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Mathew AJ, Lund ML, Pedersen MP, Rasmussen SH, Glintborg B, Loft AG, Nissen MJ, Möller B, Rodrigues AM, Santos FP, Rotar Z, Tomšič M, Relas H, Peltomaa R, Gudbjornsson B, Löve TJ, Kocaer SB, Koken Avsar A, Midtbøll Ørnbjerg L, Østergaard M. Enthesitis in a European registry-based cohort of patients with psoriatic arthritis treated with tumour necrosis factor inhibitors: clinical burden, patient-reported outcomes, and treatment response. Scand J Rheumatol 2024:1-11. [PMID: 38771017 DOI: 10.1080/03009742.2024.2336743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/27/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE To explore the registration of enthesitis among biologic-naïve patients with psoriatic arthritis (PsA) initiating tumour necrosis factor inhibitor (TNFi) treatment across 12 European registries, compare the disease burden and patient-reported outcomes (PROs) between patients with and without enthesitis, and assess the enthesitis treatment response. METHOD Demographics, clinical characteristics, and PROs at first TNFi (TNFi-1) initiation (baseline) were assessed in patients with PsA, diagnosed by a rheumatologist, with versus without assessment of entheses and between those with versus without enthesitis. Enthesitis scores and resolution frequency were identified at follow-up. RESULTS Of 10 547 patients in the European Spondyloarthritis (EuroSpA) Research Collaboration Network initiating TNFi, 1357 underwent evaluation for enthesitis. Eight registries included a validated scoring system for enthesitis. At baseline, 874 patients underwent entheses assessment [Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) 485 patients, Spondyloarthritis Research Consortium of Canada (SPARCC) 389 patients]. Enthesitis was detected by MASES in 170/485 (35%, mean score ± sd 3.1 ± 2.4) and by SPARCC in 236/389 (61%, 4 ± 3.4). Achilles enthesitis was most frequent, by both MASES (unilateral/bilateral 28%/9%) and SPARCC (48%/18%). MASES/SPARCC baseline and follow-up scores for TNFi-1 were available for 100/105 patients. Of these, 63 patients (63%) (MASES) and 46 (43.8%) (SPARCC) achieved resolution of enthesitis. The site-specific enthesitis resolution was overall lower at SPARCC sites (peripheral; 63-80%) than at MASES sites (mainly axial; 82-100%) following TNFi-1. Disease activity and PROs were worse in patients with versus without enthesitis. CONCLUSION Entheseal assessments are only registered in a minority of patients with PsA in routine care. When assessed, enthesitis was common, and a substantial proportion demonstrated resolution following treatment with TNFi-1.
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Affiliation(s)
- A J Mathew
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics Rigshospitalet, Glostrup, Denmark
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - M L Lund
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics Rigshospitalet, Glostrup, Denmark
- The DANBIO Registry, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M P Pedersen
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics Rigshospitalet, Glostrup, Denmark
| | - S H Rasmussen
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics Rigshospitalet, Glostrup, Denmark
| | - B Glintborg
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics Rigshospitalet, Glostrup, Denmark
- The DANBIO Registry, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - A G Loft
- The DANBIO Registry, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - M J Nissen
- Department of Rheumatology, Geneva University Hospital, Geneva, Switzerland
| | - B Möller
- Department of Rheumatology and Immunology, Inselspital - University Hospital Bern, University of Bern, Bern, Switzerland
| | - A M Rodrigues
- Reuma.pt, Sociedade Portuguesa de Reumatologia, Lisbon, Portugal
- EpiDoC Unit, CEDOC, Nova Medical School, Lisbon, Portugal
- Rheumatology Unit, Hospital dos Lusíadas, Lisbon, Portugal
| | - F P Santos
- Reuma.pt, Sociedade Portuguesa de Reumatologia, Lisbon, Portugal
- Rheumatology Unit, Hospital dos Lusíadas, Lisbon, Portugal
- Rheumatic Diseases Lab, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Z Rotar
- biorx.si and Department of Rheumatology, University Medical Centre Ljubljana, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - M Tomšič
- biorx.si and Department of Rheumatology, University Medical Centre Ljubljana, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - H Relas
- Inflammation Center, Department of Rheumatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - R Peltomaa
- Inflammation Center, Department of Rheumatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - B Gudbjornsson
- Centre for Rheumatology Research (ICEBIO), University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - T J Löve
- Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - S B Kocaer
- Faculty of Medicine, and Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
| | - A Koken Avsar
- Department of Rheumatology, Kocaeli Public Hospital, Kocaeli, Turkey
| | - L Midtbøll Ørnbjerg
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics Rigshospitalet, Glostrup, Denmark
| | - M Østergaard
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics Rigshospitalet, Glostrup, Denmark
- The DANBIO Registry, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Storch P, Burow P, Möller B, Kraya T, Heintz S, Politz N, Naegel S. Pooled retrospective analysis of 70 mg erenumab in episodic and chronic migraine: a two tertiary headache centers experience during clinical practice. Acta Neurol Belg 2021; 122:931-937. [PMID: 34406609 PMCID: PMC9300569 DOI: 10.1007/s13760-021-01770-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/29/2021] [Indexed: 12/27/2022]
Abstract
Erenumab is a monoclonal antibody, targeted against the calcitonin gene-related peptide (CGRP) receptor. Clinical studies have demonstrated prophylactic efficacy in both episodic (EM) and chronic migraine (CM). The aim of the present study is to evaluate the efficacy of treatment in tertiary headache centers under real-life conditions. In a retrospective analysis, the period of 3 months before and after initiation of erenumab therapy was compared. Relevant parameters (headache days, headache intensity, headache duration, acute medication, previous prophylaxis treatments) were collected from medical charts of all migraine patients (N = 82) who started treatment with erenumab between November 1st 2018 and May 1st 2019 at two tertiary headache centers in Germany. The sample included 68 female (82.9%) and 14 male patients aged between 22 and 78 years (mean 51.1 years, SD 10.5 years). Of these patients, 57.3% met the criteria for CM and 56.9% overused acute medication. Under therapy with erenumab, a significant reduction of headache days was observed from the first month on. The effect was most pronounced in the third month with a decrease in monthly headache days from 16.6 to 11.6 days (p < 0.001). There was also a significant reduction in reported headache intensity (p = 0.004) and average duration of headache attacks (p = 0.016). The 50% responder rate in patients with CM was lower in the first month compared to EM but then increased similarly to EM. Patients with medication overuse (MO) also responded to the therapy. There was a reduction in medication overuse from 57% at baseline to 29% after therapy (p = 0.011). Overall, a positive result of treatment with erenumab can be shown in a highly selected sample with severely affected migraine patients and a refractory course prior to treatment. This re-confirms the clinical trial data also for this highly selected group.
