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Caimmi C, De Marchi S, Bosello SL, Giuggioli D, Caramaschi P, Di Giorgio A, Spinella A, Astorino G, Canestrari G, Cocchiara E, Gremese E, Viapiana O, Rossini M. Ultrasonography involvement of carotid, upper and lower limb arteries in a large cohort of systemic sclerosis patients. Int J Rheum Dis 2020; 23:681-692. [DOI: 10.1111/1756-185x.13824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/26/2020] [Accepted: 02/24/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | - Sergio De Marchi
- Angiology Unit Department of Medicine University of Verona Verona Italy
| | - Silvia Laura Bosello
- UOC di Reumatologia Fondazione Policlinico Universitario A. Gemelli – IRCCS Rome Italy
| | - Dilia Giuggioli
- Rheumatology Unit University of Modena and Reggio Emilia Medical School Azienda Ospedaliero‐Universitaria di Modena Modena Italy
| | | | - Angela Di Giorgio
- UOS di Angiologia Columbus Fondazione Policlinico Universitario A. Gemelli – IRCCS Rome Italy
| | - Amelia Spinella
- Rheumatology Unit University of Modena and Reggio Emilia Medical School Azienda Ospedaliero‐Universitaria di Modena Modena Italy
| | | | - Giovanni Canestrari
- UOC di Reumatologia Fondazione Policlinico Universitario A. Gemelli – IRCCS Rome Italy
| | - Emanuele Cocchiara
- Rheumatology Unit University of Modena and Reggio Emilia Medical School Azienda Ospedaliero‐Universitaria di Modena Modena Italy
| | - Elisa Gremese
- UOC di Reumatologia Fondazione Policlinico Universitario A. Gemelli – IRCCS Rome Italy
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Scambi C, Ugolini S, Tonello M, Bortolami O, De Franceschi L, Castagna A, Lotti V, Corbella M, Raffaelli R, Caramaschi P, Mattia E, Biasi D, Ruffatti A. Complement activation in the plasma and placentas of women with different subsets of antiphospholipid syndrome. Am J Reprod Immunol 2019; 82:e13185. [DOI: 10.1111/aji.13185] [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: 12/05/2018] [Revised: 07/13/2019] [Accepted: 08/21/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Cinzia Scambi
- Department of Medicine Rheumatology Unit University Hospital of Verona Verona Italy
| | - Sara Ugolini
- Department of Medicine Section of Internal Medicine University Hospital of Verona Verona Italy
| | - Marta Tonello
- Department of Medicine Rheumatology Unit University Hospital of Padua Padua Italy
| | - Oscar Bortolami
- Department of Diagnostics and Public Health University Hospital of Verona Verona Italy
| | | | | | - Virginia Lotti
- Department of Medicine Rheumatology Unit University Hospital of Verona Verona Italy
| | - Michela Corbella
- Department of Medicine University Hospital of Verona Verona Italy
| | - Ricciarda Raffaelli
- Department of Surgical Sciences Dentistry, Gynecology and Pediatrics University Hospital of Verona Verona Italy
| | - Paola Caramaschi
- Department of Medicine University Hospital of Verona Verona Italy
| | - Elena Mattia
- Department of Medicine Rheumatology Unit University Hospital of Padua Padua Italy
| | - Domenico Biasi
- Department of Medicine Rheumatology Unit University Hospital of Verona Verona Italy
| | - Amelia Ruffatti
- Department of Medicine Rheumatology Unit University Hospital of Padua Padua Italy
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3
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Fasano S, Riccardi A, Messiniti V, Caramaschi P, Rosato E, Maurer B, Smith V, Siegert E, De Langhe E, Riccieri V, Airó P, Mihai C, Avouac J, Zanatta E, Walker UA, Iannone F, García De la Peña Lefebvre P, Distler JHW, Vacca A, Distler O, Kowal-Bielecka O, Allanore Y, Valentini G. Revised European Scleroderma Trials and Research Group Activity Index is the best predictor of short-term severity accrual. Ann Rheum Dis 2019; 78:1681-1685. [PMID: 31422354 DOI: 10.1136/annrheumdis-2019-215787] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 05/28/2019] [Revised: 07/12/2019] [Accepted: 07/19/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND The European Scleroderma Trials and Research Group (EUSTAR) recently developed a preliminarily revised activity index (AI) that performed better than the European Scleroderma Study Group Activity Index (EScSG-AI) in systemic sclerosis (SSc). OBJECTIVE To assess the predictive value for short-term disease severity accrual of the EUSTAR-AI, as compared with those of the EScSG-AI and of known adverse prognostic factors. METHODS Patients with SSc from the EUSTAR database with a disease duration from the onset of the first non-Raynaud sign/symptom ≤5 years and a baseline visit between 2003 and 2014 were first extracted. To capture the disease activity variations over time, EUSTAR-AI and EScSG-AI adjusted means were calculated. The primary outcome was disease progression defined as a Δ≥1 in the Medsger's severity score and in distinct items at the 2-year follow-up visit. Logistic regression analysis was carried out to identify predictive factors. RESULTS 549 patients were enrolled. At multivariate analysis, the EUSTAR-AI adjusted mean was the only predictor of any severity accrual and of that of lung and heart, skin and peripheral vascular disease over 2 years. CONCLUSION The adjusted mean EUSTAR-AI has the best predictive value for disease progression and development of severe organ involvement over time in SSc.
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Affiliation(s)
- Serena Fasano
- Department of Precision Medicine, Section of Rheumatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Antonella Riccardi
- Department of Precision Medicine, Section of Rheumatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Valentina Messiniti
- Department of Precision Medicine, Section of Rheumatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Edoardo Rosato
- Dipartimento di Medicina Traslazionale e di Precisione, Sapienza University of Rome, Roma, Italy
| | - Britta Maurer
- Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Vanessa Smith
- Department of Rheumatology, University Hospital Ghent, Gent, Belgium
| | - Elise Siegert
- Department of Rheumatology, Charit University Hospital, Berlin, Germany
| | - Ellen De Langhe
- Department of Development and Regeneration, Laboratory of Tissue Homeostasis and Disease, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium
| | - Valeria Riccieri
- Clinical Medicine and Therapy, Sapienza University of Rome, Rome, Italy
| | - Paolo Airó
- Rheumatology and Clinical Immunology Department, Spedali Civili di Brescia, Brescia, Italy
| | - Carina Mihai
- Department of Rheumatology, Carol Davila University of Medicine and Pharmacy, Bucarest, Romania
| | - Jerome Avouac
- Department of Rheumatology, Paris Descartes University, Rheumatology A and INSER U1016, Cochin Hospital, Paris, France
| | - Elisabetta Zanatta
- Dipartimento di Medicina, DIMED, Universita degli Studi di Padova, Padova, Italy
| | - Ulrich A Walker
- Department of Rheumatology, Basel University, Basel, Switzerland
| | | | | | - Jörg H W Distler
- Department of Internal Medicine III, University of Erlangen, Erlangen, Germany
| | - Alessandra Vacca
- Chair and Rheumatology Unit, University Clinic AOU Cagliari, Monserrato, Italy
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Otylia Kowal-Bielecka
- Department of Rheumatology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Yannick Allanore
- Department of Rheumatology, Paris Descartes University, Rheumatology A and INSER U1016, Cochin Hospital, Paris, France
| | - Gabriele Valentini
- Department of Precision Medicine, Section of Rheumatology, University of Campania Luigi Vanvitelli, Naples, Italy
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4
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Caimmi C, Bertoldo E, Pozza A, Caramaschi P, Orsolini G, Gatti D, Rossini M, Viapiana O. Vitamin D serum levels and the risk of digital ulcers in systemic sclerosis: A longitudinal study. Int J Rheum Dis 2019; 22:1041-1045. [PMID: 30938067 DOI: 10.1111/1756-185x.13554] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/19/2019] [Accepted: 02/28/2019] [Indexed: 12/25/2022]
Abstract
AIM Low levels of vitamin D (25OHD) have been found to associated with digital ulcers (DUs) in systemic sclerosis (SSc), although only cross-sectional studies have been performed. We aimed to investigate if variations in vitamin D serum levels over time affect DU in SSc. METHODS This is a retrospective study on 65 patients. 25OHD was measured in 2011 and 2016 and its variations correlated with DU. RESULTS The mean age of our cohort was 58 (SD 12) years with a mean disease duration of 9.5 (5.3) years. Most of our patients had a limited SSc (69.2%). At baseline 50.8% and 41.5% after 5 years had 25OHD <30 ng/mL. Patients receiving supplementation (8750 IU/wk) at baseline numbered 39 (60.0%) and 45 (69.2%) at the end of follow up. Nevertheless, 31 (47.7%) had a decrease of 25OHD in 5 years. In univariate analysis, patients with incident DU had a decrease in 25OHD as compared to patients with no incident DU (-17.4 [37.0] vs 13.0 [89.5], P = 0.018). No differences in 25OHD variations were found for other disease characteristics. In multivariate analysis correcting for previous DU and modified Rodnan Skin Score at baseline, patients with a decrease in 25OHD had an increased risk of developing DU (odds ratio 16.6; 95% CI 1.7-164.5, P = 0.017). CONCLUSIONS A decrease in 25OHD is associated with the risk of developing DUs. In addition, vitamin D supplementation with the doses currently recommended may be insufficient in SSc. Further studies in wider cohorts are needed to confirm these results.
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Affiliation(s)
| | | | - Alice Pozza
- Rheumatology Unit, University of Verona, Verona, Italy
| | | | | | - Davide Gatti
- Rheumatology Unit, University of Verona, Verona, Italy
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5
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Galvani C, Caramaschi P, Mura P, Paladini A, Piroli A, Arnaudo E, De Franceschi L, Evangelista M, Pari A, Ongaro G, Finco G, Ciannameo A, Carletto A, Varrassi G, Biasi D. Postural counseling represents a novel option in pain management of fibromyalgia patients. J Pain Res 2019; 12:327-337. [PMID: 30666151 PMCID: PMC6333156 DOI: 10.2147/jpr.s164714] [Citation(s) in RCA: 3] [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] [Indexed: 12/26/2022] Open
Abstract
Background Chronic pain is a key symptom in fibromyalgia (FM), and its management is still challenging for rheumatologists in daily practice. FM patients show psychological and psychiatric manifestations, going from mood and emotional disorders to depression and alexithymia that negatively impact their quality of life, limiting their daily activities. Since pharmacological strategies have a limited efficacy in FM pain, alternative or complementary non-pharmacological approaches have been introduced in the clinical management of FM. Patients and methods This is a retrospective study on FM patients (n=52) treated with a novel integrated postural counseling (PC) rehabilitation program carried out by a counselor physiotherapist. The clinical impact of PC was evaluated by 1) a semi-structured interview using an ad hoc modified questionnaire McGill Illness Narrative Interview (MINI) 1 to obtain data on pain management by highlighting everyday experience of living with pain and 2) an FM impact questionnaire (FIQ) total score. Results Two main structures of narrative emplotment of FM illness were recognized: 1) the cumulative life narrative structure (46.15%) and 2) the broken life (53.85%) narrative structure. Baseline FIQ score was 77.38±7.77, and it was significantly reduced after PC to 39.12±13.27 (P<0.0001). Although well-being still requires further definition as outcome in pain management, it is important for FM patients, dealing with pain-related sensations, thoughts and feelings and limiting their daily activities. In our study, 87.5% of interviewed FM patients reported an improvement in their well-being after PC. Conclusion Our data suggest that an integrated PC program positively impacts chronic pain and fatigue based on self-management strategies. PC allows FM patients to resume their own life and regenerate their own image. Finally, we propose the introduction of the evaluation of the ability to resume daily activities as the target of rehabilitation programs in FM.
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Affiliation(s)
- Carla Galvani
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
| | - Paola Caramaschi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
| | - Paolo Mura
- Anesthesia, Intensive Care and Pain Therapy Unit, Department of Medical Science "M. Aresu", University of Cagliari, Cagliari, Italy
| | | | - Alba Piroli
- Department of MESVA, University of L'Aquila, L'Aquila, Italy
| | - Elisa Arnaudo
- Department of Internal Medicine, University of Bologna, Bologna, Italy
| | - Lucia De Franceschi
- Internal Medicine Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Maurizio Evangelista
- Emergency Department, Institute of Anesthesia, Resuscitation and Pain Medicine, Catholic University of Sacred Heart, Rome, Italy
| | - Alice Pari
- Department of Internal Medicine, University of Bologna, Bologna, Italy
| | - Giovanna Ongaro
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
| | - Gabriele Finco
- Anesthesia, Intensive Care and Pain Therapy Unit, Department of Medical Science "M. Aresu", University of Cagliari, Cagliari, Italy
| | - Anna Ciannameo
- Department of Internal Medicine, University of Bologna, Bologna, Italy
| | - Antonio Carletto
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
| | - Giustino Varrassi
- Department of MESVA, University of L'Aquila, L'Aquila, Italy.,Paolo Procacci Foundation, Rome, Italy
| | - Domenico Biasi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
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Caimmi C, Bertoldo E, Venturini A, Caramaschi P, Frulloni L, Ciccocioppo R, Brunelli S, Idolazzi L, Gatti D, Rossini M, Viapiana O. Relationship Between Increased Fecal Calprotectin Levels and Interstitial Lung Disease in Systemic Sclerosis. J Rheumatol 2018; 46:274-278. [PMID: 30442820 DOI: 10.3899/jrheum.171445] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To evaluate the relationship between fecal calprotectin (FC) and interstitial lung disease (ILD) in systemic sclerosis (SSc). METHODS The study enrolled 129 outpatients with SSc. Data about disease characteristics, in particular lung involvement, were collected and FC was measured. RESULTS Patients with ILD (35, 27.1%) had higher values of FC (p < 0.001). In multivariate analysis, these variables were associated with increased risk of ILD: diffuse disease subset, higher modified Rodnan skin score, longer disease duration, higher severity scores, steroid treatment, and higher FC levels, while diverticulosis was protective. CONCLUSION ILD is independently associated with increased FC levels in SSc.
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Affiliation(s)
- Cristian Caimmi
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy. .,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi.
| | - Eugenia Bertoldo
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Anna Venturini
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Paola Caramaschi
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Luca Frulloni
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Rachele Ciccocioppo
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Sabrina Brunelli
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Luca Idolazzi
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Davide Gatti
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Maurizio Rossini
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
| | - Ombretta Viapiana
- From the Rheumatology Unit, and the Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi, Verona, Italy.,C. Caimmi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; E. Bertoldo, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; A. Venturini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; P. Caramaschi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; L. Frulloni, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; R. Ciccocioppo, MD, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; S. Brunelli, Gastroenterology Unit, University of Verona, Policlinico G.B. Rossi; L. Idolazzi, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; D. Gatti, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; M. Rossini, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi; O. Viapiana, MD, Rheumatology Unit, University of Verona, Policlinico G.B. Rossi
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Carreira PE, Carmona L, Joven BE, Loza E, Andréu JL, Riemekasten G, Vettori S, Balbir-Gurman A, Airò P, Walker U, Damjanov N, Matucci-Cerinic M, Ananieva LP, Rednic S, Czirják L, Distler O, Farge D, Hesselstrand R, Corrado A, Caramaschi P, Tikly M, Allanore Y. Differences associated with age at onset in early systemic sclerosis patients: a report from the EULAR Scleroderma Trials and Research Group (EUSTAR) database. Scand J Rheumatol 2018; 48:42-51. [DOI: 10.1080/03009742.2018.1459830] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- PE Carreira
- Rheumatology Department, University Hospital 12 de Octubre, Madrid, Spain
| | - L Carmona
- Musculoskeletal Health Institute, Madrid, Spain
| | - BE Joven
- Rheumatology Department, University Hospital 12 de Octubre, Madrid, Spain
| | - E Loza
- Musculoskeletal Health Institute, Madrid, Spain
| | - JL Andréu
- Rheumatology Department, University Hospital Puerta de Hierro, Madrid, Spain
| | - G Riemekasten
- Department of Rheumatology, University of Lübeck, Lübeck, Germany
| | - S Vettori
- Rheumatology Unit, Department of Internal Medicine Clinical and Experimental ‘F Magrassi-A-Lanzara’, Second University of Naples, Naples, Italy
| | - A Balbir-Gurman
- B Shine Rheumatology Unit, Rambam Health Care Campus and Rappaport Faculty of Medicine-Technion, Haifa, Israel
| | - P Airò
- Rheumatology and Clinical Immunology Unit, Civil Hospitali, Brescia, Italy
| | - U Walker
- Rheumatology Department, Felix Platter Hospital, Basel, Switzerland
| | - N Damjanov
- University of Belgrade School of Medicine, Belgrade, Serbia
| | - M Matucci-Cerinic
- Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - LP Ananieva
- Institute of Rheumatology, Russian Academy of Medical Science, Moscow, Russia
| | - S Rednic
- Rheumatology Clinic, University of Medicine and Pharmacy ‘Iuliu Hatieganu’ Cluj, Cluj-Napoca, Romania
| | - L Czirják
- Department of Immunology and Rheumatology, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | - O Distler
- Division of Rheumatology, University Hospital Zürich, Zürich, Switzerland
| | - D Farge
- Department of Internal Medicine, Saint-Louis Hospital, Paris, France
| | - R Hesselstrand
- Department of Rheumatology, Lund University Hospital, Lund, Sweden
| | - A Corrado
- Rheumatology Unit, University of Foggia, ‘Col. D’Avanzo’ Hospital, Foggia, Italy
| | | | - M Tikly
- Rheumatology Unit, Department of Medicine, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - Y Allanore
- Rheumatology A Department, Cochin Hospital, APHP, Paris Descartes University, Paris, France
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8
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Carreira PE, Carmona L, Joven BE, Loza E, Andreu JL, Riemekasten G, Vettori S, Balbir-Gurman A, Airò P, Walker UA, Damjanov N, Matucci-Cerinic M, Ananieva LP, Rednic S, Czirják L, Distler O, Farge D, Hesselstrand R, Corrado A, Caramaschi P, Tikly M, Allanore Y. Gender differences in early systemic sclerosis patients: a report from the EULAR scleroderma trials and research group (EUSTAR) database. Clin Exp Rheumatol 2018; 36 Suppl 113:68-75. [PMID: 30277860] [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: 04/21/2017] [Accepted: 03/09/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To describe differences in clinical presentation between men and women in a large group of patients with early (<3 years' duration) systemic sclerosis (SSc) according to disease subsets. METHODS A cross-sectional analysis of the prospective EULAR Scleroderma Trial and Research database (EUSTAR) was performed. Patients fulfilling preliminary ACR 1980 classification criteria for SSc, with less than 3 years from the first non-Raynaud's symptom at first entry, were selected. A group of patients with less than 3 years from the first SSc symptom, including Raynaud's phenomenon, was also analysed. SSc related variables, including antibodies, SSc subsets, disease activity and organ involvement were included. Descriptive and bivariate analyses were performed. RESULTS A total of 1,027 patients were included, 90% Caucasian, 80% women, and 40% with diffuse cutaneous disease. In early stages of SSc, men showed more frequently than women active disease, diffuse cutaneous subset, anti-Scl-70 antibodies, elevated acute phase reactants, muscular and pulmonary involvement. Differences between men and women were confirmed in the limited, but not in the diffuse SSc subset. The results were similar when 650 patients with less than three years from the first SSc symptom, including Raynaud's phenomenon, were analysed. CONCLUSIONS In early stages of SSc, men present signs and symptoms of more severe disease. In the limited disease subset, men might appear with clinical features and organ involvement similar to those of the diffuse subgroup. In clinical practice, the identification of such differences might help to select the appropriate management for each particular patient.
