1
|
Najm A, Alunno A, Machado P, Bertheussen H, Burmester G, Carubbi F, De Marco G, Giacomelli R, Hermine O, Isaacs J, Koné-Paut I, Magro-Checa C, McInnes I, Meroni P, Quartuccio L, Athimalaipet V, Ramos-Casals M, Rodríguez-Carrio J, Schultze-Koops H, Stamm T, Tas S, Terrier B, McGonagle D, Mariette X. Mise à jour des recommandations EULAR sur l’utilisation des thérapies immunomodulatrices dans la prise en charge de la Covid-19. Revue du Rhumatisme 2021. [PMCID: PMC8626108 DOI: 10.1016/j.rhum.2021.10.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
|
2
|
Abstract
Background:Immune checkpoint inhibitors (ICI) have changed the treatment landscape of many cancer types, but are also associated with development of immune-related adverse events, includingde novosarcoid like reactions. However, little is known about the use of ICI therapy in patients with preexisting sarcoidosis as patients with preexisting autoimmune diseases have been systematically excluded from clinical trials of ICI therapy due to concerns of heightened toxicities. Emerging research suggests that ICI therapy can be considered in some patients with autoimmune diseases.1Objectives:To determine the risk of sarcoidosis exacerbation or flare in patients with preexisting sarcoidosis receiving ICI therapy.Methods:We conducted a retrospective cohort study of patients seen at The University of Texas MD Anderson Cancer Center between 2016-2019. Patients were included in the cohort if they received one of 7 ICI therapies (ipilimumab, nivolumab, pembrolizumab, durvalumab, avelumab, atezolizumab, or cemiplimab) and had an International Classification of Disease version 10 code of sarcoidosis (D86.*), prior to the ICI initiation, with diagnosis confirmed in medical record by treating physicians. A sarcoidosis diagnosis was considered “possible” if the medical record documented a history of sarcoidosis, “probable” if a history of biopsy proven sarcoidosis was mentioned, and “definitive” if histological evidence was available. Frequency of flares and outcomes of patients after receiving ICI were collected.Results:During the study timeframe a total of 32 patients with preexisting sarcoidosis received ICI therapy. Nine patients (28%) had a definitive diagnosis of sarcoidosis, 12 (37%) had a probable diagnosis and 11 (35%) had a possible diagnosis of sarcoidosis. The mean time between diagnosis of sarcoidosis and initiation of ICI therapy was 13 years (range: <1 to 51 years). Twenty-seven patients (84%) received monotherapy and five patients (16%) received combination or sequential ICI therapy. Of the 32 patients, one patient with a 20-year remote history of sarcoidosis, never treated, developed a clinically symptomatic exacerbation of sarcoidosis one month after the initial dose of atezolizumab, with increased hilar nodules on imaging, skin nodules, arthritis and uveitis. Biopsy of a lymph node showed non-necrotizing granulomas, and biopsy of the skin panniculitis. The patient also developed colitis thought to be an immune-related adverse event. Atezolizumab was discontinued after 3 doses. Patient was treated with prednisone and azathioprine.Conclusion:Patients with a remote history of stable sarcoidosis at the time of ICI therapy infrequently develop a flare of their sarcoidosis. The risk of flares in patients with active sarcoidosis requiring immunosuppression at the time of ICI initiation is unknown.References:[1]Kennedy LC, Bhatia S, Thompson JA, Grivas P. Preexisting autoimmune disease: implications for immune checkpoint inhibitor therapy in solid tumors. Journal of the National Comprehensive Cancer Network. 2019 Jun 1;17(6):750-7.Acknowledgments:NoneDisclosure of Interests:Xerxes Pundole: None declared, Olivier Lambotte Consultant of: BMS France, MSD, Astra Zeneca, Incyte, Manuel Ramos-Casals: None declared, Maria Suarez-Almazor: None declared
Collapse
|
3
|
Jousse-Joulin S, Gatineau F, Baldini C, Baer A, Barone F, Bootsma H, Bowman S, Brito-Zerón P, Cornec D, Dorner T, de Vita S, Fisher B, Hammenfors D, Jonsson M, Mariette X, Milic V, Nakamura H, Ng WF, Nowak E, Ramos-Casals M, Rasmussen A, Seror R, Shiboski CH, Nakamura T, Vissink A, Saraux A, Devauchelle-Pensec V. Weight of salivary gland ultrasonography compared to other items of the 2016 ACR/EULAR classification criteria for Primary Sjögren's syndrome. J Intern Med 2020; 287:180-188. [PMID: 31618794 DOI: 10.1111/joim.12992] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Major salivary gland ultrasonography (SGUS) is widely used for the diagnosis of primary Sjögren's syndrome (pSS). Our objective was to assess the contribution of SGUS compared to other items of the 2016 ACR/EULAR pSS classification criteria, based on expert opinion. METHODS A secure web-based relational database was used by 24 experts from 14 countries to assess 512 realistic vignettes developed from data of patients with suspected pSS. Each vignette provided classification criteria items and information on history, clinical symptoms and SGUS findings. Each expert assessed 64 vignettes, and each vignette was assessed by 3 experts. A diagnosis of pSS was defined according to at least 2 of 3 experts. Validation was performed in the independent French DiapSS cohort of patients with suspected pSS. RESULTS A criteria-based pSS diagnosis and SGUS findings were independently associated with an expert diagnosis of pSS (P < 0.001). The derived diagnostic weights of individual items in the 2016 ACR/EULAR criteria including SGUS were as follows: anti-SSA, 3; focus score ≥ 1, 3; SGUS score ≥ 2, 1; positive Schirmer's test, 1; dry mouth, 1; and salivary flow rate < 0.1 mL/min, 1. The corrected C statistic area under the curve for the new weighted score was 0.96. Adding SGUS improves the sensitivity from 90.2 % to 95.6% with a quite similar specificity 84.1% versus 82.6%. Results were similar in the DiapSS cohort: adding SGUS improves the sensitivity from 87% to 93%. CONCLUSION SGUS had similar weight compared to minor items, and its addition improves the performance of the 2016 ACR/EULAR classification criteria.
Collapse
Affiliation(s)
- S Jousse-Joulin
- From the, Rheumatology Department, INSERM UMR 1227, Cavale Blanche Hospital and Brest Occidentale University, Brest, France
| | - F Gatineau
- INSERM CIC 1412, Brest Medical University Hospital, Brest, France
| | - C Baldini
- Rheumatology Unit, University of Pisa, Pisa, Italy
| | - A Baer
- Department of Medicine (Rheumatology), Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - F Barone
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - H Bootsma
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - S Bowman
- Department of Rheumatology, University Hospitals, Birmingham NHS Trust, Birmingham, UK
| | - P Brito-Zerón
- Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA- Sanitas, Barcelona, Spain
| | - D Cornec
- From the, Rheumatology Department, INSERM UMR 1227, Cavale Blanche Hospital and Brest Occidentale University, Brest, France
| | - T Dorner
- Department of Medicine, Rheumatology and Clinical Immunology, Charite Universitätsmedizin Berlin and DRFZ Berlin, Berlin, Germany
| | - S de Vita
- Clinic of Rheumatology, Department of Medical and Biological Sciences, University Hospital "Santa Maria della Misericordia", Udine, Italy
| | - B Fisher
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - D Hammenfors
- Department of Rheumatology, Haukeland University Hospital, Bergen, Norway.,Section for Rheumatology, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - M Jonsson
- Section for Oral and Maxillofacial Radiology, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - X Mariette
- Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique, Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, France.,INSERM, Université Paris Sud, Paris, France
| | - V Milic
- Institute of Rheumatology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - H Nakamura
- Department of Immunology and Rheumatology, Unit of Advanced Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - W-F Ng
- Institute of Cellular Medicine, Newcastle University & NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne, UK
| | - E Nowak
- INSERM CIC 1412, Brest Medical University Hospital, Brest, France
| | - M Ramos-Casals
- Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA- Sanitas, Barcelona, Spain
| | - A Rasmussen
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - R Seror
- Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique, Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, France.,INSERM, Université Paris Sud, Paris, France
| | - C H Shiboski
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, CA, USA
| | - T Nakamura
- Department of Radiology and Cancer Biology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - A Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - A Saraux
- From the, Rheumatology Department, INSERM UMR 1227, Cavale Blanche Hospital and Brest Occidentale University, Brest, France
| | - V Devauchelle-Pensec
- From the, Rheumatology Department, INSERM UMR 1227, Cavale Blanche Hospital and Brest Occidentale University, Brest, France
| |
Collapse
|
4
|
Pérez-Alvarez R, Brito-Zerón P, Kostov B, Feijoo-Massó C, Fraile G, Gómez-de-la-Torre R, De-Escalante B, López-Dupla M, Alguacil A, Chara-Cervantes J, Pérez-Conesa M, Rascón J, Garcia-Morillo JS, Perez-Guerrero P, Fonseca-Aizpuru E, Akasbi M, Bonet M, Callejas JL, Pallarés L, Ramos-Casals M. Systemic phenotype of sarcoidosis associated with radiological stages. Analysis of 1230 patients. Eur J Intern Med 2019; 69:77-85. [PMID: 31521474 DOI: 10.1016/j.ejim.2019.08.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 07/22/2019] [Accepted: 08/27/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND To analyze the association between Scadding radiological stages of sarcoidosis at diagnosis and the disease phenotype (epidemiology, clinical presentation and extrathoracic involvement) in one of the largest cohorts of patients with sarcoidosis reported from southern Europe. METHODS The SARCOGEAS-Study Group includes a multicenter database of consecutive patients diagnosed with sarcoidosis according to the WASOG 1999 criteria. Extrathoracic disease at diagnosis was defined according to the 2014 instrument and the clusters proposed by Schupp et al. RESULTS: We analyzed 1230 patients (712 female, mean age 47 yrs.) who showed the following Scadding radiologic stages at diagnosis: stage 0 (n = 98), stage I (n = 395), stage II (n = 500), stage III (n = 195) and stage IV (n = 42). Women were overrepresented in patients presenting with extrathoracic/extrapulmonary disease, while the diagnosis was made at younger ages in patients presenting with BHL, and at older ages in those presenting with pulmonary fibrosis (q values <0.05). Multivariable adjusted analysis showed that patients presenting with pulmonary involvement (especially those with stages II and III) had a lower frequency of concomitant systemic involvement in some specific extrathoracic clusters (cutaneous-adenopathic/musculoskeletal, ENT and neuro-ocular/OCCC) but a higher frequency for others (hepatosplenic), in comparison with patients with extrapulmonary involvement (stages 0 and I). The presence of either BHL or fibrotic lesions did not influence the systemic phenotype of patients with pulmonary involvement. CONCLUSIONS The key determinant associated with a differentiated systemic phenotype of sarcoidosis at diagnosis was interstitial pulmonary involvement rather than the individual Scadding radiological stage.
