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Terrone G, Gragnaniello V, Esposito A, Del Puente A, Del Giudice E. Effects of antiepileptic therapy on bone mineral status evaluated by phalangeal quantitative ultrasound in pediatric patients with epilepsy and motor impairment. Minerva Pediatr (Torino) 2023; 75:476-481. [PMID: 31129950 DOI: 10.23736/s2724-5276.18.05235-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND In epileptic patients with motor disability, it's difficult to disentangle the effects of antiepileptic drugs (AEDs) on bone health from those provoked by impaired mobility. The aim of this study was to evaluate the effects of AEDs on bone mineral status by phalangeal quantitative ultrasound (QUS), a no-radiation and non-invasive method, in pediatric patients with motor impairment and epilepsy. METHODS We enrolled 56 patients (31 females, 25 males) with epilepsy and motor impairment and 24 children with only motor disability (13 females, 11 males). Patients were stratified by Gross Motor Function Classification System Scale (GMFCS) in 4 groups: group A1 with epilepsy and mild motor impairment (GMFCS levels I-II), group A2 with only mild motor impairment, group B1 with epilepsy and severe motor impairment (GMFCS levels III-V), group B2 with only severe motor impairment. The bone mineral status was evaluated by phalangeal QUS and amplitude-dependent speed of sound (AD-SoS) Z-score was calculated for each patient. RESULTS The four groups showed no significant differences in age, gender and 25-hydroxyvitamin D levels. The group B1 had a statistically lower amplitude-dependent speed of sound Z-score as compared to group A2 (P<0.05). The multivariate analysis of independent factors revealed a significant correlation between amplitude-dependent speed of sound Z-score and Gross Motor Function Classification System levels (P=0.004). The mean Z-score value decreased by 0.53, increasing the motor impairment. CONCLUSIONS The bone mineral status measured as AD-SoS strongly correlates with severity of motor disability evaluated by GMFCS as compared to antiepileptic therapy and 25-hydroxyvitamin D levels.
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Affiliation(s)
- Gaetano Terrone
- Section of Pediatrics, Department of Translational Medicine, University of Naples Federico II, Naples, Italy -
| | - Vincenza Gragnaniello
- Section of Pediatrics, Department of Translational Medicine, University of Naples Federico II, Naples, Italy
| | - Antonella Esposito
- Unit of Rheumatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Antonio Del Puente
- Unit of Rheumatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Ennio Del Giudice
- Section of Pediatrics, Department of Translational Medicine, University of Naples Federico II, Naples, Italy
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Tasso M, Del Puente A, Navarini L, Currado D, Giacomelli R, Scarpa R, Costa L, Caso F. Patrick-FABER test in detecting active sacroiliitis in spondyloarthritis patients: a prospective study using magnetic resonance as reference standard. Clin Exp Rheumatol 2021; 40:1451-1452. [DOI: 10.55563/clinexprheumatol/4igmus] [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] [Received: 10/23/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Marco Tasso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Luca Navarini
- Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Italy
| | - Damiano Currado
- Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Italy
| | - Roberto Giacomelli
- Rheumatology, Immunology and Clinical Medicine Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy.
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
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Tasso M, Mostacciuolo E, Ugoccioni V, Del Puente A, Peluso R, Scarpa R, Costa L, Caso F. COVID-19 clinical spectrum in psoriatic arthritis patients on biologics and tsDMARDs: results from a cohort at an Italian epicentre of the pandemic's third wave. Clin Exp Rheumatol 2021; 40:1061. [DOI: 10.55563/clinexprheumatol/8839ak] [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] [Received: 06/16/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Marco Tasso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Erika Mostacciuolo
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Valentina Ugoccioni
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Rosario Peluso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Lupoli GA, Tasso M, Costa L, Caso F, Scarpa R, Del Puente A, Peluso R. Coeliac disease is a risk factor for the development of seronegative arthritis in patients with autoimmune thyroid disease. Rheumatology (Oxford) 2021; 60:2440-2447. [PMID: 33197262 DOI: 10.1093/rheumatology/keaa640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/20/2020] [Revised: 08/16/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Hashimoto's thyroiditis is known to cluster with other systemic autoimmune disorders. Rheumatic manifestations, such as a seronegative non-erosive polyarthritis have been described. The aim of this study was to evaluate the characteristics and the prevalence of rheumatic features in thyroiditis patients, and to ascertain whether the association with systemic autoimmune disorders improved the arthritis manifestations. METHODS In total, 180 thyroiditis patients were enrolled. Major clinical and demographic characteristics have been recorded. Patients underwent a rheumatological clinical assessment and extra-articular manifestations allowing for a differential diagnosis with systemic autoimmune diseases and spondyloarthropathy. Presence of systemic autoimmune diseases was recorded. RESULTS A total of 8.33% of thyroiditis patients shown a peripheral inflammatory arthritis (P = 0.002). Female gender (P = 0.042) and thyroid peroxidase (TPOAbs) positivity (P = 0.001) were more frequent. In total, 37 patients had systemic autoimmune diseases (P = 0.0003). A significant high prevalence of coeliac disease and Addison disease was found (P = 0.034 and P = 0.049, respectively). In patients with coeliac disease, the articular manifestations were more frequent (21.21%) (P = 0.001) and the risk to develop joint involvement was 2.96. CONCLUSION Although we found an articular involvement in about one-third of thyroiditis patients, the prevalence of inflammatory arthropathy was only 8.33%. The prevalence of other coexisting autoimmune disorders was 34.26% with a significant prevalence of coeliac disease (7.41%). Thyroiditis patients with coeliac disease have an articular involvement more frequently than those without. In these patients, we have found a high risk of developing arthritis than patients with only thyroiditis, suggesting cumulative autoimmune effects in the developing articular involvement.
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Affiliation(s)
| | - Marco Tasso
- Department of Clinical Medicine and Surgery, Rheumatology Unit, Federico II University of Naples, Naples, Italy
| | - Luisa Costa
- Department of Clinical Medicine and Surgery, Rheumatology Unit, Federico II University of Naples, Naples, Italy
| | - Francesco Caso
- Department of Clinical Medicine and Surgery, Rheumatology Unit, Federico II University of Naples, Naples, Italy
| | - Raffaele Scarpa
- Department of Clinical Medicine and Surgery, Rheumatology Unit, Federico II University of Naples, Naples, Italy
| | - Antonio Del Puente
- Department of Clinical Medicine and Surgery, Rheumatology Unit, Federico II University of Naples, Naples, Italy
| | - Rosario Peluso
- Department of Clinical Medicine and Surgery, Rheumatology Unit, Federico II University of Naples, Naples, Italy
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Scarpa R, Caso F, Costa L, Passavanti S, Vitale MG, Trojaniello C, Del Puente A, Ascierto PA. May the analysis of 1918 influenza pandemic give hints to imagine the possible magnitude of Corona Virus Disease-2019 (COVID-19)? J Transl Med 2020; 18:489. [PMID: 33353549 PMCID: PMC7753514 DOI: 10.1186/s12967-020-02673-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/10/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In 1918 an unknown infectious agent spread around the world infecting over one-third of the general population and killing almost 50 million people. Many countries were at war, the First World War. Since Spain was a neutral country and Spanish press could report about the infection without censorship, this condition is commonly remembered as "Spanish influenza". This review examines several aspects during the 1918 influenza pandemic to bring out evidences which might be useful to imagine the possible magnitude of the present coronavirus disease 2019 (COVID-19). METHODS In the first part of this review we will examine the origin of the SARS-Coronavirus-2 and 1918 Spanish Influenza Virus and the role played by host and environment in its diffusion. We will also include in our analysis an evaluation of different approaches utilized to restrain the spread of pandemic and to treat infected patients. In the second part, we will try to imagine the magnitude of the present COVID-19 pandemic and the possible measures able to restrain in the present environment its spread. RESULTS Several factors characterize the outcome in a viral pandemic infection. They include the complete knowledge of the virus, the complete knowledge of the host and of the environment where the host lives and the pandemic develops. CONCLUSION By comparing the situation seen in 1918 with the current one, we are now in a more favourable position. The experience of the past teaches us that their success is linked to a rapid, constant and lasting application. Then, rather than coercion, awareness of the need to observe such prevention measures works better.
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Affiliation(s)
- Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio, Pansini 5, 80131, Naples, Italy.
| | - Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio, Pansini 5, 80131, Naples, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio, Pansini 5, 80131, Naples, Italy
| | - Saverio Passavanti
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio, Pansini 5, 80131, Naples, Italy
| | - Maria Grazia Vitale
- Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Naples, Italy
| | - Claudia Trojaniello
- Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Naples, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio, Pansini 5, 80131, Naples, Italy
| | - Paolo A Ascierto
- Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Naples, Italy
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Caso F, Del Puente A, Girolimetto N, Tasso M, Caso C, Scarpa R, Costa L. Improving telemedicine and in-person management of rheumatic and autoimmune diseases,during and after COVID-19 pandemic outbreak. Definite need for more Rheumatologists. Response to: 'Can telerheumatology improve rheumatic and musculoskeletal disease service delivery in sub-Saharan Africa?' by Akpabio et al. Ann Rheum Dis 2020; 81:e143. [PMID: 32723750 DOI: 10.1136/annrheumdis-2020-218472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/17/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Francesco Caso
- Department of Clinical Medicine and Surgery, University of Naples Federico II, School of Medicine and Surgery, Napoli, Campania, Italy
| | - Antonio Del Puente
- Department of Clinical Medicine and Surgery, University of Naples Federico II, School of Medicine and Surgery, Napoli, Campania, Italy
| | - Nicolò Girolimetto
- Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Emilia Romagna, Italy
| | - Marco Tasso
- Department of Clinical Medicine and Surgery, University of Naples Federico II, School of Medicine and Surgery, Napoli, Campania, Italy
| | - Corrado Caso
- Italian Federation of General Practitioners, FIMMG, Salerno, Italy
| | - Raffaele Scarpa
- Department of Clinical Medicine and Surgery, University of Naples Federico II, School of Medicine and Surgery, Napoli, Campania, Italy
| | - Luisa Costa
- Department of Clinical Medicine and Surgery, University of Naples Federico II, School of Medicine and Surgery, Napoli, Campania, Italy
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Costa L, Tasso M, Scotti N, Mostacciuolo E, Girolimetto N, Foglia F, Del Puente A, Scarpa R, Caso F. Telerheumatology in COVID-19 era: a study from a psoriatic arthritis cohort. Ann Rheum Dis 2020; 80:e46. [PMID: 32527866 DOI: 10.1136/annrheumdis-2020-217806] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 05/07/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II Scuola di Medicina e Chirurgia, Napoli, Campania, Italy
| | - Marco Tasso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II Scuola di Medicina e Chirurgia, Napoli, Campania, Italy
| | - Nadia Scotti
- Rheumatology Unit, Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II Scuola di Medicina e Chirurgia, Napoli, Campania, Italy
| | - Erika Mostacciuolo
- Rheumatology Unit, Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II Scuola di Medicina e Chirurgia, Napoli, Campania, Italy
| | - Nicolò Girolimetto
- Rheumatology Unit, Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II Scuola di Medicina e Chirurgia, Napoli, Campania, Italy
| | - Francesca Foglia
- Rheumatology Unit, Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II Scuola di Medicina e Chirurgia, Napoli, Campania, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II Scuola di Medicina e Chirurgia, Napoli, Campania, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II Scuola di Medicina e Chirurgia, Napoli, Campania, Italy
| | - Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II Scuola di Medicina e Chirurgia, Napoli, Campania, Italy
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Affiliation(s)
- Raffaele Scarpa
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, via S. Pansini 5, 80131, Naples, Italy.
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Caso F, Chimenti MS, Navarini L, Ruscitti P, Peluso R, Girolimetto N, Del Puente A, Giacomelli R, Scarpa R, Costa L. Metabolic Syndrome and psoriatic arthritis: considerations for the clinician. Expert Rev Clin Immunol 2020; 16:409-420. [PMID: 32149545 DOI: 10.1080/1744666x.2020.1740593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 12/12/2022]
Abstract
Introduction: Metabolic Syndrome (MetS) is strictly interconnected with systemic inflammation, and increased evidence has described a close link between this condition and Psoriatic Arthritis (PsA).Areas covered: This review summarizes main studies exploring clinical aspects and prevalence of MetS in PsA cohorts. Further, there is accumulating evidence showing shared inflammatory pathways between MetS, its components, and PsA.Expert opinion: The high prevalence of MetS in PsA highlights the need for screening, evaluation, and close monitoring of MetS and its components (namely, diabetes mellitus, obesity, hypertension, and dyslipidemia) in psoriatic patients.Further studies should focus on the pathogenetic link between MetS and PsA. More studies are required to identify appropriate algorithms for the assessment and management of MetS in PsA patients.
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Affiliation(s)
- Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Luca Navarini
- Unit of Allergology, Clinical Immunology and Rheumatology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Piero Ruscitti
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Rosario Peluso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Nicolò Girolimetto
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.,Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Roberto Giacomelli
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
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Caso F, Navarini L, Ruscitti P, Chimenti MS, Girolimetto N, Del Puente A, Giacomelli R, Scarpa R, Costa L. Targeted synthetic pharmacotherapy for psoriatic arthritis: state of the art. Expert Opin Pharmacother 2020; 21:785-796. [PMID: 32057269 DOI: 10.1080/14656566.2020.1726317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/07/2023]
Abstract
INTRODUCTION In recent years, different studies regarding psoriatic arthritis (PsA) have shown the pathogenetic role of dysfunction of signaling pathways involving the phosphodiesterase-4 enzyme and transcription factors or enzymes belonging to the kinase (JAK)-signal family pathway. These also represent the target of several drugs known as targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs). AREAS COVERED The authors performed a systematic literature search using the PubMed database, as well as through retrieving data from randomized controlled trials, their post-hoc analysis, and pooled data analysis on the efficacy and safety profile of the PDE4 inhibitor (PDE4i), apremilast, and the inhibitors of JAK (JAKis), tofacitinib, filgotinib, baricitinib, and upadacitinib, in PsA. EXPERT OPINION In PsA, the PDE4i, apremilast, and the JAKi, tofacitinib, are effective across multiple clinical domains and have an acceptable tolerability profile, thus expanding the treatment options available for PsA patients. Apremilast and tofacitinib show several advantages mainly represented by their oral administration, a fast onset of action, and a short half-life. Data on tsDMARDs in PsA are still limited, and randomized trials and real-life studies are advocated.
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Affiliation(s)
- Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II , Naples, Italy
| | - Luca Navarini
- Unit of Allergology, Clinical Immunology and Rheumatology, Università Campus Bio-Medico Di Roma , Rome, Italy
| | - Piero Ruscitti
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila , L'Aquila, Italy
| | - Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of System Medicine, University of Rome Tor Vergata , Rome, Italy
| | - Nicolò Girolimetto
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II , Naples, Italy.,Department of Rheumatology, Azienda USL-IRCCS Di Reggio Emilia , Reggio Emilia, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II , Naples, Italy
| | - Roberto Giacomelli
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila , L'Aquila, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II , Naples, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II , Naples, Italy
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Terrone G, Gragnaniello V, Esposito A, Del Puente A, Del Giudice E. Effects of antiepileptic therapy on bone mineral status evaluated by phalangeal quantitative ultrasound in pediatric patients with epilepsy and motor impairment. Minerva Pediatr 2019:S0026-4946.18.05235-0. [PMID: 31129950 DOI: 10.23736/s0026-4946.18.05235-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In epileptic patients with motor disability, it's difficult to disentangle the effects of antiepileptic drugs (AEDs) on bone health from those provoked by impaired mobility. The aim of this study was to evaluate the effects of AEDs on bone mineral status by phalangeal quantitative ultrasound (QUS), a no-radiation and non-invasive method, in pediatric patients with motor impairment and epilepsy. METHODS We enrolled 56 patients (31 females, 25 males) with epilepsy and motor impairment and 24 children with only motor disability (13 females, 11 males). Patients were stratified by Gross Motor Function Classification System Scale (GMFCS) in 4 groups: group A1 with epilepsy and mild motor impairment (GMFCS levels I-II), group A2 with only mild motor impairment, group B1 with epilepsy and severe motor impairment (GMFCS levels III-V), group B2 with only severe motor impairment. The bone mineral status was evaluated by QUS and amplitude-dependent speed of sound (AD-SoS) Z-score was calculated for each patient. RESULTS The four groups showed no significant differences in age, gender and 25- hydroxyvitamin D levels. The group B1 had a statistically lower amplitude-dependent speed of sound Z-score as compared to group A2 (p<0.05). The multivariate analysis of independent factors revealed a significant correlation between amplitude-dependent speed of sound Z-score and Gross Motor Function Classification System levels (p=0.004). The mean Z-score value decreased by 0.53, increasing the motor impairment. CONCLUSIONS The bone mineral status measured as AD-SoS strongly correlates with severity of motor disability evaluated by GMFCS as compared to antiepileptic therapy and 25-hydroxyvitamin D levels.
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Affiliation(s)
- Gaetano Terrone
- Section of Pediatrics, Department of Translational Medicine, University Federico II, Naples, Italy -
| | - Vincenza Gragnaniello
- Section of Pediatrics, Department of Translational Medicine, University Federico II, Naples, Italy
| | - Antonella Esposito
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Ennio Del Giudice
- Section of Pediatrics, Department of Translational Medicine, University Federico II, Naples, Italy
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Girolimetto N, Macchioni P, Tinazzi I, Costa L, McGonagle D, Peluso R, Del Puente A, Addimanda O, Marchetta A, Possemato N, Tasso M, Salvarani C, Scarpa R, Caso F. Ultrasonographic Evidence of Predominance of Acute Extracapsular and Chronic Intrasynovial Patterns in 100 Cases of Psoriatic Hand Dactylitis. J Rheumatol 2019; 47:227-233. [PMID: 31092722 DOI: 10.3899/jrheum.190046] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 04/24/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To use ultrasonography to study whether the duration of psoriatic dactylitis was associated with different patterns of extracapsular and synovial-based involvement. METHODS One hundred cases of hand dactylitis from 85 patients with psoriatic arthritis (PsA) were consecutively enrolled in a multicenter cross-sectional study and divided into 2 groups according to dactylitis duration (shorter or longer than the median: 20 weeks). All dactylitis fingers were investigated using high-frequency ultrasound both in greyscale (GS) and power Doppler (PD), evaluating the presence of flexor tenosynovitis, soft tissue edema, subcutaneous PD signal (PDS), extensor tendon involvement, and joint synovitis. RESULTS Cases with a shorter dactylitis duration (< 20 weeks) had a significantly higher prevalence of GS flexor tenosynovitis of grade > 2, PD flexor tenosynovitis, soft tissue edema, and subcutaneous PDS (p = 0.001, p < 0.001, p < 0.05, and p = 0.001, respectively). However, the presence of synovitis in GS and PD mode (in both cases at proximal interphalangeal level) was more frequent in patients with longer dactylitis duration (p < 0.001). When detected in the chronic form, flexor tenosynovitis was grade 2 or lower. CONCLUSION In a large cohort of PsA hand dactylitis, we found a predominant extracapsular inflammation (flexor tenosynovitis and soft tissue edema) in early cases and a high prevalence of joint synovitis at proximal interphalangeal level in the chronic form. However, longitudinal imaging studies are needed to clarify these aspects.
