Search

Your search keyword '"Mueller-Ladner, U"' showing total 26 results
Start Over Author "Mueller-Ladner, U" Database OpenAIRE
26 results on '"Mueller-Ladner, U"'

1. EULAR definition of difficult-to-treat rheumatoid arthritis

Author

Nagy, G., Roodenrijs, N.M., Welsing, P.M., Kedves, M., Hamar, A., van der Goes, M.C., Kent, A., Bakkers, M., Blaas, E., Senolt, L., Szekanecz, Z., Choy, E., Dougados, M., Jacobs, J.W., Geenen, R., Bijlsma, H.W., Zink, A., Aletaha, D., Schoneveld, L., van Riel, P., Gutermann, L., Prior, Y., Nikiphorou, E., Ferraccioli, G., Schett, G., Hyrich, K.L., Mueller-Ladner, U., Buch, M.H., McInnes, I.B., van der Heijde, D., van Laar, J.M., Leerstoel Geenen, Clinical Psychology (overkoepelend voor heel KP), Leerstoel Geenen, and Clinical Psychology (overkoepelend voor heel KP)

Subjects
musculoskeletal diseases, medicine.medical_specialty, rheumatoid, Advisory Committees, immune system diseases, Immunology, Drug Resistance, Arthritis, Biochemistry, General Biochemistry, Genetics and Molecular Biology, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Arthritis, Rheumatoid, All institutes and research themes of the Radboud University Medical Center, Quality of life, Rheumatology, Stakeholder Participation, Synovitis, Terminology as Topic, Dmard therapy, medicine, Humans, Immunology and Allergy, Treatment Failure, Intensive care medicine, skin and connective tissue diseases, Glucocorticoids, Biological Products, business.industry, Task force, Biochemistry, Genetics and Molecular Biology(all), Recommendation, medicine.disease, Clinical trial, Europe, arthritis, Rheumatoid arthritis, Antirheumatic Agents, Practice Guidelines as Topic, Disease Progression, Drug Therapy, Combination, business, synovitis, Rheumatism, Genetics and Molecular Biology(all)
Abstract

BackgroundDespite treatment according to the current management recommendations, a significant proportion of patients with rheumatoid arthritis (RA) remain symptomatic. These patients can be considered to have ‘difficult-to-treat RA’. However, uniform terminology and an appropriate definition are lacking.ObjectiveThe Task Force in charge of the “Development of EULAR recommendations for the comprehensive management of difficult-to-treat rheumatoid arthritis” aims to create recommendations for this underserved patient group. Herein, we present the definition of difficult-to-treat RA, as the first step.MethodsThe Steering Committee drafted a definition with suggested terminology based on an international survey among rheumatologists. This was discussed and amended by the Task Force, including rheumatologists, nurses, health professionals and patients, at a face-to-face meeting until sufficient agreement was reached (assessed through voting).ResultsThe following three criteria were agreed by all Task Force members as mandatory elements of the definition of difficult-to-treat RA: (1) Treatment according to European League Against Rheumatism (EULAR) recommendation and failure of ≥2 biological disease-modifying antirheumatic drugs (DMARDs)/targeted synthetic DMARDs (with different mechanisms of action) after failing conventional synthetic DMARD therapy (unless contraindicated); (2) presence of at least one of the following: at least moderate disease activity; signs and/or symptoms suggestive of active disease; inability to taper glucocorticoid treatment; rapid radiographic progression; RA symptoms that are causing a reduction in quality of life; and (3) the management of signs and/or symptoms is perceived as problematic by the rheumatologist and/or the patient.ConclusionsThe proposed EULAR definition for difficult-to-treat RA can be used in clinical practice, clinical trials and can form a basis for future research.

Published
2021

5. Idiopathic inflammatory myopathies: Narrative review of unmet needs in clinical practice guidelines

Author

Meyer A., Scire C. A., Talarico R., Alexander T., Amoura Z., Avcin T., Barsotti S., Beretta L., Blagojevic J., Burmester G., Cavazzana I., Cherrin P., Damian L., Doria A., Fonseca J. E., Furini F., Galetti I., Houssiau F., Krieg T., Maddalena L., Launay D., Campanilho-Marques R., Martin T., Matucci-Cerinic M., Moinzadeh P., Montecucco C., Moraes-Fontes M. F., Mouthon L., Neri R., Paolino S., Piette Y., Rednic S., Tamirou F., Tincani A., Toplak N., Bombardieri S., Hachulla E., Mueller-Ladner U., Schneider M., Smith V., Vieira A., Cutolo M., Mosca M., Cavagna L., Meyer, A, Scire, C, Talarico, R, Alexander, T, Amoura, Z, Avcin, T, Barsotti, S, Beretta, L, Blagojevic, J, Burmester, G, Cavazzana, I, Cherrin, P, Damian, L, Doria, A, Fonseca, J, Furini, F, Galetti, I, Houssiau, F, Krieg, T, Maddalena, L, Launay, D, Campanilho-Marques, R, Martin, T, Matucci-Cerinic, M, Moinzadeh, P, Montecucco, C, Moraes-Fontes, M, Mouthon, L, Neri, R, Paolino, S, Piette, Y, Rednic, S, Tamirou, F, Tincani, A, Toplak, N, Bombardieri, S, Hachulla, E, Mueller-Ladner, U, Schneider, M, Smith, V, Vieira, A, Cutolo, M, Mosca, M, and Cavagna, L

Subjects
myositi
Abstract

Idiopathic inflammatory myopathies (IIMs) encompass a heterogeneous group of rare autoimmune diseases characterised by muscle weakness and inflammation, but in antisynthetase syndrome arthritis and interstitial lung disease are more frequent and often inaugurate the disease. Clinical practice guidelines (CPGs) have been proposed for IIMs, but they are sparse and heterogeneous. This work aimed at identifying: i) current available CPGs for IIMs, ii) patients ' and clinicians' unmet needs not covered by CPGs. It has been performed in the framework of the European Reference Network on rare and complex connective tissue and musculoskeletal diseases (ReCONNET), a network of centre of expertise and patients funded by the European Union's Health Programme. Fourteen original CPGs were identified, notably recommending that: i) extra-muscular involvements should be assessed; ii) corticosteroids and methotrexate or azathioprine are first-line therapies of IIMs. ii) IVIG is a treatment of resistant-DM that may be also used in other resistant-IIMs; iii) physical therapy and sun protection (in DM patients) are part of the treatment; v) tumour screening for patients with DM include imaging of chest, abdomen, pelvis and breast (in woman) along with colonoscopy (in patients over 50 years); vi) disease activity and damages should be monitor using standardised and validated tools. Yet, only half of these CPGs were evidence-based. Crucial unmet needs were identified both by patients and clinicians. In particular, there was a lack of large multidisciplinary working group and of patients ' preferences. The following fields were not or inappropriately targeted: diagnosis; management of extra-muscular involvements other than skin; co-morbidities and severe manifestations.

Published
2018

6. Systemic lupus erythematosus: state of the art on clinical practice guidelines

Author

Tamirou, F, Arnaud, L, Talarico, R, Scirè, Ca, Alexander, T, Amoura, Z, Avcin, T, Bortoluzzi, A, Cervera, R, Conti, F, Cornet, A, Devilliers, H, Doria, A, Frassi, M, Fredi, M, Govoni, M, Houssiau, F, Lladò, A, Macieira, C, Martin, T, Massaro, L, Moraes-Fontes, Mf, Pamfil, C, Paolino, S, Tani, C, Tas, Sw, Tektonidou, M, Tincani, A, Van Vollenhoven RF, Bombardieri, S, Burmester, G, Eurico, Fj, Galetti, I, Hachulla, E, Mueller-Ladner, U, Schneider, M, Smith, V, Cutolo, M, Mosca, M, and Costedoat-Chalumeau, N.

Published
2018

7. Characteristics of difficult-to-treat rheumatoid arthritis: results of an international survey

Author

Roodenrijs, N.M.T., Hair, M.J.H. de, Goes, M.C. van der, Jacobs, J.W.G., Welsing, P.M.J., Heijde, D. van der, Aletaha, D., Dougados, M., Hyrich, K.L., McInnes, I.B., Mueller-Ladner, U., Senolt, L., Szekanecz, Z., Laar, J.M. van, Nagy, G., and EULAR Recommendations

Subjects
musculoskeletal diseases, 0301 basic medicine, medicine.medical_specialty, Immunology, Comorbidity, Disease, Klinikai orvostudományok, General Biochemistry, Genetics and Molecular Biology, Arthritis, Rheumatoid, Disease activity, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Prednisone, Surveys and Questionnaires, Humans, Immunology and Allergy, Medicine, Intensive care medicine, 030203 arthritis & rheumatology, Polypharmacy, business.industry, International survey, Orvostudományok, medicine.disease, 030104 developmental biology, Current management, Rheumatoid arthritis, Rheumatologists, business, Rheumatism, medicine.drug
Abstract

ObjectivesPatients with difficult-to-treat rheumatoid arthritis (RA) remain symptomatic despite treatment according to current European League Against Rheumatism (EULAR) management recommendations. These focus on early phases of the disease and pharmacological management. We aimed to identify characteristics of difficult-to-treat RA and issues to be addressed in its workup and management that are not covered by current management recommendations.MethodsAn international survey was conducted among rheumatologists with multiple-choice questions on disease characteristics of difficult-to-treat RA. Using open questions, additional items to be addressed and items missing in current management recommendations were identified.Results410 respondents completed the survey: 50% selected disease activity score assessing 28 joints >3.2 OR presence of signs suggestive of active disease as characteristics of difficult-to-treat RA; 42% selected fatigue; 48% selected failure to ≥2 conventional synthetic disease-modifying antirheumatic drugs (DMARDs) AND ≥2 biological/targeted synthetic DMARDs; 89% selected inability to taper glucocorticoids below 5 mg or 10 mg prednisone equivalent daily. Interfering comorbidities, extra-articular manifestations and polypharmacy were identified as important issues missing in current management recommendations.ConclusionsThere is wide variation in concepts of difficult-to-treat RA. Several important issues regarding these patients are not addressed by current EULAR recommendations.