Collapse
Affiliation(s)
- R Pérez-Alvarez
- Department of Internal Medicine, Hospital Alvaro Cunqueiro, Vigo, Spain
| | - P Brito-Zerón
- Laboratory of Autoimmune Diseases Josep Font, IDIBAPS, Department of Autoimmune Diseases, ICMiD, Hospital Clinic, Barcelona, Spain; Systemic Autoimmune Diseases Unit, Hospital CIMA-Sanitas, Barcelona, Spain
| | - B Kostov
- Primary Healthcare Transversal Research Group, IDIBAPS, Primary Care Center Les Corts, CAPSBE, Barcelona, Spain; Department of Statistics and Operational Research, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - C Feijoo-Massó
- Department of Internal Medicine, Hospital Parc Tauli, Sabadell, Spain
| | - G Fraile
- Department of Internal Medicine, Hospital Ramon y Cajal, Madrid, Spain
| | - R Gómez-de-la-Torre
- Department of Internal Medicine, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - B De-Escalante
- Department of Internal Medicine, Hospital Clínico, Zaragoza, Spain
| | - M López-Dupla
- Department of Internal Medicine, Hospital Joan XXIII, Tarragona, Spain
| | - A Alguacil
- Department of Internal Medicine, Hospital Virgen de la Salud, Toledo, Spain
| | - J Chara-Cervantes
- Department of Internal Medicine, Hospital Josep Trueta, Girona, Spain
| | - M Pérez-Conesa
- Department of Internal Medicine, Hospital Miguel Servet, Zaragoza, Spain
| | - J Rascón
- Department of Internal Medicine, Hospital Son Espases, Palma de Mallorca, Spain
| | - J S Garcia-Morillo
- Department of Internal Medicine, Hospital Virgen del Rocio, Sevilla, Spain
| | - P Perez-Guerrero
- Department of Internal Medicine, Hospital Puerta del Mar, Cadiz, Spain
| | | | - M Akasbi
- Department of Internal Medicine, Hospital Infanta Leonor, Madrid, Spain
| | - M Bonet
- Department of Internal Medicine, Althaia, Xarxa Assistencial de Manresa, Manresa, Spain
| | - J L Callejas
- Department of Internal Medicine, Hospital San Cecilio, Granada, Spain
| | - L Pallarés
- Department of Internal Medicine, Hospital Son Espases, Palma de Mallorca, Spain
| | - M Ramos-Casals
- Laboratory of Autoimmune Diseases Josep Font, IDIBAPS, Department of Autoimmune Diseases, ICMiD, Hospital Clinic, Barcelona, Spain.
| |
Collapse
|
5
|
Abstract
Sjögren syndrome is a systemic autoimmune disease that principally affects women between the fourth and sixth decades of life who present with sicca symptomatology caused by dryness of the main mucosal surfaces. The clinical spectrum of Sjögren syndrome extends from dryness to systemic involvement. Since 1978, Sjögren syndrome has been closely associated with an enhanced risk of lymphoma, one of the most severe complications a patient may develop. Primary Sjögren syndrome patients have a 10-44-fold greater risk of lymphoma than healthy individuals, higher than that reported for systemic lupus erythematosus and rheumatoid arthritis. The close link between lymphoma and Sjögren syndrome is clearly exemplified by the very specific type of lymphoma arising in Sjögren syndrome patients, mainly low-grade B-cell lymphomas (predominantly a marginal zone histological type) with primary extranodal involvement of the major salivary glands (overwhelmingly parotid), with a primordial role of cryoglobulinemic-related markers (both clinical and immunological). The most recent studies support a higher number of risk factors detected in an individual leads to a higher lymphoma risk. A close follow-up of high-risk groups with longitudinal assessments of all known risk factors, including cryoglobulin-related markers and EULAR Sjögren's syndrome disease activity index measurement in particular, is mandatory.
Collapse
Affiliation(s)
- S Retamozo
- 1 Instituto de Investigaciones en Ciencias de la Salud (INICSA), Universidad Nacional de Córdoba (UNC), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina.,2 Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Córdoba, Argentina.,3 Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Barcelona, Spain
| | - P Brito-Zerón
- 3 Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Barcelona, Spain.,4 Department of Medicine, Hospital CIMA-Sanitas, Barcelona, Spain
| | - M Ramos-Casals
- 3 Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Barcelona, Spain.,5 Department of Autoimmune Diseases, ICMiD, Barcelona, Spain.,6 Department of Medicine, University of Barcelona, Barcelona, Spain
| |
Collapse
|
6
|
Flores-Chávez A, Carrion JA, Forns X, Ramos-Casals M. Extrahepatic manifestations associated with Chronic Hepatitis C Virus Infection. Rev Esp Sanid Penit 2017; 19:87-97. [PMID: 29364334 PMCID: PMC6241927 DOI: 10.4321/s1575-06202017000300004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 10/10/2017] [Indexed: 12/11/2022]
Abstract
Chronic hepatitis C virus (HCV) infection has been associated with both organ-specific and systemic autoimmune diseases, with cryoglobulinemia being the most frequent associated disease. Experimental, virologic, and clinical evidence have demon-strated a close association between HCV infection and some systemic autoimmune diseases, especially Sjögren's syndrome, but also rheumatoid arthritis and lupus. A higher prevalence of hematological processes has also been described in patients with HCV infection, including cytopenias and lymphoproliferative disorders (B-cell lymphoma). In addition, patients with chronic HCV infection have a higher frequency of other extrahepatic manifestations including endocrine, metabolic and cardiovascular disorders that may worse the prognosis of patients, along with neuropsychiatric manifestations and general symptoms that have a significant influence on the quality of life of the patient. Direct-acting antiviral therapies (DAAs) that have recently begun to be used are providing the opportunity to effectively cure chronic HCV infection and reduce the burden of both hepatic and extrahepatic complications.
Collapse
Affiliation(s)
- A Flores-Chávez
- Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain
| | - J A Carrion
- Department of Hepatology, Hospital del Mar, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), University Autónoma de Barcelona, Barcelona
| | - X Forns
- Department of Hepatology, Hospital Clinic, IDIBAPS y CIBEREHD, University of Barcelona, Barcelona
| | - M Ramos-Casals
- Department of Medicine, University of Barcelona, Barcelona, Spain
| |
Collapse
|
7
|
Abstract
Diagnosis and treatment of hepatitis C virus (HCV) -related autoimmune features has become a clinical challenge in HCV-infected patients, in whom chronic liver disease associated with severe autoimmune features may contribute to a very poor prognosis. Both antiviral and immunosuppressive therapies, either alone or in combination, seem likely to have a key role. Based on the experience of mycophenolate mofetil (MMF) use in HCV patients receiving organ transplantation, this new immunosuppressive agent might represent a safe and effective therapeutic option to treat HCV-related extrahepatic features. Recent data are available for the use of MMF in HCV patients with autoimmune manifestations, mainly for autoimmune cytopenias and vasculitic features. MMF may be used as monotherapy or in association with other drugs for cases of HCV-related autoimmune diseases refractory or intolerant to common immunosuppressive treatments, allowing the reduction of the drug dosage and avoiding serious side effects.
Collapse
Affiliation(s)
- M Ramos-Casals
- Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Hospital Clinic, Barcelona, Spain
| | - J Font
- Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Hospital Clinic, Barcelona, Spain
| |
Collapse
|
8
|
Abstract
Diagnosis and treatment of hepatitis C virus (HCV) -related autoimmune features has become a clinical challenge in HCV-infected patients, in whom chronic liver disease associated with severe autoimmune features may contribute to a very poor prognosis. Both antiviral and immunosuppressive therapies, either alone or in combination, seem likely to have a key role. Based on the experience of mycophenolate mofetil (MMF) use in HCV patients receiving organ transplantation, this new immunosuppressive agent might represent a safe and effective therapeutic option to treat HCV-related extrahepatic features. Recent data are available for the use of MMF in HCV patients with autoimmune manifestations, mainly for autoimmune cytopenias and vasculitic features. MMF may be used as monotherapy or in association with other drugs for cases of HCV-related autoimmune diseases refractory or intolerant to common immunosuppressive treatments, allowing the reduction of the drug dosage and avoiding serious side effects.