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Affiliation(s)
- Nicolò Girolimetto
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II
| | - Pierluigi Macchioni
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II
| | - Ilaria Tinazzi
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II
| | - Luisa Costa
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II
| | - Dennis McGonagle
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II
| | - Rosario Peluso
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II
| | - Antonio Del Puente
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II
| | - Olga Addimanda
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II
| | - Antonio Marchetta
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II
| | - Niccolò Possemato
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II
| | - Marco Tasso
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II
| | - Carlo Salvarani
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II
| | - Raffaele Scarpa
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy. .,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II.
| | - Francesco Caso
- From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL-Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.,N. Girolimetto, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; P. Macchioni, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; I. Tinazzi, MD, Unit of Rheumatology, Ospedale Sacro Cuore; L. Costa, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; D. McGonagle, MD, PhD, Professor, FRCPI, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds; R. Peluso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; A. Del Puente, MD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; O. Addimanda, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia; A. Marchetta, MD, Unit of Rheumatology, Ospedale Sacro Cuore; N. Possemato, MD, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia;. Tasso, MD, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; C. Salvarani, MD, Full Professor, Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia; R. Scarpa, MD, Full Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II; F. Caso, MD, PhD, Assistant Professor, Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II
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Peluso R, Caso F, Tasso M, Ambrosino P, Dario Di Minno MN, Lupoli R, Criscuolo L, Caso P, Ursini F, Puente AD, Scarpa R, Costa On Behalf Of CaRRDs Study Group L. Cardiovascular Risk Markers and Major Adverse Cardiovascular Events in Psoriatic Arthritis Patients. Rev Recent Clin Trials 2018. [PMID: 29542417 PMCID: PMC6691775 DOI: 10.2174/1574887113666180314105511] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Psoriatic arthritis is a chronic inflammatory arthropathy that affects 14%- 30% of patients with skin and/or nail psoriasis, leading to severe physical limitations and disability. It has been included in the group of spondyloarthropathy with which it shares clinical, radiologic, and serologic features in addition to familial and genetic relationship. Beyond skin and joint involvement, psoriatic arthritis is characterized by a high prevalence of extra-articular manifestation and comorbidities, such as autoimmune, infectious and neoplastic diseases. In particular, an increased risk of cardiovascular comorbidity has been observed in psoriatic arthritis patients. METHODS A systematic search was performed in the electronic databases (PubMed, Web of Science, Scopus, EMBASE) up until January 2017. Studies were included if they contained data on CV disease and/or risk factors in PsA and each article was then reviewed for quality and clinical relevance. After completing the literature search all screened literature was summarized and discussed in our study group (CaRDDs study group). All literature and comments were included in the systematic review. RESULTS The initial search produced 278 abstracts, which were narrowed to 83 potentially relevant articles by preliminary review of the titles and by excluding review articles and case report (n = 195). Thirty articles were deemed ineligible after examining the abstracts. Full texts of the remaining 53 articles were retrieved. The majority of articles excluded were due to only providing data on patients with psoriasis or due to being not relevant to the CV risk in PsA. In the end, 32 articles were deemed eligible for this review. CONCLUSION Psoriatic arthritis appeared significantly associated with subclinical atherosclerosis and endothelial dysfunction and, in turn, with an increased cardiovascular risk. Thus, patients with psoriatic arthritis may benefit from a periodic assessment of surrogate markers of cardiovascular risk. This could help to establish more specific cardiovascular prevention strategies for these patients.
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Affiliation(s)
- Rosario Peluso
- Department of Clinical Medicine and Surgery - Rheumatology Research Unit - Federico II University, Naples, Italy
| | - Francesco Caso
- Department of Clinical Medicine and Surgery - Rheumatology Research Unit - Federico II University, Naples, Italy
| | - Marco Tasso
- Department of Clinical Medicine and Surgery - Rheumatology Research Unit - Federico II University, Naples, Italy
| | - Pasquale Ambrosino
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | | | - Roberta Lupoli
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Livio Criscuolo
- Department of Clinical Medicine and Surgery - Rheumatology Research Unit - Federico II University, Naples, Italy
| | - Paolo Caso
- Geriatric Unit, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Francesco Ursini
- Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Antonio Del Puente
- Department of Clinical Medicine and Surgery - Rheumatology Research Unit - Federico II University, Naples, Italy
| | - Raffaele Scarpa
- Department of Clinical Medicine and Surgery - Rheumatology Research Unit - Federico II University, Naples, Italy
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Adami G, Rossini M, Bogliolo L, Cantatore FP, Varenna M, Malavolta N, Del Puente A, Muratore M, Orsolini G, Gatti D, Viapiana O. An exploratory study on the role of vitamin D supplementation in improving pain and disease activity in rheumatoid arthritis. Mod Rheumatol 2018; 29:1059-1062. [DOI: 10.1080/14397595.2018.1532622] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | - Laura Bogliolo
- Rheumatology Unit, Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | | | | | - Nazzarena Malavolta
- Rheumatology Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | | | - Maurizio Muratore
- Rheumatology Unit, Galateo San Cesario Hospital, San Cesari di Lecce, Italy
| | | | - Davide Gatti
- Rheumatology Unit, University of Verona, Verona, Italy
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Costa L, Perricone C, Chimenti MS, Del Puente A, Caso P, Peluso R, Bottiglieri P, Scarpa R, Caso F. Switching Between Biological Treatments in Psoriatic Arthritis: A Review of the Evidence. Drugs R D 2018; 17:509-522. [PMID: 29058302 PMCID: PMC5694428 DOI: 10.1007/s40268-017-0215-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy. Therapy with anti-tumor necrosis factor (TNF)-α agents represents the first therapeutic choice for moderate and severe forms; however, PsA patients can experience anti-TNFα failure, lack of efficacy, or adverse events. Several evidences exist on the effectiveness of switching among different TNFα inhibitors, and we reviewed the published data on the effectiveness of anti-TNFα first-, second- and third-line. Most of the studies report that the main reason for switching to a second anti-TNFα agent is represented by lack of efficacy (primary or secondary) and, more rarely, adverse events. Switchers receiving their second anti-TNFα agent have considerably poorer responses compared with non-switchers. Survival of anti-TNFα treatment appears to be superior in PsA patients when compared with rheumatoid arthritis patients. Switching from anti-TNF agents to ustekinumab or secukinumab or apremilast can represent a valid alternative therapeutic strategy.
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Affiliation(s)
- Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, 80131, Naples, Italy
| | - Carlo Perricone
- Rheumatology, Department of Internal Medicine, Sapienza University of Rome, Rome, Italy
| | - Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome "Tor Vergata", Rome, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, 80131, Naples, Italy
| | - Paolo Caso
- Geriatric Unit, Faculty of Medicine and Psychology, S. Andrea Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Rosario Peluso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, 80131, Naples, Italy
| | - Paolo Bottiglieri
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, 80131, Naples, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, 80131, Naples, Italy.
| | - Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, 80131, Naples, Italy
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16
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Caso F, Del Puente A, Oliviero F, Peluso R, Girolimetto N, Bottiglieri P, Foglia F, Benigno C, Tasso M, Punzi L, Scarpa R, Costa L. Metabolic syndrome in psoriatic arthritis: the interplay with cutaneous involvement. Evidences from literature and a recent cross-sectional study. Clin Rheumatol 2018; 37:579-586. [DOI: 10.1007/s10067-017-3975-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 12/27/2017] [Accepted: 12/28/2017] [Indexed: 12/13/2022]
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Costa L, Del Puente A, Peluso R, Tasso M, Caso P, Chimenti MS, Sabbatino V, Girolimetto N, Benigno C, Bertolini N, Del Puente A, Perricone R, Scarpa R, Caso F. Small molecule therapy for managing moderate to severe psoriatic arthritis. Expert Opin Pharmacother 2017; 18:1557-1567. [PMID: 28891341 DOI: 10.1080/14656566.2017.1378343] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 01/07/2023]
Abstract
INTRODUCTION The majority of psoriatic arthritis (PsA) patients experience a good clinical response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and biologic therapies (bDMARDs). However, treatment failure with these drugs can represent a relevant clinical problem. Moreover, in daily clinical practice, the appropriate identification of patients eligible for these agents can be conditioned by numerous aspects, mainly represented by comorbidities, such as history of malignancies, chronic and recurrent infectious diseases. Areas covered: We searched in the PUBMED database and review published data on the efficacy and safety profile of the small molecules, inhibitor of phosphodiesterase 4, apremilast, and of JAK/STAT pathways, tofacitinib, in PsA. Moreover, we report data on the other JAK inhibitor, baricitinib, and the A(3) adenosine receptors agonist, CF101, emerging by studies conducted in psoriasis patients. Expert opinion: In Psoriatic Arthritis, apremilast appears promising for PsA and recent studies have shown a good efficacy and an acceptable safety profile. Data on tofacitinib in PsA are limited. Studies on the small molecules, baricitinib and CF101 are still incomplete and limited to trials conducted in Rheumatoid Arthritis and in psoriasis. Further studies on small molecules and on their underlining mechanisms are advocated in PsA.
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Affiliation(s)
- Luisa Costa
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Antonio Del Puente
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Rosario Peluso
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Marco Tasso
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Paolo Caso
- b Geriatric Unit, Faculty of Medicine and Psychology , "Sapienza" University of Rome, S. Andrea, Hospital , Rome , Italy
| | - Maria Sole Chimenti
- c Rheumatology, allergology and clinical immunology, Department of System Medicine , University of Rome Tor Vergata , Rome , Italy
| | - Vincenzo Sabbatino
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Nicolò Girolimetto
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Carolina Benigno
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Nicoletta Bertolini
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Aurora Del Puente
- d Department of Medicine and Surgery , University of Milan "Bicocca" , Naples , Italy
| | - Roberto Perricone
- c Rheumatology, allergology and clinical immunology, Department of System Medicine , University of Rome Tor Vergata , Rome , Italy
| | - Raffaele Scarpa
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Francesco Caso
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
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Caso F, Costa L, Del Puente A, Sorbo D, Balestrieri U, Peluso R, Scarpa R. Clinical effects of mud-bath therapy and oral glucosamine sulfate after 6 months of discontinuation in patients with knee osteoarthritis: results from a randomised, controlled, crossover study. Clin Exp Rheumatol 2017; 35:169. [PMID: 27749217] [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: 05/26/2016] [Accepted: 06/27/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Dario Sorbo
- Orthopaedic Unit, Rizzoli Hospital, Ischia, Italy
| | | | - Rosario Peluso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.