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Krege S, Hess J, Güldenring A, Richter E, Lederbogen S, Mengel M, Seppel T, Hetkamp M, Küntscher M, Sollenböhmer K, Henkel UM, Möller B, Romer G, Löwenberg H, Riechardt S. Symposium Genderdysphorie. Urologe A 2020; 59:1320-1330. [DOI: 10.1007/s00120-020-01336-0] [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: 10/23/2022]
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Aeberli D, Fankhauser N, Zebaze R, Bonel H, Möller B, Villiger PM. Effect of rheumatoid arthritis and age on metacarpal bone shaft geometry and density: A longitudinal pQCT study in postmenopausal women. Semin Arthritis Rheum 2019; 50:220-227. [PMID: 31466837 DOI: 10.1016/j.semarthrit.2019.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/27/2019] [Accepted: 08/05/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study aimed to elucidate the effects of changes in the geometry and density of the metacarpal bone of patients with rheumatoid arthritis (RA). METHODS This prospective study included consecutive postmenopausal RA patients who met the American College of Rheumatology Criteria and healthy controls (HC). Peripheral quantitative computed tomography scans at 50% of the total metacarpal shaft (third metacarpal bone) were obtained at baseline and follow-ups. Use of bisphosphonates (BP), glucocorticoids (GC), biologics, and disease-modifying anti-rheumatic drugs (DMARD) was monitored (baseline to follow-up). Total cross-sectional area (CSA), cortical-transitional zone and compact zone CSA, cortical volumetric bone mineral density, and compact cortex porosity were measured. A linear mixed-effects model was used to determine significant differences in the rate of change in the RA and control groups and in RA patient subgroups. RESULTS Thirty-nine RA patients and 42 consecutive postmenopausal HC were followed for 63 months. RA and HC depicted a time-dependent increase of medullary CSA (+0.41 mm2/year, P < 0.0001), while total CSA remained stable (P = 0.2). RA status was associated with a loss of cortical bone mineral density (interaction: -3.08 mg/mm3; P = 0.014). In RA subgroup analysis, GC use ≥5 mg/day was positively correlated with a fourfold increase of medullary CSA (0.67 mm2/year P = 0.009), which resulted in a three- to fourfold loss of cortical density (-6.6 mg/mm3/year; P = 0.002) and cortical CSA (-0.57 mm2/year, P = 0.004). Patients with high disease activity and high GC dose at baseline demonstrated an increase in the total CSA (0.29 mm2/y; P = 0.049) and a loss of cortical BMD (-5.73 mg/mm3/y; P = 0.05) despite good clinical response. CONCLUSION Increase in medullary metacarpal CSA and thinning of the cortical CSA are physiological and time dependent. RA status is associated with loss in cortical density. Even upon biological therapy, low glucocorticoid dose affects metacarpal bone shaft geometry and density over time.
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Affiliation(s)
- D Aeberli
- Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, 3010 Bern Switzerland.
| | - N Fankhauser
- Clinical Trial Unit (CTU), University of Bern, 3012 Bern, Switzerland
| | - R Zebaze
- Department of Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia; Department of Medicine, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia
| | - H Bonel
- Department of Radiology, University Hospital and University of Bern, Switzerland
| | - B Möller
- Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, 3010 Bern Switzerland
| | - P M Villiger
- Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, 3010 Bern Switzerland
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Naujokat H, Möller B, Terheyden H, Birkenfeld F, Caliebe D, Krause MF, Fischer-Brandies H, Wiltfang J. Tongue reduction in Beckwith-Wiedemann syndrome: outcome and treatment algorithm. Int J Oral Maxillofac Surg 2018; 48:9-16. [PMID: 30057238 DOI: 10.1016/j.ijom.2018.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/30/2018] [Accepted: 07/11/2018] [Indexed: 11/27/2022]
Abstract
Beckwith-Wiedemann syndrome is a rare congenital overgrowth disorder with macroglossia being one of the cardinal symptoms. In pronounced cases, macroglossia can lead to airway obstruction, musculoskeletal alterations and functional deficits. Surgical tongue reduction is performed at varying ages and with different techniques. This study evaluated perioperative complications, as well as long-term aesthetic and functional outcomes, in a large cohort. A total of 68 patients, treated either surgically or conservatively, were included. Depending on the severity of macroglossia, patients were divided into three groups to determine the treatment algorithm. Complications after surgical tongue reduction were prolonged intubation and revision due to dehiscence or haematoma. In the long term, no patient suffered from impaired sense of taste or paresthesia, although the shape of the tongue was disproportional in 85%. With the present treatment algorithm, operative tongue reduction exerts a positive influence on skeletal, dentoalveolar and functional development with sufficient long-term outcome and high grade of satisfaction of the patients. Supportive therapy in an interdisciplinary centre is of fundamental importance for both surgical and conservative treatment.
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Affiliation(s)
- H Naujokat
- Departments of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
| | - B Möller
- Departments of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - H Terheyden
- Departments of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - F Birkenfeld
- Departments of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - D Caliebe
- Departments of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - M F Krause
- Departments of Pediatrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - H Fischer-Brandies
- Departments of Orthodontics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - J Wiltfang
- Departments of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Kampen WU, Czech N, von Forstner C, Henze E, Möller B, Bartsch MS. Radiosynoviorthesis of the temporomandibular joint – initial clinical application. Nuklearmedizin 2018. [DOI: 10.1055/s-0037-1621116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
BACKGROUND Immunomodulatory long-term treatment has also become the standard treatment for spondyloarthritides (SpA), including psoriatic arthritis (PsA); however, uncertainty exists about dose reduction or termination of treatment after remission or low disease activity. OBJECTIVE When is it possible to reduce medication or terminate treatment for SpA? MATERIAL AND METHODS An extensive non-systematic literature search was performed focusing on practice guidelines, systematic meta-analyses and clinical trials on medicinal long-term treatment and voluntary medication reduction in axial and peripheral SpA, including PsA. RESULTS The chances of drug-free remission after treatment with biologics for axial SpA and in PsA are low; however, in remission or a state of low disease activity reduction of the cumulative dosage of biologics can be successful in 53-100% of cases without a significant increase in disease activity. The current state and duration of remission, with or without comedication with nonsteroidal anti-inflammatory drugs (NSAID), extra-articular disease manifestations and the results of previous treatment attempts have to be carefully taken into consideration before elective dose reduction. CONCLUSION Reduction of long-term treatment is an individualized decision made jointly by patients and physicians. The risk of flares and especially of extra-articular disease manifestations needs to be weighed against the possible advantages of reduced medication. Maintainenance of mediction-free disease remission is too rare in SpA or PsA patients carefully selected for biologics treatment, to allow a later voluntary termination of therapy, without at least a prior cautious attempt at dose reduction.