Collapse
Affiliation(s)
- M Ramos-Casals
- Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Hospital Clínic, Barcelona, Spain.
| | | |
Collapse
|
9
|
Abstract
Autoimmune congenital heart block (ACHB) is an immune-mediated cardiac disease included among the manifestations collectively referred to as neonatal lupus. The placental transference of maternal Ro/La autoantibodies may damage the conduction tissues during fetal development leading to blocking of signal conduction at the atrioventricular (AV) node in an otherwise structurally normal heart. Irreversible complete AV block is the main cardiac manifestation of ACHB, but some babies may develop endocardial fibroelastosis, valvular insufficiency, and/or frank cardiomyopathies with significantly reduced cardiac function requiring transplant. The severity of ACHB is illustrated by a global mortality rate of 20% and pacemaker rates of at least 64%, often within the first year of life. This review analyses the main complex and/or unusual clinical situations associated with ACHB, including unusual maternal immunological profiles, infrequent maternal autoimmune diseases, cardiac damage unrelated to AV block, fetal invasive management, late complications after birth, risk of congenital heart block (CHB) in ovodonation and in vitro fertilization techniques, the role of maternal features other than autoimmunity, the influence of the birth order or the risk of CHB in twins and triplets.
Collapse
Affiliation(s)
- P Brito-Zerón
- Josep Font Laboratory of Autoimmune Diseases, Department of Autoimmune Diseases, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - P M Izmirly
- Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, USA
| | - M Ramos-Casals
- Josep Font Laboratory of Autoimmune Diseases, Department of Autoimmune Diseases, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - J P Buyon
- Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, USA
| | - M A Khamashta
- Graham Hughes Lupus Research Laboratory, The Rayne Institute, Division of Women's Health, Kings College London St Thomas Hospital, United Kingdom
| |
Collapse
|
10
|
Brito-Zeron P, Acar-Denizli N, Zeher M, Rasmussen A, Seror R, Mandl T, Li X, Baldini C, Gottenberg JE, Danda D, Quartuccio L, Priori R, Hernández-Molina G, Kruize A, Valim V, Kvarnstrom M, Sene D, Bartoloni E, Praprotnik S, Isenberg D, Solans R, Rischmueller M, Kwok SK, Nordmark G, Suzuki Y, Giacomelli R, Devauchelle-Pensec V, Bombardieri M, Hofauer B, Bootsma H, Hammenfors D, Fraile G, Carsons S, Gheita T, Morel J, Vollenveider C, Atzeni F, Retamozo S, Horvath IF, Sivils K, Theander E, Sandhya P, De Vita S, Sanchez-Guerrero J, van der Heijden E, Moça-Trevisano V, Wahren-Herlenius M, Mariette X, Ramos-Casals M. THU0352 Worldwide Heterogeneous Diagnostic Approach To Primary Sjögren Syndrome in 8315 Patients (EULAR-SS Task Force Big Data Sjögren Project). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3490] [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]
|
11
|
Brito-Zerόn P, Acar-Denizli N, Zeher M, Rasmussen A, Seror R, Mandl T, Li X, Baldini C, Gottenberg JE, Danda D, Quartuccio L, Priori R, Hernández-Molina G, Kruize A, Valim V, Kvarnstrom M, Sene D, Gerli R, Praprotnik S, Isenberg D, Solans R, Rischmueller M, Park SH, Nordmark G, Suzuki Y, Giacomelli R, Saraux A, Bombardieri M, Hofauer B, Bootsma H, Hammenfors D, Fraile G, Carsons S, Gheita T, Morel J, Vollenveider C, Atzeni F, Retamozo S, Horvath IF, Sivils K, Theander E, Sandhya P, De Vita S, Sanchez-Guerrero J, van der Heijden E, Moça-Trevisano V, Wahren-Herlenius M, Mariette X, Ramos-Casals M. SAT0287 Ethnic Differences Strongly Influence The Phenotypic Expression of Primary Sjögren: Study of 7887 Patients from 20 Countries on 5 Continents (EULAR-SS Task Force Big Data Sjögren Project). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2884] [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]
|
12
|
Urowitz MB, Gladman DD, Anderson NM, Su J, Romero-Diaz J, Bae SC, Fortin PR, Sanchez-Guerrero J, Clarke A, Bernatsky S, Gordon C, Hanly JG, Wallace DJ, Isenberg D, Rahman A, Merrill J, Ginzler E, Alarcón GS, Fessler BF, Petri M, Bruce IN, Khamashta M, Aranow C, Dooley M, Manzi S, Ramsey-Goldman R, Sturfelt G, Nived O, Steinsson K, Zoma A, Ruiz-Irastorza G, Lim S, Kalunian KC, Ỉnanç M, van Vollenhoven R, Ramos-Casals M, Kamen DL, Jacobsen S, Peschken C, Askanase A, Stoll T. Cardiovascular events prior to or early after diagnosis of systemic lupus erythematosus in the systemic lupus international collaborating clinics cohort. Lupus Sci Med 2016; 3:e000143. [PMID: 27099765 PMCID: PMC4836282 DOI: 10.1136/lupus-2015-000143] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/18/2016] [Accepted: 03/23/2016] [Indexed: 01/07/2023]
Abstract
Objective To describe the frequency of myocardial infarction (MI) prior to the diagnosis of systemic lupus erythematosus (SLE) and within the first 2 years of follow-up. Methods The systemic lupus international collaborating clinics (SLICC) atherosclerosis inception cohort enters patients within 15 months of SLE diagnosis. MIs were reported and attributed on a specialised vascular event form. MIs were confirmed by one or more of the following: abnormal ECG, typical or atypical symptoms with ECG abnormalities and elevated enzymes (≥2 times upper limit of normal), or abnormal stress test, echocardiogram, nuclear scan or angiogram. Descriptive statistics were used. Results 31 of 1848 patients who entered the cohort had an MI. Of those, 23 patients had an MI prior to SLE diagnosis or within the first 2 years of disease. Of the 23 patients studied, 60.9% were female, 78.3% were Caucasian, 8.7% black, 8.7% Hispanic and 4.3% other. The mean age at SLE diagnosis was 52.5±15.0 years. Of the 23 MIs that occurred, 16 MIs occurred at a mean of 6.1±7.0 years prior to diagnosis and 7 occurred within the first 2 years of follow-up. Risk factors associated with early MI in univariate analysis are male sex, Caucasian, older age at diagnosis, hypertension, hypercholesterolaemia, family history of MI and smoking. In multivariate analysis only age (OR=1.06 95% CI 1.03 to 1.09), hypertension (OR=5.01, 95% CI 1.38 to 18.23), hypercholesterolaemia (OR=4.43, 95% CI 1.51 to 12.99) and smoking (OR=7.50, 95% CI 2.38 to 23.57) remained significant risk factors. Conclusions In some patients with lupus, MI may develop even before the diagnosis of SLE or shortly thereafter, suggesting that there may be a link between autoimmune inflammation and atherosclerosis.