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Costa L, Caso F, Del Puente A, Di Minno MND, Peluso R, Scarpa R. Incidence of Malignancies in a Cohort of Psoriatic Arthritis Patients Taking Traditional Disease Modifying Antirheumatic Drug and Tumor Necrosis Factor Inhibitor Therapy: An Observational Study. J Rheumatol 2016; 43:2149-2154. [DOI: 10.3899/jrheum.160542] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2016] [Indexed: 02/08/2023]
Abstract
Objective.Psoriatic arthritis (PsA) is an inflammatory arthropathy, associated with skin and/or nail psoriasis. As suggested in 2012 by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), studies devoted to assess cancer in the PsA population are still limited and need to be increased. Therefore, the aim of this study was to determine the incidence of malignancies in patients with PsA who are taking conventional and biologic therapies.Methods.A cohort of patients with PsA was followed prospectively. At first visit, as well as at each 3–4 month followup visit, according to standardized clinical practice, medical history, and physical and laboratory findings were recorded. Information on the presence of comorbidities, as well as malignancies, was collected. At each visit, data were recorded on radiography and pathology, confirming malignancy diagnosis, when present.Results.A total of 618 patients with PsA were included in the study. In particular, 296 were taking anti-tumor necrosis factor-α (anti-TNF) agents and 322 were taking disease-modifying antirheumatic drugs (DMARD). During the observation period, in the total group, 44 patients (7.1%) had a diagnosis of malignancy. Of them, 14 (4.7%; 95% CI 2.8–7.8; 0.52/100 patient-yrs) received anti-TNF therapy and 30 (9.3%; 95% CI 6.6–13.0; 1.03/100 patient-yrs) received traditional DMARD (p = 0.019). However, after adjusting for major demographic and clinical characteristics, the difference between the 2 treatments was no longer significant (p = 0.480), and the only predictor of malignancy occurrence was age (HR 1.04, 95% CI 1.009–1.073, p = 0.012).Conclusion.Data from this study confirm that biological therapies do not lead to any increased risk for cancer development, when adequately administered and with proper followup.
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Peluso R, Costa L, Caso F, Del Puente A, Di Minno MND, Manguso F, Castiglione F, Scarpa R. Dactylitis in enteropathic spondyloarthritis. Clin Exp Rheumatol 2016; 34:842-847. [PMID: 27087311] [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: 10/12/2015] [Accepted: 01/25/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Dactylitis has long been recognised as one of the significant features of spondyloarthropathies. In the literature, the prevalence of dactylitis in enteropathic spondyloarthritis (EASpA) ranges between 2% and 4%. The aim of this study was to identify the prevalence of dactylitis in EASpA patients and to investigate its association with clinical subset and with articular and bowel disease activity. METHODS 78 EASpA patients and 78 controls were enrolled for this study. All patients and controls underwent a rheumatological and a gastroenterological clinical examination. Demographic and clinical features were recorded. Diagnosis of dactylitis was made by physical examination and was evaluated using the Leeds Dactylitis Instrument (LDI). RESULTS In our study the prevalence of dactylitis in EASpA was 15.38%, mainly in patients with Crohn's disease (CD) and peripheral arthritis. A significantly higher articular and bowel disease activity was found in patients with dactylitis compared to those without it. The family history of psoriasis represented a predictor of occurrence of dactylitis. Finally, a significant correlation between disease activity and LDI score was found in EASpA. CONCLUSIONS The results of our study showed a high prevalence of dactylitis in EASpA. It was more frequent in patients with CD and peripheral involvement with a higher articular disease activity, confirming that dactylitis may be a severity marker and a prognostic factor for EASpA. The significant correlation between disease activity and LDI score could address LDI as a potential tool of assessment of dactylitis.
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Affiliation(s)
- Rosario Peluso
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.
| | - Luisa Costa
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy
| | - Francesco Caso
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy
| | - Antonio Del Puente
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | | | - Francesco Manguso
- Complex Operating Unit of Gastroenterology, AORN "A.Cardarelli", Naples, Italy
| | - Fabiana Castiglione
- Gastroenterology Research Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Raffaele Scarpa
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
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Del Puente A, Esposito A, Costa L, Benigno C, Del Puente A, Foglia F, Oriente A, Bottiglieri P, Caso F, Scarpa R. Fragility Fractures in Patients with Psoriatic Arthritis. J Rheumatol Suppl 2016; 93:36-9. [PMID: 26523054 DOI: 10.3899/jrheum.150633] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Psoriatic arthritis (PsA) can have peculiar effects on bone, including mechanisms of bone loss such as erosions, but also of bone formation, such as ankylosis or periostitis. The aim of the present study was to describe the prevalence of fractures in patients with PsA as compared to healthy controls and to investigate determinants of fractures among cases. For both cases and controls, radiographs were read to identify vertebral fractures (VF), and the presence of femoral neck or other nonvertebral fractures was obtained from patients' medical history. The prevalence of fragility fractures on radiographic readings did not differ between cases and controls. The number of subjects showing a VF was 33 (36%) among PsA patients and 36 (36%) among controls, with a prevalence of severe VF of 8% among cases and 4% among controls. Controlling for covariates in a logistic model, the only variables showing a significant correlation with the presence of nonvertebral fractures (NVF) were disease duration (p=0.02), age (p=0.03), and bone mineral density at femoral neck (inverse correlation, p=0.04). Fractures should be carefully considered when evaluating the global picture of the patient with PsA for their contribution to the "fragility" profile.
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Affiliation(s)
- Antonio Del Puente
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II.
| | - Antonella Esposito
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II
| | - Luisa Costa
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II
| | - Carla Benigno
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II
| | - Aurora Del Puente
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II
| | - Francesca Foglia
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II
| | - Alfonso Oriente
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II
| | - Paolo Bottiglieri
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II
| | - Francesco Caso
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II
| | - Raffaele Scarpa
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II
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Peluso R, Caso F, Costa L, Sorbo D, Carraturo N, Di Minno MND, Carraturo F, Oriente A, Balestrieri U, Minicucci A, Del Puente A, Scarpa R. Mud-bath therapy and oral glucosamine sulfate in patients with knee osteoarthritis: a randomized, controlled, crossover study. Clin Exp Rheumatol 2016; 34:618-624. [PMID: 27050908] [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: 10/22/2015] [Accepted: 01/07/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To evaluate the efficacy and safety of combined treatment of mud-bath therapy and glucosamine crystalline sulfate (GlcN-S) in patients with knee osteoarthritis (OA). METHODS This study was a randomised, controlled, crossover investigation. Patients were randomly assigned (1:1) by the investigators to two groups, named group 1 and 2. Group 1 included twenty-three patients receiving oral GlcN-S treatment from the beginning of the study (T0) to the end of the 3rd month of treatment (T3) and a combined treatment of both mud-bath therapy and GlcN-S from T3 to the end of the study at six months (T6). Group 2 included twenty-two patients receiving a combined treatment of both mud-bath therapy and GlcN-S from T0 to T3 and that discontinued mud-bath therapy, receiving GlcN-S treatment alone, from T3 to T6. Primary endpoints of the study consisted of evaluating OA severity and activity at baseline and at follow-up visits. RESULTS All 45 patients, eligible for the study, completed the period of the crossover. In group 1, no significant difference was shown in the comparison from T0 to T3, while from T3 to T6 most variables were significantly improved. In group 2, instead, the comparison between T0 and T3 showed a significant difference in different parameters. When comparing T3 and T6, despite an improvement of all the variables, no significant difference was shown. CONCLUSIONS The association of GlcN-S and mud-bath therapy has a positive and safe role in improving pain, function and quality of life in knee OA patients.
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Affiliation(s)
- Rosario Peluso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy
| | - Dario Sorbo
- Orthopedic Unit, Rizzoli Hospital, Ischia, Italy
| | | | | | | | - Alfonso Oriente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | | | | | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.
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Melis D, Rossi A, Pivonello R, Del Puente A, Pivonello C, Cangemi G, Negri M, Colao A, Andria G, Parenti G. Reduced bone mineral density in glycogen storage disease type III: evidence for a possible connection between metabolic imbalance and bone homeostasis. Bone 2016; 86:79-85. [PMID: 26924264 DOI: 10.1016/j.bone.2016.02.012] [Citation(s) in RCA: 19] [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: 08/07/2015] [Revised: 01/19/2016] [Accepted: 02/22/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Glycogen storage disease type III (GSDIII) is an inborn error of carbohydrate metabolism caused by deficient activity of glycogen debranching enzyme (GDE). It is characterized by liver, cardiac muscle and skeletal muscle involvement. The presence of systemic complications such as growth retardation, ovarian polycystosis, diabetes mellitus and osteopenia/osteoporosis has been reported. The pathogenesis of osteopenia/osteoporosis is still unclear. OBJECTIVES The aim of the current study was to evaluate the bone mineral density (BMD) in GSDIII patients and the role of metabolic and endocrine factors and physical activity on bone status. METHODS Nine GSDIII patients were enrolled (age 2-20years) and compared to eighteen age and sex matched controls. BMD was evaluated by Dual-emission-X-ray absorptiometry (DXA) and Quantitative ultrasound (QUS). Clinical and biochemical parameters of endocrine system function and bone metabolism were analyzed. Serum levels of the metabolic control markers were evaluated. Physical activity was evaluated by administering the International Physical Activity Questionnaire (IPAQ). RESULTS GSDIII patients showed reduced BMD detected at both DXA and QUS, decreased serum levels of IGF-1, free IGF-1, insulin, calcitonin, osteocalcin (OC) and increased serum levels of C-terminal cross-linking telopeptide of type I collagen (CTX). IGF-1 serum levels inversely correlated with AST and ALT serum levels. DXA Z-score inversely correlated with cholesterol and triglycerides serum levels and directly correlated with IGF-1/IGFBP3 molar ratio. No difference in physical activity was observed between GSDIII patients and controls. DISCUSSION Our data confirm the presence of reduced BMD in GSDIII. On the basis of the results, we hypothesized that metabolic imbalance could be the key factor leading to osteopenia, acting through different mechanisms: chronic hyperlipidemia, reduced IGF-1, Insulin and OC serum levels. Thus, the mechanism of osteopenia/osteoporosis in GSDIII is probably multifactorial and we speculate on the factors involved in its pathogenesis.