Published
2018

9. Diffusing capacity and clinical characteristics of patients with systemic sclerosis – data from the german network for systemic sclerosis

Author

Distler, JHW, Blank, N, Zeidler, G, Moinzadeh, P, Hunzelmann, N, Bonella, F, Kuhr, K, Riemekasten, G, Kreuter, M, Pfeiffer, C, Gaebelein-Wissing, N, Gunther, C, Sunderkoetter, C, Mueller-Ladner, U, Henes, J, Susok, L, Sárdy, M, Aberer, E, Schmeiser, T, Schmalzing, M, Worm, M, Siegert, E, Koetter, I, Krieg, T, Juche, A, and Kreuter, A

Subjects
Medizin
Published
2017

10. Rituximab is more effective than second anti-TNF therapy in rheumatoid arthritis patients and previous TNFα blocker failure

Author

Kekow J, Mueller-Ladner U, and Schulze-Koops H

Subjects
Medicine (General), R5-920
Abstract

Joern Kekow,1 Ulf Mueller-Ladner,2 Hendrik Schulze-Koops31Clinic of Rheumatology and Orthopedics, Otto-von-Guericke University of Magdeburg, Vogelsang-Gommern; 2Department of Rheumatology and Clinical Immunology, Kerckhoff Clinic, Bad Nauheim; 3Division of Rheumatology, University of Munich, Munich, GermanyPurpose: To assess the efficacy of one course of rituximab (two 1-g doses) compared to an alternative tumor necrosis factor-α (TNFα) blocker in rheumatoid arthritis patients who had experienced one previous TNFα blocker failure (eg, etanercept, adalimumab, or infliximab).Patients and methods: The efficacy of both treatments was studied in this retrospective, multicenter, noninterventional cohort study with 196 patients. All patients had active rheumatoid arthritis defined by a Disease Activity Score-28 of ≥3.2 despite having TNFα blocker therapy, and were followed over 6.6 months on average after switching to rituximab versus a second TNFα blocker (ie, switching to etanercept, adalimumab, or infliximab) at baseline.Results: At baseline, both cohorts showed similar demographic and disease-related characteristics (including Disease Activity Score-28). At the end of observation, mean Disease Activity Score-28 was significantly lower after treatment with rituximab than with a second TNFα blocker (-1.64 [95% confidence interval: -1.92; -1.36] versus -1.19 [95% confidence interval: -1.42; -0.96], P = 0.013). This difference between the two groups was even more pronounced when patients were seropositive for rheumatoid factor (-1.66 versus -1.17, P = 0.018) and anti-cyclic citrullinated peptide antibodies (-1.75 versus -1.06, P = 0.002). More rituximab-treated patients achieved good European League Against Rheumatism response than TNFα blocker-treated patients (30% versus 15%), and less patients were nonresponders (22% versus 35%) according to European League Against Rheumatism criteria (P = 0.022, chi-squared test).Conclusion: Treatment with rituximab was more effective than a second TNFα blocker therapy in rheumatoid arthritis patients after failure of the first TNFα blocker. It was found that anti-cyclic citrullinated peptide antibodies may be a useful predictive biomarker for response to rituximab in patients with TNFα blocker treatment failure.Keywords: rheumatoid arthritis, rituximab, anti-cyclic citrullinated peptide antibodies, rheumatoid factor

Published
2012

11. Inhibition of joint damage and improved clinical outcomes with rituximab plus methotrexate in early active rheumatoid arthritis: the IMAGE trial

Author

Tak, Pp, Rigby, Wf, Rubbert Roth, A, Peterfy, Cg, van Vollenhoven RF, Stohl, W, Hessey, E, Chen, A, Tyrrell, H, Shaw, Tm, Aelion J, IMAGE I. n. v. e. s. t. i. g. a. t. o. r. s., Afif, N, Ahmadi, F, Aires, F, Alanis, E, Alonso, Cs, Alten, Rh, Alvaro Gracia JM, Ashrafzadeh, A, Ballina, J, Bambara, Lm, Bao, C, Bell, M, Berney, S, Bessette, L, Birbara, C, Boling, E, Bourgeois, P, Braun, J, Briones, H, Brzezicki, J, Burgos Vargos, R, Burmester, G, Burnett, M, Busch, H, Cabello, E, Calvo, A, Cantagrel, A, Cantini, F, Zea, Ac, Carreño Perez, L, Chavez, J, Shim, Sc, Chindalore, V, Chiriac, R, Codding, C, Danda, D, Del Guidice, J, De Vita, S, Digiovanni, R, Dikranian, A, Eider, W, Fantini, F, Ferraccioli, G, Fietchner, J, Filipowicz Sosnowska, A, Finnanger, B, Fiocco, G, Fleck, M, Fleischmann, R, Fraser, A, Gaudin, P, Gauler, G, Gaylis, N, Gerlag, Dm, Godde, J, Gomez Reino JJ, Gornisiewicz, M, Gough, W, Greenwald, M, Guerra, G, Hackshaw, K, Haentzschel, Hm, Hammond, T, Hazleman, Bl, Heilig, B, Herenius, Mm, Hilliquin, P, Holt, D, Huang, F, Huff, J, Huizinga, T, Isaacs, J, Jaffer, A, Amante, Ej, Jeka, S, Jimenez, R, Jones, G, Jones, R, Kaine, J, Kashif, A, Kaufmann, C, Kay, J, Khraishi, M, Kivitz, A, Klinkhoff, A, Kraag, G, Krystufkova, O, Kucharz, E, Lawson, J, Leirisalo Repo, M, Levin, R, Liang, G, Liang, P, Limonta, M, Lowenstein, M, Rodriguez Lozano, C, Lue, C, Mahowald, M, Maradiaga, M, Maricic, M, Mariette, X, Martin, L, Massarotti, E, Matucci Cerinic, M, Montecucco, Cm, Mazurov, V, Mcnally, J, Mehta, D, Meyer, O, Misra, R, Moreland, Lw, Mueller Ladner, U, Myerson, G, Nasonov, E, Navarra, S, Navarro, F, Neal, N, Olech, E, Olsen, N, Pablos, Jl, Pacheco, C, Pal, S, Palomo, Er, Pandith, V, Penserga, Eg, Prupas, H, Radominski, S, Ramos Remus, C, Reid, D, Riordan, K, Rosenberg, D, Ruiz, A, Saadeh, C, Salvarani, Carlo, Samuels, A, Sanmarti, R, Sarzi Puttini, P, Saxe, P, Schechtman, J, Scoville, C, Sedlackova, M, Sedrish, M, Sejer Hansen, M, Sibilia, J, Siebert, S, Specker, C, Stern, S, Szechinski, J, Tahir, H, Taylor, A, Thompson, Pw, Tony, Hp, Tornero, J, Trapp, R, Tremblay, Jl, Valesini, G, Van Den Bosch, F, Wanchu, A, Wassenberg, S, Ximenes, Ac, Kim, Hy, Zanetakis, E, Zazueta, B, Zerbini, C., Faculteit der Geneeskunde, AII - Amsterdam institute for Infection and Immunity, Clinical Immunology and Rheumatology, and Other departments

Subjects
Adult, musculoskeletal diseases, medicine.medical_specialty, Adolescent, Immunology, 610 Medizin, Arthritis, Severity of Illness Index, Gastroenterology, Drug Administration Schedule, General Biochemistry, Genetics and Molecular Biology, law.invention, Arthritis, Rheumatoid, Antibodies, Monoclonal, Murine-Derived, Young Adult, Double-Blind Method, Rheumatology, Randomized controlled trial, law, immune system diseases, Internal medicine, medicine, Clinical endpoint, Humans, Immunology and Allergy, heterocyclic compounds, skin and connective tissue diseases, Aged, Aged, 80 and over, ddc:610, business.industry, Middle Aged, medicine.disease, Surgery, Clinical trial, Methotrexate, Treatment Outcome, Antirheumatic Agents, Rheumatoid arthritis, Disease Progression, Drug Therapy, Combination, Rituximab, business, medicine.drug
Abstract

Objectives: Rituximab is an effective treatment in patients with established rheumatoid arthritis (RA). The objective of the IMAGE study was to determine the efficacy of rituximab in the prevention of joint damage and its safety in combination with methotrexate (MTX) in patients initiating treatment with MTX. Methods: In this double-blind randomised controlled phase III study, 755 MTX-naïve patients with active RA were randomly assigned to MTX alone, rituximab 2×500 mg + MTX or rituximab 2×1000 mg + MTX. The primary end point at week 52 was the change in joint damage measured using a Genant-modified Sharp score. Results: 249, 249 and 250 patients were randomly assigned to MTX alone, rituximab 2×500 mg + MTX or rituximab 2×1000 mg + MTX, respectively. At week 52, treatment with rituximab 2×1000 mg + MTX compared with MTX alone was associated with a reduction in progression of joint damage (mean change in total modified Sharp score 0.359 vs 1.079; p=0.0004) and an improvement in clinical outcomes (ACR50 65% vs 42%; p

Published
2011
Full Text
View/download PDF

12. Vasoactive Therapy in Systemic Sclerosis

Author

Moinzadeh, P., Riemekasten, G., Siegert, E., Fierlbeck, G., Henes, J., Blank, N., Melchers, I., Mueller-Ladner, U., Frerix, M., Kreuter, A., Tigges, C., Lahner, N., Susok, L., Guenther, C., Zeidler, G., Pfeiffer, C., Worm, M., Karrer, S., Aberer, E., Bretterklieber, A., Genth, E., Simon, J.C., Distler, J.H.W., Hein, R., Schneider, M., Seitz, C.S., Herink, C., Steinbrink, K., Sárdy, M., Varga, R., Mensing, H., Mensing, C., Lehmann, P., Neeck, G., Fiehn, C., Weber, M., Goebeler, M., Burkhardt, H., Buslau, M., Ahmadi-Simab, K., Himsel, A., Juche, A., Koetter, I., Kuhn, A., Sticherling, M., Hellmich, M., Kuhr, K., Krieg, T., Ehrchen, J., Sunderkoetter, C., Hunzelmann, N., and Publica

Abstract

Objective: Vasculopathy is a key factor in the pathophysiology of systemic sclerosis (SSc) and the main cause for Raynaud phenomenon (RP), digital ulcers (DU), and/or pulmonary arterial hypertension (PAH). It is so far unknown how patients with SSc are treated with vasoactive agents in daily practice. To determine to which extent patients with SSc were treated with different vasoactive agents, we used data from the German Network for Systemic Scleroderma registry. Methods: The data of 3248 patients with SSc were analyzed. Results: Patients were treated with vasoactive drugs in 61.1% of cases (1984/3248). Of these, 47.6% received calcium channel inhibitors, followed by 34.2% treated with angiotensin-converting enzyme (ACE) inhibitors, 21.1% treated with intravenous (IV) prostanoids, 10.1% with pentoxifylline, 8.8% with angiotensin 1 receptor antagonists (AT1RA), 8.7% with endothelin 1 receptor antagonists (ET1RA), 4.1% with phosphodiesterase type 5 (PDE5) inhibitors, and 5.3% with others. Patients with RP received vasoactive therapy in 63.3% of cases, with DU in 70.1%, and with PAH in 78.2% of cases. Logistic regression analysis revealed that patients with PAH were significantly more often treated with PDE5 inhibitors and ET1RA, and those with DU with ET1RA and IV prostanoids. In addition, 41.8% of patients were treated with ACE inhibitors and/or AT1RA. Patients registered after 2009 received significantly more often ET1RA, AT1RA, and IV prostanoids compared with patients registered prior to 2005. Conclusion: These data clearly indicate that many patients with SSc do not yet receive sufficient vasoactive therapy. Further, in recent years, a marked change of treatment regimens can be observed.

Published
2016

13. Items for developing revised classification criteria in systemic sclerosis: Results of a consensus exercise with the ACR/EULAR working committee for classification criteria in systemic sclerosis

Author

Fransen, J, Johnson, S R, van den Hoogen, F, Baron, M, Allanore, Y, Carreira, P E, Czirják, L, Denton, C P, Distler, O, Furst, D E, Gabrielli, A, Herrick, A, Inanc, M, Kahaleh, B, Kowal-Bielecka, O, Medsger, T A, Mueller-Ladner, U, Riemekasten, G, Sierakowski, S, Valentini, G, Veale, D, Vonk, M C, Walker, U, Chung, L, Clements, P J, Collier, D H, Csuka, M E, Jimenez, S, Merkel, P A, Seibold, J R, Silver, R, Steen, V, Tyndall, A, Matucci-Cerinic, M, Pope, J E, Khanna, D, Fransen, J, Johnson, Sr, van den Hoogen, F, Baron, M, Allanore, Y, Carreira, Pe, Czirják, L, Denton, Cp, Distler, O, Furst, De, Gabrielli, A, Herrick, A, Inanc, M, Kahaleh, B, Kowal Bielecka, O, Medsger TA, Jr, Mueller Ladner, U, Riemekasten, G, Sierakowski, S, Valentini, Gabriele, Veale, D, Vonk, Mc, Walker, U, Chung, L, Clements, Pj, Collier, Dh, Csuka, Me, Jimenez, S, Merkel, Pa, Seibold, Jr, Silver, R, Steen, V, Tyndall, A, Matucci Cerinic, M, Pope, Je, Khanna, D., University of Zurich, and Khanna, D

Subjects
2745 Rheumatology, 10051 Rheumatology Clinic and Institute of Physical Medicine, 610 Medicine & health, Delphi technique, nominal group technique, systemic sclerosis, scleroderma, classification, classification criteria
Abstract