Collapse
Affiliation(s)
- M B Urowitz
- Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital and University of Toronto , Toronto Ontario , Canada
| | - D D Gladman
- Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital and University of Toronto , Toronto Ontario , Canada
| | - N M Anderson
- Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital and University of Toronto , Toronto Ontario , Canada
| | - J Su
- Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital and University of Toronto , Toronto Ontario , Canada
| | - J Romero-Diaz
- Instituto Nacional de Ciencias Medicas y Nutrición , Mexico City , Mexico
| | - S C Bae
- Department of Rheumatology , Hanyang University Hospital for Rheumatic Diseases , Seoul , Korea
| | - P R Fortin
- Division of Rheumatology , Centre Hospitalier Universitaire de Québec et Université Laval , Quebec City , Canada
| | - J Sanchez-Guerrero
- Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital and University of Toronto , Toronto Ontario , Canada
| | - A Clarke
- Division of Rheumatology , Cumming School of Medicine University of Calgary , Calgary, Alberta , Canada
| | - S Bernatsky
- Divisions of Clinical Immunology/Allergy and Clinical Epidemiology , Montreal General Hospital, McGill University Health Centre , Montreal, Quebec , Canada
| | - C Gordon
- Rheumatology Research Group , School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham , Birmingham , UK
| | - J G Hanly
- Division of Rheumatology, Department of Medicine and Department of Pathology , Queen Elizabeth II Health Sciences Centre and Dalhousie University , Halifax, Nova Scotia , Canada
| | - D J Wallace
- Cedars-Sinai/David Geffen School of Medicine at UCLA , Los Angeles, California , USA
| | - D Isenberg
- Centre for Rheumatology Research, University College , London , UK
| | - A Rahman
- Centre for Rheumatology Research, University College , London , UK
| | - J Merrill
- Department of Clinical Pharmacology , Oklahoma Medical Research Foundation , Oklahoma City, Oklahoma , USA
| | - E Ginzler
- Department of Medicine , SUNY Downstate Medical Center , Brooklyn, New York , USA
| | - G S Alarcón
- Department of Medicine, Division of Clinical Immunology and Rheumatology , University of Alabama at Birmingham , Birmingham, Alabama , USA
| | - B F Fessler
- Department of Medicine, Division of Clinical Immunology and Rheumatology , University of Alabama at Birmingham , Birmingham, Alabama , USA
| | - M Petri
- Department of Rheumatology , Johns Hopkins University School of Medicine , Baltimore, Maryland , USA
| | - I N Bruce
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, London, UK
| | - M Khamashta
- Lupus Research Unit , The Rayne Institute, St Thomas' Hospital, King's College London School of Medicine , London , UK
| | - C Aranow
- Feinstein Institute for Medical Research , Manhasset, New York , USA
| | - M Dooley
- Division of Rheumatology and Immunology, Department of Medicine , University of North Carolina , Chapel Hill, North Carolina , USA
| | - S Manzi
- Department of Medicine , West Penn Allegheny , Pittsburgh, Pennsylvania , USA
| | - R Ramsey-Goldman
- Northwestern University and Feinberg School of Medicine , Chicago, Illinois , USA
| | - G Sturfelt
- Department of Rheumatology , University Hospital Lund , Lund , Sweden
| | - O Nived
- Department of Rheumatology , University Hospital Lund , Lund , Sweden
| | - K Steinsson
- Department of Rheumatology , Center for Rheumatology Research Fossvogur Landspitali University Hospital , Reyjkavik , Iceland
| | - A Zoma
- Lanarkshire Centre for Rheumatology, Hairmyres Hospital , East Kilbride, Scotland , UK
| | - G Ruiz-Irastorza
- Autoimmune Disease Unit, Department of Internal Medicine , Hospital Universitario Cruces., University of the Basque Country , Barakaldo , Spain
| | - S Lim
- Division of Rheumatology, Emory University School of Medicine , Atlanta, Georgia , USA
| | - K C Kalunian
- UCSD School of Medicine , La Jolla, California , USA
| | - M Ỉnanç
- Division of Rheumatology, Department of Internal Medicine, Istanbul Medical Faculty , Istanbul University , Istanbul , Turkey
| | - R van Vollenhoven
- Unit for Clinical Therapy Research (ClinTRID), The Karolinska Institute , Stockholm , Sweden
| | - M Ramos-Casals
- Josep Font Autoimmune Diseases Laboratory, IDIBAPS, Department of Autoimmune Diseases , Hospital Clínic , Barcelona , Spain
| | - D L Kamen
- Division of Rheumatology, Medical University of South Carolina , Charleston, South Carolina , USA
| | - S Jacobsen
- Department of Rheumatology Rigshospitalet , Copenhagen University Hospital , Copenhagen , Denmark
| | - C Peschken
- Department of Medicine and Community Health Sciences, University of Manitoba , Winnipeg, Manitoba , Canada
| | - A Askanase
- Division of Rheumatology, Columbia University Medical Center , New York , USA
| | - T Stoll
- Department of Rheumatology , Kantousspital , Schaffhausen , Switzerland
| |
Collapse
|
13
|
Simeón-Aznar CP, Fonollosa-Plá V, Tolosa-Vilella C, Espinosa-Garriga G, Campillo-Grau M, Ramos-Casals M, García-Hernández FJ, Castillo-Palma MJ, Sánchez-Román J, Callejas-Rubio JL, Ortego-Centeno N, Egurbide-Arberas MV, Trapiellla-Martínez L, Caminal-Montero L, Sáez-Comet L, Velilla-Marco J, Camps-García MT, de Ramón-Garrido E, Esteban-Marcos EM, Pallarés-Ferreres L, Navarrete-Navarrete N, Vargas-Hitos JA, Torre RGDL, Salvador-Cervello G, Rios-Blanco JJ, Vilardell-Tarrés M. Registry of the Spanish Network for Systemic Sclerosis: Survival, Prognostic Factors, and Causes of Death. Medicine (Baltimore) 2015; 94:e1728. [PMID: 26512564 PMCID: PMC4985378 DOI: 10.1097/md.0000000000001728] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Systemic sclerosis (SSc) is a rare, multisystem disease showing a large individual variability in disease progression and prognosis. In the present study, we assess survival, causes of death, and risk factors of mortality in a large series of Spanish SSc patients. Consecutive SSc patients fulfilling criteria of the classification by LeRoy were recruited in the survey. Kaplan-Meier and Cox proportional-hazards models were used to analyze survival and to identify predictors of mortality. Among 879 consecutive patients, 138 (15.7%) deaths were registered. Seventy-six out of 138 (55%) deceased patients were due to causes attributed to SSc, and pulmonary hypertension (PH) was the leading cause in 23 (16.6%) patients. Survival rates were 96%, 93%, 83%, and 73% at 5, 10, 20, and 30 years after the first symptom, respectively. Survival rates for diffuse cutaneous SSc (dcSSc) and limited cutaneous SSc were 91%, 86%, 64%, and 39%; and 97%, 95%, 85%, and 81% at 5, 10, 20, and 30 years, respectively (log-rank: 67.63, P < 0.0001). The dcSSc subset, male sex, age at disease onset older than 65 years, digital ulcers, interstitial lung disease (ILD), PH, heart involvement, scleroderma renal crisis (SRC), presence of antitopoisomerase I and absence of anticentromere antibodies, and active capillaroscopic pattern showed reduced survival rate. In a multivariate analysis, older age at disease onset, dcSSc, ILD, PH, and SRC were independent risk factors for mortality. In the present study involving a large cohort of SSc patients, a high prevalence of disease-related causes of death was demonstrated. Older age at disease onset, dcSSc, ILD, PH, and SRC were identified as independent prognostic factors.
Collapse
Affiliation(s)
- C P Simeón-Aznar
- From the Department of Internal Medicine, Hospital Valld'Hebron (CPS-A, VF-P, MV-T); Department of Internal Medicine, Hospital Parc Taulí, Sabadell (CT-V); Department of Autoimmune Diseases, Hospital Clinic (GE-G, MR-C); Laboratori of Computacional Medicine, Bioestatistics Unit, Universitat Autònoma de Barcelona, Bellaterra, Barcelona (MC-G); Unit of Connective Tissue Diseases, Department of Internal Medicine, Hospital Virgen del Rocio, Sevilla (FJG-H, MJC-P, JS-R); Unit of Autoimmune Systemic Diseases, Department of Internal Medicine, Hospital Clínico San Cecilio, Granada (JLC-R, NO-C); Department of Internal Medicine, Hospital de Cruces, Galdakano, Bilbao (MVE-A); Department of Internal Medicine, Hospital de Cabueñes, Gijón (LT-M); Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo (LC-M); Department of Internal Medicine, Hospital Miguel Servet, Zaragoza (LS-C, JV-M); Department of Internal Medicine, Hospital Carlos Haya, Málaga (MTC-G, ER-G); Department of Internal Medicine, Hospital Son Espases, Palma de Mallorca (EME-M, LP-F); Department of Internal Medicine, Hospital Virgen de las Nieves, Granada (NN-N, JAV-H); Department of Internal Medicine, Hospital San Agustín, Avilés (RGT); Department of Internal Medicine, Hospital La Fe, Valencia (GS-C); and Department of Internal Medicine, Hospital La Paz, Madrid (JJR-B), Systemic Autoimmune Diseases Group (GEAS), Spanish Scleroderma Study Group (SSSG), Spanish Society of Internal Medicine, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Gheitasi H, Kostov B, Solans R, Fraile G, Suárez-Cuervo C, Casanovas A, Rascón F, Qanneta R, Pérez-Alvarez R, Ripoll M, Akasbi M, Pinilla B, Bosch J, Nava-Mateos J, Díaz-López B, Morera-Morales M, Retamozo S, Ramos-Casals M, Brito-Zerón P. How are we treating our systemic patients with primary Sjögren syndrome? Analysis of 1120 patients. Int Immunopharmacol 2015; 27:194-9. [DOI: 10.1016/j.intimp.2015.03.027] [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] [Received: 01/13/2015] [Accepted: 03/21/2015] [Indexed: 12/22/2022]