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Affiliation(s)
| | - B Möller
- Immunologie und Allergologie, Inselspital - Universitätsspital Bern, Universitätsklinik für Rheumatologie, Freiburgstr. 10, 3010, Bern, Schweiz.
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Alpizar-Rodriguez D, Brulhart L, Müller R, Möller B, Dudler J, Ciurea A, Walker U, Von Mühlenen I, Kyburz D, Zufferey P, Mahler M, Bas S, Gascon D, Lamacchia C, Roux-Lombard P, Lauper K, Nissen M, Courvoisier D, Gabay C, Finckh A. FRI0071 Predictors for The Development of anti-Citrullinated Protein Antibodies in Individuals Genetically at Risk for Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Möller B, Leichtle A, Meyer P, Fiedler M, Finckh A, Kyburz D, Gabay C, Villiger P. THU0088 Iron Deficiency and Low Erythropoietin Concentrations Are Frequent Anemia Causing Factors in Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2226] [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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Alpizar-Rodriguez D, Müller R, Möller B, Dudler J, Ciurea A, Von Mühlenen I, Kyburz D, Zufferey P, Bas S, Gascon D, Lamacchia C, Roux-Lombard P, Lauper K, Courvoisier D, Gabay C, Finckh A. AB0178 Menopause Is A Predictor for The Development of Anti-Citrullinated Protein Antibodies in Women at Risk for Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2679] [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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Möller B, Zufferey P, Brulhart L, Tamborrini G, Nydegger A, Dan D, Grobety V, Nissen M, Staerkle A, Finckh A, Aubry-Rozier B, Ziswiler HR, Andor M, Atkinson A, Scherer A. FRI0522 Ultrasound-Detected Synovitis May Predict Radiographic Damage Progression in Rheumatoid Arthritis over The Next Five Years – A Prospective Cohort Study Nested in The Swiss Quality Management Program (SCQM). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2245] [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: 11/04/2022]
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Posch S, Möller B. Design and implementation of the Alida framework to ease the development of image analysis algorithms. Pattern Recognit Image Anal 2016. [DOI: 10.1134/s105466181601020x] [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] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Lüttgenau J, Möller B, Kradolfer D, Wellnitz O, Bruckmaier RM, Miyamoto A, Ulbrich SE, Bollwein H. Lipopolysaccharide enhances apoptosis of corpus luteum in isolated perfused bovine ovaries in vitro. Reproduction 2016; 151:17-28. [DOI: 10.1530/rep-15-0281] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 10/19/2015] [Indexed: 01/04/2023]
Abstract
Lipopolysaccharide (LPS), the endotoxin of Gram-negative bacteria, has detrimental effects on the structure and function of bovine corpus luteum (CL)in vivo. The objective was to investigate whether these effects were mediated directly by LPS orviaLPS-induced release of PGF2α. Bovine ovaries with a mid-cycle CL were collected immediately after slaughter and isolated perfused for 240 min. After 60 min of equilibration, LPS (0.5 μg/ml) was added to the medium of five ovaries, whereas an additional six ovaries were not treated with LPS (control). After 210 min of perfusion, all ovaries were treated with 500 iu of hCG. In the effluent perfusate, concentrations of progesterone (P4) and PGF2αwere measured every 10 and 30 min, respectively. Punch biopsies of the CL were collected every 60 min and used for RT-qPCR to evaluate mRNA expression of receptors for LPS (TLR2,-4) and LH (LHCGR); the cytokineTNFA; steroidogenic (STAR,HSD3B), angiogenic (VEGFA121,FGF2), and vasoactive (EDN1) factors; and factors of prostaglandin synthesis (PGES,PGFS,PTGFR) and apoptosis (CASP3,-8,-9). Treatment with LPS abolished the hCG-induced increase in P4(P≤0.05); however, there was a tendency (P=0.10) for increased release of PGF2αat 70 min after LPS challenge. Furthermore, mRNA abundance ofTLR2,TNFA,CASP3,CASP8,PGES,PGFS, andVEGFA121increased (P≤0.05) after LPS treatment, whereas all other factors remained unchanged (P>0.05). In conclusion, reduced P4responsiveness to hCG in LPS-treated ovariesin vitrowas not due to reduced steroidogenesis, but was attributed to enhanced apoptosis. However, an impact of luteal PGF2αcould not be excluded.
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Mattsson M, Boström C, Mihai C, Stöcker J, Geyh S, Stummvoll G, Gard G, Möller B, Hesselstrand R, Sandqvist G, Draghicescu O, Gherghe AM, Voicu M, Distler O, Smolen JS, Stamm TA. Personal factors in systemic sclerosis and their coverage by patient-reported outcome measures. A multicentre European qualitative study and literature review. Eur J Phys Rehabil Med 2015; 51:405-421. [PMID: 25573599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Systemic sclerosis (SSc) is an autoimmune disease where thickening of the skin can lead to reduced body function and limitations in activities. Severe forms can also affect and seriously damage inner organs. Patient-centred rehabilitation emphasises considerations of patients' background, experience and behavior which highlights the need to know if patient-reported outcome measures (PROMs) include such personal factors. AIM To identify and describe personal factors in the experiences of functioning and health of persons with SSc and to examine if and to what extent PROMs in SSc research cover these factors. DESIGN Data from a qualitative study with focus group interviews were analysed. PROMs in SSc research were identified in a literature review between 2008-2013. SETTING Participants were recruited from outpatient clinics at rheumatology department. POPULATION Sixty-three patients with SSc from four European countries participated. METHODS Data from interviews were analysed using a structure of personal factors developed by Geyh et al. Identified PROMs were analysed and linked to main concepts, related to the personal factors, found in the interview data. RESULTS Nineteen main concepts were related to the area "patterns of experience and behaviour" in the personal factor structure, 16 to "thoughts and beliefs", nine to "feelings", one to "motives" and one to "personal history and biography", respectively. Among the 35 PROMs identified, 15 did not cover any of the identified concepts. Concepts within the area "feelings" were mostly covered by the PROMs. Five of the PROMs covered "patterns of experience and behaviour", while "motives" and "personal history and biography" were not covered at all. Four of the identified PROMs covered concepts within the areas "feelings", "thoughts and beliefs" and "patterns of experience and behaviour" in the same instrument. The Illness Cognition Questionnaire and Illness Behaviour Questionnaire were such PROMs. CONCLUSION Patterns of experience and behaviour had the highest number of concepts related to personal factors, but few of the PROMs in SSc research covered these factors. Only a few PROMs covered several personal factors areas in the same instrument. CLINICAL REHABILITATION IMPACT The results would be of value when developing core sets for outcome measurements in SSc.