Background Classification criteria for systemic sclerosis (SSc) are being updated. Objective To select a set of items potentially useful for the classification of SSc using consensus procedures including the Delphi and nominal group techniques (NGT). Methods Items were identified through two independent consensus exercises performed by the Scleroderma Clinical Trials Consortium (SCTC) and the EULAR Scleroderma Trials and Research Group (EUSTAR). The first-round items from both exercises were collated and redundancies were removed leaving 168 items. A 3-round Delphi exercise was performed using a 1–9 scale (1=completely inappropriate and 9=completely appropriate) and a consensus meeting using NGT. During the last Delphi, the items were ranked on a 1–10 scale. Results Round 1: 106 experts rated the 168 items. Those with a median score

Published
2012

15. DUO Registry Group. Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry

Author

Guillevin, L, Hunsche, E, Denton, Cp, Krieg, T, Schwierin, B, Rosenberg, D, Matucci Cerinic, M, DUO Registry Group Collaborators Raffier, B, Hirschi, M, Trautinger, F, Schmidt, P, Stetter, M, Hundstorfer, M, Reinhart, V, Monshi, B, Pirkhammer, D, Richter, L, Hamberger, N, Metz, S, Feldmann, R, Semmelweis, K, Lackner, K, Tomi, N, Kolle, H, Hafner, F, Brodmann, M, Kuen Spiegel, M, Minmair, G, Heil, Pm, Broil, H, Holzer, G, Illmer, X, Rintelen, B, Sautner, J, Takacs, M, Thun, M, Zemanova, I, Soukup, T, Smrzova, A, Bohmova, J, Prochazkova, L, Nemec, P, Fojtik, Z, Suchy, D, Becvar, R, Olsen, Ab, Sondergaard, Kh, Luosu jarvi, R, Vidqvist, Kl, Madaule, S, Beneton, N, Maillard, H, Charlanne, H, Granelbrocard, F, Hachulla, E, Hatron, Py, Jourdain, N, Lambert, M, Launay, D, Morell, S, Woijtasik, G, Skowron, F, Zenone, T, Dadban, A, Lok, C, Ferrandiz, D, Magybertrand, N, Moiton, Mp, Taieb, A, Balquiere, S, Belin, E, Droitcourt, C, Julien, S, Prey, S, Boulon, C, Constans, J, Doutre, Ms, Kostrzwewa, E, Richez, C, Greco, M, Misery, L, Sassolas, B, Collet, E, Berthier, S, Leguy Seguin, V, Imbert, B, Carpentier, P, Blaise, S, Couraud, A, Doeffel Hantz, V, Spars, A, Bezanahary, H, Boussely, N, Dumonteil, S, Fauchais, Al, Goudran, G, Loustaud Ratti, V, Manea, P, Vidal, E, Coppere, B, Desmursclavel, H, Girard Madoux MH, Hot, A, Ninet, J, Granel, B, Cohen, Jd, Keynote, A, Khau van Kien, A, Le Quellec, A, Riviere, S, Rullier, P, Bessis, D, Farcas, C, Bravetti, V, Moline, T, Wahl, D, Zuily, S, Granel Brocard, F, Agard, C, Durant, C, Fuzibet, Jg, Queyrel, V, Berezne, A, Mouthon, L, Cabane, J, Tiev, K, Toledano, C, Lazareth, I, Michon Pasturel, U, Priollet, P, Reguiai, Z, Cazaletslacoste, C, Jego, P, Letremy, A, Perlat, A, Duval Modeste AB, Chatelus, E, Chiffot, H, Sibillia, J, Sordet, C, Adoue, D, Couret, B, Moulis, G, Pugnet, G, Sailler, L, Diot, E, Gaches, F, Farge, D, Keshtmand, H, Frances, C, von Elling, A, Bora, D, Ebel, J, Ahmadi Simab, K, Klein, E, Hahn, K, Schulze, K, Rasche, C, Riemekasten, G, Lee, Hh, Deuschle, K, Mattat, K, Becker, M, Worm, M, Mensing, C, Klings, D, Mensing, H, Messall, J, Zuper, R, Eilbacher, P, Saar, P, Kaufmann, P, Hallermann, C, Schmidt, K, Wahn, H, Schildt, K, Schuart, T, Kaczmarczyk, A, Kellner, C, von Oelhafen, J, Baron von Bildering, P, Kunze, S, Kleiner, Hj, Alsheimer, B, Schuetz, N, Miirker Hermann, E, Gottl, Kh, Weiss, E, Reischel, N, Kern, S, Goettl, Kh, Goetheuniversitiitsklinikum, Jw, Himsel, A, Henkemeier, U, Schwarting, A, Hazenbiller, A, Nichelmann, V, Rumbaur, C, Boesenberg, I, Schmeiser, T, Mueller Ladner, U, Unholzer, A, Starz, H, Welzel, J, Plaumann, K, Stoeckl, F, Sperling, S, Podda, M, Wagner, N, Rapprich, H, Niedermeier, A, Messer, G, Sardy, M, Bekou, V, Dill MUller, D, Wlodarz, M, Belloni, B, Huettig, B, Ziai, M, Hein, R, Kneitz, C, Federow, I, Schneider, K, Semmler, M, Hapke, S, Metzler, C, Stein, T, Enderlein, M, Kayser, M, Werthmann, M, Guenther, Cu, Neul, S, Hellmich, B, Loeffler, C, Pflugfelder, J, Karaenke, P, Mueglich, C, Tony, Hp, Marina, P, Popp, M, Mittag, M, Baumann, C, Scheib, Eg, Brand, H, Wilhelm, Hu, Bohm, J, Dyballa, J, Boehm, J, Taggeselle, J, Luthke, K, Wuerzburg, I, Niefanger, K, Mayer, L, Drabek, J, Harmuth, W, Dietl, S, Moritz, D, Gause, A, Gaubitz, M, Hallecker, A, Krupp, E, Rumpel, H, Moosig, F, Frey, P, Kahl, S, Linke, M, Merk, B, Bloching, Hh, Ochs, W, Kurthen, R, Eiden, E, Guertler, I, Aries, Pm, Kirchberg, S, Jahnke, K, Mettler, S, Toeller, S, Zwenger, S, Langer, He, Deininger, F, Hartmann, F, Neeck, G, Neek, G, Wernitzsch, H, Meier, L, Herr, U, Meier, U, Aaig, W, Bruckner, L, Sheikh, N, Wollenhaupt, J, Krog, B, Wollersdorfer, E, Hall, R, Diehm, C, Tiggers, C, Peters, J, Kirschke, J, Schroeder, Jo, Zeuner, R, Uhlig, S, Barth, S, Huegel, R, Glaeser, R, Schaefer, C, Monshausen, M, Mengden, T, Funkert, A, Blank, N, Lupaschko, S, Voss, B, Megahed, M, Sadeghlar, F, Seidel, M, Wasmuth, Jc, Kreuter, A, Vosswinkel, J, Pfoehler, C, Gerber, A, Haust, M, Hoff, Np, Mota, R, Akanay Diesel, S, Homey, B, Katzemich, A, Erfurt Berge, C, Sticherling, M, Beyer, C, Distler, J, Mitchell, A, Freundlieb, C, Rushentsova, U, Hermanns, G, Blaschke, S, Fiene, M, Wessel, C, Norgauer, J, Rabe, B, Schuster, J, Scholz, J, Kremer, K, Robakidze Torbahn, M, Moinzadeh, P, Dohse, A, Muhlack, A, Schultz, L, Schult, S, Frambach, Y, Kruse, S, Kettenbach, A, Fell, I, Schweda, K, Steinbrink, K, Podobinska, M, Fieri beck, G, Schanz, S, Pfeiffer, C, Hassel, R, Herrgott, I, Sunderkoetter, C, Guenzel, J, Athanassiou, P, Dimitroulas, T, Settas, L, Kritikos, I, Tsifetaki, N, Garyfallos, A, Vasilopoulos, D, Boura, P, Kamali, S, Aslanidis, S, Vlachoyannopoulos, P, Galanopoulo, V, Sakkas, L, Koutroubas, A, Elezoglou, T, Galanopoulos, N, Grier, A, Murray, M, O'Rourke, M, Del Papa, N, Maglione, W, Zeni, S, Foti, R, Benenati, A, De Vita, S, Ferraccioli, G, Grassi, W, de Angeli, R, Pomponio, G, Mussi, A, Colonna, L, Airo, P, Zingarelli, S, Scorza, R, Serverino, A, Puppo, F, Negrini, S, Roma, I, Salsano, F, Triolo, G, Mazzuca, S, Carignola, R, Gatti, S, Lunardi, G, Riccieri, V, Salvarani, C, Bajocchi, G, Varcasia, G, Marasini, B, Belloll, L, de Luca, R, Stisi, S, Bellissimo, S, Fusaro, E, Pellerito, R, Cozzi, F, Rizzo, M, Bartoluzzi, A, Trotta, F, Cantatore, F, Corrado, A, Ferri, Claudio, Colaci, M, Malavolta, N, Mule, R, Galeazzi, M, Lapadula, G, Mathieu, A, Vacca, A, Giacomelli, Roberto, Cipriani, Paola, Montecucco, Cm, Codullo, V, Bucci, R, Battaglia, E, Valentini, G, Cuomo, G, Terlizzi, N, Serafino, L, Reumatologia, Uo, Bombardieri, S, Della Rossa, A, Doveri, M, Perricone, R, de Mattia, M, Pallotta, S, Groenendael, Jh, Seys, P, Goekoop, Rj, Han, Kh, Wlarvens, M, Bonte Mineur, F, de Bois MH, de Beus WM, van Zeben, D, Vonk, M, Knaapen, Hk, Smit, A, Bootsma, H, Ton, E, Voskuyl, A, Dutmer, Ea, Stalk, Jn, Madland, Tm, Seip, M, Hoffmann Vold AM, Bitter, H, Stocklund Thomsen, R, Resende, C, Ponte, C, Martinho, S, Silva, F, Ferreira, P, Grilo, A, Riso, N, Santos, C, Camara, I, Costa, J, Alves, J, Oliveira, S, Almeida, I, Silva, I, Cordeiro, A, Coelho, P, Lukac, J, Dolnicar, As, Espinosa, G, Mejia, Jc, Ramos, M, Plasin Rodriguez MA, Mera, A, Blanco, Js, Diaz, Jj, Losada, L, Perez, E, Maneiro, Jr, Caamano, M, Fermindez, S, Insua, Sa, Barbado, J, Fonseca, Em, Nufio, Fj, Castellvi, I, Garcia de Ia Pena, P, Bellido, D, Paulino, M, Garcia, Pv, Salas, V, Minguez, Md, Sanchez, Ma, Urrego, C, Martin, I, Rueda, A, Calvo, J, Ripoll, Mm, Torres, Mc, Corteguera, M, Maceiras, F, Cruz, J, Mosquera, Ja, Gomez, R, Area, B, Carrio, I, Rubio, M, Castellvi Barranco, I, Santos, P, Simeon, Cp, Fonollosa, V, Egurbide, Mv, Garcia de Vicuna, R, Vicente, E, Villaverde, V, Fernandez, C, Garcia, E, Uson, J, Miguelez, R, Callejas, Jl, Ortego, N, Roman, J, Alegre Sancho JJ, Robles, A, Rios, Jj, Bonilla, Mg, Sanchez Andrade, A, Vazquez, Tr, Miranda, Ja, Saez, L, Zea, A, De la Puente, C, Martinez, Fg, Aguirre, Ma, Collado, P, Cruz, A, Crespo, M, Sanchez Roman, J, Castillo, Mj, Garcia, Am, Muniz, G, Hedin, Pj, Stahl, C, Bracin, T, Nordin, A, Albertsson, K, Rydvald, Y, Thorsson, C, Hermansson, E, Maurer, B, Verner, D, Schmidt Bosshard, R, Hall, F, Murphy, K, Lamb, J, Anderson, M, Moots, R, Buch, M, Bissell, L, Madhok, R, Hampson, R, D'Cruz, D, Choong, Lm, Gordon, P, Dobson, J, Salerno, R, Nisar, M, Williams, C, Wilcox, L, Denton, C, Ochiel, R, Ngcozana, T, Parker, L, Vincent, R, Mchugh, N, Cole, S, Brown, S, James, J, Herrick, A, Manning, J, Moore, T, Faizal, A, Skyes, H, Smythe, A, and Hamilton, A.

