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Bandeira M, Silvério-António M, Khmelinskii N, Fonseca JE, Romão VC. Beyond sicca: high prevalence and predictors of baseline and worsening systemic involvement in patients with Sjögren's disease. Rheumatol Adv Pract 2024; 8:rkae035. [PMID: 38560642 PMCID: PMC10978570 DOI: 10.1093/rap/rkae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 02/22/2024] [Indexed: 04/04/2024] Open
Abstract
Objectives Systemic extraglandular involvement in SS has been reported in one-third of patients but may be more frequent. We aimed to evaluate systemic disease prevalence at baseline and throughout follow-up and find its predictors. Methods We conducted a retrospective cohort study including SS patients followed in a tertiary centre. The cumulative EULAR SS disease activity index (ESSDAI) was calculated by adding each domain's maximum score throughout follow-up. We identified independent predictors of systemic involvement (ESSDAI ≥1 at baseline and/or follow-up) through logistic regression modelling. A survival analysis was conducted to identify predictors of new/worsening ESSDAI domains. Results A total of 216 patients were included, most of whom had systemic involvement (86%), frequently at diagnosis (76%). Biological (53%) and articular ESSDAI domains (44%) were most commonly involved, but all were affected at least once. Around half of the patients with baseline systemic disease developed an additional/worsening domain throughout follow-up. Although most patients had low disease activity at baseline, 60% eventually reached moderately active disease. Younger age at diagnosis [odds ratio (OR) 0.95 (95% CI 0.91, 0.99)], a positive minor salivary gland biopsy [OR 4.08 (95% CI 1.40, 11.86)] and RF [OR 4.67 (95% CI 1.52, 14.33)] were independent predictors of systemic involvement. Patients with baseline constitutional involvement [hazard ratio (HR) 2.23 (95% CI 1.13, 4.40)] and RF [HR 1.89 (95% CI 1.20, 3.00)] were more likely to develop new/worsening systemic disease activity. Conclusion Systemic involvement is seen in most SS patients. Younger and RF and salivary gland biopsy-positive patients are at higher risk of systemic disease. Around half of patients with systemic involvement experienced aggravated disease over time, especially those with constitutional involvement or RF.
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Affiliation(s)
- Matilde Bandeira
- Rheumatology Department, Unidade Local de Saúde Santa Maria, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
| | - Manuel Silvério-António
- Rheumatology Department, Unidade Local de Saúde Santa Maria, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
| | - Nikita Khmelinskii
- Rheumatology Department, Unidade Local de Saúde Santa Maria, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
| | - João E Fonseca
- Rheumatology Department, Unidade Local de Saúde Santa Maria, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
| | - Vasco C Romão
- Rheumatology Department, Unidade Local de Saúde Santa Maria, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
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Martins-Martinho J, Ponte A, Dourado E, Khmelinskii N, Barreira SC, Cruz-Machado AR, Macieira C, Teixeira V, Rodrigues AM, Telles-Correia D, Fonseca JE, Ponte C. Anxiety and depression in patients with giant cell arteritis. Rheumatol Adv Pract 2024; 8:rkae013. [PMID: 38384323 PMCID: PMC10879746 DOI: 10.1093/rap/rkae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 09/22/2023] [Accepted: 01/14/2024] [Indexed: 02/23/2024] Open
Abstract
Objectives To compare the prevalence of anxiety and depression in patients with GCA with that in the general population, using the Hospital Anxiety and Depression Scale (HADS), and to identify independent predictors of these psychiatric manifestations in patients with GCA. Methods We conducted a cross-sectional study including all patients diagnosed with GCA followed during 1 year in a vasculitis outpatient clinic. The HADS and 36-item Short Form (SF-36) questionnaires were prospectively collected. Patients' HADS results were compared with an age- and gender-matched control group. HADS anxiety (HADS-A) and HADS depression (HADS-D) scores between 8 and 10 defined possible anxiety and depression and ≥11 defined probable anxiety and depression, respectively. Results We included 72 patients and 288 controls. Compared with controls, patients with GCA had a statistically significant higher prevalence of HADS-A ≥8 (48.6% vs 26.4%), HADS-A ≥11 (30.6% vs 12.2%) and HADS-D ≥11 (33.3% vs 18.1%). GCA was an independent predictor of HADS-A ≥8 [odds ratio (OR) 3.3 (95% CI 1.9, 5.9)], HADS-A ≥11 [OR 3.8 (95% CI 2.0, 7.4)] and HADS-D ≥11 [OR 2.6 (95% CI 1.4, 4.7)]. Among patients with GCA, a negative correlation was observed between HADS-A/D and SF-36 mental health scores (r = -0.780 and r = -0.742, respectively). Glucocorticoid therapy was a predictor of HADS-A ≥8 [OR 10.4 (95% CI 1.2, 94.2)] and older age of HADS-D ≥8 [OR 1.2 (95% CI 1.1, 1.3)] and HADS-D ≥11 [OR 1.1 (95% CI 1.0, 1.2)]. Conclusions Compared with the general population, patients with GCA have a higher prevalence of anxiety and depression and GCA is an independent predictor of these symptoms. Glucocorticoid treatment and older age are predictors of anxiety and depression, respectively, in patients with GCA.
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Affiliation(s)
- Joana Martins-Martinho
- Rheumatology Department, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - André Ponte
- Psychiatry Department, Hospital Divino Espírito Santo de Ponta Delgada, Ponta Delgada, Portugal
| | - Eduardo Dourado
- Rheumatology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
- Egas Moniz Health Alliance, Aveiro, Portugal
| | - Nikita Khmelinskii
- Rheumatology Department, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Sofia C Barreira
- Rheumatology Department, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Ana R Cruz-Machado
- Rheumatology Department, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Carla Macieira
- Rheumatology Department, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Vítor Teixeira
- Rheumatology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | - Ana M Rodrigues
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Diogo Telles-Correia
- Psychiatry Department, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - João E Fonseca
- Rheumatology Department, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Cristina Ponte
- Rheumatology Department, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
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Tani C, Cardelli C, Depascale R, Gamba A, Iaccarino L, Doria A, Bandeira M, Dinis SP, Romão VC, Gotelli E, Paolino S, Cutolo M, Di Giosaffatte N, Ferraris A, Grammatico P, Cavagna L, Codullo V, Montecucco C, Longo V, Beretta L, Cavazzana I, Fredi M, Peretti S, Guiducci S, Matucci-Cerinic M, Bombardieri S, Burmester GR, Fonseca JE, Frank C, Galetti I, Hachulla E, Müller-Ladner U, Schneider M, Smith V, Tamirou F, Van Laar JM, Vieira A, D'Urzo R, Cannizzo S, Gaglioti A, Marinello D, Talarico R, Mosca M. Long-term outcomes of COVID-19 vaccination in patients with rare and complex connective tissue diseases: The ERN-ReCONNET VACCINATE study. J Transl Autoimmun 2023; 7:100221. [PMID: 38162456 PMCID: PMC10755036 DOI: 10.1016/j.jtauto.2023.100221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 09/07/2023] [Revised: 10/27/2023] [Accepted: 11/23/2023] [Indexed: 01/03/2024] Open
Abstract
Background Vaccination is one of the most important measures to contain the COVID-19 pandemic, especially for frail patients. VACCINATE is a multicentre prospective observational study promoted by the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases (ERN ReCONNET) aimed at assessing the long-term outcomes of COVID-19 vaccination in patients with rare and complex connective tissue diseases (rcCTDs) in terms of efficacy and safety. Methods Adult rcCTDs patients were eligible for recruitment. Demographic, clinical and vaccination data were collected at enrolment. Follow-up visits were scheduled 4, 12, 24, 36 and 48 weeks after completion of the first vaccination cycle; data on adverse events, disease exacerbations and the occurrence of new SARS-CoV-2 infections were collected at these time-points. Findings 365 rcCTDs patients (87 % female, mean age 51.8 ± 14.6 years) were recruited. Overall, 200 patients (54.8 %) experienced at least one adverse event, generally mild and in most cases occurring early after the vaccination. During follow-up, 55 disease exacerbations were recorded in 39 patients (10.7 %), distributed over the entire observation period, although most frequently within 4 weeks after completion of the vaccination cycle. The incidence of new SARS-CoV-2 infections was 8.9 per 1000 person-months, with no cases within 12 weeks from vaccine administration and an increasing trend of infections moving away from the primary vaccination cycle. Only one case of severe COVID-19 was reported during the study period. Interpretation COVID-19 vaccination seems effective and safe in rcCTDs patients. The rate of new infections was rather low and serious infections were uncommon in our cohort. No increased risk of disease flares was observed compared to previous disease history; however, such exacerbations may be potentially severe, emphasising the need for close monitoring of our patients.
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Affiliation(s)
- Chiara Tani
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Chiara Cardelli
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Roberto Depascale
- Rheumatology Unit, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Anna Gamba
- Rheumatology Unit, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Luca Iaccarino
- Rheumatology Unit, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Andrea Doria
- Rheumatology Unit, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Matilde Bandeira
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte & Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Sara Paiva Dinis
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte & Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Vasco C. Romão
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte & Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Emanuele Gotelli
- Research Laboratory and Academic Division of Clinical Rheumatology, Internal Medicine Department, University of Genoa, Genoa, Italy
| | - Sabrina Paolino
- Research Laboratory and Academic Division of Clinical Rheumatology, Internal Medicine Department, University of Genoa, Genoa, Italy
| | - Maurizio Cutolo
- Research Laboratory and Academic Division of Clinical Rheumatology, Internal Medicine Department, University of Genoa, Genoa, Italy
| | - Niccolò Di Giosaffatte
- Laboratory of Medical Genetics, Department of Experimental Medicine, Sapienza University and San Camillo Forlanini Hospital, Rome, Italy
| | - Alessandro Ferraris
- Laboratory of Medical Genetics, Department of Experimental Medicine, Sapienza University and San Camillo Forlanini Hospital, Rome, Italy
| | - Paola Grammatico
- Laboratory of Medical Genetics, Department of Experimental Medicine, Sapienza University and San Camillo Forlanini Hospital, Rome, Italy
| | - Lorenzo Cavagna
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
- Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Veronica Codullo
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
- Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carlomaurizio Montecucco
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
- Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Valentina Longo
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Referral Center for Systemic Autoimmune Diseases, Milan, Italy
| | - Lorenzo Beretta
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Referral Center for Systemic Autoimmune Diseases, Milan, Italy
| | - Ilaria Cavazzana
- Rheumatology and Clinical Immunology Unit, ASST-Spedali Civili and University of Brescia, Brescia, Italy
| | - Micaela Fredi
- Rheumatology and Clinical Immunology Unit, ASST-Spedali Civili and University of Brescia, Brescia, Italy
| | - Silvia Peretti
- Division of Rheumatology and Scleroderma Unit, Department of Clinical and Experimental Medicine, AOU Careggi, University of Florence, Florence, Italy
| | - Serena Guiducci
- Division of Rheumatology and Scleroderma Unit, Department of Clinical and Experimental Medicine, AOU Careggi, University of Florence, Florence, Italy
| | - Marco Matucci-Cerinic
- Division of Rheumatology and Scleroderma Unit, Department of Clinical and Experimental Medicine, AOU Careggi, University of Florence, Florence, Italy
| | | | - Gerd R. Burmester
- Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin, Berlin, Germany
| | - João E. Fonseca
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte & Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Charissa Frank
- Flemish Association for Hereditary Connective Tissue Disorders, Koersel, Belgium
| | - Ilaria Galetti
- Federation of European Scleroderma Associations (FESCA), Milan, Italy
| | - Eric Hachulla
- Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Systémiques et Auto-Immunes Rares du Nord-Ouest (CERAINO), LIRIC, INSERM, Univ. Lille, CHU Lille, Lille, France
| | - Ulf Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Kerckhoff-Klinik GmbH, Justus-Liebig University of Giessen, Bad Nauheim, Germany
| | - Matthias Schneider
- Department of Rheumatology, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Vanessa Smith
- Department of Rheumatology and Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent, Belgium
| | - Farah Tamirou
- Department of Rheumatology, Cliniques Universitaires Saint-Luc, Université Catholique De Louvain, Louvain, Belgium
| | - Jacob M. Van Laar
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Ana Vieira
- Liga Portuguesa Contra as Doenças Reumáticas, Núcleo Síndrome de Sjögren, Lisbon, Portugal
| | - Rossella D'Urzo
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Cannizzo
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Gaglioti
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Diana Marinello
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Rosaria Talarico
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marta Mosca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Bandeira M, Dourado E, Melo AT, Martins P, Fraga V, Ferraro JL, Saraiva A, Sousa M, Parente H, Soares C, Correia AM, E Almeida D, P Dinis S, Pinto AS, O Pinheiro F, S Rato M, Beirão T, Samões B, Santos B, Mazeda C, T Chícharo A, Faria M, Neto A, Lourenço MH, Brites L, Rodrigues M, Silva-Dinis J, M Dias J, Araújo FC, Martins N, Couto M, Valido A, Santos MJ, Barreira S, Fonseca JE, Campanilho-Marques R. Mechanic's hands are associated with interstitial lung disease in myositis patients regardless of the presence of antisynthetase antibodies. Rheumatology (Oxford) 2023; 62:e332-e334. [PMID: 37294734 DOI: 10.1093/rheumatology/kead274] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/15/2023] [Accepted: 05/31/2023] [Indexed: 06/11/2023] Open
Affiliation(s)
- Matilde Bandeira
- Serviço de Reumatologia, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa (CAML), Lisboa, Portugal
- Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, CAML, Lisboa, Portugal
| | - Eduardo Dourado
- Serviço de Reumatologia, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa (CAML), Lisboa, Portugal
- Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, CAML, Lisboa, Portugal
| | - Ana T Melo
- Serviço de Reumatologia, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa (CAML), Lisboa, Portugal
- Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, CAML, Lisboa, Portugal
| | - Patrícia Martins
- Serviço de Reumatologia, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa (CAML), Lisboa, Portugal
- Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, CAML, Lisboa, Portugal
| | - Vanessa Fraga
- Serviço de Reumatologia, Hospital Garcia de Orta, Almada, Portugal
| | - José L Ferraro
- Serviço de Reumatologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - André Saraiva
- Serviço de Reumatologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Marlene Sousa
- Serviço de Reumatologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Hugo Parente
- Serviço de Reumatologia, Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
| | - Catarina Soares
- Serviço de Reumatologia, Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
| | - Ana M Correia
- Serviço de Reumatologia, Hospital de Braga, Braga, Portugal
| | | | - Sara P Dinis
- Serviço de Reumatologia, Unidade Local de Saúde da Guarda, Guarda, Portugal
| | - Ana S Pinto
- Serviço de Reumatologia, Unidade Local de Saúde da Guarda, Guarda, Portugal
| | - Filipe O Pinheiro
- Serviço de Reumatologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Maria S Rato
- Serviço de Reumatologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Tiago Beirão
- Serviço de Reumatologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Beatriz Samões
- Serviço de Reumatologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Bernardo Santos
- Serviço de Reumatologia, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Carolina Mazeda
- Serviço de Reumatologia, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Ana T Chícharo
- Serviço de Reumatologia, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | - Margarida Faria
- Serviço de Reumatologia, Hospital Nélio Mendonça, Serviços de Saúde da Região Autónoma da Madeira, Funchal, Portugal
| | - Agna Neto
- Serviço de Reumatologia, Hospital Nélio Mendonça, Serviços de Saúde da Região Autónoma da Madeira, Funchal, Portugal
| | - Maria H Lourenço
- Serviço de Reumatologia, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Luísa Brites
- Serviço de Reumatologia, Hospital Distrital de Leiria, Leiria, Portugal
| | - Marília Rodrigues
- Serviço de Reumatologia, Hospital Distrital de Leiria, Leiria, Portugal
| | - Joana Silva-Dinis
- Serviço de Reumatologia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - João M Dias
- Serviço de Reumatologia, Centro Hospitalar de Médio Tejo, Tomar, Portugal
| | - Filipe C Araújo
- Serviço de Reumatologia, Hospital CUF Cascais, Cascais, Portugal
| | - Nádia Martins
- Serviço de Reumatologia, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Maura Couto
- Serviço de Reumatologia, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Ana Valido
- Serviço de Reumatologia, Unidade Local de Saúde do Litoral Alentejano, Santiago do Cacém, Portugal
| | - Maria J Santos
- Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, CAML, Lisboa, Portugal
- Serviço de Reumatologia, Hospital Garcia de Orta, Almada, Portugal
| | - Sofia Barreira
- Serviço de Reumatologia, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa (CAML), Lisboa, Portugal
- Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, CAML, Lisboa, Portugal
| | - João E Fonseca
- Serviço de Reumatologia, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa (CAML), Lisboa, Portugal
- Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, CAML, Lisboa, Portugal
| | - Raquel Campanilho-Marques
- Serviço de Reumatologia, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa (CAML), Lisboa, Portugal
- Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, CAML, Lisboa, Portugal
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5
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Tomé C, Oliveira-Ramos F, Campanilho-Marques R, Mourão AF, Sousa S, Marques C, Melo AT, Teixeira RL, Martins AP, Moeda S, Costa-Reis P, Torres RP, Bandeira M, Fonseca H, Gonçalves M, Santos MJ, Graca L, Fonseca JE, Moura RA. Children with extended oligoarticular and polyarticular juvenile idiopathic arthritis have alterations in B and T follicular cell subsets in peripheral blood and a cytokine profile sustaining B cell activation. RMD Open 2023; 9:e002901. [PMID: 37652558 PMCID: PMC10476142 DOI: 10.1136/rmdopen-2022-002901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 07/03/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVES The main goal of this study was to characterise the frequency and phenotype of B, T follicular helper (Tfh) and T follicular regulatory (Tfr) cells in peripheral blood and the cytokine environment present in circulation in children with extended oligoarticular juvenile idiopathic arthritis (extended oligo JIA) and polyarticular JIA (poly JIA) when compared with healthy controls, children with persistent oligoarticular JIA (persistent oligo JIA) and adult JIA patients. METHODS Blood samples were collected from 105 JIA patients (children and adults) and 50 age-matched healthy individuals. The frequency and phenotype of B, Tfh and Tfr cells were evaluated by flow cytometry. Serum levels of APRIL, BAFF, IL-1β, IL-2, IL-4, IL-6, IL-10, IL-17A, IL-21, IL-22, IFN-γ, PD-1, PD-L1, sCD40L, CXCL13 and TNF were measured by multiplex bead-based immunoassay and/or ELISA in all groups included. RESULTS The frequency of B, Tfh and Tfr cells was similar between JIA patients and controls. Children with extended oligo JIA and poly JIA, but not persistent oligo JIA, had significantly lower frequencies of plasmablasts, regulatory T cells and higher levels of Th17-like Tfh cells in circulation when compared with controls. Furthermore, APRIL, BAFF, IL-6 and IL-17A serum levels were significantly higher in paediatric extended oligo JIA and poly JIA patients when compared with controls. These immunological alterations were not found in adult JIA patients in comparison to controls. CONCLUSIONS Our results suggest a potential role and/or activation profile of B and Th17-like Tfh cells in the pathogenesis of extended oligo JIA and poly JIA, but not persistent oligo JIA.