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MESH Headings
- Acute-Phase Proteins/analysis
- Autoantibodies/blood
- Biomarkers/blood
- Cross-Sectional Studies
- DNA Topoisomerases, Type I
- Databases, Factual
- Disease Progression
- Female
- Health Status Disparities
- Humans
- Lung Diseases/diagnosis
- Lung Diseases/etiology
- Male
- Nuclear Proteins/immunology
- Prognosis
- Raynaud Disease/diagnosis
- Raynaud Disease/etiology
- Risk Factors
- Scleroderma, Diffuse/blood
- Scleroderma, Diffuse/complications
- Scleroderma, Diffuse/diagnosis
- Scleroderma, Diffuse/immunology
- Scleroderma, Limited/blood
- Scleroderma, Limited/complications
- Scleroderma, Limited/diagnosis
- Scleroderma, Limited/immunology
- Severity of Illness Index
- Sex Factors
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Affiliation(s)
- Patricia E Carreira
- Servicio de Reumatología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Spain.
| | | | - Beatriz E Joven
- Servicio de Reumatología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Spain
| | | | - Jose Luis Andreu
- Servicio de Reumatología, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | | | - Serena Vettori
- U.O.C. di Reumatologia, Dipartimento di Internistica Clinica e Sperimentale "F.Magrassi-A-Lanzara", Seconda Università degli Studi di Napoli, Italy
| | - Alexandra Balbir-Gurman
- B. Shine Rheumatology Unit, Rambam Health Care Campus and Rappaport Faculty of Medicine-Technion, Haifa, Israel
| | - Paolo Airò
- U.O. Reumatologia e Immunologia Clinica. Spedali Civili, Brescia, Italy
| | - Ulrich A Walker
- Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland
| | - Nemanja Damjanov
- University of Belgrade School of Medicine, Institute of Rheumatology Belgrade, Serbia
| | - Marco Matucci-Cerinic
- Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Florence, Italy
| | - Lidia P Ananieva
- Institute of Rheumatology, Russian Academy of Medical Science, Moscow, Russia
| | - Simona Rednic
- Clinica Reumatologie, University of Medicine & Pharmacy 'Iuliu Hatieganu', Cluj-Napoca, Romania
| | - László Czirják
- Department of Immunology and Rheumatology, Faculty of Medicine, University of Pécs, Hungary
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zürich, Switzerland
| | - Dominique Farge
- Department of Internal Medicine, Hopital Saint-Louis, Paris, France
| | | | - Ada Corrado
- U.O. Reumatologia-Università degli Studi di Foggia, Ospedale 'Col. D'Avanzo', Foggia, Italy
| | | | - Mohammed Tikly
- Rheumatology Unit, Department of Medicine Chris Hani Bardgwanath, Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - Yannick Allanore
- Rheumatology A Department, Cochin Hospital, APHP, Paris Descartes University, Paris, France
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9
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Carreira PE, Carmona L, Joven BE, Loza E, Andreu JL, Riemekasten G, Vettori S, Allanore Y, Balbir-Gurman A, Airò P, Walker UA, Damjanov N, Ananieva LP, Rednic S, Czirják L, Distler O, Farge D, Hesselstrand R, Corrado A, Caramaschi P, Tikly M, Matucci-Cerinic M. Clinical determinants of elevated systolic pulmonary artery pressure measured by transthoracic Doppler echocardiography in early systemic sclerosis. Clin Exp Rheumatol 2017; 35 Suppl 106:114-121. [PMID: 28664832] [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: 06/24/2016] [Accepted: 10/26/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To explore the prevalence and clinical associations of elevated systolic pulmonary artery pressure (sPAP), measured by Transthoracic Doppler-echocardiography (TTE) in patients with early systemic sclerosis (SSc). METHODS A cross-sectional analysis of the prospective EULAR Scleroderma Trial and Research (EUSTAR) database was performed. SSc patients with <3 years from the first non-Raynaud's phenomenon (RP) symptom at baseline EUSTAR visit, were selected. Elevated sPAP was defined as sPAP>40 mmHg on baseline TTE. First visit SSc related variables, including disease subsets, antibodies and visceral involvement, were examined. RESULTS From 1,188 patients, 81% were women. Mean (SD) age at first non-RP symptom was 50 (14) years, 55% had limited cutaneous SSc (lcSSc) and 42% active disease. Elevated sPAP was found in 17% of patients, both lcSSc and diffuse cutaneous SSc (dcSSc). In lcSSc, older age at first non-RP symptom, ACA positivity, joint contractures, restrictive defect and lower DLCO, were independently associated with elevated sPAP. In dcSSc, older age at first non-RP symptom, longer time between RP onset and first non-RP symptom, digital ulcers, cardiac blocks, and proteinuria were associated with elevated sPAP. CONCLUSIONS The prevalence of elevated sPAP on TTE in early SSc patients is considerable. Association with cardiac, lung and renal involvement suggests that, although some patients might have pulmonary arterial hypertension, others may present pulmonary hypertension secondary to lung or heart involvement. Our findings emphasize the need to consider right heart catheterisation in selected early SSc patients with PH suspicion, to clearly determine the cause of PH.
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Affiliation(s)
- Patricia E Carreira
- Servicio de Reumatología, Hospital Universitario12 de Octubre, Madrid, Spain.
| | | | - Beatriz E Joven
- Servicio de Reumatología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Jose Luis Andreu
- Servicio de Reumatología, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | | | - Serena Vettori
- UOC di Reumatologia, Dipartimento di Internistica Clinica e Sperimentale "F-Magrassi-A-Lanzara", Seconda Università di Napoli, Italy
| | - Yannick Allanore
- Rheumatology A Department, Cochin Hospital, APHP, Paris Descartes University, France
| | - Alexandra Balbir-Gurman
- B.Shine Rheumatology Unit, Rambam Health Care Campus and Rappaport Faculty of Medicine-Technion, Haifa, Israel
| | - Paolo Airò
- UO Reumatologia ed Immunologia Clinica, Spedali Civili, Brescia, Italy
| | | | - Nemanja Damjanov
- University of Belgrade School of Medicine, Institute of Rheumatology, Belgrade, Serbia
| | - Lidia P Ananieva
- Institute of Rheumatology, Russian Academy of Medical Science, Moscow, Russia
| | - Simona Rednic
- Clinica Reumatologie, University of Medicine & Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - László Czirják
- Department of Immunology and Rheumatology, Faculty of Medicine, University of Pécs, Hungary
| | - Oliver Distler
- Division of Rheumatology, University Hospital Zurich, Switzerland
| | - Dominique Farge
- Department of Internal Medicine, Hopital Saint-Louis, Paris, France
| | | | - Ada Corrado
- UO Reumatologia-Università degli Studi di Foggia, Ospedale "Col. D'Avanzo", Foggia, Italy
| | | | - Mohammed Tikly
- Rheumatology Unit, Department of Medicine Chris Hani Baragwanath, Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - Marco Matucci-Cerinic
- Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Florence, Italy
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10
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Elhai M, Meune C, Boubaya M, Avouac J, Hachulla E, Balbir-Gurman A, Riemekasten G, Airò P, Joven B, Vettori S, Cozzi F, Ullman S, Czirják L, Tikly M, Müller-Ladner U, Caramaschi P, Distler O, Iannone F, Ananieva LP, Hesselstrand R, Becvar R, Gabrielli A, Damjanov N, Salvador MJ, Riccieri V, Mihai C, Szücs G, Walker UA, Hunzelmann N, Martinovic D, Smith V, Müller CDS, Montecucco CM, Opris D, Ingegnoli F, Vlachoyiannopoulos PG, Stamenkovic B, Rosato E, Heitmann S, Distler JHW, Zenone T, Seidel M, Vacca A, Langhe ED, Novak S, Cutolo M, Mouthon L, Henes J, Chizzolini C, Mühlen CAV, Solanki K, Rednic S, Stamp L, Anic B, Santamaria VO, De Santis M, Yavuz S, Sifuentes-Giraldo WA, Chatelus E, Stork J, Laar JV, Loyo E, García de la Peña Lefebvre P, Eyerich K, Cosentino V, Alegre-Sancho JJ, Kowal-Bielecka O, Rey G, Matucci-Cerinic M, Allanore Y. Mapping and predicting mortality from systemic sclerosis. Ann Rheum Dis 2017; 76:1897-1905. [PMID: 28835464 DOI: 10.1136/annrheumdis-2017-211448] [Citation(s) in RCA: 343] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/21/2017] [Accepted: 07/18/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To determine the causes of death and risk factors in systemic sclerosis (SSc). METHODS Between 2000 and 2011, we examined the death certificates of all French patients with SSc to determine causes of death. Then we examined causes of death and developed a score associated with all-cause mortality from the international European Scleroderma Trials and Research (EUSTAR) database. Candidate prognostic factors were tested by Cox proportional hazards regression model by single variable analysis, followed by a multiple variable model stratified by centres. The bootstrapping technique was used for internal validation. RESULTS We identified 2719 French certificates of deaths related to SSc, mainly from cardiac (31%) and respiratory (18%) causes, and an increase in SSc-specific mortality over time. Over a median follow-up of 2.3 years, 1072 (9.6%) of 11 193 patients from the EUSTAR sample died, from cardiac disease in 27% and respiratory causes in 17%. By multiple variable analysis, a risk score was developed, which accurately predicted the 3-year mortality, with an area under the curve of 0.82. The 3-year survival of patients in the upper quartile was 53%, in contrast with 98% in the first quartile. CONCLUSION Combining two complementary and detailed databases enabled the collection of an unprecedented 3700 deaths, revealing the major contribution of the cardiopulmonary system to SSc mortality. We also developed a robust score to risk-stratify these patients and estimate their 3-year survival. With the emergence of new therapies, these important observations should help caregivers plan and refine the monitoring and management to prolong these patients' survival.
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Affiliation(s)
- Muriel Elhai
- Rheumatology A department, Paris Descartes University, INSERM U1016, Sorbonne Paris Cité, Cochin Hospital, Paris, France
| | - Christophe Meune
- Department of Cardiology, Paris XIII University, INSERM UMR S-942, Bobigny Hospital, Paris, France
| | - Marouane Boubaya
- Unit of Clinical Research, Paris Seine Saint Denis University, Bobigny, France
| | - Jérôme Avouac
- Rheumatology A department, Paris Descartes University, INSERM U1016, Sorbonne Paris Cité, Cochin Hospital, Paris, France
| | - Eric Hachulla
- Department of Internal Medicine, Hôpital Claude Huriez, University Lille Nord-de-France, Lille Cedex, Lille, France
| | - Alexandra Balbir-Gurman
- B Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel
| | | | - Paolo Airò
- UO Reumatologia ed Immunologia Clinica Spedali Civili Brescia, Brescia, Italy
| | - Beatriz Joven
- Servicio de Reumatologia, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Serena Vettori
- Department of Clinical and Experimental Medicine, 'F-Magrassi' II, Naples, Italy
| | - Franco Cozzi
- Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Susanne Ullman
- Department of Dermatology, University Hospital of Copenhagen, Hospital Bispebjerg, Copenhagen, Denmark
| | - László Czirják
- Department of Immunology and Rheumatology, University of Pécs, Pécs, Hungary
| | - Mohammed Tikly
- Chris Hani Baragwanath Academic Hospital University of the Witwatersrand, Johannesburg, South Africa
| | - Ulf Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Kerckhoff Clinic, Bad Nauheim, Germany
| | - Paola Caramaschi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Florenzo Iannone
- Interdisciplinary Department of Medicine-Rheumatology Unit, Policlinico, University of Bari, Bari, Italy
| | - Lidia P Ananieva
- VA Nasonova Institute of Rheumatology, Moscow, Russian Federation
| | - Roger Hesselstrand
- Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Radim Becvar
- Institute of Rheumatology, 1st Medical School, Charles University, Praha, Czech Republic
| | - Armando Gabrielli
- Clinica Medica, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy
| | - Nemanja Damjanov
- Institute of Rheumatology, University of Belgrade Medical School, Belgrade, Serbia
| | - Maria J Salvador
- Rheumatology Department, Hospitais da Universidade, Coimbra, Portugal
| | - Valeria Riccieri
- Department of Internal Medicine and Medical Specialities, 'Sapienza', University of Rome, Italy, Rome, Italy
| | - Carina Mihai
- Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Gabriella Szücs
- Department of Internal Medicine, Division of Rheumatology, University of Debrecen, Debrecen, Hungary
| | - Ulrich A Walker
- Department of Rheumatology, Basel University, Unispital Basel, Basel, Switzerland
| | - Nicolas Hunzelmann
- Department of Dermatology, University Hospital Cologne, Cologne, Germany
| | - Duska Martinovic
- Department of Internal Medicine, Clinical Hospital of Split, Split, Croatia
| | - Vanessa Smith
- Department of Rheumatology, University of Ghent, Ghent, Belgium
| | | | | | - Daniela Opris
- Department of Rheumatology, St Maria Hospital, Carol Davila, University of Medicine and Pharmacy, Bucharest, Romania
| | - Francesca Ingegnoli
- Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico 'Gaetano Pini', Milano, Italy
| | | | - Bojana Stamenkovic
- Institute for Prevention, Treatment and Rehabilitation of Rheumatic and Cardiovascular Diseases, Niska Banja, Serbia and Montenegro
| | - Edoardo Rosato
- Dipartimento di Medicina Clinica, Centro per la Sclerosi Sistemica, Università La Sapienza, Policlinico Umberto I, Roma, Italy
| | - Stefan Heitmann
- Department of Rheumatology, Marienhospital Stuttgart, Stuttgart, Germany
| | - Jörg H W Distler
- Department of Internal Medicine 3, University Hospital Erlangen, Erlangen, Germany
| | - Thierry Zenone
- Department of Medicine, Unit of Internal Medicine, Valence cedex, France
| | - Matthias Seidel
- Medizinische Klinik III, University Hospital of Bonn, Bonn, Germany
| | - Alessandra Vacca
- Rheumatology Unit, University Hospital of Cagliari, Monserrato, Italy
| | - Ellen De Langhe
- Division of Rheumatology and Department of Development and Regeneration, University Hospital Leuven and Laboratory Tissue Homeostasis and Disease, Leuven, Belgium
| | - Srdan Novak
- Department of Rheumatology and Clinical Immunology, Internal Medicine, KBC Rijeka, Rijeka, Croatia
| | - Maurizio Cutolo
- Research Laboratory and Division of Rheumatology Department of Internal Medicine, University of Genova, Genova, Italy
| | - Luc Mouthon
- Department of Internal Medicine, Hôpital Cochin, Paris, France
| | - Jörg Henes
- Medizinische Universitätsklinik, Abt II (Onkologie, Hämatologie, Rheumatologie, Immunologie, Pulmonologie), Tübingen, Germany
| | - Carlo Chizzolini
- Department of Immunology and Allergy, University Hospital, Geneva, Switzerland
| | | | - Kamal Solanki
- Rheumatology Unit, Waikato University Hospital, Hamilton City, Hamilton, New Zealand
| | - Simona Rednic
- Department of Rheumatology, University of Medicine and Pharmacy 'Iuliu Hatieganu' Cluj, Cluj-Napoca, Romania
| | - Lisa Stamp
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Branimir Anic
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | - Maria De Santis
- Division of Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Sule Yavuz
- Department of Rheumatology, University of Marmara, Istanbul, Turkey
| | | | - Emmanuel Chatelus
- Department of Rheumatology, University Hospital of Strasbourg-, Hôpital de Hautepierre, Service de Rhumatologie, Strasbourg, France
| | - Jiri Stork
- Department of Dermatology, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jacob van Laar
- Department of Rheumatology and Clinical Immunology, James Cook University Hospital, Middlesbrough, UK
| | - Esthela Loyo
- Reumatologia e Inmunologia Clinica, Hospital Regional Universitario Jose Ma Cabral y Baez, Clinica Corominas, Santiago, Dominican Republic
| | | | - Kilian Eyerich
- Department of Dermatology and Allergy of the TU Munich, Munich, Germany
| | - Vanesa Cosentino
- Department of Rheumatology and Collagenopathies, Osteoarticular Diseases and Osteoporosis Centre, Pharmacology and Clinical Pharmacological Research Centre, School of Medicine-University of Buenos Aires, Ramos Mejía Hospital, Buenos Aires, Argentina
| | | | - Otylia Kowal-Bielecka
- Department of Rheumatology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Grégoire Rey
- INSERM, CépiDc, Le Kremlin- Bicêtre, Le Kremlin-Bicêtre, France
| | - Marco Matucci-Cerinic
- Department of Experimental and Clinical Medicine, Section of Internal Medicine and Division of Rheumatology, Azienda Ospedaliero-Universitaria Careggi (AOUC), University of Florence, Florence, Italy
| | - Yannick Allanore
- Rheumatology A department, Paris Descartes University, INSERM U1016, Sorbonne Paris Cité, Cochin Hospital, Paris, France
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11
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Ariani A, Silva M, Seletti V, Bravi E, Saracco M, Parisi S, De Gennaro F, Idolazzi L, Caramaschi P, Benini C, Bodini FC, Scirè CA, Carrara G, Lumetti F, Alfieri V, Bonati E, Lucchini G, Aiello M, Santilli D, Mozzani F, Imberti D, Michieletti E, Arrigoni E, Delsante G, Pellerito R, Fusaro E, Chetta A, Sverzellati N. Quantitative chest computed tomography is associated with two prediction models of mortality in interstitial lung disease related to systemic sclerosis. Rheumatology (Oxford) 2017; 56:922-927. [PMID: 28160007 DOI: 10.1093/rheumatology/kew480] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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: 03/10/2016] [Indexed: 11/14/2022] Open
Abstract
Objective In this multicentre study, we aimed to evaluate the capacity of a computer-assisted automated QCT method to identify patients with SSc-associated interstitial lung disease (SSc-ILD) with high mortality risk according to validated composite clinical indexes (ILD-Gender, Age, Physiology index and du Bois index). Methods Chest CT, anamnestic data and pulmonary function tests of 146 patients with SSc were retrospectively collected, and the ILD-Gender, Age, Physiology score and DuBois index were calculated. Each chest CT underwent an operator-independent quantitative assessment performed with a free medical image viewer (Horos). The correlation between clinical prediction models and QCT parameters was tested. A value of P < 0.05 was considered statistically significant. Results Most QCT parameters had a statistically different distribution in patients with diverging mortality risk according to both clinical prediction models (P < 0.01). The cut-offs of QCT parameters were calculated by receiver operating characteristic curve analysis, and most of them could discriminate patients with different mortality risk according to clinical prediction models. Conclusion QCT assessment of SSc-ILD can discriminate between well-defined different mortality risk categories, supporting its prognostic value. These findings, together with the operator independence, strengthen the validity and clinical usefulness of QCT for assessment of SSc-ILD.
