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1. Inequity and vulnerability in Latin American Indigenous and non-Indigenous populations with rheumatic diseases: a syndemic approach

Author: Bernardo A Pons-Estel, Rosana Quintana, Ruben Burgos-Vargas, Everardo Álvarez-Hernández, John Londono, Ana M Santos, Adalberto Loyola-Sanchez, Mario H Cardiel, Maria Victoria Goycochea-Robles, Ingris Peláez-Ballestas, Ysabel Granados, Flor Julián-Santiago, Celenia Rosillo, Jose Alvarez-Nemegyei, Natalia Santana, Mario Goñi, Ligia Cedeño, Romina Nieto, Silvana Conti, María Elena Calvo, Eugenia Picco, Rosa Chacón, Jorge Delgado, Alfonso Gastelum Strozzi, Sergio Guevara-Pacheco, Vicente Juarez, Mario Alberto Garza-Elizondo, Juan Camilo Rueda, Amaranta Manrique de Lara, Nora Mathern, Marisa Jorfen, Alvaro Sanabria, Cristina Prigione, Adriana MR Silvestre, Vanina García, Julio Miljevic, Daniel Dhair, Matias Laithe, Fadua Midauar, Maria Celeste Martin, Maria Cecilia Barrios, María Elena Crespo, Mariana Aciar, Emilio Buschiazzo, Natalia L Cucchiaro, Mario Ruiz, José Adolfo Sánchez, Rodolfo Franco, Natalia Estrella, Silvia Jorge, Cinthya Retamozo, Sofia Fernandez, Martina Fay, Cecilia Camacho, Graciela Gomez, Jazmin Petrelli, Andrés Honeri, Viviana Arenas Solórzano, Ana Bensi, Marcela Valdata, Rodrigo Giraldo, Ignacio Angarita, Jesus G Ballesteros, Sofia Arias, Andres Vásquez, Lina Valero, Ani Cortes, Estafania Castañeda, Elias Forero, Astrid Feicán, Fernando Vintimilla, Jaime Vintimilla, Veronica Ochoa, Angelita Lliguisaca, Holger Dután, Jacqueline Rodríguez-Amado, Julio Casasola-Vargas, Conrado Garcia, Imelda García-Olivera, César Pacheco, Susana Aidee Gonzalez-Chávez, Hazel Garcia Morales, Arturo Velasco Gutierrez, JF Moctezuma-Rios, Eduardo Navarro-Zarza, Angelia Angulo, Rosana Flores, Janeth Galván Padrón, B Lorena Pérez, Janett Riega, Brenda Vaquez Fuentes, Miguel A Villarreal, Cassandra Skinner Taylor, Sara Marín, Dionicio Galarza Delgado, Diana Flores Alvarado, Jorge A Esquivel Varerio, Luz Helena Sanín, Marco Maradiaga Ceceño, Jorge Zamudio Lerm, Ivan Stekman, Yanira Martínez, and Gloris Sánchez
Subjects: Medicine
Abstract: Objective To estimate health inequity and vulnerability among Indigenous and non-Indigenous populations with rheumatic and musculoskeletal diseases (RMD) in Latin America using the syndemic approach.Design This is a secondary analysis of a previously published large-scale study on the prevalence of RMD.Setting Studies carried out in five Latin American countries (Argentina, Colombia, Ecuador, Mexico and Venezuela). Health inequity and vulnerability in RMD were identified through a syndemic approach using network and cluster analysis.Participants A total of 44 560 individuals were studied: 29.78% self-identified as Indigenous, 60.92% were female, the mean age was 43.25 years. Twenty clusters were identified in the Indigenous population and 17 in the non-Indigenous population.Results The variables associated with RMD among Indigenous populations were rurality, public health system, high joint biomechanical stress, greater pain, disability and alcoholism; and among non-Indigenous people they were being a woman, urban origin, older age, private health system, joint biomechanical stress, greater pain and disability. We identified different health inequities among patients with RMD (ie, lower educational attainment, more comorbidities), associated with factors such as Indigenous self-identification and rural residence.Conclusions A syndemic approach enables us to identify health inequities in RMD, as shown by higher prevalence of comorbidities, disability and socioeconomic factors like lower educational attainment. These inequities exist for the overall population of patients with RMD, although it is more evident in Indigenous groups with added layers of vulnerability.
Published: 2023
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2. Editorial: Juvenile Spondyloarthritis: From Basic Science to Clinical Translation

Author: Miroslav Harjacek, Rik Joos, and Ruben Burgos Vargas
Subjects: juvenile spondyloarthritis (JSpA), classification, translational science, pathophysiology, therapy, biomarkers, Medicine (General), R5-920
Published: 2022
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3. Identification of clinical phenotypes of peripheral involvement in patients with spondyloarthritis, including psoriatic arthritis: a cluster analysis in the worldwide ASAS-PerSpA study

Author: Robert Landewé, Désirée van der Heijde, Maxime Dougados, Fernando M Pimentel-Santos, Anna Molto, Joachim Sieper, Clementina López-Medina, Marina Magrey, Sylvie Chevret, Ruben Burgos-Vargas, Floris A van Gaalen, Alessandro Biglia, Mitsumasa Kishimoto, Tuncay Duruöz, Bassel Elzorkany, Najia Hajjaj-Hassouni, José Maldonado-Cocco, Nelly Ziade, Meghna Gavali, Shue-Fen Luo, Kim Tae-Jong, Jieruo Gu, Pál Geher, Wilson Bautista-Molano, Walter Maksymowych, Laura Muntean, and Sebastián E Ibáñez-Vodnizza
Subjects: Medicine
Published: 2021
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4. Outcomes in Juvenile-Onset Spondyloarthritis

Author: Judith A. Smith and Ruben Burgos-Vargas
Subjects: juvenile spondyloarthritis, enthesitis-related arthritis (ERA), disease manifestations and outcomes, prognosis, TNF inhibitor, sacroiliitis, Medicine (General), R5-920
Abstract: Some studies have suggested children with juvenile onset spondyloarthritis (JoSpA) have a relatively poor outcome compared to other juvenile idiopathic arthritis (JIA) categories, in regards to functional status and failure to attain remission. Thus, in the interest of earlier recognition and risk stratification, awareness of the unique characteristics of this group is critical. Herein, we review the clinical burden of disease, prognostic indicators and outcomes in JoSpA. Of note, although children exhibit less axial disease at onset compared to adults with spondyloarthritis (SpA), 34–62% have magnetic resonance imaging (MRI) evidence for active inflammation in the absence of reported back pain. Furthermore, some studies have reported that more than half of children with “enthesitis related arthritis” (ERA) develop axial disease within 5 years of diagnosis. Axial disease, and more specifically sacroiliitis, portends continued active disease. The advent of TNF inhibitors has promised to be a “game changer,” given their relatively high efficacy for enthesitis and axial disease. However, the real world experience in various cohorts since the introduction of more widespread TNF inhibitor usage, in which greater than a third still have persistently active disease, suggests there is still work to be done in developing new therapies and improving the outlook for JoSpA.
Published: 2021
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5. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part three

Author: Riccardo Papa, Alessandro Consolaro, Francesca Minoia, Roberta Caorsi, Gianmichele Magnano, Marco Gattorno, Angelo Ravelli, Paolo Picco, Roberto Pillon, Denise Pires Marafon, Lidia Meli, Claudia Bracaglia, Andrea Taddio, Fabrizio De Benedetti, Enes Turan, Sara Sebnem Kilic, Yasuhiko Itoh, Tomoko Shigemori, Shingo Yamanishi, Hidehiko Nagasaki, Ela Tarakci, Nilay Arman, Devrim Tarakci, Yusuf S. Akgul, Ozgur Kasapcopur, Emily Wilson, Hanna Lythgoe, Eve Smith, Jenny Preston, Michael W. Beresford, Lynn R. Spiegel, Jennifer Stinson, Mark Connelly, Adam Huber, Nadia Luca, Argerie Tsimicalis, Stephanie Luca, Naweed Tajuddin, Roberta Berard, Julie Barsalou, Sarah Campillo, Brian Feldman, Shirley Tse, Paul Dancey, Ciaran Duffy, Nicole Johnson, Patrick McGrath, Natalie Shiff, Lori Tucker, Charles Victor, Chitra Lalloo, Lauren Harris, Joseph Cafazzo, Kristin Houghton, Ronald Laxer, Madeleine Rooney, Roisin Campbell, Catherine Wright, Wineke Armbrust, Otto Lelieveld, Jolanda Tuinstra, Nico Wulffraat, Joyce Bos, Jeanette Cappon, Marion van Rossum, Mariët Hagedoorn, Anna Vermé, Ylva Lampela, Ayse Huri Ozdogan, S. Ugurlu, K. Barut, A. Androvic, O. Kasapçopu, Jody Etheridge, Katie Dobson, Sue Kemp, AnnaCarin Horne, Karin Palmblad, Malin Höglund, Natalia Stepanenko, Svetlana Salugina, Evgeny Fedorov, Irina Nikishina, Maria Kaleda, Kenan Barut, Amra Adrovic, Sezgin Sahin, Laurence Toumoulin, Johnny Frossard, Stephanie Archimbaut, Anne Paitier, Rolande Guastalli, Severine Guillaume Czitrom, Sirirat Charuvanij, Chollada Chaiyadech, Takako Miyamae, Hisashi Yamanaka, Cecile Picard, Guillaume Thouvenin, Caroline Kannengiesser, Jean-Christophe Dubus, Nadia Jeremiah, Frédéric Rieux-Laucat, Bruno Crestani, Véronique Secq, Christelle Ménard, Martine Reynaud-Gaubert, Françoise Thivolet-Bejui, Philippe Reix, Alexandre Belot, Ezgi Deniz Batu, Hafize Emine Sonmez, Abdulsamet Erden, Ekim Z. Taskiran, Omer Karadag, Umut Kalyoncu, İbrahim Oncel, Berkan Kaplan, Zehra Serap Arici, Cagri Mesut Temucin, Haluk Topaloglu, Yelda Bilginer, Mehmet Alikasifoglu, Seza Ozen, Lien Van Eyck, Ellen De Langhe, Isabelle Jéru, Erika Van Nieuwenhove, Vasiliki Lagou, Paul J. Baker, Jocelyn Garcia-Perez, James Dooley, Lien De Somer, Raf Sciot, Pierre-Yves Jeandel, Julia Ruuth-Praz, Bruno Copin, Myrna Medley-Hashim, Andre Megarbane, Sinisa Savic, An Goris, Serge Amselem, Adrian Liston, Seth Masters, Carine Wouters, Nami Okamoto, Yuko Sugita, Kousuke Shabana, Takuji Murata, Hiroshi Tamai, Juliana Ferenczová, Erika Banóova, Pavol Mrážik, Veronika Vargova, Dubravko Bajramovic, Ksenija Stekic Novacki, Kristina Potocki, Marijan Frkovic, Marija Jelusic, Olga Kostareva, Svetlana Arsenyeva, Anna Shapovalenko, Lennart Jans, Nele Herregods, Jacob Jaremko, Rik Joos, Joke Dehoorne, Xenofon Baraliakos, Sofia Ramiro, Julio C. Casasola-Vargas, Désirée van der Heijde, Robert Landewé, Ruben Burgos-Vargas, Shirley M. Tse, Gerd Horneff, Kristina Unnebrink, Jaclyn K. Anderson, Aysenur Paç Kisaarslan, Betül Sözeri, Zübeyde Gündüz, Gökmen Zararsız, Hakan Poyrazoğlu, Ruhan Düşünsel, Kazutaka Ouchi, Shinji Akioka, Hiroshi Kubo, Norio Nakagawa, Hajime Hosoi, Lovro Lamot, Fran Borovecki, Sanja Kapitanovic, Kristina Gotovac, Mandica Vidovic, Mirta Lamot, Edi Paleka Bosak, Miroslav Harjacek, Ricardo A. Russo, María M. Katsicas, Ruben Burgos Vargas, Ana L. Ortiz-Peyegahud, Zhang Pingping, Mou Yikun, Qi Jun, Jiang Yutong, Gu Jieruo, Mikhail M. Kostik, Shilova Ekaterina, Ilia Avrusin, Yuriy Korin, Olga Kopchak, Eugenia Isupova, Irina Chikova, Panova Tatyana, Margarita Dubko, Vera Masalova, Ludmila Snegireva, Tatyana Kornishina, Olga Kalashnikova, Vyacheslav Chasnyk, Tatyana Likhacheva, N. Ruperto, H. I. Brunner, P. Quartier, T. Constantin, E. Alexeeva, R. Schneider, I. Kone-Paut, K. Schikler, K. Marzan, N. Wulffraat, S. Padeh, V. Chasnyk, C. Wouters, J. B. Kuemmerle-Deschner, T. Kallinich, B. Lauwerys, E. Haddad, E. Nasonov, M. Trachana, O. Vougiouka, K. Leon, A. Speziale, K. Lheritier, E. Vritzali, A. Martini, D. Lovell, PRINTO/PRCSG, Nienke Ter Haar, Rianne Scholman, Wilco de Jager, Tamar Tak, Pieter Leliefeld, Bas Vastert, Sytze de Roock, Ariane de Ganck, Nadia Ryter, Miha Lavric, Dirk Foell, Renee F. Modica, Kathleen G. Lomax, Pamela Batzel, Armelle Cassanas, Melissa E. Elder, Rina Denisova, Ekaterina Alexeeva, Saniya Valieva, Tatyana Bzarova, Kseniya Isayeva, Tatyana Sleptsova, Olga Lomakina, Alexandra Chomahidze, Margarita Soloshenko, Meyry Shingarova, Elena Kachshenko, Wilco De Jager, Sebastiaan J. Vastert, Gerdien Mijnheer, Berent J. Prakken, Nico M. Wulffraat, Hafize E. Sönmez, Asuman N. Karhan, Ezgi D. Batu, Zehra S. Arıcı, Ersin Gümüş, Hülya Demir, Aysel Yüce, Seza Özen, Jasmina Ahluwalia, Bhavneet Bharti, Sweta Rajpal, Varun Uppal, Alaknanda Walia, Surjit S. Samlok, Narender Kumar, Clarissa C. Valões, Beatriz C. Molinari, Ana Claudia G. Pitta, Natali W. Gormezano, Sylvia C. Farhat, Kátia Kozu, Adriana M. Sallum, Simone Appenzeller, Ana Paula Sakamoto, Maria T. Terreri, Rosa M. Pereira, Claudia S. Magalhães, Cássia Maria Barbosa, Francisco Hugo Gomes, Eloisa Bonfá, Clovis A. Silva, Kubra Ozturk, Zelal Ekinci, Maie Helal, Natalia Cabrera, Jean Christophe Lega, Jocelyne Drai, Rene Ecochard, O. V. Shpitonkova, N. S. Podchernyaeva, Y. O. Kostina, N. G. Dashkova, M. K. Osminina, Gozde Yucel, Ahmet Arvas, Nandini Moorthy, Paraskevi Dimou, Angela Midgley, Matthew Peak, Simon C. Satchell, Rachael D. Wright, Rachel Corkhill, Eve M. Smith, Sagar Bhattad, Amit Rawat, Surjit Singh, Anju Gupta, Deepti Suri, Martin de Boer, Taco Kuijpers, Vignesh Pandiarajan, Sapna Sandal, Sebastian Giraldo, Roy Sanguino, Adriana S. Diaz, Selcuk Uzuner, Gizem Durcan, Ali Guven Kilicoglu, Ayhan Bilgic, Kayhan Bahali, Sinem Durmus, Hafize Uzun, Nur Canpolat, Salim Caliskan, Lale Sever, Tomomi Sato, Fuminori Kimura, Wafaa Suwairi, Reem Abdwani, Abdulaziz Al Rowais, Jubran Al qanatish, Abdulrahman Al Asiri, Ekaterina Gaidar, Mikhail Kostik, Elena Serogodskaya, Tatyana Nikitina, Evgenia Isupova, Elham Sardar, Perrine Dusser, Antoine Rousseau, Marc Labetoulle, Emanuel Barreau, Bahram Bodaghi, Isabelle Kone-Paut, Ivan Foeldvari, Jordi Anton, Rosa Bou, Sheila Angeles-Han, Regitze Bangsgaard, Gabriele Brumm, Tamas Constantin, Clive Edelsten, Jens Klotsche, Kirsten Minden, Elisabetta Miserocchi, Susan Nielsen, Gabriele Simonini, Arnd Heiligenhaus, Juan Manuel Mosquera Angarita, Carmen Garcia de Vicuña, Maria Victoria Hernandez, Alfredo Adan, Victor Llorens, Rosa Alcobendas, Susana Noval, Juan Carlos Lopez Robledillo, Isabel Valls, Mari Carmen Pinedo, Alejandro Fonollosa, Jaime de Inocencio, Pilar Tejada, Beatriz Bravo, Manuel Torribio, María Jesús García de Yebenes, Jordi Antón, Uveitis Working Group of the Spanish Pediatric Rheumatology Society, Lorenza Maria Argolini, Irene Pontikaki, Maria Orietta Borghi, Laura Cesana, Barbara Castiglioni, Maurizio Gattinara, Pierluigi Meroni, Pierre Quartier, Veronique Despert, Sylvaine Poignant, Amandine Baptiste, Caroline Elie, Laurent Kodjikian, Dominique Monnet, Michel Weber, Laura Moal, LuuLy Pham, Emmanuel Barreau, Cherif Titah, Pascal Dureau, Vanessa Cecchin, Maria Elisabetta Zannin, Daniele Ferrari, Francesco Comacchio, Rolando Cimaz, Fernanda Falcini, Antonella Petaccia, Stefania Viola, Luciana Breda, Francesco La Torre, Fabio Vittadello, Giorgia Martini, Francesco Zulian, Caroline Galeotti, Guillaume Sarrabay, Olivier Fogel, Isabelle Touitou, Corinne Miceli-Richard, Isabelle Koné-Paut, Hala Etayari, Hashad Soad, Ihab El Kadry, Habibullah Eatamadi, Kais AlAlgawi, Mustafa Al Maini, Khulood Khawaja, Sophie Van den Berghe, Ilse de Schryver, Ann Raes, Lídia L. C. Teixeira, Ana Duarte, Sandra Sousa, Filipe Vinagre, Maria J. Santos, Nataly S. Shevchenko, Ludmila F. Bogmat, Marina V. Demyanenko, Navdha R. Ramchurn, Mark Friswell, Rebecca A. James, Lucy R. Wedderburn, Reshma Pattani, Clarissa A. Pilkington, Sandrine Compeyrot-Lacassagne, Ana V. Villarreal, Nydia Acevedo, Enrique Faugier, Rocio Maldonado, Dilek Yılmaz, Hilal Bektaş Uysal, Elena Kamenets, Ekaterina Zaharova, Stefka Radenska-Lopovok, Joao Nascimento, Helena Sofia, Carla Zilhão, Rui Almeida, Margarida Guedes, Murat Deveci, Svetlana Rodionovskaya, Vera Vinnikova, Irina Tsymbal, Edyta Olesińska, Jacek Postępski, Agnieszka Mroczkowska-Juchkiewicz, Agnieszka Pawłowska-Kamieniak, Beata Chrapko, Damjana Ključevšek, Nina Emeršič, Nataša Toplak, Tadej Avčin, Faina Rokhlina, Galina Glazyrina, Natalia Kolyadina, Kwangnam Kim, Sinae Eom, Daeyoung Kim, Jungwoo Rhim, Francesca Ricci, Paola Montesano, Barbara Bonafini, Veronica Medeghini, Ilaria Parissenti, Antonella Meini, Marco Cattalini, Paolo Airò, Nataliya Panko, Nataliya Shevchenko, Iryna Lebec, Yevgeniya Zajceva, Sara Rostlund, Marie André, Takuma Hara, Takayuki Kishi, Yumi Tani, Aki Hanaya, Satoru Nagata, Velma Selmanovic, Aida Omercahic-Dizdarevic, Adisa Cengic, Almira Cosickic, Aida Omerčahić Dizdarević, Gemma Lepri, Clara Malattia, Eleonora Bellucci, Marco Matucci-Cerinic, Anton Solovyev, Elena Fedotova, Ana Victoria Villarreal, Talia Diaz, Yuridiana Ramirez, Teresa Giani, Achille Marino, Daniel Hunt, Muthana Al Obaidi, Veli Veli, Charalampia Papadopoulou, Jochen Kammermeier, Anna Poluha, Gangadhara C. Bharmappanavara, Alison Kelly, Lindsay Shaw, Giovanna Ferrara, Michele Luzzati, Mattia Giovannini, Liliana Jurado, Juliana Chamorro, Lorena Sarmiento, Ester Conversano, Maria Francesca Gicchino, Giulia Macchini, Carmela Granato, Assunta Tirelli, Alma N. Olivieri, Marija Perica, Lana Tambić Bukovac, Reza Sinaei, Vadood Javadi Parvaneh, Reza Shiari, Khosro Rahmani, Fatemeh F. Mehregan, Mehrnoush Hassas Yeganeh, Inmaculada Calvo Penadés, Berta López Montesinos, Ma Isabel González Fernández, Adriana Rodríguez Vidal, Anand Prahalad Rao, Ayesha Romana, Jyothi Raghuram, Ankur Kumar, Vishali Gupta, Elif Comak, Gülşah Kaya Aksoy, Aygen Yılmaz, Atike Atalay, Mustafa Koyun, Reha Artan, Sema Akman, Maria I. Kaleda, Irina P. Nikishina, Sergei K. Soloviev, Victor A. Malievsky, Ekaterina V. Nikolaeva, Agnieszka Gazda, Beata Kołodziejczyk, Lidia Rutkowska-Sak, Angela Mauro, Pierluigi Marzuillo, Stefano Guarino, and Angela La Manna
Subjects: Pediatrics, RJ1-570, Diseases of the musculoskeletal system, RC925-935
Published: 2017
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6. Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study

Author: Robert Landewé, Désirée van der Heijde, Maxime Dougados, Anna Molto, Joachim Sieper, Pedro M Machado, Clementina López-Medina, Uta Kiltz, Sebastián E Ibáñez Vodnizza, Sara Monti, Marina Magrey, Ruben Burgos-Vargas, Victoria Navarro-Compán, Floris A van Gaalen, Mitsumasa Kishimoto, Tuncay Duruöz, Bassel Elzorkany, Najia Hajjaj-Hassouni, José Maldonado-Cocco, Nelly Ziade, Meghna Gavali, Shue-Fen Luo, Kim Tae-Jong, F M Pimentel-Santos, Jieruo Gu, Ruxandra Schiotis, Pál Geher, Wilson Bautista-Molano, and Walter Maksymowych
Subjects: Medicine
Abstract: Objectives To characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.Methods Cross-sectional study with 24 participating countries. Patients with a diagnosis of axial SpA (axSpA), peripheral SpA (pSpA) or PsA according to their rheumatologist were included. The investigators were asked which diagnosis out of a list of six (axSpA, PsA, pSpA, inflammatory bowel disease-associated SpA, reactive arthritis or juvenile SpA (Juv-SpA)) fitted the patient best. Peripheral manifestations (ie, peripheral joint disease, enthesitis, dactylitis and root joint disease), their localisation and treatments were evaluated.Results A total of 4465 patients were included (61% men, mean age 44.5 years) from four geographic areas: Latin America (n=538), Europe plus North America (n=1677), Asia (n=975) and the Middle East plus North Africa (n=1275). Of those, 78% had ever suffered from at least one peripheral musculoskeletal manifestation; 57% had peripheral joint disease, 44% had enthesitis and 15% had dactylitis. Latin American had far more often peripheral joint disease (80%) than patients from other areas. Patients with PsA had predominantly upper limb and small joint involvement (52%).Hip and shoulder involvement was found in 34% of patients. The prevalence of enthesitis ranged between 41% in patients with axSpA and 65% in patients with Juv-SpA. Dactylitis was most frequent among patients with PsA (37%).Conclusion These results suggest that all peripheral features can be found in all subtypes of SpA, and that differences are quantitative rather than qualitative. In a high proportion of patients, axial and peripheral manifestations coincided. These findings reconfirm SpA clinical subtypes are descendants of the same underlying disease, called SpA.
Published: 2021
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7. Association of ERAP2 polymorphisms in Colombian HLA-B27+ or HLA-B15+ patients with SpA and its relationship with clinical presentation: axial or peripheral predominance