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Affiliation(s)
- Catarina Tomé
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Filipa Oliveira-Ramos
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Raquel Campanilho-Marques
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Ana F Mourão
- Rheumatology Department, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, EPE, Lisbon, Portugal
| | - Sandra Sousa
- Reumatology Department, Hospital Garcia de Orta, EPE, Almada, Portugal
| | - Cláudia Marques
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Ana T Melo
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Rui L Teixeira
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Ana P Martins
- Pediatric Surgery Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Lisbon, Portugal
| | - Sofia Moeda
- Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Patrícia Costa-Reis
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Rita P Torres
- Rheumatology Department, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, EPE, Lisbon, Portugal
| | - Matilde Bandeira
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Helena Fonseca
- Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Miroslava Gonçalves
- Pediatric Surgery Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Lisbon, Portugal
| | - Maria J Santos
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Reumatology Department, Hospital Garcia de Orta, EPE, Almada, Portugal
| | - Luis Graca
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - João E Fonseca
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Rita A Moura
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
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Talarico R, Ramirez GA, Barreira SC, Cardamone C, Triggianese P, Aguilera S, Andersen J, Avcin T, Benistan K, Bertsias G, Bortoluzzi A, Bouillot C, Bulina I, Burmester GR, Callens S, Carreira PE, Cervera R, Cutolo M, Damian L, Della-Torre E, Faria R, Fonseca JE, Galetti I, Hachulla E, Iaccarino L, Jacobsen S, Khmelinskii N, Limper M, Marinello D, Meyer A, Moroncini G, Nagy G, Olesinska M, Pamfil C, Pileckyte M, Pistello M, Rednic S, Richez C, Romão VC, Schneider M, Sciascia S, Scirè CA, Simonini G, Smith V, Sulli A, Tani C, Tas SW, Tincani A, Vonk MC, Tektonidou M, Mosca M. ERN ReCONNET points to consider for treating patients living with autoimmune rheumatic diseases with antiviral therapies and anti-SARS-CoV-2 antibody products. Clin Exp Rheumatol 2023; 41:543-553. [PMID: 36916322 DOI: 10.55563/clinexprheumatol/jpargp] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/13/2023] [Indexed: 03/16/2023]
Abstract
Recent studies have shown that people who are immunocompromised may inadvertently play a role in spurring the mutations of the virus that create new variants. This is because some immunocompromised individuals remain at risk of getting COVID-19 despite vaccination, experience more severe disease, are susceptible to being chronically infected and remain contagious for longer if they become infected and considering that immunocompromised individuals represent approximately 2% of the overall population, this aspect should be carefully considered. So far, some autoimmune rheumatic disease (ARD) patients with COVID-19 have been treated with antiviral therapies or anti-SARS-CoV-2 antibody products. However, there is no homogeneous approach to these treatment strategies. This issue was addressed within the European Reference Network (ERN) on Rare and Complex Connective Tissue and Musculoskeletal Diseases (ReCONNET) in a discussion among experts and patient's representatives in the context of the rare and complex connective tissue diseases (rCTDs) covered by the Network. ERN ReCONNET is one of the 24 ERNs launched by the European Commission in 2017 with the aim of tackling low prevalence and rare diseases that require highly specialised treatment and promoting concentration of knowledge and resources through virtual networks involving healthcare providers (HCPs) across the European Union (EU). Considering the urgent need to provide guidance not only to the rCTDs community, but also to the whole ARDs community, a multidisciplinary Task Force, including expert clinicians and European Patient Advocacy Group (ePAG) Advocates, was created in the framework of ERN ReCONNET with the aim of developing overarching principles (OP) and points-to-consider (PtC) on a homogenous approach to treat immunocompromised patients with ARDs (with a particular focus on CTDs) affected by COVID-19 using antiviral therapies and anti-SARS-CoV-2 antibody products. The present work reports the final OP and PtC agreed by the Task Force.
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Affiliation(s)
- Rosaria Talarico
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
| | - Giuseppe Alvise Ramirez
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milan, and Università Vita-Salute San Raffaele, Milan, Italy
| | - Sofia C Barreira
- Department of Rheumatology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre and Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Chiara Cardamone
- Division of Allergy and Clinical Immunology, University of Salerno, Italy
| | - Paola Triggianese
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Silvia Aguilera
- Spanish Association for Antiphospholipid Syndrome (SAF España), Elche, Spain
| | | | - Tadej Avcin
- Department of Allergology, Rheumatology and Clinical Immunology, University Children's Hospital, University Medical Centre Ljubljana, Slovenia
| | - Karelle Benistan
- AP-HP, GHU Paris Saclay, Hôpital Raymond Poincaré, Centre de Référence des Syndromes d'Ehlers-Danlos non vasculaires, Garches, France
| | - George Bertsias
- Rheumatology and Clinical Immunology, University of Crete Medical School, Heraklion, Greece
| | - Alessandra Bortoluzzi
- Department of Medical Sciences, Rheumatology Section, University of Ferrara, Azienda Ospedaliero-Universitaria Sant'Anna di Cona, Ferrara, Italy
| | | | - Inita Bulina
- Department of Internal Diseases, Rheumatology Centre, Paul Stradins Clinical University Hospital, Riga, Latvia
| | - Gerd R Burmester
- Department of Rheumatology and Clinical Immunology, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Steven Callens
- Department of Internal Medicine and Infectious Diseases, Ghent University Hospital, Ghent, Belgium
| | - Patricia E Carreira
- Servicio de Reumatología, Hospital Universitario 12 de Octubre, Universidad Complutentense de Madrid, Spain
| | - Ricard Cervera
- Department of Autoimmune Diseases, Reference Centre for Systemic Autoimmune Diseases (UEC/CSUR) of the Catalan and Spanish Health Systems, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Maurizio Cutolo
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genova, Italy
| | - Laura Damian
- Department of Rheumatology, County Emergency Clinical Hospital Cluj, Iuliua Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Emanuel Della-Torre
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milan, and Università Vita-Salute San Raffaele, Milan, Italy
| | - Raquel Faria
- Unidade de Imunologia Clínica, Centro Hospitalar Universitário do Porto; UMIB, Unit for Multidisciplinary Research in Biomedicine, ICBAS, School of Medicine and Biomedical Sciences, University of Porto; ITR, Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
| | - João E Fonseca
- Department of Rheumatology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre and Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Ilaria Galetti
- Federation of European Scleroderma Associations (FESCA), Milan, Italy
| | - Eric Hachulla
- Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Systémiques et Auto-Immunes Rares du Nord-Ouest (CERAINO), LIRIC, INSERM, Université de Lille, CHU Lille, France
| | - Luca Iaccarino
- Rheumatology Unit, Department of Medicine-DIMED, University Hospitalof Padova, AO Padova, Italy
| | - Søren Jacobsen
- Copenhagen Research Center for Autoimmune Connective Tissue Diseases, COPEACT, Rigshospitalet, Copenhagen, Denmark
| | - Nikita Khmelinskii
- Department of Rheumatology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre and Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Maarten Limper
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Diana Marinello
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Alain Meyer
- Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Centre National de Référence des Maladies Systémiques et Auto-immunes Rares Grand-Est Sud-Ouest (RESO), Strasbourg, France
| | - Gianluca Moroncini
- Department of Clinical and Molecular Sciences, Marche Polytechnic University, and Clinica Medica, Department of Internal Medicine, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy
| | - Gyorgy Nagy
- Department of Rheumatology and Clinical Immunology, Department. of Internal Medicine and Oncology, Semmelweis University, Budapest; Heart and Vascular Center, Semmelweis University, Budapest, and Department of Genetics, Cell and Immunobiology, Semmelweis University, Budapest; Hospital of the Hospitaller Order of Saint John of God, Budapest, Hungary
| | - Marzena Olesinska
- Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Cristina Pamfil
- Department of Rheumatology, County Emergency Clinical Hospital Cluj, Iuliua Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Margarita Pileckyte
- Department of Rheumatology, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mauro Pistello
- Retrovirus Centre, Department of Translational Medicine and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Simona Rednic
- Department of Rheumatology, County Emergency Clinical Hospital Cluj, Iuliua Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Christophe Richez
- Department of Rheumatology, CHU Bordeaux (Groupe Hospitalier Pellegrin), Bordeaux, France
| | - Vasco C Romão
- Department of Rheumatology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre and Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Matthias Schneider
- Department of Rheumatology, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany
| | - Savino Sciascia
- University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases with Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), San Giovanni Bosco Hub Hospital, Turin, Italy, and Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary
| | | | - Gabriele Simonini
- NEUROFARBA Department, Rheumatology Unit, Meyer Children's University Hospital, University of Florence, Italy
| | - Vanessa Smith
- Department of Rheumatology, Ghent University Hospital, Department of Internal Medicine, Ghent, and Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Centre (IRC), Ghent, Belgium
| | - Alberto Sulli
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genova, Italy
| | - Chiara Tani
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Sander W Tas
- Amsterdam Rheumatology and Immunology Center, Department of Rheumatology and Clinical Immunology, Amsterdam UMC, location AMC, University of Amsterdam, the Netherlands
| | - Angela Tincani
- Rheumatology and Clinical Immunology Unit, ASST-Spedali Civili and University of Brescia, Italy
| | - Madelon C Vonk
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria Tektonidou
- Rheumatology Unit, First Department of Propaedeutic Internal Medicine, Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Greece
| | - Marta Mosca
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, and Rheumatology Unit, University of Pisa, Italy
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7
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Melo AT, Dourado E, Campanilho-Marques R, Bandeira M, Barreira SC, Costa J, Pimenta R, Antunes-Duarte S, Cordeiro I, Fonseca JE. Myositis Multidisciplinary Clinic in a Tertiary Referral Center. J Multidiscip Healthc 2023; 16:1127-1139. [PMID: 37131932 PMCID: PMC10149065 DOI: 10.2147/jmdh.s404017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 03/28/2023] [Indexed: 05/04/2023] Open
Abstract
Background Idiopathic inflammatory myopathies (IIM) are a rare heterogeneous group of diseases characterised by chronic skeletal muscle inflammation, but other organs are also frequently involved. IMM represent a diagnostic challenge and a multidisciplinary approach is important to ensure successful diagnosis and adequate follow-up of these patients. Objective To describe the general functioning of our multidisciplinary myositis clinic, highlighting the benefits of multidisciplinary team management in patients with confirmed or suspected IIM and to characterise our clinical experience. Methods Description of the organization of a dedicated multidisciplinary myositis outpatient clinic, supported by IMM specific electronic assessment tools and protocols based on our Portuguese Register - Reuma.pt. In addition, an overview of our activity between 2017 and 2022 is provided. Results An IIM multidisciplinary care clinic, based on a close collaboration between Rheumatologists, Dermatologists and Physiatrist is detailed in this paper. One hundred and eighty-five patients were assessed in our myositis clinic; 138 (75%) of those were female, with a median age of 58 [45-70] years. At the last appointment, 130 patients had a confirmed IIM diagnosis, and the mean disease duration was 4 [2-6] years. The most frequent diagnosis was dermatomyositis (n = 34, 26.2%), followed by antisynthetase syndrome (n = 27, 20.8%) and clinically amyopathic/paucimyopathic dermatomyositis (n = 18, 13.8%). Twenty-four patients (18.5%) were on monotherapy and 94 (72.3%) were on combination therapy. Conclusion A multidisciplinary approach is important to ensure the correct diagnosis and follow-up of these patients. A myositis clinic, with a standardised practice at a tertiary hospital level, contributes to a standardization of care and opens research opportunities.
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Affiliation(s)
- Ana Teresa Melo
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Investigation Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Correspondence: Ana Teresa Melo, Serviço de Reumatologia, Centro Hospitalar Universitário Lisboa Norte, Hospital de Santa Maria, EPE, R. Prof. Egas Moniz, Lisboa, 1700, Portugal, Tel +351 217805139, Email
| | - Eduardo Dourado
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Investigation Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Raquel Campanilho-Marques
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Investigation Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Matilde Bandeira
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Investigation Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Sofia C Barreira
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Investigation Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - José Costa
- Physical Medicine and Rehabilitation Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Rita Pimenta
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Sofia Antunes-Duarte
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Inês Cordeiro
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Investigation Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - João E Fonseca
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Rheumatology Investigation Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
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8
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Duarte-Monteiro AM, Dourado E, Fonseca JE, Saraiva F. Safety of intra-articular glucocorticoid injections - state of the art. ARP Rheumatol 2023; 2:64-73. [PMID: 37042846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Intra-articular glucocorticoid injection (IAGCI) is frequently used to treat joint pain and inflammation. While its efficacy has been extensively studied, there are not as many detailed descriptions regarding safety. This review aimed to describe the immediate-, short- and long-term complications of IAGCI and their predictors. Most studies mainly report mild and self-limited adverse events with an incidence similar to placebo. However, the reported incidences vary significantly and are mostly inferred from retrospective data. Septic arthritis is the most feared adverse event due to its association with high mortality. Other short-term local complications include injection site pain, post-injection flare, skin hypopigmentation and atrophy, and tendon rupture. Systemic side effects are common, including vasovagal reactions, flushing, increased appetite and mood changes, hyperglycemia in diabetic patients, and bleeding in high-risk patients. Few predictors of complications have been systematically evaluated. However, male gender, advanced age, and pre-existing joint disease have been suggested in retrospective studies to correlate with infection risk. Overall, in most studies, only severe adverse event rates are reported, with no systematic prospective evaluations of safety and no report of predictors of complications. Therefore, since IAGCI is a routinely used treatment, more detailed knowledge of adverse events and complications is warranted.
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9
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Talarico R, Aguilera S, Alexander T, Amoura Z, Antunes AM, Arnaud L, Avcin T, Beretta L, Bombardieri S, Burmester GR, Cannizzo S, Cavagna L, Chaigne B, Cornet A, Costedoat-Chalumeau N, Doria A, Ferraris A, Fischer-Betz R, Fonseca JE, Frank C, Gaglioti A, Galetti I, Grunert J, Guimarães V, Hachulla E, Houssiau F, Iaccarino L, Krieg T, Limper M, Malfait F, Mariette X, Marinello D, Martin T, Matthews L, Matucci-Cerinic M, Meyer A, Montecucco C, Mouthon L, Müller-Ladner U, Rednic S, Romão VC, Schneider M, Smith V, Sulli A, Tamirou F, Taruscio D, Taulaigo AV, Terol E, Tincani A, Ticciati S, Turchetti G, van Hagen PM, van Laar JM, Vieira A, de Vries-Bouwstra JK, Cutolo M, Mosca M. Publisher Correction: The impact of COVID-19 on rare and complex connective tissue diseases: the experience of ERN ReCONNET. Nat Rev Rheumatol 2022; 18:734. [PMID: 36203063 PMCID: PMC9540116 DOI: 10.1038/s41584-022-00862-9] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Rosaria Talarico
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Silvia Aguilera
- Spanish Association for Antiphospholipid Syndrome (SAF España), Elche, Spain
| | - Tobias Alexander
- Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin, Berlin, Germany
| | - Zahir Amoura
- Department of Internal Medicine, Hospital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, French National Referral Center for SLE and APS, Paris, France
| | - Ana M Antunes
- Auto-immune Disease Unit, Hospital de Curry Cabral, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - Laurent Arnaud
- Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Centre National de Référence des Maladies Systémiques et Auto-immunes Rares Grand-Est Sud-Ouest (RESO), Strasbourg, France
| | - Tadej Avcin
- Department of Allergology, Rheumatology and Clinical Immunology, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Lorenzo Beretta
- Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | | | - Gerd R Burmester
- Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin, Berlin, Germany
| | - Sara Cannizzo
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.,Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Lorenzo Cavagna
- Department of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Benjamin Chaigne
- Service de Médecine Interne, Hôpital Cochin, Centre de Référence Maladies systémiques Autoimmunes Rares d'Ile de France, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
| | | | - Nathalie Costedoat-Chalumeau
- Service de Médecine Interne, Hôpital Cochin, Centre de Référence Maladies systémiques Autoimmunes Rares d'Ile de France, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
| | - Andrea Doria
- Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Alessandro Ferraris
- Medical Genetics Laboratory, Molecular Medicine Department, San Camillo Forlanini Hospital, Sapienza University, Rome, Italy
| | - Rebecca Fischer-Betz
- Department of Rheumatology, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - João E Fonseca
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Charissa Frank
- Flemish Association for Hereditary Connective Tissue Disorders, Koersel, Belgium
| | - Andrea Gaglioti
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Ilaria Galetti
- Federation of European Scleroderma Associations (FESCA), Milan, Italy
| | | | - Vera Guimarães
- Liga Portuguesa Contra as Doenças Reumáticas, Lisbon, Portugal
| | - Eric Hachulla
- Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Systémiques et Auto-Immunes Rares du Nord-Ouest (CERAINO), LIRIC, INSERM, Univ. Lille, CHU Lille, Lille, France
| | - Frederic Houssiau
- Department of Rheumatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Luca Iaccarino
- Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Thomas Krieg
- Department of Dermatology, Universitätsklinikum, Cologne, Germany
| | - Marteen Limper
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Fransiska Malfait
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Xavier Mariette
- Université Paris-Saclay, INSERM, CEA, Centre de recherche en Immunologie des infections virales et des maladies auto-immunes; AP-HP. Université Paris-Saclay, Hôpital Bicêtre, Rheumatology Department, Le Kremlin Bicêtre, Paris, France
| | - Diana Marinello
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Thierry Martin
- Clinical immunology department, Hôpitaux Universitaires de Strasbourg, Centre National de Référence des Maladies Systémiques et Auto-immunes Rares Grand-Est Sud-Ouest (RESO), Strasbourg, France
| | - Lisa Matthews
- Relapsing Polychondritis Awareness and Support, Worcester, UK
| | - Marco Matucci-Cerinic
- Division of Rheumatology and Scleroderma Unit, Department of Clinical and Experimental Medicine, AOU Careggi, University of Florence, Florence, Italy
| | - Alain Meyer
- Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Centre National de Référence des Maladies Systémiques et Auto-immunes Rares Grand-Est Sud-Ouest (RESO), Strasbourg, France
| | | | - Luc Mouthon
- Service de Médecine Interne, Hôpital Cochin, Centre de Référence Maladies systémiques Autoimmunes Rares d'Ile de France, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
| | - Ulf Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Kerckhoff Klinik, Justus Liebig University of Giessen, Bad Nauheim, Germany
| | - Simona Rednic
- Department of Rheumatology, Emergency County Teaching Hospital, Cluj-Napoca, Romania
| | - Vasco C Romão
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Matthias Schneider
- Department of Rheumatology, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Vanessa Smith
- Department of Rheumatology, Ghent University Hospital Department of Internal Medicine, Ghent, Belgium
| | - Alberto Sulli
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, IRCCS Polyclinic Hospital San Martino, University of Genoa, Genoa, Italy
| | - Farah Tamirou
- Department of Rheumatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Domenica Taruscio
- National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Anna V Taulaigo
- Auto-immune Disease Unit, Hospital de Curry Cabral, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - Enrique Terol
- Directorate-General for Health and Food Safety, European Commission, Brussels, Belgium
| | - Angela Tincani
- Rheumatology and Clinical Immunology Unit, ASST-Spedali Civili and University of Brescia, Brescia, Italy
| | - Simone Ticciati
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | | | - P Martin van Hagen
- Department of Internal Medicine and Immunology, Erasmus MC, Rotterdam, Netherlands
| | - Jacob M van Laar
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Ana Vieira
- Liga Portuguesa Contra as Doenças Reumáticas, Núcleo Síndrome de Sjögren, Lisbon, Portugal
| | | | - Maurizio Cutolo
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, IRCCS Polyclinic Hospital San Martino, University of Genoa, Genoa, Italy
| | - Marta Mosca
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. .,Rheumatology Unit, University of Pisa, Pisa, Italy.