|
15
|
Fraile G, Brito Zeron P, Solans R, Caravia-Durán D, Maure B, Rascόn FJ, Lopez-Dupla M, Ripoll M, Lόpez-Berastegui O, Trapiella L, García-Sánchez I, Pérez-de-Lis M, Jiménez-Heredia I, de la Red G, Gato A, Martínez-Valle F, Nava J, Díaz-Lόpez B, Pallarés L, Gheitasi H, Ramos-Casals M. FRI0604 Antimitochondrial Antibodies and Antibodies Against Subunits of Pyruvate Dehydrogenase as Serological Markers of Primary Biliary Cirrhosis in Patients with Primary SjöGren Syndrome. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3961] [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]
|
16
|
Brito Zeron P, Kostov B, Solans R, Fraile G, Caravia-Durán D, Maure B, Rascόn FJ, Villar-Navas B, Ripoll M, Pinilla B, Fonseca E, Akasbi M, Pérez-de-Lis M, Jiménez-Heredia I, de la Red G, Gato A, Ramentol M, Ruedas A, Díaz-Lόpez B, Pallarés L, Gheitasi H, Ramos-Casals M. OP0088 Categorization of Baseline Systemic Activity at Diagnosis Using the Essdai Disease Activity States (DAS) in Primary Sjögren Syndrome: Association with Poor Outcomes. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3946] [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]
|
17
|
Brito Zeron P, Kostov B, Seror R, Baldini C, Quartuccio L, Kvarnstrom M, Kruize A, Hernández Molina G, Praprotnik S, Bartoloni E, Solans R, Theander E, Valim V, Priori R, Zeher M, Isenberg D, Rasmussen A, Giacomelli R, Carsons S, Hammenfors D, Vollenweider C, Atzeni F, Mandl T, De Vita S, Wahren-Herlenius M, Sanchez-Guerrero J, Gerli R, Sivils K, Mowa S, Brun J, Mariette X, Ramos-Casals M. FRI0419 Big Data Sjogren Project (Eular-SS Task Force International Network): Systemic Involvement at Diagnosis Evaluated by the Essdai in 3314 Patients with Primary Sjögren Syndrome. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4752] [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]
|
18
|
Gheitasi H, Kostov B, Solans R, Fraile G, Suárez-Cuervo C, Casanovas A, Rascόn FJ, Qanneta R, Pérez-Alvarez R, Ripoll M, Akasbi M, Pinilla B, Bosch X, Nava-Mateos J, Díaz-Lόpez B, Morera-Morales L, Retamozo S, Ramos-Casals M, Brito Zeron P. THU0408 How we are Treating Our Systemic Patients with Primary Sjögren Syndrome? Analysis of 1120 Patients (GEAS-SS Spanish Registry). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3363] [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]
|
19
|
Brito Zeron P, Sellarés J, Bosch X, Hernández F, Lopez-Casany C, Sanchez M, Ramírez J, Gheitasi H, Kostov B, Santos J, Sisό Almirall A, Agustí C, Ramos-Casals M. SAT0547 Sequential Diagnosis of Sarcoidosis and Malignancy: A close But Complex Association with Four Differential Clinical Scenarios. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4864] [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]
|
20
|
Brito Zeron P, Espinosa G, Robles A, Rosich P, Sáez Comet L, Capdevila O, Vargas J, Pallarés L, Trapiella L, González Nieto J, Martínez Zapico A, Rodriguez M, Tolosa C, Mitjavila F, Pérez-Conesa M, Sabio J, Caminal L, Oristrell J, Ramos-Casals M. FRI0418 Outcome of the Autoimmune Congenital Heart Block in 45 Babies from Anti-RO/LA (+) Mothers: Results from the Spanish Registry (Rebacc-Geas-Semi). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4783] [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]
|
21
|
Brito Zeron P, Sellarés J, Bosch X, Hernández F, Lopez-Casany C, Sanchez M, Ramírez J, Gheitasi H, Kostov B, Santos J, Sisό Almirall A, Agustí C, Ramos-Casals M. THU0564 Is Extrathoracic Disease Associated with Mortality in Sarcoidosis? Predicting Survival According to the Epidemiological and Clinical Features at Diagnosis in 170 Patients. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3357] [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]
|
22
|
Brito Zeron P, Moral Moral P, Martínez Zapico A, Fraile G, Fonseca E, Pérez Guerrero P, Robles A, Vaquero Herrero M, Ruiz De Temiño A, Forner M, Larrañaga J, Prieto S, Hurtado R, Ruiz Muñoz M, Rodriguez M, Caminal L, Chamorro A, Calvo M, Bosch X, Castro P, Ramos-Casals M. THU0563 Prognostic Value of the 2014 Hscore in Adult Hemophagocytic Syndrome: Analysis in 111 Consecutive Patients (Reghem-Geas-Semi Spanish Cohort). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4821] [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]
|
23
|
Brito Zeron P, Kostov B, Zeher M, Theander E, Gottenberg JE, Baldini C, Quartuccio L, Priori R, Kvarnstrom M, Kruize A, Hernández Molina G, Praprotnik S, Isenberg D, Bartoloni E, Rasmussen A, Solans R, Valim V, Giacomelli R, Carsons S, Hammenfors D, Vollenweider C, Atzeni F, Mandl T, De Vita S, Wahren-Herlenius M, Sanchez-Guerrero J, Gerli R, Sivils K, Mowa S, Brun J, Mariette X, Ramos-Casals M. OP0089 Big Data Sjögren Project (Eular-SS Task Force International Network): Characterization at Diagnosis of 5027 Patients with Primary Sjögren Syndrome. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
24
|
Brito Zeron P, Kostov B, Solans R, Fraile G, García-Pérez A, Maure B, Rascόn FJ, Lopez-Dupla M, Ripoll M, Lόpez González-Cobos C, Fonseca E, Akasbi M, Pérez-de-Lis M, Jiménez-Heredia I, de la Red G, Gato A, Ramentol M, Ruedas A, Díaz-Lόpez B, Pallarés L, Gheitasi H, Ramos-Casals M. SAT0417 Cancer and Primary SjÖgren Syndrome in 1216 Patients (GEAS-SS Registry): Systemic Activity Measured by the Essdai is Related to Hematological, but not Solid Neoplasia. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3796] [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]
|
25
|
Seror R, Baron G, Vitali C, Bowman S, Gottenberg JE, Tzioufas A, Theander E, Bootsma H, Doerner T, Ramos-Casals M, Mariette X, Ravaud P. FRI0421 Development of Clinessdai Score (Clinical Eular Sjögren's Syndrome Disease Activity Index) Without Biological Domain: A Tool For Biological Studies. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5236] [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]
|
26
|
Quartuccio L, Corazza L, Ramos-Casals M, Retamozo S, Ragab G, Ferraccioli G, Gremese E, Tzioufas A, Voulgarelis M, Vassilopoulos D, Koutsianas C, Scarpato S, Salvarani C, Guillevin L, Terrier B, Cacoub P, Saccardo F, Gabrielli A, Fraticelli P, Tomsic M, Tavoni A, Nishimoto N, Filippini D, Scaini P, Zignego A, Ferri C, Sansonno D, Monti G, Pietrogrande M, Galli M, Bombardieri S, De Vita S. OP0274 Cryoglobulinemic Vasculitis and Primary sjögren's Syndrome are Independent Risk Factors for Lymphoma in a Large Worldwide Population of Patients with Positive Serum Cryoglobulins. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3300] [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]
|
27
|
Brito-Zerón P, Kostov B, Solans R, Fraile G, Suárez-Cuervo C, Casanovas A, Rascón FJ, Qanneta R, Pérez-Alvarez R, Ripoll M, Akasbi M, Pinilla B, Bosch JA, Nava-Mateos J, Díaz-López B, Morera-Morales ML, Gheitasi H, Retamozo S, Ramos-Casals M. Systemic activity and mortality in primary Sjögren syndrome: predicting survival using the EULAR-SS Disease Activity Index (ESSDAI) in 1045 patients. Ann Rheum Dis 2014; 75:348-55. [PMID: 25433020 DOI: 10.1136/annrheumdis-2014-206418] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 11/07/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To score systemic activity at diagnosis and correlate baseline activity with survival in a large cohort of patients with primary Sjögren syndrome (SS). PATIENTS AND METHODS We include 1045 consecutive patients who fulfilled the 2002 classification criteria for primary SS. The clinical and immunological characteristics and level of activity (EULAR-SS Disease Activity Index (ESSDAI) scores) were assessed at diagnosis as predictors of death using Cox proportional hazards regression analysis adjusted for age at diagnosis. The risk of death was calculated at diagnosis according to four different predictive models. RESULTS After a mean follow-up of 117 months, 115 (11%) patients died. The adjusted standardised mortality ratio for the total cohort was 4.66 (95% CI 3.85 to 5.60), and survival rates at 5, 10, 20 and 30 years were 96%, 90%, 81% and 60%, respectively. The main baseline factors associated with overall mortality in the multivariate analysis were male gender, cryoglobulins and low C4 levels. Baseline activity in the constitutional, pulmonary and biological domains was associated with a higher risk of death. High activity in at least one ESSDAI domain (HR 2.14), a baseline ESSDAI score ≥14 (HR 1.85) and more than one laboratory predictive marker (lymphopenia, anti-La, monoclonal gammopathy, low C3, low C4 and/or cryoglobulins) (HR 2.82) were associated with overall mortality; these HRs increased threefold to 10-fold when the analysis was restricted to mortality associated with systemic disease. CONCLUSIONS Patients with primary SS, who present at diagnosis with high systemic activity (ESSDAI ≥14) and/or predictive immunological markers (especially those with more than one), are at higher risk of death.