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Affiliation(s)
- M Mattsson
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden -
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Alpizar-Rodriguez D, Mueller R, Möller B, Dudler J, Ciurea A, Zufferey P, Kyburz D, Walker U, Von Mühlenen I, Cornelis F, Bas S, Roux-Lombard P, Gabay C, Finckh A. AB0251 Female Reproductive Factors and the Development of Anti-Citrullinated Protein Antibodies in Women at Risk of Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3058] [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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Möller B, Florentinus S, Ganz F, Li Y, Kupper H, Finckh A. FRI0022 Anemia is an Independent Predictor of Radiographic Damage Progression in Anti-TNF-Treated Rheumatoid Arthritis Patients from Two Large Phase III Trials. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1271] [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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Mueller R, Gengenbacher M, Richter S, Dudler J, Möller B, von Kempis J. FRI0181 Change from SC to IV Abatacept and Back in Patients with Rheumatoid Arthritis as Simulation of a Vacation: A Prospective Phase IV, Open Label Trial (A-Break). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3388] [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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Stekhoven D, Scherer A, Villiger P, Möller B. SAT0386 Data-Driven Cluster Analysis of Joint Swelling and Tenderness in A Large Psoriatic Arthritis Cohort – Comparison with CASPAR Classification, Moll & Wright Subtypes, and Clinical Response to TNF Blockade. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4047] [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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Finckh A, Debost-Legrand A, Müller R, Möller B, Dudler J, Ciurea A, Walker U, Zufferey P, Kyburz D, Bas S, Dubost JJ, Crevaux I, Von Mühlenen I, Soubrier M, Cornelis F, Gabay C, Migliorini P. THU0238 Risk Factors for the Development of Anti-Citrullinated Protein Antibodies in Individuals Genetically at Risk for RA. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5178] [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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Zufferey P, Möller B, Brulhart L, Tamborrini G, Scherer A, Ziswiler H. OP0275 Persistence of ultrasound synovitis in the patients fullfiling the DAS and/or the new ACR/EULAR RA remission definitions: Results of the sonar score applied to the patients of the SCQM cohort. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1958] [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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Södergren A, Karp K, Smedby T, Möller B, Rantapää-Dahlqvist S, Wållberg-Jonsson S. SAT0086 Extent of Atherosclerosis is Associated with Biomarkers for Unstable Plaques: A Prospective Study Over Five Years in Rheumatoid Arthritis Patients and Matched Controls. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1812] [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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Möller B, Scherer A, Villiger PM, Finckh A. THU0129 Anemia Adds Information to Predict Radiographic Progression of Erosions on All Levels Levels of Clinically Assessed Disease Activity. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.657] [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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23
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Södergren A, Karp K, Boman K, Eriksson C, Lundström E, Smedby T, Möller B, Rantapää-Dahlqvist S, Wållberg-Jonsson S. FRI0134 Progression of subclinical atherosclerosis over five years in patients with early rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2591] [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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Finckh A, Müller R, Möller B, Dudler J, Kyburz D, Walker U, Von Muehlenen I, Bas S, Gabay C, Dietrich T, de Pablo P. SAT0083 Tooth loss is associated with swollen joints in a cohort of healthy individuals at increased risk of developing rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3030] [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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Södergren A, Ruge T, Karp K, Smedby T, Möller B, Rantapää-Dahlqvist S, Wållberg-Jonsson S. SAT0087 Is the Extent of Atherosclerosis in Patients with Rheumatoid Arthritis After Five Years of Follow-Up Associated with Markers of Inflammation? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1813] [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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Ernst JC, Beierlein V, Romer G, Möller B, Koch U, Bergelt C. [Parents with cancer and their minor children--a nationwide survey of outpatient psychosocial cancer counselling service regarding needs and its utilisation]. Gesundheitswesen 2012; 74:742-6. [PMID: 23175124 DOI: 10.1055/s-0032-1329953] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Children of cancer patients have an increased risk for developing emotional problems. While psychosocial cancer counselling services are available all over the country, it is unclear if parents seek for help and if specific approaches for families are offered. METHODS A survey was made of outpatient cancer counselling services in Germany (n=228). The response rate was 56%. Descriptive and content analyses of the data have been used. RESULTS Providers estimate that 55% of their patients are between 18 and 55 years with 18% of them having minor children. However, only 53% do regularly ask their patients if they have minor children. Family- or child-settings are not provided regularly. Over 60% of providers would welcome special courses on this subject. CONCLUSION Although psychosocial care of minor children is mentioned in outpatient psychosocial cancer counselling guidelines, children are not included regularly. A stronger emphasis on this topic in further education has to be made.
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Affiliation(s)
- J C Ernst
- Zentrum für Psychosoziale Medizin, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf.
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Südmeyer M, Volkmann J, Wojtecki L, Deuschl G, Schnitzler A, Möller B. [Deep brain stimulation - expectations and doubts. A nationwide questionnaire study of patients with Parkinson's disease and their family members]. Nervenarzt 2012; 83:481-6. [PMID: 22080197 DOI: 10.1007/s00115-011-3400-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this questionnaire-based study was to determine the decision-making motives from Parkinson's patients and their family members for deep brain stimulation (DBS), which are crucial for the attitude towards this therapy and which should be considered during the clinical interview. MATERIAL AND METHODS The questionnaire was sent out nationwide to members of the German Parkinson Association. Patient and family specific data as well as information sources, doubts and expectations with respect to DBS were assessed. RESULTS A total of 582 patients and 476 family members answered the questionnaire, revealing that 96% of the patients and 91% of the family members already possessed information regarding DBS. While a large proportion of interviewees had specific expectations concerning DBS, more than two thirds expressed concerns regarding DBS; the most frequent with respect to intraoperative complications and stimulation-induced worsening of symptoms. The quantity of realistic patients and family expectations significantly correlated with a positive evaluation of DBS and doubts as well as unrealistic expectations of family members correlated with a negative attitude towards the operation. CONCLUSIONS The findings suggest that patients and their relatives organized in support groups indeed possess detailed information regarding DBS. However, for the acceptance of the treatment a timely elucidation about DBS as well as responding to the individual concerns by the consulting physician is essential.
