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1. The first effect of COVID-19 pandemic on starting biological disease modifying anti-rheumatic drugs: outcomes from the TReasure real-life database

Author

Kanıtez, Nilüfer Alpay (ORCID 0000-0003-1185-5816 & YÖK ID 239432), Kiraz, Sedat; Dalkilic, Ediz; Kimyon, Gezmis; Mercan, Ridvan; Karadag, Omer; Bes, Cemal; Kilic, Levent; Akar, Servet; Ates, Askin; Emmungil, Hakan; Ertenli, Ihsan; Pehlivan, Yavuz; Coskun, Belkis Nihan; Yagiz, Burcu; Ersozlu, Duygu; Gonullu, Emel; Cinar, Muhammet; Kasifoglu, Timucin; Koca, Suleyman Serdar; Karasu, Ugur; Kucuksahin, Orhan; Kalyoncu, Umut, School of Medicine, Kanıtez, Nilüfer Alpay (ORCID 0000-0003-1185-5816 & YÖK ID 239432), Kiraz, Sedat; Dalkilic, Ediz; Kimyon, Gezmis; Mercan, Ridvan; Karadag, Omer; Bes, Cemal; Kilic, Levent; Akar, Servet; Ates, Askin; Emmungil, Hakan; Ertenli, Ihsan; Pehlivan, Yavuz; Coskun, Belkis Nihan; Yagiz, Burcu; Ersozlu, Duygu; Gonullu, Emel; Cinar, Muhammet; Kasifoglu, Timucin; Koca, Suleyman Serdar; Karasu, Ugur; Kucuksahin, Orhan; Kalyoncu, Umut, and School of Medicine

Abstract

Objective: The coronavirus disease 2019 pandemic has been resulting in increased hospital occupancy rates. Rheumatic patients cannot still reach to hospitals, or they hesitate about going to a hospital even they are able to reach. We aimed to show the effect of the first wave of coronavirus disease 2019 pandemic on the treatment of biological disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis or spondyloarthritis. Methods: Patients were divided into three groups as follows: pre-pandemic (Pre-p: starting on biological disease-modifying anti-rheumatic drug therapy for the first time within 6 months before March 11, 2020); post-pandemic A (Post-p A: starting on biological disease-modifying anti-rheumatic drug therapy for the first time within the first 6 months after March 11, 2020); post-pandemic B (Post-p B: starting on biological disease-modifying anti-rheumatic drug therapy for the first time within the second 6 months). Results: The number of rheumatoid arthritis patients in the Post-p A and B groups decreased by 51% and 48%, respectively, as compared to the Pre-p group similar rates of reduction were also determined in the number of spondyloarthritis patients. The rates of tofacitinib and abatacept use increased in rheumatoid arthritis patients in Post-p period. Conclusion: The number of rheumatoid arthritis and spondyloarthritis patients starting on biological disease-modifying anti-rheumatic drugs for the first time decreased during the first year of the coronavirus disease 2019 pandemic., NA

Published
2023

2. Maternal and Fetal Outcomes in Pregnant Women with Takayasu’s Arteritis: Single Center Experience over Ten Years.

Author

Yagiz, Burcu, Coskun, Belkis Nihan, Sakar, Orkun, Dalkilic, Ediz, and Pehlivan, Yavuz

Subjects
PREGNANT women, MATERNAL health, ANGIOGRAPHY, PREECLAMPSIA diagnosis, FETAL growth retardation
Abstract

Background This study aims to assess pregnant women’s maternal and fetal outcomes with Takayasu’s arteritis (TA). Material and Methods The study comprised ten pregnant women at the time of diagnosis or afterwards among the 50 patients diagnosed with TA between 2003 and 2021. Twenty-one pregnancy outcomes of 10 patients were obtained from hospital records and telephonic interviews. Two pregnancies were excluded due to timing before diagnosis. Results Based on the angiographic classification, six patients had type 1, two had type 2b, and two had type 1+4 TA. 63.15% of pregnancies were planned, and the rheumatologist approved 42.10%. Live birth occurred in 16 (84.2%) of 19 pregnancies, three pregnancies (15.7%) resulted in abortion and two (10.5 %) of 19 pregnancies ended in neonatal death. In five (26.3%) of the 19 pregnancies, the disease was activated during pregnancy. Two neonatal deaths were from the two patients diagnosed with preeclampsia during pregnancy. Pre-existing hypertension and active disease are shared features of these two patients. After one year of follow-up, six pregnancies (31.5%) had active disease, and four (66.6%) had active disease both before and during pregnancy. While fetal data analysis revealed no congenital anomalies, four pregnancies resulted in low birth weight and intrauterine growth retardation (21.05%). Conclusions The risk of developing preeclampsia and neonatal death should be considered, especially in TA patients with pre-existing hypertension who become pregnant during active disease. [ABSTRACT FROM AUTHOR]