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Fonseca JE, Duarte-Monteiro AM. Editorial: Insights in Rheumatology: 2021. Front Med (Lausanne) 2022; 9:971777. [PMID: 35935784 PMCID: PMC9355584 DOI: 10.3389/fmed.2022.971777] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- João E. Fonseca
- Rheumatology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- *Correspondence: João E. Fonseca
| | - Ana Margarida Duarte-Monteiro
- Rheumatology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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11
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Bandeira M, Dourado E, Fonseca JE. Etanercept for refractory chronic and deforming Chikungunya polyarthritis: a case report. Rheumatology (Oxford) 2022; 61:e344-e345. [PMID: 35639642 DOI: 10.1093/rheumatology/keac313] [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: 04/25/2022] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Matilde Bandeira
- Serviço de Reumatologia, Centro Hospitalar Universitário Lisboa Norte (CHULN), Centro Académico de Medicina de Lisboa (CAML), Lisboa, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, CAML, Lisboa, Portugal
| | - Eduardo Dourado
- Serviço de Reumatologia, Centro Hospitalar Universitário Lisboa Norte (CHULN), Centro Académico de Medicina de Lisboa (CAML), Lisboa, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, CAML, Lisboa, Portugal
| | - João E Fonseca
- Serviço de Reumatologia, Centro Hospitalar Universitário Lisboa Norte (CHULN), Centro Académico de Medicina de Lisboa (CAML), Lisboa, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, CAML, Lisboa, Portugal
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12
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Petitdemange A, Sztejkowski C, Damian L, Martin T, Mouthon L, Amoura Z, Cutolo M, Burmester GR, Fonseca JE, Rednic S, Arnaud L. Treatment of relapsing polychondritis: a systematic review. Clin Exp Rheumatol 2022; 40 Suppl 134:81-85. [PMID: 35238756 DOI: 10.55563/clinexprheumatol/h9gq1o] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Due to the rarity of relapsing polychondritis (RP), no randomised clinical trial has been conducted to date and treatment remains empirical. We performed a systematic literature review to assess the efficacy of the main conventional immunosuppressants and biotherapies used in RP. METHODS We searched MEDLINE for original articles without language restriction. Abstracts from American College of Rheumatology (ACR) and European Alliance of Associations for Rheumatology (EULAR) were also considered for inclusion. Observational studies and clinical trials reporting on the efficacy of conventional immunosuppressants and biotherapies in adult patients with RP were selected and pooled response rates for each treatment were computed. RESULTS Of 304 articles and abstracts identified, 31 underwent full-text review, and 11 were included. The studies involved a total of 177 patients, exposed to a total of 247 lines of treatments. The main treatments studied (by number of lines) were: TNF inhibitors (TNFi), n=92; methotrexate (MTX), n=38; tocilizumab (TCZ), n=26; anakinra (ANA), n=21; rituximab (RTX), n=16; abatacept (ABT), n=14; cyclophosphamide (CYC), n=14; azathioprine (AZA), n=13. The pooled response rates across studies were: 72% [95% CI: 42-95] for ABT, 66% [95% CI: 49-82] for TCZ, 64% [95% CI: 53-74] for TNFi, 56% [95% CI: 37-73] for MTX, 47% [95% CI: 26-68] for ANA, 43% [95% CI: 20-68] for RTX. Based on more limited data, response rates for AZA and CYC ranged from 38 to 100% and from 25 to 100%, respectively. CONCLUSIONS In this systematic review of available evidence regarding the treatment of relapsing polychondritis, ABT, TCZ and TNFi were the drugs associated with the best outcomes. ABT efficacy must be interpreted in light of the small number of patients treated. While MTX had slightly less efficacy, it is one of the drugs for which data are the most robust.
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Affiliation(s)
- Arthur Petitdemange
- Service d'Immunologie Clinique et de Médecine Interne, Hôpitaux Universitaires de Strasbourg, Centre National de Référence des Maladies Systémiques et Auto-immunes Rares Grand-Est Sud-Ouest (RESO), Strasbourg, France
| | - Cédric Sztejkowski
- Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Centre National de Référence des Maladies Systémiques et Auto-immunes Rares Grand-Est Sud-Ouest (RESO), Strasbourg, France
| | - Laura Damian
- Department of Rheumatology, Emergency County Teaching Hospital, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Thierry Martin
- Service d'Immunologie Clinique et de Médecine Interne, Hôpitaux Universitaires de Strasbourg, Centre National de Référence des Maladies Systémiques et Auto-immunes Rares Grand-Est Sud-Ouest (RESO), Strasbourg, France
| | - Luc Mouthon
- Service de Médecine Interne, Hôpital Cochin, Centre de Référence Maladies systémiques Autoimmunes Rares d'Ile de France, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, France
| | - Zahir Amoura
- Service de Médecine interne, Hôpital Pitié-Salpêtrière, Centre National de Référence pour le lupus, le syndrome des antiphospholipides et autres maladies auto-immunes rares, Assistance Publique Hôpitaux de Paris, France
| | - Maurizio Cutolo
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, IRCCS Polyclinic Hospital San Martino, University of Genoa, Italy
| | - Gerd R Burmester
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - João E Fonseca
- Rheumatology Department, Centro Hospitalar Universitário Lisboa Norte, Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Centre, Portugal
| | - Simona Rednic
- Department of Rheumatology, Emergency County Teaching Hospital, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Laurent Arnaud
- Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Centre National de Référence des Maladies Systémiques et Auto-immunes Rares Grand-Est Sud-Ouest (RESO), Strasbourg, France.
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13
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Gouveia VM, Rizzello L, Vidal B, Nunes C, Poma A, Lopez‐Vasquez C, Scarpa E, Brandner S, Oliveira A, Fonseca JE, Reis S, Battaglia G. Targeting Macrophages and Synoviocytes Intracellular Milieu to Augment Anti‐Inflammatory Drug Potency (Adv. Therap. 3/2022). Advanced Therapeutics 2022. [DOI: 10.1002/adtp.202270005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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14
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Gouveia VM, Rizzello L, Vidal B, Nunes C, Poma A, Lopez‐Vasquez C, Scarpa E, Brandner S, Oliveira A, Fonseca JE, Reis S, Battaglia G. Targeting Macrophages and Synoviocytes Intracellular Milieu to Augment Anti‐Inflammatory Drug Potency. Advanced Therapeutics 2022. [DOI: 10.1002/adtp.202100167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Virgínia M. Gouveia
- Department of Chemistry University College London London WC1H 0AJ UK
- Institute of Physics of Living Systems University College London London WC1H 0AJ UK
- SomaServe Ltd Babraham Research Campus Cambridge CB22 3AT UK
- LAQV REQUIMTE Department of Chemical Sciences Faculty of Pharmacy University of Porto Porto 4050‐313 Portugal
- Abel Salazar Biomedical Sciences Institute University of Porto Porto 4050‐313 Portugal
| | - Loris Rizzello
- Department of Chemistry University College London London WC1H 0AJ UK
- Institute for Bioengineering of Catalonia (IBEC) The Barcelona Institute of Science and Technology Barcelona 08028 Spain
- Department of Pharmaceutical Sciences University of Milan Milan 20133 Italy
- National Institute of Molecular Genetics (INGM) Milan 20122 Italy
| | - Bruno Vidal
- Rheumatology Research Unit Institute of Molecular Medicine – IMM João Lobo Antunes Faculty of Medicine University of Lisbon Lisbon 1649‐028 Portugal
| | - Claudia Nunes
- LAQV REQUIMTE Department of Chemical Sciences Faculty of Pharmacy University of Porto Porto 4050‐313 Portugal
| | - Alessandro Poma
- Department of Chemistry University College London London WC1H 0AJ UK
- Division of Biomaterials and Tissue Engineering Eastman Dental Institute Royal Free Hospital UCL Medical School London NW3 2PF UK
| | - Ciro Lopez‐Vasquez
- Department of Chemistry University College London London WC1H 0AJ UK
- Institute of Physics of Living Systems University College London London WC1H 0AJ UK
| | - Edoardo Scarpa
- Department of Chemistry University College London London WC1H 0AJ UK
- Department of Pharmaceutical Sciences University of Milan Milan 20133 Italy
- National Institute of Molecular Genetics (INGM) Milan 20122 Italy
| | - Sebastian Brandner
- Department of Neurodegenerative Disease Queen Square Institute of Neurology University College London London WC1N 3BG UK
| | - António Oliveira
- Abel Salazar Biomedical Sciences Institute University of Porto Porto 4050‐313 Portugal
| | - João E. Fonseca
- Rheumatology Research Unit Institute of Molecular Medicine – IMM João Lobo Antunes Faculty of Medicine University of Lisbon Lisbon 1649‐028 Portugal
- Serviço de Reumatologia Centro Hospitalar Universitário Lisboa Norte Centro Academico de Medicina de Lisboa Lisbon 1649‐028 Portugal
| | - Salette Reis
- LAQV REQUIMTE Department of Chemical Sciences Faculty of Pharmacy University of Porto Porto 4050‐313 Portugal
| | - Giuseppe Battaglia
- Department of Chemistry University College London London WC1H 0AJ UK
- Institute of Physics of Living Systems University College London London WC1H 0AJ UK
- Institute for Bioengineering of Catalonia (IBEC) The Barcelona Institute of Science and Technology Barcelona 08028 Spain
- Catalan Institution for Research and Advanced Studies (ICREA) Barcelona 08010 Spain
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15
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Janeiro J, Barreira SC, Martins P, Ninitas P, Campos J, Fonseca JE. Ultrasound Features Associated With Shoulder Complaints: Calcifications Larger Than 6 mm in Young Patients and Positive Doppler Are Associated With Pain. Front Med (Lausanne) 2021; 8:715423. [PMID: 34869414 PMCID: PMC8639518 DOI: 10.3389/fmed.2021.715423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To identify ultrasound (US) features associated with the presence of shoulder complaints. Methods: This observational, case-control study, compared US findings between participants with and without shoulder complaints, matched for age, sex, and dominancy. Data was collected from February 2018 to June 2020. Two-tailed Fisher's and Mann-Whitney U-tests were used, with p-values < 0.05 considered significant. Results: A total of 202 participants were enrolled (median age 56 years, range 18–70, 155 women), comprising 140 cases and 62 controls. A calcification size ≥6 mm, when age < 56 (p = 0.02), and a distance to tendon insertion ≥6 mm, when age ≥56 (p = 0.009), were only found in symptomatic shoulders. Color Doppler in rotator cuff (RC) tendons predominated in the presence of symptoms (26/140 vs. 2/62, p = 0.003). An algorithm also combining the number of calcifications, tendon echotexture and insertional thickening, osseous irregularity, cuff tears, and subacromial effusion showed a 92% (57/62) specificity for shoulder pain on this study sample. Conclusion: Calcification diameter of 6 mm or more is associated with shoulder pain in patients younger than 56 years. A distance from calcification to tendon insertion of 6 mm or more is related to pain in older patients. Doppler signal also is associated with shoulder pain. An algorithm based on a set of specific ultrasonographic criteria have a strong association with the presence of symptoms.
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Affiliation(s)
- João Janeiro
- Serviço de Imagiologia Geral, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
| | - Sofia C Barreira
- Serviço de Reumatologia e Doenças Ósseas Metabólicas, Hospital de Santa Maria Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
| | - Patrícia Martins
- Serviço de Reumatologia e Doenças Ósseas Metabólicas, Hospital de Santa Maria Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
| | - Pedro Ninitas
- Serviço de Imagiologia Geral, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
| | - Jorge Campos
- Serviço de Imagiologia Neurológica, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
| | - João E Fonseca
- Serviço de Reumatologia e Doenças Ósseas Metabólicas, Hospital de Santa Maria Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
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16
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Sánchez-Maldonado JM, Cáliz R, López-Nevot MÁ, Cabrera-Serrano AJ, Moñiz-Díez A, Canhão H, Ter Horst R, Quartuccio L, Sorensen SB, Glintborg B, Hetland ML, Filipescu I, Pérez-Pampin E, Conesa-Zamora P, Swierkot J, den Broeder AA, De Vita S, Petersen ERB, Li Y, Ferrer MA, Escudero A, Netea MG, Coenen MJH, Andersen V, Fonseca JE, Jurado M, Bogunia-Kubik K, Collantes E, Sainz J. Validation of GWAS-Identified Variants for Anti-TNF Drug Response in Rheumatoid Arthritis: A Meta-Analysis of Two Large Cohorts. Front Immunol 2021; 12:672255. [PMID: 34777329 PMCID: PMC8579100 DOI: 10.3389/fimmu.2021.672255] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 10/11/2021] [Indexed: 12/29/2022] Open
Abstract
We aimed to validate the association of 28 GWAS-identified genetic variants for response to TNF inhibitors (TNFi) in a discovery cohort of 1361 rheumatoid arthritis (RA) patients monitored in routine care and ascertained through the REPAIR consortium and DANBIO registry. We genotyped selected markers and evaluated their association with response to TNFi after 6 months of treatment according to the change in disease activity score 28 (ΔDAS28). Next, we confirmed the most interesting results through meta-analysis of our data with those from the DREAM cohort that included 706 RA patients treated with TNFi. The meta-analysis of the discovery cohort and DREAM registry including 2067 RA patients revealed an overall association of the LINC02549rs7767069 SNP with a lower improvement in DAS28 that remained significant after correction for multiple testing (per-allele ORMeta=0.83, PMeta=0.000077; PHet=0.61). In addition, we found that each copy of the LRRC55rs717117G allele was significantly associated with lower improvement in DAS28 in rheumatoid factor (RF)-positive patients (per-allele ORMeta=0.67, P=0.00058; PHet=0.06) whereas an opposite but not significant effect was detected in RF-negative subjects (per-allele ORMeta=1.38, P=0.10; PHet=0.45; PInteraction=0.00028). Interestingly, although the identified associations did not survive multiple testing correction, the meta-analysis also showed overall and RF-specific associations for the MAFBrs6071980 and CNTN5rs1813443 SNPs with decreased changes in DAS28 (per-allele ORMeta_rs6071980 = 0.85, P=0.0059; PHet=0.63 and ORMeta_rs1813443_RF+=0.81, P=0.0059; PHet=0.69 and ORMeta_rs1813443_RF-=1.00, P=0.99; PHet=0.12; PInteraction=0.032). Mechanistically, we found that subjects carrying the LINC02549rs7767069T allele had significantly increased numbers of CD45RO+CD45RA+ T cells (P=0.000025) whereas carriers of the LINC02549rs7767069T/T genotype showed significantly increased levels of soluble scavengers CD5 and CD6 in serum (P=0.00037 and P=0.00041). In addition, carriers of the LRRC55rs717117G allele showed decreased production of IL6 after stimulation of PBMCs with B burgdorferi and E coli bacteria (P=0.00046 and P=0.00044), which suggested a reduced IL6-mediated anti-inflammatory effect of this marker to worsen the response to TNFi. In conclusion, this study confirmed the influence of the LINC02549 and LRRC55 loci to determine the response to TNFi in RA patients and suggested a weak effect of the MAFB and CNTN5 loci that need to be further investigated.
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Affiliation(s)
- Jose Manuel Sánchez-Maldonado
- Genomic Oncology Area, Centre for Genomics and Oncological Research (GENYO), Parque tecnológico de la Salud (PTS) Granada, Granada, Spain.,Hematology Department, Virgen de las Nieves University Hospital, Granada, Spain.,Instituto de Investigación Biosanitaria (IBs) Granada, Granada, Spain
| | - Rafael Cáliz
- Genomic Oncology Area, Centre for Genomics and Oncological Research (GENYO), Parque tecnológico de la Salud (PTS) Granada, Granada, Spain.,Instituto de Investigación Biosanitaria (IBs) Granada, Granada, Spain.,Department of Rheumatology, Virgen de las Nieves University Hospital, Granada, Spain
| | - Miguel Ángel López-Nevot
- Instituto de Investigación Biosanitaria (IBs) Granada, Granada, Spain.,Immunology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Antonio José Cabrera-Serrano
- Genomic Oncology Area, Centre for Genomics and Oncological Research (GENYO), Parque tecnológico de la Salud (PTS) Granada, Granada, Spain.,Hematology Department, Virgen de las Nieves University Hospital, Granada, Spain.,Instituto de Investigación Biosanitaria (IBs) Granada, Granada, Spain
| | - Ana Moñiz-Díez
- Genomic Oncology Area, Centre for Genomics and Oncological Research (GENYO), Parque tecnológico de la Salud (PTS) Granada, Granada, Spain.,Hematology Department, Virgen de las Nieves University Hospital, Granada, Spain.,Instituto de Investigación Biosanitaria (IBs) Granada, Granada, Spain
| | - Helena Canhão
- EpiDoC Unit, CEDOC, NOVA Medical School and National School of Public Health, Universidade Nova de Lisboa, Lisbon, Portugal.,Comprehensive Health Research Center (CHRC), NOVA Medical School, Lisbon, Portugal
| | - Rob Ter Horst
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
| | - Luca Quartuccio
- Department of Medical Area, Clinic of Rheumatology, University of Udine, Udine, Italy
| | - Signe B Sorensen
- Molecular Diagnostic and Clinical Research Unit, IRS-Center Sonderjylland, University Hospital of Southern Jutland, Aabenraa, Denmark.,Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Bente Glintborg
- The Danish Rheumatologic Biobank and Copenhagen Center for Arthritis Research (DANBIO) Registry, The Danish Rheumatologic Biobank and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete L Hetland
- The Danish Rheumatologic Biobank and Copenhagen Center for Arthritis Research (DANBIO) Registry, The Danish Rheumatologic Biobank and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ileana Filipescu
- Rheumatology Department, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Eva Pérez-Pampin
- Rheumatology Unit, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Pablo Conesa-Zamora
- Clinical Analysis Department, Santa Lucía University Hospital, Cartagena, Spain
| | - Jerzy Swierkot
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Alfons A den Broeder
- Radboud Institute for Health Sciences, Department of Rheumatology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Salvatore De Vita
- Department of Medical Area, Clinic of Rheumatology, University of Udine, Udine, Italy
| | - Eva Rabing Brix Petersen
- Department of Biochemistry and Immunology, University Hospital of Southern Jutland, Aabenraa, Denmark
| | - Yang Li
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands.,Centre for Individualised Infection Medicine (CiiM) & Centre for Experimental and Clinical Infection Research (TWINCORE), Helmholtz-Centre for Infection Research (HZI) and The Hannover Medical School (MHH), Hannover, Germany
| | - Miguel A Ferrer
- Instituto de Investigación Biosanitaria (IBs) Granada, Granada, Spain
| | - Alejandro Escudero
- Rheumatology Department, Reina Sofía Hospital/Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/University of Córdoba, Córdoba, Spain
| | - Mihai G Netea
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands.,Department for Immunology & Metabolism, Life and Medical Sciences Institute (LIMES), University of Bonn, Bonn, Germany
| | - Marieke J H Coenen
- Radboud Institute for Health Sciences, Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
| | - Vibeke Andersen
- Department of Medical Area, Clinic of Rheumatology, University of Udine, Udine, Italy.,Molecular Diagnostic and Clinical Research Unit, IRS-Center Sonderjylland, University Hospital of Southern Jutland, Aabenraa, Denmark.,Institute of Regional Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - João E Fonseca
- Rheumatology and Metabolic Bone Diseases Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHLN), Lisbon, Portugal.,Rheumatology Research Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon Academic Medical Center, Lisbon, Portugal
| | - Manuel Jurado
- Genomic Oncology Area, Centre for Genomics and Oncological Research (GENYO), Parque tecnológico de la Salud (PTS) Granada, Granada, Spain.,Hematology Department, Virgen de las Nieves University Hospital, Granada, Spain.,Instituto de Investigación Biosanitaria (IBs) Granada, Granada, Spain
| | - Katarzyna Bogunia-Kubik
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland
| | - Eduardo Collantes
- Rheumatology Department, Reina Sofía Hospital/Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/University of Córdoba, Córdoba, Spain
| | - Juan Sainz
- Genomic Oncology Area, Centre for Genomics and Oncological Research (GENYO), Parque tecnológico de la Salud (PTS) Granada, Granada, Spain.,Hematology Department, Virgen de las Nieves University Hospital, Granada, Spain.,Instituto de Investigación Biosanitaria (IBs) Granada, Granada, Spain.,Department of Biochemistry and Molecular Biology I, University of Granada, Granada, Spain
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17
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Ponte C, Khmelinskii N, Teixeira V, Luz K, Peixoto D, Rodrigues M, Luís M, Teixeira L, Sousa S, Madeira N, Aleixo JA, Pedrosa T, Serra S, Campanilho-Marques R, Castelão W, Cordeiro A, Cordeiro I, Fernandes S, Macieira C, Madureira P, Malcata A, Vieira R, Martins F, Sequeira G, Branco JC, Costa L, Patto JV, da Silva JC, Pereira da Silva JA, Afonso C, Canhão H, Santos MJ, Luqmani RA, Fonseca JE. Reuma.pt/vasculitis - the Portuguese vasculitis registry. Orphanet J Rare Dis 2020; 15:110. [PMID: 32370776 PMCID: PMC7201571 DOI: 10.1186/s13023-020-01381-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 04/07/2020] [Indexed: 11/26/2022] Open
Abstract
Background The vasculitides are a group of rare diseases with different manifestations and outcomes. New therapeutic options have led to the need for long-term registries. The Rheumatic Diseases Portuguese Register, Reuma.pt, is a web-based electronic clinical record, created in 2008, which currently includes specific modules for 12 diseases and > 20,000 patients registered from 79 rheumatology centres. On October 2014, a dedicated module for vasculitis was created as part of the European Vasculitis Society collaborative network, enabling prospective collection and central storage of encrypted data from patients with this condition. All Portuguese rheumatology centres were invited to participate. Data regarding demographics, diagnosis, classification criteria, assessment tools, and treatment were collected. We aim to describe the structure of Reuma.pt/vasculitis and characterize the patients registered since its development. Results A total of 687 patients, with 1945 visits, from 13 centres were registered; mean age was 53.4 ± 19.3 years at last visit and 68.7% were females. The most common diagnoses were Behçet’s disease (BD) (42.5%) and giant cell arteritis (GCA) (17.8%). Patients with BD met the International Study Group criteria and the International Criteria for BD in 85.3 and 97.2% of cases, respectively. Within the most common small- and medium-vessel vasculitides registered, median [interquartile range] Birmingham Vasculitis Activity Score (BVAS) at first visit was highest in patients with ANCA-associated vasculitis (AAV) (17.0 [12.0]); there were no differences in the proportion of patients with AAV or polyarteritis nodosa who relapsed (BVAS≥1) or had a major relapse (≥1 major BVAS item) during prospective assessment (p = 1.00, p = 0.479). Biologic treatment was prescribed in 0.8% of patients with GCA, 26.7% of patients with AAV, and 7.6% of patients with BD. There were 34 (4.9%) deaths reported. Conclusions Reuma.pt/vasculitis is a bespoke web-based registry adapted for routine care of patients with this form of rare and complex diseases, allowing an efficient data-repository at a national level with the potential to link with other international databases. It facilitates research, trials recruitment, service planning and benchmarking.
