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Queiro R, Loredo M, Braña I, Pardo E, Alonso S, Alperi M. Managing psoriatic arthritis in different clinical scenarios. Expert Rev Clin Immunol 2023; 19:1469-1484. [PMID: 37589128 DOI: 10.1080/1744666x.2023.2249235] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/14/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION Psoriatic arthritis (PsA) is a chronic, immune-mediated disease characterized by synovio-entheseal inflammation. It is estimated to affect around 30% of patients with psoriasis and significantly reduces patients' physical function and quality of life. There is a growing number of treatment options for PsA, but due to the heterogeneous clinical features of the disease and prevalence of comorbidities, managing PsA can be challenging. AREAS COVERED In this article, we review current understanding of the disease and available pharmacological options. Based on published treatment guidelines, emerging evidence and clinical experience, we provide our expert opinion on treatment strategies, taking into consideration the predominant disease domain and the presence of comorbidities, which can impact treatment decisions and clinical outcomes. EXPERT OPINION Biological and targeted synthetic disease-modifying agents are dramatically improving the lives of patients with PsA. Biosimilar TNF inhibitors offer a particularly versatile and cost-effective option, whilst newer biologics and targeted synthetic molecules that can be used to treat most domains of psoriatic disease are an attractive alternative to TNF inhibitors. Despite a lack of consensus on treatment sequencing and tapering, it is important that PsA patients, especially those with comorbidities, are looked after by a multidisciplinary team to optimize their care.
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Affiliation(s)
- Rubén Queiro
- Rheumatology & ISPA Translational Immunology Division, Central University Hospital of Asturias, Oviedo, Spain
- Department of Medicine, Oviedo University School of Medicine, Oviedo, Spain
| | - Marta Loredo
- Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain
| | - Ignacio Braña
- Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain
| | - Estefanía Pardo
- Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain
| | - Sara Alonso
- Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain
| | - Mercedes Alperi
- Rheumatology Division, Central University Hospital of Asturias, Oviedo, Spain
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Alonso S, Braña I, Pardo E, Burger S, González del Pozo P, Alperi M, Queiro R. Are Patients with Axial Spondyloarthritis Who Were Breastfed Protected against the Development of Severe Disease? J Clin Med 2023; 12:jcm12051863. [PMID: 36902650 PMCID: PMC10003909 DOI: 10.3390/jcm12051863] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/12/2023] [Accepted: 02/25/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND AND AIMS Breastfeeding is recognized as one of the most influential drivers of the gut microbiome. In turn, alterations in the gut microbiome may play a role in the development and severity of spondyloarthritis (SpA). We aimed to analyze different disease outcomes in patients with axial SpA (axSpA) based on the history of breastfeeding. PATIENTS AND METHODS A random sample was selected from a large database of axSpA patients. Patients were divided based on history of breastfeeding and several disease outcomes were compared. Both groups were also compared based on disease severity. Adjusted linear and logistic regression statistical methods were used. RESULTS The study included 105 patients (46 women and 59 men), and the median age was 45 years (IQR: 16-72), and the mean age at diagnosis was 34.3 ± 10.9 years. Sixty-one patients (58.1%) were breastfed, with a median duration of 4 (IQR: 1-24) months. After the fully adjusted model, BASDAI [-1.13 (95%CI: -2.04, -0.23), p = 0.015] and ASDAS [-0.38 (95%CI: -0.72, -0.04), p = 0.030] scores were significantly lower in breastfed patients. Forty-two percent had severe disease. In the adjusted logistic model for age, sex, disease duration, family history, HLA-B27, biologic therapy, smoking, and obesity, breastfeeding had a protective effect against the development of severe disease (OR 0.22, 95%CI: 0.08-0.57, p = 0.003). The selected sample size was sufficient to detect this difference with a statistical power of 87% and a confidence level of 95%. CONCLUSION Breastfeeding might exert a protective effect against severe disease in patients with axSpA. These data need further confirmation.
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Affiliation(s)
- Sara Alonso
- Rheumatology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | - Ignacio Braña
- Rheumatology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | - Estefanía Pardo
- Rheumatology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | - Stefanie Burger
- Rheumatology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | | | - Mercedes Alperi
- Rheumatology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | - Rubén Queiro
- Rheumatology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
- ISPA Translational Immunology Section, Biohealth Research Institute of the Principality of Asturias (ISPA), 33011 Oviedo, Spain
- School of Medicine, Oviedo University, 33011 Oviedo, Spain
- Correspondence: ; Tel.: +34-985-108000
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Braña I, Pardo E, Burger S, González del Pozo P, Alperi M, Queiro R. Treatment Retention and Safety of Ixekizumab in Psoriatic Arthritis: A Real Life Single-Center Experience. J Clin Med 2023; 12:jcm12020467. [PMID: 36675395 PMCID: PMC9861177 DOI: 10.3390/jcm12020467] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 12/17/2022] [Revised: 12/28/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023] Open
Abstract
Background and objectives: Information on the performance of ixekizumab (IXE) in patients with psoriatic arthritis (PsA) in clinical practice is scarce. We aimed to analyze the retention rate and safety of IXE in patients with PsA in routine clinical practice. Methods: A retrospective longitudinal observational single-center study of all patients with PsA who had received at least one dose of IXE. Adverse events (AEs) and drug retention rate were the main study focus. Survival was analyzed using Kaplan−Meier curves and predictive factors using multivariate Cox regression analysis. The hazard ratio (HR) was used as a measure of the association. Results: Seventy-two patients were included (52 women and 20 men). Median disease duration was 5 years (IQR 3−9). More than 90% received ≥2 biologic and/or targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs) prior to IXE. Ixekizumab showed a 1-year retention rate of 65% and a 2-year retention rate of 57%. Regarding discontinuation due to AEs, 0.18 AEs per person-year were identified. The number of previous biologics did not influence drug survival but prior use of methotrexate (HR 2.31 (95% CI 1.05−5.10), p < 0.05) and depression (HR 2.40 (95% CI 1.07−5.41), p < 0.05) increased the risk of IXE discontinuation. Conclusions: Ixekizumab showed a good retention rate in a PsA population mostly refractory to biologic and targeted synthetic DMARDs. Drug survival was consistently good regardless of age, gender, metabolic comorbidities, smoking status, or prior number of biologic therapies. This information may be of interest to better position this drug in the PsA treatment algorithms.
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Affiliation(s)
- Ignacio Braña
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
| | - Estefanía Pardo
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
| | - Stefanie Burger
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
| | - Pablo González del Pozo
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
| | - Mercedes Alperi
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
| | - Rubén Queiro
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
- ISPA Translational Immunology Division & Oviedo University School of Medicine, 33011 Oviedo, Spain
- Correspondence: ; Tel.: +34-985-108000
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Queiro R, Alonso S, Morante I, Alperi M. Non-Physical Disease Facets in Spondyloarthritis: An ASAS Health Index-Based Analysis between Psoriatic Arthritis and Axial Spondyloarthritis. J Clin Med 2022; 11:jcm11206094. [PMID: 36294416 PMCID: PMC9605564 DOI: 10.3390/jcm11206094] [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: 09/08/2022] [Revised: 10/08/2022] [Accepted: 10/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background: Psychosocial health is a key driver of quality of life (QoL) in axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA), but it is often overlooked in clinical practice. We aimed to analyze this aspect of QoL by using the Assessment of SpA International Society−Health Index (ASAS HI) in both SpA phenotypes. Patients and methods: One hundred and eleven patients with axSpA and 90 with PsA were consecutively recruited from two rheumatology centers. In both populations, the categories of stress handling (ASAS HI items #11 and 17) and emotional functions (ASAS HI item #13) were analyzed based on the International Classification of Functioning, Disability, and Health (ICF). A multivariate regression model was used to analyze the explanatory factors associated with positive responses to these items. Results: Thirty-four of the 90 PsA patients (37.8%) and 37/111 of the patients (33.3%) with axSpA reported a positive response to at least one of the stress-handling items. Compared to the patients with PsA, patients with axSpA were less likely to report stress-handling issues (OR 0.48, p < 0.05). Thirty-one of the 90 PsA patients (34.4%) and 44/111 of the patients (39.6%) with axSpA reported positive responses to item #13. In both groups of SpA patients, disease activity and severity (OR 6.6, p < 0.001) were independently associated with alterations in psychosocial health. Compared with those in the axSpA group, the psychosocial health items were better correlated with each other and with the ASAS HI sum score in the PsA group. Conclusions: Psychosocial health is frequently altered in SpA. Both disease activity and severity are associated with this issue. However, psychosocial factors seem to have a greater impact on QoL in PsA than in axSpA.