Author: Ruben Burgos-Vargas, John Londono, Ana M Santos, Juan C Rueda, Enrique Calvo-Paramo, Gilberto Vargas-Alarcon, Nancy Martinez-Rodriguez, Sofia Arias-Correal, Guisselle-Nathalia Muñoz, Diana Padilla, Francy Cuervo, Viviana Reyes-Martinez, Santiago Bernal-Macías, Catalina Villota-Eraso, Luz M Avila-Portillo, Consuelo Romero, and Juan F Medina
Subjects: Medicine
Abstract: Objective To determine the association between endoplasmic reticulum aminopeptidase (ERAP)1 and ERAP2 single-nucleotide polymorphisms (SNPs) and human leukocyte antigens (HLA)-B27+ or HLA-B15+ patients with spondyloarthritis (SpA).Methods 104 patients with SpA according to Assessment of Spondyloarthritis International Society criteria were included in the study. HLA typing was performed by PCR. The polymorphisms were determined by real-time PCR on genomic DNA using customised probes for SNPs rs27044, rs17482078, rs10050860 and rs30187 in ERAP1, and rs2910686, rs2248374 and rs2549782 in ERAP2.Results 70 of the104 patients with SpA were HLA-B27+ and 34 were HLA-B15+. The distribution of ERAP1 and ERAP2 SNPs between the HLA-B15+ and HLA-B27+ patients with SpA did not reveal differences. Likewise, no differences in the frequencies of ERAP1 SNP haplotypes and alleles HLA-B15 or HLA-B27 were found. Interestingly, however, the frequencies of three particular haplotypes formed by ERAP2 SNPs rs2549782/rs2248374/rs2910686 varied between HLA-B15+ and HLA-B27+ patients: the ERAP2 SNPs haplotype TGT was more common in HLA-B15+ patients with SpA (OR 2.943, 95% CI 1.264 to 6.585; P=0.009), whereas the ERAP2 SNP haplotypes TGC and CAT were more associated with HLA-B27+ patients with SpA: (OR 4.483, 95% CI 1.524 to 13.187; p=0.003) and (OR 9.014, 95% CI 1.181 to 68.807; p=0.009), respectively.Conclusion An association was found between HLA-B15+ patients with SpA and haplotype TGT of ERAP2 SNPs. On the other hand, HLA-B27+ patients with SpA were associated with ERAP2 haplotypes TGC and CAT. These associations could be related to the clinical presentation of the disease, specifically with a peripheral or axial predominance, respectively.
Published: 2020
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8. A Wearable System Based on Multiple Magnetic and Inertial Measurement Units for Spine Mobility Assessment: A Reliability Study for the Evaluation of Ankylosing Spondylitis

Author: Adriana Martínez-Hernández, Juan S. Perez-Lomelí, Ruben Burgos-Vargas, and Miguel A. Padilla-Castañeda
Subjects: spine, inertial measurement units, Kalman filter, human movement, ankylosing spondylitis, Chemical technology, TP1-1185
Abstract: Spinal mobility assessment is essential for the diagnostic of patients with ankylosing spondylitis. BASMI is a routine clinical evaluation of the spine; its measurements are made with goniometers and tape measures, implying systematic errors, subjectivity, and low sensitivity. Therefore, it is crucial to develop better mobility assessment methods. The design, implementation, and evaluation of a novel system for assessing the entire spine’s motion are presented. It consists of 16 magnetic and inertial measurement units (MIMUs) communicated wirelessly with a computer. The system evaluates the patient’s movements by implementing a sensor fusion of the triaxial gyroscope, accelerometer, and magnetometer signals using a Kalman filter. Fifteen healthy participants were assessed with the system through six movements involving the entire spine to calculate continuous kinematics and maximum range of motion (RoM). The intrarater reliability was computed over the observed RoM, showing excellent reliability levels (intraclass correlation >0.9) in five of the six movements. The results demonstrate the feasibility of the system for further clinical studies with patients. The system has the potential to improve the BASMI method. To the best of our knowledge, our system involves the highest number of sensors, thus providing more objective information than current similar systems.
Published: 2022
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9. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part one

Author: F. De Benedetti, J. Anton, M. Gattorno, H. Lachmann, I. Kone-Paut, S. Ozen, J. Frenkel, A. Simon, A. Zeft, E. Ben-Chetrit, H. M. Hoffman, Y. Joubert, K. Lheritier, A. Speziale, J. Guido, Roberta Caorsi, Federica Penco, Alice Grossi, Antonella Insalaco, Maria Alessio, Giovanni Conti, Federico Marchetti, Alberto Tommasini, Silvana Martino, Romina Gallizzi, Annalisa Salis, Francesca Schena, Francesco Caroli, Alberto Martini, Gianluca Damonte, Isabella Ceccherini, Marco Gattorno, Marie-Louise Frémond, Carolina Uggenti, Lien Van Eyck, Isabelle Melki, Darragh Duffy, Vincent Bondet, Yoann Rose, Bénédicte Neven, Yanick Crow, Mathieu P. Rodero, Yvonne Kusche, Johannes Roth, Katarzyna Barczyk-Kahlert, Giovanna Ferrara, Annalisa Chiocchetti, Silvio Polizzi, Josef Vuch, Diego Vozzi, Anna Mondino, Erica Valencic, Serena Pastore, Andrea Taddio, Flavio Faletra, Umberto Dianzani, Ugo Ramenghi, Qing Zhou, Xiaomin Yu, Erkan Demirkaya, Natalie Deuitch, Deborah Stone, Wanxia Tsai, Amanda Ombrello, Tina Romeo, Elaine F. Remmers, JaeJin Chae, Massimo Gadina, Steven Welch, Seza Ozen, Rezan Topaloglu, Mario Abinun, Daniel L. Kastner, Ivona Aksentijevich, Donatella Vairo, Rosalba Monica Ferraro, Giulia Zani, Jessica Galli, Micaela De Simone, Marco Cattalini, Elisa Fazzi, Silvia Giliani, Ebun Omoyinmi, Ariane Standing, Dorota Rowczenio, Annette Keylock, Sonia Melo Gomes, Fiona Price-Kuehne, Sira Nanthapisal, Claire Murphy, Thomas Cullup, Lucy Jenkins, Kimberly Gilmour, Despina Eleftheriou, Helen Lachmann, Philip Hawkins, Nigel Klein, Paul Brogan, Anita Dhanrajani, Mercedes Chan, Stephanie Pau, Janet Ellsworth, Jaime Guzman, Florence A. Aeschlimann, Marinka Twilt, Simon W. Eng, Shehla Sheikh, Ronald M. Laxer, Diane Hebert, Damien Noone, Christian Pagnoux, Susanne M. Benseler, Rae S. Yeung, Christoph Kessel, Katrin Lippitz, Toni Weinhage, Claas Hinze, Helmut Wittkowski, Dirk Holzinger, Niklas Grün, Dirk Föll, Pieter Van Dijkhuizen, Federica Del Chierico, Clara Malattia, Alessandra Russo, Denise Pires Marafon, Nienke M. ter Haar, Silvia Magni-Manzoni, Sebastiaan J. Vastert, Bruno Dallapiccola, Berent Prakken, Fabrizio De Benedetti, Lorenza Putignani, Berna Eren Fidanci, Kenan Barut, Serap Arıcı, Dogan Simsek, Mustafa Cakan, Ezgi D. Batu, Sezgin Şahin, Ayşenur Kısaarslan, Ebru Yilmaz, Özge Basaran, Ferhat Demir, Kubra Ozturk, Zübeyde Gunduz, Betül Sozeri, Balahan Makay, Nuray Ayaz, Onder Yavascan, Ozlem Aydog, Yelda Bilginer, Zelal Ekinci, Dilek Yıldız, Faysal Gök, Muferret Erguven, Erbil Unsal, Ozgur Kasapcopur, For the FMF Arthritis Vasculitis and Orphan Disease Research in Paediatric Rheumatology (FAVOR), Hafize E. Sönmez, Betül Sözeri, Yonatan Butbul, Seza Özen, Claudia Bracaglia, Giusi Prencipe, Manuela Pardeo, Geneviève Lapeyre, Emiliano Marasco, Walter Ferlin, Robert Nelson, Cristina de Min, N. Ruperto, H. I. Brunner, P. Quartier, T. Constantin, E. Alexeeva, K. Marzan, N. Wulffraat, R. Schneider, S. Padeh, V. Chasnyk, C. Wouters, J. B. Kuemmerle-Deschner, T. Kallinich, B. Lauwerys, E. Haddad, E. Nasonov, M. Trachana, O. Vougiouka, K. Leon, E. Vritzali, A. Martini, D. Lovell, PRINTO/PRCSG, Stefano Volpi, Claudia Pastorino, Francesca Kalli, Alessia Omenetti, Sabrina Chiesa, Arinna Bertoni, Paolo Picco, Gilberto Filaci, Elisabetta Traggiai, Marie-Louise Fremond, Naoki Kitabayashi, Olivero Sacco, Isabelle Meyts, Marie-Anne Morren, Carine Wouters, Eric Legius, Isabelle Callebaut, Christine Bodemer, Frederic Rieux-Laucat, Mathieu Rodero, Nadia Jeremiah, Alexandre Belot, Eric Jeziorski, Didier Bessis, Guilhem Cros, Gillian I. Rice, Bruno Charbit, Anne Hulin, Nihel Khoudour, Consuelo Modesto Caballero, Monique Fabre, Laureline Berteloot, Muriel Le Bourgeois, Philippe Reix, Thierry Walzer, Despina Moshous, Stéphane Blanche, Alain Fischer, Brigitte Bader-Meunier, Frédéric Rieux-Laucat, K. Annink, N. ter Haar, S. Al-Mayouf, G. Amaryan, K. Barron, S. Benseler, P. Brogan, L. Cantarini, M. Cattalini, A. Cochino, F. Dedeoglu, A. De Jesus, O. Dellacasa, E. Demirkaya, P. Dolezalova, K. Durrant, G. Fabio, R. Gallizzi, R. Goldbach-Mansky, E. Hachulla, V. Hentgen, T. Herlin, M. Hofer, H. Hoffman, A. Insalaco, A. Jansson, I. Koné-Paut, A. Kozlova, J. Kuemmerle-Deschner, R. Laxer, S. Nielsen, I. Nikishina, A. Ombrello, E. Papadopoulou-Alataki, A. Ravelli, D. Rigante, R. Russo, Y. Uziel, Nienke ter Haar, Jerold Jeyaratnam, Anna Simon, Matteo Doglio, Jordi Anton, Consuelo Modesto, Pierre Quartier, Esther Hoppenreijs, Luca Cantarini, Loredana Lepore, Inmaculada Calvo Penades, Christina Boros, Rita Consolini, Donato Rigante, Ricardo Russo, Jana Pachlopnik Schmid, Thirusha Lane, Nicolino Ruperto, Joost Frenkel, Chiara Passarelli, Elisa Pisaneschi, Virginia Messia, Antonio Novelli, Fabrizio Debenedetti, P. A. Brogan, X. Wei, Martina Finetti, Francesca Orlando, Elisabetta Cortis, Angela Miniaci, Nicola Ruperto, Charlotte Eijkelboom, Pavla Dolezalova, Isabelle Koné-Paut, Marija Jelusic-Drazic, Liliana Bezrodnik, Mari Carmen Pinedo, Valda Stanevicha, Marielle van Gijn, Silvia Federici, Hermann Girschick, Gerd Ganser, Susan Nielsen, Troels Herlin, Sulaiman Mohammed Al-Mayouf, Michael Hofer, Jasmin Kuemmerle-Deschner, Susanne Schalm, Annette Jansson, on behalf of PRINTO and Eurofever registry, Marta Marchi, Chiara Marini, Angelo Ravelli, Alberto Garaventa, Sonia Carta, Enrica Balza, Patrizia Castellani, Caterina Pellecchia, Silvia Borghini, Maria Libera Trotta, Anna Rubartelli, Andrew Henrey, Thomas Loughin, Roberta Berard, Natalie Shiff, Roman Jurencak, Susanne Benseler, Lori Tucker, on behalf of ReACCh-Out Investigators, Charalampia Papadopoulou, Ying Hong, Petra Krol, Yiannis Ioannou, Clarissa Pilkington, Hema Chaplin, Stephania Simou, Marietta Charakida, Lucy Wedderburn, Lynn R. Spiegel, Sara Ahola Kohut, Jennifer Stinson, Paula Forgeron, Miriam Kaufman, Nadia Luca, Khush Amaria, Mary Bell, J Swart, F. Boris, E. Castagnola, A. Groll, G. Giancane, G. Horneff, H. I. Huppertz, T. Wolfs, E. Alekseeva, V. Panaviene, F. Uettwiller, V. Stanevicha, L. M. Ailioaie, E. Tsitami, S. Kamphuis, G. Susic, F. Sztajnbok, B. Flato, A. Pistorio, Stephanie J. W. Shoop, Suzanne M. M. Verstappen, Janet E. McDonagh, Wendy Thomson, Kimme L. Hyrich, CAPS, Maarit Tarkiainen, Pirjo Tynjala, Pekka Lahdenne, Janne Martikainen, Acute-JIA Study Group, Meredyth Wilkinson, Christopher Piper, Georg Otto, Claire T. Deakin, Stefanie Dowle, Stefania Simou, Daniel Kelberman, Claudia Mauri, Elizabeth Jury, David Isenberg, Lucy R. Wedderburn, Kiran Nistala, I. Foeldvari, D. J. Lovell, G. Simonini, M. Bereswill, J. Kalabic, Kiem Oen, Brian M. Feldman, Brenden Dufault, Jennifer Lee, Karen Watanabe Duffy, Ciaran Duffy, ReACCh-Out Investigators, N. Tzaribachev, G. Vega-Cornejo, I. Louw, A. Berman, I. Calvo, R. Cuttica, F. Avila-Zapata, R. Cimaz, E. Solau-Gervais, R. Joos, G. Espada, X. Li, M. Nys, R. Wong, S. Banerjee, For Pediatric Rheumatology International Trials Organization (PRINTO)/Pediatric Rheumatology Collaborative Study Group (PRCSG), Rebecca Nicolai, Margherita Verardo, Adele D’Amico, Luisa Bracci-Laudiero, Gian Marco Moneta, Gillian Rice, Anne-Laure Mathieu, Sulliman O. Omarjee, Tracy A. Briggs, James O’Sullivan, Simon Williams, Rolando Cimaz, Eve Smith, Michael W. Beresford, Yanick J. Crow, GENIAL Investigators, UK JSLE Study Group, Madeleine Rooney, Nick Bishop, joyce davidson, Clarissa pilkington, Michael Beresford, Jacqui Clinch, Rangaraj Satyapal, Helen Foster, Janet Gardner Medwin, Janet McDonagh, Sue Wyatt, On Behalf of the British Society for Paediatric and Adolescent Rheumatology, Valentina Litta Modignani, Francesco Baldo, Stefano Lanni, Alessandro Consolaro, Giovanni Filocamo, Helen J. Lachmann, on behalf of Eurofever Registry, Gianmarco Moneta, Camilla Celani, Bilade Cherqaoui, Linda Rossi-Semerano, Perrine Dusser, Véronique Hentgen, Claire Grimwood, Linda Rossi, Isabelle Kone Paut, Veronique Hentgen, Denise Lasigliè, Denise Ferrera, Giulia Amico, Marco Di Duca, Laura Obici, Roberto Ravazzolo, Ryuta Nishikomori, Juan Arostegui, Andrea Petretto, Chiara Lavarello, Elvira Inglese, Federica Vanoni, Michaël Hofer, on behalf of EUROFEVER PROJECT, P. N. Hawkins, T. van der Poll, U. A. Walker, H. H. Tilson, Pascal N. Tyrrell, Raphaela Goldbach-Mansky, Norbert Blank, Hal M. Hoffman, Elisabeth Weissbarth-Riedel, Boris Huegle, Tilmann Kallinich, Ahmet Gul, Marlen Oswald, Fatma Dedeoglu, Aki Hanaya, Takako Miyamae, Manabu Kawamoto, Yumi Tani, Takuma Hara, Yasushi Kawaguchi, Satoru Nagata, Hisashi Yamanaka, Almira Ćosićkić, Fahrija Skokić, Belkisa Čolić, Sanimir Suljendić, Anna Kozlova, Irina Mersiyanova, Mariya Panina, Lily Hachtryan, Vasiliy Burlakov, Elena Raikina, Alexey Maschan, Anna Shcherbina, Banu Acar, Meryem Albayrak, Betul Sozeri, Sezgin Sahin, Amra Adrovic, Nese Inan, Serhan Sevgi, Caroline M. Andreasen, Anne Grethe Jurik, Mia B. Glerup, Christian Høst, Birgitte T. Mahler, Ellen-Margrethe Hauge, Cecilia Lazea, Laura Damian, Calin Lazar, Rodica Manasia, Chloe M. Stephenson, Vimal Prajapati, Paivi M. Miettunen, Dilek Yılmaz, Yavuz Tokgöz, Yasin Bulut, Harun Çakmak, Ferah Sönmez, Elif Comak, Gülşah Kaya Aksoy, Mustafa Koyun, Sema Akman, Yunus Arıkan, Ender Terzioğlu, Osman Nidai Özdeş, İbrahim Keser, Hüseyin Koçak, Ayşen Bingöl, Aygen Yılmaz, Reha Artan, X. Xu, Fatemeh F. Mehregan, Vahid Ziaee, Mohammad H. Moradinejad, Francesco La Torre, Clotilde Alizzi, Pio D’Adamo, G. Junge, J. Gregson, Hasmik Sargsyan, Hulya Zengin, Berna E. Fidanci, Cagla Kaymakamgil, Dilek Konukbay, Dilek Yildiz, Faysal Gok, Iris Stoler, Judith Freytag, Banu Orak, Christine Seib, Lars Esmann, Eva Seipelt, Faekah Gohar, Dirk Foell, Ismail Dursun, Sebahat Tulpar, Sibel Yel, Demet Kartal, Murat Borlu, Funda Bastug, Hakan Poyrazoglu, Zubeyde Gunduz, Kader Kose, Mehmet E. Yuksel, Abdullah Calıskan, Ahmet B. Cekgeloglu, Ruhan Dusunsel, Katerina Bouchalova, Jana Franova, Marcel Schuller, Marie Macku, Katerina Theodoropoulou, Raffaella Carlomagno, Annette von Scheven-Gête, Claudia Poloni, Laura O. Damian, Dan Cosma, Amanda Radulescu, Dan Vasilescu, Liliana Rogojan, Simona Rednic, Mihaela Lupse, Lien De Somer, Pierre Moens, Rocio Galindo Zavala, Laura Martín Pedraz, Esmeralda Núñez Cuadros, Gisela Díaz-Cordovés Rego, Antonio L. Urda Cardona, Ilaria Dal Forno, Sara Pieropan, Ombretta Viapiana, Davide Gatti, Gloria Dallagiacoma, Paola Caramaschi, Domenico Biasi, Daniel Windschall, Ralf Trauzeddel, Hartwig Lehmann, Rainer Berendes, Maria Haller, Manuela Krumrey-Langkammerer, Antje Nimtz-Talaska, Philipp Schoof, Ralf Felix Trauzeddel, Christine Nirschl, Estefania Quesada-Masachs, Carla Aguilar Blancafort, Sara Marsal Barril, Francisca Aguiar, Rita Fonseca, Duarte Alves, Ana Vieira, Alberto Vieira, Jorge A. Dias, Iva Brito, Gordana Susic, Vera Milic, Goran Radunovic, Ivan Boricic, Pauline Marteau, Catherine Adamsbaum, Michel De Bandt, Irène Lemelle, Chantal Deslandre, Tu Anh Tran, Anne Lohse, Elisabeth Solau-Gervais, Pascal Pillet, Julien Wipff, Cécile Gaujoux-Viala, Sylvain Breton, Valérie Devauchelle-Pensec, Sandra Gran, Olesja Fehler, Stefanie Zenker, Michael Schäfers, Thomas Vogl, Severine Guillaume Czitrom, EH Pieter Van Dijkhuizen, Silvia Magni Manzoni, Francesca Magnaguagno, Laura Tanturri de Horatio, Nienke M. Ter Haar, Annemieke S. Littooij, Vitor A. Teixeira, Raquel Campanilho-Marques, Ana F. Mourão, Filipa O. Ramos, Manuela Costa, Wafa A. Madan, Orla G. Killeen, Adriana Rodriguez Vidal, Diana Sueiro Delgado, Maria Isabel Gonzalez Fernandez, Berta Lopez Montesinos, Aleksey Kozhevnikov, Nina Pozdeeva, Mikhail Konev, Evgeniy Melchenko, Vladimir Kenis, Gennadiy Novik, Aysenur Pac Kısaarslan, Butsabong Lerkvaleekul, Suphaneewan Jaovisidha, Witaya Sungkarat, Niyata Chitrapazt, Praman Fuangfa, Thumanoon Ruangchaijatuporn, Soamarat Vilaiyuk, Dan Ø. Pradsgaard, Arne Hørlyck, Anne H. Spannow, Carsten W. Heuck, Talia Diaz, Fernando Garcia, Lorenia De La Cruz, Nadina Rubio, Joanna Świdrowska-Jaros, Elzbieta Smolewska, Mirta Lamot, Lovro Lamot, Mandica Vidovic, Edi Paleka Bosak, Ivana Rados, Miroslav Harjacek, Nikolay Tzaribachev, Polymnia Louka, Romiesa Hagoug, Chiara Trentin, Olga Kubassova, Mark Hinton, Mikael Boesen, Olena A. Oshlianska, Illya A. Chaikovsky, G. Mjasnikov, A. Kazmirchyk, Umberto Garagiola, Irene Borzani, Paolo Cressoni, Fabrizia Corona, Eszter Dzsida, Giampietro Farronato, Antonella Petaccia, Alenka Gagro, Agneza Marija Pasini, Goran Roic, Ozren Vrdoljak, Lucija Lujic, Matija Zutelija-Fattorini, Monika M. Esser, Deepthi R. Abraham, Craig Kinnear, Glenda Durrheim, Mike Urban, Eileen Hoal, Victoria B. Nikolayenko, Kubilay Şahin, Yasar Karaaslan, Adele Civino, Giovanni Alighieri, Sergio Davì, Roberto Rondelli, Andrea Magnolato, Francesca Ricci, Alma Olivieri, Valeria Gerloni, Bianca Lattanzi, Francesca Soscia, Alessandro De Fanti, Stefania Citiso, Lorenzo Quartulli, Maria Cristina Maggio, Manuela Marsili, Maria Antonietta Pelagatti, Valentino Conter, Franca Fagioli, Andrea Pession, Marco Garrone, Mariangela Rinaldi, Jaime De Inocencio, Stella Garay, Daniel J. Lovell, Berit Flato, EPOCA Study Group, Angela Aquilani, Simona Cascioli, Ivan Caiello, Denise Pires-Marafón, Rita Carsetti, Emily Robinson, Salvatore Albani, Wilco de Jager, Sytze de Roock, Trang Duong, Justine Ellis, Kimme Hyrich, Laetitia Jervis, Daniel Lovell, Lucy Marshall, Elizabeth D. Mellins, Kirsten Minden, Jane Munro, Peter A. Nigrovic, Jason Palman, Sunil Sampath, Laura E. Schanberg, Susan D. Thompson, Richard Vesely, Chris Wallace, Chris Williams, Qiong Wu, Nico Wulffraat, Rae S. M. Yeung, M. B. Seyger, D. Arikan, J. K. Anderson, A. Lazar, D. A. Williams, C. Wang, R. Tarzynski-Potempa, J. S. Hymans, Gabriele Simonini, Erika Scoccimarro, Irene Pontikaki, Teresa Giani, Alessandro Ventura, Pier Luigi Meroni, Gaetana Minnone, Marzia Soligo, Luigi Manni, Luisa Bracci Laudiero, Noortje Groot, I. Grein, N. M. Wulffraat, R. Schepp, G. Berbers, C. C. Barbosa Sandoval de Souza, V. Paes Leme Ferriani, G. Pileggi, S. de Roock, Ingrid H. R. Grein, Silvia Scala, Elisa Patrone, Casper Schoemaker, on behalf of Dutch JIA patient organization, Wendy Costello, on behalf of ENCA, Suzanne Parsons, Jean-David Cohen, Damien Bentayou, Marc-Antoine Bernard Brunel, Sonia Trope, Jens Klotsche, Miriam Listing, Martina Niewerth, Gerd Horneff, Angelika Thon, Hans-Iko Huppertz, Kirsten Mönkemöller, Ivan Foeldvari, ICON study group, Achille Marino, Stefano Stagi, Niccolò Carli, Federico Bertini, Adriana S. Díaz-Maldonado, Sally Pino, Pilar Guarnizo, Alfonso Ragnar Torres-Jimenez, Berenice Sanchez-Jara, Eunice Solis-Vallejo, Adriana Ivonne Cespedes-Cruz, Maritza Zeferino-Cruz, Julia Veronica Ramirez-Miramontes, Ankur Kumar, Anju Gupta, Deepti Suri, Amit Rawat, Nandita Kakkar, Surjit Singh, Özge A. Gücenmez, Erbil Ünsal, Bo Magnusson, Karina Mördrup, Anna Vermé, Christina Peterson, Board of the Swedish Pediatric Rheumatology Registry, Caroline Freychet, Jean Louis Stephan, Cathryn E. Harkness, Leanne Foster, Emma Henry, Pauline Taggart, Coskun F. Ozkececi, Esra Kurt, Gokalp Basbozkurt, Daiva Gorczyca, Jacek Postępski, Aleksandra Czajkowska, Bogumiła Szponar, Mariola Paściak, Anna Gruenpeter, Iwona Lachór-Motyka, Daria Augustyniak, Edyta Olesińska, Emediong S. Asuka, Tatyana Golovko, Samuel U. Aliejim, Emilio Inarejos Clemente, Estibaliz Iglesias Jimenez, Joan Calzada Hernandez, Sergi Borlan Fernandez, Clara Gimenez Roca, David Moreno Romo, Natalia Rodriguez Nieva, Juan Manuel Mosquera Angarita, Jordi Anton Lopez, Esmeralda Nuñez-Cuadros, Gisela Diaz-Cordovés, Rocío Galindo-Zavala, Antonio Urda-Cardona, Antonio Fernández-Nebro, Daniel Álvarez de la Sierra, Marina Garcia Prat, Mónica Martínez Gallo, Ricardo Pujol Borrell, Ana M. Marín Sánchez, Etienne Merlin, Sylvie Fraitag, Jean-Louis Stephan, Federico Annoni, Giancarla Di Landro, Sofia Torreggiani, Marta Torcoletti, Georgina Tiller, Jo Buckle, Angela Cox, Peter Gowdie, Roger C. Allen, Jonathan D. Akikusa, Hayde G. Hernández-Huirache, Edel R. Rodea-Montero, William Fahy, Christelle Sordet, Karin B. Berggren, Johanna T. Kembe, Joyce Bos, Wineke Armbrust, Marco van Brussel, Jeanette Cappon, Pieter Dijkstra, Jan Geertzen, Elizabeth Legger, Marion van Rossum, Pieter Sauer, Otto Lelieveld, Levent Buluc, Gur Akansel, Bahar Muezzinoglu, Ljubov Rychkova, Tatyana Knyazeva, Anna Pogodina, Tatyana Belova, Tamara Mandzyak, Ekaterina Kulesh, Alessandro Cafarotti, Cosimo Giannini, Roberta Salvatore, Giuseppe Lapergola, Caterina Di Battista, Maria Loredana Marcovecchio, Raffaella Basilico, Piernicola Pelliccia, Francesco Chiarelli, Luciana Breda, Beverley Almeida, Sarah Tansley, Harsha Gunawardena, Neil McHugh, Juvenile Dermatomyositis Research Group (JDRG), Jessie Aouizerate, Marie De Antonio, Christine Barnerias, Guillaume Bassez, Isabelle Desguerre, Romain Gherardi, Jean-Luc Charuel, François-Jérôme Authier, Cyril Gitiaux, C. H. Spencer, Rabheh Abdul Aziz, Chack-Yung Yu, Brent Adler, Sharon Bout-Tabaku, Katherine Lintner, Melissa Moore-Clingenpeel, Liza McCann, Nicola Ambrose, Mario Cortina-Borja, Juvenile Dermatomyositis Cohort and Biomarker Study (JCDBS), Prasad T. Oommen, Fabian Speth, Johannes-Peter Haas, Working Group “Juvenile Dermatomyositis” of the German Society for Paediatric and Adolescent Rheumatology (GKJR), Claudio Lavarello, Gabriella Giancane, Angela Pistorio, Lisa Rider, Rohit Aggarwal, Sheila K. Oliveira, Ruben Cuttica, Michel Fischbach, Gary Sterba, Karine Brochard, Frank Dressler, Patrizia Barone, Ruben Burgos-Vargas, Elizabeth Candell Chalom, Marine Desjonqueres, Graciela Espada, Anders Fasth, Stella Maris Garay, Rose-Marie Herbigneaux, Claire Hoyoux, Chantal Job Deslandre, Frederick W. Miller, Jiri Vencovsky, Erdal Sag, Gulsev Kale, Haluk Topaloglu, Beril Talim, Francesco Zulian, Tadej Avcin, Roberto Marini, Anne Pagnier, Michel Rodiere, Christine Soler, Rebecca Ten Cate, Yosef Uziel, Jelena Vojinovic, Ana V. Villarreal, Nydia Acevedo, Yuridiana Ramirez, Enrique Faugier, Rocio Maldonado, Bita Arabshahi, John H. Lee, Ian Leibowitz, Lawrence O. Okong’o, Jo Wilmshurst, Monika Esser, Christiaan Scott, Ezgi Deniz Batu, Nagehan Emiroglu, Hafize Emine Sonmez, Gokcen Dilsa Tugcu, Zehra Serap Arici, Ebru Yalcin, Deniz Dogru, Ugur Ozcelik, Mithat Haliloglu, Nural Kiper, Masato Yashiro, Mutsuko Yamada, Toshihiko Yabuuchi, Tomonobu Kikkawa, Nobuyuki Nosaka, Yosuke Fujii, Yukie Saito, Hirokazu Tsukahara, Sulaiman M. Al-Mayouf, Nora AlMutiari, Mohammed Muzaffer, Rawiah shehata, Adel Al-Wahadneh, Reem Abdwani, Safia Al-Abrawi, Mohammed Abu-shukair, Zeyad El-Habahbeh, Abdullah Alsonbul, Aleksandra Szabat, Monika Chęć, Violetta Opoka-Winiarska, Biman Saikia, Ranjana W. Minz, Christine Arango, Clara Malagon, Maria D. P. Gomez, Angela C. Mosquera, Ricardo Yepez, Tatiana Gonzalez, Camilo Vargas, GRIP study group, Marta Balzarin, Biagio Castaldi, Elena Reffo, Francesca Sperotto, Giorgia Martini, Alessandra Meneghel, Ornella Milanesi, Ozgur Kasapçopur, Maria Teresa Terreri, Ekaterina Alexeeva, Maria Katsicas, Mikhail Kostik, Thomas Lehman, W.-Alberto Sifuentes-Giraldo, Vanessa Smith, Flavio Sztajnbok, Tadey Avcin, Maria Jose Santos, Dana Nemcova, Cristina Battagliotti, Liora Harel, Mahesh Janarthanan, Kathryn Torok, Nicola Helmus, Eileen Baildem, Michael Blakley, Kim Fligelstone, Antonia Kienast, Clare Pain, Amanda Saracino, Gabriele Simoni, Lisa Weibel, Maria K. Osminina, Nathalia A. Geppe, Olga V. Niconorova, Olesya V. Karashtina, Oksana V. Abbyasova, Olga V. Shpitonkova, Sinem Durmus, Hafize Uzun, Angela Mauro, Eleonora Fanti, Fabio Voller, Franca Rusconi, Fernando Garcia-Rodriguez, Ana V. Villarreal-Treviño, Angel J. Flores-Pineda, Paola B. Lara-Herrea, Diego R. Salinas-Encinas, Talia Diaz-Prieto, Maria R. Maldonado-Velazquez, Sarbelio Moreno-Espinosa, Enrique Faugier-Fuentes, Mirella Crapanzano, Ilaria Parissenti, Man S. Parihar, Pandiarajan Vignesh, ManojKumar Rohit, Kavitha Gopalan, Savita V. Attri, Alan Salama, David Jayne, Mark Little, Yulia Kostina, Galina Lyskina, Olga Shpitonkova, Alena Torbyak, Olga Shirinsky, Maria Francesca Gicchino, Maria Cristina Smaldone, Mario Diplomatico, Alma Nunzia Olivieri, C H. Spencer, Richard McClead, Hiren Patel, Chung-Yung Yu, Dita Cebecauerová, Tomáš Dallos, Edita Kabíčková, Martin Kynčl, Daniela Chroustová, Jozef Hoza, Dana Němcová, Vladimír Tesař, Pavla Doležalová, Tuncay Hazirolan, Fatih Ozaltin, Fabiola Almeida, Isabela H. Faria de Paula, Maíra M. Sampaio, Fernando N. Arita, Andressa G. Alves, Maria Carolina Santos, Eunice M. Okuda, Silvana B. Sacchetti, Fernanda Falcini, Marini Francesca, Gemma Lepri, Marco Matucci-Cerinic, Maria Luisa Brandi, Hakan Kisaoglu, Sema Misir, Selim Demir, Yuksel Aliyazicioglu, Mukaddes Kalyoncu, Carlos Eduardo Ramalho, Fabiola D. Almeida, Joan Calzada-Hernández, Rosa Bou, Estíbaliz Iglesias, Judith Sánchez-Manubens, Fredy Hermógenes Prada Martínez, Clara Giménez Roca, Sergi Borlan Fernández, Marek Bohm, Kamran Mahmood, Valentina Leone, Mark Wood, Ken-Ichi Yamaguchi, Satoshi Fujikawa, Working Group of Behçet’s Disease, Pediatric Rheumatology Association of Japan (PRAJ), Kyu Yeun Kim, Do Young Kim, Dong Soo Kim, Maka Ioseliani, Ivane Chkhaidze, Maia Lekishvili, Nana Tskhakaia, Shorena Tvalabeishvili, Aleksandre Kajrishvili, Maiko Takakura, Masaki Shimizu, Natsumi Inoue, Mao Mizuta, Akihiro Yachie, Giovanni Corsello, Maryam Piram, Carla Maldini, Sandra Biscardi, Nathalie Desuremain, Catherine Orzechowski, Emilie Georget, Delphine Regnard, Isabelle Kone-Paut, Alfred Mahr, Mihaela Sparchez, Zeno Sparchez, Nydia Acevedo Silva, Ana V. Villarreal Treviño, Yuridiana Ramirez Loyola, Talia Diaz Prieto, Enrique Faugier Fuentes, Maria D. R. Maldonado Velazquez, Pilar Perez, Sagar Bhattad, Ranjana Minz, Jitendra Shandilya, Pediatric Allergy and Immunology Unit, PGIMER, Chandigarh, Ana Villarreal, Yuridiana Ramírez, Zeynep Birsin Özçakar, Suat Fitoz, Fatos Yalcinkaya, Annacarin Horne, Francesca Minoia, Francesca Bovis, Sergio Davi, Priyankar Pal, Kimo Stein, Sandra Enciso, Michael Jeng, Despoina Maritsi, Randy C. Cron, Anne Thorwarth, Sae Lim von Stuckrad, Angela Rösen-Wolff, Hella Luksch, Patrick Hundsdoerfer, Peter Krawitz, Nuray Aktay Ayaz, Doğan Simsek, Şebnem Sara Kılıc, Emine Sonmez, Aysenur Pac Kisaarslan, Ozge Altug Gucenmez, Z. Serap Arıcı, Fatih Kelesoglu, Zelal Ekinci Ekinci, Maria Miranda-Garcia, Carolin Pretzer, Michael Frosch, F. Gohar, Angela McArdle, Niamh Callan, Belinda Hernandez, Miha Lavric, Oliver FitzGerald, Stephen R. Pennington, Joachim Peitz, Joern Kekow, Ariane Klein, Anna C. Schulz, Frank Weller-Heinemann, Anton Hospach, J-Peter Haas, BIKER collaborative group, Karen Put, Jessica Vandenhaute, Anneleen Avau, Annemarie van Nieuwenhuijze, Ellen Brisse, Tim Dierckx, Omer Rutgeerts, Josselyn E. Garcia-Perez, Jaan Toelen, Mark Waer, Georges Leclercq, An Goris, Johan Van Weyenbergh, Adrian Liston, Patrick Matthys, Carine H. Wouters, Yasuo Nakagishi, Michael J. Ombrello, Victoria Arthur, Anne Hinks, Patricia Woo, International Childhood Arthritis Genetics (INCHARGE) Consortium, Barbara Stanimirovic, Biljana Djurdjevic-Banjac, Olivera Ljuboja, Boris Hugle, MArgarita Onoufriou, Olga Vougiouka, Kenza Bouayed, Sanae El Hani, Imane Hafid, Nabiha Mikou, Nunu Shelia, Mari Laan, Jaanika Ilisson, and Chris Pruunsild
Subjects: Pediatrics, RJ1-570, Diseases of the musculoskeletal system, RC925-935
Published: 2017
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10. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two