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Affiliation(s)
- Cristina Ponte
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal. .,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
| | - Nikita Khmelinskii
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Vítor Teixeira
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Karine Luz
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Rheumatology Department, Universidade Federal do Estado de São Paulo, São Paulo, Brazil
| | - Daniela Peixoto
- Rheumatology Department, Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
| | - Marília Rodrigues
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Rheumatology Department, Hospital de Santo André - Centro Hospitalar de Leiria, Leiria, Portugal
| | - Mariana Luís
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Lídia Teixeira
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal.,Rheumatology Department, Hospital Dr. Nélio Mendonça, Funchal, Portugal
| | - Sandra Sousa
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Nathalie Madeira
- Rheumatology Department, Instituto Português de Reumatologia, Lisbon, Portugal
| | - Joana A Aleixo
- Rheumatology Department, Centro Hospitalar de São João, Porto, Portugal.,Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Gaia, Portugal
| | - Teresa Pedrosa
- Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.,Multidisciplinary Unit of Chronic Pain, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - Sofia Serra
- Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Raquel Campanilho-Marques
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Rheumatology Department, Instituto Português de Reumatologia, Lisbon, Portugal
| | - Walter Castelão
- Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Ana Cordeiro
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Inês Cordeiro
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Sílvia Fernandes
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Rheumatology Department, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | - Carla Macieira
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Pedro Madureira
- Rheumatology Department, Centro Hospitalar de São João, Porto, Portugal
| | - Armando Malcata
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Romana Vieira
- Rheumatology Department, Centro Hospitalar de São João, Porto, Portugal.,Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Gaia, Portugal
| | | | - Graça Sequeira
- Rheumatology Department, Hospital de Faro, Centro Hospitalar do Algarve, Faro, Portugal
| | - Jaime C Branco
- Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Lúcia Costa
- Rheumatology Department, Centro Hospitalar de São João, Porto, Portugal
| | - José Vaz Patto
- Rheumatology Department, Instituto Português de Reumatologia, Lisbon, Portugal
| | | | | | - Carmo Afonso
- Rheumatology Department, Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
| | - Helena Canhão
- Sociedade Portuguesa de Reumatologia, Lisbon, Portugal.,CEDOC, EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Maria J Santos
- Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal.,Sociedade Portuguesa de Reumatologia, Lisbon, Portugal
| | - Raashid A Luqmani
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - João E Fonseca
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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18
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Sánchez-Maldonado JM, Cáliz R, Canet L, Horst RT, Bakker O, den Broeder AA, Martínez-Bueno M, Canhão H, Rodríguez-Ramos A, Lupiañez CB, Soto-Pino MJ, García A, Pérez-Pampin E, González-Utrilla A, Escudero A, Segura-Catena J, Netea-Maier RT, Ferrer MÁ, Collantes-Estevez E, López Nevot MÁ, Li Y, Jurado M, Fonseca JE, Netea MG, Coenen MJH, Sainz J. Steroid hormone-related polymorphisms associate with the development of bone erosions in rheumatoid arthritis and help to predict disease progression: Results from the REPAIR consortium. Sci Rep 2019; 9:14812. [PMID: 31616008 PMCID: PMC6794376 DOI: 10.1038/s41598-019-51255-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 09/28/2019] [Indexed: 12/11/2022] Open
Abstract
Here, we assessed whether 41 SNPs within steroid hormone genes associated with erosive disease. The most relevant finding was the rheumatoid factor (RF)-specific effect of the CYP1B1, CYP2C9, ESR2, FcγR3A, and SHBG SNPs to modulate the risk of bone erosions (P = 0.004, 0.0007, 0.0002, 0.013 and 0.015) that was confirmed through meta-analysis of our data with those from the DREAM registry (P = 0.000081, 0.0022, 0.00074, 0.0067 and 0.0087, respectively). Mechanistically, we also found a gender-specific correlation of the CYP2C9rs1799853T/T genotype with serum vitamin D3 levels (P = 0.00085) and a modest effect on IL1β levels after stimulation of PBMCs or blood with LPS and PHA (P = 0.0057 and P = 0.0058). An overall haplotype analysis also showed an association of 3 ESR1 haplotypes with a reduced risk of erosive arthritis (P = 0.009, P = 0.002, and P = 0.002). Furthermore, we observed that the ESR2, ESR1 and FcγR3A SNPs influenced the immune response after stimulation of PBMCs or macrophages with LPS or Pam3Cys (P = 0.002, 0.0008, 0.0011 and 1.97•10−7). Finally, we found that a model built with steroid hormone-related SNPs significantly improved the prediction of erosive disease in seropositive patients (PRF+ = 2.46•10−8) whereas no prediction was detected in seronegative patients (PRF− = 0.36). Although the predictive ability of the model was substantially lower in the replication population (PRF+ = 0.014), we could confirm that CYP1B1 and CYP2C9 SNPs help to predict erosive disease in seropositive patients. These results are the first to suggest a RF-specific association of steroid hormone-related polymorphisms with erosive disease.
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Affiliation(s)
- Jose M Sánchez-Maldonado
- Genomic Oncology Area, GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain.,Instituto de Investigación Biosanataria IBs.Granada, Granada, Spain
| | - Rafael Cáliz
- Genomic Oncology Area, GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain.,Instituto de Investigación Biosanataria IBs.Granada, Granada, Spain.,Rheumatology department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Luz Canet
- Genomic Oncology Area, GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Rob Ter Horst
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Olivier Bakker
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Alfons A den Broeder
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Manuel Martínez-Bueno
- Area of Genomic Medicine, GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, Granada, Spain
| | - Helena Canhão
- CEDOC, EpiDoC Unit, NOVA Medical School and National School of Public Health, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Ana Rodríguez-Ramos
- Genomic Oncology Area, GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Carmen B Lupiañez
- Genomic Oncology Area, GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - María José Soto-Pino
- Rheumatology department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Antonio García
- Rheumatology department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Eva Pérez-Pampin
- Rheumatology Unit, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Alejandro Escudero
- Rheumatology department, Reina Sofía Hospital/IMIBIC/University of Córdoba, Córdoba, Spain
| | - Juana Segura-Catena
- Genomic Oncology Area, GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Romana T Netea-Maier
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Miguel Ángel Ferrer
- Rheumatology department, Virgen de las Nieves University Hospital, Granada, Spain
| | | | | | - Yang Li
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Manuel Jurado
- Genomic Oncology Area, GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain.,Instituto de Investigación Biosanataria IBs.Granada, Granada, Spain
| | - João E Fonseca
- Rheumatology and Metabolic Bone Diseases Department, Hospital de Santa Maria, CHLN, Lisbon, Portugal.,Rheumatology Research Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon Academic Medical Center, Lisbon, Portugal
| | - Mihai G Netea
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.,Department for Immunology & Metabolism, Life and Medical Sciences Institute (LIMES), University of Bonn, 53115, Bonn, Germany
| | - Marieke J H Coenen
- Department of Human Genetics, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Juan Sainz
- Genomic Oncology Area, GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain. .,Instituto de Investigación Biosanataria IBs.Granada, Granada, Spain.
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19
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Sanmarti R, Veale DJ, Martin‐Mola E, Escudero‐Contreras A, González C, Ercole L, Alonso R, Fonseca JE, Alcañiz C, Álvaro‐Gracia JM, Balsa A, Pablos JL, Miguel CD, Rodríguez JM, Alves J, Aurrecoechea E, Calvo J, Belzunegui J, Blanco F, Caliz R, Calvo J, Ivorra JR, Canhão H, Santos H, Chamizo E, Pino J, Delgado C, Díaz C, Nebro AF, Fraser A, Gomez A, Hernández B, Navarro F, Povedano J, Mas AJ, Kane D, Whelan B, Marras C, Moreno J, Venegas JP, Pombo M, Riera E, Rosas A, Ryan J, Santos J, Santos M, Tornero J, Tovar JV, Ucar E, Vasconcelos C, Veiga R, Vela P. Reducing or Maintaining the Dose of Subcutaneous Tocilizumab in Patients With Rheumatoid Arthritis in Clinical Remission: A Randomized, Open‐Label Trial. Arthritis Rheumatol 2019; 71:1616-1625. [DOI: 10.1002/art.40905] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 04/02/2019] [Indexed: 12/20/2022]
Affiliation(s)
| | - Douglas J. Veale
- St. Vincent's University Hospital and University College Dublin Belfield Dublin Ireland
| | | | - Alejandro Escudero‐Contreras
- Rheumatology Service Reina Sofia Hospital Maimonides Institute for Research in Biomedicine of Cordoba University of Cordoba Cordoba Spain
| | | | | | | | - João E. Fonseca
- Universidade de Lisboa and Hospital de Santa Maria CHLN Lisbon Portugal
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20
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Canet LM, Sánchez-Maldonado JM, Cáliz R, Rodríguez-Ramos A, Lupiañez CB, Canhão H, Martínez-Bueno M, Escudero A, Segura-Catena J, Sorensen SB, Hetland ML, Soto-Pino MJ, Ferrer MA, García A, Glintborg B, Filipescu I, Pérez-Pampin E, González-Utrilla A, Nevot MÁL, Conesa-Zamora P, den Broeder A, De Vita S, Jacobsen SEH, Collantes-Estevez E, Quartuccio L, Canzian F, Fonseca JE, Coenen MJH, Andersen V, Sainz J. Correction: Polymorphisms at phase I-metabolizing enzyme and hormone receptor loci influence the response to anti-TNF therapy in rheumatoid arthritis patients. Pharmacogenomics J 2019; 19:582. [PMID: 30760878 DOI: 10.1038/s41397-019-0084-2] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The original version of this Article contained an error in the spelling of the author Ana Rodríguez-Ramos, which was incorrectly given as Ana Rodríguez Ramos. This has now been corrected in both the PDF and HTML versions of the Article.
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Affiliation(s)
- Luz M Canet
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Jose M Sánchez-Maldonado
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Rafael Cáliz
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain.,Rheumatology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Ana Rodríguez-Ramos
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Carmen B Lupiañez
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Helena Canhão
- CEDOC, EpiDoC Unit, NOVA Medical School and National School of Public Health, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Manuel Martínez-Bueno
- Area of Genomic Medicine, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, Granada, Spain
| | - Alejandro Escudero
- Rheumatology Department, Reina Sofía Hospital/IMIBIC/University of Córdoba, Córdoba, Spain
| | - Juana Segura-Catena
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Signe B Sorensen
- The Danish Rheumatologic Biobank, the DANBIO Registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.,Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Merete L Hetland
- The Danish Rheumatologic Biobank, the DANBIO Registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.,Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - María José Soto-Pino
- Rheumatology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Miguel A Ferrer
- Rheumatology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Antonio García
- Rheumatology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Bente Glintborg
- The Danish Rheumatologic Biobank, the DANBIO Registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.,Department of Rheumatology, Gentofte and Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ileana Filipescu
- Rheumatology Department, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Eva Pérez-Pampin
- Rheumatology Unit, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | - Pablo Conesa-Zamora
- Clinical Analysis Department, Santa Lucía University Hospital, Cartagena, Spain
| | - Alfons den Broeder
- Department of Human Genetics, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Salvatore De Vita
- Department of Medical and Biological Sciences, Clinic of Rheumatology, University of Udine, Udine, Italy
| | - Sven Erik Hobe Jacobsen
- The Danish Rheumatologic Biobank, the DANBIO Registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.,Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Luca Quartuccio
- Department of Medical and Biological Sciences, Clinic of Rheumatology, University of Udine, Udine, Italy
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - João E Fonseca
- Rheumatology and Metabolic Bone Diseases Department, Hospital de Santa Maria, CHLN, Lisbon, Portugal.,Rheumatology Research Unit, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon Academic Medical Center, Lisbon, Portugal
| | - Marieke J H Coenen
- Department of Human Genetics, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Vibeke Andersen
- Focused Research Unit for Molecular Diagnostic and Clinical Research, IRS-Center Sonderjylland, Hospital of Southern Jutland, DK-6200, Aabenraa, Denmark.,Faculty of Health Sciences, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Juan Sainz
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain. .,Rheumatology Department, Virgen de las Nieves University Hospital, Granada, Spain.
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21
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Canet LM, Sánchez-Maldonado JM, Cáliz R, Rodríguez-Ramos A, Lupiañez CB, Canhão H, Martínez-Bueno M, Escudero A, Segura-Catena J, Sorensen SB, Hetland ML, Soto-Pino MJ, Ferrer MA, García A, Glintborg B, Filipescu I, Pérez-Pampin E, González-Utrilla A, Nevot MÁL, Conesa-Zamora P, Broeder AD, De Vita S, Jacobsen SEH, Collantes-Estevez E, Quartuccio L, Canzian F, Fonseca JE, Coenen MJH, Andersen V, Sainz J. Polymorphisms at phase I-metabolizing enzyme and hormone receptor loci influence the response to anti-TNF therapy in rheumatoid arthritis patients. Pharmacogenomics J 2018; 19:83-96. [PMID: 30287909 DOI: 10.1038/s41397-018-0057-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 06/19/2018] [Accepted: 08/10/2018] [Indexed: 12/15/2022]
Abstract
The aim of this case-control study was to evaluate whether 47 single-nucleotide polymorphisms (SNPs) in steroid hormone-related genes are associated with the risk of RA and anti-TNF drug response. We conducted a case-control study in 3 European populations including 2936 RA patients and 2197 healthy controls. Of those, a total of 1985 RA patients were treated with anti-TNF blockers. The association of potentially interesting markers in the discovery population was validated through meta-analysis with data from DREAM and DANBIO registries. Although none of the selected variants had a relevant role in modulating RA risk, the meta-analysis of the linear regression data with those from the DREAM and DANBIO registries showed a significant correlation of the CYP3A4rs11773597 and CYP2C9rs1799853 variants with changes in DAS28 after the administration of anti-TNF drugs (P = 0.00074 and P = 0.006, respectively). An overall haplotype analysis also showed that the ESR2GGG haplotype significantly associated with a reduced chance of having poor response to anti-TNF drugs (P = 0.0009). Finally, a ROC curve analysis confirmed that a model built with eight steroid hormone-related variants significantly improved the ability to predict drug response compared with the reference model including demographic and clinical variables (AUC = 0.633 vs. AUC = 0.556; PLR_test = 1.52 × 10-6). These data together with those reporting that the CYP3A4 and ESR2 SNPs correlate with the expression of TRIM4 and ESR2 mRNAs in PBMCs (ranging from P = 1.98 × 10-6 to P = 2.0 × 10-35), and that the CYP2C9rs1799853 SNP modulates the efficiency of multiple drugs, suggest that steroid hormone-related genes may have a role in determining the response to anti-TNF drugs.KEY POINTS• Polymorphisms within the CYP3A4 and CYP2C9 loci correlate with changes in DAS28 after treatment with anti-TNF drugs.• A haplotype including eQTL SNPs within the ESR2 gene associates with better response to anti-TNF drugs.• A genetic model built with eight steroid hormone-related variants significantly improved the ability to predict drug response.