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Affiliation(s)
- Rubén Queiro
- Rheumatology Division, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
- ISPA Translational Immunology Division, 33011 Oviedo, Spain
- School of Medicine, Oviedo University, 33003 Oviedo, Spain
- Correspondence: ; Tel.: +34-985-108000
| | - Sara Alonso
- Rheumatology Division, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | - Isla Morante
- Rheumatology Division, Hospital de Sierrallana, 39300 Torrelavega, Spain
| | - Mercedes Alperi
- Rheumatology Division, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
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Alonso S, Morante I, Alperi M, Queiro R. The ASAS health index: a new era for health impact assessment in spondyloarthritis. J Rheumatol 2021; 49:8-15. [PMID: 34393105 DOI: 10.3899/jrheum.200586] [Citation(s) in RCA: 3] [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] [Accepted: 07/23/2021] [Indexed: 11/22/2022]
Abstract
The concept of spondyloarthritis (SpA) encompasses a series of entities that share clinical and imaging characteristics and a common genetic basis. These diseases can affect 0.20 to 1.6% of the general population, limiting functioning and affecting the quality of life of patients. Considering the patient perspective in the management of the disease and ensuring patients are sufficiently prepared to participate in decisionmaking is critical to treatment success as well as for optimal health outcomes. The overall picture of impairments, limitations, and restrictions in activities or social participation of patients with SpA is not adequately assessed in SpA-specific instruments. Therefore, it is quite relevant to measure the broader range of impairments that can affect SpA patients and integrate these into one measure of overall functioning in daily life. The Assessment of SpondyloArthritis international Society-Health Index (ASAS HI) is a recently introduced health instrument for evaluating SpA based on the International Classification of Functioning, Disability and Health, also known as ICF, that could cover a good part of the health metric needs in SpA. This review addresses its origins, its measurement properties, its use in routine clinical practice, as well as its prospects for future use.
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Affiliation(s)
- Sara Alonso
- Rheumatology Division. Hospital Universitario Central de Asturias (HUCA). Oviedo- Asturias (Spain); Rheumatology Division. Hospital de Sierrallana. Torrelavega-Cantabria (Spain); ISPA Translational Immunology division. Oviedo (Spain). Address correspondence to Rubén Queiro. M.D., Ph.D, Associate professor. Oviedo University School of Medicine, Rheumatology Division, HUCA. Avenida de Roma s/n, 33011. Oviedo (Spain).
| | - Isla Morante
- Rheumatology Division. Hospital Universitario Central de Asturias (HUCA). Oviedo- Asturias (Spain); Rheumatology Division. Hospital de Sierrallana. Torrelavega-Cantabria (Spain); ISPA Translational Immunology division. Oviedo (Spain). Address correspondence to Rubén Queiro. M.D., Ph.D, Associate professor. Oviedo University School of Medicine, Rheumatology Division, HUCA. Avenida de Roma s/n, 33011. Oviedo (Spain).
| | - Mercedes Alperi
- Rheumatology Division. Hospital Universitario Central de Asturias (HUCA). Oviedo- Asturias (Spain); Rheumatology Division. Hospital de Sierrallana. Torrelavega-Cantabria (Spain); ISPA Translational Immunology division. Oviedo (Spain). Address correspondence to Rubén Queiro. M.D., Ph.D, Associate professor. Oviedo University School of Medicine, Rheumatology Division, HUCA. Avenida de Roma s/n, 33011. Oviedo (Spain).
| | - Rubén Queiro
- Rheumatology Division. Hospital Universitario Central de Asturias (HUCA). Oviedo- Asturias (Spain); Rheumatology Division. Hospital de Sierrallana. Torrelavega-Cantabria (Spain); ISPA Translational Immunology division. Oviedo (Spain). Address correspondence to Rubén Queiro. M.D., Ph.D, Associate professor. Oviedo University School of Medicine, Rheumatology Division, HUCA. Avenida de Roma s/n, 33011. Oviedo (Spain).
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Queiro R, Alonso S, Morante I, Alperi M. Sexual disinterest among spondyloarthritis patients. Comparison between psoriatic arthritis and axial spondyloarthritis using a sexuality-specific question from the ASAS Health Index. Clin Exp Rheumatol 2021. [DOI: 10.55563/clinexprheumatol/d1hvl1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Rubén Queiro
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, and ISPA Translational Immunology Division, Oviedo University School of Medicine, Spain.
| | - Sara Alonso
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Isla Morante
- Rheumatology Division, Hospital de Sierrallana, Torrelavega-Cantabria, Spain
| | - Mercedes Alperi
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
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Regueiro C, Casares-Marfil D, Lundberg K, Knevel R, Acosta-Herrera M, Rodriguez-Rodriguez L, Lopez-Mejias R, Perez-Pampin E, Triguero-Martinez A, Nuño L, Ferraz-Amaro I, Rodriguez-Carrio J, Lopez-Pedrera R, Robustillo-Villarino M, Castañeda S, Remuzgo-Martinez S, Alperi M, Alegre-Sancho JJ, Balsa A, Gonzalez-Alvaro I, Mera A, Fernandez-Gutierrez B, Gonzalez-Gay MA, Trouw LA, Grönwall C, Padyukov L, Martin J, Gonzalez A. HLA-B*08 Identified as the Most Prominently Associated Major Histocompatibility Complex Locus for Anti-Carbamylated Protein Antibody-Positive/Anti-Cyclic Citrullinated Peptide-Negative Rheumatoid Arthritis. Arthritis Rheumatol 2021; 73:963-969. [PMID: 33381897 DOI: 10.1002/art.41630] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/23/2020] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Previously, only the HLA-DRB1 alleles have been assessed in rheumatoid arthritis (RA). The aim of the present study was to identify the key major histocompatibility complex (MHC) susceptibility factors showing a significant association with anti-carbamylated protein antibody-positive (anti-CarP+) RA. METHODS Analyses were restricted to RA patients who were anti-cyclic citrullinated peptide antibody negative (anti-CCP-), because the anti-CCP status dominated the results otherwise. Therefore, we studied samples from 1,821 anti-CCP- RA patients and 6,821 population controls from Spain, Sweden, and the Netherlands. The genotypes for ~8,000 MHC biallelic variants were assessed by dense genotyping and imputation. Their association with the anti-CarP status in RA patients was tested with logistic regression and combined with inverse-variance meta-analysis. Significance of the associations was assessed according to a study-specific threshold of P < 2.0 × 10-5 . RESULTS The HLA-B*08 allele and its correlated amino acid variant Asp-9 showed a significant association with anti-CarP+/anti-CCP- RA (P < 3.78 × 10-7 ; I2 = 0). This association was specific when assessed relative to 3 comparator groups: population controls, anti-CarP-/anti-CCP- RA patients, and anti-CCP- RA patients who were positive for other anti-citrullinated protein antibodies. Based on these findings, anti-CarP+/anti-CCP- RA patients could be separated from other antibody-defined subsets of RA patients in whom an association with the HLA-B*08 allele has been previously demonstrated. No other MHC variant remained associated with anti-CarP+/anti-CCP- RA after accounting for the presence of the HLA-B*08 allele. Specifically, the reported association of HLA-DRB1*03 was observed at a level comparable to that reported previously, but it was attributable to linkage disequilibrium. CONCLUSION These results identify HLA-B*08 carrying Asp-9 as the MHC locus showing the strongest association with anti-CarP+/anti-CCP- RA. This knowledge may help clarify the role of the HLA in susceptibility to specific subsets of RA, by shaping the spectrum of RA autoantibodies.