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Affiliation(s)
- M Südmeyer
- Neurologische Klinik - Bewegungsstörungen und Neuromodulation, Heinrich-Heine-Universität, Medizinische Fakultät, UKD, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
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Mattsson M, Möller B, Stamm T, Gard G, Boström C. Uncertainty and opportunities in patients with established systemic lupus erythematosus: a qualitative study. Musculoskeletal Care 2012; 10:1-12. [PMID: 22009870 DOI: 10.1002/msc.220] [Citation(s) in RCA: 26] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Systemic lupus erythematosus (SLE) is a chronic disease which can affect any organ, and the impact of the condition will affect each person differently. There are few qualitative studies including the experiences of both women and men with a diagnosis of SLE corresponding to the American College of Rheumatology (ACR) criteria where both negative and positive impacts of the disease have been presented. PURPOSE The aim was to describe how patients with established SLE experience their illness in everyday life, including both negative and positive aspects. METHOD Four focus group interviews were conducted with 16 women and three men with SLE according to ACR criteria, with varied disease activity and no or little organ damage. The interviews were tape recorded, transcribed verbatim and analysed using qualitative content analysis. RESULTS Two themes emerged: multifaceted uncertainty contained the categories 'an unreliable body', 'obtrusive pain and incomprehensible fatigue', 'mood changes and worries', 'reliance on medication and health care'; Focus on health and opportunities included 'learning process implying personal strength', 'limitations and possibilities in activities and work', 'a challenge to explain and receive support' and 'living an ordinary life incorporating meaningful occupations'. CONCLUSIONS While we expected to find a mainly negative impact, positive aspects were also described. Our findings were complex and showed that patients with established SLE can experience both uncertainty and opportunities. This highlights the importance for healthcare professionals of gaining a better understanding of patients' uncertainty, to enable them to support patients, allowing them to focus on health and opportunities. Measurement instruments that capture different aspects of uncertainty and opportunities needs to be developed.
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Affiliation(s)
- M Mattsson
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
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Açil Y, Möller B, Niehoff P, Rachko K, Gassling V, Wiltfang J, Simon MJK. The cytotoxic effects of three different bisphosphonates in-vitro on human gingival fibroblasts, osteoblasts and osteogenic sarcoma cells. J Craniomaxillofac Surg 2011; 40:e229-35. [PMID: 22082730 DOI: 10.1016/j.jcms.2011.10.024] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 10/07/2011] [Accepted: 10/10/2011] [Indexed: 10/15/2022] Open
Abstract
INTRODUCTION Osteonecrosis of the jaw (ONJ) is an emerging condition in patients undergoing long-term administration of bisphosphonates (BP) for the treatment of osteoporosis and hypercalcaemia associated with malignancy, multiple myeloma, and metastatic breast and prostate cancers. This is a follow-up study, its purpose was to examine the effects in-vitro of intravenous zoledronic acid (ZOL) and pamidronate (PAM) and oral alendronate (FOS) on the human oral cavity using gingival fibroblasts and osteoblasts cells and, in addition, osteogenic sarcoma cells (SaOS-2-cells). MATERIALS AND METHODS Human gingival fibroblasts, osteoblasts and SaOS-2-cells were seeded on multiple 6-well plates at a density of 5 × 10(5)cells in a 4-week cell culture. Four different concentrations (1, 5, 10, 20 μM) of each BP (ZOL, PAM, FOS) and pyrophosphate were used in this study. RESULTS All BP decreased collagen production and lowered cell proliferation in-vitro. ZOL was the component with most inhibitory effect. CONCLUSION The findings in this study suggest that ZOL, PAM and FOS generally diminish cell proliferation and collagen production of human gingival fibroblasts, osteoblasts and SaOS-2-cells. The present follow-up study shows that not only ZOL and PAM but also FOS have a strong inhibitory effect on collagen production and cell survival in-vitro.
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Affiliation(s)
- Y Açil
- Department of Oral and Maxillofacial Surgery, UK S-H, Campus Kiel, Arnold-Heller-Strasse 3, Haus 26, 24105 Kiel, Germany
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Rodenhausen S, Dan D, Caliezi G, Möller B. T Cell Costimulation Blockade may Prevent Tumour Necrosis Factor alpha Inhibitor-Induced Palmoplantar Pustulosis. AKTUEL RHEUMATOL 2011. [DOI: 10.1055/s-0031-1283199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | - D. Dan
- Inselspital, Rheumatology, Bern, Switzerland
| | - G. Caliezi
- Inselspital, Rheumatology, Bern, Switzerland
| | - B. Möller
- Inselspital-Universitätsklinik Bern, Klinik für Rheumatologie, Klinische Immunologie und Allergologie, Bern, Switzerland
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Möller JF, Möller B, Wiedenmann B, Berg T, Schott E. CD154, a marker of antigen-specific stimulation of CD4 T cells, is associated with response to treatment in patients with chronic HCV infection. J Viral Hepat 2011; 18:e341-9. [PMID: 21692946 DOI: 10.1111/j.1365-2893.2010.01430.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
CD4 T-cell function is crucial for the eradication of HCV, and insufficient function is observed in chronic carriers. The monitoring of T-cell responses is complicated by the scarcity of antigen-specific T cells and the relative inefficiency of virus-specific T cells to produce effector cytokines. CD154 is a marker of activation expressed on T cells induced through their T-cell receptor. We analysed CD4 T-cell responses in 72 patients with chronic or resolved HCV infection (23 treatment naïve, 49 treatment experienced, including 16 who had achieved a sustained response). In an additional prospective protocol, 20 of the chronically infected patients were analysed before and after 8-12 weeks of combination therapy with peg-interferon-α and ribavirin. T-cell responses were measured by detecting the expression of CD154 and Th1 cytokines after stimulation with recombinant HCV proteins and were correlated with pretreatment status and outcome of therapy. Broader T-cell responses were observed in treatment naïve than in experienced patients, while the outcome of a preceding therapy regimen did not influence T-cell responses. In the prospective cohort, an on-treatment increase in CD154+ cytokine- T-cell activity was associated with response to treatment, while a decrease was observed in nonresponders. Stronger antigen-independent activity of CD154+ cytokine+ T cells was observed in responders than in nonresponders. Our data indicate that CD154 as a marker of activation of CD4 T cells is a suitable tool for the analysis of T-cell responses in patients with HCV infection.