Author: Olga Lomakina, Ekaterina Alekseeva, Sania Valieva, Tatiana Bzarova, Irina Nikishina, Elena Zholobova, Svetlana Rodionovskaya, Maria Kaleda, Yasuo Nakagishi, Masaki Shimizu, Mao Mizuta, Akihiro Yachie, Yuko Sugita, Nami Okamoto, Kousuke Shabana, Takuji Murata, Hiroshi Tamai, Eve M. Smith, Peng Yin, Andrea L. Jorgensen, Michael W. Beresford, on behalf of On behalf of the UK JSLE Cohort Study, Antonio Eleuteri, Beatrice Goilav, Laura Lewandowski, Angel Phuti, Dawn Wahezi, Tamar Rubinstein, Caroline Jones, Paul Newland, Stephen Marks, Rachel Corkhill, Diana Ekdawy, Clarissa Pilkington, Kjell Tullus, Chaim Putterman, Chris Scott, Antony C. Fisher, Andrea Jorgensen, Ezgi Deniz Batu, Can Kosukcu, Ekim Taskiran, Sema Akman, Kubra Ozturk, Betul Sozeri, Erbil Unsal, Zelal Ekinci, Yelda Bilginer, Mehmet Alikasifoglu, Seza Ozen, Hanna Lythgoe, Hermine I. Brunner, Gaurav Gulati, Jordan T. Jones, Mekibib Altaye, Jamie Eaton, Mark Difrancesco, Joo Guan Yeo, Jingyao Leong, Loshinidevi D/O Thana Bathi, Thaschawee Arkachaisri, Salvatore Albani, Nagla Abdelrahman, Michael W Beresford, Valentina Leone, UK JSLE study group supported by the National Institute of Health Research Clinical Research Network, Noortje Groot, D. Shaikhani, I. E. M. Bultink, M. Bijl, R. J. E. M. Dolhain, Y. K. O. Teng, E. Zirkzee, K. de Leeuw, R. Fritsch-Stork, S. S. M. Kamphuis, Rachael D. Wright, Reem Abdawani, Laila Al Shaqshi, Ibrahim Al Zakwani, Natali W. Gormezano, David Kern, Oriany L. Pereira, Gladys C. C. Esteves, Adriana M. Sallum, Nadia E. Aikawa, Rosa M. Pereira, Clovis A. Silva, Eloisa Bonfa, Jessica Beckmann, Nora Bartholomä, Nils Venhoff, Philipp Henneke, Ulrich Salzer, Ales Janda, Alina Lucica Boteanu, Sandra Garrote Corral, Alberto Sifuentes Giraldo, Mariluz Gámir Gámir, Antonio Zea Mendoza, Amra Adrovic, Reyhan Dedeoglu, Sezgin Sahin, Kenan Barut, Aida Koka, Funda Oztunc, Ozgur Kasapcopur, Ana Luisa Rodriguez-Lozano, Francisco Rivas-Larrauri, Silvestre García de la Puente, Andressa G. F. Alves, Maria F. D. A. Giacomin, Juliana Farhat, Alfésio L. F. Braga, Adriana M. E. Sallum, Lúcia M. D. A. Campos, Luiz A. A. Pereira, Ana J. D. F. C. Lichtenfels, Clóvis A. Silva, Sylvia C. L. Farhat, Banu Acar, Z. Birsin Ozcakar, Nilgün Çakar, Nermin Uncu, Gökçe Gür, Semanur Özdel, Fatoş Yalçınkaya, Christiaan Scott, Nicky Brice, Peter Nourse, Christine Arango, Angela C. Mosquera, Clara Malagon, Ana P. Sakamoto, Marco F. C. D. Silva, Ananadreia S. Lopes, Gleice C. S. Russo, Adriana E. M. Sallum, Katia Kozu, Eloisa Bonfá, Claudia Saad-Magalhães, Rosa M. R. Pereira, Claudio A. Len, Maria T. Terreri, Deepti Suri, Siyaram Didel, Amit Rawat, Surjit Singh, Despoina Maritsi, MArgarita Onoufriou, Olga Vougiouka, Maria Tsolia, Edi Paleka Bosak, Mandica Vidović, Mirta Lamot, Lovro Lamot, Miroslav Harjaček, Erika Van Nieuwenhove, Adrian Liston, Carine Wouters, Fatemeh Tahghighi, Vahid Ziaee, Seid-Reza Raeeskarami, Francisca Aguiar, Sandra Pereira, Mariana Rodrigues, Cláudia Moura, Gustavo Rocha, Hercília Guimarães, Iva Brito, Rita Fonseca, Gerd Horneff, Ariane Klein, Kirsten Minden, Hans-Iko Huppertz, Frank Weller-Heinemann, Jasmin Kuemmerle-Deschner, J-Peter Haas, Anton Hospach, BIKER collaborative group, Ricardo Menendez-Castro, Boris Huegle, Johannes-Peter Haas, Joost Swart, Gabriella Giancane, Francesca Bovis, Elio Castagnola, Andreas Groll, Daniel J. Lovell, Tom Wolfs, Michael Hofer, Violeta Panaviene, Susan Nielsen, Jordi Anton, Florence Uettwiller, Valda Stanevicha, Maria Trachana, Denise Pires Marafon, Constantin Ailioaie, Elena Tsitsami, Sylvia Kamphuis, Troels Herlin, Pavla Doležalová, Gordana Susic, Berit Flatø, Flavio Sztajnbok, Angela Pistorio, Alberto Martini, Nico Wulffraat, Nicolino Ruperto, Marco Gattorno, Antonio Brucato, Martina Finetti, George Lazaros, Silvia Maestroni, Mara Carraro, Davide Cumetti, Alessandra Carobbio, Monia Lorini, Alessandro Rimini, Renzo Marcolongo, Anna Valenti, Gian Luca Erre, Riccardo Belli, Fiorenzo Gaita, Maria Pia Sormani, Massimo Imazio, Mario Abinun, Nicola Smith, Tim Rapley, Flora McErlane, Lianne Kearsley-Fleet, Kimme L. Hyrich, Helen Foster, Nikolay Tzaribachev, Andrew Zeft, Rolando Cimaz, John Bohnsack, Thomas Griffin, Ruy Carrasco, Jason Dare, Ivan Foeldvari, Richard Vehe, Teresa Simon, Hermine Brunner, S. Verazza, S. Davì, A. Consolaro, A. Insalaco, V. Gerloni, R. Cimaz, F. Zulian, S. Pastore, F. Corona, G. Conti, P. Barone, M. Cattalini, E. Cortis, L. Breda, A. N. Olivieri, A. Civino, R. Podda, D. Rigante, F. La Torre, G. D’Angelo, M. Jorini, R. Gallizzi, M. C. Maggio, R. Consolini, A. De Fanti, M. G. Alpigiani, A. Martini, A. Ravelli, on behalf of Italian Pediatric Rheumatology Study Group, Aysenur Pac Kısaarslan, Zubeyde Gunduz, Ruhan Dusunsel, Ismail Dursun, Hakan Poyrazoglu, Ekaterina Kuchinskaya, Farida Abduragimova, Mikhail Kostik, Erik Sundberg, Soley Omarsdottir, Lena Klevenvall, Helena Erlandsson-Harris, Gokalp Basbozkurt, Ozge Erdemli, Dogan Simsek, Fatih Yazici, Yildirim Karsioglu, Aysen Tezcaner, Dilek Keskin, Huseyin Ozkan, Cengizhan Acikel, Erkan Demirkaya, Ilonka Orbán, Krisztina Sevcic, Valentin Brodszky, Emese Kiss, Ismaiel A. Tekko, Madeleine Rooney, James McElnay, Cliff Taggart, Helen McCarthy, Ryan F. Donnelly, Drug Delivery Group, Mary Slatter, Zohreh Nademi, Mark Friswell, Sharmila Jandial, Terence Flood, Sophie Hambleton, Andrew Gennery, Andrew Cant, Phoi-Ngoc Duong, Isabelle Koné-Paut, Giovanni Filocamo, María Luz Gamir, Helga Sanner, Laura Carenini, Mesut Topdemir, Yildirim Karslioglu, Faysal Gok, Nadezhda Tsurikova, Elena Ligostaeva, Navdha R. Ramchurn, O. Kostareva, I. Nikishina, S. Arsenyeva, S. Rodionovskaya, M. Kaleda, D. Alexeev, Ismail Dursun Dursun, Sara Murias, Estefania Barral, Rosa Alcobendas, Eugenia Enriquez, Agustin Remesal, Jaime de Inocencio, Tania M. Castro, Simone A. Lotufo, Tatjana Freye, Raffaella Carlomagno, Thomas Zumbrunn, Jan Bonhoeffer, Elvira Cannizzaro Schneider, Daniela Kaiser, Michaël Hofer, Véronique Hentgen, Andreas Woerner, Juvenile Inflammatory Rheumatism (JIR) Cohort, Tobias Schwarz, Jens Klotsche, Martina Niewerth, Gerd Ganser, ICON study group, Jerold Jeyaratnam, Nienke ter Haar, Donato Rigante, Fatma Dedeoglu, Ezgi Baris, Sebastiaan Vastert, Joost Frenkel, Jonathan S. Hausmann, Kathleen G. Lomax, Ari Shapiro, Karen L. Durrant, P. A. Brogan, M. Hofer, J. B. Kuemmerle-Deschner, B. Lauwerys, A. Speziale, K. Leon, X. Wei, R. M. Laxer, Sara Signa, Marta Rusmini, Elena Campione, Sabrina Chiesa, Alice Grossi, Alessia Omenetti, Roberta Caorsi, Gianmaria Viglizzo, Isabella Ceccherini, Silvia Federici, Helen Lachmann, Nicola Ruperto, on behalf of PRINTO and Eurofever Registry, Federica Vanoni, on behalf of PRINTO and Eurofever Project, Sonia Melo Gomes, Ebun Omoyinmi, Juan I. Arostegui, Eva Gonzalez-Roca, Despina Eleftheriou, Nigel Klein, Paul Brogan, Stefano Volpi, Elettra Santori, Paolo Picco, Claudia Pastorino, Gillian Rice, Alessandra Tesser, Yanick Crow, Fabio Candotti, Ada B. Sinoplu, Gozde Yucel, Gizem Pamuk, Laura O. Damian, Cecilia Lazea, Mihaela Sparchez, Paulina Vele, Laura Muntean, Adriana Albu, Simona Rednic, Calin Lazar, Leonardo O. Mendonça, Alessandra Pontillo, Jorge Kalil, Fabio M. Castro, Myrthes T. Barros, Manuela Pardeo, Virginia Messia, Fabrizio De Benedetti, Antonella Insalaco, Giorgia Malighetti, Chiara Gorio, Francesca Ricci, Ilaria Parissenti, Paola Montesano, Barbara Bonafini, Veronica Medeghini, Marco Cattalini, Lucio Giordano, Giulia Zani, Rosalba Ferraro, Donatella Vairo, Silvia Giliani, Maria Cristina Maggio, Girolamo Luppino, Giovanni Corsello, Maria Isabel Gonzalez Fernandez, Berta Lopez Montesinos, Adriana Rodriguez Vidal, Juan I. Arostegui Gorospe, Inmaculada Calvo Penades, Nadia K. Rafiq, Karen Wynne, Khalid Hussain, Paul A. Brogan, Elizabeth Ang, Nicholas Ng, Ayla Kacar, Ozge Altug Gucenmez, Balahan Makay, Sevket Erbil Unsal, Yasin Sahin, Tufan Kutlu, Fugen Cullu-Cokugras, Hasret Ayyildiz-Civan, Tulay Erkan, Sana Al Zuhbi, Eiman Abdalla, Ricardo A. Russo, María M. Katsicas, Francesca Minoia, Angelo Ravelli, Sagar Bhattad, Anju Gupta, Vignesh Pandiarajan, Ritambhra Nada, Kaara Tiewsoh, Philip Hawkins, Dorota Rowczenio, Sarka Fingerhutova, Jana Franova, Leona Prochazkova, Eva Hlavackova, Pavla Dolezalova, Havva Evrengül, Selçuk Yüksel, Mustafa Doğan, Dolunay Gürses, Harun Evrengül, Silvia De Pauli, Serena Pastore, Anna Monica Bianco, Giovanni Maria Severini, Andrea Taddio, Alberto Tommasini, Svetlana O. Salugina, Evgeny Fedorov, Elena Kamenets, Ekaterina Zaharova, Tatiana Sleptsova, Ekaterina Alexeeva, Kirill Savostyanov, Alexander Pushkov, Tatyana Bzarova, Saniya Valieva, Rina Denisova, Kseniya Isayeva, Evgeniya Chistyakova, Margarita Soloshenko, Elena Kaschenko, Utako Kaneko, Chihaya Imai, Akihiko Saitoh, Vitor A. Teixeira, Filipa O. Ramos, Manuela Costa, Yonatan Butbul Aviel, Shafe Fahoum, Riva Brik, Zeynep Birsin Özçakar, Banu Acar Celikel, Fatos Yalcinkaya, Benedetta Schiappapietra, Sergio Davi’, Federica Mongini, Luisa Giannone, Cecilia Bava, Maria Giannina Alpigiani, Alessandro Consolaro, Dragana S. Lazarevic, Jelena Vojinovic, Jelena Basic, Valentina Muratore, Valentina Marzetti, Neus Quilis, Belen Serrano Benavente, Alessandra Alongi, Adele Civino, Lorenzo Quartulli, Giedre Januskeviciute, Pieter van Dijkhuizen, N. Groot, W. van Dijk, A. Kardolus, Raul Gutiérrez Suárez, Ellen B. Nordal, Veronika G. Rypdal, Lillemor Berntson, Maria Ekelund, Kristiina Aalto, Suvi Peltoniemi, Marek Zak, Mia Glerup, Ellen D. Arnstad, Anders Fasth, Marite Rygg, the Nordic Study Group of Pediatric Rheumatology (NoSPeR), Ana Catarina Duarte, Sandra Sousa, Lídia Teixeira, Ana Cordeiro, Mª José Santos, Ana Filipa Mourão, Maria José Santos, Mónica Eusébio, Ana Lopes, Filipa Oliveira-Ramos, Manuel Salgado, Paula Estanqueiro, José Melo-Gomes, Fernando Martins, José Costa, Carolina Furtado, Ricardo Figueira, Jaime C. Branco, João E. Fonseca, Helena Canhão, Ana F. Mourão, Maria Jose Santos, Andrea Coda, Samuel Cassidy, Kerry West, Gordon Hendry, Debra Grech, Julie Jones, Fiona Hawke, Davinder Singh Grewal, Charlene Foley, Orla Killeen, Emma MacDermott, Douglas Veale, Ursula Fearon, Dilek Konukbay, Ela Tarakci, Nilay Arman, Sezgin Şahin, Jane Munro, Esi Morgan, Meredith Riebschleger, Jennifer Horonjeff, Vibeke Strand, Clifton Bingham, Ma. Theresa M. Collante, Margarita Ganeva, Stefan Stefanov, Albena Telcharova, Dimitrina Mihaylova, Radoslava Saraeva, Reni Tzveova, Radka Kaneva, Adelina Tsakova, Katya Temelkova, GRANT Medical University, Sofia 68/, Maria Mercedes C. Picarelli, Luiz C. Danzmann, Florencia Barbé-Tuana, Lucas K. Grun, Marcus H. Jones, Marijan Frković, Karla Ištuk, Ika Birkić, Saša Sršen, Marija Jelušić, Alan Easton, Rachael Quarmby, Raju Khubchandani, Mercedes Chan, Radoslav Srp, Katerina Kobrova, Dana Nemcova, Jozef Hoza, Michal Uher, Melania Saifridova, Lenka Linkova, Sirirat Charuvanij, Isree Leelayuwattanakul, Thita Pacharapakornpong, Sakda A.-O. Vallipakorn, Butsabong Lerkvaleekul, Soamarat Vilaiyuk, Stefano Lanni, Sergio Davì, Randy Q. Cron, Chiara Passarelli, Elisa Pisaneschi, Antonio Novelli, Claudia Bracaglia, Ivan Caiello, Kathy de Graaf, Florence Guilhot, Walter Ferlin, Grant Schulert, Alexi A. Grom, Robert Nelson, Cristina de Min, Dirk Holzinger, Christoph Kessel, Ndate Fall, Alexei Grom, Wilco de Jager, Raffaele Strippoli, Anna Horne, Stephan Ehl, Sandra Ammann, Kai Lehmberg, Karin Beutel, Dirk Foell, AnnaCarin Horne, Laura Pagani, Graciela Espada, Yi-jin Gao, Susan Shenoi, Sheila Weitzman, Giusi Prencipe, Antonia Pascarella, Walter G. Ferlin, Laurence Chatel, Philippe Jacqmin, Kathy De Graaf, Maria Ballabio, Zoë Johnson, Geneviève Lapeyre, Fabrizio de Benedetti, de Min Cristina, Hiroyuki Wakiguchi, Shunji Hasegawa, Reiji Hirano, Fumiko Okazaki, Tamaki Nakamura, Hidenobu Kaneyasu, Shouichi Ohga, Kazuko Yamazaki, Tomo Nozawa, Taichi Kanetaka, Shuichi Ito, Shumpei Yokota, Kirsty McLellan, Ishbel MacGregor, Neil Martin, Joyce Davidson, Sandra Hansmann, Andreas Eikelberg, Iris Haug, Sabrina Schuller, Susanne M. Benseler, Single Hub and Access point for paediatric Rheumatology in Europe (SHARE), Liliia S. Nazarova, Kseniia V. Danilko, Viktor A. Malievsky, Tatiana V. Viktorova, Angela Mauro, Angela Barnicoat, Jane Hurst, Nathalie Canham, Sandrine Lacassagne, Anastasia Wiener, Boris Hügle, Bernd Denecke, Ivan Costa-Filho, Johannes Peter Haas, Klaus Tenbrock, David Popp, Arjan Boltjes, Frank Rühle, Stefanie Herresthal, Femke van Wijk, Joachim Schultze, Monika Stoll, Luisa Klotz, Thomas Vogl, Johannes Roth, Estefania Quesada-Masachs, Daniel Álvarez de la Sierra, Marina Garcia Prat, Ana M. Marín Sánchez, Ricardo Pujol Borrell, Sara Marsal Barril, Mónica Martínez Gallo, Consuelo Modesto Caballero, Iryna Chyzheuskaya, Lyudmyla M. Byelyaeva, Rostislav M. Filonovich, Helena K. Khrustaleva, Larisa I. Zajtseva, Tamara M. Yuraga, Thomas Giner, Lukas Hackl, Julia Albrecht, Reinhard Würzner, Juergen Brunner, Marta Minute, Fulvio Parentin, Agostino Nocerino, Mette Nørgaard, Mikel Alberdi-Saugstrup, Marek S. Zak, Susan M. Nielsen, Ellen Nordal, Klaus G. Müller, Nordic Study Group of Pediatric Rheumatology (NoSPeR), Mojca Zajc Avramovič, Vita Dolžan, Nataša Toplak, Tadej Avčin, N. Ruperto, D. J. Lovell, C. Wallace, M. Toth, I. Foeldvari, J. Bohnsack, D. Milojevic, C. Rabinovich, D. Kingsbury, K. Marzan, P. Quartier, K. Minden, E. Chalom, G. Horneff, R. M. Kuester, J. Dare, M. Heinrich, H. Kupper, J. Kalabic, H. I. Brunner, on behalf of PRINTO and PRCSG, Ruben Burgos-Vargas, Tamas Constantin, Joke Dehoorne, Valda Stanevica, Katarzyna Kobusinska, Zbigniew Zuber, Richard Mouy, Ingrida Rumba-Rozenfelde, Chantal Job-Deslandre, Ronald Pederson, Jack Bukowski, Tina Hinnershitz, Bonnie Vlahos, Paula Keskitalo, Salla Kangas, Paula Vähäsalo, Raul A. Chavez Valencia, David Martino, Anne-Louise Ponsonby, Rachel Chiaroni-Clarke, Braydon Meyer, Roger C. Allen, Jonathan D. Akikusa, Jeffrey M. Craig, Richard Saffrey, Justine A. Ellis, Carol Wallace, Yosef Uziel, Gary Sterba, Rayfel Schneider, Ricardo Russo, Athimalaipet V. Ramanan, Jana Pachlopnik Schmid, Kim E Nichols, Paivi Miettunen, Toshiyuki Kitoh, Norman T. Ilowite, Jan-Inge Henter, Alexei A Grom, Edward M. Behrens, Tadej Avcin, Maurizio Aricò, Sriharsha Grevich, Peggy Lee, Sarah Ringold, Brian Leroux, Hannah Leahey, Megan Yuasa, Jessica Foster, Jeremy Sokolove, Lauren Lahey, William Robinson, Joshua Newson, Anne Stevens, Stephanie J. W. Shoop, Suzanne M. M. Verstappen, Wendy Thomson, Janet E. McDonagh, CAPS, Timothy Beukelman, Yuki Kimura, Marc Natter, Norm Ilowite, Kelly Mieszkalski, Grendel Burrell, Brian Best, Helen Bristow, Shannon Carr, Anne Dennos, Rachel Kaufmann, Laura Schanberg, for the CARRA Registry Investigators, Gabriele Simonini, Francesca Lancini, Margaux Gerbaux, Phu-Quoc Lê, Laurence Goffin, Valérie Badot, Céline La, Laure Caspers, François Willermain, Alina Ferster, Maria Ceci, Francesco Licciardi, Marco Turco, Francesca Santarelli, Davide Montin, Claudia Toppino, Clotilde Alizzi, Bruno Papia, Beatrice Vergara, Umberto Corpora, Luca Messina, Maria Tsinti, Vasiliko Dermentzoglou, Panagiotis Tziavas, Marija Perica, Lana Tambić Bukovac, Mustafa Çakan, Nuray Aktay Ayaz, Gonca Keskindemirci, Michael Lang, Catherine Laing, Susanne Benseler, Tommy Gerschman, Nadia Luca, Heinrike Schmeling, Anastasia Dropol, Jaymi Taiani, Nicole Johnson, Brian Rusted, Panagiota Nalbanti, Polyxeni Pratsidou, Grigoris Pardalos, Vasiliki Tzimouli, Anna Taparkou, Maria Stavrakidou, Fotios Papachristou, Florence Kanakoudi-Tsakalidou, Peter Bale, Emily Robinson, Jason Palman, Elizabeth Ralph, Kimberly Gilmour, Clare Heard, Lucy R. Wedderburn, Yara Barrense-Dias, Antonarakis Gregory, Dhouib Amira, Scolozzi Paolo, Hanquinet Sylviane, Hofer Michaël, Nataliya Panko, Salah Shokry, Liudmila Rakovska, Sally Pino, Adriana Diaz-Maldonado, Pilar Guarnizo, Sofia Torreggiani, Paolo Cressoni, Umberto Garagiola, Giancarla Di Landro, Giampietro Farronato, Fabrizia Corona, Samantha Bell, Parveen Bhatti, Lee Nelson, Beth A. Mueller, T. A. Simon, A. Baheti, N. Ray, Z. Guo, Anasuya Hazra, Thomas Stock, Ronnie Wang, Charles Mebus, Christine Alvey, Manisha Lamba, Sriram Krishnaswami, Umberto Conte, Min Wang, Daniel Kingsbury, Elena Koskova, Elzbieta Smolewska, Richard K. Vehe, Daniel Lovell, Tomohiro Kubota, Junko Yasumura, Toshitaka Kizawa, Masato Yashiro, Tsuyoshi Yamatou, Yuichi Yamasaki, Syuji Takei, Yoshifumi Kawano, Ulrika Järpemo Nykvist, Bo Magnusson, Rikard Wicksell, Karin Palmblad, Gunnar L. Olsson, Mohammadreza Modaressi, Mohammad-Hassan Moradinejad, Valentina Seraya, Alisa Vitebskaya, Veronica Moshe, Gil Amarilyo, Liora Harel, Phillip J Hashkes, Amir Mendelson, Noa Rabinowicz, Yonit Reis, Zane Dāvidsone, Arina Lazareva, Ruta Šantere, Dace Bērziņa, Valda Staņēviča, Giulia Camilla Varnier, Susan Maillard, Cristina Ferrari, Silvia Zaffarano, Juvenile Dermatomyositis Research Group and European Federation of Immunological Societies, Judith Wienke, Felicitas Bellutti Enders, Lucas L. van den Hoogen, Jorre S. Mertens, Timothy R. Radstake, Henny G. Hotten, Ruth Fritsch, Lucy Wedderburn, Kiran Nistala, Berent Prakken, Annet van Royen-Kerkhof, Mohammad Alhemairi, Mohammed Muzaffer, Pieter Van Dijkhuizen, Claire T. Deakin, Stefania Simou, Maria De Iorio, Qiong Wu, Tania Amin, Lee Dossetter, Juvenile Dermatomyositis Research Group (JDRG), Raquel Campanilho-Marques, Claire Deakin, Clarissa A. Pilkington, on behalf of Juvenile Dermatomyositis Research Group (JDRG), Silvia Rosina, Sirisucha Soponkanaporn, on behalf of the UK Juvenile Dermatomyositis Research Group (JDRG), Zehra S. Arıcı, Gökçen D. Tuğcu, Ezgi D. Batu, Hafize E. Sönmez, Deniz Doğru-Ersöz, Beril Talim, Nural Kiper, Seza Özen, Alexander Solyom, Ezgi Batu, John Mitchell, Ariana Kariminejad, Fatemeh Hadipour, Zahra Hadipour, Marta Torcoletti, Carlo Agostoni, Maja Di Rocco, Pranoot Tanpaiboon, Andrea Superti-Furga, Luisa Bonafé, Nur Arslan, Norberto Guelbert, Karoline Ehlert, Giedre Grigelioniene, Ratna Puri, Edward Schuchman, Pilar Gomez, Tatiana Gonzalez, Ricardo Yepez, Camilo Vargas, GRIP study group, Falcini Fernanda, Gemma Lepri, Alessandra Ferrari, Marco Matucci-Cerinic, Antonella Meini, Gian Marco Moneta, Emiliano Marasco, Rebecca Nicolai, Luisa Bracci-Laudiero, Olga Kopchak, Alexander Mushkin, Alexey Maletin, Catalina Mosquera, Rita A. Amorim, Juliana Molina, Gustavo Moreira, Flávia H. Santos, Melissa Fraga, Livia Keppeke, Vanessa M. Silva, Camila Hirotsu, Sergio Tufik, Maria Teresa Terreri, Vinícius L. Braga, Maria Beatriz Fonseca, Vania Schinzel, Maria Teresa R. Terreri, Liliana Jorge, Liana Guerra, Edson Amaro Junior, Maria Cristina Castiglione, Alessandra Tricarico, Emily Boulter, Andre Schultz, Kevin Murray, Fernanda Falcini, Stefano Stagi, Eleonora Bellucci, Ingrid H. R. Grein, Gecilmara Pileggi, Natália B. F. Pinto, Aline L. de Oliveira, Lyudmila Belyaeva, Rostislav Filonovich, Helena Khrustaleva, Larisa Zajtseva, Jaanika Ilisson, Chris Pruunsild, Olivier Gilliaux, Francis Corazza, Christophe Lelubre, on behalf of PANLAR Pediatric Rheumatology Study Group, Zoilo Morel, Claudia Saad-Magalhães C, Luis Lira, Mabel Ladino, Ruth Eraso, Ivonne Arroyo, Clovis Silva, Carlos Rose, and PANLAR Pediatric Rheumatology Study Group
Subjects: Pediatrics, RJ1-570, Diseases of the musculoskeletal system, RC925-935
Published: 2017
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11. Development of an environmental contextual factor item set relevant to global functioning and health in patients with axial Spondyloarthritis