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Affiliation(s)
- Cristina Regueiro
- Instituto de Investigacion Sanitaria and Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | | | - Karin Lundberg
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Rachel Knevel
- Leiden University Medical Center, Leiden, The Netherlands, and Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | - Raquel Lopez-Mejias
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Eva Perez-Pampin
- Instituto de Investigacion Sanitaria and Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | - Ana Triguero-Martinez
- Instituto de Investigación Sanitaria la Princesa and Hospital Universitario de la Princesa, Madrid, Spain
| | - Laura Nuño
- Instituto de Investigación del Hospital Universitario La Paz, Madrid, Spain
| | | | - Javier Rodriguez-Carrio
- University of Oviedo, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Reina Sofía de Investigación Nefrológica, REDinREN del ISCIII, Oviedo, Spain
| | - Rosario Lopez-Pedrera
- Maimonides Institute for Research in Biomedicine of Cordoba, Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain
| | | | - Santos Castañeda
- Instituto de Investigación Sanitaria la Princesa and Hospital Universitario de la Princesa, Madrid, Spain
| | - Sara Remuzgo-Martinez
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Mercedes Alperi
- Hospital Universitario Central de Asturias, and Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | | | - Alejandro Balsa
- Instituto de Investigación del Hospital Universitario La Paz, Madrid, Spain
| | - Isidoro Gonzalez-Alvaro
- Instituto de Investigación Sanitaria la Princesa and Hospital Universitario de la Princesa, Madrid, Spain
| | - Antonio Mera
- Instituto de Investigacion Sanitaria and Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | | | - Miguel A Gonzalez-Gay
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | | | - Caroline Grönwall
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Leonid Padyukov
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Javier Martin
- Instituto de Parasitología y Biomedicina López-Neyra, IPBLN-CSIC, Granada, Spain
| | - Antonio Gonzalez
- Instituto de Investigacion Sanitaria and Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
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Julià A, López-Lasanta M, Blanco F, Gómez A, Haro I, Mas AJ, Erra A, Vivar MLG, Monfort J, Sánchez-Fernández S, González I, Alperi M, Castellanos-Moreira R, Fernández-Nebro A, Díaz-Torné C, Palau N, Lastra R, Lladós J, Sanmartí R, Marsal S. Interactions between rheumatoid arthritis antibodies are associated with the response to anti-tumor necrosis factor therapy. BMC Musculoskelet Disord 2021; 22:372. [PMID: 33882889 PMCID: PMC8061050 DOI: 10.1186/s12891-021-04248-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/12/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Blocking of the Tumor Necrosis Factor (TNF) activity is a successful therapeutic approach for 50-60% of rheumatoid arthritis (RA) patients. However, there are yet no biomarkers to stratify patients for anti-TNF therapy. Rheumatoid factor (RF) and anti-cyclic-citrullinated antibodies (anti-CCP) have been evaluated as biomarkers of response but the results have shown limited consistency. Anti-carbamylated protein (anti-CarP) and anti-peptidylarginine deiminase type 4 (anti-PAD4) antibodies have been much less studied. Despite being linked to common immune processes, the interaction between these markers has not been evaluated yet. Our aim was to analyze the interaction between these four antibodies in relation to the response to anti-TNF therapy. METHODS For this objective, a prospective cohort of n = 80 RA patients starting anti-TNF therapy was recruited. Serum determinations at baseline were performed for RF, anti-CCP, anti-CarP and anti-PAD4 antibodies using enzyme-linked immunosorbent assays (ELISA). The clinical response to anti-TNF therapy was determined at week 12 using the change in DAS28 score. Association was performed using multivariate linear regression adjusting for baseline DAS28, sex and age. RESULTS The interaction between pairs of antibodies was tested by the addition of an interaction term. We found two highly significant antibody interactions associated with treatment response: anti-CarP with anti-PAD4 (p = 0.0062), and anti-CCP with RF (p = 0.00068). The latter antibody interaction was replicated in an independent retrospective cohort of RA patients (n = 199, p = 0.04). CONCLUSIONS The results of this study suggest that antibody interaction effects are important factors in the response to anti-TNF therapy in RA.
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Affiliation(s)
- Antonio Julià
- Rheumatology Research Group, Vall d'Hebron University Hospital Research Institute, 08035, Barcelona, Spain.
| | - María López-Lasanta
- Rheumatology Research Group, Vall d'Hebron University Hospital Research Institute, 08035, Barcelona, Spain
| | - Francisco Blanco
- Rheumatology Department, INIBIC-Hospital Universitario A Coruña, A Coruña, Spain
| | - Antonio Gómez
- Rheumatology Research Group, Vall d'Hebron University Hospital Research Institute, 08035, Barcelona, Spain
| | - Isabel Haro
- Unitat de Síntesi i Aplicacions Biomèdiques de Pèptids, IQAC-CSIC, Barcelona, Spain
| | - Antonio Juan Mas
- Rheumatology Department, Hospital Universitario Son Llàtzer, Mallorca, Spain
| | - Alba Erra
- Rheumatology Research Group, Vall d'Hebron University Hospital Research Institute, 08035, Barcelona, Spain
| | | | - Jordi Monfort
- Rheumatology Department, Hospital del Mar, Barcelona, Spain
| | | | - Isidoro González
- Rheumatology Department, Hospital Universitario La Princesa, Madrid, Spain
| | - Mercedes Alperi
- Rheumatology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - César Díaz-Torné
- Rheumatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Núria Palau
- Rheumatology Research Group, Vall d'Hebron University Hospital Research Institute, 08035, Barcelona, Spain
| | - Raquel Lastra
- Rheumatology Research Group, Vall d'Hebron University Hospital Research Institute, 08035, Barcelona, Spain
| | - Jordi Lladós
- Rheumatology Research Group, Vall d'Hebron University Hospital Research Institute, 08035, Barcelona, Spain
| | - Raimon Sanmartí
- Rheumatology Department, Fundació Clínic Recerca Biomèdica, Barcelona, Spain
| | - Sara Marsal
- Rheumatology Research Group, Vall d'Hebron University Hospital Research Institute, 08035, Barcelona, Spain
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Queiro R, Alonso-Castro S, Alperi M. ASAS Health Index as an Addition to Routine Clinical Practice. J Rheumatol 2021; 48:787. [PMID: 33452176 DOI: 10.3899/jrheum.201440] [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: 10/22/2022]
Affiliation(s)
- Rubén Queiro
- Oviedo University School of Medicine, Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain.
