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ŞAŞAK KUZGUN G, MURAT S, ÖZKÖK S, KASAPOGLU E. Sulfasalazine related nephrolithiasis in patients with rheumatoid arthritis and ankylosing spondylitis. TURKISH JOURNAL OF INTERNAL MEDICINE 2022. [DOI: 10.46310/tjim.1058021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Sulfasalazine (SSZ) is an anti-inflammatory and immunomodulatory drug used to treat many inflammatory diseases. Bacteria in the gut metabolize SSZ to active 5-aminosalicylic acid and inactive sulfapyridine. Sulfapyridine can crystallize in the kidney. We aimed to investigate the frequency of nephrolithiasis in patients who were diagnosed with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and who received SSZ treatment retrospectively.
Material and Methods We retrospectively analyzed the files of AS and RA patients in the rheumatology outpatient clinic between 2009 and 2018. We identified patients who underwent kidney ultrasonography at least six months after initiation of SSZ. One hundred six patients and 50 healthy adults were included in the study.
Results Only eight patients (6 AS, 2 RA) had nephrolithiasis on ultrasonography, but none in the control group (p=0.046). In logistic regression analysis, no correlation was found between gender, age, vitamin D, parathyroid hormone, and urinary calcium excretion with SSZ use (p>0.05).
Conclusion Although, it is noteworthy that these patients are prone to stone formation for various reasons. Therefore, paying attention to the patient’s hydration while using these drugs may prevent such side effects.
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Affiliation(s)
| | - Sadiye MURAT
- Istanbul Prof Dr Suleyman Yalcin City Hospital, Department of Physical Therapy and Rehabilitation
| | - Serçin ÖZKÖK
- Acibadem International Hospital, Department of Radiology
| | - Esen KASAPOGLU
- Istanbul Medeniyet University, Department of Rheumatology
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Urolithiasis in ankylosing spondylitis : a systematic review of the literature and meta-analysis. Joint Bone Spine 2022; 89:105388. [PMID: 35490944 DOI: 10.1016/j.jbspin.2022.105388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 11/21/2022]
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Onmaz DE, Isik K, Sivrikaya A, Abusoglu S, Gezer İA, Abusoglu G, Yerlikaya FH, Unlu A. Determination of serum methylarginine levels by tandem mass spectrometric method in patients with ankylosing spondylitis. Amino Acids 2021; 53:1329-1338. [PMID: 34273021 DOI: 10.1007/s00726-021-03046-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
Our aim in this study was to measure serum levels of methylarginines and related metabolites in patients with ankylosing spondylitis (AS), moreover, to investigate the relationship between these parameters and various clinical and laboratory parameters of patients with AS. The study included 60 patients with AS and 60 healthy volunteers. Serum asymmetric dimethylarginine (ADMA), L-N monomethylarginine (L-NMMA), symmetric dimethylarginine (SDMA), arginine (Arg), homoarginine (hArg), ornithine, and citrulline concentrations were measured with tandem mass spectrometry. In addition, participants were divided into three groups according to the treatment regimen: TNF-α inhibitor group (n = 25), conventional therapy group (n = 35), and control group (n = 60). These groups were compared in terms of serum levels of methylarginine pathway metabolites and various biochemical parameters. It was found that total methylated arginine load significantly increased in patients with AS (p < 0.001), and the Arg/ADMA ratio was positively correlated with HDL levels and negatively correlated with glucose, ESR, total cholesterol, triglyceride, and LDL levels. In addition, serum ADMA, SDMA, total methylated arginine load, and CRP levels were lower (p < 0.05) in the TNF-α group compared to the conventional treatment group. To the best of our knowledge, this is the first study to comprehensively investigate serum methylarginine levels in patients with AS. Elevated total methylated arginine load and decreased global arginine bioavailability ratio (GABR) indicate that NO metabolism is impaired in patients with AS. Therefore, the increased cardiovascular risk in patients with AS may be related to the decreased NO production or bioavailability due to the elevated total methylarginine load.