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Affiliation(s)
- Daniela Melis
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University, Naples, Italy.
| | - Alessandro Rossi
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University, Naples, Italy.
| | - Rosario Pivonello
- Department of Medicine and Surgery, Section of Endocrinology, Federico II University, Naples, Italy.
| | - Antonio Del Puente
- Department of Medicine and Surgery, Section of Rheumatology, Federico II University, Naples, Italy.
| | - Claudia Pivonello
- Department of Medicine and Surgery, Section of Endocrinology, Federico II University, Naples, Italy.
| | - Giuliana Cangemi
- Clinical Pathology Laboratory, Istituto Giannina Gaslini, Genoa, Italy.
| | - Mariarosaria Negri
- Department of Medicine and Surgery, Section of Endocrinology, Federico II University, Naples, Italy.
| | - Annamaria Colao
- Department of Medicine and Surgery, Section of Endocrinology, Federico II University, Naples, Italy.
| | - Generoso Andria
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University, Naples, Italy.
| | - Giancarlo Parenti
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University, Naples, Italy.
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Caso F, Ramonda R, Del Puente A, Darda MA, Cantarini L, Peluso R, Esposito C, Ortolan A, Fiocco U, Punzi L, Scarpa R, Costa L. Influenza vaccine with adjuvant on disease activity in psoriatic arthritis patients under anti-TNF-α therapy. Clin Exp Rheumatol 2016; 34:507-512. [PMID: 26967009] [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: 09/16/2015] [Accepted: 12/14/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To evaluate the effects on disease activity of seasonal influenza vaccination with adjuvant in psoriatic arthritis (PsA) patients in stable disease activity on anti-TNF-α drugs as compared to not vaccinated PsA patients adequately matched. METHODS An observational study was conducted on a cohort of PsA patients in stable disease activity who underwent administration of an adjuvanted vaccine for seasonal influenza. Cases (Group 1) were matched for age, sex, disease activity and therapy with not vaccinated PsA patients (Group 2). Analysis included patients data before vaccination (T0), and one month (T1) and three months (T3) after administration of the vaccination for Group 1 and at correspondent intervals for Group 2. Assessment of disease activity parameters was performed at each visit. RESULTS Twenty-five vaccinated and 25 not vaccinated patients were included in the study. As a first approach, we analysed the data within groups. At T1, as compared to baseline, the group of vaccinated patients had a statistically significant increase in TJC (tender joint count) and ESR (erythrocyte sedimentation rate). At T3, a statistically significant difference from baseline characteristics was found only for the TJC. In Group 2, all the observed variables showed no significant differences when comparing baseline to T1 and T3. Analysis of the data between groups at T1, Group 1, as compared to Group 2, showed a significant increase of TJC, ESR, HAQ (Health Assessment Questionnaire), PtGA (patient global assessment) and PhGA (physician global assessment). These findings were also confirmed when comparing the two groups at T3 for ESR and PtGA, while they were not confirmed for TJC, HAQ and PhGA. CONCLUSIONS Influenza vaccination is clinically efficacious in PsA patients under anti-TNF-α therapy, but it could trigger a short-lasting exacerbation of the disease.
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Affiliation(s)
- Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Napoli, Italy
| | - M Abud Darda
- Department of Statistics, Natural Science Academic Group, National University, Gazipur, Bangladesh
| | - Luca Cantarini
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy
| | - Rosario Peluso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Napoli, Italy
| | - Carmela Esposito
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Napoli, Italy
| | - Augusta Ortolan
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy
| | - Ugo Fiocco
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy
| | - Leonardo Punzi
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Napoli, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy.
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Abstract
INTRODUCTION The majority of Psoriatic Arthritis patients experience a good clinical response to anti-Tumor Necrosis Factor (TNF)-α therapies. However, treatment failure with anti-TNF-α can represent a relevant clinical problem. AREAS COVERED We review the efficacy and safety profile of biological therapies that have been reported from randomized, controlled trials in phase II and phase III available in Pubmed Database for agents targeting IL-12/23p40 antibody (ustekinumab) and IL-17 (secukinumab), inhibitor of phosphodiesterase 4, (apremilast), and of JAK/STAT pathways (tofacitinib) and CTLA4 co-stimulation (abatacept) in Psoriatic Arthritis. EXPERT OPINION In Psoriatic Arthritis, main emerging drugs are represented by the fully human monoclonal IL-12/23p40 antibody, ustekinumab, the agent targeting IL-17, secukinumab, and the inhibitor of phosphodiesterase 4, apremilast. Results on T cell co-stimulation inhibition by abatacept are insufficient both in psoriasis and in PsA. In vitro investigations on JAK/STAT pathways in PsA suggest that tofacitinib could represent a further valuable therapeutic option. Emerging biological treatments other than anti-TNF agents, ustekinumab, secukinumab and apremilast appear promising for Psoriatic Arthritis and recent studies have showed a good efficacy and an acceptable safety profile; however, further and long-term studies are advocated.
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Affiliation(s)
- Francesco Caso
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy.,b Rheumatology Unit, Department of Medicine DIMED , University of Padova , Padova , Italy
| | - Antonio Del Puente
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Rosario Peluso
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Paolo Caso
- c Geriatric Unit, Faculty of Medicine and Psychology , "Sapienza" University of Rome, S. Andrea Hospital , Rome , Italy
| | - Nicolò Girolimetto
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Aurora Del Puente
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Raffaele Scarpa
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Luisa Costa
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy.,b Rheumatology Unit, Department of Medicine DIMED , University of Padova , Padova , Italy
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Caso F, Lubrano E, Del Puente A, Caso P, Peluso R, Foglia F, Benigno C, Girolimetto N, Bottiglieri P, Scarpa R, Costa L. Progress in understanding and utilizing TNF-α inhibition for the treatment of psoriatic arthritis. Expert Rev Clin Immunol 2015; 12:315-31. [PMID: 26558483 DOI: 10.1586/1744666x.2016.1117941] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The improved recognition of pathogenetic molecular mechanisms has led to the use of drugs targeting cytokines in different inflammatory arthropathies as well psoriatic arthritis (PsA). In particular, the progress in knowledge on tumor necrosis factor (TNF)-α in the pathogenesis of PsA has changed the therapeutic approach by use of direct and receptor cytokine antagonists. Currently, infliximab (IFX), adalimumab, etanercept, golimumab and certolizumab pegol represent the five anti-TNF-α available for the treatment of PsA. This review describes evidence on treatment aimed at neutralizing TNF-α in PsA patients, from the first study in 2000 until today, mainly derived from randomized clinical trials. In comparison with traditional therapies, anti-TNF-α agents have shown to have more efficacy both in treating clinical aspects, including enthesitis, dactylitis, joint pain and swelling, axial involvement, nail and skin lesions, and in reducing radiographic progression. Moreover, anti-TNF-α agents have been demonstrated to be reasonably safe in PsA, as confirmed by data derived by different registries.
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Affiliation(s)
- Francesco Caso
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy.,b Rheumatology Unit, Department of Medicine DIMED , University of Padova , Padova , Italy
| | - Ennio Lubrano
- c Department of Medicine and Health Sciences "Vincenzo Tiberio" , University of Molise , Campobasso , Italy
| | - Antonio Del Puente
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Paolo Caso
- d Geriatric Unit, Faculty of Medicine and Psychology , "Sapienza" University of Rome, S. Andrea Hospital , Rome , Italy
| | - Rosario Peluso
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Francesca Foglia
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Carolina Benigno
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Nicolò Girolimetto
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Paolo Bottiglieri
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Raffaele Scarpa
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy
| | - Luisa Costa
- a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy.,b Rheumatology Unit, Department of Medicine DIMED , University of Padova , Padova , Italy
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Caso F, Costa L, Del Puente A, Di Minno MND, Lupoli G, Scarpa R, Peluso R. Pharmacological treatment of spondyloarthritis: exploring the effectiveness of nonsteroidal anti-inflammatory drugs, traditional disease-modifying antirheumatic drugs and biological therapies. Ther Adv Chronic Dis 2015; 6:328-38. [PMID: 26568809 PMCID: PMC4622317 DOI: 10.1177/2040622315608647] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 12/16/2022] Open
Abstract
Spondyloarthritis represents a heterogeneous group of articular inflammatory diseases that share common genetic, clinical and radiological features. The therapy target of spondyloarthritis relies mainly in improving patients' quality of life, controlling articular inflammation, preventing the structural joints damage and preserving the functional abilities, autonomy and social participation of patients. Among these, traditional disease-modifying antirheumatic drugs have been demonstrated to be effective in the management of peripheral arthritis; moreover, in the last decade, biological therapies have improved the approach to spondyloarthritis. In patients with axial spondyloarthritis, tumor necrosis factor α inhibitors are currently the only effective therapy in patients for whom conventional therapy with nonsteroidal anti-inflammatory drugs has failed. The aim of this review is to summarize the current experience and evidence about the pharmacological approach in spondyloarthritis patients.
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Affiliation(s)
- Francesco Caso
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, and Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, and Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Italy
| | | | - Gelsy Lupoli
- Department of Clinical Medicine and Surgery, University Federico II Naples, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Italy
| | - Rosario Peluso
- Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II - Via Sergio Pansini 5 - 80131 Naples, Italy
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Abstract
In 2006, the introduction of the concept "psoriatic disease" (PsD) extended the traditional idea of a condition confined to skin and joints. Now we consider PsD a systemic condition, in which the increased activity of tumor necrosis factor acts as the most potent engine for a series of molecular interactions. These lead not only to the genesis of skin and joint symptoms, but also to other clinical aspects such as inflammatory bowel disease, eye involvement, and metabolic syndrome. The blocking of a precise molecular target has dramatically modified therapeutic strategies, making possible adequate control of all the clinical aspects of the condition. Therefore, an expanded clinical staging of patients could now be considered in order to ensure the best therapeutic approach and prognosis.