Collapse
Affiliation(s)
- P Brito-Zerón
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ICMiD, Hospital Clínic, Barcelona, Spain
| | - B Kostov
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ICMiD, Hospital Clínic, Barcelona, Spain Primary Care Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Primary Care Centre Les Corts, CAPSE, Barcelona, Spain
| | - R Solans
- Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Spain
| | - G Fraile
- Department of Internal Medicine, Hospital Ramón y Cajal, Madrid, Spain
| | - C Suárez-Cuervo
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A Casanovas
- Department of Internal Medicine, Hospital Parc Taulí, Sabadell, Spain
| | - F J Rascón
- Department of Internal Medicine, Hospital Son Espases, Palma de Mallorca, Spain
| | - R Qanneta
- Department of Internal Medicine, Hospital Joan XXIII, Tarragona, Spain
| | - R Pérez-Alvarez
- Department of Internal Medicine, Hospital do Meixoeiro, Vigo, Spain
| | - M Ripoll
- Department of Internal Medicine, Hospital Infanta Sofía, Madrid, Spain
| | - M Akasbi
- Department of Internal Medicine, Hospital Infanta Leonor, Madrid, Spain
| | - B Pinilla
- Department of Internal Medicine, Hospital Gregorio Marañón, Madrid, Spain
| | - J A Bosch
- Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Spain
| | - J Nava-Mateos
- Department of Internal Medicine, Hospital Ramón y Cajal, Madrid, Spain
| | - B Díaz-López
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - H Gheitasi
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ICMiD, Hospital Clínic, Barcelona, Spain
| | - S Retamozo
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ICMiD, Hospital Clínic, Barcelona, Spain
| | - M Ramos-Casals
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ICMiD, Hospital Clínic, Barcelona, Spain
| | | |
Collapse
|
28
|
Seror R, Gottenberg J, Bootsma H, Saraux A, Theander E, Ramos-Casals M, Bowman S, Le Guern V, Dörner T, Tzioufas A, Goeb V, Vitali C, Ravaud P, Mariette X. OP0217 Defining Disease Activity Sates and Minimal Clinically Important Improvement (MCII) with the EULAR Primary SjÖGren's Syndrome Disease Activity Index (ESSDAI). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4399] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
29
|
Brito Zeron P, Kostov B, Solans R, de Luna G, Casanovas A, Díaz-Lόpez B, Rascόn F, Qanneta R, Pérez-Alvarez R, García-Sánchez I, Ripoll M, Pinilla B, Gheitasi H, Retamozo S, Ramos-Casals M. OP0211 Association between Systemic Activity and Lymphoma in Primary Sjogren Syndrome: Baseline Essdai Predictors in 921 Spanish Patients (GEAS-SS Registry). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
30
|
Brito Zeron P, Retamozo S, Bové A, Kostov B, Gheitasi H, Ligero M, Sisό-Almirall A, Alόs L, Ramos-Casals M. SAT0206 Minimally-Invasive Technique for the Biopsy of Minor Salivary Glands: Searching for Systemic Infiltrative Diseases in Patients Presenting with SICCA Symptoms. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5132] [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]
|
31
|
Brito Zeron P, Caminal-Montero L, Chamorro A, de la Hera Fernández J, Gato A, Marín-Ballvé A, Robles A, Rodríguez-Carballeira M, Salvador G, Saez L, Ruiz-Irastorza G, Gheitasi H, Retamozo S, Ramos-Casals M. AB0542 Blocking the Human B Lymphocyte Stimulator Molecule (BLYS) Using A Monoclonal Antibody (Belimumab) in Systemic Lupus Erythematosus: First Results in Real-Life Spanish Patients with Refractory Disease (Biogeas-Semi Registry). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
32
|
Brito Zeron P, Retamozo S, Solans R, Fraile G, Morera-Morales L, Suárez-Cuervo C, Rascόn F, Qanneta R, Pérez-de-Lis M, Akasbi M, Ripoll M, Pinilla B, Kostov B, Gheitasi H, Ramos-Casals M. OP0213 The Degree of Activity Measured with the EULAR-SS Disease Activity Index (ESSDAI) Strongly Correlated with Death in Patients with Primary Sjogren Syndrome (GEAS-SS REGISTRY). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4342] [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]
|
33
|
Brito Zeron P, Mañá J, Pérez-Alvarez R, Retamozo S, Gheitasi H, Fernández-Martín J, Pérez-de-Lis M, Bosch X, Ramos-Casals M. THU0397 Clinical Presentation and Characterization of Neurosarcoidosis: Analysis in 719 Patients (Sarcogeas-Semi Registry). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5374] [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]
|
34
|
Brito Zeron P, Cajamarca L, Perez-Alvarez R, Real de Asua D, Benito Conejero S, Beamud F, Martinez-Valle F, Bosch X, Villaverde I, Fonseca E, Acevedo L, Gonzalez Vazquez L, de la Red G, Santiago C, Gonzalez Vazquez E, Inglada L, Robles Marhuenda A, Castro Salomo A, Jordana R, Fernandez Martin J, Perez de Lis M, Retamozo S, Gheitasi H, Lopez Soto A, Ramos-Casals M. THU0399 Systemic Amyloidosis as A Multi-Organ, Life-Threatening Disease: Predictive Baseline Factors Associated to Mortality in 570 Patients (Ramyd-Geas-Semi Registry). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5896] [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]
|
35
|
Brito Zeron P, Retamozo S, Gheitasi H, Bové A, Kostov B, Sisό-Almirall A, Ramos-Casals M, Stone J. THU0396 Igg4-Related Disease or Primary Sjogren Syndrome? Organ-Specific Involvement and Immunological Profile Are Clues in Differentiating Two Diseases with A Common Clinical Presentation. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5099] [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]
|
36
|
Brito Zeron P, Kaveri S, Bové A, Retamozo S, Gheitasi H, Akasbi M, Gandía M, Soto-Cárdenas M, Pérez-de-Lis M, Pérez-Alvarez R, Kostov B, Sisό-Almirall A, Londoño M, Forns X, Ramos-Casals M. THU0298 Are Anti-La Antibodies A Potential Protection for Hepatitis C Virus Infection in SjÖGren Syndrome? Analysis in 663 Patients. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4158] [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]
|
37
|
Brito-Zerón P, Retamozo S, Akasbi M, Gandía M, Perez-De-Lis M, Soto-Cardenas MJ, Diaz-Lagares C, Kostov B, Bove A, Bosch X, Perez-Alvarez R, Siso A, Ramos-Casals M. Annular erythema in primary Sjögren’s syndrome: description of 43 non-Asian cases. Lupus 2013; 23:166-75. [DOI: 10.1177/0961203313515764] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective The objective of this paper is to evaluate the prevalence and characterize the main epidemiological, clinical and immunological features of annular erythema (AE) in non-Asian patients with primary Sjögren’s syndrome (SS). Methods We carried out a retrospective study searching for AE in 377 Spanish patients with primary SS fulfilling the 2002 American-European criteria. In addition, we searched PubMed (1994–2012) using the MeSH terms “annular erythema” and “primary Sjögren’s syndrome” for additional cases. All cases with AE reported in patients with SS associated with systemic lupus erythematosus were excluded. Results In our Spanish cohort, we found 35 (9%) patients diagnosed with AE. All were white females, with a mean age of 47 years at diagnosis of AE. AE preceded diagnosis of SS in 27 (77%) patients. Cutaneous AE lesions involved principally the face and upper extremities. All patients reported photosensitivity, with cutaneous flares being reported during the warmest months in 93% of patients. Immunological markers consisted of anti-Ro/La antibodies in 31 (89%) patients. In the literature search, we identified eight additional non-Asian patients with primary SS diagnosed with AE. In comparison with 52 Asian patients, the 43 non-Asian patients with AE related to primary SS were more frequently women (100% vs 78%, p = 0.008), and cutaneous lesions were less frequently reported in the face (55% vs 81%, p = 0.045) and more frequently in the neck (40% vs 14%, p = 0.041). Immunologically, non-Asian patients had a lower frequency of anti-Ro antibodies and a higher frequency of negative Ro/La antibodies, although the differences were not statistically significant. Conclusion AE is not an exclusive cutaneous feature of Asian patients with primary SS. In addition to the characteristic cutaneous expression, AE has a very specific clinical and immunological profile: often presenting before the fulfillment of SS criteria, overwhelmingly associated with anti-Ro antibodies but weakly associated with other immunological markers and the main systemic SS-related features.
