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1. Immunology of pregnancy and reproductive health in autoimmune rheumatic diseases. Update from the 11th International Conference on Reproduction, Pregnancy and Rheumatic Diseases

Author

Andreoli, Laura, Chighizola, Cecilia B., Iaccarino, Luca, Botta, Angela, Gerosa, Maria, Ramoni, Véronique, Tani, Chiara, Bermas, Bonnie, Brucato, Antonio, Buyon, Jill, Cetin, Irene, Chambers, Christina D., Clowse, Megan E.B., Costedoat-Chalumeau, Nathalie, Cutolo, Maurizio, De Carolis, Sara, Dolhain, Radboud, Fazzi, Elisa M., Förger, Frauke, Giles, Ian, Haase, Isabell, Khamashta, Munther, Levy, Roger A., Meroni, Pier Luigi, Mosca, Marta, Nelson-Piercy, Catherine, Raio, Luigi, Salmon, Jane, Villiger, Peter, Wahren-Herlenius, Marie, Wallenius, Marianne, Zanardini, Cristina, Shoenfeld, Yehuda, and Tincani, Angela

Published
2023
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2. Long-term Outcome of Children Born to Women with Autoimmune Rheumatic Diseases: A Multicentre, Nationwide Study on 299 Randomly Selected Individuals

Author

Andreoli, Laura, Nalli, Cecilia, Lazzaroni, Maria Grazia, Carini, Chiara, Dall’Ara, Francesca, Reggia, Rossella, Rodrigues, Marília, Benigno, Carolina, Baldissera, Elena, Bartoloni, Elena, Basta, Fabio, Bellisai, Francesca, Bortoluzzi, Alessandra, Campochiaro, Corrado, Cantatore, Francesco Paolo, Caporali, Roberto, Ceribelli, Angela, Chighizola, Cecilia B., Conigliaro, Paola, Corrado, Addolorata, Cutolo, Maurizio, D’Angelo, Salvatore, De Stefani, Elena, Doria, Andrea, Favaro, Maria, Fischetti, Colomba, Foti, Rosario, Gabrielli, Armando, Generali, Elena, Gerli, Roberto, Gerosa, Maria, Larosa, Maddalena, Maier, Armin, Malavolta, Nazzarena, Meroni, Marianna, Meroni, Pier Luigi, Montecucco, Carlomaurizio, Mosca, Marta, Padovan, Melissa, Paolazzi, Giuseppe, Pazzola, Giulia, Peccatori, Susanna, Perricone, Roberto, Pettiti, Giorgio, Picerno, Valentina, Prevete, Immacolata, Ramoni, Véronique, Romeo, Nicoletta, Ruffatti, Amelia, Salvarani, Carlo, Sebastiani, Gian Domenico, Selmi, Carlo, Serale, Francesca, Sinigaglia, Luigi, Tani, Chiara, Trevisani, Marica, Vadacca, Marta, Valentini, Eleonora, Valesini, Guido, Visalli, Elisa, Vivaldelli, Ester, Zuliani, Lucia, and Tincani, Angela

Published
2022
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4. Management of pregnancy in autoimmune rheumatic diseases: maternal disease course, gestational and neonatal outcomes and use of medications in the prospective Italian P-RHEUM.it study

