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Luo Q, Zhang Y, Yang X, Qin L, Wang H. Hypertension in connective tissue disease. J Hum Hypertens 2024; 38:19-28. [PMID: 35505225 DOI: 10.1038/s41371-022-00696-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 02/23/2022] [Accepted: 04/12/2022] [Indexed: 11/10/2022]
Abstract
It is well documented that connective tissue disease (CTD) is a type of autoimmune disease characterized by chronic inflammation, which can occur across various organ systems throughout the whole body. Although the clinical manifestations of CTD are different, studies have shown that different CTD diseases have similar pathogenesis, implying that different CTD diseases may have similar clinical outcomes. Recent population-based studies have demonstrated an increased risk of cardiovascular disease (CVD) in patients with CTD compared with the control group, which is partially attributed to traditional cardiovascular risk factors, such as hypertension (HT), and that controlling the patients' blood pressure (BP) still constitutes one of the most effective means to prevent CVD. Although many studies have shown that the prevalence of HT in patients with CTD is higher than that in the general population, there is a lack of adequate data on the possible pathogenesis of HT. Also, the factors that promote the rise of BP, especially the relationship between connective tissue disease- hypertension (CTD-HT) and traditional cardiovascular risk factors (aging, sex, race, dyslipidemia, diabetes mellitus, smoking, obesity, etc.), have not been fully confirmed. In this review, we explore the mechanisms that might lead to elevated BP in patients with CTD and the factors that contribute to elevated BP and the management of CTD-HT, and we focus on whether traditional cardiovascular risk factors, the disease, and the presence of related therapeutic drugs are associated with an increased risk of HT in patients with CTD.
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Affiliation(s)
- Qiang Luo
- Department of Cardiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, 82 Qinglong St., Chengdu, Sichuan, China
| | - Yiwen Zhang
- Department of Cardiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, 82 Qinglong St., Chengdu, Sichuan, China
| | - Xiaoqian Yang
- Department of Cardiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, 82 Qinglong St., Chengdu, Sichuan, China
| | - Li Qin
- Department of Cardiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, 82 Qinglong St., Chengdu, Sichuan, China
| | - Han Wang
- Department of Cardiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, 82 Qinglong St., Chengdu, Sichuan, China.
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Yeh WB, Lee WK, Chou MC, Jou IM. Comments on the Risk of Gout in Patients with Psoriasis [Letter]. Clin Epidemiol 2022; 14:849-850. [PMID: 35874906 PMCID: PMC9297038 DOI: 10.2147/clep.s379488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/01/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Wen-Bin Yeh
- Emergency department, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan
| | - Wei-Kai Lee
- Emergency Department, Sinying Hospital, Ministry of Health and Welfare, Tainan, Taiwan.,Min-Hwei Junior College of Health Care Management, Tainan, Taiwan
| | - Mei-Chia Chou
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Pingtung County, Taiwan
| | - I-Ming Jou
- Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan
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ÖZYURT K, ZARARSIZ G, ERTAŞ R, CEPHE A, KUTLU Ö, ELMAS ÖF, AKKUŞ MR, KUTLU FN, ATASOY M. Survival of biological therapeutics in psoriasis: retrospective analysis of 3-years data in a Turkish registry, PSORTAKSIS. Turk J Med Sci 2022; 52:58-66. [PMID: 34365780 PMCID: PMC10734864 DOI: 10.3906/sag-2104-339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 02/22/2022] [Accepted: 08/07/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND TPSORTAKSIS is a psoriasis registry, which is used for follow-up of patients in Kayseri City Education and Research Hospital, Dermatology Clinic since 2016 in Turkey. PSORTAKSIS includes demographic data, follow-up clinical findings, laboratory output, and treatment information of patients. Here, drug survivals of biologic therapeutics (BT) according to three-year data of PSORTAKSIS will be presented. METHODS Drug survival of BT in PSORTAKSIS was analyzed from 2016 to March 2019. RESULTS 158 patients (111 of them BT-naive) with psoriasis under BT were enrolled in the current study. Drug survival analysis of patients with ongoing BT (158 treatment periods) revealed mean survival time as 15.49 months for ustekinumab, 15.37 months for adalimumab, 14.00 months for etanercept, 5 months for infliximab, and 4.59 months for secukinumab. The differences between drug survivals of BT were statistically significant (log-rank test, χ2 = 79.915, p < 0.0001).