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Affiliation(s)
- Duygu Eryavuz Onmaz
- Department of Biochemistry, Selcuk University Faculty of Medicine Alaaddin Keykubat Campus, 42075, Selcuklu, Konya, Turkey.
| | - Kevser Isik
- Department of Physical Medicine and Rehabilitation, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Abdullah Sivrikaya
- Department of Biochemistry, Selcuk University Faculty of Medicine Alaaddin Keykubat Campus, 42075, Selcuklu, Konya, Turkey
| | - Sedat Abusoglu
- Department of Biochemistry, Selcuk University Faculty of Medicine Alaaddin Keykubat Campus, 42075, Selcuklu, Konya, Turkey
| | - İlknur Albayrak Gezer
- Department of Physical Medicine and Rehabilitation, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Gulsum Abusoglu
- Department of Medical Laboratory Techniques, Selcuk University Vocational School of Health, Konya, Turkey
| | - Fatma Humeyra Yerlikaya
- Department of Biochemistry, Selcuk University Faculty of Medicine Alaaddin Keykubat Campus, 42075, Selcuklu, Konya, Turkey
| | - Ali Unlu
- Department of Biochemistry, Selcuk University Faculty of Medicine Alaaddin Keykubat Campus, 42075, Selcuklu, Konya, Turkey
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Baillet A, Romand X, Pflimlin A, Dalecky M, Claudepierrec P, Flipo RM, Ruyssen-Witrand A, Gaudin P, Gossec L, Molto A, Lukas C, Pouplin S, Soubrier M, Wendling D, Fayet F, Hudry C, Senbel E, Schwartz M, Hacquard-Bouder C, Dougados M. Data to be collected for an optimal management of axial spondyloarthritis in daily practice: Proposal from evidence-based and consensual approaches. Joint Bone Spine 2020; 87:405-411. [PMID: 32428691 DOI: 10.1016/j.jbspin.2020.04.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/30/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To propose a list of variables to be collected right after the diagnosis has been made and during the follow-up of patients with axial spondyloarthritis (ax-SpA) for an optimal management in daily practice. METHODS The process comprised (1) the evaluation of the interest of 51 variables proposed for the assessment of ax-SpA by means of a systematic literature research; (2) a consensus process involving 78 hospital-based or office-based rheumatologists, considering the collection of each variable in a 4 grade scale from "not very useful/useless" to "mandatory"; (3) a consensus on the minimum interval of time for periodic assessment of the selected variables on a 5 grade scale from "at each visit" to "never to be re-collected". RESULTS The systematic literature research retrieved a total of 14,133 abstracts, of which 213 were included in the final qualitative synthesis. Data to be collected at the initial systematic review comprised 5 patient's self-administered questionnaires, 3 variables of the physician's interview, 2 variables of the physical examination, 2 variables of the specific ax-SpA imaging and 2 other investigations. Two variables were recommended to be systematically collected at each visit, 1 variable twice a year, 6 variables yearly and 1 variable every 2 years. CONCLUSIONS Using an evidence-based and an expert consensus approaches, this initiative defined a core set of variables to be collected and reported right after the diagnosis and during follow-up of patients with ax-SpA in daily practice.
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Affiliation(s)
- Athan Baillet
- University Grenoble Alpes, GREPI TIMC, CNRS UMR 5525, Grenoble, France.
| | - Xavier Romand
- University Grenoble Alpes, GREPI TIMC, CNRS UMR 5525, Grenoble, France
| | - Arnaud Pflimlin
- Rheumatology, R Salengro Hospital, University of Lille, Lille, France
| | - Mickael Dalecky
- University Grenoble Alpes, GREPI TIMC, CNRS UMR 5525, Grenoble, France
| | - Pascal Claudepierrec
- Departement de Rhumatologie, Henri Mondor Hospital, AP-HP, Université Paris Est Créteil, EA 7379 - EpidermE, 94010, Créteil, France
| | - René-Marc Flipo
- Rheumatology, R Salengro Hospital, University of Lille, Lille, France
| | - Adeline Ruyssen-Witrand
- Rheumatology, UMR 1027 Inserm, Paul Sabatier University and Purpan Hospital, Toulouse, France. Sorbonne Universités, UPMC Univ, Paris, France
| | - Philippe Gaudin
- University Grenoble Alpes, GREPI TIMC, CNRS UMR 5525, Grenoble, France
| | - Laure Gossec
- Sorbonne Université, inserm, Institut Pierre-Louis d'épidémiologie et de santé Publique, Paris, France; Pitié Salpêtrière hospital, AP-HP, Rheumatology department, Paris, France
| | - Anna Molto
- Paris Descartes University, Department of Rheumatology - Hôpital Cochin. Assistance publique-Hôpitaux de Paris. inserm (U1153): Clinical epidemiology and biostatistics, Université de Paris, Paris, France
| | - Cédric Lukas
- Department of Rheumatology, CHU Montpellier and UMR5535 CNRS, Montpellier, France
| | | | - Martin Soubrier
- Department of Rheumatology, Gabriel Montpied University Hospital, Clermont-Ferrand, France
| | - Daniel Wendling
- Department of Rheumatology, CHRU Besançon, and EA 4266, Université de Franche-Comté, Besançon, France
| | - Françoise Fayet
- Department of Rheumatology, Gabriel Montpied University Hospital, Clermont-Ferrand, France
| | - Christophe Hudry
- Department of Rheumatology - Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eric Senbel
- AP-HM, Rheumatology Department, Sainte Marguerite Hospital, Marseille, France
| | - Marjorie Schwartz
- Departement de Rhumatologie, Henri Mondor Hospital, AP-HP, Université Paris Est Créteil, EA 7379 - EpidermE, 94010, Créteil, France
