - Maurizio Rossini
- Rheumatology Section, Department of Medicine, University of Verona, Policlinico G.B Rossi, Piazzale Ludovico Scuro, 10, 37134, Verona, Italy
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Fassio A, Idolazzi L, Jaber M, Dartizio C, Viapiana O, Rossini M, Gatti D. The negative bone effects of the disease and of chronic corticosteroid treatment in premenopausal women affected by rheumatoid arthritis. Reumatismo 2016; 68:65-71. [DOI: 10.4081/reumatismo.2016.878] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/11/2016] [Accepted: 07/12/2016] [Indexed: 11/23/2022] Open
Abstract
Osteoporosis is a well-known extra-articular complication in rheumatoid arthritis (RA). The chronic corticosteroid treatment, the functional impairment associated with RA and the disease itself appear to be the most relevant determinants. Most of the previous studies involved postmenopausal women, in whom the estrogenic deficiency might amplify the negative effect towards bone of both RA and corticosteroid therapy. We decided to evaluate bone health in a cohort of premenopausal RA patients. The study population includes 47 premenopausal women attending our outpatient clinic for RA and twice as many healthy age-matched control women selected from the hospital personnel. The bone density at the spine and femoral neck were significantly lower in patients with RA as compared with controls. When spine bone mineral density (BMD) values were adjusted for the cumulative glucocorticoid (GC) dose alone and for the cumulative GC dose plus body mass index (BMI) the mean differences between two groups decreased but they remained statistically significant. We found no difference when the spine BMD was adjusted for cumulative GC dose, BMI and health assessment questionnaire. The difference in femoral neck BMD remained statistically significant also after all the same adjustments. In conclusion, our study shows that a BMD deficiency is frequent also in premenopausal women affected by RA, especially at femoral site and that the main determinants of this bone loss are not only the disease-related weight loss, corticosteroid therapy and functional impairment, but also the systemic effects of the disease itself.
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Rossini M, Viapiana O, Adami S, Idolazzi L, Ghellere F, Tripi G, Ortolani R, Zanotti R, Gatti D. Effects of denosumab on peripheral lymphocyte subpopulations. Endocrine 2016; 53:857-9. [PMID: 26289128 DOI: 10.1007/s12020-015-0723-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 08/11/2015] [Indexed: 01/22/2023]
Affiliation(s)
- Maurizio Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, Policlinico Borgo Roma, Piazzale Scuro, 10, 37134, Verona, Italy.
| | - Ombretta Viapiana
- Rheumatology Unit, Department of Medicine, University of Verona, Policlinico Borgo Roma, Piazzale Scuro, 10, 37134, Verona, Italy
| | - Silvano Adami
- Rheumatology Unit, Department of Medicine, University of Verona, Policlinico Borgo Roma, Piazzale Scuro, 10, 37134, Verona, Italy
| | - Luca Idolazzi
- Rheumatology Unit, Department of Medicine, University of Verona, Policlinico Borgo Roma, Piazzale Scuro, 10, 37134, Verona, Italy
| | - Francesco Ghellere
- Rheumatology Unit, Department of Medicine, University of Verona, Policlinico Borgo Roma, Piazzale Scuro, 10, 37134, Verona, Italy
| | - Gaia Tripi
- Rheumatology Unit, Department of Medicine, University of Verona, Policlinico Borgo Roma, Piazzale Scuro, 10, 37134, Verona, Italy
| | - Riccardo Ortolani
- Immunology Unit, Department of Pathology, University Hospital, Verona, Italy
| | - Roberta Zanotti
- Hematology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Davide Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Policlinico Borgo Roma, Piazzale Scuro, 10, 37134, Verona, Italy
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