| | - Sara Alonso-Castro
- Oviedo University School of Medicine, Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Mercedes Alperi
- Oviedo University School of Medicine, Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
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Pardo E, Charca L, Alonso S, Alperi M, Arboleya L, Queiro R. Disease Activity in Psoriatic Arthritis Index and Psoriatic Arthritis Impact of Disease Questionnaire: correlation and sensitivity to change in a real clinical setting. Clin Exp Rheumatol 2020; 38:973-977. [PMID: 31969229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 11/04/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES The performance of many outcome measures for psoriatic arthritis (PsA) is almost unknown in real clinical practice. Our objective was to study the correlation and sensitivity to change of the Disease Activity in Psoriatic Arthritis (DAPSA) index and the Psoriatic Arthritis Impact of Disease (PsAID) questionnaire in a real practice setting. METHODS This was a prospective, open, non-controlled study that included 60 consecutive patients with PsA treated with ustekinumab. Most had been previously treated with one or more biologic therapeutic agents. The correlation (Spearman's rho coefficient) and the sensitivity to change [Standardized Mean Response (SMR)] of DAPSA and PsAID were studied. Effect size values of 0.20, 0.50 and 0.80 corresponded to low, moderate and high sensitivity to change, respectively. RESULTS More than 70% of patients achieved therapeutic goals (21.7% were in remission and 50% in low disease activity according to DAPSA categories). Two out of three patients reached an acceptable symptomatic state (PsAID <4). The correlation between final values of both instruments was substantial (Spearman's rho: 0.62, p<0.0001). The SMR for the PsAID was 1.08 (0.95-1.21) and for DAPSA was 1.5 (1.37-1.63), both values corresponding to instruments with a high sensitivity to change (>0.80). The best PsAID cut-off value for identifying DAPSA remission was 3.32 with an area under the ROC curve of 0.82. CONCLUSIONS DAPSA and PsAID seem to be useful instruments for a more comprehensive assessment of PsA in daily practice. Our results can help to disseminate the use of these instruments in the clinical practice of many rheumatologists.
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Affiliation(s)
- Estefanía Pardo
- Rheumatology Division, Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Lilyan Charca
- Rheumatology Division, Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Sara Alonso
- Rheumatology Division, Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Mercedes Alperi
- Rheumatology Division, Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Luis Arboleya
- Rheumatology Division, Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Rubén Queiro
- Rheumatology Division, Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain.
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Alonso-Castro S, Pardo E, Charca L, Pino M, Fernández S, Alperi M, Arboleya L, Queiro R. Performance of the ASAS Health Index for the Evaluation of Spondyloarthritis in Daily Practice. J Rheumatol 2020; 47:1483-1489. [DOI: 10.3899/jrheum.200025] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2020] [Indexed: 01/08/2023]
Abstract
ObjectiveThe Assessment of SpondyloArthritis international Society Health Index (ASAS HI) is a tool designed to assess disease impact in spondyloarthritis (SpA), but its clinical performance is barely known. We aimed to test the clinimetric properties of ASAS HI in a real clinical setting.MethodsThis cross-sectional study included 111 consecutive patients with SpA. The measurement properties of ASAS HI were tested against conventional assessment measures. Convergent validity was assessed by Spearman rho correlations, while discriminative validity was analyzed through receiver-operating characteristic (ROC) curves. A multivariate regression analysis was designed to identify ASAS HI items associated with active disease.ResultsThe average ASAS HI was 5.4 ± 3.8 (interquartile range 3–8). ASAS HI showed high convergent validity against other SpA measures (rho ≥ 0.70, p < 0.0005). The optimal criteria for detecting high/very high disease activity Ankylosing Spondylitis Disease Activity Score (ASDAS) categories was an ASAS HI score > 6, area under the ROC curve 0.86 (95% CI 0.78–0.92), positive likelihood ratio 7.3 (95% CI 3.1–17.1), p < 0.0001. The ASAS HI items significantly associated with Bath Ankylosing Spondylitis Disease Activity Index active disease were “I often get frustrated” (OR 9.2, 95% CI 1.2–69.4, p = 0.032), and “I sleep badly at night” (OR 7.7, 95% CI 1.4–41.6, p = 0.018). As for ASDAS, it was “pain sometimes disrupts my normal activities” (OR 8.7, 95% CI 1.7–45.2, p = 0.010).ConclusionThe ASAS HI is a useful and simple instrument for its application in daily practice. Given its good clinimetric properties, it could be used as an additional instrument to evaluate SpA.
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Queiro R, Pardo E, Charca L, Alonso S, Arboleya L, Alperi M. Analysis by Age Group of Disease Outcomes in Patients with Psoriatic Arthritis: A Cross-Sectional Multicentre Study. Drugs Aging 2019; 37:99-104. [DOI: 10.1007/s40266-019-00724-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Arboleya L, Queiro R, Alperi M, Lorenzo JA, Ballina J. Pyle's Disease: A human model of differentiated cortical and trabecular homeostasis. ACTA ACUST UNITED AC 2018; 16:56-58. [PMID: 29463445 DOI: 10.1016/j.reuma.2018.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 10/19/2017] [Revised: 12/07/2017] [Accepted: 01/10/2018] [Indexed: 12/14/2022]
Abstract
Pyle's disease (OMIN number 265900) is a metaphyseal dysplasia of benign course, inherited with an autosomal recessive pattern. Some 30 genuine cases have been described so far. The cause of this process has been known since 2016, when its relationship to mutations in the gene encoding the sFRP protein, a known inhibitor of the Wnt pathway, was discovered. We report the case of a 58-year-old man, diagnosed with Pyle's disease based on his clinical and radiographic characteristics, whose phenotype suggested a differential control of cortical and trabecular bone homeostasis.
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Affiliation(s)
- Luis Arboleya
- Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
| | - Rubén Queiro
- Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - Mercedes Alperi
- Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | | | - Javier Ballina
- Hospital Universitario Central de Asturias, Oviedo, Asturias, España
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Martín-Martínez MA, Andreu-Sanchez JL, Sanchez-Alonso F, Corominas H, Perez-Venegas JJ, Roman-Ivorra JA, Alperi M, Blanco-Alonso R, Caliz R, Chamizo-Carmona E, Graña-Gil J, Hernández B, Marras C, Mazzucchelli R, Medina Luezas JA, Naranjo-Hernández A, Ortiz A, Roselló R, Sanchez-Nievas G, Sanmartí R, Vela-Casasempere P. A composite indicator to assess the quality of care in the management of patients with rheumatoid arthritis in outpatient rheumatology clinics. ACTA ACUST UNITED AC 2017; 15:156-164. [PMID: 28789978 DOI: 10.1016/j.reuma.2017.06.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 12/20/2016] [Revised: 05/30/2017] [Accepted: 06/02/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The current guidelines in the treatment of rheumatoid arthritis (RA) include the early diagnosis and early use of disease modifying drugs to achieve remission or low disease activity level, known as "Treat to Target" (T2T). The objective of this study is to develop a composite indicator (CI) to evaluate the quality of care in the management of patients with RA, according to the T2T strategy and other general recommendations concerning the management of these patients. MATERIAL AND METHOD The phases of the construction of the CI were: 1) selection of quality criteria through expert judgment; 2) prioritization of the criteria, according to relevance and feasibility, applying the Delphi methodology (two rounds) involving 20 experts; 3) design of quality indicators; and 4) calculation of the weighted CI, using the mean value in relevance and feasibility granted by the experts. The source of information for the calculation of the CI are the medical records of patients with RA. RESULTS Twelve criteria out of 37 required a second Delphi round. Thirty-one criteria were prioritized. These criteria presented a median in relevance and feasibility greater than or equal to 7.5, with an interquartile range of less than 3.5, and a level of agreement (score greater than or equal to 8) greater than or equal to 80%. CONCLUSIONS The constructed CI allows us to evaluate the quality of care of patients with RA following the T2T strategy in the rheumatology units of Spanish hospitals, offering a valid and easily interpretable summary measure.