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Affiliation(s)
- Luz M Canet
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Jose M Sánchez-Maldonado
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Rafael Cáliz
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain.,Rheumatology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Ana Rodríguez-Ramos
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Carmen B Lupiañez
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Helena Canhão
- CEDOC, EpiDoC Unit, NOVA Medical School and National School of Public Health, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Manuel Martínez-Bueno
- Area of Genomic Medicine, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, Granada, Spain
| | - Alejandro Escudero
- Rheumatology Department, Reina Sofía Hospital/IMIBIC/University of Córdoba, Córdoba, Spain
| | - Juana Segura-Catena
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Signe B Sorensen
- The Danish Rheumatologic Biobank, the DANBIO Registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.,Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Merete L Hetland
- The Danish Rheumatologic Biobank, the DANBIO Registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.,Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - María José Soto-Pino
- Rheumatology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Miguel A Ferrer
- Rheumatology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Antonio García
- Rheumatology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Bente Glintborg
- The Danish Rheumatologic Biobank, the DANBIO Registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.,Department of Rheumatology, Gentofte and Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ileana Filipescu
- Rheumatology Department, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Eva Pérez-Pampin
- Rheumatology Unit, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | - Pablo Conesa-Zamora
- Clinical Analysis Department, Santa Lucía University Hospital, Cartagena, Spain
| | - Alfons den Broeder
- Department of Human Genetics, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Salvatore De Vita
- Department of Medical and Biological Sciences, Clinic of Rheumatology, University of Udine, Udine, Italy
| | - Sven Erik Hobe Jacobsen
- The Danish Rheumatologic Biobank, the DANBIO Registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.,Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Luca Quartuccio
- Department of Medical and Biological Sciences, Clinic of Rheumatology, University of Udine, Udine, Italy
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - João E Fonseca
- Rheumatology and Metabolic Bone Diseases Department, Hospital de Santa Maria, CHLN, Lisbon, Portugal.,Rheumatology Research Unit, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon Academic Medical Center, Lisbon, Portugal
| | - Marieke J H Coenen
- Department of Human Genetics, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Vibeke Andersen
- Focused Research Unit for Molecular Diagnostic and Clinical Research, IRS-Center Sonderjylland, Hospital of Southern Jutland, DK-6200, Aabenraa, Denmark.,Faculty of Health Sciences, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Juan Sainz
- Genomic Oncology Area, GENYO Centre for Genomics and Oncological Research, Pfizer / University of Granada / Andalusian Regional Government, PTS Granada, Granada, Spain. .,Rheumatology Department, Virgen de las Nieves University Hospital, Granada, Spain.
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22
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Vidal B, Cascão R, Finnilä MAJ, Lopes IP, Saarakkala S, Zioupos P, Canhão H, Fonseca JE. Early arthritis induces disturbances at bone nanostructural level reflected in decreased tissue hardness in an animal model of arthritis. PLoS One 2018; 13:e0190920. [PMID: 29315314 PMCID: PMC5760022 DOI: 10.1371/journal.pone.0190920] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 12/22/2017] [Indexed: 11/21/2022] Open
Abstract
Introduction Arthritis induces joint erosions and skeletal bone fragility. Objectives The main goal of this work was to analyze the early arthritis induced events at bone architecture and mechanical properties at tissue level. Methods Eighty-eight Wistar rats were randomly housed in experimental groups, as follows: adjuvant induced arthritis (AIA) (N = 47) and a control healthy group (N = 41). Rats were monitored during 22 days for the inflammatory score, ankle perimeter and body weight and sacrificed at different time points (11 and 22 days post disease induction). Bone samples were collected for histology, micro computed tomography (micro-CT), 3-point bending and nanoindentation. Blood samples were also collected for bone turnover markers and systemic cytokine quantification. Results At bone tissue level, measured by nanoindentation, there was a reduction of hardness in the arthritic group, associated with an increase of the ratio of bone concentric to parallel lamellae and of the area of the osteocyte lacuna. In addition, increased bone turnover and changes in the microstructure and mechanical properties were observed in arthritic animals, since the early phase of arthritis, when compared with healthy controls. Conclusion We have shown in an AIA rat model that arthritis induces very early changes at bone turnover, structural degradation and mechanical weakness. Bone tissue level is also affected since the early phase of arthritis, characterized by decreased tissue hardness associated with changes in bone lamella organization and osteocyte lacuna surface. These observations highlight the pertinence of immediate control of inflammation in the initial stages of arthritis.
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Affiliation(s)
- Bruno Vidal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- * E-mail:
| | - Rita Cascão
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Mikko A. J. Finnilä
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Inês P. Lopes
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulo, Oulu University, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Peter Zioupos
- Biomechanics Labs, Cranfield Forensic Institute, Cranfield University, Defence Academy of the UK, Shrivenham, United Kingdom
| | - Helena Canhão
- EpiDoC Unit, CEDOC, NOVA Medical School, NOVA University, Lisbon, Portugal
| | - João E. Fonseca
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon Academic Medical Centre, Lisbon, Portugal
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23
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Orr C, Vieira-Sousa E, Boyle DL, Buch MH, Buckley CD, Cañete JD, Catrina AI, Choy EHS, Emery P, Fearon U, Filer A, Gerlag D, Humby F, Isaacs JD, Just SA, Lauwerys BR, Goff BL, Manzo A, McGarry T, McInnes IB, Najm A, Pitzalis C, Pratt A, Smith M, Tak PP, Tas SW, Thurlings R, Fonseca JE, Veale DJ. Corrigendum: Synovial tissue research: a state-of-the-art review. Nat Rev Rheumatol 2018; 14:60. [PMID: 29255214 DOI: 10.1038/nrrheum.2017.206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This corrects the article DOI: 10.1038/nrrheum.2017.115.
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24
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Rodrigues AM, Canhão H, Marques A, Ambrósio C, Borges J, Coelho P, Costa L, Fernandes S, Gonçalves I, Gonçalves M, Guerra M, Marques ML, Pimenta S, Pinto P, Sequeira G, Simões E, Teixeira L, Vaz C, Vieira-Sousa E, Vieira R, Alvarenga F, Araújo F, Barcelos A, Barcelos F, Barros R, Bernardes M, Canas da Silva J, Cordeiro A, Costa M, Cunha-Miranda L, Cruz M, Duarte AC, Duarte C, Faustino A, Figueiredo G, Fonseca JE, Furtado C, Gomes J, Lopes C, Mourão AF, Oliveira M, Pimentel-Santos FM, Ribeiro A, Sampaio da Nóvoa T, Santiago M, Silva C, Silva-Dinis A, Sousa S, Tavares-Costa J, Terroso G, Vilar A, Branco JC, Tavares V, Romeu JC, da Silva J. Portuguese recommendations for the prevention, diagnosis and management of primary osteoporosis - 2018 update. Acta Reumatol Port 2018; 43:10-31. [PMID: 29602163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Advances in osteoporosis (OP)case definition, treatment options, optimal therapy duration and pharmacoeconomic evidence in the national context motivated the Portuguese Society of Rheumatology (SPR) to update the Portuguese recommendations for the diagnosis and management of osteoporosis published in 2007. METHODS SPR bone diseases' working group organized meetings involving 55 participants (rheumatologists, rheumatology fellows and one OP specialist nurse) to debate and develop the document. First, the working group selected 11 pertinent clinical questions for the diagnosis and management of osteoporosis in standard clinical practice. Then, each question was investigated through literature review and draft recommendations were built through consensus. When insufficient evidence was available, recommendations were based on experts' opinion and on good clinical practice. At two national meetings, the recommendations were discussed and updated. A draft of the recommendations full text was submitted to critical review among the working group and suggestions were incorporated. A final version was circulated among all Portuguese rheumatologists before publication and the level of agreement was anonymously assessed using an online survey. RESULTS The 2018 SPR recommendations provide comprehensive guidance on osteoporosis prevention, diagnosis, fracture risk assessment, pharmacological treatment initiation, therapy options and duration of treatment, based on the best available evidence. They attained desirable agreement among Portuguese rheumatologists. As more evidence becomes available, periodic revisions will be performed. Target audience and patient population: The target audience for these guidelines includes all clinicians. The target patient population includes adult Portuguese people. Intended use: These recommendations provide general guidance for typical cases. They may not be appropriate in all situations - clinicians are encouraged to consider this information together with updated evidence and their best clinical judgment in individual cases.
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25
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Orr C, Vieira-Sousa E, Boyle DL, Buch MH, Buckley CD, Cañete JD, Catrina AI, Choy EHS, Emery P, Fearon U, Filer A, Gerlag D, Humby F, Isaacs JD, Just SA, Lauwerys BR, Le Goff B, Manzo A, McGarry T, McInnes IB, Najm A, Pitzalis C, Pratt A, Smith M, Tak PP, Thurlings R, Fonseca JE, Veale DJ. Synovial tissue research: a state-of-the-art review. Nat Rev Rheumatol 2017; 13:630. [PMID: 28935945 DOI: 10.1038/nrrheum.2017.161] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This corrects the article DOI: 10.1038/nrrheum.2017.115.
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26
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Moura RA, Quaresma C, Vieira AR, Gonçalves MJ, Polido-Pereira J, Romão VC, Martins N, Canhão H, Fonseca JE. B-cell phenotype and IgD-CD27- memory B cells are affected by TNF-inhibitors and tocilizumab treatment in rheumatoid arthritis. PLoS One 2017; 12:e0182927. [PMID: 28886017 PMCID: PMC5590747 DOI: 10.1371/journal.pone.0182927] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 07/18/2017] [Indexed: 01/22/2023] Open
Abstract
Background The use of TNF-inhibitors and/or the IL-6 receptor antagonist, tocilizumab, in rheumatoid arthritis (RA) have pleiotropic effects that also involve circulating B-cells. The main goal of this study was to assess the effect of TNF-inhibitors and tocilizumab on B-cell phenotype and gene expression in RA. Methods Blood samples were collected from untreated early RA (ERA) patients, established RA patients under methotrexate treatment, established RA patients before and after treatment with TNF-inhibitors and tocilizumab, and healthy donors. B-cell subpopulations were characterized by flow cytometry and B-cell gene expression was analyzed by real-time PCR on isolated B-cells. Serum levels of BAFF, CXCL13 and sCD23 were determined by ELISA. Results The frequency of total CD19+ B cells in circulation was similar between controls and all RA groups, irrespective of treatment, but double negative (DN) IgD-CD27- memory B cells were significantly increased in ERA and established RA when compared to controls. Treatment with TNF-inhibitors and tocilizumab restored the frequency of IgD-CD27- B-cells to normal levels, but did not affect other B cell subpopulations. TACI, CD95, CD5, HLA-DR and TLR9 expression on B-cells significantly increased after treatment with either TNF-inhibitors and/ or tocilizumab, but no significant changes were observed in BAFF-R, BCMA, CD69, CD86, CXCR5, CD23, CD38 and IgM expression on B-cells when comparing baseline with post-treatment follow-ups. Alterations in B-cell gene expression of BAFF-R, TACI, TLR9, FcγRIIB, BCL-2, BLIMP-1 and β2M were found in ERA and established RA patients, but no significant differences were observed after TNF-inhibitors and tocilizumab treatment when comparing baseline and follow-ups. Serum levels of CXCL13, sCD23 and BAFF were not significantly affected by treatment with TNF-inhibitors and tocilizumab. Conclusions In RA patients, the use of TNF-inhibitors and/ or tocilizumab treatment affects B-cell phenotype and IgD-CD27- memory B cells in circulation, but not B-cell gene expression levels.
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MESH Headings
- Antibodies, Monoclonal, Humanized/pharmacology
- Antibodies, Monoclonal, Humanized/therapeutic use
- Arthritis, Rheumatoid/diagnosis
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/immunology
- Arthritis, Rheumatoid/metabolism
- B-Lymphocyte Subsets/drug effects
- B-Lymphocyte Subsets/immunology
- B-Lymphocyte Subsets/metabolism
- Biomarkers
- Chemokine CXCL13/blood
- Follow-Up Studies
- Gene Expression Profiling
- Gene Expression Regulation/drug effects
- Humans
- Immunoglobulin D/metabolism
- Immunologic Memory
- Immunophenotyping
- Lymphocyte Count
- Methotrexate/pharmacology
- Methotrexate/therapeutic use
- Phenotype
- Receptors, CXCR5/metabolism
- Receptors, IgE/blood
- Treatment Outcome
- Tumor Necrosis Factor Receptor Superfamily, Member 7/metabolism
- Tumor Necrosis Factor-alpha/antagonists & inhibitors
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Affiliation(s)
- Rita A. Moura
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- * E-mail:
| | - Cláudia Quaresma
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Ana R. Vieira
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Maria J. Gonçalves
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Joaquim Polido-Pereira
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Vasco C. Romão
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Nádia Martins
- Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Helena Canhão
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - João E. Fonseca
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon Academic Medical Centre, Lisbon, Portugal
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27
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Abstract
The identification of new bioactive compounds derived from medicinal plants with significant therapeutic properties has attracted considerable interest in recent years. Such is the case of the Tripterygium wilfordii (TW), an herb used in Chinese medicine. Clinical trials performed so far using its root extracts have shown impressive therapeutic properties but also revealed substantial gastrointestinal side effects. The most promising bioactive compound obtained from TW is celastrol. During the last decade, an increasing number of studies were published highlighting the medicinal usefulness of celastrol in diverse clinical areas. Here we systematically review the mechanism of action and the therapeutic properties of celastrol in inflammatory diseases, namely, rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel diseases, osteoarthritis and allergy, as well as in cancer, neurodegenerative disorders and other diseases, such as diabetes, obesity, atherosclerosis, and hearing loss. We will also focus in the toxicological profile and limitations of celastrol formulation, namely, solubility, bioavailability, and dosage issues that still limit its further clinical application and usefulness.
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Affiliation(s)
- Rita Cascão
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - João E Fonseca
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Luis F Moita
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
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28
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Lomakina O, Alekseeva E, Valieva S, Bzarova T, Nikishina I, Zholobova E, Rodionovskaya S, Kaleda M, Nakagishi Y, Shimizu M, Mizuta M, Yachie A, Sugita Y, Okamoto N, Shabana K, Murata T, Tamai H, Smith EM, Yin P, Jorgensen AL, Beresford MW, Smith EM, Eleuteri A, Goilav B, Lewandowski L, Phuti A, Wahezi D, Rubinstein T, Jones C, Newland P, Marks S, Corkhill R, Ekdawy D, Pilkington C, Tullus K, Putterman C, Scott C, Fisher AC, Beresford MW, Smith EM, Lewandowski L, Phuti A, Jorgensen A, Scott C, Beresford MW, Batu ED, Kosukcu C, Taskiran E, Akman S, Ozturk K, Sozeri B, Unsal E, Ekinci Z, Bilginer Y, Alikasifoglu M, Ozen S, Lythgoe H, Beresford MW, Brunner HI, Gulati G, Jones JT, Altaye M, Eaton J, Difrancesco M, Yeo JG, Leong J, Bathi LDT, Arkachaisri T, Albani S, Abdelrahman N, Beresford MW, Leone V, Groot N, Shaikhani D, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Wright RD, Smith EM, Beresford MW, Abdawani R, Al Shaqshi L, Al Zakwani I, Gormezano NW, Kern D, Pereira OL, Esteves GCC, Sallum AM, Aikawa NE, Pereira RM, Silva CA, Bonfa E, Beckmann J, Bartholomä N, Foeldvari I, Bohnsack J, Milojevic D, Rabinovich C, Kingsbury D, Marzan K, Quartier P, Minden K, Chalom E, Horneff G, Venhoff N, Kuester RM, Dare J, Heinrich M, Kupper H, Kalabic J, Martini A, Brunner HI, Consolaro A, Horneff G, Burgos-Vargas R, Henneke P, Constantin T, Foeldvari I, Vojinovic J, Dehoorne J, Panaviene V, Susic G, Stanevica V, Kobusinska K, Zuber Z, Mouy R, Salzer U, Rumba-Rozenfelde I, Dolezalova P, Job-Deslandre C, Wulffraat N, Pederson R, Bukowski J, Hinnershitz T, Vlahos B, Martini A, Ruperto N, Janda A, Keskitalo P, Kangas S, Vähäsalo P, Valencia RAC, Martino D, Munro J, Ponsonby AL, Chiaroni-Clarke R, Meyer B, Allen RC, Boteanu AL, Akikusa JD, Craig JM, Saffrey R, Ellis JA, Davì S, Minoia F, Horne A, Wulffraat N, Wouters C, Wallace C, Corral SG, Uziel Y, Sterba G, Schneider R, Russo R, Ramanan AV, Schmid JP, Ozen S, Nichols KE, Miettunen P, Lovell DJ, Giraldo AS, Lehmberg K, Kitoh T, Khubchandani R, Ilowite NT, Henter JI, Grom AA, De Benedetti F, Behrens EM, Avcin T, Aricò M, Gámir MG, Martini A, Ruperto N, Cron RQ, Ravelli A, Grevich S, Lee P, Ringold S, Leroux B, Leahey H, Yuasa M, Mendoza AZ, Foster J, Sokolove J, Lahey L, Robinson W, Newson J, Stevens A, Shoop SJW, Hyrich KL, Verstappen SMM, Thomson W, Adrovic A, McDonagh JE, Beukelman T, Kimura Y, Natter M, Ilowite N, Mieszkalski K, Burrell G, Best B, Bristow H, Carr S, Dedeoglu R, Dennos A, Kaufmann R, Schanberg L, Parissenti I, Insalaco A, Taddio A, Mauro A, Pardeo M, Ricci F, Simonini G, Sahin S, Cattalini M, Montesano P, Parissenti I, Ricci F, Bonafini B, Medeghini V, Lancini F, Cattalini M, Gerbaux M, Lê PQ, Barut K, Goffin L, Badot V, La C, Caspers L, Willermain F, Ferster A, Ceci M, Licciardi F, Turco M, Santarelli F, Koka A, Montin D, Toppino C, Maggio MC, Alizzi C, Papia B, Vergara B, Corpora U, Messina L, Corsello G, Tsinti M, Oztunc