Published
2023
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4. Vasküler Behçet Hastalığı Tanısı Olan Hastalarımızın Klinik Özellikleri, Tedavi Protokolleri ve Relaps Oranları: Tek Merkez Deneyimi

Author

COSKUN, Belkis Nihan, YAĞIZ, Burcu, ÇAKAN, Zeliha, PEHLİVAN, Yavuz, and DALKILIÇ, Hüseyin Ediz

Subjects
Anticoagulant therapy,Behçet,immunosuppressive therapy,thrombosis,vascular involvement, Rheumatology, Antikoagülan tedavi,Behçet Hastalığı,immünsupresif tedavi,tromboz,vasküler tutulum, Romatoloji
Abstract

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

Published
2021

5. Biological Agent Use in Behcet's Patients who are Resistant to Conventional Treatments: A Multidisciplinary Retrospective Study.

Author

YAGIZ, Burcu, COSKUN, Belkis Nihan, CAKAN, Zeliha Kübra, GUNDUZ, Gamze Ucan, YALCINBAYIR, Ozgur, YAZICI, Serkan, SARICAOGLU, Hayriye, DALKILIC, Ediz, and PEHLIVAN, Yavuz

Subjects
BEHCET'S disease, BIOTHERAPY, RHEUMATOLOGY, OPHTHALMOLOGY, TUMOR necrosis factors
Abstract

Background Comparing treatment modalities is difficult in Behcet's syndrome, even if tumour necrosis factor-alpha (TNF-α) inhibitors are a treatment option for all involvements resistant to conventional therapy. This study evaluated how different departments dealt with treatment, particularly with TNF-α inhibitors. Material and Methods The study comprised 111 patients from our Behcet's syndrome cohort who were treated with TNF-α inhibitors between 2010 and 2019. Data on patients were retrieved retrospectively from the rheumatology, ophthalmology, and dermatology clinics' patient records. Results Patients followed up in rheumatology (n: 40) were classified as Group 1, and patients followed up in ophthalmology (n: 49) and dermatology (n: 5) as Group 2. In Group 1, genital ulcers, erythema nodosum (p=0.009, p=0.003, respectively), lower extremity deep vein thrombosis, arterial aneurysm and neurological involvement were more common (p=0.005, p=0.008, p=0.001, respectively). In Group 2, the use of cyclosporine and interferon-α before the anti-TNF agent was higher (p<0.001, p<0.001, respectively), and the use of cyclophosphamide were higher in Group 1 (p<0.001). Both groups preferred infliximab, and ocular involvement was the most common reason for starting. Conclusions While TNF-α inhibitors were chosen equally across departments, conventional medicines, including cyclosporine, cyclophosphamide, and interferon-α, were not. This choice was determined by the departments' experience and the clinical traits that predominated. [ABSTRACT FROM AUTHOR]

Published
2023
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6. Romatoid Artrit Hastalarının Metotreksat Kullanımı ile İlgili Farkındalıkları

Author

COSKUN, Belkis Nihan, YAĞIZ, Burcu, PEHLİVAN, Yavuz, and DALKILIÇ, Hüseyin Ediz

Subjects
Rheumatology, Farkındalık,metotreksat,romatoid artrit, Romatoloji, Awareness,methotrexate,rheumatoid arthritis
Abstract