Author

Andreoli, L, Gerardi, M, Gerosa, M, Rozza, D, Crisafulli, F, Erra, R, Lini, D, Trespidi, L, Padovan, M, Ruffilli, F, Serale, F, Cuomo, G, Raffeiner, B, Semeraro, P, Tani, C, Chimenti, M, Conigliaro, P, Hoxha, A, Nalli, C, Fredi, M, Lazzaroni, M, Filippini, M, Taglietti, M, Franceschini, F, Zatti, S, Loardi, C, Orabona, R, Ramazzotto, F, Zanardini, C, Fontana, G, Gozzoli, G, Barison, C, Bizioli, P, Caporali, R, Carrea, G, Ossola, M, Maranini, B, Silvagni, E, Govoni, M, Morano, D, Verteramo, R, Doria, A, Del Ross, T, Favaro, M, Calligaro, A, Tonello, M, Larosa, M, Zen, M, Zambon, A, Mosca, M, Zucchi, D, Elefante, E, Gori, S, Iannone, F, Anelli, M, Lavista, M, Abbruzzese, A, Fasano, C, D'Angelo, S, Cutro, M, Picerno, V, Carbone, T, Padula, A, Rovere-Querini, P, Canti, V, De Lorenzo, R, Cavallo, L, Ramoni, V, Montecucco, C, Codullo, V, Milanesi, A, Pazzola, G, Comitini, G, Marvisi, C, Salvarani, C, Epis, O, Benedetti, S, Di Raimondo, G, Gagliardi, C, Lomater, C, Crepaldi, G, Bellis, E, Bellisai, F, Garcia Gonzalez, E, Pata, A, Zerbinati, M, Urban, M, Mattioli, I, Iuliano, A, Sebastiani, G, Brucato, A, Bizzi, E, Cutolo, M, Santo, L, Tonetta, S, Landolfi, G, Carrara, G, Bortoluzzi, A, Scirè, C, Tincani, A, Andreoli, Laura, Gerardi, Maria Chiara, Gerosa, Maria, Rozza, Davide, Crisafulli, Francesca, Erra, Roberta, Lini, Daniele, Trespidi, Laura, Padovan, Melissa, Ruffilli, Francesca, Serale, Francesca, Cuomo, Giovanna, Raffeiner, Bernd, Semeraro, Paolo, Tani, Chiara, Chimenti, Maria Sole, Conigliaro, Paola, Hoxha, Ariela, Nalli, Cecilia, Fredi, Micaela, Lazzaroni, Maria Grazia, Filippini, Matteo, Taglietti, Marco, Franceschini, Franco, Zatti, Sonia, Loardi, Chiara, Orabona, Rossana, Ramazzotto, Francesca, Zanardini, Cristina, Fontana, Giulia, Gozzoli, Giorgia, Barison, Claudia, Bizioli, Paola, Caporali, Roberto Felice, Carrea, Giulia, Ossola, Manuela Wally, Maranini, Beatrice, Silvagni, Ettore, Govoni, Marcello, Morano, Danila, Verteramo, Rosita, Doria, Andrea, Del Ross, Teresa, Favaro, Maria, Calligaro, Antonia, Tonello, Marta, Larosa, Maddalena, Zen, Margherita, Zambon, Alessandra, Mosca, Marta, Zucchi, Dina, Elefante, Elena, Gori, Sabrina, Iannone, Florenzo, Anelli, Maria Grazia, Lavista, Marlea, Abbruzzese, Anna, Fasano, Carlo Giuseppe, D'Angelo, Salvatore, Cutro, Maria Stefania, Picerno, Valentina, Carbone, Teresa, Padula, Angela Anna, Rovere-Querini, Patrizia, Canti, Valentina, De Lorenzo, Rebecca, Cavallo, Ludovica, Ramoni, Véronique, Montecucco, Carlomaurizio, Codullo, Veronica, Milanesi, Alessandra, Pazzola, Giulia, Comitini, Giuseppina, Marvisi, Chiara, Salvarani, Carlo, Epis, Oscar Massimiliano, Benedetti, Sara, Di Raimondo, Giuseppina, Gagliardi, Clizia, Lomater, Claudia, Crepaldi, Gloria, Bellis, Elisa, Bellisai, Francesca, Garcia Gonzalez, Estrella, Pata, Anna Paola, Zerbinati, Martina, Urban, Maria Letizia, Mattioli, Irene, Iuliano, Annamaria, Sebastiani, Giandomenico, Brucato, Antonio Luca, Bizzi, Emanuele, Cutolo, Maurizio, Santo, Leonardo, Tonetta, Sara, Landolfi, Gianpiero, Carrara, Greta, Bortoluzzi, Alessandra, Scirè, Carlo Alberto, Tincani, Angela, Andreoli, L, Gerardi, M, Gerosa, M, Rozza, D, Crisafulli, F, Erra, R, Lini, D, Trespidi, L, Padovan, M, Ruffilli, F, Serale, F, Cuomo, G, Raffeiner, B, Semeraro, P, Tani, C, Chimenti, M, Conigliaro, P, Hoxha, A, Nalli, C, Fredi, M, Lazzaroni, M, Filippini, M, Taglietti, M, Franceschini, F, Zatti, S, Loardi, C, Orabona, R, Ramazzotto, F, Zanardini, C, Fontana, G, Gozzoli, G, Barison, C, Bizioli, P, Caporali, R, Carrea, G, Ossola, M, Maranini, B, Silvagni, E, Govoni, M, Morano, D, Verteramo, R, Doria, A, Del Ross, T, Favaro, M, Calligaro, A, Tonello, M, Larosa, M, Zen, M, Zambon, A, Mosca, M, Zucchi, D, Elefante, E, Gori, S, Iannone, F, Anelli, M, Lavista, M, Abbruzzese, A, Fasano, C, D'Angelo, S, Cutro, M, Picerno, V, Carbone, T, Padula, A, Rovere-Querini, P, Canti, V, De Lorenzo, R, Cavallo, L, Ramoni, V, Montecucco, C, Codullo, V, Milanesi, A, Pazzola, G, Comitini, G, Marvisi, C, Salvarani, C, Epis, O, Benedetti, S, Di Raimondo, G, Gagliardi, C, Lomater, C, Crepaldi, G, Bellis, E, Bellisai, F, Garcia Gonzalez, E, Pata, A, Zerbinati, M, Urban, M, Mattioli, I, Iuliano, A, Sebastiani, G, Brucato, A, Bizzi, E, Cutolo, M, Santo, L, Tonetta, S, Landolfi, G, Carrara, G, Bortoluzzi, A, Scirè, C, Tincani, A, Andreoli, Laura, Gerardi, Maria Chiara, Gerosa, Maria, Rozza, Davide, Crisafulli, Francesca, Erra, Roberta, Lini, Daniele, Trespidi, Laura, Padovan, Melissa, Ruffilli, Francesca, Serale, Francesca, Cuomo, Giovanna, Raffeiner, Bernd, Semeraro, Paolo, Tani, Chiara, Chimenti, Maria Sole, Conigliaro, Paola, Hoxha, Ariela, Nalli, Cecilia, Fredi, Micaela, Lazzaroni, Maria Grazia, Filippini, Matteo, Taglietti, Marco, Franceschini, Franco, Zatti, Sonia, Loardi, Chiara, Orabona, Rossana, Ramazzotto, Francesca, Zanardini, Cristina, Fontana, Giulia, Gozzoli, Giorgia, Barison, Claudia, Bizioli, Paola, Caporali, Roberto Felice, Carrea, Giulia, Ossola, Manuela Wally, Maranini, Beatrice, Silvagni, Ettore, Govoni, Marcello, Morano, Danila, Verteramo, Rosita, Doria, Andrea, Del Ross, Teresa, Favaro, Maria, Calligaro, Antonia, Tonello, Marta, Larosa, Maddalena, Zen, Margherita, Zambon, Alessandra, Mosca, Marta, Zucchi, Dina, Elefante, Elena, Gori, Sabrina, Iannone, Florenzo, Anelli, Maria Grazia, Lavista, Marlea, Abbruzzese, Anna, Fasano, Carlo Giuseppe, D'Angelo, Salvatore, Cutro, Maria Stefania, Picerno, Valentina, Carbone, Teresa, Padula, Angela Anna, Rovere-Querini, Patrizia, Canti, Valentina, De Lorenzo, Rebecca, Cavallo, Ludovica, Ramoni, Véronique, Montecucco, Carlomaurizio, Codullo, Veronica, Milanesi, Alessandra, Pazzola, Giulia, Comitini, Giuseppina, Marvisi, Chiara, Salvarani, Carlo, Epis, Oscar Massimiliano, Benedetti, Sara, Di Raimondo, Giuseppina, Gagliardi, Clizia, Lomater, Claudia, Crepaldi, Gloria, Bellis, Elisa, Bellisai, Francesca, Garcia Gonzalez, Estrella, Pata, Anna Paola, Zerbinati, Martina, Urban, Maria Letizia, Mattioli, Irene, Iuliano, Annamaria, Sebastiani, Giandomenico, Brucato, Antonio Luca, Bizzi, Emanuele, Cutolo, Maurizio, Santo, Leonardo, Tonetta, Sara, Landolfi, Gianpiero, Carrara, Greta, Bortoluzzi, Alessandra, Scirè, Carlo Alberto, and Tincani, Angela

