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Safran A, Perreau M, So A, Zufferey P. High titers of ADAbs in rheumatic disease patients undergoing anti-TNF therapy is not associated with lupus-like autoimmunity. Lupus 2017. [DOI: 10.1177/0961203317713145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Molnar C, Scherer A, Baraliakos X, de Hooge M, Micheroli R, Exer P, Kissling RO, Tamborrini G, Wildi LM, Nissen MJ, Zufferey P, Bernhard J, Weber U, Landewé RBM, van der Heijde D, Ciurea A. TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity: results from the Swiss Clinical Quality Management cohort. Ann Rheum Dis 2017; 77:63-69. [PMID: 28939631 PMCID: PMC5754737 DOI: 10.1136/annrheumdis-2017-211544] [Citation(s) in RCA: 184] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/16/2017] [Accepted: 09/08/2017] [Indexed: 01/02/2023]
Abstract
Objectives To analyse the impact of tumour necrosis factor inhibitors (TNFis) on spinal radiographic progression in ankylosing spondylitis (AS). Methods Patients with AS in the Swiss Clinical Quality Management cohort with up to 10 years of follow-up and radiographic assessments every 2 years were included. Radiographs were scored by two readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) with known chronology. The relationship between TNFi use before a 2-year radiographic interval and progression within the interval was investigated using binomial generalised estimating equation models with adjustment for potential confounding and multiple imputation of missing values. Ankylosing Spondylitis Disease Activity Score (ASDAS) was regarded as mediating the effect of TNFi on progression and added to the model in a sensitivity analysis. Results A total of 432 patients with AS contributed to data for 616 radiographic intervals. Radiographic progression was defined as an increase in ≥2 mSASSS units in 2 years. Mean (SD) mSASSS increase was 0.9 (2.6) units in 2 years. Prior use of TNFi reduced the odds of progression by 50% (OR 0.50, 95% CI 0.28 to 0.88) in the multivariable analysis. While no direct effect of TNFi on progression was present in an analysis including time-varying ASDAS (OR 0.61, 95% CI 0.34 to 1.08), the indirect effect, via a reduction in ASDAS, was statistically significant (OR 0.75, 95% CI 0.59 to 0.97). Conclusion TNFis are associated with a reduction of spinal radiographic progression in patients with AS. This effect seems mediated through the inhibiting effect of TNFi on disease activity.
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Laporte S, Chapelle C, Bertoletti L, Ollier E, Zufferey P, Lega JC, Merah A, Décousus H, Schulman S, Meyer G, Cucherat M, Mismetti P. Assessment of clinically relevant bleeding as a surrogate outcome for major bleeding: validation by meta-analysis of randomized controlled trials. J Thromb Haemost 2017; 15:1547-1558. [PMID: 28544422 DOI: 10.1111/jth.13740] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Indexed: 01/27/2023]
Abstract
Essentials Surrogacy of clinically relevant bleeding (CRB) for major bleeding has never been validated. Our meta-analysis evaluated CRB surrogacy in trials of new versus traditional anticoagulants. Surrogacy was not validated in orthopedic surgery, venous thromboembolism or atrial fibrillation The difficulty in demonstrating the surrogacy may reflect a lack of homogeneity in its definition SUMMARY: Background Clinically relevant bleeding (CRB), comprising major bleeding and clinically relevant non-major bleeding, has been used as a surrogate for major bleeding in most anticoagulant trials. The validity of this surrogate to estimate trade-off between thrombotic and bleeding events in clinical trials was never assessed. Methods We systematically reviewed randomized phase III trials comparing new anticoagulants with the standard of care for venous thromboembolism prevention following major orthopedic surgery, venous thromboembolism (VTE) treatment, or stroke and systemic embolism prevention in atrial fibrillation (AF), and reporting both major bleeding and CRB rates. The validity of CRB as a surrogate for major bleeding was assessed according to the strength of the association between the relative risks of major bleeding and CRB, measured by the use of R2trial and its 95% confidence interval (CI). Results In the postoperative prophylactic setting (13 studies), major bleeding and CRB rates were 1.12% and 3.56%, respectively, and R2trial was 0.69 (95% CI 0.34-0.93). For acute VTE studies (n = 12), major bleeding and CRB rates were 1.87% and 9.07%; the corresponding R2trial values were 0.28 (95% CI 0.01-0.80) and 0.68 (95% CI 0.09-1.00) when only double-blind studies were considered (n = 7). For AF studies (n = 7; 22 strata), major bleeding and CRB rates were 4.82% and 15.3%, and R2trial was 0.59 (95% CI 0.15-0.82). Conclusion Despite an apparent correlation between CRB and major bleeding in major orthopedic surgery, AF, and double-blind acute VTE studies, the wide CIs suggest that CRB might not be an acceptable surrogate outcome in any of these settings.