F, 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M, Hentgen V, Woerner A, Schwarz T, Klotsche J, Niewerth M, Horneff G, Haas JP, Hospach A, Huppertz HI, Ganser G, Minden K, Jeyaratnam J, ter Haar N, Kasapcopur O, Rigante D, Dedeoglu F, Baris E, Vastert S, Wulffraat N, Frenkel J, Hausmann JS, Lomax KG, Shapiro A, Durrant KL, Brogan PA, Hofer M, Kuemmerle-Deschner JB, Lauwerys B, Speziale A, Leon K, Wei X, Laxer RM, Signa S, Rusmini M, Campione E, Chiesa S, Grossi A, Omenetti A, Caorsi R, Viglizzo G, Martini A, Ceccherini I, Gattorno M, Federici S, Frenkel J, Ozen S, Lachmann H, Finetti M, Martini A, Ruperto N, Gattorno M, Federici S, Vanoni F, Ozen S, Hofer M, Frenkel J, Lachmann H, Martini A, Ruperto N, Gattorno M, Gomes SM, Omoyinmi E, Arostegui JI, Gonzalez-Roca E, Eleftheriou D, Klein N, Brogan P, Volpi S, Santori E, Picco P, Pastorino C, Caorsi R, Rice G, Tesser A, Martini A, Crow Y, Candotti F, Gattorno M, Barut K, Sahin S, Adrovic A, Sinoplu AB, Yucel G, Pamuk G, Kasapcopur O, Damian LO, Lazea C, Sparchez M, Vele P, Muntean L, Albu A, Rednic S, Lazar C, Mendonça LO, Pontillo A, Kalil J, Castro FM, Barros MT, Pardeo M, Messia V, De Benedetti F, Insalaco A, Malighetti G, Gorio C, Ricci F, Parissenti I, Montesano P, Bonafini B, Medeghini V, Cattalini M, Giordano L, Zani G, Ferraro R, Vairo D, Giliani S, Cattalini M, Maggio MC, Luppino G, Corsello G, Fernandez MIG, Montesinos BL, Vidal AR, Gorospe JIA, Penades IC, Rafiq NK, Wynne K, Hussain K, Brogan PA, Ang E, Ng N, Kacar A, Gucenmez OA, Makay B, Unsal SE, Sahin Y, Barut K, Kutlu T, Cullu-Cokugras F, Sahin S, Adrovic A, Ayyildiz-Civan H, Kasapcopur O, Erkan T, Abdawani R, Al Zuhbi S, Abdalla E, Russo RA, Katsicas MM, Caorsi R, Minoia F, Viglizzo G, Grossi A, Chiesa S, Picco P, Ravelli A, Gattorno M, Bhattad S, Rawat A, Gupta A, Suri D, Pandiarajan V, Nada R, Tiewsoh K, Hawkins P, Rowczenio D, Singh S, Fingerhutova S, Franova J, Prochazkova L, Hlavackova E, Dolezalova P, Evrengül H, Yüksel S, Doğan M, Gürses D, Evrengül H, De Pauli S, Pastore S, Bianco AM, Severini GM, Taddio A, Tommasini A, Salugina SO, Fedorov E, Kamenets E, Zaharova E, Kaleda M, Salugina SO, Fedorov E, Kamenets E, Zaharova E, Kaleda M, Sleptsova T, Alexeeva E, Savostyanov K, Pushkov A, Bzarova T, Valieva S, Denisova R, Isayeva K, Chistyakova E, Lomakina O, Soloshenko M, Kaschenko E, Kaneko U, Imai C, Saitoh A, Teixeira VA, Ramos FO, Costa M, Aviel YB, Fahoum S, Brik R, Özçakar ZB, Çakar N, Uncu N, Celikel BA, Yalcinkaya F, Schiappapietra B, Davi’ S, Mongini F, Giannone L, Bava C, Alpigiani MG, Martini A, Ravelli A, Consolaro A, Lazarevic DS, Vojinovic J, Susic G, Basic J, Giancane G, Muratore V, Marzetti V, Quilis N, Benavente BS, Alongi A, Civino A, Quartulli L, Consolaro A, Martini A, Ravelli A, Januskeviciute G, van Dijkhuizen P, Muratore V, Giancane G, Schiappapietra B, Martini A, Ravelli A, Consolaro A, Groot N, van Dijk W, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Groot N, Kardolus A, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Suárez RG, Nordal EB, Rypdal VG, Berntson L, Ekelund M, Aalto K, Peltoniemi S, Zak M, Nielsen S, Glerup M, Herlin T, Arnstad ED, Fasth A, Rygg M, Duarte AC, Sousa S, Teixeira L, Cordeiro A, Santos MJ, Mourão AF, Santos MJ, Eusébio M, Lopes A, Oliveira-Ramos F, Salgado M, Estanqueiro P, Melo-Gomes J, Martins F, Costa J, Furtado C, Figueira R, Brito I, Branco JC, Fonseca JE, Canhão H, Mourão AF, Santos MJ, Eusébio M, Lopes A, Oliveira-Ramos F, Salgado M, Estanqueiro P, Melo-Gomes J, Martins F, Costa J, Furtado C, Figueira R, Brito I, Branco JC, Fonseca JE, Canhão H, Coda A, Cassidy S, West K, Hendry G, Grech D, Jones J, Hawke F, Grewal DS, Coda A, Jones J, Grech D, Grewal DS, Foley C, Killeen O, MacDermott E, Veale D, Fearon U, Konukbay D, Demirkaya E, Tarakci E, Arman N, Barut K, Şahin S, Adrovic A, Kasapcopur O, Munro J, Consolaro A, Morgan E, Riebschleger M, Horonjeff J, Strand V, Bingham C, Collante MTM, Ganeva M, Stefanov S, Telcharova A, Mihaylova D, Saraeva R, Tzveova R, Kaneva R, Tsakova A, Temelkova K, Picarelli MMC, Danzmann LC, Barbé-Tuana F, Grun LK, Jones MH, Frković M, Ištuk K, Birkić I, Sršen S, Jelušić M, Smith N, Jandial S, Easton A, Quarmby R, Khubchandani R, Chan M, Rapley T, Foster H, Srp R, Kobrova K, Franova J, Fingerhutova S, Nemcova D, Hoza J, Uher M, Saifridova M, Linkova L, Dolezalova P, Charuvanij S, Leelayuwattanakul I, Pacharapakornpong T, Vallipakorn SAO, Lerkvaleekul B, Vilaiyuk S, Muratore V, Giancane G, Lanni S, Alongi A, Alpigiani MG, Martini A, Ravelli A, Consolaro A, Alongi A, Bovis F, Minoia F, Davì S, Martini A, Ruperto N, Cron RQ, Ravelli A, Passarelli C, Pardeo M, Pisaneschi E, Novelli A, De Benedetti F, Bracaglia C, Bracaglia C, Marafon DP, Caiello I, de Graaf K, Guilhot F, Ferlin W, Davi’ S, Schulert G, Ravelli A, Grom AA, Nelson R, de Min C, De Benedetti F, Holzinger D, Kessel C, Fall N, Grom A, de Jager W, Vastert S, Strippoli R, Bracaglia C, Sundberg E, Horne A, Ehl S, Ammann S, Lehmberg K, De Benedetti F, Beutel K, Foell D, Minoia F, Horne A, Bovis F, Davì S, Pagani L, Espada G, Gao YJ, Insalaco A, Lehmberg K, Sanner H, Shenoi S, Weitzman S, Ruperto N, Martini A, Cron RQ, Ravelli A, Prencipe G, Caiello I, Pascarella A, Bracaglia C, Ferlin WG, Chatel L, Strippoli R, de Min C, De Benedetti F, Jacqmin P, De Graaf K, Ballabio M, Nelson R, Johnson Z, Ferlin W, Lapeyre G, de Benedetti F, Cristina DM, Wakiguchi H, Hasegawa S, Hirano R, Okazaki F, Nakamura T, Kaneyasu H, Ohga S, Yamazaki K, Nozawa T, Kanetaka T, Ito S, Yokota S, McLellan K, MacGregor I, Martin N, Davidson J, Kuemmerle-Deschner J, Hansmann S, Wulffraat N, Eikelberg A, Haug I, Schuller S, Benseler SM, Nazarova LS, Danilko KV, Malievsky VA, Viktorova TV, Mauro A, Omoyinmi E, Barnicoat A, Brogan P, Foley C, Killeen O, MacDermott E, Veale D, Foley C, Killeen O, MacDermott E, Veale D, Gomes SM, Omoyinmi E, Hurst J, Canham N, Eleftheriou D, Klein N, Lacassagne S, Brogan P, Wiener A, Hügle B, Denecke B, Costa-Filho I, Haas JP, Tenbrock K, Popp D, Boltjes A, Rühle F, Herresthal S, de Jager W, van Wijk F, Schultze J, Stoll M, Klotz L, Vogl T, Roth J, Quesada-Masachs E, de la Sierra DÁ, Prat MG, Sánchez AMM, Borrell RP, Barril SM, Gallo MM, Caballero CM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Giner T, Hackl L, Albrecht J, Würzner R, Brunner J, Pastore S, Minute M, Parentin F, Tesser A, Nocerino A, Taddio A, Tommasini A, Nørgaard M, Herlin T, Alberdi-Saugstrup M, Zak MS, Nielsen SM, Herlin T, Nordal E, Berntson L, Fasth A, Rygg M, Müller KG, Avramovič MZ, Dolžan V, Toplak N, Avčin T, Ruperto N, Lovell DJ, Wallace C, Toth M. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461533 DOI: 10.1186/s12969-017-0142-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Perpétuo IP, Caetano-Lopes J, Vieira-Sousa E, Campanilho-Marques R, Ponte C, Khmelinskii N, Canhão H, Ainola M, Fonseca JE. Corrigendum: Ankylosing Spondylitis Patients Have Impaired Osteoclast Gene Expression in Circulating Osteoclast Precursors. Front Med (Lausanne) 2017; 4:38. [PMID: 28405583 PMCID: PMC5388692 DOI: 10.3389/fmed.2017.00038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 03/21/2017] [Indexed: 11/16/2022] Open
Affiliation(s)
- Inês P Perpétuo
- Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa , Lisboa , Portugal
| | - Joana Caetano-Lopes
- Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa , Lisboa , Portugal
| | - Elsa Vieira-Sousa
- Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisboa, Portugal; Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre, Lisboa, Portugal
| | - Raquel Campanilho-Marques
- Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisboa, Portugal; Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre, Lisboa, Portugal
| | - Cristina Ponte
- Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisboa, Portugal; Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre, Lisboa, Portugal
| | - Nikita Khmelinskii
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre , Lisboa , Portugal
| | - Helena Canhão
- EpiDoC Unit, Chronic Diseases Research Center (CEDOC), NOVA Medical School, Universidade Nova de Lisboa , Lisboa , Portugal
| | - Mari Ainola
- Musculoskeletal Diseases and Inflammation Research Group, Biomedicum Helsinki 1, Faculty of Medicine, Institute of Clinical Medicine, University of Helsinki , Helsinki , Finland
| | - João E Fonseca
- Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisboa, Portugal; Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre, Lisboa, Portugal
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Vieira-Sousa E, Cavaleiro J, Mourão AF, Rodrigues AM, Albino-Teixeira A, Pimentel-Santos FM, Oliveira-Ramos F, Canhão H, Polido-Pereira J, Fonseca JE, Pereira da Silva JA, Romeu JC, Melo Gomes J, Costa L, Graça L, Leandro MJ, Santos MJ, Machado PM, Ramiro S. Acta Reumatológica Portuguesa: perspectives in 2017. Acta Reumatol Port 2017; 42:110-111. [PMID: 28693032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Gonçalves MJ, Mourão AF, Martinho A, Simões O, Melo-Gomes J, Salgado M, Estanqueiro P, Ribeiro C, Brito I, Fonseca JE, Canhão H. Genetic Screening of Mutations Associated with Fabry Disease in a Nationwide Cohort of Juvenile Idiopathic Arthritis Patients. Front Med (Lausanne) 2017; 4:12. [PMID: 28299312 PMCID: PMC5331034 DOI: 10.3389/fmed.2017.00012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 02/06/2017] [Indexed: 01/09/2023] Open
Abstract
Fabry’s disease (FD) is a lysosomal storage disorder associated with an alpha-galactosidase A deficiency. The prevalence of FD among juvenile idiopathic arthritis (JIA) patients with established diagnosis is unknown, but as musculoskeletal pain may be an important complaint at presentation, misdiagnosed cases are anticipated. With this study, we aim to calculate the frequency of FD-associated mutations in a cohort of JIA patients. Children with JIA from a national cohort were selected. Clinical and laboratorial information was recorded in the Portuguese rheumatic diseases register (http://Reuma.pt). Molecular genetic testing to detect GLA gene mutations was performed. After the multiplex polymerase chain reactions technique for DNA amplification, direct sequencing of the complete sequence of GLA gene was completed. From a cohort of 292 patients with JIA (188 females, 104 males), mutations were identified in 5 patients (all female). Four patients had the mutation D313Y, a rare GLA variant, which is associated with low enzymatic levels in plasma, but normal lysosomal levels. One patient presented the missense mutation R118C, which was previously described in Mediterranean patients with FD. This is the first screening of FD mutations in a cohort of JIA patients. No “classic” pathogenic FD mutations were reported. The late-onset FD-associated mutation, R118C, was found in a frequency of 0.34% (1/292).
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Affiliation(s)
- Maria J Gonçalves
- Rheumatology Department, Hospital Santa Maria, Lisbon Academic Medical Centre, Lisboa, Portugal; Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Ana F Mourão
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal; Rheumatology Department, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | | | - Olívia Simões
- Centro de Histocompatibilidade do Centro , Coimbra , Portugal
| | | | - Manuel Salgado
- Pediatric Rheumatology Unit, Hospital Pediátrico de Coimbra , Coimbra , Portugal
| | - Paula Estanqueiro
- Pediatric Rheumatology Unit, Hospital Pediátrico de Coimbra , Coimbra , Portugal
| | - Célia Ribeiro
- Rheumatology Department, Hospital de Faro , Faro , Portugal
| | - Iva Brito
- Rheumatology Department, Centro Hospitalar S. João , Porto , Portugal
| | - João E Fonseca
- Rheumatology Department, Hospital Santa Maria, Lisbon Academic Medical Centre, Lisboa, Portugal; Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Helena Canhão
- EpiDoC, CEDOC, Nova Medical School , Lisbon , Portugal
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Perpétuo IP, Caetano-Lopes J, Vieira-Sousa E, Campanilho-Marques R, Ponte C, Canhão H, Ainola M, Fonseca JE. Ankylosing Spondylitis Patients Have Impaired Osteoclast Gene Expression in Circulating Osteoclast Precursors. Front Med (Lausanne) 2017; 4:5. [PMID: 28191455 PMCID: PMC5269449 DOI: 10.3389/fmed.2017.00005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/09/2017] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Ankylosing spondylitis (AS) is typically characterized by focal bone overgrowth and also by systemic bone loss. We hypothesize that the increased osteoproliferation found in AS might be partially due to reduced ability of osteoclast precursors (OCPs) to differentiate into osteoclasts (OCs). Therefore, our aim was to characterize bone remodeling and pro-osteoclastogenesis inflammatory environment, monocytes' phenotype, and in vitro osteoclast differentiation in AS patients. METHODS Patients with active AS without any ongoing therapy and age- and gender-matched healthy donors were recruited. Receptor activator of nuclear factor-κβ (RANKL) surface expression on circulating leukocytes and frequency and phenotype of monocyte subpopulations were assessed. Quantification of serum levels of bone turnover markers and cytokines, in vitro OC differentiation assay and quantitative reverse transcription real-time PCR for OC-specific genes were performed. RESULTS Pro- and anti-inflammatory cytokine serum levels were higher in AS patients than in controls. RANKL neutrophil expression was higher in AS patients when compared to healthy donors, but CD51/CD61 expression was lower in the classical monocyte subpopulation. Concerning osteoclastogenesis, we found no differences in the in vitro osteoclast differentiating potential of these cells when compared to healthy donors. However, we observed low expression of CSF1R, RANK, and NFATc1 in AS OCPs. CONCLUSION Despite the high levels of pro-inflammatory cytokines present in AS patients, no differences in the number of OC or resorbed area were found between AS patients and healthy donors. Moreover, we observed that OCPs have low OC-specific gene expression. These findings support our hypothesis of an impaired response of OCPs to pro-osteoclastogenic stimuli in vivo in AS patients.
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Affiliation(s)
- Inês P Perpétuo
- Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa , Lisboa , Portugal
| | - Joana Caetano-Lopes
- Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa , Lisboa , Portugal
| | - Elsa Vieira-Sousa
- Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisboa, Portugal; Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre, Lisboa, Portugal
| | - Raquel Campanilho-Marques
- Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisboa, Portugal; Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre, Lisboa, Portugal
| | - Cristina Ponte
- Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisboa, Portugal; Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre, Lisboa, Portugal
| | - Helena Canhão
- EpiDoC Unit, Chronic Diseases Research Center (CEDOC), NOVA Medical School, Universidade Nova de Lisboa , Lisboa , Portugal
| | - Mari Ainola
- Musculoskeletal Diseases and Inflammation Research Group, Biomedicum Helsinki 1, Faculty of Medicine, Institute of Clinical Medicine, University of Helsinki , Helsinki , Finland
| | - João E Fonseca
- Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisboa, Portugal; Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre, Lisboa, Portugal
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van Steenbergen HW, Aletaha D, Beaart-van de Voorde LJJ, Brouwer E, Codreanu C, Combe B, Fonseca JE, Hetland ML, Humby F, Kvien TK, Niedermann K, Nuño L, Oliver S, Rantapää-Dahlqvist S, Raza K, van Schaardenburg D, Schett G, De Smet L, Szücs G, Vencovský J, Wiland P, de Wit M, Landewé RL, van der Helm-van Mil AHM. EULAR definition of arthralgia suspicious for progression to rheumatoid arthritis. Ann Rheum Dis 2016; 76:491-496. [DOI: 10.1136/annrheumdis-2016-209846] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 08/18/2016] [Accepted: 09/17/2016] [Indexed: 12/22/2022]
Abstract
BackgroundDuring the transition to rheumatoid arthritis (RA) many patients pass through a phase characterised by the presence of symptoms without clinically apparent synovitis. These symptoms are not well-characterised. This taskforce aimed to define the clinical characteristics of patients with arthralgia who are considered at risk for RA by experts based on their clinical experience.MethodsThe taskforce consisted of 18 rheumatologists, 1 methodologist, 2 patients, 3 health professionals and 1 research fellow. The process had three phases. In phase I, a list of parameters considered characteristic for clinically suspect arthralgia (CSA) was derived; the most important parameters were selected by a three-phased Delphi approach. In phase II, the experts evaluated 50 existing patients on paper, classified them as CSA/no-CSA and indicated their level of confidence. A provisional set of parameters was derived. This was studied for validation in phase III, where all rheumatologists collected patients with and without CSA from their outpatient clinics.ResultsThe comprehensive list consisted of 55 parameters, of which 16 were considered most important. A multivariable model based on the data from phase II identified seven relevant parameters: symptom duration <1 year, symptoms of metacarpophalangeal (MCP) joints, morning stiffness duration ≥60 min, most severe symptoms in early morning, first-degree relative with RA, difficulty with making a fist and positive squeeze test of MCP joints. In phase III, the combination of these parameters was accurate in identifying patients with arthralgia who were considered at risk of developing RA (area under the receiver operating characteristic curve 0.92, 95% CI 0.87 to 0.96). Test characteristics for different cut-off points were determined.ConclusionsA set of clinical characteristics for patients with arthralgia who are at risk of progression to RA was established.
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Santos MJ, Conde M, Mourão AF, Ramos FO, Cabral M, Brito I, Ramos MP, Marques RC, Gomes SM, Guedes M, Gonçalves MJ, Estanqueiro P, Zilhão C, Rodrigues M, Henriques C, Salgado M, Canhão H, Fonseca JE, Gomes JM. 2016 update of the Portuguese recommendations for the use of biological therapies in children and adolescents with Juvenile Idiopathic Arthritis. Acta Reumatol Port 2016; 41:194-212. [PMID: 27770754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To provide evidence-based guidance for the rational and safe prescription of biological therapies in children and adolescents with juvenile idiopathic arthritis (JIAs) considering the latest available evidence and the new licensed biologics. METHODS Rheumatologists and Pediatricians with expertise in Pediatric Rheumatology updated the recommendations endorsed by the Portuguese Society of Rheumatology and the Portuguese Society of Pediatrics based on published evidence and expert opinion. The level of agreement with final propositions was voted using an online survey. RESULTS In total, 20 recommendations to guide the use of biological therapy in children and adolescents with JIAs are issued, comprising 4 general principles and 16 specific recommendations. A consensus was achieved regarding the eligibility and response criteria, maintenance of biological therapy, and procedures in case of non-response, for each JIA category. Specific recommendations concerning safety procedures were also updated. CONCLUSIONS These recommendations take into account the specificities of each JIA category and are intended to continuously improve the management of JIA patients.