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Affiliation(s)
| | | | | | - Hector Corominas
- Servicio de Reumatología, Hospital de Sant Joan Despí Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, España
| | - Jose Javier Perez-Venegas
- Servicio de Reumatología, Hospital General de Jerez de la Frontera, Jerez de la Frontera, Cádiz, España
| | | | - Mercedes Alperi
- Servicio de Reumatología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - Ricardo Blanco-Alonso
- Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
| | - Rafael Caliz
- Servicio de Reumatología, Hospital Universitario Virgen de las Nieves, Granada, España
| | | | - Jenaro Graña-Gil
- Servicio de Reumatología, Complejo Hospitalario Universitario A Coruña, A Coruña, España
| | - Blanca Hernández
- Servicio de Reumatología, Hospital Universitario Virgen de la Macarena, Sevilla, España
| | - Carlos Marras
- Servicio de Reumatología, Hospital Universitario Virgen de la Arrixaca, Murcia, España
| | - Ramon Mazzucchelli
- Servicio de Reumatología, Fundación Hospital Alcorcón, Alcorcón, Madrid, España
| | | | - Antonio Naranjo-Hernández
- Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, España
| | - Ana Ortiz
- Servicio de Reumatología, Hospital Universitario La Princesa, Madrid, España
| | - Rosa Roselló
- Servicio de Reumatología, Hospital San Jorge, Huesca, España
| | - Ginés Sanchez-Nievas
- Servicio de Reumatología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - Raimon Sanmartí
- Servicio de Reumatología, Hospital Clínic de Barcelona, Barcelona, España
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Queiro R, Tejόn P, Morante I, Cabezas I, Brandy A, Alperi M, Belmonte M, Riestra J, Arboleya L, Ballina J. FRI0475 Frequency and Predictors of Cardiovascular Events in A Bicentric Cohort of Psoriatic Arthritis from Spain. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4084] [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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Nolla JM, Martínez C, García-Vicuña R, Seoane-Mato D, Rosario Lozano MP, Alonso A, Alperi M, Barbazán C, Calvo J, Delgado C, Fernández-Nebro A, Mateo L, Pérez Sandoval T, Pérez Venegas J, Rodríguez Lozano C, Rosas J. Quality standards for rheumatology outpatient clinic. The EXTRELLA project. ACTA ACUST UNITED AC 2016; 12:248-55. [PMID: 26775226 DOI: 10.1016/j.reuma.2015.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 09/11/2015] [Revised: 11/02/2015] [Accepted: 11/06/2015] [Indexed: 11/18/2022]
Abstract
INTRODUCTION In recent years, outpatient clinics have undergone extensive development. At present, patients with rheumatic diseases are mainly assisted in this area. However, the quality standards of care are poorly documented. OBJECTIVE To develop specific quality criteria and standards for an outpatient rheumatology clinic. METHOD The project was based on the two-round Delphi method. The following groups of participants took part: scientific committee (13 rheumatologists), five nominal groups (45 rheumatologists and 12 nurses) and a group of discussion formed by 9 patients. Different drafts were consecutively generated until a final document was obtained that included the standards that received a punctuation equal or over 7 in at least 70% of the participants. RESULTS 148 standards were developed, grouped into the following 9 dimensions: a) structure (22), b) clinical activity and relationship with the patients (34), c) planning (7), d) levels of priority (5), e) relations with primary care physicians, with Emergency Department and with other clinical departments, f) process (26), g) nursing (13), h) teaching and research (13) and i) activity measures (8). CONCLUSION This study established specific quality standards for rheumatology outpatient clinic. It can be a useful tool for organising this area in the Rheumatology Department and as a reference when proposing improvement measures to health administrators.
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Affiliation(s)
- Joan M Nolla
- Servicio de Reumatología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
| | - Carmen Martínez
- Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España
| | - Rosario García-Vicuña
- Servicio de Reumatología, Hospital Universitario de la Princesa, IIS-IP, Madrid, España
| | - Daniel Seoane-Mato
- Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España
| | | | - Alberto Alonso
- Servicio de Reumatología, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España
| | - Mercedes Alperi
- Servicio de Reumatología, Hospital Universitario Central de Asturias, Oviedo, España
| | - Ceferino Barbazán
- Servicio de Reumatología, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España
| | - Jaime Calvo
- Servicio de Reumatología, Hospital Sierrallana, Torrelavega, Cantabria, España
| | - Concepción Delgado
- Servicio de Reumatología, Hospital Clínco Universitario Lozano Blesa, Zaragoza, España
| | | | - Lourdes Mateo
- Servicio de Reumatología, Hospital Universitari Germans Trías i Pujol, Badalona, Barcelona, España
| | | | - José Pérez Venegas
- Servicio de Reumatología, Hospital de Jerez de la Frontera, Jerez de la Frontera, Cádiz, España
| | - Carlos Rodríguez Lozano
- Servicio de Reumatología, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, España
| | - José Rosas
- Servicio de Reumatología, Hospital de la Marina Baixa, Villajoyosa, Alicante, España
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Alonso S, Tejón P, Sarasqueta C, Coto P, Alperi M, Queiro R. Age at disease onset may help to further characterize the disease phenotype in psoriatic arthritis. Joint Bone Spine 2015; 83:533-7. [PMID: 26750761 DOI: 10.1016/j.jbspin.2015.09.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 06/01/2015] [Accepted: 09/07/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate whether the age of disease presentation helps to better characterize the disease phenotype in PsA. METHODS Retrospective cohort study that included 205 consecutive patients fulfilling the CASPAR criteria for PsA. Study outcomes were assessed using univariate and multivariate analyses according to the age of onset of both skin and joint disease (cut off at 40years). RESULTS Early onset psoriasis (EOP) showed more extensive skin involvement (OR 2.3, P=0.011), axial pattern as disease onset (OR 4.6, P=0.009) and mixed pattern during evolution (OR 2.4, P=0.019), family history of both psoriasis (OR 3.1, P=0.003) and PsA (OR 4.0, P=0.021), higher prevalence of HLA-C*06 (OR 2.03, P=0.03) and HLA-B*27 (OR 2.7, P=0.02). Early onset arthritis (EOA) had more family history of PsA (OR 2.9, P=0.007), and HLA-B*27 positivity (OR 5.9, P<0.0001). Patients with late onset arthritis (LOA) were more likely to have DM (OR 4.0, P=0.009), hypertension (OR 2.5, P=0.004), dyslipidemia (OR 2.3, P=0.011), and obesity (OR 1.7, P=0.012). Late onset psoriasis (LOP) tended to have more obesity (OR 1.9, P=0.035), DM (OR 9.4, P<0.0001), hypertension (OR 4.1, P<0.0001), and ischemic heart disease during follow-up (OR 5.9, P=0.021). In multivariate analysis, LOP predicted DM development (OR 12.1, P=0.006). LOA was shown to be an independent risk factor for hypertension (OR 5.2, P=0.039). CONCLUSION Age at disease onset exerts a strong influence on several domains of disease phenotype in PsA. Therefore, this descriptor should be considered a good stratification option for epidemiological and genetic studies in PsA.