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Affiliation(s)
- Kemal ÖZYURT
- Department of Dermatology and Venereology, Medicine Faculty, Ahi Evran University, Kırşehir,
Turkey
| | - Gökmen ZARARSIZ
- ERFARMA, Personalized Medicine and Advanced Analytics Research Group, Erciyes University, Kayseri,
Turkey
- Department of Biostatistics, Faculty of Medicine, Erciyes University Kayseri,
Turkey
| | - Ragıp ERTAŞ
- Department of Dermatology and Venereology, Kayseri City Hospital, Health Science University, Kayseri,
Turkey
| | - Ahu CEPHE
- ERFARMA, Personalized Medicine and Advanced Analytics Research Group, Erciyes University, Kayseri,
Turkey
| | - Ömer KUTLU
- Department of Dermatology and Venereology, School of Medicine, Tokat Gaziosmanpaşa University, Tokat,
Turkey
| | - Ömer Faruk ELMAS
- Department of Dermatology and Venereology, School of Medicine, Kırıkkale University, Kırıkkale,
Turkey
| | - Muhammed Reşat AKKUŞ
- Department of Dermatology and Venereology, Kayseri City Hospital, Health Science University, Kayseri,
Turkey
| | - Fatma Nur KUTLU
- Department of Dermatology and Venereology, Kayseri City Hospital, Health Science University, Kayseri,
Turkey
| | - Mustafa ATASOY
- Department of Dermatology and Venereology, Kayseri City Hospital, Health Science University, Kayseri,
Turkey
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Osuna CG, García SR, Martín JC, Jiménez VG, López FV, Santos-Juanes J. Use of Biological Treatments in Elderly Patients with Skin Psoriasis in the Real World. Life (Basel) 2021; 11:1348. [PMID: 34947880 PMCID: PMC8705752 DOI: 10.3390/life11121348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/26/2021] [Accepted: 12/02/2021] [Indexed: 12/24/2022] Open
Abstract
Biological drugs have prompted a revolution in the treatment of patients with psoriasis because of their favourable efficacy/risk profile. The aims of our study are to determine whether there is any difference in the pattern of use of biological treatments for older (65+ years) and younger patients diagnosed with plaque psoriasis by the Dermatology Service of the Hospital Universitario de Asturias (HUCA), to understand the survival of these drugs, and to identify the factors that predict the discontinuation of treatments. We report a retrospective observational hospital-based study of 300 patients registered at HUCA's Dermatology Service who were receiving one of the following biological treatments for psoriasis on 30 November 2020: adalimumab, ustekinumab, secukinumab, or ixekizumab. The age groups were compared using Student's t-test for quantitative variables and the chi-squared test for qualitative variables. We used the Kaplan-Meier estimator to estimate the survival function and the log-rank test to measure differences. No statistically significant differences in the frequency of use were noted between the younger and older groups, for any of the drugs studied. Survival on a drug regime, globally and individually, was similar in the two age groups. Factors predicting lower overall survival were being female, obesity, and having undergone previous biological treatment. The first three factors were influential in the under-65-year-old group, while arthritis was a significant factor for the older group.
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Affiliation(s)
- Cristina Galache Osuna
- Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Asturias, Spain; (C.G.O.); (S.R.G.); (J.C.M.); (F.V.L.)
| | - Sebastián Reyes García
- Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Asturias, Spain; (C.G.O.); (S.R.G.); (J.C.M.); (F.V.L.)
| | - Jimena Carrero Martín
- Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Asturias, Spain; (C.G.O.); (S.R.G.); (J.C.M.); (F.V.L.)
| | - Virginia García Jiménez
- Clinical Management Unit, UGC Farmacia, Hospital Universitario Central de Asturias, 33011 Oviedo, Asturias, Spain;
| | - Francisco Vázquez López
- Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Asturias, Spain; (C.G.O.); (S.R.G.); (J.C.M.); (F.V.L.)
- Dermatology, Instituto de Investigación Sanitaria del Principado de Asturias, IUOPA, University of Oviedo, 33011 Oviedo, Asturias, Spain
| | - Jorge Santos-Juanes
- Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Asturias, Spain; (C.G.O.); (S.R.G.); (J.C.M.); (F.V.L.)