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Fernandes S, Vieira-Sousa E, Furtado C, Costa A, Barros R, Fonseca JE. A diagnosis of disseminated tuberculosis based on knee arthroscopic guided synovial biopsy in the context of monoarthritis. Acta Reumatol Port 2016; 41:256-259. [PMID: 27155318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Accounting for 2.2-4.7% of all tuberculosis cases in Europe and USA and around 10-15% of extra-pulmonary tuberculosis cases, osteoarticular tuberculosis tends to be chronic, slowly progressive and destructive. We report the case of an 81-year-old male with 3 weeks of progressively worsening pain, swelling and limited range of motion of the left knee. A knee arthroscopy was performed for synovial biopsy at our department revealing diffuse synovitis with scarce villi formation. The positive polymerase chain reaction assay for Mycobacterium tuberculosis in the synovial tissue allowed the establishment of the diagnosis and synovium histology showed caseating granulomas. A lengthy delay between first symptoms of osteoarticular tuberculosis and the beginning of treatment has been reported. A high index of suspicion, synovial membrane biopsy and appropriate microbiologic testing are fundamental to avoid a delay in diagnosis.
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Castro AM, Carmona-Fernandes D, Rodrigues AM, Pedro LM, Santos MJ, Canhão H, Fonseca JE. Incidence and predictors of cardiovascular events in a cohort of patients with rheumatoid arthritis. Acta Reumatol Port 2016; 41:213-219. [PMID: 27682808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION An excess in cardiovascular (CV) morbidity and mortality has been recognized in Rheumatoid Arthritis (RA) patients when compared to the general population. Given the paucity of prospective data, our aim was to estimate the incidence of CV events and the contribution of traditional CVD risk factors and RA-related parameters to future events. METHODS Incident fatal and non-fatal CV events (hospitalizations due to unstable angina, myocardial infarction, coronary artery revascularization procedures, stroke, or CV death) were assessed in a prospective cohort of RA women followed since 2007 and without CV events at cohort entry. The presence of traditional CV risk factors, disease characteristics, medication, carotid ultrasound, and biomarkers of inflammation and endothelial activation were evaluated at baseline. Univariate Cox proportional hazard models were used to identify risk factors for CV events. RESULTS Among 106 women followed over 565 patient-years we identified 4 CV events (1 fatal stroke, 2 myocardial infarction and 1 unstable angina), which contributed to an incidence rate of 7 per 1000 person-years (95%CI 2.0- 13.9). Patients who developed CV events were older, but the distribution of other traditional CV risk factors was otherwise similar in both groups. Also, corticosteroid dosage and proportion of patients with carotid atherosclerotic plaques was higher in those with CV events. Erythrocyte sedimentation rate (ESR) (HR 1.036; 95%CI 1.005-1.067) and soluble intercellular adhesion molecule-1 (sICAM-1) serum levels (HR 1.002; 95%CI 1.000-1.003) significantly contributed to CV events. These results remained significant after adjusting for patients' age. CONCLUSION We found an incidence of cardiovascular events in women with RA of 7 per 1000 patent-years. This value is similar to that found in other Portuguese cohort of RA patients1 and much higher than the incidence reported for the general Portuguese population. Markers of inflammation and endothelial activation contributed significantly to CV events, but the limited number of events prevents further analysis.
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Moura RA, Quaresma C, Vieira AR, Gonçalves MJ, Polido-Pereira J, Romão V, Martins N, Canhão H, Fonseca JE. A2.12 Increased CXCR5 B cell expression, CXCL13 and SCD23 serum levels in untreated early rheumatoid arthritis patients support B cell activation since the initial phase of the disease. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-209124.47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Vieira-Sousa E, van Duivenvoorde LM, Fonseca JE, Lories RJ, Baeten DL. Review: animal models as a tool to dissect pivotal pathways driving spondyloarthritis. Arthritis Rheumatol 2016. [PMID: 26215401 DOI: 10.1002/art.39282] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Elsa Vieira-Sousa
- University of Lisbon, Hospital de Santa Maria, and Lisbon Academic Medical Center, Lisbon, Portugal
| | - Leonie M van Duivenvoorde
- Amsterdam Rheumatology and Immunology Center, Academic Medical Center, and University of Amsterdam, Amsterdam, The Netherlands
| | - João E Fonseca
- University of Lisbon, Hospital de Santa Maria, and Lisbon Academic Medical Center, Lisbon, Portugal
| | - Rik J Lories
- KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Dominique L Baeten
- Amsterdam Rheumatology and Immunology Center, Academic Medical Center, and University of Amsterdam, Amsterdam, The Netherlands
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Araujo GR, Fujimura PT, Vaz ER, Silva TA, Rodovalho VR, Britto-Madurro AG, Madurro JM, Fonseca JE, Silva CHM, Santos PS, Mourão AF, Canhão H, Goulart LR, Gonçalves J, Ueira-Vieira C. A novel reactive epitope-based antigen targeted by serum autoantibodies in oligoarticular and polyarticular juvenile idiopathic arthritis and development of an electrochemical biosensor. Immunobiology 2016; 221:634-40. [PMID: 26806845 DOI: 10.1016/j.imbio.2016.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 01/12/2016] [Accepted: 01/12/2016] [Indexed: 12/17/2022]
Abstract
Currently, there are no specific markers for juvenile idiopathic arthritis (JIA) diagnosis, which is based on clinical symptoms and some blood tests for diseases' exclusion. Aiming to select new epitope-based antigens (mimotopes) that could recognize circulating autoantibodies in most JIA forms, we screened a phage displayed random peptide library against IgG antibodies purified from serum of JIA patients. ELISA assay was carried out to confirm immunoreactivity of selected peptides against sera IgG antibodies from JIA patients, healthy children and patients with other autoimmune diseases. The mimotope PRF+1 fused to phage particles was able to efficiently discriminate JIA patients from controls, and for this reason was chosen to be chemically synthesized for validation in a larger sample size. The synthetic peptide was immobilized onto bioelectrodes' surface for antibody detection by electrochemical analyses through differential pulse voltammetry. The PRF+1 synthetic peptide has efficiently discriminated JIA patients from control groups (p<0.0001) with a very good accuracy (AUC>0.84; sensitivity=61%; specificity=91%). The electrochemical platform proved to be fast, low cost and effective in detecting anti-PRF+1 antibodies from JIA patients compared to healthy controls (p=0.0049). Our study describes a novel and promising epitope-based biomarker for JIA diagnosis that can become a useful tool for screening tests, which was successfully incorporated onto an electrochemical biosensor and could be promptly used in field diagnostics.
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Affiliation(s)
- Galber R Araujo
- Laboratório de Nanobiotecnologia, Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Av. Amazonas, Bloco 2E, sala 248, Uberlândia 38400-902, Minas Gerais, Brazil.
| | - Patricia T Fujimura
- Laboratório de Nanobiotecnologia, Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Av. Amazonas, Bloco 2E, sala 248, Uberlândia 38400-902, Minas Gerais, Brazil
| | - Emília R Vaz
- Laboratório de Nanobiotecnologia, Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Av. Amazonas, Bloco 2E, sala 248, Uberlândia 38400-902, Minas Gerais, Brazil
| | - Tamiris A Silva
- Laboratório de Nanobiotecnologia, Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Av. Amazonas, Bloco 2E, sala 248, Uberlândia 38400-902, Minas Gerais, Brazil
| | - Vinícius R Rodovalho
- Laboratório de Biomateriais, Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Av. Amazonas, Bloco 2E, Uberlândia 38400-902, Minas Gerais, Brazil
| | - Ana Graci Britto-Madurro
- Laboratório de Biomateriais, Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Av. Amazonas, Bloco 2E, Uberlândia 38400-902, Minas Gerais, Brazil
| | - João M Madurro
- Laboratório de Filmes Poliméricos e Nanotecnologia, Instituto de Química, Universidade Federal de Uberlândia, Av. João Naves de Ávila 2121, Uberlândia 38408-100, Minas Gerais, Brazil
| | - João E Fonseca
- Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Av. Prof. Egas Moniz, Lisboa 1649-028, Portugal
| | - Carlos H M Silva
- Unidade de Reumatologia Pediátrica, Hospital de Clínicas, Faculdade de Medicina da Universidade Federal de Uberlândia, Av. Pará 1720, Bloco 2U, Uberlândia 38400-902, Brazil
| | - Paula S Santos
- Laboratório de Nanobiotecnologia, Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Av. Amazonas, Bloco 2E, sala 248, Uberlândia 38400-902, Minas Gerais, Brazil
| | - Ana F Mourão
- Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Av. Prof. Egas Moniz, Lisboa 1649-028, Portugal
| | - Helena Canhão
- Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Av. Prof. Egas Moniz, Lisboa 1649-028, Portugal
| | - Luiz R Goulart
- Laboratório de Nanobiotecnologia, Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Av. Amazonas, Bloco 2E, sala 248, Uberlândia 38400-902, Minas Gerais, Brazil; Department of Medical Microbiology and Immunology, University of California Davis, 1 Shields Avenue, Tupper Hall, Rm. 3146, Davis, CA 95616, USA
| | - João Gonçalves
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Av. Prof. Egas Moniz, Lisboa 1649-028, Portugal
| | - Carlos Ueira-Vieira
- Laboratório de Nanobiotecnologia, Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Av. Amazonas, Bloco 2E, sala 248, Uberlândia 38400-902, Minas Gerais, Brazil
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Perpétuo IP, Raposeiro R, Caetano-Lopes J, Vieira-Sousa E, Campanilho-Marques R, Ponte C, Canhão H, Ainola M, Fonseca JE. Effect of Tumor Necrosis Factor Inhibitor Therapy on Osteoclasts Precursors in Ankylosing Spondylitis. PLoS One 2015; 10:e0144655. [PMID: 26674064 PMCID: PMC4682624 DOI: 10.1371/journal.pone.0144655] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 11/20/2015] [Indexed: 12/12/2022] Open
Abstract
Introduction Ankylosing Spondylitis (AS) is characterized by excessive local bone formation and concomitant systemic bone loss. Tumor necrosis factor (TNF) plays a central role in the inflammation of axial skeleton and enthesis of AS patients. Despite reduction of inflammation and systemic bone loss, AS patients treated with TNF inhibitors (TNFi) have ongoing local bone formation. The aim of this study was to assess the effect of TNFi in the differentiation and activity of osteoclasts (OC) in AS patients. Methods 13 AS patients treated with TNFi were analyzed at baseline and after a minimum follow-up period of 6 months. 25 healthy donors were recruited as controls. Blood samples were collected to assess receptor activator of nuclear factor kappa-B ligand (RANKL) surface expression on circulating leukocytes and frequency and phenotype of monocyte subpopulations. Quantification of serum levels of bone turnover markers and cytokines, in vitro OC differentiation assay and qRT-PCR for OC specific genes were performed. Results RANKL+ circulating lymphocytes (B and T cells) and IL-17A, IL-23 and TGF-β levels were decreased after TNFi treatment. We found no differences in the frequency of the different monocyte subpopulations, however, we found decreased expression of CCR2 and increased expression of CD62L after TNFi treatment. OC number was reduced in patients at baseline when compared to controls. OC specific gene expression was reduced in circulating OC precursors after TNFi treatment. However, when cultured in OC differentiating conditions, OC precursors from AS TNFi-treated patients showed increased activity as compared to baseline. Conclusion In AS patients, TNFi treatment reduces systemic pro osteoclastogenic stimuli. However, OC precursors from AS patients exposed to TNFi therapy have increased in vitro activity in response to osteoclastogenic stimuli.
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Affiliation(s)
- Inês P. Perpétuo
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon Academic Medical Centre, Lisboa, Portugal
- * E-mail:
| | - Rita Raposeiro
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon Academic Medical Centre, Lisboa, Portugal
| | - Joana Caetano-Lopes
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon Academic Medical Centre, Lisboa, Portugal
| | - Elsa Vieira-Sousa
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon Academic Medical Centre, Lisboa, Portugal
- Rheumatology and bone metabolic diseases department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre, Lisboa, Portugal
| | - Raquel Campanilho-Marques
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon Academic Medical Centre, Lisboa, Portugal
- Rheumatology and bone metabolic diseases department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre, Lisboa, Portugal
| | - Cristina Ponte
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon Academic Medical Centre, Lisboa, Portugal
- Rheumatology and bone metabolic diseases department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre, Lisboa, Portugal
| | - Helena Canhão
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon Academic Medical Centre, Lisboa, Portugal
- Rheumatology and bone metabolic diseases department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre, Lisboa, Portugal
| | - Mari Ainola
- Musculoskeletal Diseases and Inflammation Research Group, Biomedicum Helsinki, Faculty of Medicine, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland
| | - João E. Fonseca
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon Academic Medical Centre, Lisboa, Portugal
- Rheumatology and bone metabolic diseases department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisbon Academic Medical Centre, Lisboa, Portugal
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Mourão AF, Santos MJ, Melo Gomes JA, Martins FM, Mendonça SC, Oliveira Ramos F, Fernandes S, Salgado M, Guedes M, Carvalho S, Costa JA, Brito I, Duarte C, Furtado C, Lopes A, Rodrigues A, Sequeira G, Branco JC, Fonseca JE, Canhão H. Effectiveness and long-term retention of anti-tumour necrosis factor treatment in juvenile and adult patients with juvenile idiopathic arthritis: data from Reuma.pt. Rheumatology (Oxford) 2015; 55:697-703. [PMID: 26672905 DOI: 10.1093/rheumatology/kev398] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 02/16/2015] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Assess the effectiveness and safety of biologic therapy as well as predictors of response at 1 year of therapy, retention rate in biologic treatment and predictors of drug discontinuation in JIA patients in the Portuguese register of rheumatic diseases. METHODS We prospectively collected patient and disease characteristics from patients with JIA who started biological therapy. Adverse events were collected during the follow-up period. Predictors of response at 1 year and drug retention rates were assessed at 4 years of treatment for the first biologic agent. RESULTS A total of 812 JIA patients [65% females, mean age at JIA onset 6.9 years (s.d. 4.7)], 227 received biologic therapy; 205 patients (90.3%) were treated with an anti-TNF as the first biologic. All the parameters used to evaluate disease activity, namely number of active joints, ESR and Childhood HAQ/HAQ, decreased significantly at 6 months and 1 year of treatment. The mean reduction in Juvenile Disease Activity Score 10 (JADAS10) after 1 year of treatment was 10.4 (s.d. 7.4). According to the definition of improvement using the JADAS10 score, 83.3% respond to biologic therapy after 1 year. Fourteen patients discontinued biologic therapies due to adverse events. Retention rates were 92.9% at 1 year, 85.5% at 2 years, 78.4% at 3 years and 68.1% at 4 years of treatment. Among all JIA subtypes, only concomitant therapy with corticosteroids was found to be univariately associated with withdrawal of biologic treatment (P = 0.016). CONCLUSION Biologic therapies seem effective and safe in patients with JIA. In addition, the retention rates for the first biologic agent are high throughout 4 years.
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Affiliation(s)
- Ana F Mourão
- Rheumatology Research Unit, Instituto de Medicina Molecular, Rheumatology Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, CEDOC, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisbon,
| | - Maria J Santos
- Rheumatology Research Unit, Instituto de Medicina Molecular, Rheumatology Department, Hospital Garcia de Orta, Almada
| | | | - Fernando M Martins
- Rheumatology Research Unit, Instituto de Medicina Molecular, Portuguese Society of Rheumatology
| | | | | | | | - Manuel Salgado
- Pediatrics Department, Centro Universitário Hospitalar de Coimbra, Coimbra
| | - Margarida Guedes
- Pediatrics Department, Unidade de Imunologia Clínica, Centro Hospitalar do Porto, Porto
| | - Sónia Carvalho
- Pediatrics Department, Centro Hospitalar do Médio-Ave, Famalicão
| | - José A Costa
- Rheumatology Department, ULSAM - Hospital Conde de Bertiandos, Ponte de Lima
| | - Iva Brito
- Rheumatology Department, Hospital de São João, Faculdade de Medicina da Universidade do Porto, Porto
| | - Cátia Duarte
- Rheumatology Department, Centro Universitário Hospitalar de Coimbra, Coimbra
| | - Carolina Furtado
- Rheumatology Department, Hospital do Divino Espírito Santo, S. Miguel, Açores
| | - Ana Lopes
- Rheumatology Research Unit, Instituto de Medicina Molecular
| | - Ana Rodrigues
- Rheumatology Research Unit, Instituto de Medicina Molecular, Rheumatology Department, Hospital de Santo Espírito, Angra do Heroísmo, Terceira and
| | - Graça Sequeira
- Rheumatology Department, Centro Hospitalar do Algarve, Faro, Portugal
| | - Jaime C Branco
- Rheumatology Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, CEDOC, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisbon
| | - João E Fonseca
- Rheumatology Research Unit, Instituto de Medicina Molecular, Rheumatology Department, Lisbon Academic Medical Center, Lisbon
| | - Helena Canhão
- Rheumatology Research Unit, Instituto de Medicina Molecular, Rheumatology Department, Lisbon Academic Medical Center, Lisbon
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Cascão R, Vidal B, Lopes IP, Paisana E, Rino J, Moita LF, Fonseca JE. Decrease of CD68 Synovial Macrophages in Celastrol Treated Arthritic Rats. PLoS One 2015; 10:e0142448. [PMID: 26658436 PMCID: PMC4676706 DOI: 10.1371/journal.pone.0142448] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/21/2015] [Indexed: 01/08/2023] Open
Abstract
Background Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disease characterized by cellular infiltration into the joints, hyperproliferation of synovial cells and bone damage. Available treatments for RA only induce remission in around 30% of the patients, have important adverse effects and its use is limited by their high cost. Therefore, compounds that can control arthritis, with an acceptable safety profile and low production costs are still an unmet need. We have shown, in vitro, that celastrol inhibits both IL-1β and TNF, which play an important role in RA, and, in vivo, that celastrol has significant anti-inflammatory properties. Our main goal in this work was to test the effect of celastrol in the number of sublining CD68 macrophages (a biomarker of therapeutic response for novel RA treatments) and on the overall synovial tissue cellularity and joint structure in the adjuvant-induced rat model of arthritis (AIA). Methods Celastrol was administered to AIA rats both in the early (4 days after disease induction) and late (11 days after disease induction) phases of arthritis development. The inflammatory score, ankle perimeter and body weight were evaluated during treatment period. Rats were sacrificed after 22 days of disease progression and blood, internal organs and paw samples were collected for toxicological blood parameters and serum proinflammatory cytokine quantification, as well as histopathological and immunohistochemical evaluation, respectively. Results Here we report that celastrol significantly decreases the number of sublining CD68 macrophages and the overall synovial inflammatory cellularity, and halted joint destruction without side effects. Conclusions Our results validate celastrol as a promising compound for the treatment of arthritis.