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Micheroli R, Hebeisen M, Wildi LM, Exer P, Tamborrini G, Bernhard J, Möller B, Zufferey P, Nissen MJ, Scherer A, Ciurea A. Impact of obesity on the response to tumor necrosis factor inhibitors in axial spondyloarthritis. Arthritis Res Ther 2017; 19:164. [PMID: 28724442 PMCID: PMC5518107 DOI: 10.1186/s13075-017-1372-3] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Few studies have investigated the impact of obesity on the response to tumor necrosis factor inhibitors (TNFi) in patients with axial spondyloarthritis (axSpA). The aim of our study was to investigate the impact of different body mass index (BMI) categories on TNFi response in a large cohort of patients with axSpA. METHODS Patients with axSpA within the Swiss Clinical Quality Management (SCQM) program were included in the current study if they fulfilled the Assessment in Spondyloarthritis International Society (ASAS) criteria for axSpA, started a first TNFi after recruitment, and had available BMI data as well as a baseline and follow-up visit at 1 year (±6 months). Patients were categorized according to BMI: normal (BMI 18.5 to <25), overweight (BMI 25-30), and obese (BMI >30). We evaluated the proportion of patients achieving the 40% improvement in ASAS criteria (ASAS40), as well as Ankylosing Spondylitis Disease Activity Score (ASDAS) improvement and status scores at 1 year. Patients having discontinued the TNFi were considered nonresponders. We controlled for age, sex, HLA-B27, axSpA type, BASDAI, BASMI, elevated C-reactive protein (CRP), current smoking, enthesitis, physical exercise, and co-medication with disease-modifying antirheumatic drugs, as well as with nonsteroidal anti-inflammatory drugs in multiple adjusted logistic regression analyses. RESULTS A total of 624 axSpA patients starting a first TNFi were considered in the current study (332 patients of normal weight, 204 patients with overweight, and 88 obese patients). Obese individuals were older, had higher BASDAI levels, and had a more important impairment of physical function in comparison to patients of normal weight, while ASDAS and CRP levels were comparable between the three BMI groups. An ASAS40 response was reached by 44%, 34%, and 29% of patients of normal weight, overweight, and obesity, respectively (overall p = 0.02). Significantly lower odds ratios (ORs) for achieving ASAS40 response were found in adjusted analyses in obese patients versus patients with normal BMI (OR 0.27, 95% confidence interval (CI) 0.09-0.70). The respective adjusted ASAS40 OR in overweight versus normal weight patients was 0.62 (95% CI 0.24-1.14). Comparable results were found for the other outcomes assessed. CONCLUSIONS Obesity is associated with significantly lower response rates to TNFi in patients with axSpA.
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Alpizar-Rodriguez D, Mueller RB, Möller B, Dudler J, Ciurea A, Zufferey P, Kyburz D, Walker UA, von Mühlenen I, Roux-Lombard P, Mahler M, Lamacchia C, Courvoisier DS, Gabay C, Finckh A. Female hormonal factors and the development of anti-citrullinated protein antibodies in women at risk of rheumatoid arthritis. Rheumatology (Oxford) 2017; 56:1579-1585. [DOI: 10.1093/rheumatology/kex239] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Indexed: 12/13/2022] Open
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Zufferey P, Rebell C, Benaim C, Ziswiler HR, Dumusc A, So A. Ultrasound can be useful to predict an evolution towards rheumatoid arthritis in patients with inflammatory polyarthralgia without anticitrullinated antibodies. Joint Bone Spine 2017; 84:299-303. [DOI: 10.1016/j.jbspin.2016.05.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 05/18/2016] [Indexed: 10/21/2022]
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Zufferey P. [Drug-induced iatrogenic arthropathies]. REVUE MEDICALE SUISSE 2017; 13:559-564. [PMID: 28718589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Arthropathies induced by drugs, especially arthralgias, are very frequently reported in pharmacology. The major difficulty often consists in confirming the accountability of the drug in the occurrence of the symptoms. Stopping the drug when it really responsible of the arthralgia is then likely to lead to the disappearance of the symptoms. The aim of this article is to review some of classical known induced arthropathies and some innovations by describing the clinical characteristics as well as the mechanisms linking the drug to the arthropathies when these have been clarified.