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Affiliation(s)
- Alarico Ariani
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero
| | - Mario Silva
- Department of Clinical Sciences, Section of Radiology, University of Parma, Parma
| | - Valeria Seletti
- Department of Clinical Sciences, Section of Radiology, University of Parma, Parma
| | - Elena Bravi
- Department of Medicine, Internal Medicine and Rheumatology Unit, Ospedale G. Da Saliceto, Piacenza
| | - Marta Saracco
- Rheumatology Unit, Ospedale Mauriziano - Umberto I di Torino, Turin
| | - Simone Parisi
- Rheumatology Department, Azienda Ospedaliera Cittá della Salute e della Scienza di Torino, Turin
| | - Fabio De Gennaro
- Rheumatology Unit, Azienda Ospedaliera 'Istituti Ospitalieri' di Cremona, Cremona
| | - Luca Idolazzi
- Rheumatology Section, Department of Medicine, University of Verona, Azienda Ospedaliero Universitaria Integrata, Verona
| | - Paola Caramaschi
- Rheumatology Section, Department of Medicine, University of Verona, Azienda Ospedaliero Universitaria Integrata, Verona
| | - Camilla Benini
- Rheumatology Section, Department of Medicine, University of Verona, Azienda Ospedaliero Universitaria Integrata, Verona
| | | | | | - Greta Carrara
- Epidemiology Unit, Italian Society for Rheumatology, Milano
| | - Federica Lumetti
- Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena
| | - Veronica Alfieri
- Department of Clinical and Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Elisa Bonati
- Department of Clinical and Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Gianluca Lucchini
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero
| | - Marina Aiello
- Department of Clinical and Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Daniele Santilli
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero
| | - Flavio Mozzani
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero
| | - Davide Imberti
- Department of Medicine, Internal Medicine and Rheumatology Unit, Ospedale G. Da Saliceto, Piacenza
| | | | - Eugenio Arrigoni
- Department of Medicine, Internal Medicine and Rheumatology Unit, Ospedale G. Da Saliceto, Piacenza
| | - Giovanni Delsante
- Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero
| | | | - Enrico Fusaro
- Rheumatology Department, Azienda Ospedaliera Cittá della Salute e della Scienza di Torino, Turin
| | - Alfredo Chetta
- Department of Clinical and Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - Nicola Sverzellati
- Department of Clinical Sciences, Section of Radiology, University of Parma, Parma
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De Benedetti F, Anton J, Gattorno M, Lachmann H, Kone-Paut I, Ozen S, Frenkel J, Simon A, Zeft A, Ben-Chetrit E, Hoffman HM, Joubert Y, Lheritier K, Speziale A, Guido J, Caorsi R, Penco F, Grossi A, Insalaco A, Alessio M, Conti G, Marchetti F, Tommasini A, Martino S, Gallizzi R, Salis A, Schena F, Caroli F, Martini A, Damonte G, Ceccherini I, Gattorno M, Frémond ML, Uggenti C, Van Eyck L, Melki I, Duffy D, Bondet V, Rose Y, Neven B, Crow Y, Rodero MP, Kusche Y, Roth J, Barczyk-Kahlert K, Ferrara G, Chiocchetti A, Polizzi S, Vuch J, Vozzi D, Mondino A, Valencic E, Pastore S, Taddio A, Faletra F, Dianzani U, Ramenghi U, Tommasini A, Zhou Q, Yu X, Demirkaya E, Deuitch N, Stone D, Tsai W, Ombrello A, Romeo T, Remmers EF, Chae J, Gadina M, Welch S, Ozen S, Topaloglu R, Abinun M, Kastner DL, Aksentijevich I, Vairo D, Ferraro RM, Zani G, Galli J, De Simone M, Cattalini M, Fazzi E, Giliani S, Omoyinmi E, Standing A, Rowczenio D, Keylock A, Gomes SM, Price-Kuehne F, Nanthapisal S, Murphy C, Cullup T, Jenkins L, Gilmour K, Eleftheriou D, Lachmann H, Hawkins P, Klein N, Brogan P, Nikolayenko VB, Şahin K, Karaaslan Y, Civino A, Alighieri G, Davì S, Rondelli R, Martino S, Filocamo G, Magnolato A, Dhanrajani A, Ricci F, Gallizzi R, Olivieri A, Gerloni V, Lattanzi B, Soscia F, De Fanti A, Manzoni SM, Citiso S, Quartulli L, Chan M, La Torre F, Rigante D, Maggio MC, Marsili M, Pelagatti MA, Conter V, Fagioli F, Lepore L, Pession A, Ravelli A, Pau S, Consolaro A, Ruperto N, Garrone M, Rinaldi M, De Inocencio J, Demirkaya E, Garay S, Foell D, Lovell DJ, Lazar C, Ellsworth J, Nielsen S, Flato B, Martini A, Ravelli A, Marasco E, Aquilani A, Cascioli S, Caiello I, Moneta GM, Pires-Marafón D, Guzman J, Magni-Manzoni S, Carsetti R, De Benedetti F, Robinson E, Albani S, Beresford MW, de Jager W, de Roock S, Duong T, Ellis J, Aeschlimann FA, Hyrich K, Jervis L, Lovell D, Marshall L, Mellins ED, Minden K, Munro J, Nigrovic PA, Palman J, Roth J, Twilt M, Ruperto N, Sampath S, Schanberg LE, Thompson SD, Thomson W, Vesely R, Wallace C, Williams C, Wu Q, Wulffraat N, Eng SW, Yeung RSM, Prakken B, Wedderburn LR, Horneff G, Seyger MB, Arikan D, Kalabic J, Anderson JK, Lazar A, Williams DA, Sheikh S, Wang C, Tarzynski-Potempa R, Hymans JS, Simonini G, Scoccimarro E, Pontikaki I, Ferrara G, Giani T, Ventura A, Meroni PL, Laxer RM, Cimaz R, Minnone G, Soligo M, Caiello I, Prencipe G, Marafon DP, Magni-Manzoni S, Manni L, De Benedetti F, Laudiero LB, Hebert D, Groot N, Grein I, Wulffraat NM, Schepp R, Berbers G, de Souza CCBS, Ferriani VPL, Pileggi G, de Roock S, Grein IHR, Noone D, Scala S, Patrone E, Schoemaker C, Costello W, Wulffraat N, Parsons S, McDonagh J, Thomson W, Cohen JD, Bentayou D, Pagnoux C, Brunel MAB, Trope S, Klotsche J, Listing M, Niewerth M, Horneff G, Thon A, Huppertz HI, Mönkemöller K, Foeldvari I, Benseler SM, Föll D, Minden K, Marino A, Stagi S, Carli N, Bertini F, Giani T, Simonini G, Cimaz R, Díaz-Maldonado AS, Yeung RS, Pino S, Guarnizo P, Torres-Jimenez AR, Sanchez-Jara B, Solis-Vallejo E, Cespedes-Cruz AI, Zeferino-Cruz M, Ramirez-Miramontes JV, Kumar A, Gupta A, Kessel C, Suri D, Rawat A, Kakkar N, Singh S, Makay B, Gücenmez ÖA, Ünsal E, Magnusson B, Mördrup K, Vermé A, Lippitz K, Peterson C, Freychet C, Stephan JL, Hofer M, Belot A, Harkness CE, Rooney M, Foster L, Henry E, Taggart P, Weinhage T, Simsek D, Ozkececi CF, Kurt E, Basbozkurt G, Gok F, Demirkaya E, Gorczyca D, Postępski J, Czajkowska A, Szponar B, Hinze C, Paściak M, Gruenpeter A, Lachór-Motyka I, Augustyniak D, Olesińska E, Asuka ES, Golovko T, Aliejim SU, Clemente EI, Jimenez EI, Wittkowski H, Hernandez JC, Fernandez SB, Roca CG, Romo DM, Nieva NR, Angarita JMM, Lopez JA, Nuñez-Cuadros E, Diaz-Cordovés G, Galindo-Zavala R, Holzinger D, Urda-Cardona A, Fernández-Nebro A, Quesada-Masachs E, de la Sierra DÁ, Prat MG, Gallo MM, Borrell RP, Barril SM, Sánchez AMM, Caballero CM, Grün N, Merlin E, Breton S, Fraitag S, Stephan JL, Wouters C, Bodemer C, Bader-Meunier B, Baldo F, Annoni F, Di Landro G, Föll D, Torreggiani S, Torcoletti M, Petaccia A, Corona F, Filocamo G, Tiller G, Buckle J, Munro J, Cox A, Gowdie P, Van Dijkhuizen P, Allen RC, Akikusa JD, Hernández-Huirache HG, Rodea-Montero ER, Cohen JD, Belot A, Fahy W, Quartier P, Sordet C, Trope S, Del Chierico F, Berggren KB, Kembe JT, Bos J, Armbrust W, Wulffraat N, van Brussel M, Cappon J, Dijkstra P, Geertzen J, Legger E, Malattia C, van Rossum M, Sauer P, Lelieveld O, Ozturk K, Buluc L, Akansel G, Muezzinoglu B, Ekinci Z, Rychkova L, Knyazeva T, Russo A, Pogodina A, Belova T, Mandzyak T, Kulesh E, Cafarotti A, Marsili M, Giannini C, Salvatore R, Lapergola G, Di Battista C, Marafon DP, Marcovecchio ML, Basilico R, Pelliccia P, Chiarelli F, Breda L, Almeida B, Tansley S, Simou S, Gunawardena H, McHugh N, ter Haar NM, Wedderburn L, Aouizerate J, Bader-Meunier B, De Antonio M, Bodemer C, Barnerias C, Bassez G, Desguerre I, Quartier P, Gherardi R, Magni-Manzoni S, Charuel JL, Authier FJ, Gitiaux C, Spencer CH, Aziz RA, Yu CY, Adler B, Bout-Tabaku S, Lintner K, Moore-Clingenpeel M, Vastert SJ, Boros C, McCann L, Ambrose N, Cortina-Borja M, Simou S, Pilkington C, Wedderburn L, Hinze C, Oommen PT, Speth F, Dallapiccola B, Haas JP, Hinze C, Oommen PT, Speth F, Haas JP, Speth F, Haas JP, Hinze C, Lavarello C, Giancane G, Prakken B, Pistorio A, Rider L, Aggarwal R, Oliveira SK, Cuttica R, Fischbach M, Sterba G, Brochard K, Dressler F, Barone P, Martini A, Burgos-Vargas R, Chalom EC, Desjonqueres M, Espada G, Fasth A, Garay SM, Herbigneaux RM, Hoyoux C, Deslandre CJ, Miller FW, De Benedetti F, Vencovsky J, Ravelli A, Martini A, Ruperto N, Sag E, Ozen S, Kale G, Topaloglu H, Talim B, Giancane G, Putignani L, Lavarello C, Pistorio A, Zulian F, Magnusson B, Avcin T, Corona F, Gerloni V, Pastore S, Marini R, Martino S, Fidanci BE, Pagnier A, Rodiere M, Soler C, Stanevicha V, Ten Cate R, Uziel Y, Vojinovic J, Ravelli A, Martini A, Ruperto N, Barut K, Villarreal AV, Acevedo N, Diaz T, Ramirez Y, Faugier E, Maldonado R, Arabshahi B, Lee JH, Leibowitz I, Okong’o LO, Arıcı S, Wilmshurst J, Esser M, Scott C, Batu ED, Emiroglu N, Sonmez HE, Tugcu GD, Arici ZS, Yalcin E, Dogru D, Simsek D, Ozcelik U, Bilginer Y, Haliloglu M, Kiper N, Ozen S, Yashiro M, Yamada M, Yabuuchi T, Kikkawa T, Nosaka N, Cakan M, Fujii Y, Saito Y, Tsukahara H, Al-Mayouf SM, AlMutiari N, Muzaffer M, shehata R, Al-Wahadneh A, Abdwani R, Al-Abrawi S, Batu ED, Abu-shukair M, El-Habahbeh Z, Alsonbul A, Szabat A, Chęć M, Opoka-Winiarska V, Kumar A, Gupta A, Rawat A, Saikia B, Şahin S, Minz RW, Suri D, Singh S, Arango C, Malagon C, Gomez MDP, Mosquera AC, Yepez R, Gonzalez T, Vargas C, Kısaarslan A, Zulian F, Balzarin M, Castaldi B, Reffo E, Sperotto F, Martini G, Meneghel A, Milanesi O, Foeldvari I, Klotsche J, Yilmaz E, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Sifuentes-Giraldo WA, Basaran Ö, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Kallinich T, Demir F, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Foeldvari I, Baildem E, Blakley M, Boros C, Ozturk K, Fligelstone K, Kienast A, Nemcova D, Pain C, Saracino A, Simoni G, Torok K, Weibel L, Helmus N, Foeldvari I, Gunduz Z, Klotsche J, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Sozeri B, Sifuentes-Giraldo WA, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Makay B, Kallinich T, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Osminina MK, Geppe NA, Niconorova OV, Ayaz N, Karashtina OV, Abbyasova OV, Shpitonkova OV, Adrovic A, Sahin S, Barut K, Durmus S, Uzun H, Kasapcopur O, Foeldvari I, Yavascan O, Klotsche J, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Aydog O, Sifuentes-Giraldo WA, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Bilginer Y, Kallinich T, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Mauro A, Fanti E, Voller F, Ekinci Z, Rusconi F, Cimaz R, Garcia-Rodriguez F, Villarreal-Treviño AV, Flores-Pineda AJ, Lara-Herrea PB, Salinas-Encinas DR, Diaz-Prieto T, Maldonado-Velazquez MR, Moreno-Espinosa S, Yıldız D, Faugier-Fuentes E, Gallizzi R, Finetti M, Crapanzano M, Cantarini L, Cattalini M, Filocamo G, Insalaco A, Mauro A, Rigante D, Gök F, Zulian F, Alessio M, Parissenti I, Ruperto N, Gattorno M, Cimaz R, Parihar MS, Singh S, Vignesh P, Gupta A, Erguven M, Rohit M, Gopalan K, Singh S, Vignesh P, Gupta A, Rohit M, Attri SV, Hong Y, Eleftheriou D, Nanthapisal S, Unsal E, Salama A, Jayne D, Little M, Brogan P, Kostina Y, Lyskina G, Shpitonkova O, Torbyak A, Lyskina G, Shirinsky O, Kasapcopur O, Mauro A, Gicchino MF, Smaldone MC, Diplomatico M, Olivieri AN, Spencer CH, Aziz RA, McClead R, Bout-Tabaku S, Patel H, Ozen S, Yu CY, Ozkececi CF, Basbozkurt G, Simsek D, Kurt E, Gok F, Demirkaya E, Cebecauerová D, Dallos T, Kabíčková E, Demirkaya E, Kynčl M, Chroustová D, Hoza J, Němcová D, Tesař V, Doležalová P, Batu ED, Sonmez HE, Hazirolan T, Ozaltin F, Sönmez HE, Bilginer Y, Ozen S, Almeida F, de Paula IHF, Sampaio MM, Arita FN, Alves AG, Santos MC, Okuda EM, Sacchetti SB, Batu ED, Falcini F, Francesca M, Stagi S, Rigante D, Lepri G, Matucci-Cerinic M, Brandi ML, Di Landro G, Torreggiani S, Petaccia A, Sözeri B, Torcoletti M, Corona F, Filocamo G, Kisaoglu H, Misir S, Demir S, Aliyazicioglu Y, Kalyoncu M, de Paula IHF, Ramalho CE, Butbul Y, Almeida FD, Alves AG, Santos MC, Sacchetti SB, Okuda EM, Calzada-Hernández J, Bou R, Iglesias E, Sánchez-Manubens J, Martínez FHP, Bilginer Y, Roca CG, Fernández SB, Angarita JMM, Anton J, Bohm M, Mahmood K, Leone V, Wood M, Yamaguchi KI, Fujikawa S, Özen S, Kim KY, Kim DY, Kim DS, Ioseliani M, Chkhaidze I, Lekishvili M, Tskhakaia N, Tvalabeishvili S, Kajrishvili A, Takakura M, Bracaglia C, Shimizu M, Inoue N, Mizuta M, Yachie A, Alizzi C, Corsello G, Maggio MC, Piram M, Maldini C, Biscardi S, Prencipe G, Desuremain N, Orzechowski C, Georget E, Regnard D, Kone-Paut I, Mahr A, Sparchez M, Damian L, Sparchez Z, Silva NA, Pardeo M, Treviño AVV, Loyola YR, Prieto TD, Fuentes EF, Velazquez MDRM, Perez P, Mosquera AC, Malagon C, Bhattad S, Rawat A, Lapeyre G, Saikia B, Minz R, Shandilya J, Singh S, Parihar MS, Singh S, Vignesh P, Gupta A, Rohit M, Maldonado R, Marasco E, Faugier E, Villarreal A, Acevedo N, Ramírez Y, Diaz T, Kostina Y, Lyskina G, Shpitonkova O, Ozturk K, Ekinci Z, Insalaco A, Özçakar ZB, Fitoz S, Yalcinkaya F, Horne A, Minoia F, Bovis F, Davi S, Pal P, Anton J, Stein K, Ferlin W, Enciso S, Kasapcopur O, Jeng M, Maritsi D, Cron RC, Ravelli A, Thorwarth A, von Stuckrad SL, Rösen-Wolff A, Luksch H, Nelson R, Hundsdoerfer P, Minden K, Krawitz P, Kallinich T, Sozeri B, Ayaz NA, Batu ED, Makay B, Şahin S, Simsek D, de Min C, Kılıc ŞS, Ozturk K, Sonmez E, Kisaarslan AP, Gucenmez OA, Cakan M, Arıcı ZS, Adrovic A, Kelesoglu F, Bilginer Y, De Benedetti F, Demirkaya E, Ekinci ZE, Dusunsel R, Unsal E, Kasapcopur O, Ozen S, Lerkvaleekul B, Vilaiyuk S, Miranda-Garcia M, Pretzer