Collapse
Affiliation(s)
- P Brito-Zerón
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font-CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases
| | - S Retamozo
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font-CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases
| | - M Akasbi
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font-CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases
- Department of Internal Medicine, Hospital Infanta Leonor, Spain
| | - M Gandía
- Department of Internal Medicine, University of Cadiz, Hospital Puerta del Mar, Spain
| | - M Perez-De-Lis
- Department of Internal Medicine, Hospital do Meixoeiro, Spain
| | - M-J Soto-Cardenas
- Department of Internal Medicine, University of Cadiz, Hospital Puerta del Mar, Spain
| | - C Diaz-Lagares
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font-CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases
| | - B Kostov
- Primary Care Research Group, IDIBAPS, Centre d’Assistència Primària ABS Les Corts, GESCLINIC, Spain
| | - A Bove
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font-CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases
| | - X Bosch
- Department of Internal Medicine, ICMiD, Spain
| | - R Perez-Alvarez
- Department of Internal Medicine, Hospital do Meixoeiro, Spain
| | - A Siso
- Primary Care Research Group, IDIBAPS, Centre d’Assistència Primària ABS Les Corts, GESCLINIC, Spain
| | - M Ramos-Casals
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font-CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases
| |
Collapse
|
38
|
Ramos-Casals M, Brito-Zeron P, Solans R, Camps MT, Casanovas A, Sopena B, Diaz-Lopez B, Rascon FJ, Qanneta R, Fraile G, Perez-Alvarez R, Callejas JL, Ripoll M, Pinilla B, Akasbi M, Fonseca E, Canora J, Nadal ME, Red GDL, Fernandez-Regal I, Jimenez-Heredia I, Bosch JA, Ayala MDM, Morera-Morales L, Maure B, Mera A, Ramentol M, Retamozo S, Kostov B. Systemic involvement in primary Sjogren's syndrome evaluated by the EULAR-SS disease activity index: analysis of 921 Spanish patients (GEAS-SS Registry). Rheumatology (Oxford) 2013; 53:321-31. [DOI: 10.1093/rheumatology/ket349] [Citation(s) in RCA: 140] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
39
|
Seror R, Theander E, Brun J, Ramos-Casals M, valim V, Dörner T, Mariette X, bootsma H, Tzioufas A, Solans Laqué R, Mandl T, Gottenberg JE, Hachulla E, Ng WF, Bombardieri S, Gerli R, sumida T, saraux A, tomsic M, caporali R, Priori R, Moser K, Kruize AA, Vollenweider C, Ravaud P, Praprotnik S, Scofield H, Valesini G, Montecucco C, Fauchais AL, Vitali C, Bowman S. FRI0303 Validation of eular primary sjögren’s syndrome disease activity and patient indexes. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1430] [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]
|
40
|
van Vollenhoven R, Mild M, Jacobsen S, Wallace DJ, Hanley JG, Petri MA, Bernatsky SR, Bae SC, Ramos-Casals M, Garcia-Hernandez F, Ayala-Guiterrez MDM, Ramsey-Goldman R, Doria A, Mosca M. THU0283 Two Year Follow-Up on Biologics Use in 13 Centers - Data from the International Registry for Biologics in SLE (IRBIS). Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.811] [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]
|
41
|
De Vita S, Quartuccio L, Isola M, Corazza L, Ramos-Casals M, Retamozo S, Ragab G, Zoheir N, El Menyawi MM, Salem M, Sansonno D, Conteduca V, Ferraccioli G, Gremese E, Tzioufas A, Voulgarelis M, Vassilopoulos D, Koutsianas C, Zignego AL, Urraro T, Pipitone N, Salvarani C, Ghinoi A, Guillevin L, Terrier B, Cacoub P, Filippini D, Saccardo F, Gabrielli A, Fraticelli P, Tomsic M, Ferri C, Sebastiani M, Tavoni A, Catarsi E, Mazzaro C, Pioltelli P, Nishimoto N, Scaini P, Monti G, Pietrogrande M, Galli M, Bombardieri S. SAT0175 Results of the Classification Criteria for Cryoglobulinemic Vasculitis Validation Study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1901] [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]
|
42
|
Ramos-Casals M, Ruiz-Irastorza G, Jiménez-Alonso J, Khamashta MA. [Belimumab in systemic lupus erythematosus: a guide for its use in the daily practice]. Rev Clin Esp 2013; 213:66-67. [PMID: 23565550] [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] [Indexed: 06/02/2023]
Affiliation(s)
- M Ramos-Casals
- Laboratorio de Enfermedades Autoinmunes Josep Font , IDIBAPS, Servicio de Enfermedades Autoinmunes, Hospital Clínic, Barcelona, España.
| | | | | | | |
Collapse
|
43
|
Ramos-Casals M, Ruiz-Irastorza G, Jiménez-Alonso J, Khamashta MA. [Recommendations on the use of belimumab in systemic lupus erythematosus. GEAS-SEMI Clinical Practice Guide]. Rev Clin Esp 2012; 213:42-58. [PMID: 23266125 DOI: 10.1016/j.rce.2012.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 10/10/2012] [Indexed: 12/23/2022]
Abstract
Biological therapies are based on the administration of various types of synthetic molecules related to the immune response. Their use has spread in recent years to the field of systemic autoimmune diseases, particularly to systemic lupus erythematosus (SLE). Until 2011, these diseases were not included in the therapeutic indications approved by international regulatory agencies. Therefore, the use of biological therapies was restricted to clinical trials and to compassionate use for cases refractory to standard treatments (off-label use), which require the approval of the Health Ministry. In 2011, belimumab, a human monoclonal antibody that specifically binds to the soluble form of the protein human B lymphocyte stimulator BlyS, was approved for use in patients with SLE. Because the clinical information on the use of this new drug in patients with SLE has only been obtained from the results of randomized trials, the Study Group of Autoimmune Diseases (GEAS) of the Spanish Society of Internal Medicine (SEMI) has developed therapeutic guidelines. These guidelines are based on the current scientific evidence on the use of belimumab in SLE patients in the clinical practice.
Collapse
Affiliation(s)
- M Ramos-Casals
- Servicio de Enfermedades Autoinmunes, Laboratorio de Enfermedades Autoinmunes Josep Font, IDIBAPS, Hospital Clínic, Barcelona, España.
| | | | | | | |
Collapse
|
44
|
|
45
|
Akasbi M, Berenguer J, Saiz A, Brito-Zerón P, Pérez-De-Lis M, Bové A, Diaz-Lagares C, Retamozo S, Blanco Y, Perez-Alvarez R, Bosch X, Sisó A, Graus F, Ramos-Casals M. White matter abnormalities in primary Sjögren syndrome. QJM 2012; 105:433-43. [PMID: 22156707 DOI: 10.1093/qjmed/hcr218] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe the main characteristics of patients with primary Sjögren syndrome (SS) and white matter abnormalities (WMA) seen by a specialist SS unit. METHODS The study cohort included 321 consecutive patients fulfilling the 2002 classification criteria for primary SS. We retrospectively analyzed the results of neuroimaging studies performed in patients who presented with neurological symptoms. Patients were further evaluated by three neurologists to determine fulfillment of the McDonald criteria for the diagnosis of multiple sclerosis (MS). RESULTS Fifty-one (16%) patients had at least one neuroimaging study, and 25 of these had WMA. WMA were classified as vascular pathological changes in 21 patients: 10 had multiple small focal lesions, 7 had beginning confluence of lesions and 4 had diffuse involvement of the entire region. WMA were classified as inflammatory/demyelinating lesions (MS-like) in 4 patients who fulfilled the MRI Barkhof criteria. Patients with inflammatory/demyelinating lesions were younger (53.7 vs. 73.5 years, P = 0.001) and had a lower frequency of hypertension (25% vs. 86%, P = 0.031) and altered glomerular filtration rate (0% vs. 70%, P = 0.047) in comparison with patients with vascular lesions. The multivariate age-sex adjusted model including the seven variables which were statistically significant in the univariate analysis (antimalarial therapy, leukopenia, anti-La/SSB antibodies, diabetes, hypertension, metabolic syndrome and HDL-c levels) identified hypertension (P = 0.019) and HDL-c levels (P = 0.032) as independent predictors of WMA in primary SS patients. CONCLUSION Neuroimaging studies disclosed WMA in 49% of patients with primary SS and suspected neurological involvement. WMA were identified as vascular pathological changes in 80% of the patients, and hypertension and HDL-c levels as predictive factors for this association.