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Affiliation(s)
- J F Möller
- Medizinische Klinik m.S. Hepatologie und Gastroenterologie, Charité Universitätsmedizin Berlin, CVK, Berlin Hepatologische Schwerpunktpraxis, Berlin, Germany
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Möller B, Stockheim M, Kraus T, Weber A. Medizintechnische Innovationen im Spannungsfeld zwischen Zertifizierung und Vergütung. Dtsch Med Wochenschr 2010. [DOI: 10.1055/s-0030-1248662] [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: 10/18/2022]
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Möller B, Stockheim M, Kraus T, Weber A. [Medical innovations in the area of conflict between certification and allowance]. Dtsch Med Wochenschr 2010; 135:2088-92. [PMID: 20941684 DOI: 10.1055/s-0030-1267484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The medical technology industry is one of the most innovative industries in Germany. Once a medical product is developed, it will be certificated according to European harmonized guidelines and norms. The respective national regulations in Germany are stipulated in the Medical Devices Act (MPG). Part of the certification process is a clinical assessment with the aim to prove that the medical device complies with the so-called essential requirements concerning safety, performance and suitability for the intended use as defined by the manufacturer. A clinical trial may be necessary to establish compliance with these requirements. During this clinical trial the devices are being assessed in patients according to strict requirements by law. The main criticism by the funding agencies is that these trials do not sufficiently apply methods of evidence-based medicine. Thereby they are not useful for assessing the medical benefit of the devices. The manufacturers' counter-argument is that the products are bearing the CE mark, that they comply with the uniform European standards and that their quality therefore has been appropriately assessed. This discussion relates to the question about payment for the products, as according to the Fifth Social Act the funding agencies are only permitted to finance products with a scientifically proven medical benefit. The present article discusses both positions in the context of national and international legislation for the certification of medical devices and presents possible solutions.
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Affiliation(s)
- B Möller
- Medizinischer Dienst des Spitzenverbandes Bund der Krankenkassen e.V., Essen.
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Berg T, Möller B, Gerken G, Zachoval R, Spengler U, Hartmann H, Snow-Lampart A, Oldach D, Sorbel J, Borroto-Esoda K, Frederick D, Rousseau F. Tenofovir disoproxil fumarate (TDF) versus emtricitabine plus TDF (FTC/TDF) for treatment of chronic hepatitis B (CHB) in patients with persistent viral replication receiving adefovir dipivoxi. Z Gastroenterol 2009. [DOI: 10.1055/s-0029-1241401] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Möller B, Schmidt S, Volkmann J, Schnitzler A, Deuschl G, Südmeyer M. Fragebogenstudie zur Erfassung von Zusammenhängen zwischen Zufriedenheit mit der Hirnschrittmachertherapie und subjektiven Faktoren bei Patienten mit M. Parkinson. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238852] [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: 10/20/2022]
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Südmeyer M, Schmidt S, Volkmann J, Stoerig P, Deuschl G, Schnitzler A, Möller B. Fragebogenstudie zu Bedenken und Einstellung gegenüber der tiefen Hirnstimulation bei Patienten mit M. Parkinson und deren Angehörigen. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238853] [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: 10/20/2022]
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Schmid L, Müller M, Treumann T, Arnold W, Möller B, Aeberli D, Villiger PM. Induction of complete and sustained remission of rheumatoid pachymeningitis by rituximab. ACTA ACUST UNITED AC 2009; 60:1632-4. [PMID: 19479865 DOI: 10.1002/art.24577] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aseptic pachymeningitis is a rare and serious complication of rheumatoid arthritis (RA). Herein, we describe a patient with rheumatoid factor-positive and anti-cyclic citrullinated peptide-positive RA who experienced a focal seizure, with aphasia and convulsions of the right side of the body. The findings of magnetic resonance imaging and histologic analysis led to a diagnosis of rheumatoid pachymeningitis. Because the patient had a large number of CD20-expressing B lymphocytes, therapy with rituximab was started and has resulted in complete and sustained remission of both the pachymeningitis and the RA for >2 years. Despite a decrease in immunoglobulins, the patient has remained free of infections, which illustrates the favorable outcome that can result from therapeutic B cell depletion in this potentially lethal manifestation of RA.
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Affiliation(s)
- L Schmid
- Kantonsspital, Lucerne, Switzerland
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Turan B, Pfister K, Diener P, Hell M, Möller B, Boyvat A, Ergin S, Villiger PM. Soluble tumour necrosis factor receptors sTNFR1 and sTNFR2 are produced at sites of inflammation and are markers of arthritis activity in Behçet's disease. Scand J Rheumatol 2009; 37:135-41. [DOI: 10.1080/03009740701747137] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Finckh A, Ciurea A, Brulhart L, Möller B, Walker UA, Courvoisier D, Kyburz D, Dudler J, Gabay C. Which subgroup of patients with rheumatoid arthritis benefits from switching to rituximab versus alternative anti-tumour necrosis factor (TNF) agents after previous failure of an anti-TNF agent? Ann Rheum Dis 2009; 69:387-93. [PMID: 19416802 PMCID: PMC2800201 DOI: 10.1136/ard.2008.105064] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Patients with rheumatoid arthritis (RA) with an inadequate response to TNF antagonists (aTNFs) may switch to an alternative aTNF or start treatment from a different class of drugs, such as rituximab (RTX). It remains unclear in which clinical settings these therapeutic strategies offer most benefit. OBJECTIVE To analyse the effectiveness of RTX versus alternative aTNFs on RA disease activity in different subgroups of patients. METHODS A prospective cohort study of patients with RA who discontinued at least one aTNF and subsequently received either RTX or an alternative aTNF, nested within the Swiss RA registry (SCQM-RA) was carried out. The primary outcome, longitudinal improvement in 28-joint count Disease Activity Score (DAS28), was analysed using multivariate regression models for longitudinal data and adjusted for potential confounders. RESULTS Of the 318 patients with RA included; 155 received RTX and 163 received an alternative aTNF. The relative benefit of RTX varied with the type of prior aTNF failure: when the motive for switching was ineffectiveness to previous aTNFs, the longitudinal improvement in DAS28 was significantly better with RTX than with an alternative aTNF (p = 0.03; at 6 months, -1.34 (95% CI -1.54 to -1.15) vs -0.93 (95% CI -1.28 to -0.59), respectively). When the motive for switching was other causes, the longitudinal improvement in DAS28 was similar for RTX and alternative aTNFs (p = 0.40). These results were not significantly modified by the number of previous aTNF failures, the type of aTNF switches, or the presence of co-treatment with a disease-modifying antirheumatic drug. CONCLUSION This observational study suggests that in patients with RA who have stopped a previous aTNF treatment because of ineffectiveness changing to RTX is more effective than switching to an alternative aTNF.
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Affiliation(s)
- A Finckh
- University Hospital of Geneva, Switzerland.
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40
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Hermann LS, Magnusson S, Möller B, Casey C, Tucker GT, Woods HF. Lactic acidosis during metformin treatment in an elderly diabetic patient with impaired renal function. Acta Med Scand 2009; 209:519-20. [PMID: 7257870 DOI: 10.1111/j.0954-6820.1981.tb11639.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In recent years, lactic acidosis has been described in association with metformin therapy in diabetics. We report a fatal case in an elderly diabetic patient with impaired renal function and cardiac insufficiency. The patient presented with an elevated plasma metformin concentration and a concomitant digitoxin intoxication.