C, Ruperto N, Huppertz HI, Horneff G, Haas JP, Ganser G, Kuemmerle-Deschner J, Wittkowski H, Frosch M, Roth J, Foell D, Holzinger D, Brunner HI, Gohar F, McArdle A, Callan N, Hernandez B, Lavric M, Kessel C, Holzinger D, FitzGerald O, Pennington SR, Foell D, Quartier P, Horneff G, Peitz J, Kekow J, Klein A, Horneff G, Schulz AC, Minden K, Weller-Heinemann F, Hospach A, Haas JP, Constantin T, Put K, Vandenhaute J, Avau A, van Nieuwenhuijze A, Brisse E, Dierckx T, Rutgeerts O, Garcia-Perez JE, Toelen J, Waer M, Alexeeva E, Leclercq G, Goris A, Van Weyenbergh J, Liston A, De Somer L, Matthys P, Wouters CH, Mizuta M, Shimizu M, Inoue N, Kone-Paut I, Nakagishi Y, Yachie A, Shimizu M, Inoue N, Mizuta M, Yachie A, Ombrello MJ, Arthur V, Remmers EF, Hinks A, Marzan K, Kastner DL, Woo P, Thomson W, Stanimirovic B, Djurdjevic-Banjac B, Ljuboja O, Hugle B, Speth F, Haas JP, Maritsi D, Wulffraat N, Onoufriou MA, Vougiouka O, Eleftheriou D, Horneff G, Peitz J, Kekow J, Foell D, Bouayed K, El Hani S, Hafid I, Schneider R, Mikou N, Ioseliani M, Lekishvili M, Shelia N, Tvalabeishvili S, Kajrishvili A, Laan M, Ilisson J, Pruunsild C, Padeh S, Chasnyk V, Wouters C, Kuemmerle-Deschner JB, Kallinich T, Lauwerys B, Haddad E, Nasonov E, Trachana M, Vougiouka O, Leon K, Vritzali E, Lheritier K, Martini A, Lovell D, Schena F, Volpi S, Caorsi R, Penco F, Pastorino C, Kalli F, Omenetti A, Chiesa S, Bertoni A, Picco P, Filaci G, Aksentijevich I, Grossi A, Ceccherini I, Martini A, Traggiai E, Gattorno M, Melki I, Rose Y, Uggenti C, Fremond ML, Van Eyck L, Kitabayashi N, Gattorno M, Volpi S, Sacco O, Meyts I, Morren MA, Wouters C, Legius E, Callebaut I, Bodemer C, Rieux-Laucat F, Rodero M, Crow Y, Frémond ML, Rodero MP, Jeremiah N, Belot A, Jeziorski E, Duffy D, Bessis D, Cros G, Rice GI, Charbit B, Hulin A, Khoudour N, Caballero CM, Bodemer C, Fabre M, Berteloot L, Le Bourgeois M, Reix P, Walzer T, Moshous D, Blanche S, Fischer A, Bader-Meunier B, Rieux-Laucat F, Crow Y, Neven B, Annink K, ter Haar N, Al-Mayouf S, Amaryan G, Anton J, Barron K, Benseler S, Brogan P, Cantarini L, Cattalini M, Cochino A, De Benedetti F, Dedeoglu F, De Jesus A, Dellacasa O, Demirkaya E, Dolezalova P, Durrant K, Fabio G, Gallizzi R, Goldbach-Mansky R, Hachulla E, Hentgen V, Herlin T, Hofer M, Hoffman H, Insalaco A, Jansson A, Kallinich T, Koné-Paut I, Kozlova A, Kuemmerle-Deschner J, Lachmann H, Laxer R, Martini A, Nielsen S, Nikishina I, Ombrello A, Ozen S, Papadopoulou-Alataki E, Quartier P, Ravelli A, Rigante D, Russo R, Simon A, Trachana M, Uziel Y, Gattorno M, Frenkel J, ter Haar N, Jeyaratnam J, Lachmann H, Simon A, Brogan P, Doglio M, Cattalini M, Anton J, Modesto C, Quartier P, Hoppenreijs E, Martino S, Insalaco A, Cantarini L, Lepore L, Alessio M, Penades IC, Boros C, Consolini R, Rigante D, Russo R, Schmid JP, Lane T, Martini A, Ruperto N, Frenkel J, Gattorno M, Passarelli C, Pisaneschi E, Messia V, Pardeo M, Novelli A, Debenedetti F, Insalaco A, Brogan PA, Hofer M, Kuemmerle-Deschner JB, Lauwerys B, Speziale A, Wei X, Laxer R, Insalaco A, Marafon DP, Finetti M, Pardeo M, Martino S, Cattalini M, Alessio M, Orlando F, Taddio A, Pastore S, Cortis E, Miniaci A, Ruperto N, Martini A, De Benedetti F, Gattorno M, Eijkelboom C, ter Haar N, Cantarini L, Finetti M, Brogan P, Dolezalova P, Koné-Paut I, Insalaco A, Jelusic-Drazic M, Bezrodnik L, Pinedo MC, Stanevicha V, van Gijn M, Federici S, Ruperto N, Frenkel J, Gattorno M, Girschick H, Finetti M, Orlando F, Insalaco A, Ganser G, Nielsen S, Herlin T, Koné-Paut I, Martino S, Cattalini M, Anton J, Al-Mayouf SM, Hofer M, Quartier P, Boros C, Kuemmerle-Deschner J, Schalm S, Alessio M, Ruperto N, Martini A, Jansson A, Gattorno M, Finetti M, Marchi M, Marini C, Doglio M, Malattia C, Ravelli A, Martini A, Garaventa A, Gattorno M, Bertoni A, Carta S, Balza E, Castellani P, Pellecchia C, Penco F, Schena F, Borghini S, Trotta ML, Pastorino C, Ceccherini I, Martini A, Gattorno M, Rubartelli A, Chiesa S, Guzman J, Henrey A, Loughin T, Berard R, Shiff N, Jurencak R, Benseler S, Tucker L, Papadopoulou C, Hong Y, Krol P, Ioannou Y, Pilkington C, Chaplin H, Simou S, Charakida M, Wedderburn L, Brogan P, Eleftheriou D, Spiegel LR, Kohut SA, Stinson J, Forgeron P, Kaufman M, Luca N, Amaria K, Bell M, Swart J, Boris F, Castagnola E, Groll A, Giancane G, Horneff G, Huppertz HI, Lovell D, Wolfs T, Hofer M, Alekseeva E, Panaviene V, Nielsen S, Anton J, Uettwiller F, Stanevicha V, Trachana M, De Benedetti F, Ailioaie LM, Tsitami E, Kamphuis S, Herlin T, Dolezalova P, Susic G, Sztajnbok F, Flato B, Pistorio A, Martini A, Wulffraat N, Ruperto N, Shoop SJW, Verstappen SMM, McDonagh JE, Thomson W, Hyrich KL, Tarkiainen M, Tynjala P, Lahdenne P, Martikainen J, Wilkinson M, Piper C, Otto G, Deakin CT, Dowle S, Simou S, Kelberman D, Ioannou Y, Mauri C, Jury E, Isenberg D, Wedderburn LR, Nistala K, Foeldvari I, Ruperto N, Lovell DJ, Horneff G, Huppertz HI, Quartier P, Simonini G, Bereswill M, Kalabic J, Martini A, Brunner HI, Oen K, Guzman J, Feldman BM, Dufault B, Lee J, Shiff N, Duffy KW, Tucker L, Duffy C, Ruperto N, Lovell DJ, Tzaribachev N, Vega-Cornejo G, Louw I, Berman A, Calvo I, Cuttica R, Horneff G, Avila-Zapata F, Anton J, Cimaz R, Solau-Gervais E, Joos R, Espada G, Li X, Nys M, Wong R, Banerjee S, Martini A, Brunner HI, Nicolai R, Marafon DP, Verardo M, D’Amico A, Bracci-Laudiero L, De Benedetti F, Moneta GM, Belot A, Rice G, Mathieu AL, Omarjee SO, Bader-Meunier B, Walzer T, Briggs TA, O’Sullivan J, Williams S, Cimaz R, Smith E, Beresford MW, Crow YJ, Rooney M, Bishop N, davidson J, pilkington C, Beresford M, Clinch J, Satyapal R, Foster H, Medwin JG, McDonagh J, Wyatt S, Modignani VL, Baldo F, Lanni S, Consolaro A, Ravelli A, Filocamo G, Omenetti A, Frenkel J, Lachmann HJ, Ozen S, Ruperto N, Gattorno M, Insalaco A, Moneta G, Pardeo M, Passarelli C, Celani C, Messia V, De Benedetti F, Cherqaoui B, Rossi-Semerano L, Dusser P, Hentgen V, Koné-Paut I, Grimwood C, Dusser P, Rossi L, Paut IK, Hentgen V, Lasigliè D, Ferrera D, Amico G, Di Duca M, Caorsi R, Lepore L, Insalaco A, Cattalini M, Obici L, Consolini R, Ravazzolo R, Martini A, Ceccherini I, Nishikomori R, Arostegui J, Gattorno M, Borghini S, Penco F, Petretto A, Lavarello C, Inglese E, Omenetti A, Finetti M, Pastorino C, Bertoni A, Gattorno M, Vanoni F, Federici S, Ozen S, Frenkel J, Lachmann H, Martini A, Ruperto N, Gattorno M, Hofer M, Kuemmerle-Deschner JB, Hoffman HM, Hawkins PN, van der Poll T, Walker UA, Speziale A, Joubert Y, Tilson HH, Kuemmerle-Deschner J, Ozen S, Tyrrell PN, Koné-Paut I, Goldbach-Mansky R, Lachmann H, Blank N, Hoffman HM, Weissbarth-Riedel E, Huegle B, Kallinich T, Gattorno M, Gul A, ter Haar NM, Oswald M, Dedeoglu F, Benseler SM, Hanaya A, Miyamae T, Kawamoto M, Tani Y, Hara T, Kawaguchi Y, Nagata S, Yamanaka H, Ćosićkić A, Skokić F, Čolić B, Suljendić S, Kozlova A, Mersiyanova I, Panina M, Hachtryan L, Burlakov V, Raikina E, Maschan A, Shcherbina A, Acar B, Albayrak M, Sozeri B, Sahin S, Barut K, Adrovic A, Inan N, Sevgi S, Kasapcopur O, Andreasen CM, Jurik AG, Glerup MB, Høst C, Mahler BT, Hauge EM, Herlin T, Lazea C, Damian L, Lazar C, Manasia R, Stephenson CM, Prajapati V, Miettunen PM, Yılmaz D, Tokgöz Y, Bulut Y, Çakmak H, Sönmez F, Comak E, Aksoy GK, Koyun M, Akman S, Arıkan Y, Terzioğlu E, Özdeş ON, Keser İ, Koçak H, Bingöl A, Yılmaz A, Artan R, De Benedetti F, Anton J, Gattorno M, Lachmann H, Kone-Paut I, Ozen S, Frenkel J, Simon A, Zeft A, Ben-Chetrit E, Hoffman HM, Joubert Y, Lheritier K, Speziale A, Guido J, Xu X, Mehregan FF, Ziaee V, Moradinejad MH, Ferrara G, Pastore S, Insalaco A, Pardeo M, Tommasini A, La Torre F, Alizzi C, Cimaz R, Finetti M, Gattorno M, D’Adamo P, Taddio A, Lachmann H, Simon A, Anton J, Gattorno M, Kone-Paut I, Ozen S, Frenkel J, Ben-Chetrit E, Hoffman H, Zeft A, Joubert Y, Lheritier K, Speziale A, Junge G, Gregson J, De Benedetti F, Sargsyan H, Sargsyan H, Zengin H, Fidanci BE, Kaymakamgil C, Konukbay D, Simsek D, Batu ED, Yildiz D, Gok F, Ozen S, Demirkaya E, Stoler I, Freytag J, Orak B, Seib C, Esmann L, Seipelt E, Gohar F, Foell D, Wittkowski H, Kallinich T, Dursun I, Tulpar S, Yel S, Kartal D, Borlu M, Bastug F, Poyrazoglu H, Gunduz Z, Kose K, Yuksel ME, Calıskan A, Cekgeloglu AB, Dusunsel R, Bouchalova K, Franova J, Schuller M, Macku M, Theodoropoulou K, Carlomagno R, von Scheven-Gête A, Poloni C, Hofer M, Damian LO, Cosma D, Radulescu A, Vasilescu D, Rogojan L, Lazar C, Rednic S, Lupse M, De Somer L, Moens P, Wouters C, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Forno ID, Pieropan S, Viapiana O, Gatti D, Dallagiacoma G, Caramaschi P, Biasi D, Windschall D, Trauzeddel R, Lehmann H, Ganser G, Berendes R, Haller M, Krumrey-Langkammerer M, Nimtz-Talaska A, Schoof P, Trauzeddel RF, Nirschl C, Quesada-Masachs E, Blancafort CA, Barril SM, Caballero CM, Aguiar F, Fonseca R, Alves D, Vieira A, Vieira A, Dias JA, Brito I, Susic G, Milic V, Radunovic G, Boricic I, Marteau P, Adamsbaum C, Rossi-Semerano L, De Bandt M, Lemelle I, Deslandre C, Tran TA, Lohse A, Solau-Gervais E, Pillet P, Bader-Meunier B, Wipff J, Gaujoux-Viala C, Breton S, Devauchelle-Pensec V, Gran S, Fehler O, Zenker S, Schäfers M, Roth J, Vogl T, Czitrom SG, Foell D, Holzinger D, Lanni S, Van Dijkhuizen EHP, Manzoni SM, Marafon DP, Magnaguagno F, de Horatio LT, Ter Haar NM, Littooij AS, Vastert SJ, De Benedetti F, Ravelli A, Martini A, Malattia C, Teixeira VA, Campanilho-Marques R, Mourão AF, Ramos FO, Costa M, Madan WA, Killeen OG, Vidal AR, Delgado DS, Fernandez MIG, Montesinos BL, Penades IC, Kozhevnikov A, Pozdeeva N, Konev M, Melchenko E, Kenis V, Novik G, Sozeri B, Kısaarslan AP, Gunduz Z, Poyrazoglu H, Dusunsel R, Lerkvaleekul B, Jaovisidha S, Sungkarat W, Chitrapazt N, Fuangfa P, Ruangchaijatuporn T, Vilaiyuk S, Pradsgaard DØ, Hørlyck A, Spannow AH, Heuck CW, Herlin T, Diaz T, Garcia F, De La Cruz L, Rubio N, Świdrowska-Jaros J, Smolewska E, Lamot M, Lamot L, Vidovic M, Bosak EP, Rados I, Harjacek M, Tzaribachev N, Louka P, Hagoug R, Trentin C, Kubassova O, Hinton M, Boesen M, Oshlianska OA, Chaikovsky IA, Mjasnikov G, Kazmirchyk A, Garagiola U, Borzani I, Cressoni P, Corona F, Dzsida E, Farronato G, Garagiola U, Cressoni P, Corona F, Petaccia A, Dzsida E, Farronato G, Gagro A, Pasini AM, Roic G, Vrdoljak O, Lujic L, Zutelija-Fattorini M, Esser MM, Abraham DR, Kinnear C, Durrheim G, Urban M, Hoal E, Crow Y, Oshlianska OA. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part one. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461530 DOI: 10.1186/s12969-017-0141-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 12/02/2022] Open
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Terao C, Kawaguchi T, Dieude P, Varga J, Kuwana M, Hudson M, Kawaguchi Y, Matucci-Cerinic M, Ohmura K, Riemekasten G, Kawasaki A, Airo P, Horita T, Oka A, Hachulla E, Yoshifuji H, Caramaschi P, Hunzelmann N, Baron M, Atsumi T, Hassoun P, Torii T, Takahashi M, Tabara Y, Shimizu M, Tochimoto A, Ayuzawa N, Yanagida H, Furukawa H, Tohma S, Hasegawa M, Fujimoto M, Ishikawa O, Yamamoto T, Goto D, Asano Y, Jinnin M, Endo H, Takahashi H, Takehara K, Sato S, Ihn H, Raychaudhuri S, Liao K, Gregersen P, Tsuchiya N, Riccieri V, Melchers I, Valentini G, Cauvet A, Martinez M, Mimori T, Matsuda F, Allanore Y. Transethnic meta-analysis identifies GSDMA and PRDM1 as susceptibility genes to systemic sclerosis. Ann Rheum Dis 2017; 76:1150-1158. [PMID: 28314753 DOI: 10.1136/annrheumdis-2016-210645] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [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: 10/06/2016] [Revised: 01/08/2017] [Accepted: 02/21/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Systemic sclerosis (SSc) is an autoimmune disease characterised by skin and systemic fibrosis culminating in organ damage. Previous genetic studies including genome-wide association studies (GWAS) have identified 12 susceptibility loci satisfying genome-wide significance. Transethnic meta-analyses have successfully expanded the list of susceptibility genes and deepened biological insights for other autoimmune diseases. METHODS We performed transethnic meta-analysis of GWAS in the Japanese and European populations, followed by a two-staged replication study comprising a total of 4436 cases and 14 751 controls. Associations between significant single nuclear polymorphisms (SNPs) and neighbouring genes were evaluated. Enrichment analysis of H3K4Me3, a representative histone mark for active promoter was conducted with an expanded list of SSc susceptibility genes. RESULTS We identified two significant SNP in two loci, GSDMA and PRDM1, both of which are related to immune functions and associated with other autoimmune diseases (p=1.4×10-10 and 6.6×10-10, respectively). GSDMA also showed a significant association with limited cutaneous SSc. We also replicated the associations of previously reported loci including a non-GWAS locus, TNFAIP3. PRDM1 encodes BLIMP1, a transcription factor regulating T-cell proliferation and plasma cell differentiation. The top SNP in GSDMA was a missense variant and correlated with gene expression of neighbouring genes, and this could explain the association in this locus. We found different human leukocyte antigen (HLA) association patterns between the two populations. Enrichment analysis suggested the importance of CD4-naïve primary T cell. CONCLUSIONS GSDMA and PRDM1 are associated with SSc. These findings provide enhanced insight into the genetic and biological basis of SSc.