Published
2013

16. Efficacy and safety of various repeat treatment dosing regimens of rituximab in patients with active rheumatoid arthritis: results of a Phase III randomized study (MIRROR)

Author

Rubbert Roth, Andrea, Tak, Paul P, Zerbini, Cristiano, Tremblay, Jean Luc, Carreño, Luis, Armstrong, Gillian, Collinson, Neil, Shaw, Tim M, MIRROR Trial Investigators, Nash, P, Bagga, H, Hall, S, Littlejohn, G, Manolios, N, Van Den Bosch, F, Ximenes, Ac, Mccarthy, T, Atkins, C, Thorne, Jc, Offer, R, Pope, J, Keystone, E, Huang, F, Wu, D, Karjalainen, A, Schaeverbeke, T, Euller Ziegler, L, Jorgensen, C, Nguyen, M, Puechal, X, Wassenberg, S, Heilig, B, Mueller Ladner, U, Wollenhaupt, J, Braun, J, Gauler, G, Szekanecz, Z, Nagy, K, Galeazzi, M, Trotta, F, Bombardieri, S, Salvarani, Carlo, Pellerito, R, Seriolo, B, Adami, S, Bianchi, G, Giacomelli, R, Arioli, G, Cantini, F, Ching, D, Gilchrist, N, Singh, J, Lukac, J, Rovensky, J, Macejova, Z, Kalla, A, Tikly, M, Ally, Mm, Marenco, Jl, Tinture, T, Juanola, J, Alvaro Gracia JM, Rodriguez Heredia JM, Sandoval, Tp, Cheng, Tt, Luo, Sf, Lan, Jl, Osiri, M, Nilganuwong, S, Asavatanabodee, P, Nanagara, R, Louthrenoo, W, Hazleman, Bl, Jubb, R, George, E, Hakim, A, Grennan, D, Gardiner, P, Taylor, J, Mcnally, J, Hutchinson, D, Plant, M., AII - Amsterdam institute for Infection and Immunity, and Clinical Immunology and Rheumatology

Subjects
Male, Gastroenterology, law.invention, Arthritis, Rheumatoid, Antibodies, Monoclonal, Murine-Derived, Adult, Aged, Antirheumatic Agents, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Humans, Middle Aged, Treatment Outcome, Randomized controlled trial, law, Rheumatoid, Monoclonal, Clinical endpoint, Medicine, Pharmacology (medical), B-cell depletion, Clinical Science, Repeat treatment, Rheumatoid arthritis, Rituximab, Drug, medicine.drug, Murine-Derived, medicine.medical_specialty, Antibodies, Dose-Response Relationship, Phase III, Rheumatology, Internal medicine, In patient, Dosing, business.industry, Arthritis, medicine.disease, Surgery, Clinical trial, business, Rheumatism
Abstract

Objective. To evaluate the efficacy and safety of three dosing and repeat treatment regimens of rituximab (RTX) plus MTX in patients with active RA. Methods. Patients with active RA despite stable MTX (10–25 mg/week) were randomly assigned to one of the three treatment regimens comprising two courses of RTX given 24 weeks apart: 2 × 500 and 2 × 500 mg; 2 × 500 and 2 × 1000 mg (dose escalation); and 2 × 1000 and 2 × 1000 mg. The primary endpoint was proportion of patients achieving ACR20 at Week 48. Results. At Week 48, ACR20 responses were not statistically significantly different between the dose regimens. Compared with RTX 2 × 500 mg (n = 134) or dose escalation (n = 119), ACR and European League Against Rheumatism (EULAR) outcomes in the RTX 2 × 1000 mg group (n = 93) were consistently higher, with significantly more patients achieving EULAR responses (P = 0.0495). At Week 48, rituximab 2 × 1000 mg was associated with a higher proportion of patients who, following retreatment, maintained or improved their Week 24 responses. Dose escalation from 2 × 500 to 2 × 1000 mg did not appear to be associated with improved outcomes compared with continual 2 × 500 mg. All RTX regimens demonstrated comparable safety. Conclusions. RTX 2 × 500 and 2 × 1000 mg could not be clearly differentiated, although some efficacy outcomes suggest improved outcomes in the rituximab 2 × 1000 mg group. Retreatment from Week 24 resulted in a sustained suppression of disease activity through to Week 48. Trial registration. ClinicalTrials.gov, http://clinicaltrials.gov/, NCT00422383.

Published
2010

17. Systemic sclerosis in Europe: first report from the EULAR Scleroderma Trials And Research (EUSTAR) group database

Author

Tyndall, A, Mueller-Ladner, U, Matucci-Cerinic, M, and on, b

Subjects
medicine.medical_specialty, business.industry, Immunology, EULAR News, medicine.disease, Therapeutic trial, General Biochemistry, Genetics and Molecular Biology, Scleroderma, Rheumatology, Family medicine, Immunology and Allergy, Medicine, business
Abstract

Under the auspices of the EULAR Standing Committee for International clinical Studies Including therapeutic Trials (ESCISIT), the EULAR Scleroderma Trials And Research (EUSTAR) group was officially founded in June 2004 during the Berlin EULAR congress. This was the culmination of 18 months’ intense activity by many people across Europe, and a summary is available on the website (http://www.EUSTAR.org). The logo (fig 1) features a star from a painting by Paul Klee, who himself succumbed to this dreadful disease. Figure 1 EUSTAR logo. An integral part of the EUSTAR mission was the development of a Minimal Essential Data Set, called MEDS. This consists of a simple two page form …