Abstract

Objectives To investigate pregnancy outcomes in women with autoimmune rheumatic diseases (ARD) in the Italian prospective cohort study P-RHEUM.it. Methods Pregnant women with different ARD were enrolled for up to 20 gestational weeks in 29 Rheumatology Centres for 5 years (2018-2023). Maternal and infant information were collected in a web-based database. Results We analysed 866 pregnancies in 851 patients (systemic lupus erythematosus was the most represented disease, 19.6%). Maternal disease flares were observed in 135 (15.6%) pregnancies. 53 (6.1%) pregnancies were induced by assisted reproduction techniques, 61 (7%) ended in miscarriage and 11 (1.3%) underwent elective termination. Obstetrical complications occurred in 261 (30.1%) pregnancies, including 2.3% pre-eclampsia. Two cases of congenital heart block were observed out of 157 pregnancies (1.3%) with anti-Ro/SSA. Regarding treatments, 244 (28.2%) pregnancies were treated with glucocorticoids, 388 (44.8%) with hydroxychloroquine, 85 (9.8%) with conventional synthetic disease-modifying anti-rheumatic drugs and 122 (14.1%) with biological disease-modifying anti-rheumatic drugs. Live births were 794 (91.7%), mostly at term (84.9%); four perinatal deaths (0.5%) occurred. Among 790 newborns, 31 (3.9%) were small-for-gestational-age and 169 (21.4%) had perinatal complications. Exclusive maternal breast feeding was received by 404 (46.7%) neonates. The Edinburgh Postnatal Depression Scale was compiled by 414 women (52.4%); 89 (21.5%) scored positive for emotional distress. Conclusions Multiple factors including preconception counselling and treat-to-target with pregnancy-compatible medications may have contributed to mitigate disease-related risk factors, yielding limited disease flares, good pregnancy outcomes and frequency of complications which were similar to the Italian general obstetric population. Disease-specific issues need to be further addressed to plan preventative measures.

Published
2024

5. “Disease knowledge index” and perspectives on reproductive issues: A nationwide study on 398 women with autoimmune rheumatic diseases

Author

Andreoli, Laura, Lazzaroni, Maria Grazia, Carini, Chiara, Dall’Ara, Francesca, Nalli, Cecilia, Reggia, Rossella, Rodrigues, Marília, Benigno, Carolina, Baldissera, Elena, Bartoloni-Bocci, Elena, Basta, Fabio, Bellisai, Francesca, Bortoluzzi, Alessandra, Campochiaro, Corrado, Cantatore, Francesco Paolo, Caporali, Roberto, Ceribelli, Angela, Chighizola, Cecilia B., Conigliaro, Paola, Corrado, Addolorata, Cutolo, Maurizio, D’Angelo, Salvatore, De Stefani, Elena, Doria, Andrea, Favaro, Maria, Fischetti, Colomba, Foti, Rosario, Gabrielli, Armando, Generali, Elena, Gerli, Roberto, Gerosa, Maria, Larosa, Maddalena, Maier, Armin, Malavolta, Nazzarena, Meroni, Marianna, Meroni, Pier Luigi, Montecucco, Carlomaurizio, Mosca, Marta, Padovan, Melissa, Paolazzi, Giuseppe, Pazzola, Giulia, Peccatori, Susanna, Perricone, Roberto, Pettiti, Giorgio, Picerno, Valentina, Prevete, Immacolata, Ramoni, Véronique, Romeo, Nicoletta, Ruffatti, Amelia, Salvarani, Carlo, Sebastiani, Gian Domenico, Selmi, Carlo, Serale, Francesca, Sinigaglia, Luigi, Tani, Chiara, Trevisani, Marica, Vadacca, Marta, Valentini, Eleonora, Valesini, Guido, Visalli, Elisa, Vivaldelli, Ester, Zuliani, Lucia, and Tincani, Angela