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Affiliation(s)
- Sara Alonso
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Avenida de Roma, C/Celestino Villamil s/n, 33011 Oviedo, Spain
| | - Patricia Tejón
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Avenida de Roma, C/Celestino Villamil s/n, 33011 Oviedo, Spain
| | - Cristina Sarasqueta
- Clinical Epidemiology Unit, Complejo Hospitalario Donostia, 20080 Donostia, Spain
| | - Pablo Coto
- Dermatology Division, Hospital Universitario Central de Asturias (HUCA), Avenida de Roma, C/Celestino Villamil s/n, 33011 Oviedo, Spain
| | - Mercedes Alperi
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Avenida de Roma, C/Celestino Villamil s/n, 33011 Oviedo, Spain
| | - Rubén Queiro
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Avenida de Roma, C/Celestino Villamil s/n, 33011 Oviedo, Spain.
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Queiro R, Acasuso B, Morante I, Cabezas I, Tejόn P, Alperi M, Arboleya L, Riestra J, Ballina J. AB0824 Predictors of Cerebrovascular Disease Among Psoriatic Arthritis Patients. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4755] [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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Andreu J, Martín-Martínez M, Corominas H, Pérez-Venegas J, Román-Ivorra J, Sánchez-Alonso F, Alperi M, Blanco R, Caliz R, Chamizo E, Graña G, Hernández-Cruz B, Marras C, Martín-Santos J, Mazzucchelli R, Medina J, Naranjo A, Ortiz A, Rosellό R, Sánchez-Nievas G, Sanmartí R, Vela P. AB1132 Development of Quality Criteria for the Assessment of Care in Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2624] [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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Queiro R, Morante I, Cabezas I, Acasuso B, Tejόn P, Alperi M, Riestra J, Arboleya L, Ballina J. AB0823 Age at Disease Onset Helps to Further Characterize the Disease Phenotype in Psoriatic Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6343] [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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Queiro R, Rodríguez S, Acasuso B, Morante I, Cabezas I, Coto P, Alperi M, Ballina J. AB0764 An Onset of Psoriasis after 40 Years and A Low Education Level May PREDICT the Development of Diabetes Mellitus in Psoriatic Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2056] [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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Queiro R, Alperi M, Alonso S, Riestra JL, Ballina J. Determinants of psoriatic arthritis in patients with psoriasis. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.09.69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Queiro-Silva R, Tejón P, Coto P, Alonso S, Alperi M, Rodríguez S, Acasuso B, Riestra JL, Arboleya L, Ballina J. AB0588 Prevalence of conventional cardiovascular risk factors in patients with psoriasis alone and in patients with psoriatic arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2910] [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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Alperi M, Belmonte-Serrano M, Lluch P, Trenor P, Calvo-Alen J, García-Fernández E, Olivé A, Tinture J, Romero A. FRI0195 Tocilizumab infusion performed in 31 minutes in patients with rheumatoid arthritis is safe and well tolerated. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2652] [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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Queiro R, Alonso S, Tejόn P, Fernández M, Alperi M, Riestra J, Arboleya L, Ballina J. SAT0311 Men and women with psoriatic arthritis express a different genetic profile within the major histocompatibility complex region. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3258] [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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Tejón Menéndez P, Alonso S, Alperi M, Ballina J. Paniculitis mesentérica en un paciente con espondilitis anquilosante. ACTA ACUST UNITED AC 2013; 9:197. [DOI: 10.1016/j.reuma.2012.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 10/18/2012] [Accepted: 10/23/2012] [Indexed: 10/26/2022]
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Queiro R, Tejón P, Coto P, Alperi M, Alonso S, Sarasqueta C, González S, Martínez-Borra J, López-Larrea C, Ballina J. Could the clinical differences between men and women with psoriatic arthritis be explained in part by genetic factors? Clin Exp Rheumatol 2013; 31:324-325. [PMID: 23414960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 09/25/2012] [Indexed: 06/01/2023]
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Queiro R, Tejón P, Alonso S, Alperi M, Ballina J. Erosive discovertebral lesion (Andersson lesion) as the first sign of disease in axial psoriatic arthritis. Scand J Rheumatol 2013; 42:220-5. [DOI: 10.3109/03009742.2012.739637] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Descalzo MÁ, Carbonell J, González-Álvaro I, Sanmartí R, Balsa A, Hernandez-Barrera V, Román-Ivorra JA, Ivorra-Cortés J, Lisbona P, Alperi M, Jiménez-Garcia R, Carmona L. Effectiveness of a clinical practice intervention in early rheumatoid arthritis. Arthritis Care Res (Hoboken) 2012; 64:321-30. [PMID: 22052599 DOI: 10.1002/acr.20682] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To compare the outcome of early rheumatoid arthritis (RA) patients in a country where early clinics were established versus the outcome of patients in nonprotocolized clinics. METHODS We compared 2 multicenter cohorts: an RA cohort derived from an early arthritis registry set in 36 reference hospitals in which a specific intervention was established (Evaluation of a Model for Arthritis Care in Spain [SERAP]), and a historical control cohort of patients with early RA attending 34 rheumatology departments (Prognosis in Rheumatoid Arthritis [PROAR] cohort). Effectiveness was tested by comparing the change in the Disease Activity Score in 28 joints (DAS28), the change in the Health Assessment Questionnaire (HAQ), and the change in the Sharp/van der Heijde radiologic score using marginal structural models. RESULTS A total of 161 early RA patients were recruited in the PROAR cohort and 447 in the SERAP cohort. Being a SERAP patient was inversely correlated with activity, resulting in a decrease of -0.24 (95% confidence interval [95% CI] -0.39, -0.08) units in the population average of the DAS28 after adjustment was made. Moreover, intervention may be seen as a protective factor of radiologic damage, with a decrease of -0.05 (95% CI -0.09, -0.01) units in the logarithm of the total Sharp/van der Heijde score. On the other hand, a decrease in functional impairment was detected, but intervention was not statistically associated with HAQ changes. CONCLUSION Preventing major radiographic progression in a 2-year term inside structured and organized special programs for the management of disease, such as early arthritis clinics, are effective compared to nonprotocolized referrals, treatment, and followup.
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Queiro R, Alperi M, Alonso-Castro S, Ballina J, Huergo-Zapico L, Fernández-Guizán A, Acebes-Huerta A, Martínez-Borra J, Sarasqueta C, López-Larrea C, González S. Patients with psoriatic arthritis may show differences in their clinical and genetic profiles depending on their age at psoriasis onset. Clin Exp Rheumatol 2012; 30:476-480. [PMID: 22510299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 11/28/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES The age of psoriasis onset has an important impact on the clinical expression and heritability of psoriasis. Psoriasis characteristics according to the age at disease onset have been extensively studied. However, the impact of the age of psoriasis onset on psoriatic arthritis (PsA) features has not been analysed in depth. The aim of the present paper is to analyse whether the age of psoriasis onset may have an impact on the clinical and genetic characteristics in a cohort of PsA patients. METHODS The study included 110 PsA patients classified in accordance with the CASPAR criteria. Patients were divided into early (onset age <30 years) and late (onset age >30 years) onset psoriasis, and clinical features were studied in accordance to this stratification. Distribution of several genes within the MHC region were analysed in accordance with the prior stratification, and their frequencies compared to that of 110 healthy matched blood donors. RESULTS Compared to patients with late-onset disease, PsA patients with early-onset psoriasis showed more frequently: a longer psoriasis-arthritis latency period (9.9±6 years vs. 3.8±4 years, p=0.0001), a positive family history of disease (60.3% vs. 20.5%, OR 6.1, 95% CI: 2.5-15.0, p=0.0001), severe psoriasis (PASI 8.2±4 vs. 3.6±2.2, p=0.0001), clinical enthesitis (37.7% vs. 22.4%, OR 2.09, 95% CI: 0.9-4.9, p=0.08), and oligoarthritis (47.5% vs. 28.6%, OR 2.26, 95% CI: 1.02-5.02, p=0.04). MICA-A9 was associated with susceptibility in both early-onset (60.7% vs. 30%, p=0.0002) and late-onset patients (59.2% vs. 30%, p=0.0008). However, HLA-Cw*0602 was significantly increased in patients with early-onset psoriasis (73.8% vs. 17%, p<0.0001), whereas the allele 384 of the microsatellite C1_4_4, located 34 kb telomeric to HLA-C locus, was increased only in late-onset cases (49% vs. 21%, p=0.001). CONCLUSIONS Clinical and genetic features of PsA may differ depending on the age at psoriasis onset. This type of stratification should be considered in future genetic and epidemiological studies of PsA.