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Affiliation(s)
- Chikashi Terao
- Department of Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Center for the Promotion of Interdisciplinary Education and Research, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA
| | - Takahisa Kawaguchi
- Department of Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Philippe Dieude
- Rheumatology Bichat Hospital, Paris 7 University, Paris, France
| | - John Varga
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Masataka Kuwana
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Marie Hudson
- Jewish General Hospital and Lady Davis Research Institute, Montreal, Quebec, Canada
| | - Yasushi Kawaguchi
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Marco Matucci-Cerinic
- Division of Rheumatology AOUC, Department of Experimental and Clinical Medicine, Department of Medical & Geriatrics Medicine, University of Florence, Firenze, Italy
| | - Koichiro Ohmura
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Gabriela Riemekasten
- Clinic for Rheumatology, University of Lübeck, Lübeck, Germany.,German Lung Center Borstel, Leibniz Institute, Germany
| | - Aya Kawasaki
- Molecular and Genetic Epidemiology Laboratory, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Paolo Airo
- Rheumatology Unit, Spedali Civili, Brescia, Italy
| | - Tetsuya Horita
- Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akira Oka
- The Institute of Medical Science, Tokai University, Isehara, Japan
| | - Eric Hachulla
- Internal Medicine Department, FHU Immune-Mediated Inflammatory Diseases and Targeted Therapies, Lille University, Lille, France
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Paola Caramaschi
- Rheumatology Department, University of Verona, Azienda Ospedaliera Universitaria Integrata, Italy
| | | | - Murray Baron
- Jewish General Hospital and Lady Davis Research Institute, Montreal, Quebec, Canada
| | - Tatsuya Atsumi
- Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Paul Hassoun
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Meiko Takahashi
- Department of Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuharu Tabara
- Department of Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masakazu Shimizu
- Department of Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akiko Tochimoto
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Naho Ayuzawa
- Department of Rheumatology, National Hospital Organization, Utano National Hospital, Kyoto, Japan
| | - Hidetoshi Yanagida
- Department of Rheumatology, National Hospital Organization, Utano National Hospital, Kyoto, Japan
| | - Hiroshi Furukawa
- Molecular and Genetic Epidemiology Laboratory, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Clinical Research Center for Allergy and Rheumatology, Sagamihara Hospital, National Hospital Organization, Sagamihara, Japan
| | - Shigeto Tohma
- Clinical Research Center for Allergy and Rheumatology, Sagamihara Hospital, National Hospital Organization, Sagamihara, Japan
| | - Minoru Hasegawa
- Division of Medicine, Faculty of Medical Sciences, Department of Dermatology, University of Fukui, Fukui, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Osamu Ishikawa
- Department of Dermatology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Toshiyuki Yamamoto
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - Daisuke Goto
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yoshihide Asano
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Masatoshi Jinnin
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hirahito Endo
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Toho University, Tokyo, Japan
| | - Hiroki Takahashi
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Kazuhiko Takehara
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Shinichi Sato
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Soumya Raychaudhuri
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Katherine Liao
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Peter Gregersen
- Robert S. Boas Center for Genomics and Human Genetics, The Feinstein Institute for Medical Research, Manhasset, New York, USA
| | - Naoyuki Tsuchiya
- Molecular and Genetic Epidemiology Laboratory, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | | | | | - Gabriele Valentini
- Department of Clinical and Experimental Medicine, Rheumatology Section, Second University of Naples, Naples, Italy
| | - Anne Cauvet
- INSERM U1016/UMR 8104, Cochin Institute, Paris Descartes University, Paris, France
| | - Maria Martinez
- INSERM U1220-IRSD-Batiment B Purpan Hospital Toulouse, Paris, France
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Fumihiko Matsuda
- Department of Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yannick Allanore
- Rheumatology A Department, INSERM U1016/UMR 8104, Cochin Institute, Paris Descartes University, Paris, France
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Lazzaroni MG, Cavazzana I, Colombo E, Dobrota R, Hernandez J, Hesselstrand R, Varju C, Nagy G, Smith V, Caramaschi P, Riccieri V, Hachulla E, Balbir-Gurman A, Chatelus E, Romanowska-Próchnicka K, Araújo AC, Distler O, Allanore Y, Airò P. Malignancies in Patients with Anti-RNA Polymerase III Antibodies and Systemic Sclerosis: Analysis of the EULAR Scleroderma Trials and Research Cohort and Possible Recommendations for Screening. J Rheumatol 2017; 44:639-647. [PMID: 28089973 DOI: 10.3899/jrheum.160817] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To analyze the characteristics of anti-RNA polymerase III antibodies (anti-RNAP3)- positive patients with systemic sclerosis (SSc) in the European League Against Rheumatism Scleroderma Trials and Research group (EUSTAR) registry with a focus on the risk of cancer and the characteristics of malignancies, and the aim to provide guidelines about potential cancer screening in these patients. METHODS (1) Analysis of the EUSTAR database: 4986 patients with information on their anti-RNAP3 status were included. (2) Case-control study: additional retrospective data, including malignancy history, were queried in 13 participating EUSTAR centers; 158 anti-RNAP3+ cases were compared with 199 local anti-RNAP3- controls, matched for sex, cutaneous subset, disease duration, and age at SSc onset. (3) A Delphi exercise was performed by 82 experts to reach consensus for cancer screening in anti-RNAP3+ patients. RESULTS In the EUSTAR registry, anti-RNAP3 were associated in multivariable analysis with renal crisis and diffuse cutaneous involvement. In the case-control study, anti-RNAP3 were associated with gastric antral vascular ectasia, rapid progression of skin involvement, and malignancies concomitant to SSc onset (OR 7.38, 95% CI 1.61-33.8). When compared with other anti-RNAP3+ patients, those with concomitant malignancies had older age (p < 0.001) and more frequent diffuse cutaneous involvement (p = 0.008). The Delphi exercise highlighted the need for malignancy screening at the time of diagnosis for anti-RNAP3+ patients and tight followup in the following years. CONCLUSION Anti-RNAP3+ patients with SSc have a high risk of concomitant malignancy. These results have implications for clinical practice and suggest regular screening for cancer in anti-RNAP3+ patients.
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Affiliation(s)
- Maria-Grazia Lazzaroni
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal. .,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia.
| | - Ilaria Cavazzana
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Enrico Colombo
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Rucsandra Dobrota
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Jasmin Hernandez
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Roger Hesselstrand
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Cecilia Varju
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Gabriella Nagy
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Vanessa Smith
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Paola Caramaschi
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Valeria Riccieri
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Eric Hachulla
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Alexandra Balbir-Gurman
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Emmanuel Chatelus
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Katarzyna Romanowska-Próchnicka
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Ana Carolina Araújo
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Oliver Distler
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Yannick Allanore
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
| | - Paolo Airò
- From the Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia, Brescia; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona; Department of Internal Medicine and Medical Specialties, University Sapienza, Rome, Italy; Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland; Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology and Immunology, Medical Center, University of Pecs, Pecs, Hungary; Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Internal Medicine, University Lille Nord-de-France, Lille; Department of Rheumatology, Strasbourg University Hospital, Strasbourg; Department of Rheumatology, University Paris Descartes and Cochin Hospital, Paris, France; B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland; Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal.,M.G. Lazzaroni, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; I. Cavazzana, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia; E. Colombo, MD, Rheumatology and Clinical Immunology, University of Brescia and Spedali Civili of Brescia; R. Dobrota, MD, Division of Rheumatology, University Hospital Zurich; J. Hernandez, MD, Division of Rheumatology, University Hospital Zurich; R. Hesselstrand, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University; C. Varju, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; G. Nagy, MD, Department of Rheumatology and Immunology, Medical Center, University of Pecs; V. Smith, MD, PhD, Rheumatology, Ghent University Hospital, Ghent University; P. Caramaschi, MD, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata; V. Riccieri, MD, Department of Internal Medicine and Medical Specialties, University Sapienza; E. Hachulla, MD, PhD, Department of Internal Medicine, University Lille Nord-de-France; A. Balbir-Gurman, MD, PhD, B. Shine Rheumatology Unit, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion - Institute of Technology; E. Chatelus, MD, Department of Rheumatology, Strasbourg University Hospital; K. Romanowska-Próchnicka, MD, Department of Pathophysiology, Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology; A.C. Araújo, MD, Unidade de Doenças Auto-Imunes, Serviço de Medicina 2, Hospital de Curry Cabral, Centro Hospitalar Lisboa Central; O. Distler, MD, PhD, Division of Rheumatology, University Hospital Zurich; Y. Allanore, MD, PhD, Department of Rheumatology, University Paris Descartes and Cochin Hospital; P. Airò, MD, Rheumatology and Clinical Immunology, Spedali Civili of Brescia
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15
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Koumakis E, Bouaziz M, Dieudé P, Cauvet A, Ruiz B, Airò P, Cusi D, Matucci-Cerinic M, Salvi E, Cuomo G, Hachulla E, Diot E, Caramaschi P, Riccieri V, Avouac J, Allanore Y. A candidate gene study identifies a haplotype of CD2 as novel susceptibility factor for systemic sclerosis. Clin Exp Rheumatol 2016; 34 Suppl 100:43-48. [PMID: 27385538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 02/15/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Systemic sclerosis (SSc) is a rare autoimmune disease (AID) with a complex genetic etiology. Evidence for a shared pathogenesis across AIDs is given by the well-known pleiotropism of autoimmune genes. Recently, several unbiased approaches have identified an association between polymorphisms of the CD2 gene, and rheumatoid arthritis (RA) susceptibility. The objective of this study was to investigate whether CD2 polymorphisms are associated with SSc. METHODS Two SNPs of CD2, rs624988 and rs798036, were genotyped in a total of 1,786 SSc patients and 2,360 healthy individuals from two European populations (France and Italy). Meta-analyses were performed to assess whether an association exists between CD2 polymorphisms or haplotypes and SSc or its main subtypes. RESULTS The combined analyses revealed an association between the rs624988 A allele and SSc susceptibility: padj=0.023, OR=1.14 (95%CI 1.04-1.25). Single marker analysis did not reveal any association between rs798036 and SSc. Haplotype analysis identified that the A-T haplotype, previously described in RA, was associated with higher susceptibility for SSc (padj=0.029, OR=1.14, 95%CI 1.04-1.25) and with the positive anti-centromere antibody sub-group of SSc patients (padj=0.009, OR=1.19 95%CI 1.07-1.32). Genotype-mRNA expression correlations revealed that the CD2 risk haplotype was associated with decreased CD2 mRNA expression in SSc patients. CONCLUSIONS Our study establishes CD2 as a new susceptibility factor for SSc, in a European Caucasian population, confirming the sharing of autoimmune risk factors by SSc and RA.
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Affiliation(s)
- Eugenie Koumakis
- INSERM, Institut Cochin, INSERM U1016, Sorbonne Paris Cité, and Paris Descartes University, Paris; and Paris Descartes University, Rheumatology A Department, Cochin Hospital, APHP, Paris, France
| | - Matthieu Bouaziz
- UMR CNRS-8071/INRA-1152, Université d'Evry Val d'Essonne, Evry, France
| | - Philippe Dieudé
- Paris Diderot University, Rheumatology Department, Hôpital Bichat Claude Bernard, APHP, Paris; and Paris Diderot University, INSERM U699, Hôpital Bichat Claude Bernard, Paris, France
| | - Anne Cauvet
- INSERM, Institut Cochin, INSERM U1016, Sorbonne Paris Cité, and Paris Descartes University, Paris, France
| | - Barbara Ruiz
- INSERM, Institut Cochin, INSERM U1016, Sorbonne Paris Cité, and Paris Descartes University, Paris, France
| | - Paolo Airò
- Rheumatology and Clinical Immunology, Spedali Civili, Brescia, Italy
| | - Daniele Cusi
- Institute of Biomedical Technologies, National Centre of Research, Milan, Italy
| | - Marco Matucci-Cerinic
- Department of Experimental and Clinical Medicine, Division of Rheumatology, AOUC, University of Florence, Italy
| | - Erika Salvi
- Department of Health Sciences, University of Milan, Italy
| | - Giovanna Cuomo
- Department of Clinical and Experimental Medicine, Rheumatology Unit, Second University of Naples, Italy
| | - Eric Hachulla
- Department of Internal Medicine, Hôpital Claude Huriez, Université de Lille II, Lille, France
| | | | - Paola Caramaschi
- Unità di Reumatologia, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Valeria Riccieri
- Rheumatology, Department of Internal Medicine and Medical Specialities, "Sapienza" University of Rome, Italy
| | - Jerome Avouac
- INSERM, Institut Cochin, INSERM U1016, Sorbonne Paris Cité, and Paris Descartes University, Paris; and Paris Descartes University, Rheumatology A Department, Cochin Hospital, APHP, Paris, France
| | - Yannick Allanore
- INSERM, Institut Cochin, INSERM U1016, Sorbonne Paris Cité, and Paris Descartes University, Paris; and Paris Descartes University, Rheumatology A Department, Cochin Hospital, APHP, Paris, France.
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16
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Caimmi C, Caramaschi P, Barausse G, Orsolini G, Idolazzi L, Gatti D, Viapiana O, Adami S, Biasi D, Rossini M. Bone Metabolism in a Large Cohort of Patients with Systemic Sclerosis. Calcif Tissue Int 2016; 99:23-9. [PMID: 26898382 DOI: 10.1007/s00223-016-0119-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Accepted: 02/09/2016] [Indexed: 10/22/2022]
Abstract
The aim of this study was to evaluate in a large size cohort of SSc patients bone mineral density (BMD) and to analyze its possible determinants. 106 consecutive outpatients affected by SSc were enrolled and completely evaluated for bone metabolism and SSc characteristics. For the statistical analysis, we preferred Z score to BMD or T score since the population was composed of patients of different ages and of both sexes. Mean neck Z score was significantly lower than 0. No significant differences were found for other sites. Female patients were shown to have a total femur and neck Z score significantly lower than 0 (p = 0.028 and p < 0.001, respectively). 13 % of patients had at least one morphometric non-clinical vertebral fracture. In univariate analysis, total femur Z score was lower in female (p = 0.050) and positively correlates with BMI (p = 0.001), neck Z score positively correlates with age (p = 0.016), and whole body Z score positively correlates with BMI (p < 0.001). No correlations were found for lumbar Z score. The multivariate analysis confirmed the positive correlation between BMI and total femur and whole body Z score and between age and neck femur Z score (p = 0.005, p < 0.001 and p = 0.040, respectively). Lung involvement was shown to correlate with a lower whole body Z score in multivariate analysis (p = 0.037). We found a modest risk of low BMD in patients with SSc and the important protective role of BMI. Patients with lung involvement showed lower whole body Z score.