Published
2019
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6. Disease activity assessment of rheumatic diseases during pregnancy: a comprehensive review of indices used in clinical studies

Author

Andreoli, Laura, Gerardi, Maria Chiara, Fernandes, Melissa, Bortoluzzi, Alessandra, Bellando-Randone, Silvia, Brucato, Antonio, Caporali, Roberto, Chighizola, Cecilia Beatrice, Chimenti, Maria Sole, Conigliaro, Paola, Cutolo, Maurizio, Cutro, Maria Stefania, D’Angelo, Salvatore, Doria, Andrea, Elefante, Elena, Fredi, Micaela, Galeazzi, Mauro, Gerosa, Maria, Govoni, Marcello, Iuliano, Annamaria, Larosa, Maddalena, Lazzaroni, Maria Grazia, Matucci-Cerinic, Marco, Meroni, Marianna, Meroni, Pier Luigi, Mosca, Marta, Patanè, Massimo, Pazzola, Giulia, Pendolino, Monica, Perricone, Roberto, Ramoni, Véronique, Salvarani, Carlo, Sebastiani, Gian Domenico, Selmi, Carlo, Spinelli, Francesca Romana, Valesini, Guido, Scirè, Carlo Alberto, and Tincani, Angela

Published
2019
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11. Systemic vasculitis and pregnancy: A multicenter study on maternal and neonatal outcome of 65 prospectively followed pregnancies

Author

Fredi, Micaela, Lazzaroni, Maria Grazia, Tani, Chiara, Ramoni, Véronique, Gerosa, Maria, Inverardi, Flora, Sfriso, Paolo, Caramaschi, Paola, Andreoli, Laura, Sinico, Renato Alberto, Motta, Mario, Lojacono, Andrea, Trespidi, Laura, Strigini, Francesca, Brucato, Antonio, Caporali, Roberto, Doria, Andrea, Guillevin, Loic, Meroni, Pier Luigi, Montecucco, Carlomaurizio, Mosca, Marta, and Tincani, Angela

Published
2015
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13. Changes to expert opinion in the use of antirheumatic drugs before and during pregnancy five years after EULAR: points to consider

Author

Ramoni, Véronique Laure, primary, Häfeli, Céline, additional, Costedoat-Chalumeau, Nathalie, additional, Chambers, Christina, additional, Dolhain, Radboud J E M, additional, Govoni, Marcello, additional, Levy, Roger A, additional, Götestam Skorpen, Carina, additional, Tincani, Angela, additional, and Förger, Frauke, additional

Published
2022
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15. Long-term Outcome of Children Born to Women with Autoimmune Rheumatic Diseases: A Multicentre, Nationwide Study on 299 Randomly Selected Individuals

Author

Andreoli, Laura, primary, Nalli, Cecilia, additional, Lazzaroni, Maria Grazia, additional, Carini, Chiara, additional, Dall’Ara, Francesca, additional, Reggia, Rossella, additional, Rodrigues, Marília, additional, Benigno, Carolina, additional, Baldissera, Elena, additional, Bartoloni, Elena, additional, Basta, Fabio, additional, Bellisai, Francesca, additional, Bortoluzzi, Alessandra, additional, Campochiaro, Corrado, additional, Cantatore, Francesco Paolo, additional, Caporali, Roberto, additional, Ceribelli, Angela, additional, Chighizola, Cecilia B., additional, Conigliaro, Paola, additional, Corrado, Addolorata, additional, Cutolo, Maurizio, additional, D’Angelo, Salvatore, additional, De Stefani, Elena, additional, Doria, Andrea, additional, Favaro, Maria, additional, Fischetti, Colomba, additional, Foti, Rosario, additional, Gabrielli, Armando, additional, Generali, Elena, additional, Gerli, Roberto, additional, Gerosa, Maria, additional, Larosa, Maddalena, additional, Maier, Armin, additional, Malavolta, Nazzarena, additional, Meroni, Marianna, additional, Meroni, Pier Luigi, additional, Montecucco, Carlomaurizio, additional, Mosca, Marta, additional, Padovan, Melissa, additional, Paolazzi, Giuseppe, additional, Pazzola, Giulia, additional, Peccatori, Susanna, additional, Perricone, Roberto, additional, Pettiti, Giorgio, additional, Picerno, Valentina, additional, Prevete, Immacolata, additional, Ramoni, Véronique, additional, Romeo, Nicoletta, additional, Ruffatti, Amelia, additional, Salvarani, Carlo, additional, Sebastiani, Gian Domenico, additional, Selmi, Carlo, additional, Serale, Francesca, additional, Sinigaglia, Luigi, additional, Tani, Chiara, additional, Trevisani, Marica, additional, Vadacca, Marta, additional, Valentini, Eleonora, additional, Valesini, Guido, additional, Visalli, Elisa, additional, Vivaldelli, Ester, additional, Zuliani, Lucia, additional, and Tincani, Angela, additional