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Affiliation(s)
- Rubén Queiro
- Hospital Universitario Central de Asturias, Oviedo, Spain.
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Queiro R, Alonso S, Alperi M, Fernández M, Tejón P, Riestra JL, Arboleya L, Ballina J. Entheseal ultrasound abnormalities in patients with SAPHO syndrome. Clin Rheumatol 2012; 31:913-9. [PMID: 22349879 DOI: 10.1007/s10067-012-1959-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Revised: 12/23/2011] [Accepted: 02/03/2012] [Indexed: 11/26/2022]
Abstract
This study was conducted to investigate the presence and characteristics of the ultrasound lesions that may be found in the entheses of patients with SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome. This cross-sectional study included 15 patients with SAPHO syndrome and 30 healthy controls matched for age, sex and body mass index. Subjects with regular sport activities as well as those with other rheumatic conditions were excluded from the study. Ultrasonography was used in both groups to study 14 entheses of the upper and lower extremities. Different elementary lesions representative of enthesis damage were defined. A total of 210 entheses in the study group and 420 in the control group were evaluated. Only one patient presented clinical enthesitis. In the study group, seven of the 15 patients (47%) showed morpho-structural entheseal alterations, versus only four of the 30 controls (13.3%; p < 0.001). The subjects with SAPHO showed ultrasound alterations in 32/210 entheses (15%), while the controls showed alterations in 20/420 entheses (4.8%), p < 0.001. The entheses with the largest number of morpho-structural alterations were those of the patellar and Achilles tendon. None of the controls showed power Doppler signal at enthesis or perienthesis level. Ultrasound evidence of enthesopathy seems to be a common feature in this series of patients with SAPHO syndrome.
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Affiliation(s)
- Rubén Queiro
- Department of Rheumatology, Hospital Universitario Central de Asturias, C/ Celestino Villamil s/n, Oviedo, Spain.
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López-Robles A, Queiro R, Alperi M, Alonso S, Riestra JL, Ballina J. Psoriasis and psoriasiform lesions induced by TNFα antagonists: the experience of a tertiary care hospital from northern Spain. Rheumatol Int 2011; 32:3779-83. [PMID: 22187056 DOI: 10.1007/s00296-011-2265-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2011] [Accepted: 12/08/2011] [Indexed: 01/01/2023]
Abstract
The aim of this study was to investigate the cumulated incidence and clinical characteristics of the psoriasiform lesions seen in a wide cohort of rheumatic patients exposed to anti-TNFα drugs in a tertiary care hospital from northern Spain. The study population included 450 patients exposed to anti-TNFα agents from 2001 to 2007 and treated in a university hospital in northern Spain. Two hundred patients were exposed to infliximab (44%), 129 (29%) to etanercept, and 121 (27%) to adalimumab. The cumulated incidence (CI) of this skin reaction was calculated for each of the three agents studied. Psoriasis and psoriasiform lesions were documented in 7 patients diagnosed with different rheumatic inflammatory conditions (1.56%). Cases of this adverse effect were identified with all three anti-TNFα agents available at that time, but less frequently with infliximab (CI: 0.5%) compared with etanercept (CI: 2.3%) or adalimumab (CI: 2.5%). The most common lesion was palmoplantar pustulosis (71.3% of the cases), and the latency period to the development of the lesions ranged from 4 to 38 months (mean 9 months). In four of the 7 patients, treatment was suspended, while in the remaining three patients treatment was continued. The CI of this skin reaction in our setting is similar to that published by others. Infliximab was found to be less frequently associated with this adverse event. In our experience, it is not always necessary to stop anti-TNFα therapy for the skin lesions to improve.
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Affiliation(s)
- Alejandra López-Robles
- Rheumatology Service, Hospital Universitario Central de Asturias (HUCA), C/Celestino Villamil s/n, 33006 Oviedo, Spain
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Queiro R, González S, Alperi M, Alonso S, López-Larrea C, Martínez-Borra J, Sarasqueta C, Ballina J. HLA-DR17 is associated with enthesitis in psoriatic arthritis. Joint Bone Spine 2011; 78:428-9. [DOI: 10.1016/j.jbspin.2011.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 03/10/2011] [Indexed: 10/18/2022]
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Arboleya L, Alperi M, Alonso S. Efectos adversos de los bisfosfonatos. ACTA ACUST UNITED AC 2011; 7:189-97. [DOI: 10.1016/j.reuma.2010.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 09/29/2010] [Accepted: 10/05/2010] [Indexed: 11/30/2022]
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Queiro R, Alonso S, Alperi M, Fernández M, Sarasqueta C. Stratification by age of onset with 30 years as age limit is an effective means of identifying PSORS1-associated psoriasis in patients with psoriatic arthritis. Joint Bone Spine 2011; 78:581-3. [PMID: 21511512 DOI: 10.1016/j.jbspin.2011.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 02/07/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To determine which of the following is the best method to identify PSORS1-associated psoriasis in patients with psoriatic arthritis (PsA): age at disease onset or positive family history of disease. METHODS A total of 71 patients with PsA who met the CASPAR criteria were recruited on a randomized basis. The patients were stratified according to age at disease onset, with cutoff points at 25, 30, 35 and 40years of age. The alleles of locus Cw were analyzed by PCR-based methods, and their distribution was compared to that of 177 healthy blood donors. RESULTS HLA-Cw*0602-PSORS1- was associated with disease risk (56% vs. 18%) OR 5.8, 95%CI: 3.2-10.7, P=0.00001. A close relationship was established between this allele and onset of psoriasis under 30years of age (68% vs. 24%) OR 6.4, 95%CI: 2.3-18.2, P=0.0003. The relationship in turn lost significance above this age limit. An association was found between a family history of psoriasis and disease risk, though there was no specific cutoff point according to age at onset of the disease. Sixty-four percent of the subjects with positive family history were HLA-Cw*06 (+) compared to 44% of those without a family history, OR 2.3, 95% CI: 0.82-6.36, P=0.08. CONCLUSIONS In patients with PsA, the susceptibility effect of HLA-Cw*06 declines with increasing age of onset. Disease onset under or above 30years of age may contribute to differentiate type I vs. type II psoriasis in PsA populations, while the family history have a lesser contribution to such stratification.
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Affiliation(s)
- Ruben Queiro
- Rheumatology Service, Hospital Universitario Central de Asturias, Oviedo, Spain.