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Affiliation(s)
- Cristian Caimmi
- Unità di Reumatologia, Policlinico G.B. Rossi, University of Verona, Piazzale Scuro, 37134, Verona, Italy.
| | - Paola Caramaschi
- Unità di Reumatologia, Policlinico G.B. Rossi, University of Verona, Piazzale Scuro, 37134, Verona, Italy
| | - Giovanni Barausse
- Unità di Reumatologia, Policlinico G.B. Rossi, University of Verona, Piazzale Scuro, 37134, Verona, Italy
| | - Giovanni Orsolini
- Unità di Reumatologia, Policlinico G.B. Rossi, University of Verona, Piazzale Scuro, 37134, Verona, Italy
| | - Luca Idolazzi
- Unità di Reumatologia, Policlinico G.B. Rossi, University of Verona, Piazzale Scuro, 37134, Verona, Italy
| | - Davide Gatti
- Unità di Reumatologia, Policlinico G.B. Rossi, University of Verona, Piazzale Scuro, 37134, Verona, Italy
| | - Ombretta Viapiana
- Unità di Reumatologia, Policlinico G.B. Rossi, University of Verona, Piazzale Scuro, 37134, Verona, Italy
| | - Silvano Adami
- Unità di Reumatologia, Policlinico G.B. Rossi, University of Verona, Piazzale Scuro, 37134, Verona, Italy
| | - Domenico Biasi
- Unità di Reumatologia, Policlinico G.B. Rossi, University of Verona, Piazzale Scuro, 37134, Verona, Italy
| | - Maurizio Rossini
- Unità di Reumatologia, Policlinico G.B. Rossi, University of Verona, Piazzale Scuro, 37134, Verona, Italy
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17
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Ariani A, Silva M, Seletti V, Bravi E, Saracco M, Parisi S, De Gennaro F, Lumetti F, Idolazzi L, Caramaschi P, Benini C, Bodini F, Scirè C, Alfieri V, Bonati E, Lucchini G, Aiello M, Santilli D, Mozzani F, Imberti D, Arrigoni E, Delsante G, Michieletti E, Pellerito R, Fusaro E, Chetta A, Sverzellati N. AB0930 Quantitative Chest Ct in Ild-Ssc Patients with Divergent Risks of Mortality. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2995] [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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18
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Dobrota R, Maurer B, Graf N, Kowal-Bielecka O, Matucci-Cerinic M, Airò P, Caramaschi P, Carreira P, Riemekasten G, Rosato E, Allanore Y, Distler O. SAT0244 Active Skin Disease at Baseline Does Not Predict Progression of Skin Fibrosis at One Year Follow Up – A Eustar Analysis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5450] [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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Betelli M, Ramoni V, Meroni M, Allanore Y, Baresic M, Beneventi F, Caramaschi P, Cutolo M, Favaro M, Govoni M, Hachulla E, Limonta M, Matucci Cerinic M, Riccieri V, Rosato E, Salsano F, Scolack M, Smith V, Taraborelli M, Tincani A, Valentini G, Vonk M, Brucato A. SAT0196 Impress 2 (International Multicentric Prospective Study on Pregnancy in Systemic Sclerosis). Prospective, Case-Control Study of Pregnancy in Systemic Sclerosis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3875] [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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20
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Ariani A, Bravi E, Saracco M, Parisi S, De Gennaro F, Idolazzi L, Silva M, Seletti V, Lumetti F, Caramaschi P, Benini C, Bodini F, Scirè C, Lucchini G, Santilli D, Imberti D, Arrigoni E, Michieletti E, Pellerito R, Fusaro E, Sverzellati N. FRI0260 Quantitative CT Indexes in ILD-SSC Patients with Different Autoantibodies: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3021] [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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21
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Lazzaroni M, Cavazzana I, Colombo E, Distler O, Dobrota R, Hernandez J, Hesselstrand R, Czirjak L, Varju C, Nagy G, Smith V, Caramaschi P, Riccieri V, Hachulla E, Romanowska-Prochnicka K, Balbir-Gurman A, Chatelus E, Araùjo A, Allanore Y, Airò P. OP0031 Risk Factors for Malignancies Synchronous To The Onset of Systemic Sclerosis in Patients Positive for Anti- RNA Polymerase III Antibodies: A Eustar Multicentre Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3171] [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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22
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Brand M, Hollaender R, Rosenberg D, Scott M, Hunsche E, Tyndall A, Denaro V, Carreira P, Varju C, Gabrielli B, Zingarelli S, Caramaschi P, Simic-Pasalic K, Müller-Ladner U, Vasile M, Mihai C, Rosato E, Vacca A, Zenone T, Mohamed WA, Ancuta C, Zampogna G, Rednic S, Jabaar N, Belloli L, Pozzi MR, Foti R, Walker UA. An observational cohort study of patients with newly diagnosed digital ulcer disease secondary to systemic sclerosis registered in the EUSTAR database. Clin Exp Rheumatol 2015; 33:S47-S54. [PMID: 26243652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 04/30/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES This study describes clinical characteristics, prognostic factors, and quality of life in patients with newly diagnosed (incident) digital ulcers (DU). METHODS Observational cohort study of 189 consecutive SSc patients with incident DU diagnosis identified from the EUSTAR database (22 centres in 10 countries). Data were collected from medical charts and during one prospective visit between 01/2004 and 09/2010. RESULTS Median age at DU diagnosis was 51 years, majority of patients were female (88%), and limited cutaneous SSc was the most common subtype (61%). At incident DU diagnosis, 41% of patients had one DU and 59% had ≥2 DU; at the prospective visit 52% had DU. Pulmonary arterial hypertension (PAH) and multiple DU at diagnosis were associated with presence of any DU at the prospective visit (odds ratios: 4.34 and 1.32). During the observation period (median follow-up was 2 years) 127 patients had ≥1 hospitalisation. The event rate of new DU per person-year was 0.66, of DU-associated complications was 0.10, and of surgical or diagnostic procedures was 0.12. At the prospective visit, patients with ≥1 DU reported impairment in daily activities by 57%, those with 0 DU by 37%. The mean difference between patients with or without DU in the SF-36 physical component was 2.2, and in the mental component 1.4. DU patients were not routinely prescribed endothelin receptor antagonists or prostanoids. CONCLUSIONS This real world cohort demonstrates that DU require hospital admission, and impair daily activity. PAH and multiple DU at diagnosis were associated with future occurrence of DU.
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Affiliation(s)
- Monika Brand
- Actelion Pharmaceuticals Ltd., Departments of Epidemiology and Observational Studies, and Global Market Access and Pricing, Allschwil, Switzerland
| | - Rebecca Hollaender
- Basel University Department of Rheumatology, Felix Platter-Spital, Basel, Switzerland
| | - Daniel Rosenberg
- Actelion Pharmaceuticals Ltd., Departments of Epidemiology and Observational Studies, and Global Market Access and Pricing, Allschwil, Switzerland
| | | | - Elke Hunsche
- Actelion Pharmaceuticals Ltd., Departments of Epidemiology and Observational Studies, and Global Market Access and Pricing, Allschwil, Switzerland
| | - Alan Tyndall
- Basel University Department of Rheumatology, Felix Platter-Spital, Basel, Switzerland
| | - Valentina Denaro
- Department of Biomedicine, Section of Rheumatology, University of Florence, Florence, Italy
| | - Patricia Carreira
- Servicio de Reumatologia, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Cecilia Varju
- Department of Rheumatology and Immunology, University of Pécs, Pécs, Hungary
| | - Barbara Gabrielli
- Department Clinica Medica, Università Politecnica delle Marche, Ancona, Italy
| | - Stefania Zingarelli
- Rheumatology and Clinical Immunology Service, Spedali Civili di Brescia, Brescia, Italy
| | | | | | - Ulf Müller-Ladner
- Department of Rheumatology, Justus- Liebig-University, Bad Nauheim, Germany
| | - Massimiliano Vasile
- Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, Rome, Italy
| | - Carina Mihai
- Department of Rheumatology, Cantacuzino Hospital, Carol Davila University, Bucharest, Romania
| | - Edoardo Rosato
- Clinical Immunology Unit, Sapienza University of Rome, Rome, Italy
| | - Alessandra Vacca
- AOU Rheumatology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - Thierry Zenone
- Department of Internal Medicine, Centre Hospitalier, Valence, France
| | | | - Codrina Ancuta
- Department of Rheumatology, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | | | - Simona Rednic
- University of Medicine and Pharmacy Iuliu Hatieganu, Cluj Napoca, Romania
| | - Nadia Jabaar
- Division of Rheumatology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Laura Belloli
- Rheumatology Unit, Istituto Clinico Humanitas, University of Milan, Rozzano, Italy
| | - Maria R Pozzi
- Clinica Medica, Azienda Ospedaliera San Gerardo, University of Milano, Bicocca, Italy
| | - Rosario Foti
- Rheumatology Unit, Azienda Ospedaliera Universitaria Policlinico V.E., Catania, Italy
| | - Ulrich A Walker
- Basel University Department of Rheumatology, Felix Platter-Spital, Basel, Switzerland.
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Dal Forno I, Pieropan S, Facci M, Dosso G, Caramaschi P, Biasi D, Adami S. AB0981 Anxiety and Depression in JIA: Is There Any Difference in the Perception Among the Young Patients and Their Parents? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3982] [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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Lazzaroni M, Colombo E, Cavazzana I, Distler O, Hesselstrand R, Smith V, Caramaschi P, Hachulla E, Balbir-Gurman A, Romanowska-Pròchnicka K, Riccieri V, Allanore Y, Airo' P. OP0055 Anti-RNA Polymerase III Antibodies in Patients with Systemic Sclerosis: A Eustar Multicenter Collaborative Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1728] [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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Dal Forno I, Pieropan S, Facci M, Dosso G, Ravagnani V, Caramaschi P, Biasi D, Adami S. AB0982 Juvenile Idiopathic Arthritis: Parental Stress Reaction After Diagnosis of a Chronic Desease of their Sons. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5500] [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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Caimmi C, Caramaschi P, Barausse G, Orsolini G, Idolazzi L, Gatti D, Viapiana O, Rossini M, Adami S. AB0684 Bone Metabolism in a Large Cohort of Patients with Systemic Sclerosis: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2854] [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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Ariani A, Silva M, Parisi S, Saracco M, Bravi E, De Gennaro F, Benini C, Caramaschi P, Lumetti F, Seletti V, Idolazzi L, Bodini F, Scirè C, Lucchini G, Santilli D, Mozzani F, Delsante G, Imberti D, Arrigoni E, Pellerito R, Fusaro E, Sverzellati N. FRI0443 Can Quantitative Chest CT Predict Interstitial Lung Disease Worsening in Systemic Sclerosis? Results from a Multi-Centre Prospective Cohort Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6409] [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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Ariani A, Silva M, Bravi E, Saracco M, Parisi S, De Gennaro F, Lumetti F, Idolazzi L, Seletti V, Caramaschi P, Benini C, Bodini FC, Scirè CA, Lucchini G, Santilli D, Mozzani F, Imberti D, Arrigoni E, Delsante G, Pellerito R, Fusaro E, Sverzellati N. Operator-independent quantitative chest computed tomography versus standard assessment of interstitial lung disease related to systemic sclerosis: A multi-centric study. Mod Rheumatol 2015; 25:724-30. [DOI: 10.3109/14397595.2015.1016200] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Caramaschi P, Biasi D, Caimmi C, Vaccari R, Dal Forno I, Pieropan S, Adami S. Adherence to recommendations for cervical and breast cancer screening in systemic sclerosis. Reumatismo 2015; 66:264-9. [PMID: 25829186 DOI: 10.4081/reumatismo.2014.794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 12/23/2014] [Accepted: 12/29/2014] [Indexed: 11/22/2022] Open
Abstract
The aim of the study was to evaluate the adherence of systemic sclerosis (SSc) female patients to cervix and breast cancer screening procedures, as suggested by local guidelines. A cohort of 84 SSc women was asked if they had undergone mammography and Pap test during the previous 2- and 3-year intervals, as indicated according to the Italian recommendations. The results were compared with those collected in patients affected by other chronic rheumatic disorders and in the general population. More than 85% of SSc women declared to comply with an age-related cervix and breast cancer screening schedule. The data were similar to those collected in patients affected by other chronic rheumatic disorders, whereas the subjects belonging to the general population reported to undergo breast cancer screening more frequently. Among SSc women, neither the educational level, nor the lung and skin involvement influenced their cancer screening program compliance. Only a positive history of ischemic digital ulcers seemed to interfere with mammography. Our study reported a very high percentage of SSc female patients who adhered to programs for the early detection of cervical and breast cancer. The significant adherence to guidelines may be due to the schedule adopted by the local health public service, which regularly invites eligible subjects by mail to undergo cancer screening at no charge.
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Affiliation(s)
- P Caramaschi
- Rheumatology Unit, Department of Medicine, University of Verona.
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Arismendi M, Giraud M, Ruzehaji N, Dieudé P, Koumakis E, Ruiz B, Airo P, Cusi D, Matucci-Cerinic M, Salvi E, Cuomo G, Hachulla E, Diot E, Caramaschi P, Riccieri V, Avouac J, Kayser C, Allanore Y. Identification of NF-κB and PLCL2 as new susceptibility genes and highlights on a potential role of IRF8 through interferon signature modulation in systemic sclerosis. Arthritis Res Ther 2015; 17:71. [PMID: 25880423 PMCID: PMC4422604 DOI: 10.1186/s13075-015-0572-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [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: 05/04/2014] [Accepted: 02/20/2015] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Systemic sclerosis (SSc) and primary biliary cirrhosis (PBC) are rare polygenic autoimmune diseases (AIDs) characterized by fibroblast dysfunction. Furthermore, both diseases share some genetic bases with other AIDs, as evidenced by autoimmune gene pleiotropism. The present study was undertaken to investigate whether single-nucleotide polymorphisms (SNPs) identified by a large genome-wide association study (GWAS) in PBC might contribute to SSc susceptibility. METHODS Sixteen PBC susceptibility SNPs were genotyped in a total of 1,616 patients with SSc and 3,621 healthy controls from two European populations (France and Italy). RESULTS We observed an association between PLCL2 rs1372072 (odds ratio (OR) = 1.22, 95% confidence interval (CI) 1.12 to 1.33, P adj = 7.22 × 10(-5)), nuclear factor-kappa-B (NF-κB) rs7665090 (OR = 1.15, 95% CI 1.06 to 1.25, P adj = 0.01), and IRF8 rs11117432 (OR = 0.75, 95% CI 0.67 to 0.86, P adj = 2.49 × 10(-4)) with SSc susceptibility. Furthermore, phenotype stratification showed an association between rs1372072 and rs11117432 with the limited cutaneous subgroup (lcSSc) (P adj = 4.45 × 10(-4) and P adj = 0.001), whereas rs7665090 was associated with the diffuse cutaneous subtype (dcSSc) (P adj = 0.003). Genotype-mRNA expression correlation analysis revealed that the IRF8 protective allele was associated with increased interferon-gamma (IFN-γ) expression (P = 0.03) in patients with SSc but decreased type I IFN (IFIT1) expression in patients and controls (P = 0.02). In addition, we found an epistatic interaction between NF-κB and IRF8 (OR = 0.56, 95% CI 0.00 to 0.74, P = 4 × 10(-4)) which in turn revealed that the IRF8 protective effect is dependent on the presence of the NF-κB susceptibility allele. CONCLUSIONS An analysis of pleiotropic genes identified two new susceptibility genes for SSc (NF-κB and PLCL2) and confirmed the IRF8 locus. Furthermore, the IRF8 variant influenced the IFN signature, and we found an interaction between IRF8 and NF-κB gene variants that might play a role in SSc susceptibility.
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Affiliation(s)
- Maria Arismendi
- Paris Descartes University, INSERM U1016, Institut Cochin, Sorbonne Paris Cité, Paris, France. .,CAPES Foundation, Ministry of Education of Brazil, Brasília, DF, 70040-020, Brazil.
| | - Matthieu Giraud
- Paris Descartes University, INSERM U1016, Institut Cochin, Sorbonne Paris Cité, Paris, France.
| | - Nadira Ruzehaji
- Paris Descartes University, INSERM U1016, Institut Cochin, Sorbonne Paris Cité, Paris, France.
| | - Philippe Dieudé
- Paris Diderot University, Rheumatology Department, Hôpital Bichat Claude Bernard, APHP, Paris, France. .,Paris Diderot University, INSERM U699, Hôpital Bichat Claude Bernard, Paris, France.
| | - Eugenie Koumakis
- Paris Descartes University, INSERM U1016, Institut Cochin, Sorbonne Paris Cité, Paris, France.
| | - Barbara Ruiz
- Paris Descartes University, INSERM U1016, Institut Cochin, Sorbonne Paris Cité, Paris, France.
| | - Paolo Airo
- Rheumatology and Clinical Immunology, Spedali Civili, Brescia, Italy.
| | - Daniele Cusi
- University of Milano, Department of Medicine, Surgery and Dentistry San Paolo & Genomics and Bioinformatics Platform, Fondazione Filarete, Milan, Italy.
| | - Marco Matucci-Cerinic
- Department of Biomedicine & Division of Rheumatology AOUC, Department of Rheumatology AVC, Department of Medicine & Denothe Centre, University of Florence, Florence, Italy.
| | - Erika Salvi
- University of Milano, Department of Medicine, Surgery and Dentistry San Paolo & Genomics and Bioinformatics Platform, Fondazione Filarete, Milan, Italy.
| | - Giovanna Cuomo
- Department of Clinical and Experimental Medicine, Rheumatology Unit, Second University of Naples, Naples, Italy.
| | - Eric Hachulla
- Université Lille II, Médecine Interne, Lille, France.
| | | | - Paola Caramaschi
- Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
| | - Valeria Riccieri
- Division of Rheumatology, Department of Medical Clinic and Therapy, University "Sapienza" of Rome, Rome, Italy.
| | - Jérôme Avouac
- Paris Descartes University, INSERM U1016, Institut Cochin, Sorbonne Paris Cité, Paris, France. .,Paris Descartes University, Rheumatology A Department, Cochin Hospital, APHP, Paris, France.
| | - Cristiane Kayser
- Department of Rheumatology, Federal University of São Paulo, São Paulo, Brazil.
| | - Yannick Allanore
- Paris Descartes University, INSERM U1016, Institut Cochin, Sorbonne Paris Cité, Paris, France. .,Paris Descartes University, Rheumatology A Department, Cochin Hospital, APHP, Paris, France.