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Filippou G, Scirè CA, Damjanov N, Adinolfi A, Carrara G, Picerno V, Toscano C, Bruyn GA, D'Agostino MA, Delle Sedie A, Filippucci E, Gutierrez M, Micu M, Möller I, Naredo E, Pineda C, Porta F, Schmidt WA, Terslev L, Vlad V, Zufferey P, Iagnocco A. Definition and Reliability Assessment of Elementary Ultrasonographic Findings in Calcium Pyrophosphate Deposition Disease: A Study by the OMERACT Calcium Pyrophosphate Deposition Disease Ultrasound Subtask Force. J Rheumatol 2017; 44:1744-1749. [PMID: 28250136 DOI: 10.3899/jrheum.161057] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2017] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To define the ultrasonographic characteristics of calcium pyrophosphate crystal (CPP) deposits in joints and periarticular tissues and to evaluate the intra- and interobserver reliability of expert ultrasonographers in the assessment of CPP deposition disease (CPPD) according to the new definitions. METHODS After a systematic literature review, a Delphi survey was circulated among a group of expert ultrasonographers, who were members of the CPPD Ultrasound (US) Outcome Measures in Rheumatology (OMERACT) subtask force, to obtain definitions of the US characteristics of CPPD at the level of fibrocartilage (FC), hyaline cartilage (HC), tendon, and synovial fluid (SF). Subsequently, the reliability of US in assessing CPPD at knee and wrist levels according to the agreed definitions was tested in static images and in patients with CPPD. Cohen's κ was used for statistical analysis. RESULTS HC and FC of the knee yielded the highest interobserver κ values among all the structures examined, in both the Web-based (0.73 for HC and 0.58 for FC) and patient-based exercises (0.55 for the HC and 0.64 for the FC). Kappa values for the other structures were lower, ranging from 0.28 in tendons to 0.50 in SF in the static exercise and from 0.09 (proximal patellar tendon) to 0.27 (triangular FC of the wrist) in the patient-based exercise. CONCLUSION The new OMERACT definitions for the US identification of CPPD proved to be reliable at the level of the HC and FC of the knee. Further studies are needed to better define the US characteristics of CPPD and optimize the scanning technique in other anatomical sites.
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Hardy S, Hashemi K, Catanese M, Candil M, Zufferey P, Gabison E, Guex-Crosier Y. Necrotising Scleritis and Peripheral Ulcerative Keratitis Associated with Rheumatoid Arthritis Treated with Rituximab. Klin Monbl Augenheilkd 2017; 234:567-570. [DOI: 10.1055/s-0042-121315] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Alpizar-Rodriguez D, Brulhart L, Mueller RB, Möller B, Dudler J, Ciurea A, Walker UA, Von Mühlenen I, Kyburz D, Zufferey P, Mahler M, Bas S, Gascon D, Lamacchia C, Roux-Lombard P, Lauper K, Nissen MJ, Courvoisier DS, Gabay C, Finckh A. The prevalence of anticitrullinated protein antibodies increases with age in healthy individuals at risk for rheumatoid arthritis. Clin Rheumatol 2017; 36:677-682. [DOI: 10.1007/s10067-017-3547-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 12/21/2016] [Accepted: 01/14/2017] [Indexed: 12/20/2022]
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Candil M, Zufferey P. [Anti-IL-6 : new therapeutic trends]. REVUE MEDICALE SUISSE 2017; 13:105-109. [PMID: 28703549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The anti-IL-6 tocilizumab is a recognized treatment in rheumatoid arthritis and in systemic juvenile idiopathic arthritis. Almost ten years after its first use, there is more information about its security profile and its indication should be extended to other systemic inflammatory diseases, such as the giant cell arteritis. New molecules targetting the IL-6 pathway are under validation : sarilumab, sirukumab and olokizumab. Here is a brief state of the future outlook and trends of this therapeutic class.
