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In this study, we aimed to evaluate the clinical and demographic data of the patients followed up with the diagnosis of Vascular Behçet's Disease (BD), and to examine the frequency of relapse and its relationship with the treatments used. The data of 512 patients diagnosed with BD were reviewed retrospectively, and 68 BD with vascular involvement were detected. Demographic characteristics, first vascular event, and recurrence, if any, and treatment protocols were recorded. The frequency of vascular involvement was 13.28%. 85% of the patients were man. Venous involvement was most common in the lower extremities. (77.9%) The first vascular relapse occurred in 29.4% of the patients, and the second vascular relapse occurred in 8.8%. After the first vascular event, 73.5% of the patients received systemic immunosuppressive therapy and 45.5% received anticoagulant therapy. The risk of relapse was found to be significantly higher in the group that did not receive immunosuppressive therapy. (p=0.001) Although the relapse rate was higher in the group receiving anticoagulant treatment, no statistically significant difference was found. (p=0.61) Vascular involvement often occurs in male patients. Immunosuppressive therapies and anticoagulants are used in the treatment. The use of immunosuppressive therapy can reduce the risk of vascular relapse. No additional benefit of anticoagulant therapy was observed. Multicenter studies with larger numbers of patients are needed for a better understanding in this issue., Bu çalışmada, vasküler Behçet Hastalığı (BH) tanısı ile izlediğimiz hastaların klinik, demografik verilerinin değerlendirilmesi, relaps sıklığı ve kullanılan tedavilerle olan ilişkisinin irdelenmesi amaçlanmıştır. BH tanılı 512 hastanın dosyası geriye dönük incelenerek 68 vasküler tutulumlu Behçet hastası tespit edildi. Demografik özellikler, birinci vasküler olay ve varsa nüksü, tedavi protokolleri kaydedildi. Vasküler tutulum sıklığı %13,28’idi. Hastaların %85’i erkekti. En sık alt ekstremitelerde venöz tutulum görüldü (%77,9). İlk vasküler relaps, hastaların %29,4’inde, ikinci vasküler relaps ise %8,8’inde gelişti. Vasküler tutulumlu Behçet hastalarında vasküler tutulumun tespit edilmesini takiben hastaların %73,5’i sistemik immünsüpresif (İS) tedavi, %45,5’i antikoagülan tedavi almıştı. İS tedavi almayan grupta relaps riski anlamlı olarak yüksek bulundu. (p=0.001) Antikoagülan tedavi alan grupta relaps oranı daha fazla olmakla birlikte istatistiksel olarak anlamlı bir fark saptanmadı (p=0.61). Vasküler tutulum sıklıkla erkeklerde görülmektedir. Tedavide İS'ler ve antikoagülanlar kullanılmaktadır. İmmünsupresif tedavi kullanımı vasküler relaps riskini azaltabilir, ancak antikoagülan tedavinin ek faydası gösterilememiştir. Bu konuda daha fazla sayıda hasta ile yapılacak çok merkezli çalışmalara ihtiyaç vardır.

The aim of the study is to evaluate the rheumatoid arthritis (RA) patients' knowledge about methotrexate (MTX), the standard drug in the treatment of RA, through a questionnaire. In August-October 2017, patients who used MTX with a diagnosis of RA in a university hospital were asked to answer questionnaire about the mechanism of action of MTX, administration method, drug interaction, side effects, frequency of follow-up of patients and changes to the lifestyle that should be done. One hundred and sixty-two patients (144 women) were included in the study. The mean patient age was 52 (18-77) years, the mean disease duration was 10.3 (1-40) years, and the mean duration of MTX use was 7.1 (1-38) years. 50% of the patients correctly answered that MTX is an anti-inflammatory drug that regulates the disease. 85% of patients correctly responded to the weekly application frequency correctly.; 19% of the patients stated that the reason for using folic acid was to reduce the toxicity of the treatment and again only 11% knew that trimethoprim was contraindicated. 11% were aware of the hematological risks and 11% were aware of the risk of hypersensitivity pneumonia. 51% of them had knowledge about laboratory tests. 20% of women and men of childbearing age knew that they should use contraception while using MTX. 34% stated that alcohol consumption should be limited. Men and those with a high level of education gave a statistically higher rate of correct answers. (p=0.019, p=0.000) It was observed that the patients had insufficient knowledge about MTX, which is frequently used in RA patients in daily practice. There are shortcomings on important issues, especially serious side effects, drug interactions, and birth control. Patient information regarding MTX should be checked and supported regularly by using different training tools., Çalışmanın amacı, Romatoid artrit (RA) tedavisinde standart ilaç olan metotreksat (MTX) ile ilgili RA hastalarının bilgilerini bir anket aracılığıyla değerlendirmektir. Ağustos-Ekim 2017 tarihinde bir üniversite hastanesinde RA tanısı ile MTX kullanan hastalardan, MTX’in etki mekanizması, uygulama şekli, ilaç etkileşimi, yan etkileri, hastaların izlenme sıklığı ve yapılması gereken yaşam tarzı değişiklikleri ile ilgili soruları içeren anketi yanıtlamaları istendi. Yüz altmış iki hasta (144 kadın) çalışmaya dahil edildi. Ortalama hasta yaşı 52 (18-77), ortalama hastalık süresi 10.3 (1-40) yıl ve ortalama MTX kullanma süresi 7,1 (1-38) yıl idi. MTX’in hastalığı düzenleyen antiromatizmal bir ilaç olduğunu %50 hasta doğru yanıtladı. Uygulama sıklığının haftalık olduğunu %85; folik asid kullanma gerekçesinin, tedavi toksisitesini azaltmak olduğunu ise %19 hasta belirtti ve yine sadece %11’i trimetoprimin kontraendike olduğunu biliyordu. Hematolojik risklerden %11’i haberdardı ve %11’i aşırı duyarlılık pnömonisi riskinin farkındaydı. Laboratuvar testleri ile ilgili %51’inin bilgisi vardı. Doğurganlık çağında kadın ve erkeklerin MTX kullanırken kontrasepsiyon kullanması gerekliliğini bilenler %20 idi. %34’ü alkol tüketiminin sınırlı olması gerektiğini belirtti. Erkekler ve eğitim seviyesi yüksek olanlar istatistiksel olarak daha yüksek oranda doğru cevap verdi (p=0.019, p=0.000). Günlük pratikte RA hastalarında sıklıkla kullanılan MTX hakkında hastaların yetersiz bilgiye sahip olduğu görüldü. Özellikle ciddi yan etkiler, ilaç etkileşimleri ve doğum kontrolü gibi önemli konularda eksiklikler vardı. MTX’e ilişkin hasta bilgisi farklı eğitim araçlarını kullanarak düzenli olarak kontrol edilmeli ve desteklenmelidir.