Published
2021
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17. Successful pregnancies but a higher risk of preterm births in patients with systemic sclerosis: An Italian multicenter study

Author

Taraborelli, Mara, Ramoni, Véronique, Brucato, Antonio, Airò, Paolo, Bajocchi, Gianluigi, Bellisai, Francesca, Biasi, Domenico, Blagojevic, Jelena, Canti, Valentina, Caporali, Roberto, Caramaschi, Paola, Chiarolanza, Ilaria, Codullo, Veronica, Cozzi, Franco, Cuomo, Giovanna, Cutolo, Maurizio, De Santis, Maria, De Vita, Salvatore, Di Poi, Emma, Doria, Andrea, Faggioli, Paola, Favaro, Maria, Ferraccioli, Gianfranco, Ferri, Clodoveo, Foti, Rosario, Gerosa, Alessandro, Gerosa, Maria, Giacuzzo, Sarah, Giani, Leopoldo, Giuggioli, Dilia, Imazio, Massimo, Iudici, Michele, Iuliano, Annamaria, Leonardi, Roberto, Limonta, Massimiliano, Lojacono, Andrea, Lubatti, Chiara, Matucci-Cerinic, Marco, Mazzone, Antonino, Meroni, Marianna, Meroni, Pier Luigi, Mosca, Marta, Motta, Mario, Muscarà, Marina, Nava, Simona, Padovan, Melissa, Pagani, Giorgio, Paolazzi, Giuseppe, Peccatori, Susanna, Ravagnani, Viviana, Riccieri, Valeria, Rosato, Edoardo, Rovere-Querini, Patrizia, Salsano, Felice, Santaniello, Alessandro, Scorza, Raffaella, Tani, Chiara, Valentini, Gabriele, Valesini, Guido, Vanoli, Massimo, Vigone, Barbara, Zeni, Silvana, and Tincani, Angela

Published
2012
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19. Role of placental inflammatory mediators and growth factors in patients with rheumatic diseases with a focus on systemic sclerosis

Author

Motta, Francesca, primary, Codullo, Veronica, additional, Ramoni, Véronique, additional, Cesari, Stefania, additional, Ferrario, Giuseppina, additional, Fiandrino, Giacomo, additional, Beneventi, Fausta, additional, Rampello, Stefania, additional, Johnsson, Hanna, additional, Montecucco, Carlomaurizio, additional, and Graham, Gerard J, additional

Published
2020
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20. Endothelial Progenitor Cell CD34+ and CD133+ Concentrations and Soluble HLA-G Concentrations During Pregnancy and in Cord Blood in Undifferentiated Connective Tissue Diseases Compared to Controls

Author

Beneventi, Fausta, primary, De Maggio, Irene, additional, Cavagnoli, Chiara, additional, Bellingeri, Camilla, additional, Ruspini, Beatrice, additional, Riceputi, Greta, additional, Viarengo, Gianluca, additional, Ramoni, Véronique, additional, and Spinillo, Arsenio, additional

Published
2020
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25. Role of placental inflammatory mediators and growth factors in patients with rheumatic diseases with a focus on systemic sclerosis.

Author

Motta, Francesca, Codullo, Veronica, Ramoni, Véronique, Cesari, Stefania, Ferrario, Giuseppina, Fiandrino, Giacomo, Beneventi, Fausta, Rampello, Stefania, Johnsson, Hanna, Montecucco, Carlomaurizio, and Graham, Gerard J

Subjects
CYTOKINES, GROWTH factors, IMMUNOHISTOCHEMISTRY, SYSTEMIC scleroderma, CASE-control method, COMPARATIVE studies, PLACENTA, INFLAMMATORY mediators, RHEUMATISM, POLYMERASE chain reaction, CHEMOKINES, LIGANDS (Biochemistry)
Abstract

Objectives Pregnancy in SSc is burdened with an increased risk of obstetric complications. Little is known about the underlying placental alterations. This study aimed to better understand pathological changes and the role of inflammation in SSc placentas. Leucocyte infiltration, inflammatory mediators and atypical chemokine receptor 2 (ACKR2) expression in SSc placentas were compared with those in other rheumatic diseases (ORD) and healthy controls (HC). Methods A case–control study was conducted on eight pregnant SSc patients compared with 16 patients with ORD and 16 HC matched for gestational age. Clinical data were collected. Placentas were obtained for histopathological analysis and immunohistochemistry (CD3, CD20, CD11c, CD68, ACKR2). Samples from four SSc, eight ORD and eight HC were analysed by qPCR for ACKR2 expression and by multiplex assay for cytokines, chemokines and growth factors involved in angiogenesis and inflammation. Results The number of placental CD3, CD68 and CD11 cells was significantly higher in patients affected by rheumatic diseases (SSc+ORD) compared with HC. Hepatocyte growth factor was significantly increased in the group of rheumatic diseases patients (SSc+ORD) compared with HC, while chemokine (C-C motif) ligand 5 (CCL5) was significantly higher in SSc patients compared with ORD and HC. CCL5 levels directly correlated with the number of all local inflammatory cells and higher levels were associated with histological villitis. Conclusions Inflammatory alterations characterize placentas from rheumatic disease patients and could predispose to obstetric complications in these subjects. [ABSTRACT FROM AUTHOR]

