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1. Drug survival of the first course of anti-TNF agents in patients with rheumatoid arthritis and seronegative spondyloarthritis: Analysis from the monitornet databas

Author

Scirè, Ca, Caporali, R, Sarzi Puttini, P, Frediani, B, Di Franco, M, Tincani, A, Sinigaglia, L, Sfriso, P, Tirri, R, Bellis, E, Delsante, G, Porru, G, Salaffi, F, Giuggioli, D, Rossini, M, Todoerti, M, Bazzichi, L, Govoni, M, Gerli, R, Raschetti, R, Minisola, G, Montecucco, C, Todesco, S, Naldi, L, Galeazzi, M, Fantini, F, Mathieu, A, Valesini, G, Ferri, Clodoveo, Bambara, Lm, Grassi, W, Trotta, F, Adami, S, Lapadula, G, Pellerito, R, De Vita, S, Foti, R, Paolazzi, G, Bagnato, G, Cutolo, M, Rocchetta, Pa, Ferraccioli, G, Canesi, Ba, Matucci Cerinic, M, Vittorio, M, Canzoni, M., Scire', C, Caporali, R, Sarzi Puttini, P, Frediani, B, Di Franco, M, Tincani, A, Sinigaglia, L, Sfriso, P, Tirri, R, Bellis, E, Delsante, G, Porru, G, Salaffi, F, Giuggioli, D, Rossini, M, Todoerti, M, Bazzichi, L, Govoni, M, Gerli, R, Raschetti, R, Minisola, G, Montecucco, C, Todesco, S, Scirè, Ca, SARZI PUTTINI, P, DI FRANCO, M, Tirri, Rosella, and Todesco, S.

Subjects
rheumatoid arthritis, Adult, Male, Settore MED/16 - REUMATOLOGIA, Time Factors, Databases, Factual, databases, retention rate, Anti-TNFalpha blockers, Kaplan-Meier Estimate, Drug Administration Schedule, NO, anti-TNF, Rheumatoid arthritis, seronegative spondyloarthritis, Arthritis, Rheumatoid, Databases, anti-TNF therapies, Risk Factors, Rheumatoid, Spondylarthritis, Humans, Registries, Treatment Failure, Rheumatoid arthriti, Factual, Aged, Proportional Hazards Models, therapy, Tumor Necrosis Factor-alpha, Arthritis, seronegative spondyloarthriti, Middle Aged, Italy, Antirheumatic Agents, Multivariate Analysis, Female, Biomarkers
Abstract

Objective: To compare drug survival of different anti-TNF drugs (inliximab, INF, etanercept, ETA, and adalimumab, ADA) in rheumatoid arthritis (RA) and spondyloarthritis (SpA) by analysing data collected from an Italian multicentre observational cohort study.Methods: All patients with RA or SpA registered in the MonitorNet database who started their irst course of anti-TNF therapy were included.Overall drug survival was measured, along with speciic reasons of discontinuation (ineficacy or adverse events).A first set of analyses using RA as reference category assessed the relationship between diagnosis and drug survival.A second set of analyses stratiied by diagnosis (RA and SpA) used INF as reference drug.Adjustment for confounders was performed.The results are presented as adjusted hazard ratios (adjHR) and 95% conidence intervals (95%CI).Results: 2640 RA patients and 1220 SpA patients with a median follow-up of 17 months (IQR 7.2-33.4) were included in the analyses.Patients with a diagnosis of SpA showed a lower risk of drug discontinuation with an adjHR (95%CI) of 0.81 (0.73, 0.90).In SpA, the subset of patients with ankylosing spondylitis (AS) showed the best survival on treatment.In RA, both ETA and ADA showed a signiicantly lower probability of withdrawal when compared to INF [adjHR (95%CI) 0.46 (0.38, 0.56) and 0.68 (0.57, 0.81), respectively].Similar results were found in SpA.Conclusion: Drug survival for SpA is longer than that in RA mainly due to the AS subgroup.In both RA and SpA, ETA and ADA showed a better retention on treatment when compared to INF.

2. HLA-B*2709 and lack of susceptibility to sacroiliitis: Further support from the clinic

Author

Cauli, A., Alessandra VACCA, Dessole, G., Fiorillo, M. T., Porru, G., Ibba, V., Mura, V., Piga, M., Sorrentino, R., and Mathieu, A.

Subjects
ankylosing, ankylosing spondylitis, hla-b*2709, hla-b27, ifn-alpha, ifn-α, sacroiliitis, spondylitis, Adult, HLA-B Antigens, Arthritis, Humans, Immunologic Factors, Interferon-alpha, Female, Genetic Predisposition to Disease, Sacroiliac Joint, Spondylitis, Ankylosing, Thrombocythemia, Essential
Abstract

Interferons (IFN) are well known triggers of immunomediated diseases in genetically predisposed subjects. We describe the unique case of a HLA-B*2709 positive subject who underwent IFN-alpha treatment for essential thrombocythemia and developed arthritis of the proximal interphalangeal joints of the hands but not sacroiliitis. The possible mechanisms of IFN-induced arthritis are discussed.