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

Published
2020

9. Methodology of a new inflammatory arthritis registry: TReasure

Author

Tufan, Muge Aydin, Kalyoncu, Umut, Tascilar, Etem Koray, Ertenli, Ali Ihsan, Dalkilic, Huseyin Ediz, Bes, Cemal, Kucuksahin, Orhan, Kasifoglu, Timucin, Alpay Kanitez, Nilufer, Emmungil, Hakan, Kimyon, Gezmis, Yasar Bilge, Nafize Sule, Akar, Servet, Atagunduz, Mehmet Pamir, Koca, Suleyman Serdar, Ates, Askin, Yazisiz, Veli, Terzioglu, Ender, Ersozlu, Emine Duygu, Cinar, Muhammet, Mercan, Ridvan, Sahin, Ali, Erten, Sukran, Pehlivan, Yavuz, Yilmaz, Sedat, Kelesoglu Dincer, Ayse Bahar, Gercik, Onay, Coskun, Belkis Nihan, Yagiz, Burcu, Kaymaz Tahra, Sema, Aksoy, Aysun, Karadag, Omer, Kilic, Levent, Kiraz, Sedat, [Kalyoncu, Umut -- Ertenli, Ali Ihsan -- Karadag, Omer -- Kilic, Levent -- Kiraz, Sedat] Hacettepe Univ, Fac Med, Dept Internal Med, Div Rheumatol, Ankara, Turkey -- [Tascilar, Etem Koray] Okmeydani Training & Res Hosp, Rheumatol Clin, Istanbul, Turkey -- [Dalkilic, Huseyin Ediz -- Pehlivan, Yavuz -- Coskun, Belkis Nihan -- Yagiz, Burcu] Uludag Univ, Fac Med, Dept Internal Med, Div Rheumatol, Bursa, Turkey -- [Bes, Cemal -- Alpay Kanitez, Nilufer] Rheumatol Clin, Bakirkoy Dr Sadi Konuk Training & Res Hosp, Istanbul, Turkey -- [Kucuksahin, Orhan] Istinye Univ, Fac Med, Dept Internal Med, Div Rheumatol, Istanbul, Turkey -- [Kasifoglu, Timucin -- Yasar Bilge, Nazife Sule] Eskisehir Osmangazi Univ, Fac Med, Dept Internal Med, Div Rheumatol, Eskisehir, Turkey -- [Emmungil, Hakan] Trakya Univ, Fac Med, Dept Internal Med, Div Rheumatol, Edirne, Turkey -- [Kimyon, Gezmis] Mustafa Kemal Univ, Fac Med, Dept Internal Med, Div Rheumatol, Antakya, Turkey -- [Akar, Servet -- Gercik, Onay] Izmir Katip Celebi Univ, Fac Med, Dept Internal Med, Div Rheumatol, Izmir, Turkey -- [Atagunduz, Mehmet Pamir -- Kaymaz Tahra, Sema -- Aksoy, Aysun] Marmara Univ, Fac Med, Dept Internal Med, Div Rheumatol, Istanbul, Turkey -- [Koca, Suleyman Serdar] Firat Univ, Fac Med, Dept Internal Med, Div Rheumatol, Elazig, Turkey -- [Ates, Askin] Ankara Univ, Fac Med, Dept Internal Med, Div Rheumatol, Ankara, Turkey -- [Yazisiz, Veli -- Terzioglu, Ender] Akdeniz Univ, Fac Med, Dept Internal Med, Div Rheumatol, Antalya, Turkey -- [Ersozlu, Emine Duygu] Adana Numune Training & Res Hosp, Unit Rheumatol, Adana, Turkey -- [Tufan, Muge Aydin] Baskent Univ, Unit Rheumatol, Adana Hosp, Adana, Turkey -- [Cinar, Muhammet -- Yilmaz, Sedat] Univ Hlth Sci, Gulhane Fac Med, Dept Internal Med, Div Rheumatol, Ankara, Turkey -- [Mercan, Ridvan] Namik Kemal Univ, Fac Med, Dept Internal Med, Div Rheumatol, Tekirdag, Turkey -- [Sahin, Ali] Cumhuriyet Univ, Fac Med, Dept Internal Med, Div Rheumatol, Sivas, Turkey -- [Erten, SUkran] Yildirim Beyazit Univ, Fac Med, Dept Internal Med, Div Rheumatol, Ankara, Turkey, TASCILAR, Koray -- 0000-0002-8109-826X, Kaymaz-Tahra, Sema -- 0000-0001-5706-4943, Kalyoncu, Umut, Tascilar, Etem Koray, Ertenli, Ali Ihsan, Dalkilic, Huseyin Ediz, Bes, Cemal, Kucuksahin, Orhan, Kasifoglu, Timucin, Alpay Kanitez, Nilufer, Emmungil, Hakan, Kimyon, Gezmis, Yasar Bilge, Nazife Sule, Akar, Servet, Atagunduz, Mehmet Pamir, Koca, Suleyman Serdar, Ates, Askin, Yazisiz, Veli, Terzioglu, Ender, Ersozlu, Emine Duygu, Tufan, Muge Aydin, Cinar, Muhammet, Mercan, Ridvan, Sahin, Ali, Erten, SUkran, Pehlivan, Yavuz, Yilmaz, Sedat, Kelesoglu Dincer, Ayse Bahar, Gercik, Onay, Coskun, Belkis Nihan, Yagiz, Burcu, Kaymaz Tahra, Sema, Aksoy, Aysun, Karadag, Omer, Kilic, Levent, Kiraz, Sedat, İç Hastalıkları, İstinye Üniversitesi, Hastane, and Ege Üniversitesi