Author: Simon Stebbings, Helena Marzo-Ortega, Muhammad Asim Khan, Wilson Bautista-Molano, Ruben Burgos Vargas, Simeon Grazio, Filip Van den Bosch, Laure Gossec, Inna Gaydukova, Praveena Chiowchanwisawakit, Juergen Braun, Walter P. Maksymowych, Bassel Elzorkany, Pál Géher, Victoria Navarro-Compán, D Patrikos, Michael Schirmer, Ulrich Weber, Annelies Boonen, Michele Gilio, Jieruo Gu, Désirée van der Heijde, John D. Reveille, Uta Kiltz, Tae-Jong Kim, Salih Ozgocmen, Fernando Pimentel-Santos, İstinye Üniversitesi, Hastane, Salih Özgöçmen / 0000-0002-4860-452X, Özgöçmen, Salih, Salih Özgöçmen / K-9588-2015, Salih Özgöçmen / 7003693574, Interne Geneeskunde, MUMC+: MA Reumatologie (9), and RS: CAPHRI - R3 - Functioning, Participating and Rehabilitation
Subjects: Disease specific, Applied psychology, INTERNATIONAL CLASSIFICATION, Severity of Illness Index, ontextual factors, outcome research, spondyloarthritis, Health services, Rheumatology, Spondylarthritis, Humans, Medicine, Spondylitis, Ankylosing, Pharmacology (medical), In patient, Axial spondyloarthritis, Set (psychology), ASAS, Core set, OUTCOMES, business.industry, DISABILITY, Health condition, International survey, contextual factors, ANKYLOSING-SPONDYLITIS, Quality of Life, business, CONSENSUS, Axial Spondyloarthritis
Abstract: Objective To describe the development of an Environmental contextual factors (EF) Item Set (EFIS) accompanying the disease specific Assessment of SpondyloArthritis international Society Health Index (ASAS HI). Method First, a candidate item pool was developed by linking items from existing questionnaires to 13 EF previously selected for the International Classification of Functioning, Disability and Health (ICF) /ASAS Core Set. Second, using data from two international surveys, which contained the EF item pool as well as the items from the ASAS HI, the number of EF items was reduced based on the correlation between the item and the ASAS HI sum score combined with expert opinion. Third, the final English EFIS was translated into 15 languages and cross-culturally validated. Results The initial item pool contained 53 EF addressing four ICF EF chapters: products and technology (e1), support and relationship (e3), attitudes (e4) and health services (e5). Based on 1754 responses of axial spondyloarthritis patients in an international survey, 44 of 53 initial items were removed based on low correlations to the ASAS HI or redundancy combined with expert opinion. Nine items of the initial item pool (range correlation 0.21–0.49) form the final EFIS. The EFIS was translated into 15 languages and field tested in 24 countries. Conclusions An EFIS is available complementing the ASAS HI and helps to interpret the ASAS HI results by gaining an understanding of the interaction between a health condition and contextual factors. The EFIS emphasizes the importance of support and relationships, as well as attitudes of the patient and health services in relation to self-reported health.
Published: 2022
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12. Efficacy and Safety of Tocilizumab for Polyarticular‐Course Juvenile Idiopathic Arthritis in the Open‐Label Two‐Year Extension of a Phase III Trial