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Queiro R, Alperi M, Lopez A, Sarasqueta C, Riestra JL, Ballina J. Clinical expression, but not disease outcome, may vary according to age at disease onset in psoriatic spondylitis. Joint Bone Spine 2008; 75:544-7. [PMID: 18456537 DOI: 10.1016/j.jbspin.2007.11.005] [Citation(s) in RCA: 22] [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: 08/28/2007] [Accepted: 11/21/2007] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To investigate whether the clinical expression and disease outcome in psoriatic spondylitis (PsS) may vary according to age at disease onset. METHODS This study included 70 patients from a unique outpatient spondylitis clinic followed on a regular basis with a standard protocol. Patients were diagnosed with PsS according to ESSG criteria plus radiographic sacroiliitis (SI). Outcome parameters included: disease activity, functional evaluation, radiological damage, mobility restriction, and enthesitis score. Patients were divided into those with disease onset before 40 years (young-onset PsS) and those with onset over this age (late-onset PsS). Clinical features and outcome parameters were compared between groups. RESULTS There were 44 men and 26 women. Thirty-nine (M:F ratio 1.8) patients had disease onset before 40 years and 31 (M:F ratio 1.6) over this age. HLA-B27 correlated with PsS susceptibility (34% vs 7%, RR 6.4, p<0.0004), but it was found over-represented in young-onset PsS compared to late-onset cases (51% vs 13%, p=0.001). Young-onset cases tended to have a higher frequency of family history (26% vs 13%), bilateral SI (62% vs 29%, p=0.013), isolated axial pattern (31% vs 13%), and enthesitis (54% vs 29%, p=0.09). In late-onset PsS there was a higher frequency of unilateral SI (71% vs 38%, p=0.013), polyarthritis (45% vs 23%, p=0.022), and silent axial disease (32% vs 10%, p=0.022). Outcome parameters were similar between groups. CONCLUSIONS Clinical picture but not outcome parameters, varies according to age at disease onset in PsS. The correlation between HLA-B27 and young-onset PsS supports the notion that disease susceptibility and disease expression are not driven by the same gene in this entity.
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Affiliation(s)
- Ruben Queiro
- Rheumatology Service, Hospital Universitario Central de Asturias, C/ Celestino Villamil s/n, 33006 Oviedo, Spain.
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Queiro R, Moreno P, Sarasqueta C, Alperi M, Riestra JL, Ballina J. Synovitis-acne-pustulosis-hyperostosis-osteitis syndrome and psoriatic arthritis exhibit a different immunogenetic profile. Clin Exp Rheumatol 2008; 26:125-128. [PMID: 18328159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND AND OBJECTIVES Patients with psoriatic arthritis (PsA) as well as those with synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome share some common features, and in fact, for many authors the SAPHO concept fits well into the broader concept of PsA. However, some clinical features are unique to the SAPHO syndrome, and in the other hand, these patients do not show the known association between the HLA-B27 antigen and the spondyloarthropathies. To date, there are no studies comparing the immunogenetic profile of these two conditions, so the main objective of the present report was to analyse whether or not both entities may share the same genetic basis. PATIENTS AND METHODS All patients with SAPHO syndrome (n=25) seen in a single university hospital from 1985 to 2005 were recruited and followed up in standardised manner in order to study their main characteristics and HLA profile. The HLA-Cw6, DR and B27 antigen distribution of these cases was compared to that of 50 patients with psoriasis vulgaris, 120 with PsA, and 170 healthy blood donors. PsA patients were classified in accordance with their predominant pattern observed in the last 5 years of disease evolution. Odds ratios (OR) values were calculated to measure the strength of the association between HLA antigens and disease, while the statistical significance of the association was assessed with a two-tailed Fisher's exact test. P<0.05 values were considered significant. RESULTS No association was found between HLA-Cw6, B27, or DR antigens, and SAPHO syndrome. HLA-Cw6 was strongly associated with psoriasis, OR 12 (95% CI: 5.6-26, p<0.0001) and PsA, OR 10 (95% CI: 5.4-19.5, p<0.0001), however this antigen was equally distributed among the three articular categories of PsA. HLA-DR4 was found under-represented in PsA patients compared to controls, OR 0.4 (95% CI: 0.2-0.7, p=0.002). HLA-DR7 correlated well with psoriatic oligoarthritis, OR 9.6 (95% CI: 2.9-28, p<0.0001), HLA-DR8 was found associated with polyarthritis, OR 6.7 (95% CI: 2-25, p=0.002), while HLA-B27 was over-represented in psoriatic spondylitis, OR 10 (95% CI: 3.3-25, p<0.0001). CONCLUSIONS Psoriasis/PsA and SAP-HO syndrome show a different immunogenetic background, however the genetic basis of SAPHO syndrome remains unknown.
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Affiliation(s)
- R Queiro
- Rheumatology Department, Hospital Universitario Central de Asturias, Oviedo, Spain.
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Queiro R, Gonzalez S, López-Larrea C, Alperi M, Sarasqueta C, Riestra JL, Ballina J. HLA-C locus alleles may modulate the clinical expression of psoriatic arthritis. Arthritis Res Ther 2007; 8:R185. [PMID: 17166285 PMCID: PMC1794531 DOI: 10.1186/ar2097] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2006] [Revised: 11/04/2006] [Accepted: 12/13/2006] [Indexed: 12/03/2022] Open
Abstract
The aim of the present study was to evaluate the relative contribution of human leukocyte antigen (HLA)-C locus alleles in determining the risk and the clinical expression of psoriatic arthritis (PsA). One hundred PsA patients were randomly selected and grouped into three disease subsets: oligoarthritis (n = 40), polyarthritis (n = 25) and spondylitis (n = 35). The HLA-C locus profile of this cohort was studied by methods based on molecular biology and was compared with that of 45 patients with psoriasis vulgaris and 177 healthy blood donors from the same ethnic origin. HLA-Cw*0602 was found associated with both psoriasis (odds ratio (OR) 6.2; 95% confidence interval (CI) 3.1 to 12.5; p < 0.0001) and PsA (OR 6.2; 95% CI 3.6 to 10.8; p < 0.0001); however, this allele was equally found among the PsA subsets. HLA-Cw6-positive patients showed a longer psoriasis-arthritis latency period (p = 0.012). HLA-Cw*0701 was found under-represented in PsA in comparison with controls (OR 0.5; 95% CI 0.3 to 0.9; p = 0.04), as was HLA-Cw*0802 (OR 0.3; 95% CI 0.08 to 1; p = 0.05). A positive association was found between psoriatic spondylitis and HLA-Cw*0702 (OR 5.0; 95% CI 1.4 to 25; p = 0.01). HLA-Cw*0602 seems to confer a general risk for psoriasis, but the presence of other HLA-C locus alleles may explain an additional arthritogenic risk. HLA-C alleles may modulate some aspects of the clinical expression of PsA, but these findings need confirmation.
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Affiliation(s)
- Ruben Queiro
- Rheumatology Service, Hospital Universitario Central de Asturias (HUCA), C/Celestino Villamil s/n. 33006, Oviedo, Spain
| | - Segundo Gonzalez
- Department of Functional Biology, University of Oviedo, C/Julian Claveria s/n. 33006, Oviedo, Spain
| | - Carlos López-Larrea
- Immunology Department, Hospital Universitario Central de Asturias (HUCA), C/Celestino Villamil s/n. 33006, Oviedo, Spain
| | - Mercedes Alperi
- Rheumatology Service, Hospital Universitario Central de Asturias (HUCA), C/Celestino Villamil s/n. 33006, Oviedo, Spain
| | - Cristina Sarasqueta
- Clinical Epidemiology Unit, Complejo Hospitalario Donostia, P° del Dr Beguiristain 111, 20014, San Sebastian, Basque Country, Spain
| | - Jose Luis Riestra
- Rheumatology Service, Hospital Universitario Central de Asturias (HUCA), C/Celestino Villamil s/n. 33006, Oviedo, Spain
| | - Javier Ballina
- Rheumatology Service, Hospital Universitario Central de Asturias (HUCA), C/Celestino Villamil s/n. 33006, Oviedo, Spain
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Queiro R, Alperi M, Riestra JL, Ballina J. RS3PE syndrome: bad or good prognosis? J Rheumatol 2007; 34:452-3. [PMID: 17304672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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