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31
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Scambi C, Ugolini S, Jokiranta TS, De Franceschi L, Bortolami O, La Verde V, Guarini P, Caramaschi P, Ravagnani V, Martignoni G, Colato C, Pedron S, Benedetti F, Sorio M, Poli F, Biasi D. The local complement activation on vascular bed of patients with systemic sclerosis: a hypothesis-generating study. PLoS One 2015; 10:e0114856. [PMID: 25658605 PMCID: PMC4319765 DOI: 10.1371/journal.pone.0114856] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 02/21/2014] [Accepted: 11/13/2014] [Indexed: 11/26/2022] Open
Abstract
Objective The role of complement system in the pathogenesis of systemic sclerosis (SSc) has been debated during the last decade but an evident implication in this disease has never been found. We carried out an explorative study on SSc patients to evaluate the expression of soluble and local C5b-9 complement complex and its relation with a complement regulator, the Membrane Cofactor Protein (MCP, CD46) on skin vascular bed as target distinctive of SSc disease. We also analyzed two polymorphic variants in the complement activation gene cluster involving the MCP region. Methods C5b-9 plasma levels of SSc patients and healthy subjects were analyzed by ELISA assay. Archival skin biopsies of SSc patients and controls were subjected to immunofluorescence analysis to detect C5b-9 and MCP on vascular endothelial cells. The expression of MCP was validated by immunoblot analysis with specific antibody. Polymorphic variants in the MCP gene promoter were tested by a quantitative PCR technique-based allelic discrimination method. Results Even though circulating levels of C5b-9 did not differ between SSc and controls, C5b-9 deposition was detected in skin biopsies of SSc patients but not in healthy subjects. MCP was significantly lower in skin vessels of SSc patients than in healthy controls and was associated with the over-expression of two polymorphic variants in the MCP gene promoter, which has been related to more aggressive phenotypes in other immune-mediated diseases. Conclusions Our results firsty document the local complement activation with an abnormal expression of MCP in skin vessels of SSc patients, suggesting that a subset of SSc patients might be exposed to more severe organ complications and clinical evolution due to abnormal local complement activation.
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Affiliation(s)
- Cinzia Scambi
- Department of Medicine, University of Verona, Verona, Italy
- * E-mail:
| | - Sara Ugolini
- Department of Medicine, University of Verona, Verona, Italy
| | - T. Sakari Jokiranta
- Department of Bacteriology and Immunology, Haartman Institute and Research Programs Unit, Immunobiology, University of Helsinki, Helsinki, Finland
| | | | - Oscar Bortolami
- Research Support Unit and Biostatistics, Verona University Hospital, Verona, Italy
| | | | | | | | | | - Guido Martignoni
- Department of Pathology and Diagnostics, University of Verona, Verona, Italy
| | - Chiara Colato
- Department of Pathology and Diagnostics, University of Verona, Verona, Italy
| | - Serena Pedron
- Department of Pathology and Diagnostics, University of Verona, Verona, Italy
| | | | - Marco Sorio
- Department of Medicine, University of Verona, Verona, Italy
| | - Fabio Poli
- Department of Medicine, University of Verona, Verona, Italy
| | - Domenico Biasi
- Department of Medicine, University of Verona, Verona, Italy
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32
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Hachulla E, Clerson P, Airò P, Cuomo G, Allanore Y, Caramaschi P, Rosato E, Carreira PE, Riccieri V, Sarraco M, Denton CP, Riemekasten G, Pozzi MR, Zeni S, Mihai CM, Ullman S, Distler O, Rednic S, Smith V, Walker UA, Matucci-Cerinic M, Müller-Ladner U, Launay D. Value of systolic pulmonary arterial pressure as a prognostic factor of death in the systemic sclerosis EUSTAR population. Rheumatology (Oxford) 2015; 54:1262-9. [PMID: 25596413 PMCID: PMC4473765 DOI: 10.1093/rheumatology/keu450] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Indexed: 11/21/2022] Open
Abstract
Objective. The aim of this study was to assess the prognostic value of systolic pulmonary artery pressure (sPAP) estimated by echocardiography in the multinational European League Against Rheumatism Scleroderma Trial and Research (EUSTAR) cohort. Methods. Data for patients with echocardiography documented between 1 January 2005 and 31 December 2011 were extracted from the EUSTAR database. Stepwise forward multivariable statistical Cox pulmonary hypertension analysis was used to examine the independent effect on survival of selected variables. Results. Based on our selection criteria, 1476 patients were included in the analysis; 87% of patients were female, with a mean age of 56.3 years (s.d. 13.5) and 31% had diffuse SSc. The mean duration of follow-up was 2.0 years (s.d. 1.2, median 1.9). Taking index sPAP of <30 mmHg as reference, the hazard ratio (HR) for death was 1.67 (95% CI 0.92, 2.96) if the index sPAP was between 30 and 36 mmHg, 2.37 (95% CI 1.14, 4.93) for sPAP between 36 and 40 mmHg, 3.72 (95% CI 1.61, 8.60) for sPAP between 40 and 50 mmHg and 9.75 (95% CI 4.98, 19.09) if sPAP was >50 mmHg. In a multivariable Cox model, sPAP and the diffusing capacity for carbon monoxide (DLCO) were independently associated with the risk of death [HR 1.833 (95% CI 1.035, 3.247) and HR 0.973 (95% CI 0.955, 0.991), respectively]. sPAP was an independent risk factor for death with a HR of 3.02 (95% CI 1.91, 4.78) for sPAP ≥36 mmHg. Conclusion. An estimated sPAP >36 mmHg at baseline echocardiography was significantly and independently associated with reduced survival, regardless of the presence of pulmonary hypertension based on right heart catheterization.
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Affiliation(s)
- Eric Hachulla
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Pierre Clerson
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Paolo Airò
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Giovanna Cuomo
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Yannick Allanore
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Paola Caramaschi
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Edoardo Rosato
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Patricia E Carreira
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Valeria Riccieri
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Marta Sarraco
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Christopher P Denton
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Gabriela Riemekasten
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Maria Rosa Pozzi
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Silvana Zeni
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Carmen Marina Mihai
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Susanne Ullman
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Oliver Distler
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Simona Rednic
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Vanessa Smith
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Ulrich A Walker
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Marco Matucci-Cerinic
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - Ulf Müller-Ladner
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
| | - David Launay
- National Scleroderma Reference Centre, Department of Internal Medicine, Lille Nord University, Lille, Orgamétrie biostatistiques, Roubaix, France, UO Reumatologia e Immunologia Clinica, Spedali Civili Brescia, Dipartimento Medicina Clinica e Sperimentale F-Magrassi II Policlinico U.O., Reumatologia, Napoli, Italy, Rheumatology A dpt, Paris 5 University, Cochin Hospital, Paris, France, Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Centro per la Sclerosi Sistemica - Dipartimento di Medicina Clinica, Università La Sapienza, Policlinico Umberto I, Roma, Italy, Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, Divisione di Reumatologia, Università di Roma La Sapienza, Dipartimento di Clinica e Terapia medica applicata, Policlinico Umberto I, Roma, Ospedale Mauriziano, Centro di Reumatologia, Torino, Italy, Centre for Rheumatology, Royal Free and University College London Medical School, Royal Free Campus, London, UK, Department of Rheumatology, Charité University Hospital, German Rheumatism Research Centre, a Leibniz institute, Berlin, Germany, Dipartimento di Medicina, Ospedale San Gerardo, Monza, Dipartimento e Cattedra di Reumatologia, Università degli Studi di Milano, Istituto Ortopedico Gaetano Pini, Milano, Italy, Department of Internal Medicine and Rheumatology Clinic, Ion Cantacuzino Clinical Hospital, Bucharest, Romania, University Hospital of Copenhagen, Department of Dermatology D-40, HS-Bispebjerg Hospital, Copenhagen, Denmark, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland, Clinica Reumatologie, University of Medicine & Pharmacy, Iuliu Hatieganu Cluj, Cluj-Napoca, Romania, Ghent University Hospital, Department of Rheumatology, Gent, Belgium, Rheumatologische Universitätsklinik, Felix Platter Spital, Basel, Switzerland, University of Florence, Department of Medicine, Section of Rheumatology, Florence, Italy and Lehrstuhl für Innere Medizin mit Schwerpunkt Rheumatologie der
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Caramaschi P, Tonolli E, Biasi D, Caimmi C, Pieropan S, Dal Forno I, Scambi C, Adami S. Antinuclear autoantibody profile in systemic sclerosis patients who are negative for anticentromere and anti-topoisomerase I specificities. Joint Bone Spine 2014; 82:209-10. [PMID: 25543274 DOI: 10.1016/j.jbspin.2014.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 03/14/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Paola Caramaschi
- Rheumatology Unit, Department of Medicine, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
| | - Elisabetta Tonolli
- Microbiology and Virology, Diagnostic and Pathology Department, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Domenico Biasi
- Rheumatology Unit, Department of Medicine, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Cristian Caimmi
- Rheumatology Unit, Department of Medicine, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Sara Pieropan
- Rheumatology Unit, Department of Medicine, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Ilaria Dal Forno
- Rheumatology Unit, Department of Medicine, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Cinzia Scambi
- Rheumatology Unit, Department of Medicine, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Silvano Adami
- Rheumatology Unit, Department of Medicine, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
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Avouac J, Walker UA, Hachulla E, Riemekasten G, Cuomo G, Carreira PE, Caramaschi P, Ananieva LP, Matucci-Cerinic M, Czirjak L, Denton C, Ladner UM, Allanore Y. Joint and tendon involvement predict disease progression in systemic sclerosis: a EUSTAR prospective study. Ann Rheum Dis 2014; 75:103-9. [DOI: 10.1136/annrheumdis-2014-205295] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 08/10/2014] [Indexed: 12/20/2022]
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Ruffatti A, Salvan E, Del Ross T, Gerosa M, Andreoli L, Maina A, Alijotas-Reig J, De Carolis S, Mekinian A, Bertero MT, Canti V, Brucato A, Bremme K, Ramoni V, Mosca M, Di Poi E, Caramaschi P, Galeazzi M, Tincani A, Trespidi L, Meroni PL. Treatment strategies and pregnancy outcomes in antiphospholipid syndrome patients with thrombosis and triple antiphospholipid positivity. A European multicentre retrospective study. Thromb Haemost 2014; 112:727-35. [PMID: 25008944 DOI: 10.1160/th14-03-0191] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [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: 03/01/2014] [Accepted: 05/08/2014] [Indexed: 12/15/2022]
Abstract
Previous thrombosis, diagnosis of systemic lupus erythematosus (SLE) and triple antiphospholipid (aPL) antibody positivity have recently been found to be independent factors associated to pregnancy failure during conventional therapy in women with antiphospholipid syndrome (APS). This study aimed to assess the effect of various treatment strategies on pregnancy outcomes in women with APS and the risk factors for pregnancy failure. One hundred ninety-six pregnancies of 156 patients diagnosed with APS were analysed: 118 (60.2%) of these had previous thrombosis, 81 (41.3%) were diagnosed with SLE, and 107 (54.6%) had triple aPL positivity. One hundred seventy-five (89.3%) were treated with conventional therapies (low-dose aspirin [LDA] or prophylactic doses of heparin + LDA or therapeutic doses of heparin + LDA), while 21 (10.7%) were prescribed other treatments in addition to conventional therapy. The pregnancies were classified into seven risk profiles depending on the patients' risk factors - thrombosis, SLE, and triple aPL positivity - and their single, double or triple combinations. It was possible to find significant difference in outcomes correlated to treatments only in the thrombosis plus triple aPL positivity subset, and logistic regression analysis showed that additional treatments were the only independent factor associated to a favourable pregnancy outcome (odds ratio=9.7, 95% confidence interval=1.1-88.9, p-value<0.05). On the basis of this retrospective study, we found that APS pregnant patients with thrombosis and triple aPL positivity treated with additional therapy had a significant higher live-birth rate with respect to those receiving conventional therapy alone.
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Affiliation(s)
- Amelia Ruffatti
- Amelia Ruffatti, Reumatologia, Policlinico Universitario, Via Giustiniani, 2 - 35128 Padova, Italy, Tel.: +039 049 8212192, Fax: +039 049 8212191, E-mail:
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Lazzaroni M, Fredi M, Andreoli L, Brucato A, Caporali R, Caramaschi P, Doria A, Gerosa M, Guillevin L, Inverardi F, Lojacono A, Meroni P, Montecucco C, Mosca M, Motta M, Ramoni V, Sfriso P, Sinico R, Strigini F, Tani C, Tincani A. OP0230 Systemic Vasculitis and Pregnancy: A Multicenter Study on Maternal and Neonatal Outcome of 66 Prospectively Followed Pregnancies. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2312] [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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Koumakis E, Bouaziz M, Dieudé P, Ruiz B, Riemekasten G, Airo P, Müller-Nurasyid M, Cusi D, Matucci-Cerinic M, Melchers I, Salvi E, Strauch K, Peters A, Cuomo G, Hachulla E, Diot E, Hunzelmann N, Caramaschi P, Riccieri V, Distler JHW, Tarner I, Avouac J, Letenneur L, Amouyel P, Lambert JC, Chiocchia G, Boileau C, Allanore Y. A regulatory variant in CCR6 is associated with susceptibility to antitopoisomerase-positive systemic sclerosis. ACTA ACUST UNITED AC 2014; 65:3202-8. [PMID: 23983073 DOI: 10.1002/art.38136] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 08/13/2013] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Recognition of the well-known pleiotropism of autoimmune genes supports the concept of a shared pathogenesis across autoimmune diseases such as rheumatoid arthritis (RA) and systemic sclerosis (SSc). Studies have reproducibly demonstrated an association between susceptibility to RA and polymorphisms of the CCR6 gene, a surface marker for Th17 cells, and the causal variant was recently identified. The present study was thus undertaken to investigate whether CCR6 polymorphisms could also be associated with susceptibility to SSc. METHODS Twelve tag single-nucleotide polymorphisms (SNPs) of CCR6, including the known RA-associated SNP rs3093023, were genotyped in a total of 2,411 SSc patients and 7,084 healthy individuals from 3 European populations (France, Italy, and Germany). Meta-analyses of the data were performed to assess whether an association exists between CCR6 polymorphisms and susceptibility to SSc or its main subtypes. Direct sequencing of DNA was performed to ascertain whether the functional dinucleotide polymorphism of CCR6 previously identified in RA (CCR6DNP) was also present in SSc. RESULTS Combined analyses revealed an association between the rs10946216 SNP and SSc susceptibility (odds ratio [OR] 1.13, 95% confidence interval [95% CI] 1.05-1.21, adjusted P [P(adj)] = 0.026). The rs3093023 A allele and rs10946216 T allele were in high linkage disequilibrium, and both were found to confer disease susceptibility in the antitopoisomerase-positive subset of SSc patients (OR 1.27, 95% CI 1.13-1.42, P(adj) = 1.5 × 10(-3) and OR 1.32, 95% CI 1.17-1.48, P(adj) = 9.0 × 10(-5), respectively, relative to healthy controls). Direct sequencing of the DNA of 78 individuals supported the hypothesis that the regulatory dinucleotide CCR6DNP could be the causal variant in SSc. CONCLUSION The results of this study establish CCR6 as a new susceptibility factor for antitopoisomerase-positive SSc, as demonstrated in 3 European Caucasian populations, confirming the notion that SSc and RA could conceivably share autoimmune risk alleles. The results also suggest a potential role of the interleukin-17 pathway in SSc.