Published
2005
Full Text
View/download PDF

19. Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry

Author

Guillevin, L, Hunsche, E, Denton, Cp, Krieg, T, Schwierin, B, Rosenberg, D, Matucci-Cerinic, M, Raffier, B, Hirschi, M, Trautinger, F, Schmidt, P, Stetter, M, Hundstorfer, M, Reinhart, V, Monshi, B, Pirkhammer, D, Richter, L, Hamberger, N, Metz, S, Feldmann, R, Semmelweis, K, Lackner, K, Tomi, N, Kolle, H, Hafner, F, Brodmann, M, Kuen-Spiegel, M, Minmair, G, Heil, Pm, Broil, H, Holzer, G, Illmer, X, Rintelen, B, Sautner, J, Takacs, M, Thun, M, Zemanova, I, Soukup, T, Smrzova, A, Bohmova, J, Prochazkova, L, Nemec, P, Fojtik, Z, Suchy, D, Becvar, R, Olsen, Ab, Sondergaard, Kh, Luosu jarvi, R, Vidqvist, Kl, Madaule, S, Beneton, N, Maillard, H, Charlanne, H, Granelbrocard, F, Hachulla, E, Hatron, Py, Jourdain, N, Lambert, M, Launay, D, Morell, S, Woijtasik, G, Skowron, F, Zenone, T, Dadban, A, Lok, C, Ferrandiz, D, Magybertrand, N, Moiton, Mp, Taieb, A, Balquiere, S, Belin, E, Droitcourt, C, Julien, S, Prey, S, Boulon, C, Constans, J, Doutre, Ms, Kostrzwewa, E, Richez, C, Greco, M, Misery, L, Sassolas, B, Collet, E, Berthier, S, Leguy-Seguin, V, Imbert, B, Carpentier, P, Blaise, S, Couraud, A, Doeffel-Hantz, V, Spars, A, Bezanahary, H, Boussely, N, Dumonteil, S, Fauchais, Al, Goudran, G, Loustaud-Ratti, V, Manea, P, Vidal, E, Coppere, B, Desmursclavel, H, Girard-Madoux, Mh, Hot, A, Ninet, J, Granel, B, Cohen, Jd, Keynote, A, Khau van Kien, A, Le Quellec, A, Riviere, S, Rullier, P, Bessis, D, Farcas, C, Bravetti, V, Moline, T, Wahl, D, Zuily, S, Granel-Brocard, F, Agard, C, Durant, C, Fuzibet, Jg, Queyrel, V, Berezne, A, Mouthon, L, Cabane, J, Tiev, K, Toledano, C, Lazareth, I, Michon-Pasturel, U, Priollet, P, Reguiai, Z, Cazaletslacoste, C, Jego, P, Letremy, A, Perlat, A, Duval-Modeste, Ab, Chatelus, E, Chiffot, H, Sibillia, J, Sordet, C, Adoue, D, Couret, B, Moulis, G, Pugnet, G, Sailler, L, Diot, E, Gaches, F, Farge, D, Keshtmand, H, Frances, C, von Elling, A, Bora, D, Ebel, J, Ahmadi-Simab, K, Klein, E, Hahn, K, Schulze, K, Rasche, C, Riemekasten, G, Lee, Hh, Deuschle, K, Mattat, K, Becker, M, Worm, M, Mensing, C, Klings, D, Mensing, H, Messall, J, Zuper, R, Eilbacher, P, Saar, P, Kaufmann, P, Hallermann, C, Schmidt, K, Wahn, H, Schildt, K, Schuart, T, Kaczmarczyk, A, Kellner, C, von Oelhafen, J, Baron von Bildering, P, Kunze, S, Kleiner, Hj, Alsheimer, B, Schuetz, N, Miirker-Hermann, E, Gottl, Kh, Weiss, E, Reischel, N, Kern, S, Goettl, Kh, Goetheuniversitiitsklinikum, Jw, Himsel, A, Henkemeier, U, Schwarting, A, Hazenbiller, A, Nichelmann, V, Rumbaur, C, Boesenberg, I, Schmeiser, T, Mueller-Ladner, U, Unholzer, A, Starz, H, Welzel, J, Plaumann, K, Stoeckl, F, Sperling, S, Podda, M, Wagner, N, Rapprich, H, Niedermeier, A, Messer, G, Sardy, M, Bekou, V, Dill-MUller, D, Wlodarz, M, Belloni, B, Huettig, B, Ziai, M, Hein, R, Kneitz, C, Federow, I, Schneider, K, Semmler, M, Hapke, S, Metzler, C, Stein, T, Enderlein, M, Kayser, M, Werthmann, M, Guenther, Cu, Neul, S, Hellmich, B, Loeffler, C, Pflugfelder, J, Karaenke, P, Mueglich, C, Tony, Hp, Marina, P, Popp, M, Mittag, M, Baumann, C, Scheib, Eg, Brand, H, Wilhelm, Hu, Bohm, J, Dyballa, J, Boehm, J, Taggeselle, J, Luthke, K, Wuerzburg, I, Niefanger, K, Mayer, L, Drabek, J, Harmuth, W, Dietl, S, Moritz, D, Gause, A, Gaubitz, M, Hallecker, A, Krupp, E, Rumpel, H, Moosig, F, Frey, P, Kahl, S, Linke, M, Merk, B, Bloching, Hh, Ochs, W, Kurthen, R, Eiden, E, Guertler, I, Aries, Pm, Kirchberg, S, Jahnke, K, Mettler, S, Toeller, S, Zwenger, S, Langer, He, Deininger, F, Hartmann, F, Neeck, G, Neek, G, Wernitzsch, H, Meier, L, Herr, U, Meier, U, Aaig, W, Bruckner, L, Sheikh, N, Wollenhaupt, J, Krog, B, Wollersdorfer, E, Hall, R, Diehm, C, Tiggers, C, Peters, J, Kirschke, J, Schroeder, Jo, Zeuner, R, Uhlig, S, Barth, S, Huegel, R, Glaeser, R, Schaefer, C, Monshausen, M, Mengden, T, Funkert, A, Blank, N, Lupaschko, S, Voss, B, Megahed, M, Sadeghlar, F, Seidel, M, Wasmuth, Jc, Kreuter, A, Vosswinkel, J, Pfoehler, C, Gerber, A, Haust, M, Hoff, Np, Mota, R, Akanay-Diesel, S, Homey, B, Katzemich, A, Erfurt-Berge, C, Sticherling, M, Beyer, C, Distler, J, Mitchell, A, Freundlieb, C, Rushentsova, U, Hermanns, G, Blaschke, S, Fiene, M, Wessel, C, Norgauer, J, Rabe, B, Schuster, J, Scholz, J, Kremer, K, Robakidze-Torbahn, M, Moinzadeh, P, Dohse, A, Muhlack, A, Schultz, L, Schult, S, Frambach, Y, Kruse, S, Kettenbach, A, Fell, I, Schweda, K, Steinbrink, K, Podobinska, M, Fieri beck, G, Schanz, S, Pfeiffer, C, Hassel, R, Herrgott, I, Sunderkoetter, C, Guenzel, J, Athanassiou, P, Dimitroulas, T, Settas, L, Kritikos, I, Tsifetaki, N, Garyfallos, A, Vasilopoulos, D, Boura, P, Kamali, S, Aslanidis, S, Vlachoyannopoulos, P, Galanopoulo, V, Sakkas, L, Koutroubas, A, Elezoglou, T, Galanopoulos, N, Grier, A, Murray, M, O'Rourke, M, Del Papa, N, Maglione, W, Zeni, S, Foti, R, Benenati, A, De Vita, S, Ferraccioli, G, Grassi, W, de Angeli, R, Pomponio, G, Mussi, A, Colonna, L, Airo, P, Zingarelli, S, Scorza, R, Serverino, A, Puppo, F, Negrini, S, Roma, I, Salsano, F, Triolo, G, Mazzuca, S, Carignola, R, Gatti, S, Lunardi, G, Riccieri, V, Salvarani, C, Bajocchi, G, Varcasia, G, Marasini, B, Belloll, L, de Luca, R, Stisi, S, Bellissimo, S, Fusaro, E, Pellerito, R, Cozzi, F, Rizzo, M, Bartoluzzi, A, Trotta, F, Cantatore, F, Corrado, A, Ferri, C, Colaci, M, Malavolta, N, Mule, R, Galeazzi, M, Lapadula, G, Mathieu, A, Vacca, A, Giacomelli, R, Cipriani, P, Montecucco, Cm, Codullo, V, Bucci, R, Battaglia, E, Valentini, G, Cuomo, G, Terlizzi, N, Serafino, L, Reumatologia, Uo, Bombardieri, S, Della Rossa, A, Doveri, M, Perricone, R, de Mattia, M, Pallotta, S, Groenendael, Jh, Seys, P, Goekoop, Rj, Han, Kh, Wlarvens, M, Bonte-Mineur, F, de Bois MH, de Beus WM, van Zeben, D, Vonk, M, Knaapen, Hk, Smit, A, Bootsma, H, Ton, E, Voskuyl, A, Dutmer, Ea, Stalk, Jn, Madland, Tm, Seip, M, Hoffmann Vold AM, Bitter, H, Stocklund Thomsen, R, Resende, C, Ponte, C, Martinho, S, Silva, F, Ferreira, P, Grilo, A, Riso, N, Santos, C, Camara, I, Costa, J, Alves, J, Oliveira, S, Almeida, I, Silva, I, Cordeiro, A, Coelho, P, Lukac, J, Dolnicar, As, Espinosa, G, Mejia, Jc, Ramos, M, Plasin Rodriguez MA, Mera, A, Blanco, Js, Diaz, Jj, Losada, L, Perez, E, Maneiro, Jr, Caamano, M, Fermindez, S, Insua, Sa, Barbado, J, Fonseca, Em, Nufio, Fj, Castellvi, I, Garcia de Ia Pena, P, Bellido, D, Paulino, M, Garcia, Pv, Salas, V, Minguez, Md, Sanchez, Ma, Urrego, C, Martin, I, Rueda, A, Calvo, J, Ripoll, Mm, Torres, Mc, Corteguera, M, Maceiras, F, Cruz, J, Mosquera, Ja, Gomez, R, Area, B, Carrio, I, Rubio, M, Castellvi Barranco, I, Santos, P, Simeon, Cp, Fonollosa, V, Egurbide, Mv, Garcia de Vicuna, R, Vicente, E, Villaverde, V, Fernandez, C, Garcia, E, Uson, J, Miguelez, R, Callejas, Jl, Ortego, N, Roman, J, Alegre-Sancho, Jj, Robles, A, Rios, Jj, Bonilla, Mg, Sanchez Andrade, A, Vazquez, Tr, Miranda, Ja, Saez, L, Zea, A, De la Puente, C, Martinez, Fg, Aguirre, Ma, Collado, P, Cruz, A, Crespo, M, Sanchez-Roman, J, Castillo, Mj, Garcia, Am, Muniz, G, Hedin, Pj, Stahl, C, Bracin, T, Nordin, A, Albertsson, K, Rydvald, Y, Thorsson, C, Hermansson, E, Maurer, B, Verner, D, Schmidt Bosshard, R, Hall, F, Murphy, K, Lamb, J, Anderson, M, Moots, R, Buch, M, Bissell, L, Madhok, R, Hampson, R, D'Cruz, D, Choong, Lm, Gordon, P, Dobson, J, Salerno, R, Nisar, M, Williams, C, Wilcox, L, Denton, C, Ochiel, R, Ngcozana, T, Parker, L, Vincent, R, Mchugh, N, Cole, S, Brown, S, James, J, Herrick, A, Manning, J, Moore, T, Faizal, A, Skyes, H, Smythe, A, Hamilton, A., L., Guillevin, E., Hunsche, C. P., Denton, T., Krieg, B., Schwierin, D., Rosenberg, DUO Registry Group: B Raffier, Matucci-Cerinic M., Hirschi, M, Trautinger, F, Schmidt, P, Stetter, M, Hundstorfer, M, Reinhart, V, Monshi, B, Pirkhammer, D, Richter, L, Hamberger, N, Metz, S, Feldmann, R, Semmelweis, K, Lackner, K, Tomi, N, Kolle, H, Hafner, F, Brodmann, M, Kuen-Spiegel, M, Minmair, G, M Heil, P, Broil, H, Holzer, G, Illmer, X, Rintelen, B, Sautner, J, Takacs, M, Thun, M, Zemanova, I, Soukup, T, Smrzova, A, Bohmova, J, Prochazkova, L, Nemec, P, Fojtik, Z, Suchy, D, Becvar, R, B Olsen, A, H Sondergaard, K, Luosu jarvi, R, Vidqvist, K-L, Madaule, S, Beneton, N, Maillard, H, Charlanne, H, Granelbrocard, F, Hachulla, E, Y Hatron, P, Jourdain, N, Lambert, M, Launay, D, Morell, S, Woijtasik, G, Skowron, F, Zenone, T, Dadban, A, Lok, C, Ferrandiz, D, Magybertrand, N, P Moiton, M, Taieb, A, Balquiere, S, Belin, E, Droitcourt, C, Julien, S, Prey, S, Boulon, C, Constans, J, S Doutre, M, Kostrzwewa, E, Richez, C, Greco, M, Misery, L, Sassolas, B, Collet, E, Berthier, S, Leguy-Seguin, V, Imbert, B, Carpentier, P, Blaise, S, Couraud, A, Doeffel-Hantz, V, Spars, A, Bezanahary, H, Boussely, N, Dumonteil, S, L Fauchais, A, Goudran, G, Loustaud-Ratti, V, Manea, P, Vidal, E, Coppere, B, Desmursclavel, H, H Girard-Madoux, M, Hot, A, Ninet, J, Granel, B, D Cohen, J, Keynote, A, Khau van Kien, A, Le Quellec, A, Riviere, S, Rullier, P, Bessis, D, Farcas, C, Bravetti, V, Moline, T, Wahl, D, Zuily, S, Granel-Brocard, F, Agard, C, Durant, C, G Fuzibet, J, Queyrel, V, Berezne, A, Guillevin, L, Mouthon, L, Cabane, J, Tiev, K, Toledano, C, Lazareth, I, Michon-Pasturel, U, Priollet, P, Reguiai, Z, Cazaletslacoste, C, Jego, P, Letremy, A, Perlat, A, B Duval-Modeste, A, Chatelus, E, Chiffot, H, Sibillia, J, Sordet, C, Adoue, D, Couret, B, Moulis, G, Pugnet, G, Sailler, L, Diot, E, Gaches, F, Farge, D, Keshtmand, H, Frances, C, von Elling, A, Bora, D, Ebel, J, Ahmadi-Simab, K, Klein, E, Hahn, K, Schulze, K, Rasche, C, Riemekasten, G, H Lee, H, Deuschle, K, Mattat, K, Becker, M, Worm, M, Mensing, C, Klings, D, Mensing, H, Messall, J, Zuper, R, Eilbacher, P, Saar, P, Kaufmann, P, Hallermann, C, Schmidt, K, Wahn, H, Schildt, K, Schuart, T, Kaczmarczyk, A, Kellner, C, von Oelhafen, J, Baron von Bildering, P, Kunze, S, J Kleiner, H, Alsheimer, B, Schuetz, N, Miirker-Hermann, E, Gottl, K-H, Weiss, E, Reischel, N, Kern, S, H Goettl, K, Goetheuniversitiitsklinikum, J-W, Himsel, A, Henkemeier, U, Schwarting, A, Hazenbiller, A, Nichelmann, V, Rumbaur, C, Boesenberg, I, Schmeiser, T, Mueller-Ladner, U, Unholzer, A, Starz, H, Welzel, J, Plaumann, K, Stoeckl, F, Sperling, S, Podda, M, Wagner, N, Rapprich, H, Niedermeier, A, Messer, G, Sardy, M, Bekou, V, Dill-MUller, D, Wlodarz, M, Belloni, B, Huettig, B, Ziai, M, Hein, R, Kneitz, C, Federow, I, Schneider, K, Semmler, M, Hapke, S, Metzler, C, Stein, T, Enderlein, M, Kayser, M, Werthmann, M, U Guenther, C, Neul, S, Hellmich, B, Loeffler, C, Pflugfelder, J, Karaenke, P, Mueglich, C, P Tony, H, Marina, P, Popp, M, Mittag, M, Baumann, C, G Scheib, E, Brand, H, U Wilhelm, H, Bohm, J, Dyballa, J, Boehm, J, Taggeselle, J, Luthke, K, Wuerzburg, I, Niefanger, K, Mayer, L, Drabek, J, Harmuth, W, Dietl, S, Moritz, D, Gause, A, Gaubitz, M, Hallecker, A, Krupp, E, Rumpel, H, Moosig, F, Frey, P, Kahl, S, Linke, M, Merk, B, H Bloching, H, Ochs, W, Kurthen, R, Eiden, E, Guertler, I, M Aries, P, Kirchberg, S, Jahnke, K, Mettler, S, Toeller, S, Zwenger, S, E Langer, H, Deininger, F, Hartmann, F, Neeck, G, Neek, G, Wernitzsch, H, Meier, L, Herr, U, Meier, U, Aaig, W, Bruckner, L, Sheikh, N, Wollenhaupt, J, Krog, B, Wollersdorfer, E, Hall, R, Diehm, C, Tiggers, C, Peters, J, Kirschke, J, O Schroeder, J, Zeuner, R, Uhlig, S, Barth, S, Huegel, R, Glaeser, R, Schaefer, C, Monshausen, M, Mengden, T, Funkert, A, Blank, N, Lupaschko, S, Voss, B, Megahed, M, Sadeghlar, F, Seidel, M, C Wasmuth, J, Kreuter, A, Vosswinkel, J, Pfoehler, C, Gerber, A, Haust, M, P Hoff, N, Mota, R, Akanay-Diesel, S, Homey, B, Katzemich, A, Erfurt-Berge, C, Sticherling, M, Beyer, C, Distler, J, Mitchell, A, Freundlieb, C, Rushentsova, U, Hermanns, G, Blaschke, S, Fiene, M, Wessel, C, Norgauer, J, Rabe, B, Schuster, J, Scholz, J, Kremer, K, Robakidze-Torbahn, M, Moinzadeh, P, Dohse, A, Muhlack, A, Schultz, L, Schult, S, Frambach, Y, Kruse, S, Kettenbach, A, Fell, I, Schweda, K, Steinbrink, K, Podobinska, M, Fieri beck, G, Schanz, S, Pfeiffer, C, Hassel, R, Herrgott, I, Sunderkoetter, C, Guenzel, J, Athanassiou, P, Dimitroulas, T, Settas, L, Kritikos, I, Tsifetaki, N, Garyfallos, A, Vasilopoulos, D, Boura, P, Kamali, S, Aslanidis, S, Vlachoyannopoulos, P, Galanopoulo, V, Sakkas, L, Koutroubas, A, Elezoglou, T, Galanopoulos, N, Grier, A, Murray, M, O'Rourke, M, Del Papa, N, Maglione, W, Zeni, S, Foti, R, Benenati, A, De Vita, S, Ferraccioli, G, Grassi, W, de Angeli, R, Pomponio, G, Mussi, A, Colonna, L, Airo, P, Zingarelli, S, Scorza, R, Serverino, A, Puppo, F, Negrini, S, Roma, I, Salsano, F, Triolo, G, Mazzuca, S, Carignola, R, Gatti, S, Lunardi, G, Riccieri, V, Salvarani, C, Bajocchi, G, Varcasia, G, Marasini, B, Belloll, L, Matucci-Cerinic, M, de Luca, R, Stisi, S, Bellissimo, S, Fusaro, E, Pellerito, R, Cozzi, F, Rizzo, M, Bartoluzzi, A, Trotta, F, Cantatore, F, Corrado, A, Ferri, C, Colaci, M, Malavolta, N, Mule, R, Galeazzi, M, Lapadula, G, Mathieu, A, Vacca, A, Giacomelli, R, Cipriani, P, M Montecucco, C, Codullo, V, Bucci, R, Battaglia, E, Valentini, G, Cuomo, G, Terlizzi, N, Serafino, L, O Reumatologia, U, Bombardieri, S, Della Rossa, A, Doveri, M, Perricone, R, de Mattia, M, Pallotta, S, M Groenendael, J H L, Seys, P, J Goekoop, R, H Han, K, Wlarvens, M, Bonte-Mineur, F, and W de Bois, M H