Author: Ruben Cuttica, Rik Joos, Hermine I. Brunner, Yukiko Kimura, Zbigniew Zuber, Manuel Ferrandiz Zavaler, Nicolino Ruperto, Kamal N. Bharucha, Fabrizio De Benedetti, Sunethra Wimalasundera, Ruben Burgos-Vargas, Inmaculada Calvo Penades, Graciela Espada, Wendy Douglass, Alberto Martini, Vladimir Keltsev, Chris Wells, Earl D. Silverman, Ricardo Machado Xavier, Chantal Job-Deslandre, Daniel J. Lovell, and Carolina Duarte
Subjects: musculoskeletal diseases, Male, medicine.medical_specialty, Adolescent, Immunology, Population, Full Length, Arthritis, Placebo, Antibodies, Monoclonal, Humanized, Infections, 03 medical and health sciences, Juvenile Arthritis Disease Activity Score, chemistry.chemical_compound, 0302 clinical medicine, Tocilizumab, Chickenpox, Rheumatology, 030225 pediatrics, Internal medicine, medicine, Immunology and Allergy, Humans, Patient Reported Outcome Measures, Adverse effect, education, skin and connective tissue diseases, Bronchitis, Child, Glucocorticoids, 030203 arthritis & rheumatology, education.field_of_study, business.industry, Cellulitis, Pneumonia, medicine.disease, Pediatric Rheumatology, Arthritis, Juvenile, Clinical trial, Methotrexate, Treatment Outcome, chemistry, Antirheumatic Agents, Child, Preschool, Female, Chemical and Drug Induced Liver Injury, business, medicine.drug
Abstract: Objective To report the 2‐year efficacy and safety of tocilizumab (TCZ) in patients with polyarticular‐course juvenile idiopathic arthritis (JIA). Methods Patients ages 2–17 years with active polyarticular‐course JIA, in whom treatment with methotrexate was unsuccessful, received 16 weeks of open‐label intravenous TCZ in part 1 (once every 4 weeks: 8 mg/kg or 10 mg/kg for body weight [BW] 1 of the remaining JIA CRVs by >30%) at week 16 were randomly assigned (1:1) to receive TCZ or placebo in part 2. Patients remained in part 2 until either week 40 or the occurrence of JIA flare. Upon starting part 3, all patients received open‐label TCZ. At week 104 of the study, efficacy was assessed using JIA‐ACR50/70/90 response rates (defined as 50%, 70%, or 90% improvement, respectively), achievement of inactive disease, and the Juvenile Arthritis Disease Activity Score in 71 joints (JADAS‐71). Safety was assessed in the all‐exposure population per 100 patient‐years of exposure. Results Overall, 188 patients entered part 1, 166 patients entered part 2, and 160 patients entered part 3. By week 104, among the 188 patients in the modified intent‐to‐treat group who received TCZ, JIA‐ACR50/70/90 response rates were 80.3%/77.1%/59.6%, respectively, the median JADAS‐71 score decreased from 3.6 at week 40 to 0.7 at week 104, 51.1% of patients had achieved inactive disease, and 31 of 66 patients who had been receiving glucocorticoids discontinued them. Adverse event (AE) and serious AE rates were 406.5 per 100 patient‐years and 11.1 per 100 patient‐years, respectively. The infection rate was 151.4 per 100 patient‐years, and the serious infection rate was 5.2 per 100 patient‐years. Conclusion Patients treated with TCZ for polyarticular‐course JIA showed high‐level disease control for up to 2 years. The TCZ safety profile was consistent with that previously reported.
Published: 2021

13. Patient-Reported Outcomes Among Patients Ages Two to Seventeen Years With Polyarticular-Course Juvenile Idiopathic Arthritis Treated With Subcutaneous Abatacept: Two-Year Results From an International Phase III Study

Author: Nicolino Ruperto, Daniel J. Lovell, Alberto Berman, Francisco Ávila-Zapata, Gerd Horneff, Maria Alessio, Mara L. Becker, Alexandre Belot, Ruben Burgos-Vargas, Maria L. Gamir, Claudia Goldenstein-Schainberg, Iloite M. Scheibel, Maria T. Terreri, Lawrence Zemel, Joe Zhuo, Margarita Askelson, Robert Wong, Alberto Martini, Hermine I. Brunner, Ruperto, Nicolino, Lovell, Daniel J., Berman, Alberto, Ávila-Zapata, Francisco, Horneff, Gerd, Alessio, Maria, Becker, Mara L., Belot, Alexandre, Burgos-Vargas, Ruben, Gamir, Maria L., Goldenstein-Schainberg, Claudia, Scheibel, Iloite M., Terreri, Maria T., Zemel, Lawrence, Zhuo, Joe, Askelson, Margarita, Wong, Robert, Martini, Alberto, and Brunner, Hermine I.
Abstract: Objective: To describe longitudinal changes in patient-reported outcomes (PROs) in children with polyarticular-course juvenile idiopathic arthritis (pJIA) treated with subcutaneous abatacept. Methods: Secondary analysis of a single-arm, open-label 24-month study of patients ages 6-17 years and 2-5 years. PROs included Childhood Health Assessment Questionnaire-Disability Index (CHAQ-DI), parent global assessment of child well-being (PaGA), pain assessment, and Activity Limitation Questionnaire (ALQ). Clinical outcomes included 50% or greater improvement in JIA American College of Rheumatology (ACR) criteria, clinically inactive disease, and Juvenile Arthritis Disease Activity Score. Results: For the 6- to 17-year-old (n = 173) and 2- to 5-year-old (n = 46) cohorts, respectively, median (Q1, Q3) changes from baseline in CHAQ-DI at months 4 and 24 were -0.3 (-0.8, 0.0) and -0.5 (-1.0, -0.1), and -0.4 (-0.8, 0.0) and -0.5 (-1.0--0.1). Median pain scores were below cutoff threshold for clinically relevant pain (
Published: 2022

14. Inflammatory Foot Involvement in Spondyloarthritis: From Tarsitis to Ankylosing Tarsitis

Author: Dirk Elewaut, César Pacheco-Tena, Ruben Burgos-Vargas, and José Pablo Romero-López
Subjects: musculoskeletal diseases, Medicine (General), medicine.medical_specialty, Peripheral arthritis, Arthritis, JUVENILE RHEUMATOID-ARTHRITIS, Review, PERIPHERAL SPONDYLOARTHRITIS, DOUBLE-BLIND, R5-920, foot arthritis, Medicine and Health Sciences, medicine, Ankylosis, ankylosing tarsitis, Foot arthritis, UNFOLDED PROTEIN RESPONSE, business.industry, juvenile onset spondyloarthritis, mechanical stress, Biology and Life Sciences, General Medicine, spondyloarthritis, medicine.disease, Dermatology, PSORIATIC-ARTHRITIS, T-CELLS, SOCIETY CLASSIFICATION CRITERIA, Medicine, AXIAL SPONDYLOARTHRITIS, Oligoarticular Arthritis, Foot inflammation, FOLLOW-UP, business, BONE-FORMATION, Foot (unit)
Abstract: Spondyloarthritis (SpA) is a group that includes a wide spectrum of clinically similar diseases manifested by oligoarticular arthritis and axial or peripheral ankylosis. Although axial SpA is predominant in Caucasians and adult-onset patients, juvenile-onset and Latin American patients are characterized by severe peripheral arthritis and particularly foot involvement. The peripheral involvement of SpA can vary from tarsal arthritis to the most severe form named ankylosing tarsitis (AT). Although the cause and etiopathogenesis of axSpA are often studied, the specific characteristics of pSpA are unknown. Several animal models of SpA develop initial tarsitis and foot ankylosis as the main signs, emphasizing the role of foot inflammation in the overall SpA spectrum. In this review, we attempt to highlight the clinical characteristics of foot involvement in SpA and update the knowledge regarding its pathogenesis, focusing on animal models and the role of mechanical forces in inflammation.
Published: 2021
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15. Outcomes in Juvenile-Onset Spondyloarthritis

Author: Ruben Burgos-Vargas and Judith A. Smith
Subjects: Medicine (General), Pediatrics, medicine.medical_specialty, medicine.medical_treatment, Arthritis, Disease, Review, juvenile spondyloarthritis, sacroiliitis, R5-920, medicine, Back pain, Juvenile Spondyloarthritis, medicine.diagnostic_test, business.industry, enthesitis-related arthritis (ERA), Enthesitis, Sacroiliitis, Magnetic resonance imaging, General Medicine, medicine.disease, TNF inhibitor, disease manifestations and outcomes, Medicine, prognosis, medicine.symptom, business
Abstract: Some studies have suggested children with juvenile onset spondyloarthritis (JoSpA) have a relatively poor outcome compared to other juvenile idiopathic arthritis (JIA) categories, in regards to functional status and failure to attain remission. Thus, in the interest of earlier recognition and risk stratification, awareness of the unique characteristics of this group is critical. Herein, we review the clinical burden of disease, prognostic indicators and outcomes in JoSpA. Of note, although children exhibit less axial disease at onset compared to adults with spondyloarthritis (SpA), 34–62% have magnetic resonance imaging (MRI) evidence for active inflammation in the absence of reported back pain. Furthermore, some studies have reported that more than half of children with “enthesitis related arthritis” (ERA) develop axial disease within 5 years of diagnosis. Axial disease, and more specifically sacroiliitis, portends continued active disease. The advent of TNF inhibitors has promised to be a “game changer,” given their relatively high efficacy for enthesitis and axial disease. However, the real world experience in various cohorts since the introduction of more widespread TNF inhibitor usage, in which greater than a third still have persistently active disease, suggests there is still work to be done in developing new therapies and improving the outlook for JoSpA.
Published: 2021

16. Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study

Author: Ruben Burgos-Vargas, Walter P. Maksymowych, Mitsumasa Kishimoto, Najia Hajjaj-Hassouni, Sara Monti, Tuncay Duruöz, Pedro Machado, Anna Molto, Robert Landewé, Joachim Sieper, Victoria Navarro-Compán, Désirée van der Heijde, Sebastian E. Ibáñez Vodnizza, Meghna Gavali, Wilson Bautista-Molano, Pál Géher, Ruxandra Elena Schiotis, Kim Tae-Jong, Jieruo Gu, Fernando Pimentel-Santos, Uta Kiltz, Maxime Dougados, Bassel Elzorkany, Shue Fen Luo, Marina Magrey, José A. Maldonado-Cocco, Nelly Ziade, Clementina López-Medina, Floris A. van Gaalen, López Medina, Clementina [0000-0002-2309-5837], Molto, Anna [0000-0003-2246-1986], Sieper, Joachim [0000-0003-0285-9890], Kiltz, Uta [0000-0001-5668-4497], Hajjaj Hassouni, Najia [0000-0003-0722-6822], Ziade, Nelly [0000-0002-4479-7678], Monti, Sara [0000-0002-1800-6772], van Gaalen, Floris A [0000-0001-8448-7407], Ibáñez Vodnizza, Sebastián E [0000-0002-9577-3078], Bautista Molano, Wilson [0000-0003-0684-9542], Machado, Pedro M [0000-0002-8411-7972], van der Heijde, Desirée [0000-0002-5781-158X], Lopez-Medina, Clementina, Molto, Anna, Sieper, Joachim, Duruoz, Tuncay, Kiltz, Uta, Elzorkany, Bassel, Hajjaj-Hassouni, Najia, Burgos-Vargas, Ruben, Maldonado-Cocco, Jose, Ziade, Nelly, Gavali, Meghna, Navarro-Compan, Victoria, Luo, Shue-Fen, Monti, Sara, Tae-Jong, Kim, Kishimoto, Mitsumasa, Pimentel-Santos, F. M., Gu, Jieruo, Schiotis, Ruxandra, van Gaalen, Floris A., Geher, Pal, Magrey, Marina, Ibanez Vodnizza, Sebastian E., Bautista-Molano, Wilson, Maksymowych, Walter, Machado, Pedro M., Landew, Robert, van der Heijde, Desiree, Dougados, Maxime, Clinical Immunology and Rheumatology, and AII - Inflammatory diseases
Subjects: Male, Arthritis, DISEASE, RECOMMENDATIONS, Dactylitis, 0302 clinical medicine, Prevalence, Immunology and Allergy, CLASSIFICATION CRITERIA, 030212 general & internal medicine, INDEX, ANKYLOSING-SPONDYLITIS, spondylitis, LATIN-AMERICA, medicine.anatomical_structure, ankylosing, arthritis, Medicine, Upper limb, Female, medicine.symptom, musculoskeletal diseases, Adult, medicine.medical_specialty, HIP INVOLVEMENT, Immunology, 03 medical and health sciences, Psoriatic arthritis, Rheumatology, Internal medicine, Spondyloarthritis, Spondylarthritis, medicine, Humans, Reactive arthritis, Spondylitis, Ankylosing, Spondylitis, ENTHESITIS, 030203 arthritis & rheumatology, business.industry, Arthritis, Psoriatic, Enthesitis, medicine.disease, juvenile, Cross-Sectional Studies, RISK-FACTORS, psoriatic, business
Abstract: ObjectivesTo characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.MethodsCross-sectional study with 24 participating countries. Patients with a diagnosis of axial SpA (axSpA), peripheral SpA (pSpA) or PsA according to their rheumatologist were included. The investigators were asked which diagnosis out of a list of six (axSpA, PsA, pSpA, inflammatory bowel disease-associated SpA, reactive arthritis or juvenile SpA (Juv-SpA)) fitted the patient best. Peripheral manifestations (ie, peripheral joint disease, enthesitis, dactylitis and root joint disease), their localisation and treatments were evaluated.ResultsA total of 4465 patients were included (61% men, mean age 44.5 years) from four geographic areas: Latin America (n=538), Europe plus North America (n=1677), Asia (n=975) and the Middle East plus North Africa (n=1275). Of those, 78% had ever suffered from at least one peripheral musculoskeletal manifestation; 57% had peripheral joint disease, 44% had enthesitis and 15% had dactylitis. Latin American had far more often peripheral joint disease (80%) than patients from other areas. Patients with PsA had predominantly upper limb and small joint involvement (52%).Hip and shoulder involvement was found in 34% of patients. The prevalence of enthesitis ranged between 41% in patients with axSpA and 65% in patients with Juv-SpA. Dactylitis was most frequent among patients with PsA (37%).ConclusionThese results suggest that all peripheral features can be found in all subtypes of SpA, and that differences are quantitative rather than qualitative. In a high proportion of patients, axial and peripheral manifestations coincided. These findings reconfirm SpA clinical subtypes are descendants of the same underlying disease, called SpA.
Published: 2021

17. Ixekizumab treatment of biologic-naive patients with active psoriatic arthritis: 3-year results from a phase III clinical trial (SPIRIT-P1)

Author: Philip S. Helliwell, J. Erickson, Eric Lespessailles, Hideto Kameda, Roy Fleischmann, Ruben Burgos-Vargas, S. Rathmann, Vinod Chandran, Catherine L Shuler, Gaia Gallo, Désirée van der Heijde, Aubrey Trevelin Sprabery, Julie Birt, Imagerie Multimodale Multiéchelle et Modélisation du Tissu Osseux et articulaire (I3MTO), and Université d'Orléans (UO)
Subjects: Male, medicine.medical_specialty, DMARDs (biologic), Antibodies, Monoclonal, Humanized, Placebo, Severity of Illness Index, 030207 dermatology & venereal diseases, 03 medical and health sciences, Psoriatic arthritis, 0302 clinical medicine, Rheumatology, ixekizumab, Psoriasis Area and Severity Index, Internal medicine, Psoriasis, medicine, Adalimumab, Humans, Pharmacology (medical), Adverse effect, AcademicSubjects/MED00360, 030203 arthritis & rheumatology, psoriatic arthritis, business.industry, Arthritis, Psoriatic, Interleukin-17, psoriasis, Middle Aged, Clinical Science, spondyloarthritis, medicine.disease, Intention to Treat Analysis, 3. Good health, Clinical trial, Ixekizumab, Treatment Outcome, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, Quality of Life, Female, Safety, business, medicine.drug
Abstract: Objective The aim was to assess the safety and efficacy of up to 156 weeks of ixekizumab (an IL-17A antagonist) treatment in PsA patients. Methods In a phase III study, patients naïve to biologic treatment were randomized to placebo, adalimumab 40 mg every 2 weeks (ADA; active reference) or ixekizumab 80 mg every 2 weeks (IXEQ2W) or every 4 weeks (IXEQ4W) after an initial dose of 160 mg. At week 24 (week 16 for inadequate responders), ADA (after 8-week washout) and placebo patients were re-randomized to IXEQ2W or IXEQ4W. Outcomes were evaluated using a modified non-responder imputation [linear extrapolation for radiographic progression (modified total Sharp score = 0)] during extended treatment until week 156. Results Of 417 patients, 381 entered the extension, and 243 of 381 (63.8%) completed the 156-week study. Incidence rates of treatment-emergent and serious adverse events, respectively, were 38.0 and 5.2 with IXEQ2W (n = 189) and 38.1 and 8.0 with IXEQ4W (n = 197). One death occurred (IXEQ4W). With IXEQ2W and IXEQ4W, respectively, the response rates persisted to week 156 as measured by the ACR response ≥20% (62.5 and 69.8%), ≥50% (56.1 and 51.8%) and ≥70% (43.8 and 33.4%), psoriasis area and severity index (PASI) 75 (69.1 and 63.5%), PASI 90 (64.5 and 51.2%) and PASI 100 (60.5 and 43.6%). Inhibition of radiographic progression also persisted to week 156 in 61% of IXEQ2W and 71% of IXEQ4W patients. Conclusion In this 156-week study of ixekizumab, the safety profile remained consistent with previous reports, and improvements in signs and symptoms of PsA were observed, including persistent low rates of radiographic progression. Trial registration ClinicalTrials.gov, http://clinicaltrials.gov, NCT01695239, EudraCT 2011-002326-49.
Published: 2020
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18. Association of ERAP2 polymorphisms in Colombian HLA-B27+ or HLA-B15+ patients with SpA and its relationship with clinical presentation: axial or peripheral predominance

Author: Enrique Calvo-Páramo, Gilberto Vargas-Alarcón, Consuelo Romero, Viviana Reyes-Martinez, Ana María Santos, Catalina Villota-Eraso, Juan C. Rueda, Luz Mabel Ávila-Portillo, Diana Padilla, Nancy Martínez-Rodríguez, Ruben Burgos-Vargas, Guisselle-Nathalia Muñoz, Francy Cuervo, John Londoño, Sofia Arias-Correal, Santiago Bernal-Macías, and Juan F. Medina
Subjects: musculoskeletal diseases, Adult, Male, Genotype, Autoimmune diseases, Ankylosing Spondylitis, Immunology, lcsh:Medicine, Single-nucleotide polymorphism, Autoimmunity, Human leukocyte antigen, Colombia, HLA-B15 Antigen, Aminopeptidases, Polymorphism, Single Nucleotide, Autoimmune Diseases, Rheumatology, Gene Polymorphism, Spondyloarthritis, Spondylarthritis, Immunology and Allergy, Medicine, SNP, Humans, Genetic Predisposition to Disease, Allele, Alleles, Genetic Association Studies, HLA-B27 Antigen, Ankylosing spondylitis, HLA-B27, business.industry, Histocompatibility Testing, lcsh:R, Haplotype, Gene polymorphism, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Radiography, Phenotype, Cytokines, Female, Inflammation Mediators, business, Biomarkers
Abstract: ObjectiveTo determine the association between endoplasmic reticulum aminopeptidase (ERAP)1 and ERAP2 single-nucleotide polymorphisms (SNPs) and human leukocyte antigens (HLA)-B27+ or HLA-B15+ patients with spondyloarthritis (SpA).Methods104 patients with SpA according to Assessment of Spondyloarthritis International Society criteria were included in the study. HLA typing was performed by PCR. The polymorphisms were determined by real-time PCR on genomic DNA using customised probes for SNPs rs27044, rs17482078, rs10050860 and rs30187 in ERAP1, and rs2910686, rs2248374 and rs2549782 in ERAP2.Results70 of the104 patients with SpA were HLA-B27+ and 34 were HLA-B15+. The distribution of ERAP1 and ERAP2 SNPs between the HLA-B15+ and HLA-B27+ patients with SpA did not reveal differences. Likewise, no differences in the frequencies of ERAP1 SNP haplotypes and alleles HLA-B15 or HLA-B27 were found. Interestingly, however, the frequencies of three particular haplotypes formed by ERAP2 SNPs rs2549782/rs2248374/rs2910686 varied between HLA-B15+ and HLA-B27+ patients: the ERAP2 SNPs haplotype TGT was more common in HLA-B15+ patients with SpA (OR 2.943, 95% CI 1.264 to 6.585; P=0.009), whereas the ERAP2 SNP haplotypes TGC and CAT were more associated with HLA-B27+ patients with SpA: (OR 4.483, 95% CI 1.524 to 13.187; p=0.003) and (OR 9.014, 95% CI 1.181 to 68.807; p=0.009), respectively.ConclusionAn association was found between HLA-B15+ patients with SpA and haplotype TGT of ERAP2 SNPs. On the other hand, HLA-B27+ patients with SpA were associated with ERAP2 haplotypes TGC and CAT. These associations could be related to the clinical presentation of the disease, specifically with a peripheral or axial predominance, respectively.
Published: 2020

19. Measurement properties of the ASAS Health Index: results of a global study in patients with axial and peripheral spondyloarthritis

Author: Juergen Braun, Wilson Bautista-Molano, Nurullah Akkoc, Helena Marzo-Ortega, Fernando Pimentel Dos Santos, Filip Van den Bosch, M. Tuncay Duruoz, Bassel Elzorkany, Désirée van der Heijde, Simeon Grazio, Uta Kiltz, Victoria Navarro-Compán, Tae-Jong Kim, Jieruo Gu, Ruben Burgos-Vargas, Simon Stebbings, James Cheng-Chung Wei, Astrid van Tubergen, Praveena Chiowchanwisawakit, Annelies Boonen, Robert D. Inman, Maxime Dougados, Inna Gaydukova, Salih Ozgocmen, Michele Gilio, Lianne S. Gensler, Michael Schirmer, Kiltz, Uta, van der Heijde, Desiree, Boonen, Annelies, Akkoc, Nurullah, Bautista-Molano, Wilson, Burgos-Vargas, Ruben, Wei, James Cheng-Chung, Chiowchanwisawakit, Praveena, Dougados, Maxime, Duruoz, M. Tuncay, Elzorkany, Bassel Kamal, Gaydukova, Inna, Gensler, Lianne S., Gilio, Michele, Grazio, Simeon, Gu, Jieruo, Inman, Robert D., Kim, Tae-Jong, Navarro-Compan, Victoria, Marzo-Ortega, Helena, Ozgocmen, Salih, dos Santos, Fernando Pimentel, Schirmer, Michael, Stebbings, Simon, van den Bosch, Filip E., van Tubergen, Astrid, Braun, Juergen, RS: CAPHRI - R3 - Functioning, Participating and Rehabilitation, Interne Geneeskunde, and MUMC+: MA Reumatologie (9)
Subjects: Adult, Male, SELECTION, medicine.medical_specialty, Psychometrics, Intraclass correlation, Immunology, Spearman's rank correlation coefficient, Sensitivity and Specificity, Severity of Illness Index, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Cronbach's alpha, Internal medicine, Spondylarthritis, medicine, Immunology and Allergy, Health Status Indicators, Humans, PHYSICIAN DISCORDANCE, Translations, ankylosing spondylitis, outcomes research, spondyloarthritis, COHORT, 030212 general & internal medicine, Reliability (statistics), 030203 arthritis & rheumatology, Ankylosing spondylitis, business.industry, Tumor Necrosis Factor-alpha, Anti-Inflammatory Agents, Non-Steroidal, Construct validity, Reproducibility of Results, ANKYLOSING-SPONDYLITIS, Middle Aged, medicine.disease, Antirheumatic Agents, Cohort, Disease Progression, SOCIETY CLASSIFICATION CRITERIA, Female, Outcomes research, ARTHRITIS, business
Abstract: ObjectivesTo evaluate construct validity, interpretability, reliability and responsiveness as well as determination of cut-off points for good and poor health within the original English version and the 18 translations of the disease-specific Assessment of Spondyloarthritis international Society Health Index (ASAS HI) in 23 countries worldwide in patients with spondyloarthritis (SpA).MethodsA representative sample of patients with SpA fulfilling the ASAS classification criteria for axial (axSpA) or peripheral SpA was used. The construct validity of the ASAS HI was tested using Spearman correlation with several standard health outcomes for axSpA. Test–retest reliability was assessed by intraclass correlation coefficients (ICCs) in patients with stable disease (interval 4–7 days). In patients who required an escalation of therapy because of high disease activity, responsiveness was tested after 2–24weeks using standardised response mean (SRM).ResultsAmong the 1548 patients, 64.9% were men, with a mean (SD) age 42.0 (13.4) years. Construct validity ranged from low (age: 0.10) to high (Bath AnkylosingSpondylitisFunctioning Index: 0.71). Internal consistency was high (Cronbach’s α of 0.93). The reliability among 578 patients was good (ICC=0.87 (95% CI 0.84 to 0.89)). Responsiveness among 246 patients was moderate-large (SRM=−0.44 for non-steroidal anti-inflammatory drugs, −0.69 for conventional synthetic disease-modifying antirheumatic drug and −0.85 for tumour necrosis factor inhibitor). The smallest detectable change was 3.0. Values ≤5.0 have balanced specificity to distinguish good health as opposed to moderate health, and values ≥12.0 are specific to represent poor health as opposed to moderate health.ConclusionsThe ASAS HI proved to be valid, reliable and responsive. It can be used to evaluate the impact of SpA and its treatment on functioning and health. Furthermore, comparison of disease impact between populations is possible.
Published: 2018
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20. Toward New Classification Criteria for Juvenile Idiopathic Arthritis : First Steps, Pediatric Rheumatology International Trials Organization International Consensus