| | | | - Maxime Dougados
- Paris Descartes University, Department of Rheumatology - Hôpital Cochin. Assistance publique-Hôpitaux de Paris. inserm (U1153): Clinical epidemiology and biostatistics, Université de Paris, Paris, France
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Xiao M, Lv Q, Zhang Y, Tu L, Yang M, Lin Z, Liao Z, Jiang Y, Zheng X, Li X, Wei Q, Cao S, Gu J. Spondyloarthritis Patients Suffer Increased Risk of Renal Complications Compared With General Population: A Retrospective Observational Study. Front Pharmacol 2019; 10:1073. [PMID: 31620002 PMCID: PMC6759995 DOI: 10.3389/fphar.2019.01073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/22/2019] [Indexed: 01/01/2023] Open
Abstract
The objective of this study was to identify the prevalence and risk factors of renal complications of spondyloarthritis (SpA) patients, and to assess increased risks compared to general people. We conducted a retrospective study enrolled with consecutive SpA patients from an inpatient department and age, sex-matched general population (GP). The renal disorders investigated in this study contained decreased estimated glomerular filtration rate (eGFR), hematuria, proteinuria and nephrolithiasis. A total of 350 admitted SpA patients with complete medical records and 323 age and sex-matched GP were enrolled. Most SpA patients were male (n = 283, 80.9%) and the mean age was 31.61 ± 10.73 years old. Among 350 SpA patients, 29 (8.8%) suffered from hematuria, six (1.8%) suffered from proteinuria, one (0.3%) had decreased eGFR, and 27 (13.0%) presented with nephrolithiasis. The relative risk (RR) of nephrolithiasis in SpA compared to the GP was 2.24 (95% CI, 1.00-4.98), and the RR of renal insufficiency was 2.04 (95% CI, 1.11-3.77). In a univariate analysis, nephrolithiasis was significantly associated with age, age of onset, smoking, extra-articular manifestation and a bamboo spine. Renal insufficiency was significantly associated with age, peripheral manifestation, serum albumin, C-reactive protein and erythrocyte sedimentation rate. In a multivariable analysis, only extra-articular manifestation (OR = 8.43, 95% CI, 1.65-43.06, p = 0.010) and bamboo spine (OR = 3.47, 95% CI, 1.01-12.06, p = 0.049) remained significantly associated with nephrolithiasis. However, no variable was recognized as an independent risk factor for renal insufficiency. Renal complications are more common in SpA patients, with more than two-fold increased risk compared with GP. Extra-articular manifestation and bamboo spine are independent risk factors of renal disease in SpA patients.
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Affiliation(s)
- Min Xiao
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qing Lv
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yanli Zhang
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Liudan Tu
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Mingcan Yang
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhiming Lin
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zetao Liao
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yutong Jiang
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xuqi Zheng
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaomin Li
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qiujing Wei
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shuangyan Cao
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jieruo Gu
- Department of Rheumatology and Immunology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Tang HY, Zhao Y, Li YZ, Wang TS. Efficacy of etoricoxib for ankylosing spondylitis: A protocol for systematic review of randomized controlled trial. Medicine (Baltimore) 2019; 98:e15155. [PMID: 30985692 PMCID: PMC6485787 DOI: 10.1097/md.0000000000015155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Previous clinical trials have reported that etoricoxib has been utilized to treat ankylosing spondylitis (AS) effectively. However, no study systematically investigated the efficacy and safety of etoricoxib for patients with AS. In this systematic review, we will assess the efficacy and safety of etoricoxib for AS. METHODS The following electronic databases will be searched from inception to the February 1, 2019: Cochrane Library, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Chinese Scientific Journal Database. This study will include randomized controlled trials that explore the efficacy and safety of etoricoxib for AS. The primary outcome is pain intensity, as measured by any pain scales, such as Numerical Rating Scale. The secondary outcomes consist of AS function, as measured by Bath Ankylosing Spondylitis Functional Index, or other tools; quality of life, as assessed by Ankylosing Spondylitis Quality of Life questionnaire or any other relevant instruments; as well as adverse events. Two authors will independently carry out the study selection, data extraction, and risk of bias assessment. Statistical analysis will be performed by using RevMan 5.3 software. RESULTS This systematic review will provide a detailed summary of present evidence related to the efficacy and safety of etoricoxib for patients with AS. CONCLUSION The results of this study may provide management guidance for AS treated by etoricoxib. DISSEMINATION AND ETHICS This systematic review dose not needs ethical approval, because it will not analyze individual patient data. The findings of this study are expected to publish through a peer-reviewed journal. SYSTEMATIC REVIEW REGISTRATION CRD42019124768.