Collapse
Affiliation(s)
- M Akasbi
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases, Hospital do Meixoeiro, Vigo, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Alexeeva E, Kozlova A, Valieva S, Bzarova T, Chomahizde A, Isaeva K, Denisova R, Slepcova T, Starkova A, Amirdzhanova V, Alexandrova E, Avdeeva A, Novikov A, Panasyuk E, Cherkasova M, Klimova N, Nasonov E, Aggarwal A, Sharma A, Bhatnagar A, Dubula T, Mody GM, Abdel-Wahab N, Tayseer Khedr S, Rashad E, Alkady E, Mosad, Owino L, Ubeer A, Pan Z, Liu X, Xu J, Zhang Y, Omurzakova NA, Volkava M, Kundzer A, Generalov I, Tan W, Wu H, Zhao J, Derber LA, Lee DM, Shadick NA, Conn DL, Smith EA, Gersuk VH, Nepom GT, Moreland LW, Furst DE, Thompson SD, Jonas BL, Michael Holers V, Glass DN, Chen PP, Louis Bridges S, Weinblatt ME, Paulus HE, Tsao BP, Umar S, Ahmad S, Kant Katiyar C, Khan HA, Munoz A, Martinez R, Rodriguez S, Luis Marenco J, Lu Z, Guo-chun W, Shah D, Bhatnagar A, Wanchu A, Sherif Suliman YA, Budhoo A, Mody GM, Hristova M, Kamenarska Z, Dourmishev L, Baleva M, Kaneva R, Savov A, Retamozo S, Diaz-Lagares C, Brito-Zeron P, Gomez ME, Bosch X, Bove A, Forns X, Yague J, Ramos-Casals M, Chen Z, Li XM, Wang GS, Qian L, Li XP, Zu N, Zhao H, Xu B, Li HY, Xiang Q, Wang GC, Mazur-Nicorici L, Mazur M, Crib L, Ding H, Chen S, Ye S, Fedorenko E, Lukina G, Sigidin Y, Hammam N, Orabi H, Lue TF, Goel R, Danda D, Eapen C, Mathew J, Kumar S. Abstracts from EIR School ES01-ES25. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/ker439] [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: 11/14/2022] Open
|
47
|
Hanly JG, Urowitz MB, Su L, Bae SC, Gordon C, Clarke A, Bernatsky S, Vasudevan A, Isenberg D, Rahman A, Wallace DJ, Fortin PR, Gladman D, Romero-Diaz J, Romero-Dirz J, Sanchez-Guerrero J, Dooley MA, Bruce I, Steinsson K, Khamashta M, Manzi S, Ramsey-Goldman R, Sturfelt G, Nived O, van Vollenhoven R, Ramos-Casals M, Aranow C, Mackay M, Kalunian K, Alarcón GS, Fessler BJ, Ruiz-Irastorza G, Petri M, Lim S, Kamen D, Peschken C, Farewell V, Thompson K, Theriault C, Merrill JT. Autoantibodies as biomarkers for the prediction of neuropsychiatric events in systemic lupus erythematosus. Ann Rheum Dis 2011; 70:1726-32. [PMID: 21893582 DOI: 10.1136/ard.2010.148502] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Neuropsychiatric events occur unpredictably in systemic lupus erythematosus (SLE) and most biomarker associations remain to be prospectively validated. This study examined a disease inception cohort of 1047 SLE patients to determine which autoantibodies at enrolment predicted subsequent neuropsychiatric events. METHODS Patients with a recent SLE diagnosis were assessed prospectively for up to 10 years for neuropsychiatric events using the American College of Rheumatology case definitions. Decision rules of graded stringency determined whether neuropsychiatric events were attributable to SLE. Associations between the first neuropsychiatric event and baseline autoantibodies (lupus anticoagulant (LA), anticardiolipin, anti-β(2) glycoprotein-I, anti-ribosomal P and anti-NR2 glutamate receptor) were tested by Cox proportional hazards regression. RESULTS Disease duration at enrolment was 5.4 ± 4.2 months, follow-up was 3.6 ± 2.6 years. Patients were 89.1% female with mean (±SD) age 35.2 ± 13.7 years. 495/1047 (47.3%) developed one or more neuropsychiatric event (total 917 events). Neuropsychiatric events attributed to SLE were 15.4% (model A) and 28.2% (model B). At enrolment 21.9% of patients had LA, 13.4% anticardiolipin, 15.1% anti-β(2) glycoprotein-I, 9.2% anti-ribosomal P and 13.7% anti-NR2 antibodies. LA at baseline was associated with subsequent intracranial thrombosis (total n=22) attributed to SLE (model B) (HR 2.54, 95% CI 1.08 to 5.94). Anti-ribosomal P antibody was associated with subsequent psychosis (total n=14) attributed to SLE (model B) (HR 3.92, 95% CI 1.23 to 12.5, p=0.02). Other autoantibodies did not predict neuropsychiatric events. CONCLUSION In a prospective study of 1047 recently diagnosed SLE patients, LA and anti-ribosomal P antibodies are associated with an increased future risk of intracranial thrombosis and lupus psychosis, respectively.
Collapse
Affiliation(s)
- J G Hanly
- Department of Medicine, Division of Rheumatology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Hanly JG, Urowitz MB, Jackson D, Bae SC, Gordon C, Wallace DJ, Clarke A, Bernatsky S, Vasudevan A, Isenberg D, Rahman A, Sanchez-Guerrero J, Romero-Diaz J, Merrill JT, Fortin PR, Gladman DD, Bruce IN, Steinsson K, Khamashta M, Alarcón GS, Fessler B, Petri M, Manzi S, Nived O, Sturfelt G, Ramsey-Goldman R, Dooley MA, Aranow C, Van Vollenhoven R, Ramos-Casals M, Zoma A, Kalunian K, Farewell V. SF-36 summary and subscale scores are reliable outcomes of neuropsychiatric events in systemic lupus erythematosus. Ann Rheum Dis 2011; 70:961-7. [PMID: 21342917 DOI: 10.1136/ard.2010.138792] [Citation(s) in RCA: 45] [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] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To examine change in health-related quality of life in association with clinical outcomes of neuropsychiatric events in systemic lupus erythematosus (SLE). METHODS An international study evaluated newly diagnosed SLE patients for neuropsychiatric events attributed to SLE and non-SLE causes. The outcome of events was determined by a physician-completed seven-point scale and compared with patient-completed Short Form 36 (SF-36) health survey questionnaires. Statistical analysis used linear mixed-effects regression models with patient-specific random effects. RESULTS 274 patients (92% female; 68% Caucasian), from a cohort of 1400, had one or more neuropsychiatric event in which the interval between assessments was 12.3 ± 2 months. The overall difference in change between visits in mental component summary (MCS) scores of the SF-36 was significant (p<0.0001) following adjustments for gender, ethnicity, centre and previous score. A consistent improvement in neuropsychiatric status (N=295) was associated with an increase in the mean (SD) adjusted MCS score of 3.66 (0.89) in SF-36 scores. Between paired visits when the neuropsychiatric status consistently deteriorated (N=30), the adjusted MCS score decreased by 4.00 (1.96). For the physical component summary scores the corresponding changes were +1.73 (0.71) and -0.62 (1.58) (p<0.05), respectively. Changes in SF-36 subscales were in the same direction (p<0.05; with the exception of role physical). Sensitivity analyses confirmed these findings. Adjustment for age, education, medications, SLE disease activity, organ damage, disease duration, attribution and characteristics of neuropsychiatric events did not substantially alter the results. CONCLUSION Changes in SF-36 summary and subscale scores, in particular those related to mental health, are strongly associated with the clinical outcome of neuropsychiatric events in SLE patients.
Collapse
Affiliation(s)
- J G Hanly
- Division of Rheumatology, Nova Scotia Rehabilitation Centre (2nd Floor), 1341 Summer Street, Halifax, NS B3H 4K4, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Vera-Recabarren MA, García-Carrasco M, Ramos-Casals M, Herrero C. Cutaneous lupus erythematosus: clinical and immunological study of 308 patients stratified by gender. Clin Exp Dermatol 2010; 35:729-35. [PMID: 20015282 DOI: 10.1111/j.1365-2230.2009.03764.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Numerous studies involving systemic lupus erythematosus (SLE) have attempted to identify gender differences in patients with lupus erythematosus (LE). However, few reports on cutaneous lupus erythematous (CLE) have identified gender differences. AIM To analyse and compare the prevalence and characteristics of the main clinical and immunological features of male and female patients with CLE. METHODS The medical records of 103 (33.4%) male and 205 (66.6%) female patients with CLE who were treated as inpatients or outpatients between January 1985 and December 2000 were retrospectively studied. All patients were reviewed in detail stratified by a predefined protocol. RESULTS Female patients had a higher prevalence of Raynaud's phenomenon (P < 0.01), chilblain lupus (P = 0.005), arthralgias (P = 0.001) and SLE (P < 0.01). Female patients were also more likely to have an increased erythrocyte sedimentation rate (P < 0.005), higher levels of antinuclear antibodies (P < 0.001) and decreased levels of C3 (P < 0.001), C4 (P < 0.01) and CH50 (P < 0.01). There was a higher prevalence of clinical and laboratory abnormalities in female patients who had both SLE and CLE than in male patients with both conditions. Conclusions. In our series, differences in the expression of CLE existed between male and female patients with respect to the type of lesions, systemic features, and immunological findings.
Collapse
Affiliation(s)
- M A Vera-Recabarren
- Department of Dermatology, Hospital Clinic, University of Barcelona, Catalonia, Spain.
| | | | | | | |
Collapse
|
50
|
Soto-Cardenas MJ, Perez-De-Lis M, Bove A, Navarro C, Brito-Zeron P, Diaz-Lagares C, Gandia M, Akasbi M, Siso A, Ballester E, Torres A, Ramos-Casals M. Bronchiectasis in primary Sjögren's syndrome: prevalence and clinical significance. Clin Exp Rheumatol 2010; 28:647-653. [PMID: 20883638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Accepted: 03/22/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVES To analyse the prevalence and clinical significance of bronchiectasis in a large series of patients with primary Sjögren's syndrome (SS) and evaluate its impact on disease expression and outcomes. METHODS The study cohort included 507 patients with primary SS. Bronchiectasis were diagnosed according to pulmonary computed tomography (CT). As a control group, we included 37 consecutive SS patients evaluated by pulmonary CT during the same study period without pulmonary involvement. RESULTS Fifty primary SS patients had bronchiectasis according to the pulmonary CT. Nine patients were excluded due to non-autoimmune processes and 41 were classified as bronchiectasis associated with primary SS (40 women, mean age of 64 years). All cases of bronchiectasis were of the cylindrical type and were located in the inferior lobes in 29 cases (71%). Patients with bronchiectasis were older at diagnosis of SS (60.39 vs. 52.54 years, p=0.022) and had a higher frequency of hiatus hernia (41% vs. 16%, p=0.024) in comparison with controls. Immunologically, patients with bronchiectasis had a lower frequency of anti-Ro/SS-A antibodies (27% vs. 54%, p=0.022) but a higher frequency of anti-smooth muscle--SMAantibodies (82% vs. 60%, p=0.043). During follow-up, patients with bronchiectasis had a higher frequency of respiratory infections (56% vs. 3%, p<0.001) and pneumonia (29% vs. 3%, p=0.002) in comparison with those without. CONCLUSIONS Patients with primary SS and bronchiectasis are characterised by an older age, a high frequency of hiatus hernia, a specific immunologic pattern (low frequency of anti-Ro/SS-A and high frequency of anti-SMA) and during follow-up a much higher frequency of respiratory infections and pneumonia.
Collapse
Affiliation(s)
- M-J Soto-Cardenas
- Sjögren's Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, IDIBAPS, Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|