Subjects
Adult, Employment, Male, Registrie, Scleroderma, Systemic, Systemic, Middle Aged, Scleroderma, Fingers, Disability Evaluation, Cost of Illness, Skin Ulcer, Activities of Daily Living, Finger, Humans, Female, Registries, Self Report, Human
Abstract

Digital ulcers (DUs) are frequent manifestations of systemic scleroderma (SSc). This study assessed functional limitations due to DUs among patients enrolled in the Digital Ulcer Outcome (DUO) Registry, an international, multicentre, observational registry of SSc patients with DU disease.Patients completed at enrolment a DU-specific functional assessment questionnaire with a 1-month recall period, measuring impairment in work and daily activities, and hours of help needed from others. Physician-reported clinical parameters were used to describe the population. For patients who completed at least part of the questionnaire, descriptive analyses were performed for overall results, and stratified by number of DUs at enrolment.This study included 2327 patients who completed at least part of the questionnaire. For patients with 0, 1-2, and ≥3 DUs at enrolment, mean overall work impairment during the prior month among employed/self-employed patients was 28%, 42%, and 48%, respectively. Across all included patients, ability to perform daily activities was impaired on average by 35%, 54%, and 63%, respectively. Patients required a mean of 2.0, 8.7, and 8.8 hours of paid help and 17.0, 35.9, and 63.7 hours of unpaid help, respectively, due to DUs in the prior month. Patients with DUs had more complications and medication use than patients with no DUs.With increasing number of DUs, SSc patients reported more impairment in work and daily activities and required more support from others.

21. Vasodilators and low-dose acetylsalicylic acid are associated with a lower incidence of distinct primary myocardial disease manifestations in systemic sclerosis: results of the DeSScipher inception cohort study

Author

László Czirják, Brigitte Krummel-Lorenz, Carina Mihai, Serena Fasano, Giuseppina Abignano, Serena Guiducci, Gabriele Valentini, Rosaria Irace, Armando Gabrielli, Francesco Del Galdo, Britta Maurer, Ivan Foeldvari, Ulrich A. Walker, Svetlana I. Nihtyanova, Alessandra Vacca, Dörte Huscher, Ulf Mueller-Ladner, Marc Frerix, Jérôme Avouac, Veronika K. Jaeger, Christopher P. Denton, Oliver Distler, Marco Matucci-Cerinic, Ingo H. Tarner, T. Schmeiser, L. Ananieva, Simona Rednic, Sergey Moiseev, Ana Maria Gherghe, Yannick Allanore, Antonella Riccardi, Elise Siegert, Joerg Henes, Gabriela Riemekasten, Veronika Lóránd, Valentina Messiniti, Valentini, G., Huscher, D., Riccardi, A., Fasano, S., Irace, R., Messiniti, V., Matucci-Cerinic, M., Guiducci, S., Distler, O., Maurer, B., Avouac, J., Tarner, I. H., Frerix, M., Riemekasten, G., Siegert, E., Czirjak, L., Lorand, V., Denton, C. P., Nihtyanova, S., Walker, U. A., Jaeger, V. K., Del Galdo, F., Abignano, G., Ananieva, L. P., Gherghe, A. M., Mihai, C., Henes, J. C., Schmeiser, T., Vacca, A., Moiseev, S., Foeldvari, I., Gabrielli, A., Krummel-Lorenz, B., Rednic, S., Allanore, Y., and Mueller-Ladner, U.

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, preventative role of vasodilator therapy, Vasodilator Agents, Immunology, primary myocardial disease in scleroderma, Vasodilation, General Biochemistry, Genetics and Molecular Biology, Ventricular Function, Left, 03 medical and health sciences, Ventricular Dysfunction, Left, 0302 clinical medicine, Rheumatology, Fibrosis, Internal medicine, medicine, Immunology and Allergy, Humans, Survival analysis, Proportional Hazards Models, 030203 arthritis & rheumatology, Heart Failure, Ejection fraction, Scleroderma, Systemic, Aspirin, Proportional hazards model, business.industry, Incidence (epidemiology), Incidence, Arrhythmias, Cardiac, Middle Aged, medicine.disease, 030104 developmental biology, Heart failure, cardiovascular system, Cardiology, Female, Endothelin receptor, business, Cardiomyopathies
Abstract

ObjectivesTo investigate the influence of vasodilator drugs on the occurrence of features depending on myocardial ischaemia/fibrosis (ventricular arrhythmias, Q waves, cardiac blocks, pacemaker implantation, left ventricular ejection fraction (LVEF) Methods601 patients with SSc were enrolled from 1 December 2012 to 30 November 2015 and had a second visit 0.5–4 years apart. 153 received no vasodilators; 448 received vasodilator therapy (ie, calcium channel blockers and/or ACE inhibitors or angiotensin II receptor blockers or combinations of them), 89 of them being also treated with either endothelin receptor antagonists or PDE5 inhibitors or prostanoids. Associations between the occurrence of myocardial disease manifestations and any demographic, disease and therapeutic aspect were investigated by Cox regression analysis. A Cox frailty survival model with centre of enrolment as random effect was performed.ResultsDuring 914 follow-up patient-years, 12 ventricular arrhythmias, 5 Q waves, 40 cardiac blocks, 6 pacemaker implantations and 19 reduced LVEF and/or congestive heart failure (CHF) occurred. In multivariate Cox regression analysis, vasodilator therapy was associated with a lower incidence of ventricular arrhythmias (p=0.03); low-dose acetylsalicylic acid (ASA) with a lower incidence of cardiac blocks and/or Q waves and/or pacemaker implantation (p=0.02); active disease with a higher incidence of LVEF ConclusionsThe present study might suggest a preventative effect on the occurrence of distinct myocardial manifestations by vasodilator therapy and low-dose ASA.

Published
2019

22. IgG4-related diseases: state of the art on clinical practice guidelines

Author

Charissa Frank, Paola Toniati, Gerd R Burmester, Tobias Alexander, Zahir Amoura, Luc Mouthon, Matthias F. Schneider, Andrea Doria, Carlomaurizio Montecucco, Vanessa Smith, Ulf Mueller-Ladner, Angela Tincani, Marta Mosca, Sara Monti, Karim Faiz, Rosaria Talarico, Stefano Bombardieri, Luca Iaccarino, Pieter van Hagen, Ronald F van Vollenhoven, Maurizio Cutolo, Miguel Hie, Carlo Alberto Scirè, Eric Hachulla, David Launay, Iaccarino, L, Talarico, R, Scire, C, Amoura, Z, Burmester, G, Doria, A, Faiz, K, Frank, C, Hachulla, E, Hie, M, Launay, D, Montecucco, C, Monti, S, Mouthon, L, Tincani, A, Toniati, P, Van Hagen, P, Van Vollenhoven, R, Bombardieri, S, Mueller-Ladner, U, Schneider, M, Smith, V, Cutolo, M, Mosca, M, Alexander, T, Immunology, and Internal Medicine

Subjects
medicine.medical_specialty, clinical practice guidelines, ERN reconnet, european reference networks, IgG4-related diseases, unmet needs, Immunology, clinical practice guidelines, ERN reconnet, european reference networks, IgG4-related diseases, unmet needs, Disease, clinical practice guidelines,ERN reconnet, european reference networks, IgG4-related diseases, unmet needs, Unmet needs, NO, Tissue infiltration, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, medicine, Medicine and Health Sciences, Immunology and Allergy, Limited evidence, IgG4-related disease, Intensive care medicine, Connective Tissue Diseases, 030203 arthritis & rheumatology, business.industry, unmet need, Clinical Practice, Group discussion, european reference network, 030211 gastroenterology & hepatology, Narrative review, business, clinical practice guideline, Systematic search
Abstract

Immunoglobulin G4-related diseases (IgG4-RD) are a group of chronic relapsing–remitting inflammatory conditions, characterised by tissue infiltration with lymphocytes and IgG4-secreting plasma cells, fibrosis and a usually favourable response to steroids.In this narrative review, we summarise the results of a systematic literature research, which was performed as part of the European Reference Network ReCONNET, aimed at evaluating existing clinical practice guidelines (CPGs) and recommendations in IgG4-RD. From 167 publications initially obtained from a systematic literature search, only one was identified as a systematic multispecialist, evidence-based, consensus guidance statement on diagnosis and treatment of IgG4-RD, which may be recommended for use as CPG in IgG4-RD.With the recognition of a limited evidence based in this increasingly recognised disease, the group discussion has identified the following unmet needs: lack of shared classification criteria, absence of formal guidelines on diagnosis, no evidence-based therapeutic recommendations and lack of activity and damage indices. Areas of unmet needs include the difficulties in diagnosis, management and monitoring and the scarcity of expert centres.