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Affiliation(s)
- Hua-yu Tang
- Second Ward of Orthopedis Department, First Affiliated Hospital of Jiamusi University, Jiamusi, China
| | - Yu Zhao
- Department of Orthopedis, Huludao Central Hospital, Huludao, China
| | - Yu-zhi Li
- Department of Urology, First Affiliated Hospital of Jiamusi University, Jiamusi, China
| | - Tian-shu Wang
- Second Ward of Orthopedis Department, First Affiliated Hospital of Jiamusi University, Jiamusi, China
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Korkmaz C, Cansu DU. Comment on: Managing morbidity and treatment-related toxicity in patients with ankylosing spondylitis. Rheumatology (Oxford) 2018; 57:1871-1872. [DOI: 10.1093/rheumatology/key239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Cengiz Korkmaz
- Department of Internal Medicine, Division of Rheumatology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Döndü U Cansu
- Department of Internal Medicine, Division of Rheumatology, Eskisehir Osmangazi University, Eskisehir, Turkey
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Sommerfleck F, Schneeberger E, Citera G. Comorbidities in Argentine patients with axial spondyloarthritis: Is nephrolithiasis associated with this disease? Eur J Rheumatol 2018; 5:169-172. [PMID: 30071942 DOI: 10.5152/eurjrheum.2018.18002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 01/31/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The objective of this study was to compare the frequency of comorbidities among patients with ax-SpA in the general population and to evaluate the impact of these comorbidities on the functional status and quality of life. METHODS Patients with ax-SpA fulfilling the modified New York 1984 criteria for Ankylosing Spondylitis (AS) and/or Assessment of SpondyloArthritis International Society (ASAS) 2009 criteria for patients with ax-SpA belonging to the ESPAXIA cohort ("Estudio de eSPondiloartritis Axial Irep Argentina") were included. Data regarding sociodemographics, comorbidities, and disease characteristics were recorded. Statistical analysis included descriptive statistics using the student t-test, Chi-square, and Fisher's exact test. Multiple logistic regression analysis was performed. A p value <0.05 was considered significant. RESULTS In total, 86 patients were included, 80% were males with a median age of 46 years (interquartile range [IQR]: 32-58) and a median disease duration of 19 years (IQR: 13-31). The most frequent comorbidities reported were hypertension (26.7%), gastritis (25.6%), dyslipidemia (24.4%), gallstone (12.8%), nephrolithiasis (11.6%), anemia (10.5%), hypothyroidism (7%), and type 2 diabetes (6%). The prevalence of these comorbidities in patients with ax-SpA was similar to that observed in the general population, with the exception of a higher frequency of nephrolithiasis among patients with ax-SpA (11.6% in ax-SpA vs 3.96% in the general population). We further categorized the study population into three groups: patients with no comorbidities, those with 1 or 2 comorbidities, and those with ≥3 comorbidities. The presence of ≥3 comorbidities was associated with older age, longer disease duration, worse disease activity, functional status, and quality of life as compared with the patients without comorbidities. In multivariate analysis, older age was the only variable independently associated with the presence of comorbidities. CONCLUSION The frequency of comorbidities in the ax-SpA cohort was high, and the only variable associated with a higher prevalence of comorbidities was older age. Nephrolithiasis was more frequent in the patients with ax-SpA than that reported in the general population.
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Affiliation(s)
- Fernando Sommerfleck
- Department of Rheumatology, Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | - Emilce Schneeberger
- Department of Rheumatology, Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | - Gustavo Citera
- Department of Rheumatology, Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
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