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Affiliation(s)
- Raffaele Scarpa
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist.
| | - Francesco Caso
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist
| | - Luisa Costa
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist
| | - Rosario Peluso
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist
| | - Angelo Spanò
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist
| | - Ennio Lubrano
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist
| | - Antonio Del Puente
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist
| | - John M H Moll
- From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, and Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.R. Scarpa, MD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, and Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD; R. Peluso, MD, PhD; A. Spanò, MD, Department of Clinical Medicine and Surgery, University Federico II; E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Del Puente, MD, PhD, Department of Clinical Medicine and Surgery, University Federico II; J.M. Moll, DM, PhD, FRCP, Emeritus Consultant Rheumatologist
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Costa L, Caso F, Ramonda R, Del Puente A, Cantarini L, Darda MA, Caso P, Lorenzin M, Fiocco U, Punzi L, Scarpa R. Metabolic syndrome and its relationship with the achievement of minimal disease activity state in psoriatic arthritis patients: an observational study. Immunol Res 2015; 61:147-53. [PMID: 25395342 DOI: 10.1007/s12026-014-8595-z] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aim of the study was to evaluate the influence of metabolic syndrome (MetS) on achieving minimal disease activity (MDA) in psoriatic arthritis (PsA) patients treated with anti-tumor necrosis factor (TNF)-α with a follow-up period of 24 months. A cohort of PsA patients was assessed at the University Federico II of Naples and at University of Padova. For the aim of the present study, patients' data were collected at baseline (T0), at 12 months (T1) and at 24 months (T2). Assessment of metabolic and disease activity parameters was performed at each visit. The NCEP-ACT III criteria were used to identify subjects with MetS and the MDA criteria to evaluate the disease activity. On the basis of the exclusion and inclusion criteria, 330 subjects were included in the study; 134 patients (40.7%) were classified as not having MetS and 196 (59.3%) as having MetS. An inverse association was found between presence of metabolic syndrome and the probability of achieving MDA. Univariate analysis indicated that patients with metabolic syndrome were less likely to achieve MDA than patients without metabolic syndrome (OR 0.45, p < 0.001). This inverse association remained statistically significant in the multivariate regression model (OR 0.56, p < 0.001). Metabolic syndrome is associated with a lower probability of achieving MDA in PsA patients in therapy with anti-TNF-α.
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Affiliation(s)
- Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, 80131, Naples, Italy,
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Atteno M, Costa L, Vitiello M, Caso F, Sarnelli G, Del Puente A, Scarpa R. Thalassemic trait prevalence in patients affected by psoriatic arthritis in anti-TNF treatment. Drug Dev Res 2015; 75 Suppl 1:S20-2. [PMID: 25381968 DOI: 10.1002/ddr.21188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Thalassemic trait (Thal) is associated with rheumatic disease, particularly a mild form of seronegative polyarthritis resembling rheumatoid arthritis (RA), but not with other rheumatic diseases. The aim of this study was to estimate the frequency of Thal in patients with psoriatic arthritis (PsA) and to evaluate the efficacy of anti-tumor necrosis factor alpha (TNF-α) therapy in patients with PsA and Thal. We performed a retrospective study in 321 patients with PsA who started therapy with TNF-α blockers. For all patients included in the study, at baseline and every 3 months for the 1 year of follow up, data concerning PsA activity and ferritin levels were registered. In our group of PsA patients, a total of 27 (8%) with concomitant Thal were identified and included in the study. In patients without Thal, all variables improved significantly after 6 months of therapy, while in patients with Thal, the same variables showed a significant decrease after 12 months.: Our study shows that PsA is significantly associated with Thal, but further studies are needed to address this issue. The presence of Thal could be a negative predictor of achieving remission during treatment with TNF-α-blockers.
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Affiliation(s)
- Mariangela Atteno
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
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Caso F, Costa L, Del Puente A, Rigante D, Selmi C, Fabbroni M, Scarpa R, Galeazzi M, Frediani B, Cantarini L. Effects of tumor necrosis factor-α inhibitors in mothers and daughters concordant for HLA-B27-positive ankylosing spondylitis. Clin Exp Rheumatol 2015; 33:411-413. [PMID: 25962691] [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: 11/15/2014] [Accepted: 02/06/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Pharmacogenomics is considered as the new frontier to predict the response to treatments and it can also be based on the comparison of family members being treated for the same condition. No data are available on the impact of anti-tumour necrosis factor (TNF)-α therapies in members of the same family with ankylosing spondylitis (AS). METHODS We describe three mother-daughter couples concordant for AS and HLA-B27, both treated with TNF-α inhibitors, for whom the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP were evaluated during a follow-up of 24 months. RESULTS All patients manifested improvements of all scores, but the daughters had a more prominent effect achieving faster complete disease remission. CONCLUSIONS We hypothesise that longer standing chronic inflammation and older age may cause a less prompt and effective response to treatment in SA when compared with their genetically related controls.
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Affiliation(s)
- Francesco Caso
- Research Center of Systemic Autoinflammatory Diseases and Behçet's disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena; and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; and Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Donato Rigante
- Institute of Paediatrics, Policlinico A. Gemelli, Università Cattolica Sacro Cuore, Rome, Italy
| | - Carlo Selmi
- Division of Rheumatology, Allergy, and Clinical Immunology, University of California, Davis, USA; and Division of Rheumatology and Clinical Immunology, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Marta Fabbroni
- Research Center of Systemic Autoinflammatory Diseases and Behçet's disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Mauro Galeazzi
- Research Center of Systemic Autoinflammatory Diseases and Behçet's disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Bruno Frediani
- Research Center of Systemic Autoinflammatory Diseases and Behçet's disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Luca Cantarini
- Research Center of Systemic Autoinflammatory Diseases and Behçet's disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
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Costa L, Caso F, Atteno M, Del Puente A, Darda MA, Caso P, Ortolan A, Fiocco U, Ramonda R, Punzi L, Scarpa R. Impact of 24-month treatment with etanercept, adalimumab, or methotrexate on metabolic syndrome components in a cohort of 210 psoriatic arthritis patients. Clin Rheumatol 2015; 33:833-9. [PMID: 23959447 DOI: 10.1007/s10067-013-2369-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 07/23/2013] [Accepted: 08/08/2013] [Indexed: 12/11/2022]
Abstract
Psoriatic arthritis (PsA) is a chronic inflammatory condition, characterized by an excess of metabolic disorders. Metabolic syndrome (MetS) is a cluster of classic cardiovascular risk factors, due to an imbalance between pro- and anti-inflammatory adipokines. Tumor necrosis factor (TNF)-α is a pro-inflammatory adipocytokine mainly produced by monocytes and macrophages with a central role in inflammatory responses, but it also induces adipocytes apoptosis, promotes insulin resistance, and stimulates lipolysis. The aim of this study was to evaluate the impact of therapy with etanercept (ETN), adalimumab (ADA), and methotrexate (MTX) on MetS components in a cohort of PsA patients with a follow-up period of 24 months. A retrospective study has been conducted in a cohort of PsA patients. On the basis of the inclusion criteria, we identified the first 70 consecutive patients, respectively, on ADA, ETN, and MTX, for a total of 210 patients achieving PsARC criteria during the observation period. As part of the routine clinical practice, assessment of metabolic parameters and of disease activity was recorded at baseline (T0), at 12 months (T1), and at 24 months (T2). The results show that when the specific components of the MetS were considered, taking also into account by regression analysis the effect of the confounding factors, the patients on etN and ADA show a significant improvement of the metabolic syndrome components (in detail, waist circumference, triglycerides, high-density lipoprotein cholesterol, and glucose) as compared to the MTX group. In conclusion, these data suggest that the biologic treatment in PsA can no longer be taken into consideration only for its positive effect on articular and cutaneous symptoms but also on the various aspects of this complex picture.
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Caso F, Cantarini L, Morisco F, Del Puente A, Ramonda R, Fiocco U, Lubrano E, Peluso R, Caso P, Galeazzi M, Punzi L, Scarpa R, Costa L. Current evidence in the field of the management with TNF-α inhibitors in psoriatic arthritis and concomitant hepatitis C virus infection. Expert Opin Biol Ther 2015; 15:641-50. [DOI: 10.1517/14712598.2015.1011616] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Caso F, Costa L, Atteno M, Del Puente A, Cantarini L, Lubrano E, Scarpa R. Simple clinical indicators for early psoriatic arthritis detection. Springerplus 2014; 3:759. [PMID: 25674484 PMCID: PMC4320171 DOI: 10.1186/2193-1801-3-759] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 12/03/2014] [Indexed: 11/10/2022]
Abstract
Background Diagnosis of psoriatic arthritis (PsA), in a period of 12 months from the onset of the first articular episode, permits of identifying the early form defined as “early PsA”. The recognition of the disease in this phase leads to better outcome. The aim of this study was to identify peculiar clinical and/or laboratory findings that could be useful for the diagnosis of “early PsA”. Findings Thirty-five patients with early onset of arthritis were observed. The following data were collected for each patient: family and personal history, physical examination, tender and swollen joint counts (TJC, SJC), tender entheseal count, presence of dactylitis and low back pain (LBP), and laboratory tests. Among the 35 total patients, 24 showed skin and/or nail psoriasis or a family history of psoriasis. The remaining 11 patients showed absence of concomitant or previous psoriasis and/or familiarity for psoriasis. The comparison between the two groups showed that patients with psoriasis had a significant presence of LBP, dactylitis and enthesitis than patients with psoriasis. Conclusions The study confirms that the distinctive clinical findings of PsA is psoriasis, but also LBP, dactylitis and enthesitis have a relevant role in early identification. A low number of SJC and TJC are frequently observed in early phases of PsA than in other forms of early arthritis. These aspects could be mostly helpful when psoriasis is not detected or can follow arthritis in absence of familiar positivity, making difficult PsA diagnosis. In conclusion, careful medical history, clinical examination and first-level laboratory investigations are useful to characterize early phases of PsA.