Subjects
Male, 0301 basic medicine, Turkey, Cross-sectional study, Inflammatory arthritis, NECROSIS FACTOR THERAPY, Datasets as Topic, Biologics Register, CLINICAL HISTORY, registry, DISEASE-ACTIVITY, Arthritis, Rheumatoid, Unique identifier, 0302 clinical medicine, Disease-Activity, Psoriatic-Arthritis, Health care, disease-modifying antirheumatic drugs, Necrosis Factor Therapy, Prospective Studies, Registries, Cerrahi, Rheumatoid-Arthritis, Clinical History, ANKYLOSING-SPONDYLITIS, General Medicine, Middle Aged, spondyloarthritis, BACK-PAIN, Antirheumatic Agents, Cohort, Society Classification Criteria, Female, Back-Pain, Treasure, medicine.medical_specialty, TReasure, Drug Industry, DIAGNOSTIC-CRITERIA, Ankylosing-Spondylitis, 03 medical and health sciences, Spondylarthritis, medicine, Humans, Rheumatoid arthritis, Diagnostic-Criteria, Aged, Retrospective Studies, business.industry, Retrospective cohort study, medicine.disease, RHEUMATOID-ARTHRITIS, Cross-Sectional Studies, 030104 developmental biology, Rheumatoid arthritis,spondyloarthritis,disease-modifying antirheumatic drugs,registry,TReasure, Family medicine, PSORIATIC-ARTHRITIS, BIOLOGICS REGISTER, 030221 ophthalmology & optometry, SOCIETY CLASSIFICATION CRITERIA, Observational study, Health Facilities, Societies, business
Abstract

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

Published
2018

10. Behçet Disease With Vascular Involvement

Author

Alibaz-Oner, Fatma, Karadeniz, Aslı, Yılmaz, Sema, Balkarlı, Ayşe, Kimyon, Gezmiş, Yazıcı, Ayten, Çınar, Muhammet, Yılmaz, Sedat, Yıldız, Fatih, Bilge, Şule Yaşar, Bilgin, Emre, Coskun, Belkis Nihan, Omma, Ahmet, Çetin, Gözde Yıldırım, Çağatay, Yonca, Karaaslan, Yaşar, Sayarlıoğlu, Mehmet, Pehlivan, Yavuz, Kalyoncu, Umut, Karadağ, Ömer, Kaşifoğlu, Timuçin, Erken, Eren, Pay, Salih, Çefle, Ayşe, Kısacık, Bünyamin, Onat, Ahmet Mesut, Çobankara, Veli, Direskeneli, Haner, and İç Hastalıkları

Subjects
Adult, Male, Vasculitis, Recurrence, Behcet Syndrome, Observational Study, Humans, Female, Article, Follow-Up Studies, Retrospective Studies
Abstract

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

Published
2015

13. Evaluation of sexual function in women with rheumatoid arthritis.

Author

Coskun, Burhan, Coskun, Belkis Nihan, Atis, Gokhan, Ergenekon, Erbil, and Dilek, Kamil