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Kampen WU, Czech N, von Forstner C, Henze E, Möller B, Bartsch MS. Radiosynoviorthesis of the temporomandibular joint--initial clinical application. Nuklearmedizin 2009; 48:N47-N49. [PMID: 20512195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Accepted: 04/27/2009] [Indexed: 05/29/2023]
Affiliation(s)
- W U Kampen
- Clinic of Nuclear Medicine, University Hospital Schleswig-Holstein, Kiel Germany
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Möller B. Hämochromatose-assoziierte Arthropathie – moderne Diagnostik für eine altmodische Therapie? AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1027637] [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: 10/21/2022]
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Mattsson M, Möller B, Lundberg I, Gard G, Boström C. Reliability and validity of the Fatigue Severity Scale in Swedish for patients with systemic lupus erythematosus. Scand J Rheumatol 2008; 37:269-77. [PMID: 18612927 DOI: 10.1080/03009740801914868] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim was to translate, test, and describe aspects of reliability and validity of the Fatigue Severity Scale (FSS) in Swedish (FSS-Swe) in patients with systemic lupus erythematosus (SLE). METHODS Patients with stable SLE, low or moderate disease activity, and low organ damage were included. Forward and back translations of the FSS were performed. Construct validity was tested with 32 women using a first Swedish translation. Feasibility, ceiling and floor effects, internal consistency, test-retest reliability, and content validity were tested on a slightly modified final version of the FSS-Swe in a non-selected group of patients (n = 23). RESULTS There were correlations (p< or =0.05) between the FSS-Swe and overall disease activity according to the Systemic Lupus Activity Measure (SLAM) (r(s) = 0.48) and the SLAM Visual Analogue Scale (SLAM-VAS) (r(s) = 0.46); between the FSS-Swe and eight subscales of the Swedish 36-Item Medical Outcomes Study Short-Form Health Survey (SF-36) (r(s) = -0.41 to -0.65) and between the FSS-Swe and age (r(s) = -0.35). All patients answered all FSS-Swe questions at both test and retest. There was one ceiling effect in one question on one occasion. The Kolmogorov-Smirnov test indicated normal distribution. Cronbach's alpha was 0.94 and corrected item-to-total correlation exceeded 0.3. There were no significant systematic test-retest differences, and the median-weighted kappa coefficient was 0.75. Twenty patients understood the questions in FSS-Swe, 18 considered they were relevant, reflected their fatigue, and that none should be excluded. Five items were suggested to be included. CONCLUSIONS The FSS-Swe supports construct validity, is feasible, has no important ceiling or floor effects, has satisfactory internal consistency, substantial test-retest reliability, and satisfactory content validity in the SLE patients studied. However, its sensitivity to change needs to be tested.
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Affiliation(s)
- M Mattsson
- Department of Physiotherapy, Sunderby Hospital, Luleå, Sweden.
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Berg T, Möller B, Gerken G, Jung MC, Spengler U, Hartmann H, Snow-Lampart A, Frederick D, Oldach D, Sorbel J, Borroto-Esoda K, Rousseau F. Tenofovir disoproxil fumarate (TDF) versus Emtricitabine plus TDF for treatment of chronic Hepatitis B (CHB) in subjects with persistent viral replication receiving Adefovir dipivoxil (ADV). Z Gastroenterol 2008. [DOI: 10.1055/s-0028-1089367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Möller B, Stegemann T, Romer G. [Psychosocial stress in children of somatically ill parents. Perspectives of mental health prevention]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2008; 51:657-63. [PMID: 18446298 DOI: 10.1007/s00103-008-0542-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Irrespective of their well-known increased risk for mental health problems, children of somatically ill parents are a clinically underserved as well as under-researched group. In this article, the authors introduce the epidemiologic and clinical relevance of this topic and present a theoretical framework for understanding the sequelae of a serious parental illness on minor-age children, based on family dynamics and developmental concepts. This is followed by a comprehensive review of current empirical studies in this field, with a special emphasis on results from a transnational European collaborative study (COSIP = Children of Somatically Ill Parents), which was coordinated by the last author. The most important recommendations from intervention concepts published to date are summarized. Some outlooks for clinical practice as well as future research are presented.
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Affiliation(s)
- B Möller
- Universitätsklinik Hamburg-Eppendorf, BRD
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Hüppe D, Zehnter E, Mauss S, Böker K, Lutz T, Racky S, Schmidt W, Ullrich J, Sbrijer I, Heyne R, Schober A, John C, Hey KH, Bokemeyer B, Kallinowski B, Möller B, Pape S, Gutmann M, Alshuth U, Niederau C. [Epidemiology of chronic hepatitis C in Germany--an analysis of 10,326 patients in hepatitis centres and outpatient units]. Z Gastroenterol 2008; 46:34-44. [PMID: 18188814 DOI: 10.1055/s-2007-963691] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Little is known about the epidemiology of chronic hepatitis C (CHC) in Germany and especially about the importance of transmission, duration of infection, genotypes, symptoms and quality of life of the patients. The current study prospectively evaluates epidemiological and clinical data of patients infected with the hepatitis C virus (HCV). Using online data entry, various characteristics of 10,326 untreated patients with CHC were documented from March 2003 until May 2006 in 352 centres all over Germany. Mean age of patients was 43.4 years. Patients infected by i.v. drug abuse were considerably younger (36.5 years) than the remaining patients (49.2 years). As indicated by their native language, 64.4% of the patients came from Germany and 19.2% from Russia. 61.7% were infected with genotype 1 and 34.9% with genotype 2 or 3. 45.5% of the patients had been infected by i.v. drug abuse. In at least 5.4% of the patients liver cirrhosis had been proved by biopsy. 63.5% of the patients felt an impairment of quality of life caused by CHC. In many patients infected with hepatitis C socio-economic issues are existent. This is reflected, i.e., in very high rates of unemployment in special subpopulations. Coinfections with hepatitis B and HIV occurred in 1.5% and 4.7%, respectively. Nearly 80% of patients were managed near their homes. The data of the 10 326 patients represent about 2% of all German patients with CHC. This database is up to now the largest of its kind and gives a representative insight into the epidemiological situation of CHC in Germany.
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Affiliation(s)
- D Hüppe
- Gastroenterologische Gemeinschaftspraxis Herne, Herne.