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MESH Headings
- Adjuvants, Immunologic
- Animals
- Anti-Inflammatory Agents/pharmacology
- Antigens, CD/genetics
- Antigens, CD/immunology
- Antigens, Differentiation, Myelomonocytic/genetics
- Antigens, Differentiation, Myelomonocytic/immunology
- Arthritis, Experimental/chemically induced
- Arthritis, Experimental/drug therapy
- Arthritis, Experimental/genetics
- Arthritis, Experimental/immunology
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/genetics
- Arthritis, Rheumatoid/immunology
- Arthritis, Rheumatoid/pathology
- Cell Count
- Female
- Gene Expression
- Humans
- Injections, Intraperitoneal
- Interleukin-1beta/genetics
- Interleukin-1beta/immunology
- Macrophages/drug effects
- Macrophages/immunology
- Macrophages/pathology
- Pentacyclic Triterpenes
- Rats
- Rats, Wistar
- Synovial Membrane/drug effects
- Synovial Membrane/immunology
- Synovial Membrane/pathology
- Treatment Outcome
- Triterpenes/pharmacology
- Tumor Necrosis Factor-alpha/genetics
- Tumor Necrosis Factor-alpha/immunology
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Affiliation(s)
- Rita Cascão
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
- * E-mail:
| | - Bruno Vidal
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Inês P. Lopes
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Eunice Paisana
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - José Rino
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | | | - João E. Fonseca
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
- Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon Academic Medical Centre, Lisbon, Portugal
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Diogo D, Bastarache L, Liao KP, Graham RR, Fulton RS, Greenberg JD, Eyre S, Bowes J, Cui J, Lee A, Pappas DA, Kremer JM, Barton A, Coenen MJH, Franke B, Kiemeney LA, Mariette X, Richard-Miceli C, Canhão H, Fonseca JE, de Vries N, Tak PP, Crusius JBA, Nurmohamed MT, Kurreeman F, Mikuls TR, Okada Y, Stahl EA, Larson DE, Deluca TL, O'Laughlin M, Fronick CC, Fulton LL, Kosoy R, Ransom M, Bhangale TR, Ortmann W, Cagan A, Gainer V, Karlson EW, Kohane I, Murphy SN, Martin J, Zhernakova A, Klareskog L, Padyukov L, Worthington J, Mardis ER, Seldin MF, Gregersen PK, Behrens T, Raychaudhuri S, Denny JC, Plenge RM. TYK2 protein-coding variants protect against rheumatoid arthritis and autoimmunity, with no evidence of major pleiotropic effects on non-autoimmune complex traits. PLoS One 2015; 10:e0122271. [PMID: 25849893 PMCID: PMC4388675 DOI: 10.1371/journal.pone.0122271] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 02/17/2015] [Indexed: 02/06/2023] Open
Abstract
Despite the success of genome-wide association studies (GWAS) in detecting a large number of loci for complex phenotypes such as rheumatoid arthritis (RA) susceptibility, the lack of information on the causal genes leaves important challenges to interpret GWAS results in the context of the disease biology. Here, we genetically fine-map the RA risk locus at 19p13 to define causal variants, and explore the pleiotropic effects of these same variants in other complex traits. First, we combined Immunochip dense genotyping (n = 23,092 case/control samples), Exomechip genotyping (n = 18,409 case/control samples) and targeted exon-sequencing (n = 2,236 case/controls samples) to demonstrate that three protein-coding variants in TYK2 (tyrosine kinase 2) independently protect against RA: P1104A (rs34536443, OR = 0.66, P = 2.3x10-21), A928V (rs35018800, OR = 0.53, P = 1.2x10-9), and I684S (rs12720356, OR = 0.86, P = 4.6x10-7). Second, we show that the same three TYK2 variants protect against systemic lupus erythematosus (SLE, Pomnibus = 6x10-18), and provide suggestive evidence that two of the TYK2 variants (P1104A and A928V) may also protect against inflammatory bowel disease (IBD; Pomnibus = 0.005). Finally, in a phenome-wide association study (PheWAS) assessing >500 phenotypes using electronic medical records (EMR) in >29,000 subjects, we found no convincing evidence for association of P1104A and A928V with complex phenotypes other than autoimmune diseases such as RA, SLE and IBD. Together, our results demonstrate the role of TYK2 in the pathogenesis of RA, SLE and IBD, and provide supporting evidence for TYK2 as a promising drug target for the treatment of autoimmune diseases.
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Affiliation(s)
- Dorothée Diogo
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, United States of America
- Partners HealthCare Center for Personalized Genetic Medicine, Boston, Massachusetts, United States of America
- * E-mail:
| | - Lisa Bastarache
- Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Katherine P. Liao
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Robert R. Graham
- ITGR Human Genetics Group, Genentech Inc, San Francisco, California, United States of America
| | - Robert S. Fulton
- The Genome Institute, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Jeffrey D. Greenberg
- New York University Hospital for Joint Diseases, New York, New York, United States of America
| | - Steve Eyre
- Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - John Bowes
- Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Jing Cui
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Annette Lee
- The Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, New York, United States of America
| | - Dimitrios A. Pappas
- Columbia University, College of Physicians and Surgeons, New York, New York, United States of America
| | - Joel M. Kremer
- The Albany Medical College and The Center for Rheumatology, Albany, New York, United States of America
| | - Anne Barton
- Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Marieke J. H. Coenen
- Radboud university medical center, Radboud Institute for Health Sciences, Department of Human Genetics, Nijmegen, The Netherlands
| | - Barbara Franke
- Radboud University Medical Center, Donders Centre for Neurosciences, Department of Psychiatry and Human Genetics, Nijmegen, The Netherlands
| | - Lambertus A. Kiemeney
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Xavier Mariette
- Université Paris-Sud, Orsay, France
- APHP–Hôpital Bicêtre, INSERM U1012, Le Kremlin Bicêtre, Paris, France
| | - Corrine Richard-Miceli
- Université Paris-Sud, Orsay, France
- APHP–Hôpital Bicêtre, INSERM U1012, Le Kremlin Bicêtre, Paris, France
| | - Helena Canhão
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
- Rheumatology Department, Santa Maria Hospital–CHLN, Lisbon, Portugal
| | - João E. Fonseca
- Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
- Rheumatology Department, Santa Maria Hospital–CHLN, Lisbon, Portugal
| | - Niek de Vries
- Amsterdam Rheumatology and Immunology Center, Department of Clinical Immunology & Rheumatology, Academic Medical Center /University of Amsterdam, Amsterdam, The Netherlands
| | - Paul P. Tak
- Amsterdam Rheumatology and Immunology Center, Department of Clinical Immunology & Rheumatology, Academic Medical Center /University of Amsterdam, Amsterdam, The Netherlands
| | - J. Bart A. Crusius
- Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, The Netherlands
| | - Michael T. Nurmohamed
- Amsterdam Rheumatology and Immunology Center, Department of Rheumatology, Reade, Amsterdam, The Netherlands
| | - Fina Kurreeman
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Ted R. Mikuls
- Division of Rheumatology and Immunology, Omaha VA and University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Yukinori Okada
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, United States of America
| | - Eli A. Stahl
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, United States of America
| | - David E. Larson
- The Genome Institute, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Tracie L. Deluca
- The Genome Institute, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Michelle O'Laughlin
- The Genome Institute, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Catrina C. Fronick
- The Genome Institute, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Lucinda L. Fulton
- The Genome Institute, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Roman Kosoy
- Department of Biochemistry and Molecular Medicine, University of California Davis, Davis, California, United States of America
| | - Michael Ransom
- Department of Biochemistry and Molecular Medicine, University of California Davis, Davis, California, United States of America
| | - Tushar R. Bhangale
- ITGR Human Genetics Group, Genentech Inc, San Francisco, California, United States of America
| | - Ward Ortmann
- ITGR Human Genetics Group, Genentech Inc, San Francisco, California, United States of America
| | - Andrew Cagan
- Information Systems, Partners Healthcare, Charlestown, Massachusetts, United States of America
| | - Vivian Gainer
- Information Systems, Partners Healthcare, Charlestown, Massachusetts, United States of America
| | - Elizabeth W. Karlson
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Isaac Kohane
- Information Systems, Partners Healthcare, Charlestown, Massachusetts, United States of America
| | - Shawn N. Murphy
- Information Systems, Partners Healthcare, Charlestown, Massachusetts, United States of America
| | - Javier Martin
- Instituto de Parasitologia y Biomedicina Lopez-Neyra, CSIC, Granada, 18100, Spain
| | - Alexandra Zhernakova
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
- Genetics Department, University Medical Center and Groningen University, Groningen, The Netherlands
| | - Lars Klareskog
- Rheumatology Unit, Department of Medicine, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden
| | - Leonid Padyukov
- Rheumatology Unit, Department of Medicine, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden
| | - Jane Worthington
- Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Elaine R. Mardis
- The Genome Institute, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Michael F. Seldin
- Division of Rheumatology and Immunology, Omaha VA and University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Peter K. Gregersen
- The Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, New York, United States of America
| | - Timothy Behrens
- ITGR Human Genetics Group, Genentech Inc, San Francisco, California, United States of America
| | - Soumya Raychaudhuri
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, United States of America
- Partners HealthCare Center for Personalized Genetic Medicine, Boston, Massachusetts, United States of America
- Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Joshua C. Denny
- Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, United States of America
- Department of Medicine, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Robert M. Plenge
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, United States of America
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Araujo GR, Fonseca JE, Fujimura PT, Cunha-Junior JP, Silva CHM, Mourão AF, Canhão H, Goulart LR, Gonçalves J, Ueira-Vieira C. Anti-type II collagen antibodies detection and avidity in patients with oligoarticular and polyarticular forms of juvenile idiopathic arthritis. Immunol Lett 2015; 165:20-5. [PMID: 25800643 DOI: 10.1016/j.imlet.2015.03.006] [Citation(s) in RCA: 6] [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: 01/16/2015] [Revised: 02/14/2015] [Accepted: 03/11/2015] [Indexed: 11/28/2022]
Abstract
Juvenile idiopathic arthritis (JIA) refers to a heterogeneous group of illnesses that have in common the occurrence of chronic joint inflammation in children younger than 16 years of age. The diagnosis is made only on clinical assessment. The identification of antibody markers could improve the early diagnosis, optimizing the clinical management of patients. Type II collagen is one potential autoantigen that has been implicated in the process of arthritis development. The aims of our study were to investigate the occurrence of anti-type II collagen antibodies and also to determine the avidity of the antibody-antigen binding. Ninety-six patients with oligoarticular or polyarticular JIA, 13 patients with ankylosing spondylitis (AS) and 61 healthy controls (HC) were tested for anti-type II collagen antibodies by ELISA and avidity ELISA. Sensitivity and specificity were determined by the receiver operating characteristic (ROC) curve analysis. Forty-two JIA patients (44%) were positive for antibodies against type II collagen. Its detection was significantly higher in JIA patients than in AS patients (p=0.006) and HCs (p<0.0001). Furthermore, anti-type II collagen antibody detection was significantly more frequent in patients with JIA of ≤6 months duration (p=0.0007). Antibodies displaying high avidity to type II collagen were associated with disease activity (p=0.004). This study demonstrates that antibodies against type II collagen are present in the serum of patients with oligoarticular and polyarticular JIA, being its presence more prevalent in patients with early disease. It also demonstrates that JIA patients with active disease present antibodies with high avidity against type II collagen.
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Affiliation(s)
- Galber R Araujo
- Laboratory of Nanobiotecnology, Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Uberlândia, Brazil; iMed - Instituto de Medicina, Faculdade de Farmácia da Universidade de Lisboa, Lisbon, Portugal.
| | - João E Fonseca
- Rheumatology Research Unit, Instituto de Medicina Molecular, Lisbon, Portugal; Rheumatology Department, Lisbon Academic Medical Center, Lisbon, Portugal
| | - Patricia T Fujimura
- Laboratory of Nanobiotecnology, Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Jair P Cunha-Junior
- Laboratory of Immunotecnology and Imunochemistry, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Carlos H M Silva
- Pediatric Rheumatology Department, Hospital de Clínicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Ana F Mourão
- Rheumatology Research Unit, Instituto de Medicina Molecular, Lisbon, Portugal; Rheumatology Department, Hospital Egas Moniz, Lisbon, Portugal
| | - Helena Canhão
- Rheumatology Research Unit, Instituto de Medicina Molecular, Lisbon, Portugal; Rheumatology Department, Lisbon Academic Medical Center, Lisbon, Portugal
| | - Luiz R Goulart
- Laboratory of Nanobiotecnology, Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Uberlândia, Brazil; Department of Medical Microbiology and Immunology, University of California Davis, Davis, CA, USA
| | - João Gonçalves
- iMed - Instituto de Medicina, Faculdade de Farmácia da Universidade de Lisboa, Lisbon, Portugal; IMM - Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Carlos Ueira-Vieira
- Laboratory of Nanobiotecnology, Instituto de Genética e Bioquímica, Universidade Federal de Uberlândia, Uberlândia, Brazil
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Vidal B, Cascão R, Vale AC, Cavaleiro I, Vaz MF, Brito JA, Canhão H, Fonseca JE. A4.5 Arthritis induces early bone high turnover, structural degradation and mechanical weakness. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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46
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Romão VC, DiCicco M, Mahto A, Lazarou I, Fonseca JE, Kelly S, Humby F, Pitzalis C. A7.6 Clinical and pathological differences of elderly- and younger-onset rheumatoid arthritis in an early arthritis cohort. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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47
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Moura RA, Quaresma C, Vieira A, Gonçalves MJ, Polido-Pereira J, Romão V, Martins N, Canhão H, Fonseca JE. A1.12 B-cell markers expression is affected by TNF-inhibitors and tocilizumab treatment in rheumatoid arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Perpétuo IP, Raposeiro R, Caetano-Lopes J, Vieira-Sousa E, Campanilho-Marques R, Ponte C, Canhão H, Ainola M, Fonseca JE. A4.21 Effect of TNF blocking therapy on osteoclasts from ankylosing spondylitis patients. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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49
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Mourão AF, Santos MJ, Melo-Gomes J, Martins FM, Costa JA, Ramos F, Brito I, Duarte C, Figueira R, Figueiredo G, Furtado C, Lopes A, Oliveira M, Rodrigues A, Salgado M, Sousa M, Branco JC, Fonseca JE, Canhão H. Using the Juvenile Arthritis Disease Activity Score based on erythrocyte sedimentation rate or C-reactive protein level: results from the Portuguese register. Arthritis Care Res (Hoboken) 2014; 66:585-91. [PMID: 25354266 DOI: 10.1002/acr.22215] [Citation(s) in RCA: 14] [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] [Received: 05/10/2013] [Accepted: 10/15/2013] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Our aims were to evaluate the correlation between Juvenile Arthritis Disease Activity Score 27-joint reduced count (JADAS27) with erythrocyte sedimentation rate (ESR) and JADAS27 with C-reactive protein (CRP) scores and to test the agreement of both scores on classifying each disease activity state. We also aimed at verifying the correlation of the 2 scores across juvenile idiopathic arthritis (JIA) categories and to check the correlation between JADAS27-ESR and clinical JADAS27 (JADAS27 without ESR). METHODS A nationwide cohort of patients with JIA registered in the Portuguese Register, Reuma.pt, was studied. JADAS27-CRP was adapted by replacing ESR with CRP level as the inflammatory marker. JADAS27-CRP was calculated similarly to JADAS27-ESR as the simple linear sum of its 4 components. Pearson's correlations and K statistics were used in the analyses. RESULTS A total of 358 children had full data to calculate JADAS27; 65.4% were female and the mean ± SD disease duration was 11.8 ± 9.1 years. The correlation coefficient between JADAS27-ESR and JADAS27-CRP was 0.967 (P < 0.0001), although the correlation coefficient between ESR and CRP level was 0.335 (P < 0.0001). The strong correlation between JADAS27-ESR and JADAS27-CRP was maintained when compared within each JIA category. The agreement between JADAS27-ESR and JADAS27-CRP across the 4 activity states was very good, showing 91.1% of the observations in agreement; K = 0.867 (95% confidence interval 0.824-0.91). The correlation between JADAS27 with ESR and JADAS27 without ESR was high (r = 0.97, P < 0.0001). CONCLUSION JADAS27 based on CRP level correlated closely with JADAS27-ESR across all disease activity states and JIA categories, indicating that both measures can be used in clinical practice. Moreover, the correlation of JADAS27 with and without ESR was also high, suggesting that this tool might be useful even in the absence of laboratorial measures.
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Affiliation(s)
- Ana F Mourão
- Instituto de Medicina Molecular and Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
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Kearsley-Fleet L, Závada J, Hetland ML, Nordström DC, Aaltonen KJ, Listing J, Zink A, Gati T, Rojkovich B, Iannone F, Gremese E, van Riel PLCM, van de Laar MAFJ, Lie E, Kvien TK, Canhão H, Fonseca JE, Rotar Ž, Loza E, Carmona L, Askling J, Johansson K, Finckh A, Dixon WG, Hyrich KL. The EULAR Study Group for Registers and Observational Drug Studies: comparability of the patient case mix in the European biologic disease modifying anti-rheumatic drug registers. Rheumatology (Oxford) 2014; 54:1074-1079. [PMID: 25433042 DOI: 10.1093/rheumatology/keu446] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Under the auspices of the European League Against Rheumatism (EULAR), a study group of investigators representing European biologic DMARD (bDMARD) registers was convened. The purpose of this initial assessment was to collect and compare a cross section of patient characteristics and collate information on the availability of potential confounders within these registers. METHODS Baseline characteristics of patients starting their first bDMARD in an arbitrary year (2008) for the treatment of RA, including demographic and disease characteristics, bDMARD drug details and co-morbidities, were collected and compared across 14 European bDMARD registers. RESULTS A total of 5320 patients were included. Half the registers had restricted recruitment to certain bDMARDs during the study year. All registers` collected data on age, gender, disease duration, seropositivity for IgM-RF and 28-joint DAS (DAS28). The mean DAS28 ranged from 4.2 to 6.6 and the mean HAQ from 0.8 to 1.9. Current smoking ranged from 9% to 34%. Nine registers reported co-morbidities with varying prevalence. CONCLUSION In addition to demonstrating European-wide collaboration across rheumatology bDMARD registers, this assessment identified differences in prescribing patterns, recruitment strategies and data items collected. These differences need to be considered when applying strategies for combined analysis. The lack of a common data model across Europe calls for further work to harmonize data collection across registers.
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Affiliation(s)
- Lianne Kearsley-Fleet
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Jakub Závada
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Merete Lund Hetland
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Dan C Nordström
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Kalle J Aaltonen
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Joachim Listing
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Angela Zink
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Tamas Gati
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Bernadette Rojkovich
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Florenzo Iannone
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Elisa Gremese
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Piet L C M van Riel
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Martinus A F J van de Laar
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Elisabeth Lie
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Tore K Kvien
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Helena Canhão
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - João E Fonseca
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Žiga Rotar
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Estibaliz Loza
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Loreto Carmona
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Johan Askling
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Kari Johansson
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Axel Finckh
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - William G Dixon
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Kimme L Hyrich
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, 2Institute of Rheumatology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 3DANBIO, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, 5 Department of Medicine, Helsinki University Central Hospital, 6Faculties of Pharmacy and Medicine, University of Helsinki, Helsinki, Finland, 7German Rheumatism Research Centre, Epidemiology Unit, Berlin, 8German Rheumatism Research Centre, Epidemiology Unit and Charité University Medicine, Berlin, Germany, 9Department of Rheumatology, Semmelweis University, Polyclinic of the Hospitaller Brothers of St John of God, Budapest, Hungary,10Rheumatology Unit, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Italy, 11Institute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy, 12Radboud University Medical Center, Rheumatology, Nijmegen, 13Arthritis Centre Twente, Medisch Spectrum Twente & University Twente, Department of Psychology Health and Technology, Enschede, The Netherlands, 14Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 15Rheumatology Research Group, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal, 16Hospital de Santa Maria, Lisbon Academic Medical Centre, Portugal,17Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 18Institute for Musculoskeletal Health, Madrid, Spain,19Karolinska Institutet, Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden and 20Division of Rheumatology, University of Geneva, Geneva, Switzerland
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