Abstract

Purpose: To evaluate the link between rheumatoid arthritis (RA) and female sexual functioning.Material and Methods: A total of 32 women with RA and 20 healthy age matched controls were enrolled in this study. The participations are asked to complete Female Sexual Function Index (FSFI), The Short form 36 (SF-36) Health Survey and Beck Depression Inventory (BDI)questionnaires.Results: The groups were comparable in terms of demographic characteristics. The women with RA represented significantly worse sexual functioning in category of desire, arousal, lubrication,orgasm, satisfaction domain and total FSFI score compared with healthy women (P = .0001, P = .0001, P = .0001, P = .0001, P = .022 and P = .0001, respectively). The mean BDI scores for the patients with RA were greater than control group (P = .036). Women with RA also had significantly lower quality of life (QoL) parameters: physical functioning, limitations due to physical health, pain, general health, vitality and limitations due to emotional problems compared with healthy women (P = .0001, P = .0001, P = .028, P = .002, P = .001 and P = .0001, respectively).Conclusion: The present study shows that a significant percent of patients with RA had sexual dysfunction and also deterioration in QoL. [ABSTRACT FROM AUTHOR]

Published
2013

14. Is Baricitinib Effective and Safe for Patients with Difficult-to-Treat Rheumatoid Arthritis? Comparative Data with the Rheumatoid Arthritis Group of Rheumatoid Arthritis Not Difficult to Treat.

Author

Ekin, Ali, Misirci, Salim, Görünen, Ahmet, Coskun, Belkis Nihan, Yagiz, Burcu, Dalkilic, Ediz, and Pehlivan, Yavuz

Subjects
*ANTIRHEUMATIC agents, *RHEUMATOID arthritis, *BARICITINIB, *DISEASE duration, *DRUG efficacy
Abstract

Objective: This study investigates the efficacy and safety of baricitinib, an oral targeted synthetic disease-modifying antirheumatic drugs (DMARDs), in patients with difficult-to-treat rheumatoid arthritis (D2T RA) compared to those without, aiming to determine its potential as an alternative treatment for D2T RA. Subject and Methods: A total of 78 patients participated in this retrospective cohort study, with 33 meeting the D2T RA criteria and 45 in the non-D2T RA group. Various clinical and laboratory parameters, adverse events, and disease activity indices were assessed, alongside drug efficacy and survival rates. Results: Patients with D2T RA exhibited higher seronegativity, prior use of b-DMARDs and c-DMARDs, and longer disease duration. Both groups experienced reductions in VAS and DAS28 scores, as well as SDAI, CDAI, HAQ, CRP, and ESR levels at baseline and 3, 6, and 12 months post-baricitinib initiation, with sustained efficacy observed over 12 months. The most prevalent adverse event was infection (28.21%). Although initial drug survival rates were similar between groups, the non-D2T RA group demonstrated higher rates at 24 months (46.70% vs. 59.40%). Subgroup analyses showed comparable survival rates between D2T RA and non-D2T RA groups, whether treated with baricitinib alone or in combination with methotrexate or leflunomide. Conclusion: Despite potential treatment resistance, patients meeting the D2T RA criteria shared similar safety and efficacy profiles with those non-D2T RA. Baricitinib emerges as a promising treatment option for D2T RA patients, offering effectiveness and safety comparable to the non-D2T RA group. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Incidence of cyclophosphamide-induced urotoxicity and protective effect of mesna in rheumatic diseases

Author

Yavuz Pehlivan, Ediz Dalkilic, Gezmiş Kimyon, Kenan Aksu, Gulsen Ozen, Belkıs Nihan Coşkun, Sercan Gücenmez, Ayse Cefle, Hakan Emmungil, Neslihan Yilmaz, Haner Direskeneli, O.N. Pamuk, Omer Karadag, Sema Yilmaz, Veli Cobankara, İsmail Doğan, Ayten Yazici, Yonca Cagatay, Bunyamin Kisacik, Sule Yasar, Serpil Ergulu Esmen, Ayse Balkarli, Eren Erken, Mehmet Sayarlioglu, Timuçin Kaşifoğlu, Fatih Yildiz, Gozde Yildirim Cetin, Sule Yavuz, Yilmaz, Neslihan, Emmungil, Hakan, Gucenmez, Sercan, Ozen, Gulsen, Yildiz, Fatih, Balkarli, Ayse, Kimyon, Gezmis, Coskun, Belkis Nihan, Dogan, Ismail, Pamuk, Omer Nuri, Yasar, Sule, Cetin, Gozde Yildirim, Yazici, Ayten, Esmen, Serpil Ergulu, Cagatay, Yonca, Yilmaz, Sema, Cefle, Ayse, Sayarlioglu, Mehmet, Kasifoglu, Timucin, Karadag, Omer, Pehlivan, Yavuz, Dalkilic, Ediz, Kisacik, Bunyamin, Cobankara, Veli, Erken, Eren, Direskeneli, Haner, Aksu, Kenan, Yavuz, Sule, Çukurova Üniversitesi, Uludağ Üniversitesi/Tıp Fakültesi/Romatoloji Anabilim Dalı., Coşkun, Belkıs Nihan, Dalkılıç, Ediz, AAG-8227-2021, and AAG-7155-2021