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Omoumi P, Zufferey P, Malghem J, So A. Imaging in Gout and Other Crystal-Related Arthropathies. Rheum Dis Clin North Am 2016; 42:621-644. [PMID: 27742018 DOI: 10.1016/j.rdc.2016.07.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In this article, the authors consider the manifestations of intraarticular and periarticular crystal deposits. Most cases of crystal deposits are asymptomatic and represent incidental findings at imaging. In symptomatic arthropathies, imaging can play an important role in the diagnosis and assessment of disease progression and the extent of crystal deposits. Conventional radiography is the most common imaging modality. But ultrasound, conventional computerized tomography (CT), dual-energy CT, and MRI play an increasing role. The authors review typical radiographic features of crystal-induced arthropathies and findings that help to differentiate them. The authors also emphasize the increasing role of complementary imaging techniques.
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Adinolfi A, Filippou G, Scirè C, Damjanov N, Carrara G, Picerno V, Toscano C, Bruyn G, D'Agostino M, Delle Sedie A, Filippucci E, Gutierrez M, Micu M, Moller I, Naredo E, Pascal Z, Pineda C, Porta F, Schmidt W, Terslev L, Vlad V, Zufferey P, Frediani B, Iagnocco A. FRI0517 The Omeract Ultrasonographic Criteria for Elementary Lesions in Calcium Pyrophosphate Deposition Disease: Results of A Delphi Process by Ultrasound Working Group. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Alpizar-Rodriguez D, Brulhart L, Müller R, Möller B, Dudler J, Ciurea A, Walker U, Von Mühlenen I, Kyburz D, Zufferey P, Mahler M, Bas S, Gascon D, Lamacchia C, Roux-Lombard P, Lauper K, Nissen M, Courvoisier D, Gabay C, Finckh A. FRI0071 Predictors for The Development of anti-Citrullinated Protein Antibodies in Individuals Genetically at Risk for Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Galeazzi M, Voll R, Sebastiani G, Bazzichi L, Viapiana O, Dudler J, Sarzi-Puttini P, Selvi E, Iuliano A, Pedretti M, Giovannoni L, Bindi I, Bettini C, Ravenni N, Wilton J, Zufferey P, Ferraccioli G, Caporali R, Specker C, Wollenhaupt J, Neri D. AB0364 A Novel Approach for Rheumatoid Arthritis: Results of The Ongoing Clinical Trials with The Fully Human Immunocytokine Dekavil (F8-IL10). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Brulhart L, Alpizar-Rodriguez D, Zufferey P, Bas S, Gascon D, Lamacchia C, Roux-Lombard P, Ciubotariu E, Nissen M, Gabay C, Finckh A. SAT0072 Ultrasound Is Associated with Late Phases Preceding The Clinical Onset of Rheumatoid Arthritis in Individuals Genetically at Risk. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.6084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Alpizar-Rodriguez D, Müller R, Möller B, Dudler J, Ciurea A, Von Mühlenen I, Kyburz D, Zufferey P, Bas S, Gascon D, Lamacchia C, Roux-Lombard P, Lauper K, Courvoisier D, Gabay C, Finckh A. AB0178 Menopause Is A Predictor for The Development of Anti-Citrullinated Protein Antibodies in Women at Risk for Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Möller B, Zufferey P, Brulhart L, Tamborrini G, Nydegger A, Dan D, Grobety V, Nissen M, Staerkle A, Finckh A, Aubry-Rozier B, Ziswiler HR, Andor M, Atkinson A, Scherer A. FRI0522 Ultrasound-Detected Synovitis May Predict Radiographic Damage Progression in Rheumatoid Arthritis over The Next Five Years – A Prospective Cohort Study Nested in The Swiss Quality Management Program (SCQM). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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44
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Filippou G, Scirè C, Damjanov N, Adinolfi A, Carrara G, Picerno V, Toscano C, Bruyn G, D'Agostino M, Delle Sedie A, Filippucci E, Gutierrez M, Micu M, Moller I, Naredo E, Pineda C, Porta F, Schmidt W, Terslev L, Vlad V, Zufferey P, Frediani B, Iagnocco A. OP0122 Inter-Reader and Intra-Reader Reliability of The New Omeract Ultrasonographic Criteria for The Diagnosis of CPPD. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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45