Author: Tadej Avcin, Nico M. Wulffraat, Raju Khubchandani, Ruben Cuttica, Angela Pistorio, Angelo Ravelli, Ruben Burgos-Vargas, Ronald M. Laxer, Carol A. Wallace, Daniel J. Lovell, Alberto Martini, Ross E. Petty, Michael W. Beresford, Norman T. Ilowite, and Nicolino Ruperto
Subjects: Adult, musculoskeletal diseases, medicine.medical_specialty, Consensus, genetic structures, Immunology, Arthritis, antinuclear antibodies, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Rheumatoid Factor, Terminology as Topic, Internal medicine, Nominal group technique, Humans, Medicine, Immunology and Allergy, 030212 general & internal medicine, Pediatric rheumatology, Child, skin and connective tissue diseases, Societies, Medical, computer.programming_language, 030203 arthritis & rheumatology, Data collection, business.industry, Data Collection, Enthesitis, International Agencies, Juvenile idiopathic arthritis, medicine.disease, Arthritis, Juvenile, Homogeneous, Antibodies, Antinuclear, Family medicine, AUTOIMMUNE DISEASES, medicine.symptom, business, computer, Delphi, Spondylitis
Abstract: Objective.To revise the current juvenile idiopathic arthritis (JIA) International League of Associations for Rheumatology (ILAR) classification criteria with an evidence-based approach, using clinical and routine laboratory measures available worldwide, to identify homogeneous clinical groups and to distinguish those forms of chronic arthritis typically seen only in children from the childhood counterpart of adult diseases.Methods.The overall project consists of 4 steps. This work represents Step 1, a Delphi Web-based consensus and Step 2, an international nominal group technique (NGT) consensus conference for the new provisional Pediatric Rheumatology International Trials Organization JIA classification criteria. A future large data collection of at least 1000 new-onset JIA patients (Step 3) followed by analysis and NGT consensus (Step 4) will provide data for the evidence-based validation of the JIA classification criteria.Results.In Step 1, three Delphi rounds of interactions were implemented to revise the 7 ILAR JIA categories. In Step 2, forty-seven questions with electronic voting were implemented to derive the new proposed criteria. Four disorders were proposed: (a) systemic JIA; (b) rheumatoid factor–positive JIA; (c) enthesitis/spondylitis-related JIA; and (d) early-onset antinuclear antibody–positive JIA. The other forms were gathered under the term “others.” These will be analyzed during the prospective data collection using a list of descriptors to see whether the clustering of some of them could identify homogeneous entities.Conclusion.An international consensus was reached to identify different proposed homogeneous chronic disorders that fall under the historical termJIA. These preliminary criteria will be formally validated with a dedicated project.
Published: 2019

21. Treating juvenile idiopathic arthritis to target : Recommendations of an international task force

Author: Joost F. Swart, Nico M Wulffraat, Jonathan D Akikusa, Christiaan Scott, Fabrizio De Benedetti, Ruben Burgos-Vargas, Pierre Quartier, Yasuhiko Itoh, Ronald M. Laxer, Nicolino Ruperto, Erkan Demirkaya, Alessandro Consolaro, Tadej Avcin, Sulaiman M. Al-Mayouf, Claudia Saad-Magalhães, Roberta A. Berard, Yosef Uziel, Sebastiaan J. Vastert, Susan Shenoi, Esi M. Morgan, Ricardo Russo, Michael W. Beresford, Josef S Smolen, Sujata Sawhney, Pekka Lahdenne, Dirk Foell, Jordi Anton, Rolando Cimaz, Angelo Ravelli, Gerd Horneff, Daniel J. Lovell, Istituto Giannina, Asklepios Klinik Sankt Augustin, University Hospital of Cologne, Hospital for Sick Children, University of Cincinnati, University of Utrecht, Murdoch Children's Research Institute, Alfaisal University, Universitat de Barcelona, University of Ljubljana, London Health Sciences Centre, Alder Hey Children's NHS Foundation Trust, Hospital General de México Eduardo Liceaga, Azienda Ospedaliero Universitaria Meyer, Ospedale Pediatrico Bambino Gesù, University of Muenster, Nippon Medical School, Helsinki University Hospital, Assistance Publique Hopitaux de Paris, Istituto Giannina Gaslini, Hospital de Pediatría Garrahan, Universidade Estadual Paulista (Unesp), Sir Ganga Ram Hospital, University of Cape Town, University of Washington, Meir Medical Center, Tel Aviv University Sackler School of Medicine, and Medical University of Vienna
Subjects: Genetics and Molecular Biology (all), Arthritis, Biochemistry, Pediatrics, Severity of Illness Index, Stiffness, 0302 clinical medicine, Treatment targets, Immunology and Allergy, 030212 general & internal medicine, Disease activity, Fatigue, Shared decision making, outcomes research, Evidence-Based Medicine, treatment, Remission Induction, juvenile idiopathic arthritis, Rheumatology, Immunology, Biochemistry, Genetics and Molecular Biology (all), Disease Management, Systematic review, Antirheumatic Agents, medicine.medical_specialty, Advisory Committees, Pain, General Biochemistry, Genetics and Molecular Biology, Indirect evidence, Patient perspective, 03 medical and health sciences, medicine, Humans, Intensive care medicine, Set (psychology), 030203 arthritis & rheumatology, business.industry, Task force, Biochemistry, Genetics and Molecular Biology(all), Timeline, Treat to target, medicine.disease, Arthritis, Juvenile, Commentary, Outcomes research, business, Genetics and Molecular Biology(all)
Abstract: Made available in DSpace on 2018-12-11T16:53:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-06-01 Recent therapeutic advances in juvenile idiopathic arthritis (JIA) have made remission an achievable goal for most patients. Reaching this target leads to improved outcomes. The objective was to develop recommendations for treating JIA to target. A Steering Committee formulated a set of recommendations based on evidence derived from a systematic literature review. These were subsequently discussed, amended and voted on by an international Task Force of 30 paediatric rheumatologists in a consensus-based, Delphi-like procedure. Although the literature review did not reveal trials that compared a treat-to-target approach with another or no strategy, it provided indirect evidence regarding an optimised approach to therapy that facilitated development of recommendations. The group agreed on six overarching principles and eight recommendations. The main treatment target, which should be based on a shared decision with parents/patients, was defined as remission, with the alternative target of low disease activity. The frequency and timeline of follow-up evaluations to ensure achievement and maintenance of the target depend on JIA category and level of disease activity. Additional recommendations emphasise the importance of ensuring adequate growth and development and avoiding long-term systemic glucocorticoid administration to maintain the target. All items were agreed on by more than 80% of the members of the Task Force. A research agenda was formulated. The Task Force developed recommendations for treating JIA to target, being aware that the evidence is not strong and needs to be expanded by future research. These recommendations can inform various stakeholders about strategies to reach optimal outcomes for JIA. Clinica Pediatrica e Reumatologia Università degli Studi di Genova Istituto di Ricovero e Cura a Carattere Scientifico Istituto Giannina Department of Pediatrics Asklepios Klinik Sankt Augustin Department of Pediatric and Adolescents Medicine University Hospital of Cologne Division od Rheumatology University of Toronto Hospital for Sick Children Division of Rheumatology Cincinnati Children's Hospital Medical Center University of Cincinnati Department of Paediatric Immunology Wilhelmina Children's Hospital University Medical Center Utrecht University of Utrecht Rheumatology Unit Department of General Medicine Royal Children's Hospital Murdoch Children's Research Institute Department of Pediatric Rheumatology King Faisal Specialist Hospital and Research Center Alfaisal University Division of Pediatric Rheumatology Hospital Sant Joan de Déu Universitat de Barcelona Department of Allergology Rheumatology and Clinical Immunology University Medical Center Ljubljana Medical Faculty University of Ljubljana Division of Rheumatology Western University Children's Hospital London Health Sciences Centre Institute of Translational Medicine University of Liverpool Alder Hey Children's NHS Foundation Trust Rheumatology Department Hospital General de México Eduardo Liceaga Pediatric Rheumatology Azienda Ospedaliero Universitaria Meyer Division of Rheumatology Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Pediatrico Bambino Gesù Pediatric Rheumatology and Immunology University of Muenster Department of Pediatrics Nippon Medical School Institute of Clinical Medicine Children's Hospital Helsinki University Hospital Paris-Descartes University IMAGINE Institute RAISE 22 National Reference Centre Necker-Enfants Malades Hospital Assistance Publique Hopitaux de Paris Clinica Pediatrica e Reumatologia Istituto di Ricovero e Cura a Carattere Scientifico Istituto Giannina Gaslini Servicio de Inmunología y Reumatología Hospital de Pediatría Garrahan Reumatologia Pediátrica São Paulo State University (UNESP) Department of Rheumatology ISIC Superspeciality Hospital Sir Ganga Ram Hospital Red Cross War Memorial Children's Hospital University of Cape Town Pediatric Rheumatology Seattle Children's Hospital and Research Center University of Washington Pediatric Rheumatology Unit Department of Pediatrics Meir Medical Center Tel Aviv University Sackler School of Medicine Division of Rheumatology Department of Medicine3 Medical University of Vienna Reumatologia Pediátrica São Paulo State University (UNESP)
Published: 2018

22. The juvenile-onset spondyloarthritides: rationale for clinical evaluation

Author: Burgos-Vargas, Rubén, Pacheco-Tena, César, and Vázquez-Mellado, Janitzia
Published: 2002
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23. Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group

Author: Martin Rudwaleit, Jürgen Braun, Irene E. van der Horst-Bruinsma, Xenofon Baraliakos, Filip Van den Bosch, P. Bakker, Walter P. Maksymowych, Alexander N. Bennett, Maxime Dougados, Denis Poddubnyy, Joachim Sieper, Kay-Geert A. Hermann, Désirée van der Heijde, Susanne Juhl Pedersen, Ulrich Weber, Robert Landewé, Robert G. W. Lambert, Monique Reijnierse, Anne Grethe Jurik, Mikkel Østergaard, Helena Marzo-Ortega, Ruben Burgos-Vargas, Clinical Immunology and Rheumatology, Rheumatology, and AII - Inflammatory diseases
Subjects: medicine.medical_specialty, Pathology, Sacroiliac Joint/diagnostic imaging, Ankylosing Spondylitis, Sacroiliitis/diagnostic imaging, Immunology, General Biochemistry, Genetics and Molecular Biology, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Bone Marrow, Spondyloarthritis, Spondylarthritis, medicine, Immunology and Allergy, Humans, Sacroiliitis, Axial spondyloarthritis, Spondylitis, 030203 arthritis & rheumatology, Sacroiliac joint, Ankylosing spondylitis, medicine.diagnostic_test, business.industry, Magnetic Resonance Imaging/standards, Magnetic resonance imaging, Sacroiliac Joint, medicine.disease, Magnetic Resonance Imaging, Spondylarthritis/classification, medicine.anatomical_structure, Mri diagnosis, Subchondral bone, Bone Marrow/diagnostic imaging, Practice Guidelines as Topic, Radiology, business
Abstract: ObjectivesTo review and update the existing definition of a positive MRI for classification of axial spondyloarthritis (SpA).MethodsThe Assessment in SpondyloArthritis International Society (ASAS) MRI working group conducted a consensus exercise to review the definition of a positive MRI for inclusion in the ASAS classification criteria of axial SpA. Existing definitions and new data relevant to the MRI diagnosis and classification of sacroiliitis and spondylitis in axial SpA, published since the ASAS definition first appeared in print in 2009, were reviewed and discussed. The precise wording of the existing definition was examined in detail and the data and a draft proposal were presented to and voted on by the ASAS membership.ResultsThe clear presence of bone marrow oedema on MRI in subchondral bone is still considered to be the defining observation that determines the presence of active sacroiliitis. Structural damage lesions seen on MRI may contribute to a decision by the observer that inflammatory lesions are genuinely due to SpA but are not required to meet the definition. The existing definition was clarified adding guidelines and images to assist in the application of the definition.ConclusionThe definition of a positive MRI for classification of axial SpA should continue to primarily depend on the imaging features of ‘active sacroiliitis’ until more data are available regarding MRI features of structural damage in the sacroiliac joint and MRI features in the spine and their utility when used for classification purposes.
Published: 2016
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24. ERAP2 is associated with ankylosing spondylitis in HLA-B27-positive and HLA-B27-negative patients

Author: John D. Reveille, Seung Cheol Shim, Maxime Breban, Walter P. Maksymowych, Maria Consuelo Romero-Sanchez, Kari Laiho, Kyung Bin Joo, Javier Martin, Nigil Haroon, C.T. Chou, Ruben Burgos-Vargas, Øystein Førre, Lianne S. Gensler, Henri Jean Garchon, Kelly A. Hollis, Robert D. Inman, Yu Liu, Huji Xu, Tae-Hwan Kim, Irene E. van der Horst-Bruinsma, Juan Mulero, Proton Rahman, Michael H. Weisman, Dirk Elewaut, Paul Bowness, Gilles Chiocchia, Johannes C. Nossent, Benedicte A. Lie, Karl Gafney, Matthew A. Brown, Xin Wu, Jaakko Tuomilehto, Carlos López-Larrea, Linda A. Bradbury, Dafna D. Gladman, Simon Stebbings, J. S. H. Gaston, Seung-Hun Lee, Mary-Ellen Costello, Raphael Valle-Oñate, Philip Robinson, Michael Ward, Adrian Cortes, Xiaodong Zhou, José Luis Fernández-Sueiro, Lei Jiang, David M. Evans, Fernando Pimentel-Santos, B. Paul Wordsworth, Inger Myrnes Hansen, Paul Leo, Miguel A. Gonzalez-Gay, Rheumatology, and CCA - Disease profiling
Subjects: Genetics, HLA-B27, Linkage disequilibrium, business.industry, Immunology, Locus (genetics), Human leukocyte antigen, Endoplasmic reticulum aminopeptidase 2, Aminopeptidases, General Biochemistry, Genetics and Molecular Biology, Article, Logistic Models, Rheumatology, Gene interaction, Haplotypes, Genetic Loci, Immunology and Allergy, Medicine, Humans, Spondylitis, Ankylosing, Allele, business, HLA-B27 Antigen, Genetic association
Abstract: The association of endoplasmic reticulum aminopeptidase 2 (ERAP2) with ankylosing spondylitis (AS) was recently described in the large International Genetics of AS Consortium Immunochip study. Variants in ERAP2 have also been associated with inflammatory bowel disease, psoriasis, acute anterior uveitis and birdshot chorioretinopathy. Subsequent investigation demonstrated an association of ERAP2 with AS which was present when one conditioned on one of the two independent haplotypes of ERAP1 associated with AS or when HLA-B27-negative patients were analysed separately. These two analyses provide analogous evidence for the association of ERAP2 with AS in HLA-B27-negative cases because of the genetic interaction between HLA-B27 and the AS-associated ERAP1 variants in AS cases. ERAP1 and ERAP2 are located on chromosome 5q15 in the opposite orientation. The locus is challenging to analyse because of the strong linkage disequilibrium (LD) across the locus and the epistasis between ERAP1 and HLA-B alleles associated with AS. We therefore sought to investigate the association of ERAP2 with AS in HLA-B27-positive patients. This is of clinical importance because functional studies have demonstrated that the strongly AS-protective variant rs2248374 causes a functional ERAP2 protein knockout, because its G allele causes a loss of ERAP2 protein expression. There is also a variant of ERAP2 which changes its enzyme catalytic activity and specificity (rs2549782, K392A). Because this is in almost complete LD with rs2248374 (1000 Genomes D′=1.00, r2=0.90), it is almost never translated in vivo. Further, the very strong LD between these markers means that analysis of rs2549782 for association would yield results almost identical to the results for rs2248374 presented below. Therefore, it is of relevance to determine whether the association of ERAP2 with HLA-B27-negative disease is also found in HLA-B27-positive cases, since ERAP inhibition may offer a novel therapeutic for AS...
Published: 2015
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25. The Pediatric Rheumatology International Trials Organization/American College of Rheumatology provisional criteria for the evaluation of response to therapy in juvenile systemic lupus erythematosus: prospective validation of the definition of improvement

Author: Ruben Burgos-Vargas, Fabrizia Corona, Richard Vesely, Gerd Horneff, Stefan Hagelberg, Troels Herlin, Angela Pistorio, Tadej Avcin, Nicolino Ruperto, Dimitrina Mihaylova, Maria Teresa Apaz, Carolina Duarte, Elisabetta Cortis, Marion A J van Rossum, Edward H. Giannini, Lucia Trail, Sang Cheol Bae, Pavla Dolezalova, Sheila Knupp Feitosa de Oliveira, Ximena Norambuena, Srdjan Pasic, Amita Aggarwal, Florence Kanakoudi-Tsakalidou, Helen E. Foster, Claudia Magalhaes Saad, Alberto Martini, Boel Andersson-Gäre, Loredana Lepore, Angelo Ravelli, Valeria Gerloni, Maria Alessio, AII - Amsterdam institute for Infection and Immunity, Paediatric Infectious Diseases / Rheumatology / Immunology, Univ Genoa, Inst Puericultura & Pediat Martagao Gesteira, Univ Naples Federico II, Childrens Univ Hosp, Mother & Child Hlth Inst Serbia, Univ Catolica, Hosp Gen Mexico City, Aristotle Univ Thessaloniki, Hosp Dr Exequiel Gonzalez Cortes, Clin Pediat 2 de Marchi, Ist Gaetano Pini, Karolinska Univ Hosp, Sanjay Gandhi Inst Med Sci, Fac Med 1, Gen Fac Hosp, Universidade Estadual Paulista (Unesp), Hanyang Univ, Univ Hosp, Univ Med Ctr, Royal Victoria Infirm, Ctr Nacl Rehabil, Skejby Sygehus Univ Hosp, Univ Klin & Poliklin Kinder & Jugendmed, Univ Trieste, Emma Childrens Hosp, IRCCS G Gaslini, Ryhovs Cty Hosp, and Childrens Hosp
Subjects: Male, medicine.medical_specialty, Consensus, Response to therapy, Endpoint Determination, Health Status, International Cooperation, education, Immunology, MEDLINE, Pediatrics, Severity of Illness Index, Systemic therapy, Outcome Assessment (Health Care), Rheumatology, response to therapy, Internal medicine, Outcome Assessment, Health Care, Severity of illness, Health care, medicine, Humans, Lupus Erythematosus, Systemic, Immunology and Allergy, Pharmacology (medical), Pediatric rheumatology, Child, Intensive care medicine, skin and connective tissue diseases, Societies, Medical, Lupus erythematosus, business.industry, juvenile systemic lupus erythematosus, Reproducibility of Results, core set, medicine.disease, Treatment Outcome, consensus, Physical therapy, Female, business, disease activity
Abstract: Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2014-02-26T17:25:12Z No. of bitstreams: 1 WOS000238172900004.pdf: 103404 bytes, checksum: 52ca85593f8181517f9ab1e237d2d561 (MD5) Made available in DSpace on 2014-02-26T17:25:13Z (GMT). No. of bitstreams: 1 WOS000238172900004.pdf: 103404 bytes, checksum: 52ca85593f8181517f9ab1e237d2d561 (MD5) Previous issue date: 2006-06-15 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:20:26Z No. of bitstreams: 1 WOS000238172900004.pdf: 103404 bytes, checksum: 52ca85593f8181517f9ab1e237d2d561 (MD5) Made available in DSpace on 2014-05-20T15:20:26Z (GMT). No. of bitstreams: 1 WOS000238172900004.pdf: 103404 bytes, checksum: 52ca85593f8181517f9ab1e237d2d561 (MD5) Previous issue date: 2006-06-15 Objective. To use the Pediatric Rheumatology International Trials Organization (PRINTO) core set of outcome measures to develop a validated definition of improvement for the evaluation of response to therapy in juvenile systemic lupus erythematosus (SLE).Methods. Thirty-seven experienced pediatric rheumatologists from 27 countries, each of whom had specific experience in the assessment of juvenile SLE patients, achieved consensus on 128 patient profiles as being clinically improved or not improved. Using the physicians' consensus ratings as the gold standard measure, the chi-square, sensitivity, specificity, false-positive and false-negative rates, area under the receiver operating characteristic curve, and kappa level of agreement for 597 candidate definitions of improvement were calculated. Only definitions with a kappa value greater than 0.7 were retained. The top definitions were selected based on the product of the content validity score multiplied by its kappa statistic.Results. The definition of improvement with the highest final score was at least 50% improvement from baseline in any 2 of the 5 core set measures, with no more than 1 of the remaining worsening by more than 30%.Conclusion. PRINTO proposes a valid and reproducible definition of improvement that reflects well the consensus rating of experienced clinicians and that incorporates clinically meaningful change in core set measures in a composite end point for the evaluation of global response to therapy in patients with juvenile SLE. The definition is now proposed for use in juvenile SLE clinical trials and may help physicians to decide whether a child with SLE responded adequately to therapy. Univ Genoa, Pediat Rheumatol Int Trials Org, IRCCS G Gaslini, I-16147 Genoa, Italy Inst Puericultura & Pediat Martagao Gesteira, Rio de Janeiro, Brazil Univ Naples Federico II, Naples, Italy Childrens Univ Hosp, Sofia, Bulgaria Mother & Child Hlth Inst Serbia, Belgrade, Serbia Monteneg Univ Catolica, Cordoba, Argentina Hosp Gen Mexico City, Mexico City, DF, Mexico Aristotle Univ Thessaloniki, Ippokrat Gen Hosp, Thessaloniki, Greece Hosp Dr Exequiel Gonzalez Cortes, Santiago, Chile Clin Pediat 2 de Marchi, Milan, Italy Ist Gaetano Pini, Milan, Italy Karolinska Univ Hosp, Stockholm, Sweden Sanjay Gandhi Inst Med Sci, Lucknow, Uttar Pradesh, India Fac Med 1, Prague, Czech Republic Gen Fac Hosp, Prague, Czech Republic Univ Estadual Paulista, Fac Med Botucatu, Botucatu, SP, Brazil Hanyang Univ, Med Ctr, Hosp Rheumat Dis, Seoul 133791, South Korea Univ Hosp, Kosice, Slovakia Univ Med Ctr, Ljubljana, Slovenia Royal Victoria Infirm, Newcastle Upon Tyne NE1 4LP, Tyne & Wear, England Ctr Nacl Rehabil, Mexico City, DF, Mexico Skejby Sygehus Univ Hosp, Aarhus, Denmark Univ Klin & Poliklin Kinder & Jugendmed, Halle, Germany Univ Trieste, Trieste, Italy Emma Childrens Hosp, AMC, Amsterdam, Netherlands IRCCS G Gaslini, Serv Epidemiol & Biostat, Genoa, Italy Ryhovs Cty Hosp, Jonkoping, Sweden Childrens Hosp, Med Ctr, Cincinnati, OH 45229 USA Univ Estadual Paulista, Fac Med Botucatu, Botucatu, SP, Brazil
Published: 2006
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26. Efficacy and safety of open-label etanercept on extended oligoarticular juvenile idiopathic arthritis, enthesitis-related arthritis and psoriatic arthritis: part 1 (week 12) of the CLIPPER study