3. Identification of the Clinical Features Distinguishing Psoriatic Arthritis and Fibromyalgia

Author

Gabriele De Marco, Raffaele Scarpa, V. Varisco, Luisa Costa, Ignazio Olivieri, Giovanni Porru, Antonio Marchesoni, Antonio Spadaro, Orazio De Lucia, M. Manara, L. Rotunno, Mariagrazia Catanoso, Alberto Cauli, Giuseppe Provenzano, Ennio Lubrano, Fabiola Atzeni, Piercarlo Sarzi-Puttini, Salvatore D'Angelo, Daniela Melchiorre, Monica Montepaone, Carlo Salvarani, Marchesoni, A, Atzeni, F, Spadaro, A, Lubrano, E, Provenzano, G, Cauli, A, Olivieri, I, Melchiorre, D, Salvarani, C, Scarpa, Raffaele, Sarzi Puttini, P, Montepaone, M, Porru, G, D'Angelo, S, Catanoso, M, Costa, Luisa, Manara, M, Varisco, V, Rotunno, L, DE Lucia, O, and DE Marco, G.

Subjects
Adult, Male, medicine.medical_specialty, Fibromyalgia, Multivariate analysis, Cross-sectional study, Immunology, Pain, Arthritis, Psoriatic, Diagnosis, Differential, Psoriatic arthritis, Rheumatology, Arthritis, Psoriatic, Cross-Sectional Studies, Female, Humans, Middle Aged, Internal medicine, Diagnosis, Enthesitis, medicine, Immunology and Allergy, Univariate analysis, enthesitis, enthesitis scores, fibromyalgia, fibromyalgia. tender point, pain, psoriatic arthritis, business.industry, medicine.disease, Differential, Physical therapy, medicine.symptom, business
Abstract

Objective.To identify the clinical features that can help to distinguish between psoriatic arthritis (PsA) and fibromyalgia (FM).Methods.Our cross-sectional study was carried out in 10 Italian rheumatology centers between January and September 2009, and enrolled all consecutive patients with PsA and FM who agreed to participate. Standard clinical and laboratory data for PsA and FM were collected from all patients. Records were made of somatic symptoms, response to nonsteroidal antiinflammatory drugs (NSAID), self-evaluated pain, general health, disability, and responses to the Fibromyalgia Impact Questionnaire. Data were statistically analyzed by univariate and multivariate analyses, and receiver-operating characteristic curves. The analysis concentrated on the clinical features shared by the 2 conditions.Results.Two hundred sixty-six patients with PsA (mean age 51.7 yrs; disease duration 10.2 yrs) and 120 patients with FM (mean age 50.2 yrs; disease duration 5.6 yrs) were evaluated. Univariate analysis showed that patients with FM had higher mean tender point and enthesitis scores, more somatic symptoms, and responded less to NSAID. Multivariate analysis showed that the presence of ≥ 6 FM-associated symptoms and ≥ 8 tender points was the best predictor of FM.Conclusion.The shared clinical features of PsA and FM that had the greatest discriminating power for FM were the number of FM-associated symptoms and tender point count.

Published
2012
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4. Patient global assessment in psoriatic arthritis: A multicenter GRAPPA and OMERACT study

Author

Paolo Contu, Ilona Ujfalussy, Claudia Sardu, Ignazio Olivieri, Alessandra Vacca, Dafna D. Gladman, Joachim R. Kalden, Philip J. Mease, Alessandro Mathieu, Antonio Marchesoni, Ennio Lubrano, John A. Flynn, José Luis Fernández-Sueiro, Antonio Spadaro, Sueli Carneiro, Paul P. Tak, Carlo Salvarani, Alberto Cauli, Mathias Gruenke, Arno W R van Kuijk, William J. Taylor, Francesca Desiati, Nicola Ferrara, Salvatore D'Angelo, Raffaele Scarpa, Maria Grazia Catanoso, Wendy J Parsons, Rosario Peluso, Philip S. Helliwell, Giovanni Porru, Cauli, A., Gladman, D. D., Mathieu, A., Olivieri, I., Porru, G., Tak, P. P., Sardu, C., Ujfalussy, I., Scarpa, R., Marchesoni, A., Taylor, W. J., Spadaro, A., Fernàndez Sueiro, J. L., Salvarani, C., Kalden, J. R., Lubrano, E., Carneiro, S., Desiati, F., Flynn, J. A., D'Angelo, S., Vacca, A., Van Kuijk, A. W. R., Catanoso, M. G., Gruenke, M., Peluso, Rosario, Parsons, W. J., Ferrara, Nicola, Contu, P., Helliwell, P. S., Mease, P. J., AII - Amsterdam institute for Infection and Immunity, and Clinical Immunology and Rheumatology