Published
2019

23. Systemic sclerosis: state of the art on clinical practice guidelines

Author

Jeska K de Vries-Bouwstra, Jacob M van Laar, Ronald F van Vollenhoven, Els Vandecasteele, Alexandre E. Voskuyl, Charissa Frank, Tobias Alexander, Gemma Lepri, Fonseca João Eurico, Eric Hachulla, Angela Tincani, Alexis Mathian, Elisabetta Zanatta, Veronica Codullo, Alberto Sulli, Luc Mouthon, Marco Matucci-Cerinic, Vanessa Smith, Amber Vanhaecke, Gerd R Burmester, Marie Vanthuyne, Frank J. A. van den Hoogen, D. Launay, Matthias Schneider, Maurizio Cutolo, Rosaria Talarico, Yannick Allanore, Ilaria Galetti, Frédéric Houssiau, Virgil A. S. H. Dalm, Alessandra Della Rossa, Cosimo Bruni, Carlo Alberto Scirè, Ulf Mueller-Ladner, Oliver Distler, Stefano Bombardieri, Paolo Airò, Barbara Ruaro, Marta Mosca, Ana Rita Vieira, Immunology, Internal Medicine, Smith, V, Scire, C, Talarico, R, Airo, P, Alexander, T, Allanore, Y, Bruni, C, Codullo, V, Dalm, V, De Vries-Bouwstra, J, Della Rossa, A, Distler, O, Galetti, I, Launay, D, Lepri, G, Mathian, A, Mouthon, L, Ruaro, B, Sulli, A, Tincani, A, Vandecasteele, E, Vanhaecke, A, Vanthuyne, M, Van Den Hoogen, F, Van Vollenhoven, R, Voskuyl, A, Zanatta, E, Bombardieri, S, Burmester, G, Eurico, F, Frank, C, Hachulla, E, Houssiau, F, Mueller-Ladner, U, Schneider, M, Van Laar, J, Vieira, A, Cutolo, M, Mosca, M, Matucci-Cerinic, M, Scirè, Ca, Van den Hoogen, F, Voskuyl, Ae, Eurico, Fj, van Laar, Jm, and Matucci-Cerinic, M.

Subjects
ERN ReCONNET, European reference networks, clinical practice guidelines, nailfold videocapillaroscopy, systemic sclerosis, unmet needs, European reference network, Disease, INTERSTITIAL LUNG-DISEASE, RECOMMENDATIONS, DEVELOPING CRITERIA, PRACTICE PATHWAY, High morbidity, 0302 clinical medicine, Fibrosis, Medicine and Health Sciences, EXPERT CONSENSUS, Immunology and Allergy, 030212 general & internal medicine, skin and connective tissue diseases, integumentary system, Interstitial lung disease, unmet need, Clinical Practice, medicine.symptom, systemic sclerosi, clinical practice guideline, medicine.medical_specialty, Immunology, Systemic Sclerosis, NO, Pharmacological treatment, Unmet needs, 03 medical and health sciences, Rheumatology, medicine, SIMPLE CAPILLAROSCOPIC DEFINITIONS, Intensive care medicine, 030203 arthritis & rheumatology, business.industry, STEM-CELL TRANSPLANTATION, medicine.disease, Sexual dysfunction, SKIN ULCERS, FUNCTIONAL DISABILITY, clinical practice guidelines, ERN ReCONNET, European reference networks, nailfold videocapillaroscopy, systemic sclerosis, unmet needs, POINTS, business
Abstract

Systemic sclerosis (SSc) is an orphan disease characterised by autoimmunity, fibrosis of the skin and internal organs, and vasculopathy. SSc may be associated with high morbidity and mortality. In this narrative review we summarise the results of a systematic literature research, which was performed as part of the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases project, aimed at evaluating existing clinical practice guidelines or recommendations. Only in the domains ‘Vascular & Ulcers’ (ie, non-pharmacological approach to digital ulcer), ‘PAH’ (ie, screening and treatment), ‘Treatment’ and ‘Juveniles’ (ie, evaluation of juveniles with Raynaud’s phenomenon) evidence-based and consensus-based guidelines could be included. Hence there is a preponderance of unmet needs in SSc referring to the diagnosis and (non-)pharmacological treatment of several SSc-specific complications. Patients with SSc experience significant uncertainty concerning SSc-related taxonomy, management (both pharmacological and non-pharmacological) and education. Day-to-day impact of the disease (loss of self-esteem, fatigue, sexual dysfunction, and occupational, nutritional and relational problems) is underestimated and needs evaluation.

Published
2018

24. Systemic lupus erythematosus: state of the art on clinical practice guidelines

Author

Ricard Cervera, Sabrina Paolino, Angela Tincani, Ulf Mueller-Ladner, Hervé Devilliers, Gerd R Burmester, Zahir Amoura, Fabrizio Conti, Thierry Martin, Marcello Govoni, Laurent Arnaud, Carlo Alberto Scirè, Tadej Avcin, Matthias Schneider, Marta Mosca, Micaela Fredi, Ana Lladó, Carla Macieira, Maria G Tektonidou, Ilaria Galetti, Alain Cornet, Cristina Pamfil, Maurizio Cutolo, Vanessa Smith, Farah Tamirou, Stefano Bombardieri, Laura Massaro, Eric Hachulla, Frédéric Houssiau, Andrea Doria, Micol Frassi, Fonseca João Eurico, Ronald F van Vollenhoven, Rosaria Talarico, Tobias Alexander, Maria Francisca Moraes-Fontes, Sander W. Tas, Chiara Tani, Alessandra Bortoluzzi, N. Costedoat-Chalumeau, Université Catholique de Louvain = Catholic University of Louvain (UCL), Les Hôpitaux Universitaires de Strasbourg (HUS), Azienda Ospedaliero-Universitaria Pisana [Pisa, Italy], Università degli Studi di Ferrara (UniFE), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), University Medical Centre Ljubljana [Ljubljana, Slovenia] (UMCL), Clinic Barcelona Hospital Universitari, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Université de Bourgogne (UB), Azienda Ospedale Università di Padova = Hospital-University of Padua (AOUP), Spedali Civili Hospital [Brescia], Centro Hospitalar de Lisboa Central [Portugal], Centro Hospitalar Universitário Lisboa Norte [Lisbon, Portugal] (CHULN), University of Genoa (UNIGE), University of Amsterdam [Amsterdam] (UvA), Amsterdam Rheumatology & Immunology Center - ARC [Amsterdam, the Netherlands] (Amsterdam UMC), National and Kapodistrian University of Athens (NKUA), University of Pisa - Università di Pisa, Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Lille Inflammation Research International Center - U 995 (LIRIC), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Lille, Kerckhoff clinic, Partenaires INRAE, Universitätsklinikum Düsseldorf, Universiteit Gent = Ghent University [Belgium] (UGENT), Hôpital Cochin [AP-HP], Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université (HESAM)-HESAM Université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Università degli Studi di Ferrara = University of Ferrara (UniFE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), Università degli studi di Genova = University of Genoa (UniGe), Universiteit Gent = Ghent University (UGENT), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), UCL - SSS/IREC/RUMA - Pôle de Pathologies rhumatismales, UCL - (SLuc) Service de rhumatologie, Tamirou, F, Arnaud, L, Talarico, R, Scire, C, Alexander, T, Amoura, Z, Avcin, T, Bortoluzzi, A, Cervera, R, Conti, F, Cornet, A, Devilliers, H, Doria, A, Frassi, M, Fredi, M, Govoni, M, Houssiau, F, Llado, A, Macieira, C, Martin, T, Massaro, L, Moraes-Fontes, M, Pamfil, C, Paolino, S, Tani, C, Tas, S, Tektonidou, M, Tincani, A, Van Vollenhoven, R, Bombardieri, S, Burmester, G, Eurico, F, Galetti, I, Hachulla, E, Mueller-Ladner, U, Schneider, M, Smith, V, Cutolo, M, Mosca, M, and Costedoat-Chalumeau, N

Subjects
medicine.medical_specialty, HCC DAUTOIM, Immunology, MEDLINE, Lupus nephritis, Lupus, Guidelines, AMERICAN-COLLEGE, DIAGNOSIS, Systemic Lupus Erythematosus, Unmet needs, NO, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), lupu, Rheumatology, immune system diseases, EUROPEAN LEAGUE, Immunology and Allergy, Internal medicine, medicine, Medicine and Health Sciences, MANAGEMENT, 030212 general & internal medicine, EVIDENCE-BASED RECOMMENDATIONS, Disease management (health), Intensive care medicine, RHEUMATIC-DISEASES, 030203 arthritis & rheumatology, RISK, business.industry, ASSOCIATION, medicine.disease, State of the Art, 3. Good health, Clinical Practice, EULAR RECOMMENDATIONS, PREGNANCY, [SDV.IMM]Life Sciences [q-bio]/Immunology, business
Abstract

Systemic lupus erythematosus (SLE) is the paradigm of systemic autoimmune diseases characterised by a wide spectrum of clinical manifestations with an unpredictable relapsing-remitting course. The aim of the present work was to identify current available clinical practice guidelines (CPGs) for SLE, to provide their review and to identify physicians' and patients' unmet needs. Twenty-three original guidelines published between 2004 and 2017 were identified. Many aspects of disease management are covered, including global disease management, lupus nephritis and neuropsychiatric involvement, management of pregnancies, vaccinations and comorbidities monitoring. Unmet needs relate with disease management of some clinical manifestations and adherence to treatment. Many patient's unmet needs have been identified starting with faster diagnosis, need for more therapeutic options, guidelines on lifestyle issues, attention to quality of life and adequate education. info:eu-repo/semantics/publishedVersion

Published
2018
Full Text
View/download PDF

25. FRI0446 Severe Heart Disease in Systemic Sclerosis: Prevalence, Risk Factors and Current Treatment. A Eustar-Desscipher Study

Author

Ingo H. Tarner, Serena Vettori, Ulrich A. Walker, Ulf Mueller-Ladner, Suzana Jordan, L. Czirják, Marc Frerix, Veronika Lóránd, Elise Siegert, Marco Matucci-Cerinic, Yannick Allanore, Gabriele Valentini, F. Del Galdo, Christopher P. Denton, Giovanna Cuomo, G. Riemekasten, Oliver Distler, Veronika K. Jaeger, Vettori, Serena, Cuomo, Giovanna, Jaeger, V. K., Frerix, M., Siegert, E., Lorand, V., Jordan, S., Riemekasten, G., Allanore, Y., Czirjak, L., Tarner, I. H., Distler, O., Denton, C. P., Matucci Cerinic, M., Del Galdo, F., Walker, U. A., Mueller Ladner, U., and Valentini, G.