Subjects
Male, BLADDER TOXICITY, systemic sclerosis, retrospective study, PULSE CYCLOPHOSPHAMIDE, vasculitis, DOUBLE-BLIND, Rheumatic diseases, systemic lupus erythematosus, middle aged, Cystitis, Immunology and Allergy, rheumatic disease, Mesna, Cumulative dose, Incidence, Middle Aged, cohort analysis, female, Treatment Outcome, priority journal, Anesthesia, Toxicity, chemically induced, bladder cancer, Female, medicine.drug, RHEUMATIC DISEASES, Adult, medicine.medical_specialty, Cyclophosphamide, Immunology, Urology, Aged, Cyclophosphamide/*adverse effects/therapeutic use, Cystitis/chemically induced/*epidemiology, Humans, Mesna/*therapeutic use, Protective Agents/*therapeutic use, Rheumatic Diseases/*drug therapy, CONTROLLED-TRIAL, Protective Agents, MESNA, Article, INDUCED HEMORRHAGIC CYSTITIS, INTRAVENOUS CYCLOPHOSPHAMIDE, WEGENERS-GRANULOMATOSIS, Rheumatology, Hemorrhagic cystitis, medicine, controlled study, human, ORAL CYCLOPHOSPHAMIDE, protective agent, Bladder cancer, treatment duration, business.industry, Retrospective cohort study, medicine.disease, major clinical study, LUPUS NEPHRITIS, HEMORRHAGIC CYSTITIS, Concomitant, FOLLOW-UP, business, Wegener Granulomatosis, ANCA Associated Vasculitis, Antineutrophil Cytoplasmic Antibodies
Abstract

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

Published
2015

16. Evaluation of sexual function in women with rheumatoid arthritis.

Author

Coskun B, Coskun BN, Atis G, Ergenekon E, and Dilek K

Subjects
Adult, Arousal, Arthritis, Rheumatoid complications, Arthritis, Rheumatoid psychology, Case-Control Studies, Female, Health Status, Humans, Middle Aged, Orgasm, Pain etiology, Quality of Life psychology, Sexual Dysfunctions, Psychological psychology, Sexuality psychology, Surveys and Questionnaires, Arthritis, Rheumatoid physiopathology, Sexual Dysfunctions, Psychological physiopathology, Sexuality physiology
Abstract

Purpose: To evaluate the link between rheumatoid arthritis (RA) and female sexual functioning., Material and Methods: A total of 32 women with RA and 20 healthy age matched controls were enrolled in this study. The participations are asked to complete Female Sexual Function Index (FSFI), The Short form 36 (SF-36) Health Survey and Beck Depression Inventory (BDI)questionnaires., Results: The groups were comparable in terms of demographic characteristics. The women with RA represented significantly worse sexual functioning in category of desire, arousal, lubrication,orgasm, satisfaction domain and total FSFI score compared with healthy women (P = .0001, P = .0001, P = .0001, P = .0001, P = .022 and P = .0001, respectively). The mean BDI scores for the patients with RA were greater than control group (P = .036). Women with RA also had significantly lower quality of life (QoL) parameters: physical functioning, limitations due to physical health, pain, general health, vitality and limitations due to emotional problems compared with healthy women (P = .0001, P = .0001, P = .028, P = .002, P = .001 and P = .0001, respectively)., Conclusion: The present study shows that a significant percent of patients with RA had sexual dysfunction and also deterioration in QoL.

Published
2014

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