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Affiliation(s)
- Francesco Caso
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128 Padua, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128 Padua, Italy ; Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Mariangela Atteno
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Antonio Del Puente
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Luca Cantarini
- Interdepartmental Research Center of Systemic Autoimmune and Autoinflammatory Diseases, Rheumatology Unit, Policlinico Le Scotte, University of Siena, Viale Bracci 1, 53100 Siena, Italy
| | - Ennio Lubrano
- Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, 80131 Naples, Italy
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Caso F, Costa L, Del Puente A, Scarpa R. Psoriatic arthritis and TNF inhibitors: advances on effectiveness and toxicity. Expert Opin Biol Ther 2014; 15:1-2. [DOI: 10.1517/14712598.2015.973398] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Costa L, Atteno M, Caso F, Scarpato L, Del Puente A, Scarpa R. Alopecia areata in a patient with psoriatic arthritis and Crohn's disease receiving etanercept. Int J Rheum Dis 2014; 17:219-20. [PMID: 24576280 DOI: 10.1111/1756-185x.12057] [Citation(s) in RCA: 3] [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] [Indexed: 01/20/2023]
Affiliation(s)
- Luisa Costa
- Rheumatology Research Unit, Department of Clinical and Experimental Medicine, University Federico II, Naples, Italy
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Atteno M, Costa L, Matarese A, Caso F, Del Puente A, Cantarini L, Bocchino ML, Sanduzzi A, Scarpa R. The use of TNF-α blockers in psoriatic arthritis patients with latent tuberculosis infection. Clin Rheumatol 2014; 33:543-7. [PMID: 24554385 PMCID: PMC3962579 DOI: 10.1007/s10067-014-2536-z] [Citation(s) in RCA: 29] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 02/05/2014] [Accepted: 02/10/2014] [Indexed: 11/26/2022]
Abstract
Psoriatic arthritis (PsA) is an inflammatory arthropathy associated with skin and/or nail psoriasis. TNF-α is an essential cytokine for the host defense, and its depletion by treatment may facilitate the risk of infections or their reactivation. The aim of this study was to evaluate the efficacy and safety of TNF-α blockers in patients with PsA and concomitant latent tuberculosis infection (LTBI) comparing their outcome with non-infected PsA patients. This is a retrospective study in 321 patients with PsA, attending the Psoriatic Arthritis Clinic at the University Federico II of Naples, who had an inadequate response to DMARDs and started therapy with TNF-α blockers. We identified 40 patients with LTBI, who were included in this study along with 40 not infected PsA patients as control group. At baseline (T0) and every 3 months for 2 years (T2), data concerning PsA activity were registered. All patients underwent chest X-ray every 6 months (or 12 if appropriate). In each group, 22 patients were on etanercept therapy, 14 on adalimumab, and 4 on infliximab. Anti-TNF-α therapy was effective in both group of patients, and no statistically significant differences were found in the analysis of the study variables between the two groups from T0 to T2. No serious adverse events occurred in both groups, and no patient was withdrawn from therapy. Our experience suggests that anti-TNF-α treatment is effective and safe in PsA patients with concomitant LTBI. Therefore, neither LTBI nor chemoprophylaxis seems to influence the course of anti-TNF-α therapy.
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Affiliation(s)
- Mariangela Atteno
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University Federico II, Via S. Pansini 5, 80131, Naples, Italy,
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Scarpa R, Costa L, Atteno M, Del Puente A, Caso F, Moll JMH. Psoriatic arthritis: advances in pharmacotherapy based on molecular target. Expert Opin Pharmacother 2013; 14:2311-3. [PMID: 24067053 DOI: 10.1517/14656566.2013.840292] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The progress on the improved understanding of disease pathogenesis and molecular biology has changed the understanding of disease profiles, emphasizing aspects that simple clinical observation could not identify, and demarcating differences between clinical pictures that seemed to overlap. An example of this spectacular evolution is represented by psoriatic arthritis (PsA). This increase of knowledge on pathogenesis has led to an important impact on therapeutic approach. Therapies are now taken into account because their precise target is known. The authors describe treatment guidelines and revisit traditional therapies as well as innovative therapies in PsA.
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Affiliation(s)
- Raffaele Scarpa
- University Federico II, Rheumatology Research Unit, Department of Clinical and Experimental Medicine , via S. Pansini 5, 80131 - Naples , Italy +39 081 7462063 ; +39 081 5463445 ;
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Costa L, Caso F, Atteno M, Giannitti C, Spadaro A, Ramonda R, Vezzù M, Del Puente A, Morisco F, Fiocco U, Galeazzi M, Punzi L, Scarpa R. Long-term safety of anti-TNF-α in PsA patients with concomitant HCV infection: a retrospective observational multicenter study on 15 patients. Clin Rheumatol 2013; 33:273-6. [DOI: 10.1007/s10067-013-2378-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 08/19/2013] [Indexed: 02/07/2023]
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Cosenza L, Pezzella V, Nocerino R, Di Costanzo M, Coruzzo A, Passariello A, Leone L, Savoia M, Del Puente A, Esposito A, Terrin G, Berni Canani R. Calcium and vitamin D intakes in children: a randomized controlled trial. BMC Pediatr 2013; 13:86. [PMID: 23702146 PMCID: PMC3665520 DOI: 10.1186/1471-2431-13-86] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 05/15/2013] [Indexed: 11/23/2022] Open
Abstract
Background Calcium (Ca2+) and vitamin D (VitD) play an important role in child health. We evaluated the daily intake of Ca2+ and VitD in healthy children. Moreover, we demonstrate the efficacy of Ca2+ and VitD supplementation. Methods Daily Ca2 + and VitD intake was evaluated in consecutive healthy children through a validated questionnaire. Subjects with <70% of dietary reference intakes (DRIs) of Ca2+ and VitD were invited to participate in a prospective randomized trial with 2 groups of nutritional intervention: Group 1, dietary counseling aiming to optimize daily Ca2+ and VitD intake plus administration of a commercially available Ca2 + and VitD supplementation product; Group 2, dietary counseling alone. At the enrollment (T0) and after 4 months (T1) serum 25(OH) Vitamin D levels were assessed. Results We evaluated 150 healthy children (male 50%, mean age 10 years); at baseline a low VitD intake was observed in all subjects (median 0.79 μg/die, IQR 1.78; range 0.01-5.02); this condition was associated with Ca2+ intake <70% of the DRIs in 82 subjects (55%). At baseline serum 25(OH)D levels were low (<30 ng/ml) in all study subjects and after 4 months of nutritional intervention, a normalization of serum 25(OH)D levels (≥30 ng/ml) was observed in all children in Group 1 and in only one subject in Group 2 [Group 1: T1 33.8 ng/ml (IQR 2.5) vs Group 2: T1 24.5 ng/ml (IQR 5.2), p <0.001]. Conclusions Adequate Ca2+ and VitD intakes are difficult to obtain through dietary counseling alone in pediatric subjects. Oral supplementation with of Ca2+ and VitD is a reliable strategy to prevent this condition. Trial registration The study was registered in Clinical Trials Protocol Registration System (ID number: NCT01638494).
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Affiliation(s)
- Linda Cosenza
- Department of Pediatrics, University of Naples Federico II, Naples, Italy
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Del Puente A, Esposito A, Lombardi V, Bova A, Zecca R, Torella R. [The complex interplay between health services administration, health professionals and patients. A challenge to take up]. Recenti Prog Med 2013; 104:49-53. [PMID: 23535956 DOI: 10.1701/1241.13703] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The risk of loss of essential elements of our professionalism, such as sense of duty, altruism and collegiality, contributes to the difficulties in the interplay between health services administration, health professionals and patients. It is not enough to increase salaries or change organization models. It is also insufficient a generic reference to the values of our profession, but it is mandatory to overcome the self-referencing attitude of health professions.
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Sanduzzi A, Bocchino M, Atteno M, Costa L, Ponticiello A, Matarese A, Spanò A, Bruner V, Peluso R, Aquino MM, Del Puente A, Scarpa R. Screening and monitoring of latent tubercular infection in patients taking tumor necrosis factor-α blockers for psoriatic arthritis. J Rheumatol Suppl 2012; 89:82-5. [PMID: 22751601 DOI: 10.3899/jrheum.120252] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Patients with arthritis who need treatment with biologics are carefully screened for possible previous exposure to tuberculosis to detect any latent tubercular infection (LTBI). The traditional method of screening for LTBI is not specific, because positivity could also depend on infection by atypical mycobacteria and bacillus Calmette-Guerin vaccination. In addition, the screening does not show high sensitivity, frequently presenting a false negativity because of immunosuppression caused by drugs used for arthritis. Recently, interferon-γ release assays (IGRA) have been used to screen LTBI with more sensitivity and specificity before treatment with anti-tumor necrosis factor-α drugs. Moreover, in our experience, IGRA are potentially useful in monitoring LTBI during biologic therapy.
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Affiliation(s)
- Alessandro Sanduzzi
- Respiratory and Rheumatology Research Units, Department of Clinical and Experimental Medicine, University Federico II, Naples, Italy.