Subjects
medicine.medical_specialty, Univariate analysis, Myocarditis, Heart disease, business.industry, Immunology, Disease, medicine.disease, Sudden death, General Biochemistry, Genetics and Molecular Biology, Surgery, Rheumatology, Internal medicine, Heart failure, medicine, Immunology and Allergy, business, Rheumatism, Cause of death
Abstract

Background Heart disease in patients with systemic sclerosis (SSc) can cause manifestations such as cardiac blocks (CBs), ventricular arrhythmias (VA), and congestive heart failure (CHF) which may require a pacemaker/defibrillator implant, are the cause of death or sudden death (SD) in about 20% of patients and can be referred to as severe heart disease (SHD). The European League against Rheumatism – Scleroderma Trial and Research (EUSTAR) database provides an unique opportunity to address this topic. The results of such analysis are instrumental for the DeSScipher project, an EU funded project devoted to decipher the optimal management of SSc . Objectives To investigate the prevalence of each SHD manifestation and their associations with demographic, serological, clinical and therapeutic aspects in a large series of adult SSc patients. Methods Seven EUSTAR-DeSScipher centers provided clinical charts at study entry including all the items of SHD. The prevalence of any and each SHD manifestation was calculated. The associations with demographic, serological, clinical features and treatment with vasodilators, i.e. calcium channel blockers (CCBs) and /or ACE inhibitors (ACEi), were investigated by univariate analysis and confirmed by multivariate logistic regression analysis. Results At July 6th 2012, 1119 SSc patients from the 7 EUSTAR centers had no missing data (995 females, 164 males; median age 53.6 years, range 14-86). Out of them, 211 patients (19%) had at least 1 SHD manifestation, 152 patients had CBs (14%), 71 had VA (6%), 132 had CHF (12%), and 27 received a pacemaker/defibrillator implant (2%). CBs were the only SHD manifestation in 100 patients, VA in 31, and CHF in 80. No association was found between SHD and clinical (diffuse or limited) and serological (ACA or anti-Scl-70) subset. No association was found between either CHF or pacemaker/defibrillator implant and any other disease feature. In multiple logistic regression analysis, CBs were associated with bibasilar lung fibrosis at chest X-Ray (OR=2.6; 95%CI=1-6.4; p=0.04), while VA were associated with increased CPK levels (OR=11; 95%CI=1-117; p=0.02) and, unexpectedly, current CCB use (OR 10; 95%CI 1.4-76.1; p=0.02). Conclusions This is the first study devoted to investigate SHD in a large series of carefully assessed SSc patients. SHD was detected in about 19% of the cases, CBs in 14%, VA in 6%, CHF in 12%. Pacemaker/defibrillator implant was needed in 2.4%. These data highlight the importance of an accurate heart assessment in SSc patients. Moreover, the associations between VA and CPK elevation and current CCB use should stimulate the clinician to avoid these drugs in patients with myositis/myocarditis. Acknowledgements The DeSScipher project was funded by the European Community9s Framework Programme 7 (FP7-HEALTH-2012.2.4.4-2 - Observational trials in rare diseases) under grant agreement N° 305495 Disclosure of Interest S. Vettori Grant/research support from: Roche, Consultant for: Phadia Thermofisher, Pfizer, Abbvie, G. Cuomo: None declared, V. Jaeger: None declared, M. Frerix: None declared, E. Siegert: None declared, V. Lorand: None declared, S. Jordan: None declared, G. Riemekasten: None declared, Y. Allanore: None declared, L. Czirjak: None declared, I. Tarner: None declared, O. Distler Grant/research support from: 4D Science, Actelion, Active Biotec, Bayer-Schering, Biogen, Biovitrium, BMS, Boehringer Ingelheim Pharma, EpiPharm, Ergonex, GSK, Inventiva, Medac, Novartis, Pfizer, Pharmacyclics, Roche/Genentech, Sanofi/Genzyme, Serodapharm, Sinoxa and United BioSource Corporation, Consultant for: 4D Science, Actelion, Active Biotec, Bayer-Schering, Biogen, Biovitrium, BMS, Boehringer Ingelheim Pharma, EpiPharm, Ergonex, GSK, Inventiva, Medac, Novartis, Pfizer, Pharmacyclics, Roche/Genentech, Sanofi/Genzyme, Serodapharm, Sinoxa and United BioSource Corporation, C. Denton: None declared, M. Matucci-Cerinic: None declared, F. Del Galdo: None declared, U. Walker: None declared, U. Mueller-Ladner: None declared, G. Valentini: None declared

Published
2015
Full Text
View/download PDF

26. Is there a role for TNF-alpha antagonists in the treatment of SSc? EUSTAR expert consensus development using the Delphi technique

Author

Distler, J. H. W., Jordan, S., Airo, P., Alegre-Sancho, J. J., Allanore, Y., Gurman, A. B., Caporali, R., Caramaschi, P., Carreira, P. E., Chizzolini, C., Cutolo, M., Duruoz, M. T., Farge-Bancel, D., Hesselstrand, R., Iannone, F., Keyser, F., Kucharz, E. J., David Launay, Lefebvre, P. G. D., Lukacova, O., Marasini, B., Martinovic, D., Neto, J. F. M., Radic, M., Rednic, S., Riemekasten, G., Rovensky, J., Seidel, M. F., Senel, S., Smith, V., Sunderkotter, C., Ton, E., Laar, J. M., Matucci-Cerinic, M., Muller-Ladner, U., Distler, O., [Jordan, S. -- Distler, O.] Univ Zurich Hosp, Dept Rheumatol, CH-8091 Zurich, Switzerland -- [Distler, J. H. W.] Univ Erlangen Nurnberg, Dept Rheumatol, Erlangen, Germany -- [Airo, P.] Spedali Civil Brescia, Unit Rheumatol & Clin Immunol, I-25125 Brescia, Italy -- [Alegre-Sancho, J. J.] Hosp Univ Dr Peset Valencia, Valencia, Spain -- [Allanore, Y.] Univ Paris 05, Paris, France -- [Allanore, Y.] Hop Cochin, Serv Rhumatol A, F-75674 Paris, France -- [Gurman, A. Balbir] Rambam Hlth Care Campus, B Shine Rheumatol Unit, Haifa, Israel -- [Caporali, R.] Univ Pavia, Div Rheumatol, IRCCS S, Matteo Fdn, I-27100 Pavia, Italy -- [Caramaschi, P.] Rheumatol Unit, Verona, Italy -- [Carreira, P. E.] Hosp Univ 12 Octubre, Serv Reumatol, Madrid, Spain -- [Chizzolini, C.] Univ Hosp Geneva, Geneva, Switzerland -- [Cutolo, M.] Univ Genoa, Dept Internal Med, Res Lab, I-16126 Genoa, Italy -- [Cutolo, M.] Univ Genoa, Dept Internal Med, Acad Unit Clin Rheumatol, I-16126 Genoa, Italy -- [Duruoz, M. Tuncay] Celal Bayar Univ, Sch Med, PM&R Dept, Div Rheumatol, Manisa, Turkey -- [Farge-Bancel, D.] Hop St Louis, INSERM, U976, Serv Med Interne & Pathol Vasc, Paris, France -- [Hesselstrand, R.] Univ Lund Hosp, Dept Rheumatol, S-22185 Lund, Sweden -- [Iannone, F.] Univ Bari, Rheumatol Unit, DiMIMP, I-70121 Bari, Italy -- [De Keyser, F. -- Smith, V.] Ghent Univ Hosp, Dept Rheumatol, Ghent, Belgium -- [Kucharz, E. J.] Med Univ Silesia, Dept Internal Med & Rheumatol, Katowice, Poland -- [Launay, D.] Univ Lille 2, Dept Internal Med, Lille, France -- [de la Pena Lefebvre, P. Garcia] Hosp Univ Madrid Norte Sanchinarro, Madrid, Spain -- [Lukacova, O. -- Rovensky, J.] Natl Inst Rheumat Dis, Piestany, Slovakia -- [Marasini, B.] Univ Milan, Ist Clin Humanitas, I-20122 Milan, Italy -- [Martinovic, D. -- Radic, M.] Univ Hosp Split, Dept Rheumatol, Split, Croatia -- [Marques Neto, J. F.] Univ Estadual Campinas, FCM, Campinas, Brazil -- [Rednic, S.] Univ Med & Pharm Iuliu Hatieganu Cluj, Clin Reumatol, Cluj Napoca, Romania -- [Riemekasten, G.] Charite, Med Klin Schwerpunkt Rheumatol & Klin Immunol, D-13353 Berlin, Germany -- [Seidel, M. F.] Med Klin & Poliklin 1, Bonn, Germany -- [Senel, S.] Cumhuriyet Univ, Sch Med, Div Rheumatol, Sivas, Turkey -- [Sunderkoetter, C.] Univ Hosp Munster, Dept Dermatol, Munster, Germany -- [Ton, E.] Univ Med Ctr Utrecht, Dept Rheumatol & Clin Immunol, Utrecht, Netherlands -- [van Laar, J. M.] Med Sch Newcastle Upon Tyne, Inst Cellular Med, Musculoskeletal Res Grp, Newcastle Upon Tyne NE2 4HH, Tyne & Wear, England -- [Matucci-Cerinic, M.] Univ Florence, Dept Biomed, Div Rheumatol AOUC, Florence, Italy -- [Mueller-Ladner, U.] Univ Giessen, Dept Rheumatol & Clin Immunol, Kerckhoff Clin Bad Nauheim, Bad Nauheim, Germany, Radic, Mislav -- 0000-0003-0350-6800, Launay, David -- 0000-0003-1840-1817, Duruoz, Mehmet Tuncay -- 0000-0003-3584-2788, Carreira, Patricia -- 0000-0001-8279-3806, and Iannone, Florenzo -- 0000-0003-0474-5344

Subjects
fibrosis, scleroderma, TNF-alpha
Abstract

WOS: 000291117200007, PubMed ID: 21586217, Objective: To obtain experiences and expert opinion on treatment of SSc patients with TNF-alpha antagonists. Methods: An investigation was carried out among the EUSTAR centres into their expertise on use of TNF-alpha antagonists. Assessment forms on the frequency of TNF-alpha inhibitor use were distributed to EULAR Scleroderma Trials and Research Group (EUSTAR) centres. Afterwards, a three round Delphi exercise was performed to obtain expert consensus on the use of TNF-alpha inhibitors in SSc. Results: Seventy-nine centres returned information on use of TNF-alpha antagonists in SSc patients. A total of 65 patients were treated with TNF-alpha inhibitors in 14 different centres. Forty-eight of the 65 patients treated with TNF-alpha inhibitors improved. Improvement was mainly seen in patients with arthritis, whereas the effects on fibrosis varied. In the first round of the subsequent Delphi approach, 71 out of 79 experts stated that they would use TNF-alpha antagonists in SSc. Arthritis was suggested as an indication for TNF alpha antagonists by 75% of the experts. However; after the third stage of the Delphi exercise, the acceptance for the off-label use of TNF-alpha antagonists decreased and 59% recommended that TNF-alpha antagonists should not be used or only used in clinical trials in SSc patients, while 38% of the experts suggested the use of TNF-alpha antagonists for arthritis associated with SSc. Conclusions: Most of the experts do not recommend the routine use of TNF-alpha antagonists in systemic sclerosis. Arthritis might be a potential indication in SSc, although controlled clinical trials with TNF-alpha antagonists are needed before general recommendations can be given., Novartis; Bayer Schering Pharma; Cell Gen Therapeutics; NicOx; Array BioPharma; Bristol-Myers Squibb; Ergonex Pharma GmbH; Actelion Pharmaceuticals; Pfizer; GlaxoSmithKline; Merck; Amgen; Abbott; Roche; EUSTAR/EULAR; Sanofi-Aventis; United BioSource Corporation; Medac; Biovitrium; Active Biotech; Ergonex, Dr Jorg Distler has served as a consultant for Actelion Pharmaceuticals, Pfizer, and GlaxoSmithKline; has received grant support from Novartis, Bayer Schering Pharma, Cell Gen Therapeutics, NicOx, Array BioPharma, Bristol-Myers Squibb, and Ergonex Pharma GmbH; has received payment for development of educational presentations (including service on speakers' bureaus) from Actelion Pharmaceuticals, Pfizer, GlaxoSmithKline, and Bayer Schering Pharma.; Dr F. lannone has received speaker's and consultancy fees from Merck.; Dr Riemekasten has been invited for a meeting by Humira-People (Amgen) and has received speaker's fees and support for travel costs riembursed by Amgen.; Dr M.F. Seidel has received research grants from Pfizer and Abbott.; Dr J. van Laar has received speaker's and consultancy fees and research grants from Roche.; Dr U. Muller-Ladner has received research grants from EUSTAR/EULAR.; Dr Oliver Distler has a consultancy relationship and/or has received research funding from Actelion Pharmaceuticals, Pfizer, Ergonex Pharma GmbH, Bristol-Myers Squibb, Sanofi-Aventis, United BioSource Corporation, Medac, Biovitrium, Novartis and Active Biotech in the area of potential treatments of scleroderma and its complications. He has received lecture honoraria from Actelion Pharmaceuticals, Pfizer and Ergonex.

Catalog

Books, media, physical & digital resources
See catalog results