Published
2021
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26. First Report of the Italian Registry on Immune-Mediated Congenital Heart Block (Lu.Ne Registry)

Author

Fredi, Micaela, primary, Andreoli, Laura, additional, Bacco, Beatrice, additional, Bertero, Tiziana, additional, Bortoluzzi, Alessandra, additional, Breda, Silvia, additional, Cappa, Veronica, additional, Ceccarelli, Fulvia, additional, Cimaz, Rolando, additional, De Vita, Salvatore, additional, Di Poi, Emma, additional, Elefante, Elena, additional, Franceschini, Franco, additional, Gerosa, Maria, additional, Govoni, Marcello, additional, Hoxha, Ariela, additional, Lojacono, Andrea, additional, Marozio, Luca, additional, Mathieu, Alessandro, additional, Meroni, Pier Luigi, additional, Minniti, Antonina, additional, Mosca, Marta, additional, Muscarà, Marina, additional, Padovan, Melissa, additional, Piga, Matteo, additional, Priori, Roberta, additional, Ramoni, Véronique, additional, Ruffatti, Amelia, additional, Tani, Chiara, additional, Tonello, Marta, additional, Trespidi, Laura, additional, Zatti, Sonia, additional, Calza, Stefano, additional, Tincani, Angela, additional, and Brucato, Antonio, additional

Published
2019
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27. Improved Pregnancy Outcome in Patients With Rheumatoid Arthritis Who Followed an Ideal Clinical Pathway.

Author

Bortoluzzi, Alessandra, Andreoli, Laura, Carrara, Greta, Ramoni, Véronique, Rumi, Federica, Padovan, Melissa, Govoni, Marcello, Tincani, Angela, and Scirè, and Carlo Alberto

Subjects
PREGNANCY complications, PERINATAL death, RHEUMATOID arthritis risk factors, RHEUMATOID arthritis treatment, AUTOIMMUNE diseases
Abstract

Objective: To assess the effect of optimal management of pregnancy on a composite outcome of miscarriage and complicated birth among women with rheumatoid arthritis (RA). Methods: Data were extracted from health care databases of the Lombardy Region, Italy (2004–2013) as a part of the Record‐Linkage on Rheumatic Diseases Study. Analyses included women with RA identified through a copayment exemption code (International Classification of Diseases, Ninth Revision, Clinical Modification code 714.0) and controls from the general population, ages 18–50 years. Seven health care quality indicators (HCQI) were constructed and summarized in 3 pathway indicators: diagnostic, therapeutic, and prenatal follow‐up. Complicated birth or miscarriage were used to identify the adverse pregnancy outcome (APO). The relationship between HCQI and APO was analyzed using logistic models, and the results were presented as odds ratios (ORs) and 95% confidence intervals (95% CIs). Results: Data from the study cohort included the first pregnancy observed in 443 patients with RA compared with 6,097 women belonging to the general population. In the RA population, patients who followed the 3 pathway indicators had a reduced risk of overall APO, with an OR of 0.60 (95% CI 0.39–0.94), and reduced risk of miscarriage/perinatal death, with an OR of 0.40 (95% CI 0.24–0.69), compared to those who did not follow the pathway indicators. Compared with the general population, patients with RA who met all HCQI during pregnancy displayed a risk of APO with an OR of 0.92 (95% CI 0.61–1.38) and miscarriage/perinatal death with an OR of 0.77 (95% CI 0.47–1.29). Conclusion: The adherence to an ideal clinical pathway of pregnancy management in women with RA restored the risk of APO to that expected for the general population. [ABSTRACT FROM AUTHOR]

Published
2021
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28. Effect of Additional Treatments Combined with Conventional Therapies in Pregnant Patients with High-Risk Antiphospholipid Syndrome: A Multicentre Study

Author

Ruffatti, Amelia, Tonello, Marta, Hoxha, Ariela, Sciascia, Savino, Cuadrado, Maria J., Latino, José O., Udry, Sebastian, Reshetnyak, Tatiana, Costedoat-Chalumeau, Nathalie, Morel, Nathalie, Marozio, Luca, Tincani, Angela, Andreoli, Laura, Haladyj, Ewa, Meroni, Pier L., Gerosa, Maria, Alijotas-Reig, Jaume, Tenti, Sara, Mayer-Pickel, Karoline, Simchen, Michal J., Bertero, Maria T., De Carolis, Sara, Ramoni, Véronique, Mekinian, Arsène, Grandone, Elvira, Maina, Aldo, Serrano, Fátima, Pengo, Vittorio, Khamashta, Munther A., De Carolis, Sara (ORCID:0000-0002-5160-7609), Ruffatti, Amelia, Tonello, Marta, Hoxha, Ariela, Sciascia, Savino, Cuadrado, Maria J., Latino, José O., Udry, Sebastian, Reshetnyak, Tatiana, Costedoat-Chalumeau, Nathalie, Morel, Nathalie, Marozio, Luca, Tincani, Angela, Andreoli, Laura, Haladyj, Ewa, Meroni, Pier L., Gerosa, Maria, Alijotas-Reig, Jaume, Tenti, Sara, Mayer-Pickel, Karoline, Simchen, Michal J., Bertero, Maria T., De Carolis, Sara, Ramoni, Véronique, Mekinian, Arsène, Grandone, Elvira, Maina, Aldo, Serrano, Fátima, Pengo, Vittorio, Khamashta, Munther A., and De Carolis, Sara (ORCID:0000-0002-5160-7609)