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Varenna M, Manara M, Cantatore FP, Del Puente A, Di Munno O, Malavolta N, Minisola G, Adami S, Sinigaglia L, Rossini M. Determinants and effects of vitamin D supplementation on serum 25-hydroxy-vitamin D levels in patients with rheumatoid arthritis. Clin Exp Rheumatol 2012; 30:714-719. [PMID: 22766134] [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: 09/15/2011] [Accepted: 12/20/2011] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Osteoporosis (OP) and increased risk of fracture are relevant features in patients with rheumatoid arthritis (RA). Low levels of serum vitamin D are frequently reported and correlate with a higher RA activity. This study evaluated factors related with the prescription of vitamin D supplements in RA patients and variables influencing the achievement of adequate vitamin D levels. METHODS Study population was made up by 1168 consecutive RA patients from 22 Italian rheumatology centers. Demographic and clinical variables data were collected and 25OH serum vitamin D was measured in all patients. Insufficient serum 25OH vitamin D levels were defined as values lower than 20 ng/mL. RESULTS The majority of patients (56.0%) was not taking vitamin D supplements. Among the 514 supplemented patients, 196 (38.1%) were taking insufficient dosages (≤440 IU/day). Variables related with the prescription of supplements were older age, female sex, previous bone density assessment and OP diagnosis. Among the 318 patients using daily supplements ≥800 IU, 88 patients (27.7%) did not reach adequate levels of vitamin D. In these patients a higher HAQ score (OR for 1 point=1.62, 95% CI: 1.06-2.49; p=0.03) and poor sun exposure (OR=2.38, 95% CI: 1.05-5.55; p=0.04) were predictors of vitamin D insufficiency. CONCLUSIONS Vitamin D deficiency is common in patients with RA, even in patients who are regularly using supplements. Vitamin D supplementation is often ineffective even at the recommended dose of 800 IU/day in more disabled patients.
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Affiliation(s)
- Massimo Varenna
- Rheumatology Unit, Istituto Ortopedico Gaetano Pini, Milano, Italy.
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Del Puente A, Esposito A, Parisi A, Atteno M, Montalbano S, Vitiello M, Esposito C, Bertolini N, Foglia F, Costa L, Scarpa R. Osteoporosis and psoriatic arthritis. J Rheumatol Suppl 2012; 89:36-38. [PMID: 22751589 DOI: 10.3899/jrheum.120240] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Osteoporosis (OP) is a skeletal disorder characterized by compromised bone strength that predisposes to an increased risk of fracture. The prevalence of OP in the general population is very high as established in several studies, and OP represents one of the possible aspects of bone involvement in arthritis. In psoriatic arthritis this involvement is particularly complex because it affects not only mechanisms of bone loss but also of bone formation. We will discuss these aspects and the available epidemiological data.
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Soscia E, Sirignano C, Catalano O, Atteno M, Costa L, Caso F, Peluso R, Bruner V, Aquino MM, Del Puente A, Salvatore M, Scarpa R. New developments in magnetic resonance imaging of the nail unit. J Rheumatol Suppl 2012; 89:49-53. [PMID: 22751592 DOI: 10.3899/jrheum.120243] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The evolution of dedicated magnetic resonance imaging (MRI) musculoskeletal equipment allows new sequences and better images of the nail unit. The use of MRI has modified the imaging strategies used in treating inflammatory arthritis. In the case of psoriatic arthritis (PsA), the MRI study of the nail unit identifies nail involvement, which appears as an initial lesion for the induction of distal phalanx damage and consequently of distal interphalangeal joint arthritis. All patients with psoriasis, even in the absence of a clinically evident onychopathy, show characteristic MRI changes in the nail. This evidence could have a practical diagnostic value, because MRI study of the nail could document diagnosis in patients with undifferentiated spondyloarthropathies who have a barely evident psoriasis. We discuss the advantages and problems related to the use of low-field and high-field MRI in the study of the nail unit of patients with PsA.
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Affiliation(s)
- Ernesto Soscia
- Radiology Unit and the Rheumatology Unit, Department of Clinical and Experimental Medicine, University Federico II, Naples, Italy.
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Coin A, Ruggiero E, Giannini S, Pedrazzoni M, Minisola S, Rossini M, Del Puente A, Inelmen EM, Manzato E, Sergi G. Trunk and Lower Limb Fat Mass Evaluated by Dual-Energy X-Ray Absorptiometry in a 20- to 80-Year-Old Healthy Italian Population. Ann Nutr Metab 2012; 61:151-9. [DOI: 10.1159/000342086] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 07/16/2012] [Indexed: 12/25/2022]
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Costa L, Caso F, D'Elia L, Atteno M, Peluso R, Del Puente A, Strazzullo P, Scarpa R. Psoriatic arthritis is associated with increased arterial stiffness in the absence of known cardiovascular risk factors: a case control study. Clin Rheumatol 2011; 31:711-5. [PMID: 22113824 DOI: 10.1007/s10067-011-1892-1] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 11/01/2011] [Indexed: 01/23/2023]
Abstract
The objective of the study was the evaluation of arterial stiffness, a cardiovascular risk factor, in patients with psoriatic arthritis (PsA). Twenty PsA patients classified on the basis of the CASPAR criteria (M/W, 14/6; mean age, 38.6 years; range, 22-53), attending our out-patient clinic, and 20 healthy control subjects (M/W, 14/6; mean age, 38.7 years; range, 22-53) matched for age, weight, height and with similar cardiometabolic profile entered the study. An exclusion criterion was the presence of known cardiovascular risk factors. Central hemodynamic parameters and aortic pulse wave velocity (aPWV) were assessed non-invasively by a SphygmoCor device. A significantly higher aPWV was recorded in PsA patients when compared to controls. The difference remained statistically significant after adjustment for age, weight, height, heart rate (HR) and central mean pressure (mean±SE; PsA, 8.3 ± 0.2 versus control, 6.8 ± 0.2 m/s; p < 0.0001). Among PsA patients, aPWV was related to known duration of disease (r = 0.63; p = 0.003). This result was confirmed after adjustment for the main confounders (β = 0.011; p = 0.013). These results support the concept of psoriatic disease as a systemic condition involving not only the skin, joints and gastrointestinal tract but also arterial vessels. The involvement of the vascular system indicates the presence of pathogenetic mechanisms that could accelerate the atherosclerotic process in this condition.
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Affiliation(s)
- Luisa Costa
- Rheumatology Research Unit, Department of Clinical and Experimental Medicine, University Federico II, Naples, Italy
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Peluso R, Lupoli GA, Del Puente A, Iervolino S, Bruner V, Lupoli R, Di Minno MND, Foglia F, Scarpa R, Lupoli G. Prevalence of thyroid autoimmunity in patients with spondyloarthropathies. J Rheumatol 2011; 38:1371-7. [PMID: 21498480 DOI: 10.3899/jrheum.101012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To evaluate the prevalence of chronic autoimmune thyroiditis or Hashimoto's thyroiditis (HT) in a group of patients with spondyloarthritis (SpA). METHODS We evaluated serum levels of thyroid-stimulating hormone, free triiodothyronine, and free thyroxine, and titers of antithyroglobulin and antithyroid peroxidase (anti-TPO) antibodies in 357 consecutive patients with SpA. We also recruited 318 healthy age-matched controls. Ultrasonography of the thyroid gland was performed in all subjects and rheumatic activity was evaluated. RESULTS Indices of thyroid autoimmunity were significantly more frequent in patients with SpA than in controls (24.09% vs 10.69%, respectively; p < 0.05). In the SpA group, a higher prevalence of HT was found in patients with an active disease than in those with low-moderate disease levels. Also in the SpA group, patients with a disease duration > 2 years had a higher prevalence of HT and anti-TPO antibodies positivity than patients with a disease duration ≤ 2 years. Ultrasonography detected a significantly higher frequency of thyroid nodules and hypoechoic pattern in patients with SpA than in controls. Among patients with SpA, HT and anti-TPO antibodies positivity were significantly more frequent in patients with peripheral involvement (68.6%) than in patients with axial involvement (31.4%; p < 0.05). CONCLUSION Our study shows a significantly higher prevalence of thyroid autoimmunity in patients with SpA as compared to controls. Thyroiditis occurs more frequently in patients with longer disease duration and active rheumatic disease. We suggest that thyroid function tests be part of the clinical evaluation in patients with SpA.
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Affiliation(s)
- Rosario Peluso
- Rheumatology Research Unit, Department of Clinical and Experimental Medicine, University Federico II, Naples, Italy.
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Abstract
Early detection of psoriatic arthritis (PsA) can effectively help in reducing the risk of joint damage and disability. Accordingly, the authors offer diagnostic insights in order to improve the approach to the patient's medical history, clinical examination, and the imaging modalities. Early PsA is a condition with a consistent risk of clinical progression. Marked entheseal involvement is a distinctive clinical aspect that helps discriminate early PsA from other conditions observed at their onset, in particular rheumatoid arthritis.
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Affiliation(s)
- Raffaele Scarpa
- Department of Clinical and Experimental Medicine, Rheumatology Research Unit, Early Psoriatic Arthritis Clinic, University Federico II, 80131 Naples, Italy.
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Soscia E, Scarpa R, Cimmino MA, Atteno M, Peluso R, Sirignano C, Costa L, Iervolino S, Caso F, Del Puente A, Salvatore M, Soricelli A. Magnetic resonance imaging of nail unit in psoriatic arthritis. J Rheumatol Suppl 2009; 83:42-5. [PMID: 19661539 DOI: 10.3899/jrheum.090222] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The use of magnetic resonance imaging (MRI) has modified the imaging strategies of inflammatory arthritides. In psoriatic arthritis (PsA), MRI study of the nail unit identifies nail involvement that appears as the initial lesion for induction of distal phalanx damage and consequently of distal interphalangeal joint arthritis. All psoriatic patients, also in the absence of a clinically evident onychopathy, show characteristic MRI changes of the nail. This evidence could have practical diagnostic value because MRI study of the nail could document diagnosis in patients with undifferentiated spondyloarthropathies who have barely evident psoriasis. We discuss the advantages and problems related to the use of low- and high-field MRI in the study of the nail unit of patients with PsA.
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Affiliation(s)
- Ernesto Soscia
- Rheumatology Research Unit, Early Psoriatic Arthritis Clinic, Department of Clinical and Experimental Medicine, University Federico II, 80131 Naples, Italy
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