Subjects
Adult, Male, medicine.medical_specialty, Visual analogue scale, Intraclass correlation, Arthritis, Psoriatic, Female, Humans, Joints, Middle Aged, Questionnaires, Reproducibility of Results, Skin, Pain Measurement, Severity of Illness Index, Immunology, Hospital Anxiety and Depression Scale, Psoriatic arthritis, Rheumatology, Assessment measures, Psoriasis Area and Severity Index, Surveys and Questionnaires, Psoriasis, Internal medicine, Severity of illness, medicine, Immunology and Allergy, Domains, Instruments, Patient global assessment, business.industry, medicine.disease, Physical therapy, business
Abstract

Objective.During OMERACT 8, delegates selected patient global assessment (PGA) of disease as a domain to be evaluated in randomized controlled trials in psoriatic arthritis (PsA). This study assessed the reliability of the PGA, measured by means of 0–100 mm visual analog scale (VAS), and the additional utility of separate VAS scales for joints (PJA) and skin (PSA).Methods.In total, 319 consecutive patients with PsA (186 men, 133 women, mean age 51 ± 13 yrs) were enrolled. PGA, PJA, and PSA were administered at enrolment (W0) and after 1 week (W1). Detailed clinical data, including ACR joint count, Psoriasis Area and Severity Index (PASI), and Hospital Anxiety and Depression Scale, were recorded.Results.Comparison of W0 and W1 scores showed no significant variations (intraclass correlation coefficients for PGA 0.87, PJA 0.86, PSA 0.78), demonstrating the reliability of the instrument. PGA scores were not influenced by patient anxiety or depression, but were dependent on PJA and PSA (p = 0.00001). PJA was dependent on the number of swollen and tender joints (p < 0.00001). PSA scores were influenced by the extent of skin psoriasis and by hand skin involvement (p = 0.00001). Joint and skin disease were found not to correlate in terms of disease activity as evidenced by the swollen joint count compared to PASI (r = 0.11) and by the PJA compared to PSA (r = 0.38).Conclusion.PGA assessed by means of VAS is a reliable tool related to joint and skin disease activity. Because joint and skin disease often diverge it is suggested that in some circumstances both PJA and PSA are also assessed.

Published
2011

5. Switching from infliximab or etanercept to adalimumab in resistant or intolerant patients with spondyloarthritis: a 4-year study

Author

Ignazio Olivieri, Mariangela Atteno, Antonio Spadaro, Ennio Lubrano, Alessandro Mathieu, Carlo Salvarani, Leonardo Punzi, Fabrizio Cantini, Roberta Ramonda, Rossana Scrivo, Antonio Marchesoni, Mariagrazia Catanoso, Salvatore D'Angelo, Raffaele Scarpa, Guido Valesini, Giovanni Porru, Spadaro, A, Punzi, L, Marchesoni, A, Lubrano, E, Mathieu, A, Cantini, F, Olivieri, I, Salvarani, C, Scarpa, Raffaele, Scrivo, R, Ramonda, R, Porru, G, D'Angelo, S, Catanoso, M, Atteno, M, and Valesini, G.

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, psoriatic arthritis, ankylosing spondylitis, anti-tnf drugs, spondylarthropathies, Statistics as Topic, Anti-TNF drugs, Antibodies, Monoclonal, Humanized, Etanercept, Drug Hypersensitivity, Psoriatic arthritis, Ankylosing spondylitis, Spondylarthropathies, Rheumatology, Internal medicine, Aged, Antibodies, Monoclonal, Antirheumatic Agents, Female, Humans, Middle Aged, Retrospective Studies, Spondylarthritis, Treatment Outcome, Tumor Necrosis Factor-alpha, Adalimumab, medicine, Pharmacology (medical), Adverse effect, Survival analysis, spondyloarthriti, business.industry, Retrospective cohort study, medicine.disease, Infliximab, Surgery, Cohort, business, etanercept, medicine.drug
Abstract

OBJECTIVE: TNF-alpha antagonists, infliximab (INF), etanercept (ETA) and adalimumab (ADA), have been demonstrated to be effective in controlling symptoms in SpAs. The aim of this study was to investigate the possibility of using ADA as a second or third choice. METHODS: A retrospective study was conducted in patients with SpA treated with TNF-alpha blockers who switched from INF or ETA to ADA, for inefficacy or adverse events. Kaplan-Meier survival curves were plotted to determine the rates of continuation of the first treatment (INF or ETA) as compared with the rates of continuation of the second or third treatment with ADA. RESULTS: A total of 1619 patients with SpA were treated with INF (35.3%), ETA (43.7%) and ADA (20.9%). In this cohort, ADA was started in 38 (2.34%) patients as a second anti-TNF-alpha drug and in 9 (0.56%) as a third anti-TNF-alpha drug. In SpA patients who failed the first anti-TNF-alpha, for whatever reason, survival curves for ADA (as a second anti-TNF-alpha) were significantly better than survival curves for these same patients on their first anti-TNF-alpha (overall: P < 0.0001; INF: P < 0.0011; ETA: P < 0.02). CONCLUSION: Our retrospective study, resulting from real-life experience, showed that SpA patients who fail to respond to a first agent, INF or ETA, respond to ADA as a second-line drug regardless of the reason for switching

Published
2010

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