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Möller B, Kerschbaumer G, Komor M, Kerschbaumer F, Ottmann OG, Hoelzer D, Hofmann WK. Genomic imprinting of insulin-like growth factor 2 (IGF-2) in chronic synovitis. Growth Horm IGF Res 2007; 17:500-505. [PMID: 17590364 DOI: 10.1016/j.ghir.2007.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2007] [Revised: 05/10/2007] [Accepted: 05/15/2007] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To search for relaxation or loss of IGF-2 imprinting (LOI) in rheumatoid arthritis (RA) synovial tissues. DESIGN The genotype of IGF-2 was determined in 25 freshly isolated synovial tissue samples with signs of active inflammation by polymerase chain reaction (PCR) and restriction fragment length polymorphism. Imprinting was determined in synovial tissue mononuclear cells (STMC) of five informative heterozygous patients by reverse transcriptase (RT)-PCR. Mitogen-stimulated peripheral blood mononuclear cells (PBMC) from six informative healthy donors were selected for control. RESULTS In vitro proliferation of CD4+ and CD8+ PB T cells, and also of CD19+ PB B cells was detectable upon mitogen stimulation. Furthermore, MHC II molecule expression on synovial B and T cells indicated in vivo cell activation. Monoallelic IGF-2 expression was seen in PBMC cultures from two healthy donors under both, resting and stimulating conditions. In two other PBMC cultures, LOI occurred exclusively after 24 h of stimulation. PBMC from two other healthy donors showed LOI under both, resting and stimulating conditions. Mitogen induced and spontaneous LOI was reversible in each one PBMC culture after 72 h. In contrast, none of the informative STMC cultures showed LOI. CONCLUSIONS LOI in lymphocytes may occur spontaneously or inducible. However, longstanding activation of lymphocytes in RA synovitis appears not to be related to this mechanism.
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Affiliation(s)
- B Möller
- Inselspital - University Hospital Bern, Klinik für Rheumatologie, klinische Immunologie und Allergologie, CH-3010 Bern, Switzerland.
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Witthöft T, Möller B, Wiedmann KH, Mauss S, Link R, Lohmeyer J, Lafrenz M, Gelbmann CM, Hüppe D, Niederau C, Alshuth U. Safety, tolerability and efficacy of peginterferon alpha-2a and ribavirin in chronic hepatitis C in clinical practice: The German Open Safety Trial. J Viral Hepat 2007; 14:788-96. [PMID: 17927615 PMCID: PMC2156112 DOI: 10.1111/j.1365-2893.2007.00871.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The combination treatment of peginterferon alpha-2a (PEG-IFN alpha-2a; Pegasys) plus ribavirin (RBV) is recommended as a standard care for HCV infections. Side effects and aspects of efficacy and safety have to be balanced. This study evaluates clinical practice data on safety and efficacy of HCV treatment with PEG-IFN in combination with RBV over 24 and 48 weeks. This study was a phase III, multi-centre, open-label study with two treatment groups: PEG-IFN in combination with RBV for 24 or 48 weeks. The allocation to the treatment groups was at the discretion of the investigator; 309 patients entered active treatment: 90 patients received PEG-IFN plus RBV for 24 weeks and 219 patients PEG-IFN plus RBV for 48 weeks. A sustained virological response (SVR) was achieved in 48.9% of all patients. Genotype 1 patients with a 48-week combination treatment achieved an SVR of 39.9%. In the 48-week group a low baseline viral load was associated with a higher SVR rate (47.0% vs. 32.4%). For genotype 2 or 3 patients, the SVR was 67.9%. For these patients there was no relevant difference between patients with low and high viral loads; 97.7% of the patients experienced at least one adverse event. The incidence of serious adverse events was distinctly lower in the 24-week group (4.4% vs. 10.5%). This investigation confirms the well-known risk-benefit ratio found in controlled studies in a clinical practice setting. The safety profile is similar and shows the highest incidence of adverse events in the first 12 weeks of treatment.
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Affiliation(s)
- Th Witthöft
- Medical Department I, Division of Gastroenterology, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany.
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Seitz M, Wirthmüller U, Möller B, Villiger PM. The -308 tumour necrosis factor-alpha gene polymorphism predicts therapeutic response to TNFalpha-blockers in rheumatoid arthritis and spondyloarthritis patients. Rheumatology (Oxford) 2006; 46:93-6. [PMID: 16720636 DOI: 10.1093/rheumatology/kel175] [Citation(s) in RCA: 151] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To examine whether the G-to-A polymorphism at position -308 in the promoter of the tumour necrosis factor-alpha (TNFalpha) gene influences the therapeutic response to TNFalpha-blockers in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS). METHODS A total of 54 patients with RA, 10 with PsA and 22 with AS were genotyped by polymerase chain reaction for the -308 TNFalpha promoter polymorphism. They were treated with infliximab (n = 63), adalimumab (n = 10) or etanercept (n = 13). Clinical response was assessed after 24 weeks by the Disease Activity Score in 28 joints (DAS28) for RA and PsA, and the Bath Ankylosing Spondylitis Activity Index (BASDAI) for AS patients. RESULTS All patients with the A/A genotype (n = 3, all RA) and two patients with the A/G genotype (AS) failed to respond to anti-TNF treatment. Irrespective of the underlying disease, moderate response (n = 44) was predominantly associated with the A/G genotype (A/G 18/22, G/G 4/22), whereas good response (n = 59) was exclusively seen in patients with the G/G genotype. The average improvement in the DAS28 score was 0.83 in the A/A, 1.50 in the A/G and 2.64 in the G/G group of RA and PsA patients (P < 0.0001). The BASDAI score in AS improved on average by 1.21 in the A/G and by 3.30 in the G/G group (P < 0.005). CONCLUSIONS The data suggest that humans with a TNFalpha -308 G/G genotype are better responders to anti-TNFalpha treatment than those with A/A or A/G genotypes independent of the treated rheumatic disease (RA, PsA or AS).
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MESH Headings
- Adalimumab
- Adult
- Aged
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antirheumatic Agents/therapeutic use
- Arthritis, Psoriatic/drug therapy
- Arthritis, Psoriatic/genetics
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/genetics
- Etanercept
- Female
- Genotype
- Humans
- Immunoglobulin G/therapeutic use
- Infliximab
- Male
- Middle Aged
- Polymorphism, Genetic
- Prognosis
- Promoter Regions, Genetic
- Receptors, Tumor Necrosis Factor/therapeutic use
- Severity of Illness Index
- Spondylitis, Ankylosing/drug therapy
- Spondylitis, Ankylosing/genetics
- Treatment Outcome
- Tumor Necrosis Factor-alpha/antagonists & inhibitors
- Tumor Necrosis Factor-alpha/genetics
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Affiliation(s)
- M Seitz
- Department of Rheumatology and Clinical Immunology/Allergology, University Hospital, CH-3010 Berne, Switzerland.
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