WOS: 000441766000023, PubMed ID: 30119164, Background/aim: The TReasure registry, created in 2017, is an observational multicenter cohort that includes inflammatory arthritis patients. This article reviews the methodology and objectives of the TReasure registry established to collect data from rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients. Methodology: Fifteen rheumatology centers in Turkey will contribute data to the TReasure database. The actual proprietor of the database is the Hacettepe Rheumatology Association (HRD) and Hacettepe Financial Enterprises. Pharmaceutical companies that operate in Turkey (in alphabetical or er), Abbvie, Amgen, BMS, Celltrion Healthcare, Novartis, Pfizer, Roche, and UCB, support the TReasure registry. TReasure is a web-based database to which users connect through a URL (https://www.trials-network.org/treasure) with their unique identifier and passwords provided for data entry and access. TReasure records demographic and clinical features, comorbidities, radiology and laboratory results, measures of disease activity, and treatment data. Discussion: TReasure will provide us with various types of data, such as a cross-sectional view of the current nationwide status of the patients currently receiving these treatments, and retrospective data as much as allowed by the participating centers' records. Finally, a high-quality prospective dataset will be built over the ensuing years from patients with a new diagnosis of RA or SpA.

WOS: 000447268901160 …

Vascular involvement is one of the major causes of mortality and morbidity in Behçet disease (BD). There are no controlled studies for the management of vascular BD (VBD), and according to the EULAR recommendations, only immunosuppressive (IS) agents are recommended. In this study, we aimed to investigate the therapeutic approaches chosen by Turkish physicians during the initial event and relapses of VBD and the association of different treatment options with the relapses retrospectively. Patients with BD (n = 936, female/male: 347/589, mean age: 37.6 ± 10.8) classified according to ISG criteria from 15 rheumatology centers in Turkey were included. The demographic data, clinical characteristics of the first vascular event and relapses, treatment protocols, and data about complications were acquired. VBD was observed in 27.7% (n = 260) of the patients during follow-up. In 57.3% of the VBD patients, vascular involvement was the presenting sign of the disease. After the first vascular event, ISs were given to 88.8% and AC treatment to 59.8% of the patients. Median duration of AC treatment was 13 months (1–204) and ISs, 22 months (1–204). Minor hemorrhage related to AC treatment was observed in 7 (4.7%) patients. A second vascular event developed in 32.9% (n = 86) of the patients. The vascular relapse rate was similar between patients taking only ISs and AC plus IS treatments after the first vascular event (29.1% vs 22.4%, P = 0.28) and was significantly higher in group taking only ACs than taking only ISs (91.6% vs 29.1%, P

Objective.To assess bladder toxicity of cyclophosphamide (CYC) and uroprotective effect of mesna in rheumatic diseases.Methods.Data of 1018 patients (725 women/293 men) treated with CYC were evaluated in this retrospective study. All of the following information was obtained: the cumulative CYC dose, route of CYC administration, duration of therapy, concomitant mesna usage, and hemorrhagic cystitis. Cox proportional hazard model was used for statistics.Results.We identified 17 patients (1.67%) with hemorrhagic cystitis and 2 patients (0.19%) with bladder cancer in 4224 patient-years. The median time for diagnosis to hemorrhagic cystitis was 10 months (4–48) and bladder cancer was 8 years (6–10.9). There were 583 patients (57.2%) who received mesna with intravenous CYC therapy. We observed similar incidence rate for hemorrhagic cystitis in both patient groups concomitantly treated with or without mesna [9/583 (1.5%) vs 8/425 (1.8%) respectively, p = 0.08]. Cumulative CYC dose (HR for 10-g increments 1.24, p < 0.001) was associated with hemorrhagic cystitis.Conclusion.Cumulative dose was the only risk factor for hemorrhagic cystitis in patients treated with CYC. No proof was obtained for the uroprotective effect of mesna in our cohort.