- Dermatology, Instituto de Investigación Sanitaria del Principado de Asturias, IUOPA, University of Oviedo, 33011 Oviedo, Asturias, Spain
- Spanish Biomedical Research Network Centre in Oncology, CIBERONC, Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Madrid, Spain
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Galache Osuna C, Gómez-Vila B, Aubán Pariente J, Vázquez Losada B, Gómez de Castro C, Requena López S, de Dios Velázquez Á, Palacios García L, Ordoñez Fernández L, Gómez Diez S, Vázquez López F, Santos-Juanes J. Ustekinumab Drug Survival in Patients with Psoriasis: A retrospective Study of Real Clinical Practice. Medicina (B Aires) 2020; 56:medicina56110584. [PMID: 33143166 PMCID: PMC7693782 DOI: 10.3390/medicina56110584] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 11/21/2022] Open
Abstract
Background and objectives: The efficacy and safety of ustekinumab have been proved in clinical trials. In daily clinical practice, knowing the factors that determine survival differences of biological drugs allows psoriasis treatment to be optimized as a function of patient characteristics. The main objectives of this work are to understand ustekinumab drug survival in patients diagnosed with plaque psoriasis in the Hospital Universitario Central de Asturias (HUCA Dermatology Department, and to identify the predictors of drug discontinuation. Materials and Methods: A retrospective hospital-based study, including data from 148 patients who were receiving ustekinumab (Stelara®) between 1 February 2009 and 30 November 2019, were collected. Survival curves were approximated through the Kaplan–Meier estimator and compared using the log-rank test. Proportional hazard Cox regression models were used for multivariate analyses while both unadjusted and adjusted hazard ratios (HR) were used for summarizing the studied differences. Results: The average duration of the treatment before discontinuation was 47.57 months (SD 32.63 months; median 41 months). The retention rates were 82% (2 years), 66% (5 years), and 58% (8 years). Median survival was 80 months (95% confidence interval. CI 36.9 to 123.01 months). The survival study revealed statistically significant differences between patients with arthritis (log-rank test, p < 0.001) and those who had previously received biological treatment (log-rank test, p = 0.026). The five-year prevalence in patients still under treatment was 80% (those without arthritis) and 54% (arthritis patients). In the multivariate analysis, only the patients with arthritis had a lower rate of drug survival. No statistically significant differences were observed for any of the other comorbidities studied. The first and second most frequent causes of discontinuation were secondary failure and arthritis inefficacy, respectively. Conclusion: Ustekinumab is a biological drug conferring high survival in plaque psoriasis patients. Ustekinumab survival is lower in patients with arthritis.
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Affiliation(s)
- Cristina Galache Osuna
- Department of Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (C.G.O.); (B.G.-V.); (J.A.P.); (B.V.L.); (C.G.d.C.); (S.R.L.); (Á.d.D.V.); (L.P.G.); (S.G.D.); (F.V.L.)
| | - Borja Gómez-Vila
- Department of Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (C.G.O.); (B.G.-V.); (J.A.P.); (B.V.L.); (C.G.d.C.); (S.R.L.); (Á.d.D.V.); (L.P.G.); (S.G.D.); (F.V.L.)
| | - Javier Aubán Pariente
- Department of Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (C.G.O.); (B.G.-V.); (J.A.P.); (B.V.L.); (C.G.d.C.); (S.R.L.); (Á.d.D.V.); (L.P.G.); (S.G.D.); (F.V.L.)
| | - Beatriz Vázquez Losada
- Department of Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (C.G.O.); (B.G.-V.); (J.A.P.); (B.V.L.); (C.G.d.C.); (S.R.L.); (Á.d.D.V.); (L.P.G.); (S.G.D.); (F.V.L.)
| | - Celia Gómez de Castro
- Department of Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (C.G.O.); (B.G.-V.); (J.A.P.); (B.V.L.); (C.G.d.C.); (S.R.L.); (Á.d.D.V.); (L.P.G.); (S.G.D.); (F.V.L.)
| | - Sheila Requena López
- Department of Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (C.G.O.); (B.G.-V.); (J.A.P.); (B.V.L.); (C.G.d.C.); (S.R.L.); (Á.d.D.V.); (L.P.G.); (S.G.D.); (F.V.L.)
| | - Álvaro de Dios Velázquez
- Department of Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (C.G.O.); (B.G.-V.); (J.A.P.); (B.V.L.); (C.G.d.C.); (S.R.L.); (Á.d.D.V.); (L.P.G.); (S.G.D.); (F.V.L.)
| | - Laura Palacios García
- Department of Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (C.G.O.); (B.G.-V.); (J.A.P.); (B.V.L.); (C.G.d.C.); (S.R.L.); (Á.d.D.V.); (L.P.G.); (S.G.D.); (F.V.L.)
| | - Lucía Ordoñez Fernández
- Clinical Management Unit, UGC Farmacia, Hospital Universitario Central de Asturias, 33011 Oviedo, Asturias, Spain;
| | - Santiago Gómez Diez
- Department of Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (C.G.O.); (B.G.-V.); (J.A.P.); (B.V.L.); (C.G.d.C.); (S.R.L.); (Á.d.D.V.); (L.P.G.); (S.G.D.); (F.V.L.)
| | - Francisco Vázquez López
- Department of Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (C.G.O.); (B.G.-V.); (J.A.P.); (B.V.L.); (C.G.d.C.); (S.R.L.); (Á.d.D.V.); (L.P.G.); (S.G.D.); (F.V.L.)
- Area of Dermatology, Department of Medicine, University of Oviedo, 33011 Oviedo, Asturias, Spain
| | - Jorge Santos-Juanes
- Department of Dermatology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (C.G.O.); (B.G.-V.); (J.A.P.); (B.V.L.); (C.G.d.C.); (S.R.L.); (Á.d.D.V.); (L.P.G.); (S.G.D.); (F.V.L.)
- Area of Dermatology, Department of Medicine, University of Oviedo, 33011 Oviedo, Asturias, Spain
- Instittudo de Investigadión Sanitaria del Principado de Asturia (ISPA), Instituto Universitario Oncológico del Principado de Asturias (IUOPA), 33011 Oviedo, Asturias, Spain
- Correspondence:
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