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Nissen M, Lamacchia C, Bas S, Roux-Lombard P, Courvoisier D, Kyburz D, Moeller B, Ciurea A, Mueller R, Zufferey P, Bentow C, Finckh A, Mahler M, Gabay C. FRI0088 Comparison of Rheumatoid Factor, Anti-Citrullinated Protein Antibodies, Anti-Carbamylated Protein Antibody, Anti-Peptidyl Arginine Deiminase Type-3 Antibodies and Calprotectin in Patients with Rheumatoid Arthritis and Spondyloarthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Omoumi P, Larbi A, Zufferey P, So A, Becce F, Vande Berg B, Malghem J. [MRI of axial spondyloarthritis: diagnostic role and pitfalls]. REVUE MEDICALE SUISSE 2016; 12:495-502. [PMID: 27089638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
MRI has become a major tool for the diagnosis of axial spondyloarthritis and provides objective signs based on which therapy can be initiated. In clinical practice, ASAS classification criteria are often applied for the diagnosis of spondyloarthritis at a pre-radiographic stage. However, MRI signs of spondyloarthritis as stated in ASAS criteria lack specificity, and can be encountered in a wide array of diagnoses, in particular degenerative and mechanical conditions. In this article, we will review the role of MRI in the diagnosis and classification of spondyloarthritis, general technical considerations, the elementary MRI signs of axial spondyloarthritis, as well as diagnostic pitfalls. We also provide a practical approach on how to avoid overdiagnosis of spondyloarthritis and to improve the diagnostic value of MRI.
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Zufferey P. [New synthetic and biologic treatments for spondylarthritis]. REVUE MEDICALE SUISSE 2016; 12:512-516. [PMID: 27089641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The only biological treatments recognized and reimbursed for spondylarthritis in Switzerland are anti TNF. Other effective agents in rheumatoid arthritis were found to be of little use in this indication. Fortunately, in recent years appeared biological molecules blocking cytokines involved in new pathways of inflammation in particular that of IL7. They have been very effective against psoriasis and have a high potential in psoriatic arthritis and spondylarthritis. In parallel, synthetic small molecules capable of modulating the production of intracellular cytokines begin to be marketed. They also are potentially active in the same rheumatic diseases. The purpose of this article is to review these new drugs, in particular to review the progress of their development and commercialization status.
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Chevalier-Ruggeri P, Zufferey P. [Intra-articular infiltrations in rheumatology: update]. REVUE MEDICALE SUISSE 2016; 12:90-94. [PMID: 26946713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Intra-articular treatments are very useful in the daily practice of rheumatology, although their survival in the joint cavity is short and their mode of action still widely misunderstood. Corticosteroids were first used in fifty's, and are still the most widely used, despite potential local and systemic side effects. In recentyears, other molecules have been developed, especially in the treatment of osteoarthritis, but their effectiveness is controversial. Therapeutic trials were conducted with biological treatments in inflammatory arthritis, without success so far In the area of biotechnology, molecules to increase the survival of drugs into the joint are in preparation.
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Cunningham S, Maulucci F, Zufferey P, Ribi C, Maillard MH. [Whipple's disease, when to think about it?]. REVUE MEDICALE SUISSE 2015; 11:1582-1586. [PMID: 26502617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Whipple's disease is a chronic, systemic, bacterial infection caused by Tropheryma whipplei. Its cardinal symptoms include intermittent and recurrent arthralgia or arthritis together with chronic diarrhoea, abdominal pain and weight loss. It may mimick many chronic inflammatory diseases, and the diagnosis remains a challenge. Salivary and faecal quantitative PCR for T. whipplei should be ensued, if positive, by an upper endoscopy for duodenal biopsies. The treatment consists of a combination of oral doxycycline and hydroxychloroquine for 12 months followed by life-long doxycycline. Whipple's disease, although rare, is an entity that should be considered regularly, as its progression may be fatal if left untreated.
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Zufferey P, Perreau M, So A. High level of anti-drug antibodies after intra-articular injection of anti-TNF. Rheumatology (Oxford) 2015; 54:2291-2. [PMID: 26320135 DOI: 10.1093/rheumatology/kev325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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