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Affiliation(s)
- Eugénie Koumakis
- INSERM, Institut Cochin, Cochin Hospital, AP-HP, INSERM U1016, Sorbonne Paris Cité, and Paris Descartes University, Paris, France
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Keck AD, Foocharoen C, Rosato E, Smith V, Allanore Y, Distler O, Stamenkovic B, Pereira Da Silva JA, Hadj Khelifa S, Denisov LN, Hachulla E, Garcia de la Pena Lefebvre P, Sibilia J, Airo P, Caramaschi P, Muller-Ladner U, Wiland P, Walker UA. Nailfold capillary abnormalities in erectile dysfunction of systemic sclerosis: a EUSTAR group analysis. Rheumatology (Oxford) 2013; 53:639-43. [DOI: 10.1093/rheumatology/ket392] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ghrénassia E, Avouac J, Khanna D, Derk CT, Distler O, Suliman YA, Airo P, Carreira PE, Foti R, Granel B, Berezne A, Cabane J, Ingegnoli F, Rosato E, Caramaschi P, Hesselstrand R, Walker UA, Alegre-Sancho JJ, Zarrouk V, Agard C, Riccieri V, Schiopu E, Gladue H, Steen VD, Allanore Y. Prevalence, correlates and outcomes of gastric antral vascular ectasia in systemic sclerosis: a EUSTAR case-control study. J Rheumatol 2013; 41:99-105. [PMID: 24293584 DOI: 10.3899/jrheum.130386] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To estimate the prevalence, determine the subgroups at risk, and the outcomes of patients with systemic sclerosis (SSc) and gastric antral vascular ectasia (GAVE). METHODS We queried the European League Against Rheumatism Scleroderma Trials and Research (EUSTAR) network for the recruitment of patients with SSc-GAVE. Each case was matched for cutaneous subset and disease duration with 2 controls with SSc recruited from the same center, evaluated at the time the index case made the diagnosis of GAVE. SSc characteristics were recorded at the time GAVE occurred and the last observation was collected to define the outcomes. RESULTS Forty-nine patients with SSc and GAVE were included (24 with diffuse cutaneous SSc) and compared to 93 controls with SSc. The prevalence of GAVE was estimated at about 1% of patients with SSc. By multivariate analysis, patients with SSc-GAVE more frequently exhibited a diminished (< 75%) DLCO value (OR 12.8; 95% CI 1.9-82.8) despite less frequent pulmonary fibrosis (OR 0.2; 95% CI 0.1-0.6). GAVE was also associated with the presence of anti-RNA-polymerase III antibodies (OR 4.6; 95% CI 1.2-21.1). SSc-GAVE was associated with anemia (82%) requiring blood transfusion (45%). Therapeutic endoscopic procedures were performed in 45% of patients with GAVE. After a median followup of 30 months (range 1-113 months), survival was similar in patients with SSc-GAVE compared to controls, but a higher number of scleroderma renal crisis cases occurred (12% vs 2%; p = 0.01). CONCLUSION GAVE is rare and associated with a vascular phenotype, including anti-RNA-polymerase III antibodies, and a high risk of renal crisis. Anemia, usually requiring blood transfusions, is a common complication.
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Affiliation(s)
- Etienne Ghrénassia
- From the Department of Rheumatology A, Paris Descartes University, Cochin Hospital, AP-HP, Paris, France; University of Michigan Scleroderma Program, Ann Arbor, Michigan, USA; Division of Rheumatology, University of Pennsylvania, Philadelphia, USA; Department of Rheumatology, University Hospital Zurich, Switzerland; Rheumatology and Clinical Immunology Unit, Spedali Civili and University of Brescia, Brescia, Italy; Rheumatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Rheumatology Unit, Azienda Ospedaliera Universitaria V. Emanuele, Ferrarotto, S. Bambino, Catania, Italy; Service de Médecine Interne, Centre Hospitalier Nord, Marseille, France; Service de Médecine Interne, University Hospital Centre (CHU) Cochin; Service de Médecine Interne, CHU Saint-Antoine, Paris, France; Division of Rheumatology, Istituto Gaetano Pini, University of Milan, Italy; Department of Clinical Medicine, Clinical Immunology Unit, Sapienza University of Rome, Rome, Italy; Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italia; Department of Rheumatology, Lund University, Lund, Sweden; Department of Rheumatology, Basel University, Basel, Switzerland; Sección de Reumatología, Hospital Dr Peset, Valencia, Spain; Médecine interne, Hôpital Beaujon, Clichy, France; Internal Medicine, Hôtel-Dieu Hospital, CHU Nantes, Nantes, France; Rheumatologic Unit, Department of Internal Medicine and Clinical Specialties, Sapienza University of Rome, Rome, Italy; and Department of Medicine, Georgetown University Medical Center, Washington DC, USA
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Meunier M, Puechal X, Hoppé E, Soubrier M, Dieudé P, Berthelot JM, Caramaschi P, Gottenberg JE, Gossec L, Morel J, Maury E, Wipff J, Kahan A, Allanore Y. Rheumatic and musculoskeletal features of Whipple disease: a report of 29 cases. J Rheumatol 2013; 40:2061-6. [PMID: 24187107 DOI: 10.3899/jrheum.130328] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Whipple disease is a rare infection caused by Tropheryma whipplei. Although patients commonly complain of osteoarticular involvement, musculoskeletal manifestations have been poorly described. We report cases of Whipple disease with rheumatic symptoms and describe their clinical presentation, modes of diagnosis, and outcomes. METHODS This retrospective multicenter study included patients with Whipple disease diagnosed and referenced between 1977 and 2011 in 10 rheumatology centers in France and Italy. RESULTS Twenty-nine patients were included. The median age was 55 years. The median time to diagnosis from first symptoms was 5 years. Polyarthritis was the most frequent presentation (20/29), and was most often chronic, intermittent (19/29), seronegative (22/23), and nonerosive (22/29). In all cases, the symptoms had led to incorrect diagnosis of inflammatory rheumatic disease and immunosuppressants, including biotherapy, were prescribed in most cases (24/29) without success. The diagnosis of Whipple disease was made by histological analysis, molecular biology tests, or both in 21%, 36%, and 43% of the cases, respectively. Duodenal biopsies were performed in most cases (86%). Synovial biopsies were performed in 18% of cases, but all contributed to diagnosis. The clinical outcomes after antibiotic therapy were good for all patients. CONCLUSION Polyarthritis is the main feature observed in cases of Whipple disease; it is seronegative and associated with general and gastrointestinal symptoms. The molecular analysis of duodenal tissue and/or other tissues remains the method of choice to confirm the diagnosis. Reducing the time to diagnosis is important because severe late systemic and fatal forms of the disease may occur.
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Affiliation(s)
- Marine Meunier
- From the Paris Descartes University, Rheumatology A Department and Rheumatology B Department, Cochin Hospital, AP-HP, Paris; Rheumatology Department, Le Mans Hospital; Rheumatology Department, CHU Angers; Rheumatology Department, CHU Clermont-Ferrand; Rheumatology Department, Bichat Hospital, AP-HP, Paris; Rheumatology Department, CHU Nantes; Unità di Reumatologia, Azienda Ospedaliera Universitaria Integrata, Verona, Italy; Rheumatology Department, CHU Strasbourg; and the Rheumatology Department, Teaching Hospital of Lapeyronie and University of Montpellier, France
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Caramaschi P, Biasi D, Caimmi C, Barausse G, Gatti D, Ferrari M, Pieropan S, Sabbagh D, Adami S. Relationship between body composition and both cardiovascular risk factors and lung function in systemic sclerosis. Clin Rheumatol 2013; 33:77-82. [PMID: 24052413 DOI: 10.1007/s10067-013-2388-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 09/03/2013] [Accepted: 09/03/2013] [Indexed: 12/14/2022]
Abstract
The aims of this study were to evaluate body composition in systemic sclerosis (SSc) and to assess its association with the traditional risk factors for atherosclerosis and parameters of lung function. Eighty-six patients affected by SSc (13 men and 73 women, mean age 58.5 years, mean disease duration 10.7 years, 31 with diffuse form and 55 with limited pattern) underwent evaluation of body composition using a dual-energy X-ray (DXA) fan beam densitometer (GE Lunar iDXA) in order to assess total and regional body fat mass and fat-free mass. Clinical features, pulmonary function parameters, and the concomitant presence of the traditional cardiovascular risk factors were recorded. Android fat resulted to be higher in SSc patients with coexistence of hypercholesterolemia (P = 0.021), hypertension (P = 0.028), and overweight/obesity (P < 0.001) and positively correlated with body mass index (P < 0.001). Forced vital capacity (FVC) was inversely correlated with android fat (P = 0.034) and with the android fat/gynoid fat ratio (P = 0.013) and positively correlated with android lean (P = 0.041); the correlations were improved when FVC data were adjusted for sex, age, disease duration, and smoking habits (P = 0.010 for android fat, P = 0.010 for android fat/gynoid fat ratio, P = 0.011 for android lean). In this study, we showed that visceral abdominal fat, measured by DXA, is correlated with the main cardiovascular risk factors and lung volumes in SSc patients. Longitudinal studies are needed to evaluate if decrease of abdominal fat would improve lung function.
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Ghrenassia E, Avouac J, Derk C, Airo P, Khanna D, Berezne A, Tiev K, Ingegnoli F, Rosato E, Caramaschi P, Hesselstrand R, Riccieri V, Bae S, Steen V, Allanore Y. FRI0242 Watermelon stomach in systemic sclerosis: A EUSTAR case-control study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2699] [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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Ravagnani V, Pieropan S, Barausse G, Sidoti G, Boner A, Volpe A, Caramaschi P, Biasi D, Adami S. THU0339 Power doppler ultrasonograpic findings in healthy pediatric enthesises. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2304] [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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Manetti M, Allanore Y, Saad M, Fatini C, Cohignac V, Guiducci S, Romano E, Airό P, Caramaschi P, Riccieri V, della Rossa A, Caporali R, Cuomo G, Dieudé P, Chiocchia G, Martinez M, Ibba-Manneschi L, Matucci-Cerinic M. AB0242 Evidence for caveolin-1 (CAV1) as a new susceptibility gene regulating tissue fibrosis in systemic sclerosis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.242] [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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Koumakis E, Giraud M, Dieudé P, Cohignac V, Cuomo G, Airò P, Hachulla E, Matucci-Cerinic M, Diot E, Caramaschi P, Mouthon L, Riccieri V, Cracowski JL, Tiev KP, Francès C, Amoura Z, Sibilia J, Cosnes A, Carpentier P, Valentini G, Manetti M, Guiducci S, Meyer O, Kahan A, Boileau C, Chiocchia G, Allanore Y. Brief report: candidate gene study in systemic sclerosis identifies a rare and functional variant of the TNFAIP3 locus as a risk factor for polyautoimmunity. ACTA ACUST UNITED AC 2012; 64:2746-52. [PMID: 22488580 DOI: 10.1002/art.34490] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) share some pathophysiologic bases as evidenced by individual and familial polyautoimmunity and common susceptibility genetic factors. With regard to the latter, there has been a recent shift from the "common variant" to the "rare variant" paradigm, since rare variants of TNFAIP3 and TREX1 with large effect sizes have recently been discovered in SLE. The present study was undertaken to investigate whether rare variants of TNFAIP3 and TREX1 are also associated with SSc. METHODS TREX1 single-nucleotide polymorphisms (SNPs) rs3135946, rs7626978, rs3135943, and rs11797 and TNFAIP3 SNPs rs9494883, rs72063345, rs5029939, rs2230926, rs117480515, and rs7749323 were genotyped in a discovery set (985 SSc patients and 1,011 controls), and replication analysis of the most relevant results was performed in a second set (622 SSc patients and 493 controls). RESULTS No association between TREX1 variants and SSc was observed. For TNFAIP3, we first demonstrated that a low-frequency variant, rs117480515, tagged the recently identified TT>A SLE dinucleotide. In the discovery sample, we observed that all tested TNFAIP3 variants were in linkage disequilibrium and were associated with SSc and various SSc subsets, including the polyautoimmune phenotype. We subsequently genotyped rs117480515 in the replication sample and found it to be associated solely with the SSc polyautoimmune subset (odds ratio 3.51 [95% confidence interval 2.28-5.41], P = 8.58 × 10(-9) ) in the combined populations. Genotype-messenger RNA (mRNA) expression correlation analysis revealed that the TNFAIP3 rs117480515 risk allele was associated with decreased mRNA expression. CONCLUSION The present findings establish the TNFAIP3 locus as a susceptibility factor for the subset of SSc with a polyautoimmune phenotype. Our results support the implication of rare/low-frequency functional variants and the critical role of A20 in autoimmunity.
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Affiliation(s)
- Eugénie Koumakis
- Paris Descartes University, INSERM U1016, Institut Cochin, and Cochin Hospital, AP-HP, Paris, France
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Caramaschi P, Biasi D. Unusual bridge ossification of pubic symphysis in diffuse idiopathic skeletal hyperostosis. Rheumatol Int 2012; 32:3701. [DOI: 10.1007/s00296-011-2215-1] [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] [Received: 07/04/2011] [Accepted: 10/22/2011] [Indexed: 10/15/2022]
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Koumakis E, Wipff J, Dieudé P, Ruiz B, Bouaziz M, Revillod L, Guedj M, Distler JHW, Matucci-Cerinic M, Humbert M, Riemekasten G, Airo P, Melchers I, Hachulla E, Cusi D, Wichmann HE, Hunzelmann N, Tiev K, Caramaschi P, Diot E, Kowal-Bielecka O, Cuomo G, Walker U, Czirják L, Damjanov N, Lupoli S, Conti C, Müller-Nurasyid M, Müller-Ladner U, Riccieri V, Cracowski JL, Cozzi F, Bournia VK, Vlachoyiannopoulos P, Chiocchia G, Boileau C, Allanore Y. TGFβ receptor gene variants in systemic sclerosis-related pulmonary arterial hypertension: results from a multicentre EUSTAR study of European Caucasian patients. Ann Rheum Dis 2012; 71:1900-3. [DOI: 10.1136/annrheumdis-2012-201755] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
IntroductionSystemic sclerosis (SSc)-related pulmonary arterial hypertension (PAH) has emerged as a major mortality prognostic factor. Mutations of transforming growth factor beta (TGFβ) receptor genes strongly contribute to idiopathic and
familial PAH.ObjectiveTo explore the genetic bases of SSc–PAH, we combined direct sequencing and genotyping of candidate genes encoding TGFβ receptor family members.Materials and methodsTGFβ receptor genes, BMPR2, ALK1, TGFR2 and ENG, were sequenced in 10 SSc–PAH patients, nine SSc and seven controls. In addition, 22 single-nucleotide polymorphisms (SNP) of these four candidate genes were tested for association in a first set of 824 French Caucasian SSc patients (including 54 SSc–PAH) and 939 controls. The replication set consisted of 1516 European SSc (including 219 SSc–PAH) and 3129 controls from the European League Against Rheumatism Scleroderma Trials and Research group network.ResultsNo mutation was identified by direct sequencing. However, two repertoried SNP, ENG rs35400405 and ALK1 rs2277382, were found in SSc–PAH patients only. The genotyping of 22 SNP including the latter showed that only rs2277382 was associated with SSc–PAH (p=0.0066, OR 2.13, 95% CI 1.24 to 3.65). Nevertheless, this was not replicated with the following result in combined analysis: p=0.123, OR 0.79, 95% CI 0.59 to 1.07.ConclusionsThis study demonstrates the lack of association between these TGFβ receptor gene polymorphisms and SSc–PAH using both sequencing and genotyping methods.
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Caramaschi P, Biasi D, Caimmi C, Barausse G, Sabbagh D, Tinazzi I, LA Verde V, Tonetta S, Adami S. Digital amputation in systemic sclerosis: prevalence and clinical associations. A retrospective longitudinal study. J Rheumatol 2012. [PMID: 22707610 DOI: 10.3899/jrheum.111506.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the prevalence of digital necrosis requiring surgical amputation in a single-center group of patients with systemic sclerosis (SSc) and to compare the characteristics of patients with and those without this severe complication. METHODS We reviewed the medical records of 188 patients with SSc [162 women, 26 men, mean age 59.2 yrs, mean disease duration 8.0 yrs, mean time from onset of Raynaud's phenomenon (RP) 11.7 yrs, median followup duration 92 mo] enrolled in the Rheumatology Unit since 2004. Demographic and clinical features were collected, as well as the presence of the typical risk factors for atherosclerosis. RESULTS Nine patients (4.8%) underwent partial or total surgical digital amputation because of necrotic process; all these patients except 1 had a long history of multiple and persisting digital ulcers. All 9 patients had concomitant large-vessel involvement. Comparison of cases with and without digital amputation showed that this complication was associated with older age, long history of RP, long disease duration, presence of anticentromere antibody, and coexistence of peripheral artery disease and hypercholesterolemia. Discussion. We noted that 4.8% of patients with SSc underwent digital amputation. Our retrospective analysis suggests that peripheral artery disease is strongly associated with digital amputation. The preventive strategy for digital ulcers and amputation associated with SSc should include an extensive diagnostic and preventive investigation for peripheral atherosclerosis.
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Affiliation(s)
- Paola Caramaschi
- Unità di Reumatologia, Policlinico G.B. Rossi, Piazzale Scuro, 37134 Verona, Italy..
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Taraborelli M, Ramoni V, Brucato A, Airò P, Bajocchi G, Bellisai F, Biasi D, Blagojevic J, Canti V, Caporali R, Caramaschi P, Chiarolanza I, Codullo V, Cozzi F, Cuomo G, Cutolo M, De Santis M, De Vita S, Di Poi E, Doria A, Faggioli P, Favaro M, Ferraccioli G, Ferri C, Foti R, Gerosa A, Gerosa M, Giacuzzo S, Giani L, Giuggioli D, Imazio M, Iudici M, Iuliano A, Leonardi R, Limonta M, Lojacono A, Lubatti C, Matucci-Cerinic M, Mazzone A, Meroni M, Meroni PL, Mosca M, Motta M, Muscarà M, Nava S, Padovan M, Pagani G, Paolazzi G, Peccatori S, Ravagnani V, Riccieri V, Rosato E, Rovere-Querini P, Salsano F, Santaniello A, Scorza R, Tani C, Valentini G, Valesini G, Vanoli M, Vigone B, Zeni S, Tincani A. Brief Report: Successful pregnancies but a higher risk of preterm births in patients with systemic sclerosis: An Italian multicenter study. ACTA ACUST UNITED AC 2012; 64:1970-7. [DOI: 10.1002/art.34350] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Bellavite P, Guarini P, Biasi D, Carletto A, Trevisan MT, Caramaschi P, Bambara LM, Corrocher R. Correlations between the intensity of fMLP-dependent respiratory burst and cellular fatty acid composition in human neutrophils. Br J Haematol 2012. [DOI: 10.1111/j.1365-2141.1995.tb08948.x] [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: 11/29/2022]
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