Author: Ivan Foeldvari, Richard Mouy, Gordana Susic, Chuanbo Zang, Luciana Breda, Bonnie Vlahos, Jelena Vojinovic, Pavla Dolezalova, Zbigniew Zuber, Ingrida Rumba-Rozenfelde, Gerd Horneff, Ruben Burgos-Vargas, Nicolino Ruperto, Chantal Job-Deslandre, Valda Stanevica, Joseph Wajdula, Deborah A Woodworth, Alberto Martini, Violeta Panaviene, Joke Dehoorne, Katarzyna Kobusińska, Nico M Wulffraat, Tamás Constantin, Daniel F. Alvarez, Vyacheslav Chasnyk, and Wouters, Carine
Subjects: Male, Ankylosing Spondylitis, Arthritis, CHILDREN, DMARDs (biologic), NECROSIS FACTOR, DISEASE-ACTIVITY, Severity of Illness Index, Receptors, Tumor Necrosis Factor, Etanercept, INITIATION, DOUBLE-BLIND, Medicine and Health Sciences, EPIDEMIOLOGY, Immunology and Allergy, skin and connective tissue diseases, Child, METHOTREXATE, Treatment Outcome, Rheumatoid arthritis, Antirheumatic Agents, Child, Preschool, TRIAL, Female, medicine.drug, musculoskeletal diseases, medicine.medical_specialty, Adolescent, Immunology, Placebo, SELECT CATEGORIES, General Biochemistry, Genetics and Molecular Biology, Psoriatic arthritis, Rheumatology, Internal medicine, Spondyloarthritis, medicine, Humans, Juvenile Idiopathic Arthritis, Ankylosing spondylitis, business.industry, Arthritis, Psoriatic, Clinical and Epidemiological Research, medicine.disease, Arthritis, Juvenile, RHEUMATOID-ARTHRITIS, Surgery, Immunoglobulin G, Oligoarticular Juvenile Idiopathic Arthritis, business
Abstract: Objective: To investigate the efficacy and safety of etanercept (ETN) in paediatric subjects with extended oligoarticular juvenile idiopathic arthritis (eoJIA), enthesitis-related arthritis (ERA), or psoriatic arthritis (PsA). Methods: CLIPPER is an ongoing, Phase 3b, open-label, multicentre study; the 12-week (Part 1) data are reported here. Subjects with eoJIA (2-17 years), ERA (12-17 years), or PsA (12-17 years) received ETN 0.8 mg/kg once weekly (maximum 50 mg). Primary endpoint was the percentage of subjects achieving JIA American College of Rheumatology (ACR) 30 criteria at week 12; secondary outcomes included JIA ACR 50/70/90 and inactive disease. Results: 122/127 (96.1%) subjects completed the study (mean age 11.7 years). JIA ACR 30 (95% CI) was achieved by 88.6% (81.6% to 93.6%) of subjects overall; 89.7% (78.8% to 96.1%) with eoJIA, 83.3% (67.2% to 93.6%) with ERA and 93.1% (77.2% to 99.2%) with PsA. For eoJIA, ERA, or PsA categories, the ORs of ETN vs the historical placebo data were 26.2, 15.1 and 40.7, respectively. Overall JIA ACR 50, 70, 90 and inactive disease were achieved by 81.1, 61.5, 29.8 and 12.1%, respectively. Treatment-emergent adverse events (AEs), infections, and serious AEs, were reported in 45 (35.4%), 58 (45.7%), and 4 (3.1%), subjects, respectively. Serious AEs were one case each of abdominal pain, bronchopneumonia, gastroenteritis and pyelocystitis. One subject reported herpes zoster and another varicella. No differences in safety were observed across the JIA categories. Conclusions: ETN treatment for 12 weeks was effective and well tolerated in paediatric subjects with eoJIA, ERA and PsA, with no unexpected safety findings.
Published: 2014

27. Multinational evidence-based recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion of a broad panel of rheumatologists in the 3e initiative

Author: Louise Falzon, Robert Landewé, Mikkel Østergaard, Ophir Vinik, Antonio J. L. Ferrari, Caroline van Durme, Mariano Andrés, Melonie K Sriranganathan, Claire Bombardier, Irene van Echteld, Désirée van der Heijde, Ulf Müller-Ladner, Johannes W. J. Bijlsma, Daniel Aletaha, Dirk Elewaut, Alison S. R. Kydd, Carlomaurizio Montecucco, Anca I. Catrina, Jane Zochling, Mihir D. Wechalekar, Patrick D W Kiely, Burkhard F. Leeb, Loreto Carmona, Jaime Branco, John H Y Moi, Francisca Sivera, Christopher J Edwards, Rachelle Buchbinder, Ruben Burgos-Vargas, and Rakhi Seth
Subjects: Gout, International Cooperation, Alternative medicine, Comorbidity, law.invention, 0302 clinical medicine, Randomized controlled trial, QUALITY-OF-LIFE, law, SERUM URIC-ACID, Medicine and Health Sciences, Immunology and Allergy, 030212 general & internal medicine, Evidence-Based Medicine, RANDOMIZED CONTROLLED-TRIAL, Uricosuric Agents, DOUBLE-BLIND TRIAL, 3. Good health, Systematic review, Acute Disease, Practice Guidelines as Topic, Drug Monitoring, musculoskeletal diseases, RENAL-FUNCTION, medicine.medical_specialty, Evidence-based practice, Immunology, MEDLINE, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Quality of life (healthcare), ANTIHYPERURICEMIC THERAPY, Rheumatology, RISK-FACTOR, medicine, Humans, CORONARY-HEART-DISEASE, MIDDLE-AGED MEN, URATE-LOWERING THERAPY, Life Style, 030203 arthritis & rheumatology, business.industry, Synovial fluid, Evidence-based medicine, Recommendation, medicine.disease, Treatment, Family medicine, Physical therapy, business, Rheumatism, Biomarkers
Abstract: We aimed to develop evidence-based multinational recommendations for the diagnosis and management of gout. Using a formal voting process, a panel of 78 international rheumatologists developed 10 key clinical questions pertinent to the diagnosis and management of gout. Each question was investigated with a systematic literature review. Medline, Embase, Cochrane CENTRAL and abstracts from 2010-2011 European League Against Rheumatism and American College of Rheumatology meetings were searched in each review. Relevant studies were independently reviewed by two individuals for data extraction and synthesis and risk of bias assessment. Using this evidence, rheumatologists from 14 countries (Europe, South America and Australasia) developed national recommendations. After rounds of discussion and voting, multinational recommendations were formulated. Each recommendation was graded according to the level of evidence. Agreement and potential impact on clinical practice were assessed. Combining evidence and clinical expertise, 10 recommendations were produced. One recommendation referred to the diagnosis of gout, two referred to cardiovascular and renal comorbidities, six focused on different aspects of the management of gout (including drug treatment and monitoring), and the last recommendation referred to the management of asymptomatic hyperuricaemia. The level of agreement with the recommendations ranged from 8.1 to 9.2 (mean 8.7) on a 1-10 scale, with 10 representing full agreement. Ten recommendations on the diagnosis and management of gout were established. They are evidence-based and supported by a large panel of rheumatologists from 14 countries, enhancing their utility in clinical practice.
Published: 2014

28. Treating spondyloarthritis, including ankylosing spondylitis and psoriatic arthritis, to target: recommendations of an international task force

Author: Philip S. Helliwell, Josef S Smolen, Oliver FitzGerald, Jürgen Braun, Martinus de Wit, Christopher T. Ritchlin, Thomas A. Luger, Dirk Elewaut, Xenofon Baraliakos, Laure Gossec, Ignazio Olivieri, Maxime Dougados, James Cheng-Chung Wei, Martin Rudwaleit, Eduardo Collantes-Estevez, Kurt Redlich, Tore K Kvien, Atul Deodhar, Philip J. Mease, Kevin L. Winthrop, Monika Schoels, Désirée van der Heijde, Neil Betteridge, Arthur Kavanaugh, Joachim Sieper, Paul Emery, Ruben Burgos-Vargas, Robert Landewé, John D. Reveille, Mara Maccarone, Filip Van den Bosch, and Merryn Jongkees
Subjects: medicine.medical_specialty, Immunology, Placebo-controlled study, PLACEBO-CONTROLLED TRIAL, General Biochemistry, Genetics and Molecular Biology, law.invention, Psoriatic arthritis, Randomized controlled trial, Rheumatology, law, Spondylarthritis, ankylosing spondylitis, medicine, Medicine and Health Sciences, Immunology and Allergy, Humans, Spondylitis, Ankylosing, ACTIVE INFLAMMATORY LESIONS, DISEASE-ACTIVITY INDEX, psoriatic arthritis, Ankylosing spondylitis, therapy, business.industry, Arthritis, Psoriatic, Evidence-based medicine, NONSTEROIDAL ANTIINFLAMMATORY DRUGS, RANDOMIZED CONTROLLED-TRIAL, WHOLE-BODY MRI, EARLY AXIAL SPONDYLOARTHRITIS, Recommendation, spondyloarthritis, medicine.disease, Comorbidity, RHEUMATOID-ARTHRITIS, Systematic review, Rheumatoid arthritis, Antirheumatic Agents, Physical therapy, SOCIETY CLASSIFICATION CRITERIA, ACTIVITY SCORE ASDAS, business, Treat-to-target
Abstract: Background Therapeutic targets have been defined for diseases like diabetes, hypertension or rheumatoid arthritis and adhering to them has improved outcomes. Such targets are just emerging for spondyloarthritis (SpA). Objective To define the treatment target for SpA including ankylosing spondylitis and psoriatic arthritis (PsA) and develop recommendations for achieving the target, including a treat-to-target management strategy. Methods Based on results of a systematic literature review and expert opinion, a task force of expert physicians and patients developed recommendations which were broadly discussed and voted upon in a Delphi-like process. Level of evidence, grade and strength of the recommendations were derived by respective means. The commonalities between axial SpA, peripheral SpA and PsA were discussed in detail. Results Although the literature review did not reveal trials comparing a treat-to-target approach with another or no strategy, it provided indirect evidence regarding an optimised approach to therapy that facilitated the development of recommendations. The group agreed on 5 overarching principles and 11 recommendations; 9 of these recommendations related commonly to the whole spectrum of SpA and PsA, and only 2 were designed separately for axial SpA, peripheral SpA and PsA. The main treatment target, which should be based on a shared decision with the patient, was defined as remission, with the alternative target of low disease activity. Follow-up examinations at regular intervals that depend on the patient9s status should safeguard the evolution of disease activity towards the targeted goal. Additional recommendations relate to extra-articular and extramusculoskeletal aspects and other important factors, such as comorbidity. While the level of evidence was generally quite low, the mean strength of recommendation was 9–10 (10: maximum agreement) for all recommendations. A research agenda was formulated. Conclusions The task force defined the treatment target as remission or, alternatively, low disease activity, being aware that the evidence base is not strong and needs to be expanded by future research. These recommendations can inform the various stakeholders about expert opinion that aims for reaching optimal outcomes of SpA.
Published: 2014

29. Randomized trial of tocilizumab in systemic juvenile idiopathic arthritis

Author: Pavla Dolezalova, Rosa Merino, Stella Garay, Alexei A. Grom, Zbigniew Zuber, Lawrence S. Zemel, Stephen C. Wright, Ruben Burgos-Vargas, Ruben Cuttica, Nicolino Ruperto, Rik Joos, Hermine I. Brunner, Carine Wouters, Inmaculada Calvo, Eileen Baildam, Andrew Kenwright, Angelo Ravelli, Fabrizio De Benedetti, Daniel J. Lovell, Rayfel Schneider, Francesco Zulian, Ricardo Machado Xavier, Patricia Woo, Alberto Martini, and Nico M Wulffraat
Subjects: musculoskeletal diseases, Male, medicine.medical_specialty, Neutropenia, Adolescent, Anti-Inflammatory Agents, Arthritis, Juvenile, Placebo, Infections, Antibodies, Etanercept, law.invention, chemistry.chemical_compound, Tocilizumab, Randomized controlled trial, Double-Blind Method, Drug Therapy, law, Internal medicine, Monoclonal, Receptors, medicine, Clinical endpoint, Humans, skin and connective tissue diseases, Child, Preschool, Humanized, Glucocorticoids, Transaminases, Anti-Inflammatory Agents, Non-Steroidal, Antibodies, Monoclonal, Humanized, Arthritis, Juvenile, Child, Preschool, Drug Therapy, Combination, Female, Methotrexate, Receptors, Interleukin-6, business.industry, Interleukin-6, General Medicine, medicine.disease, Rheumatology, chemistry, Rheumatoid arthritis, Combination, Physical therapy, business, Non-Steroidal, medicine.drug
Abstract: Background Systemic juvenile idiopathic arthritis (JIA) is the most severe subtype of JIA; treatment options are limited. Interleukin-6 plays a pathogenic role in systemic JIA. Methods We randomly assigned 112 children, 2 to 17 years of age, with active systemic JIA (duration of ≥6 months and inadequate responses to nonsteroidal antiinflammatory drugs and glucocorticoids) to the anti–interleukin-6 receptor antibody tocilizumab (at a dose of 8 mg per kilogram of body weight if the weight was ≥30 kg or 12 mg per kilogram if the weight was
Published: 2012

30. Long-term outcome and prognostic factors of juvenile dermatomyositis: a multinational, multicenter study of 490 patients

Author: C Ferrari, Ruben Burgos-Vargas, Loredana Lepore, Virgínia Paes Leme Ferriani, Francesco Zulian, Elena Marzia Sala, Silvia Magni-Manzoni, MG Alpigiani, Angelo Ravelli, Nicolino Ruperto, Federica Rossi, Flavio Sztajnbok, Rosanna Podda, MM Katsicas, Ricardo Russo, Eunice Solis-Valleoj, Angela Pistorio, Valeria Gerloni, Elisabetta Cortis, S Maillard, Maria Alessio, Lucia Trail, Sheila Knupp Feitosa de Oliveira, Fabrizia Corona, Enrico Felici, Marcia Bandeira, Fernanda Falcini, Alberto Martini, Ruben Cuttica, Vicente Baca, Clovis A. Silva, Claudia Saad-Magalhães, Clarissa Pilkington, Matilde Beltramelli, Ist Ricovero & Cura Carattere Sci G Gaslini, Univ Genoa, Great Ormond St Hosp Sick Children, UCL, Universidade Federal do Rio de Janeiro (UFRJ), Universidade do Estado do Rio de Janeiro (UERJ), Hosp Gen Ninos Pedro de Elizalde, Fdn IRCCS Policlin, Hosp Pediat Juan P Garrahan, Universidade de São Paulo (USP), Hosp Gen Mexico City, Fdn Ist Ricovero & Cura Carattere Sci Policlin S, Ctr Med Natl La Raza, Hosp Pequeno Principe, Clin Pediat 1, Ctr Med Nacl Siglo XXI, Osped Pediat Bambino Gesu, Osped Villa Monna Tessa, Univ Naples Federico 2, Ist Ortoped Gaetano Pini, Universidade Estadual Paulista (Unesp), II Clin Pediat, Ist Ricovero & Cura Carattere Sci Burlo Garofalo, Ravelli, A, Trail, L, Ferrari, C, Ruperto, N, Pistorio, A, Pilkington, C, Maillard, S, Oliveira, Sk, Sztajnbok, F, Cuttica, R, Beltramelli, M, Corona, F, Katsicas, Mm, Russo, R, Ferriani, V, Burgos Vargas, R, Magni Manzoni, S, Solis Valleoj, E, Bandeira, M, Zulian, F, Baca, V, Cortis, E, Falcini, F, Alessio, Maria, Alpigiani, Mg, Gerloni, V, Saad Magalhaes, C, Podda, R, Silva, Ca, Lepore, L, Felici, E, Rossi, F, Sala, E, and Martini, A.
Subjects: Male, medicine.medical_specialty, Internationality, Time Factors, Adolescent, Child, Child, Preschool, Cross-Sectional Studies, Dermatomyositis, Female, Humans, Infant, Prognosis, Retrospective Studies, Treatment Outcome, Cross-sectional study, Rheumatology, Quality of life, Internal medicine, Medicine, Functional ability, Preschool, Juvenile dermatomyositis, business.industry, Mortality rate, Retrospective cohort study, medicine.disease, Surgery, Lipodystrophy, business
Abstract: Made available in DSpace on 2013-08-12T19:10:16Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-01-15 Made available in DSpace on 2013-09-30T19:20:41Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-01-15 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:33:16Z No. of bitstreams: 0 Made available in DSpace on 2014-05-20T15:33:16Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-01-15 Myositis Association European Union Objective. To investigate the long-term outcome and prognostic factors of juvenile dermatomyositis (DM) through a multinational, multicenter study.Methods. Patients consisted of inception cohorts seen between 1980 and 2004 in 27 centers in Europe and Latin America. Predictor variables were sex, continent, ethnicity, onset year, onset age, onset type, onset manifestations, course type, disease duration, and active disease duration. Outcomes were muscle strength/endurance, continued disease activity, cumulative damage, muscle damage, cutaneous damage, calcinosis, lipodystrophy, physical function, and health-related quality of life (HRQOL).Results. A total of 490 patients with a mean disease duration of 7.7 years were included. At the cross-sectional visit, 41.2-52.8% of patients, depending on the instrument used, had reduced muscle strength/endurance, but less than 10% had severe impairment. Persistently active disease was recorded in 41.2-60.5% of the patients, depending on the activity measure used. Sixty-nine percent of the patients had cumulative damage. The frequency of calcinosis and lipodystrophy was 23.6% and 9.7%, respectively. A total of 40.7% of the patients had decreased functional ability, but only 6.5% had major impairment. Only a small fraction had decreased HRQOL. A chronic course, either polycyclic or continuous, consistently predicted a poorer outcome. Mortality rate was 3.1%.Conclusion. This study confirms the marked improvement in functional outcome of juvenile DM when compared with earlier literature. However, many patients had continued disease activity and cumulative damage at followup. A chronic course was the strongest predictor of poor prognosis. These findings highlight the need for treatment strategies that enable a better control of disease activity over time and the reduction of nonreversible damage. Ist Ricovero & Cura Carattere Sci G Gaslini, Genoa, Italy Univ Genoa, Genoa, Italy Great Ormond St Hosp Sick Children, London WC1N 3JH, England UCL, Inst Child Hlth, London, England Univ Fed Rio de Janeiro, Rio de Janeiro, Brazil Universidade do Estado do Rio de Janeiro (UERJ), BR-20550011 Rio de Janeiro, Brazil Hosp Gen Ninos Pedro de Elizalde, Buenos Aires, DF, Argentina Fdn IRCCS Policlin, Milan, Italy Hosp Pediat Juan P Garrahan, Buenos Aires, DF, Argentina Univ São Paulo, Fac Med Ribeirao Preto, Hosp Clin, Ribeirao Preto, Brazil Hosp Gen Mexico City, Mexico City, DF, Mexico Fdn Ist Ricovero & Cura Carattere Sci Policlin S, Pavia, Italy Ctr Med Natl La Raza, Mexico City, DF, Mexico Hosp Pequeno Principe, Curitiba, Parana, Brazil Clin Pediat 1, Padua, Italy Ctr Med Nacl Siglo XXI, Mexico City, DF, Mexico Osped Pediat Bambino Gesu, Rome, Italy Osped Villa Monna Tessa, Florence, Italy Univ Naples Federico 2, Naples, Italy Ist Ortoped Gaetano Pini, Milan, Italy Univ estadual Paulista, Botucatu, SP, Brazil II Clin Pediat, Cagliari, Italy Univ São Paulo, São Paulo, Brazil Ist Ricovero & Cura Carattere Sci Burlo Garofalo, Trieste, Italy Univ estadual Paulista, Botucatu, SP, Brazil EU: AML/B7-311/970666/II-0246-FI
Published: 2010

31. Responsiveness of different sets of criteria for clinical response evaluation in a non-selected cohort of juvenile idiopathic arthritis (JIA) patients

Author: Ruben Burgos-Vargas and R Gutiérrez-Suárez
Subjects: musculoskeletal diseases, medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, genetic structures, business.industry, lcsh:RJ1-570, Arthritis, lcsh:Pediatrics, medicine.disease, Rheumatology, immune system diseases, Family medicine, Poster Presentation, Pediatrics, Perinatology and Child Health, Cohort, medicine, Physical therapy, Immunology and Allergy, Pediatrics, Perinatology, and Child Health, lcsh:RC925-935, Meeting Abstracts, business, skin and connective tissue diseases, Paediatric rheumatology
Abstract: 15th Paediatric Rheumatology European Society (PreS) Congress Wietse Kuis, Patricia Woo, Angelo Ravelli, Hermann Girschick, Michael Hofer, Johannes Roth, Rotraud K Saurenmann, Alberto Martini, Pavla Dolezova, Janjaap van der Net, Pierre Quartier, Lucy Wedderburn and Jan Scott Meeting abstracts – A single PDF containing all abstracts in this Supplement is available here .
Published: 2008

32. International spondyloarthritis interobserver reliability exercise--the INSPIRE study: I. Assessment of spinal measures

Author: Dafna D, Gladman, Robert D, Inman, Richard J, Cook, Desirée, van der Heijde, Robert B M, Landewé, Jurgen, Braun, John C, Davis, Philip, Mease, Joachim, Brandt, Ruben Burgos, Vargas, Vinod, Chandran, Philip, Helliwell, Arthur, Kavanaugh, Finbar D, O'Shea, Muhammad A, Khan, Nicolo, Pipitone, Proton, Rahman, John D, Reveille, Millicent A, Stone, William, Taylor, Douglas J, Veale, Walter P, Maksymowych, and Other departments
Subjects: Adult, Male, Observer Variation, Arthritis, Psoriatic, Spondylarthritis, Humans, Reproducibility of Results, Female, Spondylitis, Ankylosing, Middle Aged, Range of Motion, Articular, Severity of Illness Index, Spine
Abstract: To determine whether the axial measures used in primary ankylosing spondylitis (AS) were reproducible for both AS and psoriatic arthritis (PsA) with axial disease. A group of 20 rheumatologists from 11 countries with expertise in spondyloarthritis (SpA) met for a combined physical examination exercise to assess 10 patients with PsA with axial involvement (9 men, 1 woman, mean age 52 yrs, mean disease duration 17 yrs) and 9 AS patients (7 men, 2 women, mean age 38 yrs, mean disease duration 16 yrs). A modified Latin-square design was used. Measures included were occiput to wall, tragus to wall, cervical rotation, chest expansion, lateral spinal bending, modified Schober, and hip mobility. Data were analyzed using intraclass correlation coefficients (ICC) adjusted for order of measurements. The majority of the variance was contributed by the patients. There was no order effect. Observer effect was noted especially for chest expansion for both AS and PsA patients, and for the modified Schober in PsA. The ICC demonstrated very good to excellent agreement for most measures for both AS and PsA. Chest expansion provided only moderate agreement for AS and PsA. Overall, measures of spinal mobility used in primary AS perform well with respect to interobserver reliability, and are equally reproducible when applied to PsA patients with axial involvement. Thus, these measures should now be evaluated in therapeutic trials of patients with PsA to determine sensitivity to change and concordance with other measures of structural damage
Published: 2007