Published
2018

30. Effect of Additional Treatments Combined with Conventional Therapies in Pregnant Patients with High-Risk Antiphospholipid Syndrome: A Multicentre Study

Author

Tonello, Marta, primary, Hoxha, Ariela, primary, Sciascia, Savino, primary, Cuadrado, Maria, primary, Latino, José, primary, Udry, Sebastian, primary, Reshetnyak, Tatiana, primary, Costedoat-Chalumeau, Nathalie, primary, Morel, Nathalie, primary, Marozio, Luca, primary, Tincani, Angela, primary, Andreoli, Laura, primary, Haladyj, Ewa, primary, Meroni, Pier, primary, Gerosa, Maria, primary, Alijotas-Reig, Jaume, primary, Tenti, Sara, primary, Mayer-Pickel, Karoline, primary, Simchen, Michal, primary, Bertero, Maria, primary, De Carolis, Sara, primary, Ramoni, Véronique, primary, Mekinian, Arsène, primary, Grandone, Elvira, primary, Maina, Aldo, primary, Serrano, Fátima, primary, Pengo, Vittorio, primary, Khamashta, Munther, primary, and Ruffatti, Amelia, additional

Published
2018
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31. Maternal and neonatal outcomes in pregnant women with autoimmune diseases in Pavia, Italy

Author

Mazzucchelli, Iolanda, primary, Decembrino, Lidia, additional, Garofoli, Francesca, additional, Ruffinazzi, Giulia, additional, Ramoni, Véronique, additional, Romano, Mariaeva, additional, Prisco, Elena, additional, Locatelli, Elena, additional, Cavagnoli, Chiara, additional, Simonetta, Margherita, additional, De Silvestri, Annalisa, additional, Paolillo, Piermichele, additional, Spinillo, Arsenio, additional, and Stronati, Mauro, additional

Published
2015
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32. List of Contributors

Author

Agostini, Carlo, Alunno, Alessia, Ayvazyan, Lilit, Barbosa-Ferreira, João Marcos, Bartoloni, Elena, Binder, Christoph J., Bornholz, Beatrice, Braun, Jürgen, Brucato, Antonio, Buyon, Jill P., Caforio, Alida L.P., Dennert, Robert, Diederichsen, Louise Pyndt, Dimitroulas, Theodoros, Dörr, Marcus, Felix, Stephan B., Fernandes, Fabio, Fragkioudaki, Sofia, Freschi de Barros, Samar, Friedman, Deborah M., Gallo, Nicoletta, Gasparyan, Armen Yuri, Gerli, Roberto, Gruber, Sabrina, Guilherme, Luiza, Guillevin, Loïc, Hazebroek, Mark, Heslinga, Sjoerd C., Heymans, Stephane, Iliceto, Sabino, Imazio, Massimo, Jiang, Xiongjing, Kalil, Jorge, Kitas, George D., Köhler, Karen Francine, Könemann, Stephanie, Koster, Matthew J., Landewé, Robert, Livneh, Avi, Lundberg, Ingrid E., Maestroni, Silvia, Malik, Marek, Malipiero, Giacomo, Marcolongo, Renzo, Martini, Alberto, Matteson, Eric L., Mavragani, Clio P., Metsios, George S., Miliaresis, Christa, Mithal, Leena B., Moutsopoulos, Haralampos M., Müller, Johannes, Nurmohamed, Michael T., Nussinovitch, U., Sullivan, Miriam O’, Phoon, Colin K.L., Pipitone, Nicolò, Plebani, Mario, Pucci, Giacomo, Ramoni, Veronique, Ravelli, Angelo, Reuter, Caroline, Roggenbuck, Dirk, Rose, Noel R., Russell, Stuart D., Sabino, Ester Cerdeira, Salvarani, Carlo, Sampaio, Roney Orismar, Sandoo, Aamer, Sanner, Helga, Schiappapietra, Benedetta, Schillaci, Giuseppe, Schimke, Ingolf, Seguso, Mara, Shamriz, Oded, Shulman, Stanford T., Sjaastad, Ivar, Skeoch, Sarah, Soriano, Alessandra, Guilherme, Sobreira Spina, Tarasoutchi, Flavio, Trappe, Hans-Joachim, Tselios, Konstantinos, Tsiantoulas, Dimitrios, Urowitz, Murray B., Vacca, Alessandra, Valente Moreira, Carlos Henrique, Valenti, Anna, van Durme, Caroline, van Paassen, Pieter, Verazza, Sara, Wallukat, Gerd, Warrington, Kenneth J., Yang, Lirui, Yessirkepov, Marlen, and Zhang, Huimin

Published
2017
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33. Treatment strategies and pregnancy outcomes in antiphospholipid syndrome patients with thrombosis and triple antiphospholipid positivity