33. The Pediatric Rheumatology International Trials Organization/American College of Rheumatology provisional criteria for the evaluation of response to therapy in juvenile systemic lupus erythematosus: prospective validation of the definition of improvement

Author: Nicolino Ruperto, Angelo Ravelli, Sheila Oliveira, ALESSIO, MARIA, Dimitrina Mihaylova, Srdjan Pasic, Elisabetta Cortis, Maria Apaz, Ruben Burgos Vargas, Florence Kanakoudi Tsakalidou, Ximena Norambuena, Fabrizia Corona, Valeria Gerloni, Stefan Hagelberg, Amita Aggarwal, Pavla Dolezalova, Claudia Magalhaes Saad, Sang Cheol Bae, Richard Vesely, Tadej Avcin, Helen Foster, Carolina Duarte, Troels Herlin, Gerd Horneff, Loredana Lepore, Marion van Rossum, Lucia Trail, Angela Pistorio, Boel Andersson Gäre, Edward H. Giannini, Alberto Martini, Pediatric Rheumatology International, Nicolino, Ruperto, Angelo, Ravelli, Sheila, Oliveira, Alessio, Maria, Dimitrina, Mihaylova, Srdjan, Pasic, Elisabetta, Corti, Maria, Apaz, Ruben Burgos, Varga, Florence Kanakoudi, Tsakalidou, Ximena, Norambuena, Fabrizia, Corona, Valeria, Gerloni, Stefan, Hagelberg, Amita, Aggarwal, Pavla, Dolezalova, Claudia Magalhaes, Saad, Sang Cheol, Bae, Richard, Vesely, Tadej, Avcin, Helen, Foster, Carolina, Duarte, Troels, Herlin, Gerd, Horneff, Loredana, Lepore, Marion van, Rossum, Lucia, Trail, Angela, Pistorio, Boel Andersson, Gäre, Edward H., Giannini, Alberto, Martini, and Pediatric Rheumatology, International
Published: 2006

34. Relation between adverse events associated with allopurinol and renal function in patients with gout

Author: César Pacheco-Tena, Janitzia Vázquez-Mellado, Ruben Burgos-Vargas, and E Meoño Morales
Subjects: musculoskeletal diseases, Adult, Male, medicine.medical_specialty, congenital, hereditary, and neonatal diseases and abnormalities, Concise Report, Gout, Allopurinol, Immunology, Allopurinol hypersensitivity syndrome, Renal function, Kidney, Kidney Function Tests, Gastroenterology, General Biochemistry, Genetics and Molecular Biology, Gout Suppressants, Drug Hypersensitivity, chemistry.chemical_compound, Rheumatology, Internal medicine, medicine, Immunology and Allergy, Humans, Hyperuricemia, Adverse effect, Aged, Retrospective Studies, Creatinine, business.industry, nutritional and metabolic diseases, Middle Aged, medicine.disease, Surgery, chemistry, Uric acid, Female, Drug Eruptions, business, medicine.drug
Abstract: BACKGROUND—Because serious adverse reactions to allopurinol have been related to a reduce creatinine clearance rate and prolonged half life of oxypurinol, it has been recommended that the dose should be adjusted according to the rate of creatinine clearance. However, in some patients with gout the dose is not sufficient to reduce serum levels of uric acid (⩽390 µmol/l) and to halt disease progression. OBJECTIVE—To determine the prevalence of adverse reactions attributable to allopurinol in patients with primary gout according to dose and creatinine clearance rate. METHODS—Data on 120 patients with gout receiving allopurinol, in whom the starting dose was adjusted according to creatinine clearance rate and later increased in some patients to control the disease, were retrospectively reviewed. Two groups were compared: group A, 52 patients receiving creatinine clearance adjusted maintenance doses of allopurinol and group B, 68 patients receiving non-adjusted higher maintenance doses of allopurinol. RESULTS—During follow up 57% required higher allopurinol doses than those recommended according to their creatinine clearance rate. Only five (4%) of 120 consecutive patients developed allopurinol related adverse reactions: four minor skin reactions and one allopurinol hypersensitivity syndrome (AHS). Three of these (including the case of AHS) occurred in group A and two in group B (p=NS). The duration of allopurinol treatment was the same in both groups (group A: 2.3 (3.3) years; group B: 3.7 (4.8) years). No patient in group A, but 44% in group B had a creatinine clearance rate of
Published: 2001

35. Anti–tumor necrosis factor α blockade in the treatment of juvenile spondylarthropathy.

Author: Shirley M. L. Tse, Ruben Burgos‐Vargas, and Ronald M. Laxer
Subjects: *JUVENILE idiopathic arthritis, *TREATMENT of arthritis, *SYNOVITIS, *NONSTEROIDAL anti-inflammatory agents, *ANTINEOPLASTIC agents, *IMMUNOSUPPRESSIVE agents, *DIPHOSPHONATES, *ADRENOCORTICAL hormones
Abstract: Persistent inflammation refractory to standard antirheumatic therapy in children with juvenile spondylarthropathy (SpA) leads to morbidity and reduced quality of life. Tumor necrosis factor α (TNFα) plays an important role in the pathogenesis of synovitis and enthesitis. This study was undertaken to examine the impact of anti‐TNFα agents on juvenile SpA that is refractory to nonsteroidal antiinflammatory drugs (NSAIDs), disease‐modifying antirheumatic drugs, and corticosteroids.Ten juvenile SpA patients with a mean ± SEM age of 15.0 ± 0.7 years and disease duration of 4.4 ± 0.8 years, all of whom were HLA–B27 positive, were followed up for 1 year after initiation of either infliximab (n = 8) or etanercept (n = 2). Outcomes examined were within‐subject differences in the tender entheseal count (TEC) and active joint count (AJC), markers of inflammation, functional assessments (Childhood Health Assessment Questionnaire [C‐HAQ] score), and requirements for antirheumatic drugs.At baseline, all patients exhibited active arthritis and enthesitis that were resistant to NSAIDs (n = 10), methotrexate (n = 6), sulfasalazine (n = 8), corticosteroids (oral n = 6, intravenous pulse n = 3, and intraarticular n = 6), and bisphosphonates (n = 2). In 2 patients, sulfasalazine (n = 2), corticosteroids (n = 1), and bisphosphonates (n = 1) were stopped after initiation of the anti‐TNFα agent. In all patients, the arthritis and enthesitis significantly improved as evidenced by remission of the TEC and AJC by 6 months that was sustained during the 1‐year followup, markers of inflammation and C‐HAQ scores normalized, and there was a reduction in requirements for antirheumatic drugs (reduced dosage or discontinuation of NSAIDs n = 10, methotrexate n = 5, sulfasalazine n = 6, corticosteroids n = 4, and bisphosphonates n = 1).Anti‐TNFα therapy is a potential novel treatment for refractory juvenile SpA. Further prospective studies are required to examine the effectiveness and long‐term outcomes of anti‐TNFα therapy in this cohort. [ABSTRACT FROM AUTHOR]
Published: 2005
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36. A randomized trial of parenteral methotrexate comparing an intermediate dose with a higher dose in children with juvenile idiopathic arthritis who failed to respond to standard doses of methotrexate.

Author: Nicolino Ruperto, Kevin J. Murray, Valeria Gerloni, Nico Wulffraat, Sheila Knupp Feitosa De Oliveira, Fernanda Falcini, Pavla Dolezalova, Maria Alessio, Ruben Burgos‐Vargas, Fabrizia Corona, Richard Vesely, Helen Foster, Joyce Davidson, Francesco Zulian, Line Asplin, Eileen Baildam, Julia Garcia Consuegra, Huri Ozdogan, Rotraud Saurenmann, and Rik Joos
Subjects: PEDIATRIC rheumatology, RESPONSE rates, METHOTREXATE, ARTHRITIS patients, IMMUNOSUPPRESSIVE agents
Abstract: To compare the safety and efficacy of parenteral methotrexate (MTX) at an intermediate dosage (15 mg/m2/week) versus a higher dosage (30 mg/m2/week) in patients with polyarticular‐course juvenile idiopathic arthritis (JIA) who failed to improve while receiving standard dosages of MTX (8–12.5 mg/m2/week). In the screening phase, 595 patients who were newly started on a standard dose of MTX were followed up for 6 months. Subsequently, the nonresponders, defined according to the American College of Rheumatology (ACR) pediatric 30% improvement criteria (pediatric 30), were randomized to receive an intermediate dose or higher dose of parenteral MTX for an additional 6 months. Improvement in the screening and randomization phase was defined by the ACR pediatric 30 response, as well as by the 50% and 70% response levels (ACR pediatric 50 and ACR pediatric 70, respectively). In the screening phase, after receiving standard doses of MTX, 430 patients (72%) improved according to the ACR pediatric 30, while 360 (61%) met the ACR pediatric 50 and 225 (38%) met the ACR pediatric 70; among these patients, 69 (12%) also met the definition of complete disease control. Of the 133 nonresponders, 80 were randomized to receive an intermediate dose or higher dose of MTX. In the randomization phase, the ACR pediatric 30 response rate was 25 of 40 children (62.5%) in the intermediate‐dose group versus 23 of 40 children (57.5%) in the higher‐dose group. An ACR pediatric 50 response rate was attained by 23 patients (57.5%) receiving an intermediate dose versus 22 (55%) in the higher‐dose group. An ACR pediatric 70 response rate was seen in 18 children (45%) receiving an intermediate dose versus 19 (47.5%) receiving a higher dose. Five children (12.5%) in the intermediate‐dose group versus 4 (10%) receiving the higher dose of MTX also met the definition of complete disease control. None of the intergroup differences in response rate were significant. There were no significant differences in the frequency of adverse events or laboratory abnormalities between the 2 randomized groups. This study shows that the plateau of efficacy of MTX in JIA is reached with parenteral administration of 15 mg/m2/week and that a further increase in dosage is not associated with any additional therapeutic benefit. MTX should be administered for up to 9–12 months to appreciate its full therapeutic effect. [ABSTRACT FROM AUTHOR]
Published: 2004

37. Rheumatoid arthritis in Latin America. Important challenges to be solved

Author: Mario H. Cardiel and Ruben Burgos Vargas
Subjects: medicine.medical_specialty, Referral, Population, Disease, Arthritis, Rheumatoid, Quality of life (healthcare), Patient Education as Topic, Rheumatology, Education, Professional, Health care, medicine, Humans, education, Reimbursement, education.field_of_study, business.industry, Health Care Costs, General Medicine, Editorial, Latin America, Antirheumatic Agents, Family medicine, Physical therapy, Health education, business, Patient education
Abstract: Since the introduction of biologic agents for the treatment of patients with rheumatoid arthritis (RA), there have been enormous advances in clinical and therapeutic aspects of the disease. Likewise, there is now much more information on the role of genetics and environmental factors in the pathogenesis of the disease. Throughout the years, the main therapeutic target is the control of disease activity as soon as possible to prevent structural damage and functional consequences. RA is a diagnosis that is not easily recognized at early phases. Lay people associate rheumatic diseases with old age, minor physical trauma, weather, dietetic conditions, or emotional issues. It is not a surprise that many patients seek medical care at late stages, when irreversible damage has already occurred. Sustained remission or low-disease activity levels without joint space loss and erosions have become the main objective of current therapies. Health-related quality of life (HRQoL) improves and long-term socioeconomic consequences decreases. Primary care physicians are usually the first medical contact. These clinicians should have special tools for early diagnosis, proper referral, and initial treatment in all patients with a clinical suspicion of RA. This is not the case in many countries where rheumatology training in undergraduate programs is not fully implemented. Rheumatology societies in Latin America should have a more active participation in medical education in undergraduate programs including practical activities. This will be probably an important investment to diminish the burden of illness that RA causes to the society [1]. Another challenge that many countries face is having an insufficient number of rheumatologists. As expected, rheumatologists usually have busy clinical activities. The time devoted to individual care is not enough to establish an adequate relationship, consultations are not usually as frequent as they should be, medical resources are not always what medical guidelines suggest, and patients tend to receive a suboptimal medical care. This should motivate rheumatology organizations to identify intelligent and practical alternatives to improve medical care despite a shortage of rheumatologists. Education, innovation, and coordination seem to be the key activities to be done. Once a clinical diagnosis has been made, clinicians should be aware that low educational level in RA patients in Latin America has been associated with higher disease activity, more radiologic progression, and poor clinical outcomes. This is probably related to late diagnosis and some practical and therapeutic variables [2]. All patients and particularly those with a low educational level require special health education programs. Patient education in rheumatoid arthritis is an urgent need to discuss what is expected of medical and nonmedical treatments and the importance of patient and family participation and improve patient-doctor communication skills. Adherence to medical treatment in chronic diseases remains a very important problem in the world. It is recognized that poor adherence is associated with worse clinical and radiological outcomes [3]. Costs of medication impose an important economic burden to patients and their families [4]. Comorbidity in rheumatoid arthritis increases complexity to medical care. In many cases, rheumatologists are the team coordinators and should be prepared to offer proper management. There is a need to implement therapeutic strategies that include a more comprehensive medical care. It is now 20 years since the first report on the efficacy of a monoclonal antibody—infliximab—to tumor necrosis factor alpha (TNF-α) in patients with RA [5]. Compared to placebo, the effect of the TNF-α blocker was impressive and authors concluded that such “results provide the first good evidence that specific cytokine blockade can be effective in human inflammatory disease and define a new direction for the treatment of rheumatoid arthritis.” That new direction has benefited thousands of patients all over the world through the implementation of programs for early recognition of the disease, redefinition of classification criteria, improved designs of protocols for the study of the efficacy and safety of biologics and DMARDs, continuous increase in the number of agents—many directed to new targets, the instauration of biologic registries, and post-marketing surveillance. It is clear that the implementation and maintenance of such programs require a considerable budget to cover the cost of the infrastructure needed to accomplish their goals and the cost of biologics itself. While most European countries relay in the percentage of their gross domestic product (GDP) devoted to health care to comply with those programs, in other parts of the world, including Latin America, the cost is partially covered by a variety of entities, including patients’ and households’ own pocket money. Similar or even worst situations occur in Africa and Asia resulting in a tremendous gap between developed and underdeveloped countries regarding the identification of RA and its current treatment. In this sense, the implementation of programs for early detection and treatment of RA might be less successful than in developed countries. Health care in Latin America is typically fragmentary [6]. In some countries, the state provides health care for the whole population while in others, individuals pay for their medical expenses. Reimbursement is very limited and is only available in some countries. Access programs are available in some countries where the government usually provides the drug. In this sense, it is not convenient to make any generalization of the characteristics of health care in Latin America. Barriers to implement early recognition of RA and treat them early on the course of the disease related to the healthcare system in Latin America include several aspects. The nation’s GDP budget for health care had a sustainable increase in several Latin American nations. The mean percentage of Argentina, Brazil, Chile, Colombia, Mexico, and Venezuela increased from 7.9 % in 2009 to an estimated 8.1 % in 2017 [7]. The way each country handles their annual budget is unknown. In general, most of the budget goes to pediatric diseases, chronic degenerative conditions, and metabolic diseases reducing the individual life expectancy. The situation here is that the percentage of such budget devoted to rheumatic diseases is probably very small and insufficient to run any health program at the national level. As a group, rheumatic diseases are not considered of clinical, socioeconomic, and cost relevance for the state. It is therefore neither as a group nor individually deserve the attention of health authorities whom apparently consider that rheumatic diseases are not a health problem. The role of the state—represented by healthcare system—in implementing early arthritis clinics is limited. The cost of such a program includes some infrastructure, human resources, and effective treatment. The prevalence of RA in Latin America ranges between 0.4 and 1.6 % [8–10]. At least in the Mexican population, there are variations in the prevalence of RA related to geographic regions that might be explained by the low educational and socioeconomic level represented by people who only speak a native language. In contrast to what health authorities consider, epidemiological data supports the idea that RA is not a rare disease and that late diagnosis is associated to bad prognosis. It is possible that at the institutional level, the facilities to carry on an additional clinic, specifically an early arthritis clinic and human resources, would be impossible. Most clinics, physicians, and nurses are overwhelmed by daily consultations. Despite the fact that needs would depend on the success of the program, some challenging situations must be solved. The infrastructure requires the space needed to take care of patients with early disease. Space limitations may account for inadequate care and communication between the patient and the physician. There should be access to laboratory examinations, imaging studies, infusion rooms, and refrigeration systems. Human resources include physicians—from general practitioners to rheumatologists, nurses, joint counters, and some administrative people. They should be paid for their services and should be continuously trained. The design of protocols according to the procedures to be performed should be clear and well justified. Similarly, the clinic should have the capacity to provide the patient with the medication he needs. Despite its popularity, recommendations for treating patients with RA according to international standards, including the American College of Rheumatology/European League Against Rheumatism recommendations [11] and the Treat to Target initiative [12], its implementation in clinical practice might be difficult in the presence of some of the barriers mentioned before. Early recognition and proper assessment of the clinical status of the patient does not mean that medications would be available for everyone. In summary, recognition and therapeutic advances in RA have evolved very rapidly in the last 20 years. Unfortunately, alongside with these advances, a gap between fragmented and socialized healthcare services is becoming wide. And that seems to be the case for some Latin American countries. We have identified the most important challenges that patients, doctors, and medical systems face to improve the medical care of one of the most important rheumatic diseases. RA will remain a health problem despite medical advances if we do not effectively act on these challenges to modify the outcome in most RA patients in Latin America.
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38. Differences in therapeutic approach to juvenile dermatomyositis between Europe and Latin America

Author: Achille Stabile, E Solis-Vallejo, Ruben Burgos-Vargas, C Bruno, R Russo, V Ferriani, M Beltramelli, Antonella Meini, Rosanna Podda, R. Cimaz, Romina Gallizzi, V Baca, S Maillard, C Ferrari, Marcia Bandeira, Elisabetta Cortis, Franco Garofalo, Luciana Breda, Clarissa Pilkington, MM Katsicas, C. A. A. Silva, Sara Marchesan Oliveira, A Martini, Ruben Cuttica, Roberto Barcellona, Lucia Trail, A Ravelli, and Claudia Saad-Magalhães
Subjects: medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, Latin Americans, business.industry, lcsh:RJ1-570, lcsh:Pediatrics, Dermatomyositis, Muscle damage, medicine.disease, Dermatology, Rheumatology, Therapeutic approach, Internal medicine, Poster Presentation, Pediatrics, Perinatology and Child Health, Medicine, Immunology and Allergy, Pediatrics, Perinatology, and Child Health, lcsh:RC925-935, business, Juvenile dermatomyositis
Abstract: ss Open Acce Poster presentation Differences in therapeutic approach to juvenile dermatomyositis between Europe and Latin America L Trail*1, C Ferrari1, R Cuttica2, MM Katsicas3, R Russo3, M Bandeira4, V Ferriani5, S Oliveira6, C Saad-Magalhaes7, CA Silva8, V Baca9, R BurgosVargas10, E Solis-Vallejo11, S Maillard12, C Pilkington12, R Barcellona1, M Beltramelli1, L Breda1, C Bruno1, R Cimaz1, E Cortis1, R Gallizzi1, F Garofalo1, A Meini1, R Podda1, A Stabile1, A Martini1 and A Ravelli1
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39. The 30-kDa band from Salmonella typhimurium: IgM, IgA and IgG antibody response in patients with ankylosing spondylitis.

Author: Jose F. Zambrano-Zaragoza, Ma de Jesus Durán-Avelar, Angelica N. Rodríguez-Ocampo, Ethel García-Latorre, Ruben Burgos-Vargas, Maria-L. Dominguez-Lopez, Salvador Pena-Virgen, and Norberto Vibanco-Pérez
Subjects: SALMONELLA typhimurium, IMMUNOGLOBULIN M, IMMUNOGLOBULIN A, IMMUNOGLOBULIN G, ANKYLOSING spondylitis, BACTERIAL proteins, PROTEIN fractionation, ENZYME-linked immunosorbent assay, PATIENTS
Abstract: Objective. To determine the association of Salmonella typhimurium antigens with AS by analysing the IgA, IgG and IgM antibody response to the crude lysate and the 30-kDa band from this micro-organism. Methods. Sera from 28 AS patients, 28 HLA-B27+ healthy relatives, 28 unrelated healthy subjects and 14 RA patients were included. Salmonella typhimurium proteins were electrophoretically separated and blotted onto nitrocellulose sheets for immunodetection with sera from AS patients and unrelated healthy subjects. The electroeluted 30-kDa band (p30) and a crude lysat (StCL) from S. typhimurium were used as antigen to evaluate the IgM, IgA and IgG (total and subclasses) antibody levels by ELISA. An inhibition assay was carried out to confirm the specificity of IgG response to the p30. Results. Twenty out of 28 AS patients (71.4%) and 4 out of 28 unrelated healthy subjects (14.3%) recognized a 30-kDa band from S. typhimurium with IgG antibodies. Six out of 28 AS patients (21.4%) and 4 out of 28 unrelated healthy subjects (14.3%) detected it with IgA antibodies. Recognition of p30 and StCL by both IgA and IgG antibodies was higher in AS patients than in control groups (P = 0.003, Conclusions. Data presented suggest the association between the p30 and AS. [ABSTRACT FROM AUTHOR]
Published: 2009
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40. EXPRESSION OF IL4, IFN-GAMMA AND CD69 IN T LYMPHOCYTES OF PATIENTS WITH SPONDYLOARTHROPATHIES.

Author: Iván, Girón-Pérez, Yolanda, Ortega-Ortega, Ruben, Burgos-Vargas, Ethel, García-Latorre, and Lilia, Domínguez-López
Subjects: *SPONDYLOARTHROPATHIES, *FLOW cytometry, *LYMPHOCYTES, *STAINS & staining (Microscopy), *CYTOKINES, *T cells, *SYNOVIAL fluid
Abstract: The spondyloarthropathies (SpA) are a group of rheumatic diseases that include ankylosing spondylitis, reactive arthritis, psoriatic arthritis, and undifferentiated forms. In this study we investigated the activation, and the intracellular expression of IL-4 and IFN-gamma in CD4+ and CD8+ lymphocytes of SpA patients. SFMC and PBMC of patients with SpA and PBMC of healthy subject were analyzed by flow cytometry. The lymphocytes were cultivated in presence of PMA, ionomicin and brefeldin-A for 4 h for intracellular staining of cytokines. The cells were stimulated with CD2/CD2R for expression of the activation marker CD69. Our results show that patients with SpA have a higher percentage of CD4+ lymphocytes that produce IL-4 than healthy subjects (p=0.002). Moreover a higher percentage of CD3+ lymphocytes that produced IL-4 and IFN-gamma is present (p=0.004 and p=0.012 respectively). Also we observed a higher percentage of activated CD4+ and CD8+ cells in SpA patients than in healthy subjects. However SFCM and PBCM show similar percentage of T cells that produced IL-4 and IFN-gamma. On the other hand SFMC of the patients have a lower response to mitogenic stimuli. In conclution, in these patients we observed a higher percentage of T cells in synovial fluid and peripheral blood that express IL-4, IFN-gamma and CD69 molecule in basal conditions than in healthy subjects. [ABSTRACT FROM AUTHOR]
Published: 2002

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