Author

Salvan, Elisa, primary, Ross, Teresa Del, primary, Gerosa, Maria, primary, Andreoli, Laura, primary, Maina, Aldo, primary, Alijotas-Reig, Jaume, primary, Carolis, Sara De, primary, Mekinian, Arsene, primary, Bertero, Maria Tiziana, primary, Canti, Valentina, primary, Brucato, Antonio, primary, Bremme, Katarina, primary, Ramoni, Véronique, primary, Mosca, Marta, primary, Poi, Emma Di, primary, Caramaschi, Paola, primary, Galeazzi, Mauro, primary, Tincani, Angela, primary, Meroni, Pier Luigi, primary, and Ruffatti, Amelia, additional

Published
2014
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36. Treatment strategies and pregnancy outcomes in antiphospholipid syndrome patients with thrombosis and triple antiphospholipid positivity.

Author

Ruffatti, Amelia, Salvan, Elisa, Del Ross, Teresa, Gerosa, Maria, Andreoli, Laura, Maina, Aldo, Alijotas-Reig, Jaume, De Carolis, Sara, Mekinian, Arsene, Bertero, Maria Tiziana, Canti, Valentina, Brucato, Antonio, Bremme, Katarina, Ramoni, Véronique, Mosca, Marta, Di Poi, Emma, Caramaschi, Paola, Galeazzi, Mauro, Tincani, Angela, and Meroni, Pier Luigi

Published
2014
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37. Management of pregnancy in autoimmune rheumatic diseases: maternal disease course, gestational and neonatal outcomes and use of medications in the prospectiveItalian P-RHEUM.it study.

Author

Andreoli L, Gerardi MC, Gerosa M, Rozza D, Crisafulli F, Erra R, Lini D, Trespidi L, Padovan M, Ruffilli F, Serale F, Cuomo G, Raffeiner B, Semeraro P, Tani C, Chimenti MS, Conigliaro P, Hoxha A, Nalli C, Fredi M, Lazzaroni MG, Filippini M, Taglietti M, Franceschini F, Zatti S, Loardi C, Orabona R, Ramazzotto F, Zanardini C, Fontana G, Gozzoli G, Barison C, Bizioli P, Caporali RF, Carrea G, Ossola MW, Maranini B, Silvagni E, Govoni M, Morano D, Verteramo R, Doria A, Del Ross T, Favaro M, Calligaro A, Tonello M, Larosa M, Zen M, Zambon A, Mosca M, Zucchi D, Elefante E, Gori S, Iannone F, Anelli MG, Lavista M, Abbruzzese A, Fasano CG, D'Angelo S, Cutro MS, Picerno V, Carbone T, Padula AA, Rovere-Querini P, Canti V, De Lorenzo R, Cavallo L, Ramoni V, Montecucco C, Codullo V, Milanesi A, Pazzola G, Comitini G, Marvisi C, Salvarani C, Epis OM, Benedetti S, Di Raimondo G, Gagliardi C, Lomater C, Crepaldi G, Bellis E, Bellisai F, Garcia Gonzalez E, Pata AP, Zerbinati M, Urban ML, Mattioli I, Iuliano A, Sebastiani G, Brucato AL, Bizzi E, Cutolo M, Santo L, Tonetta S, Landolfi G, Carrara G, Bortoluzzi A, Scirè CA, and Tincani A

Subjects
Adult, Female, Humans, Infant, Newborn, Pregnancy, Antirheumatic Agents therapeutic use, Antirheumatic Agents adverse effects, Glucocorticoids therapeutic use, Hydroxychloroquine therapeutic use, Hydroxychloroquine adverse effects, Italy epidemiology, Prospective Studies, Autoimmune Diseases epidemiology, Autoimmune Diseases drug therapy, Pregnancy Complications epidemiology, Pregnancy Complications drug therapy, Pregnancy Outcome epidemiology, Rheumatic Diseases drug therapy, Rheumatic Diseases epidemiology, Rheumatic Diseases complications
Abstract

Objectives: To investigate pregnancy outcomes in women with autoimmune rheumatic diseases (ARD) in the Italian prospective cohort study P-RHEUM.it., Methods: Pregnant women with different ARD were enrolled for up to 20 gestational weeks in 29 Rheumatology Centres for 5 years (2018-2023). Maternal and infant information were collected in a web-based database., Results: We analysed 866 pregnancies in 851 patients (systemic lupus erythematosus was the most represented disease, 19.6%). Maternal disease flares were observed in 135 (15.6%) pregnancies. 53 (6.1%) pregnancies were induced by assisted reproduction techniques, 61 (7%) ended in miscarriage and 11 (1.3%) underwent elective termination. Obstetrical complications occurred in 261 (30.1%) pregnancies, including 2.3% pre-eclampsia. Two cases of congenital heart block were observed out of 157 pregnancies (1.3%) with anti-Ro/SSA. Regarding treatments, 244 (28.2%) pregnancies were treated with glucocorticoids, 388 (44.8%) with hydroxychloroquine, 85 (9.8%) with conventional synthetic disease-modifying anti-rheumatic drugs and 122 (14.1%) with biological disease-modifying anti-rheumatic drugs. Live births were 794 (91.7%), mostly at term (84.9%); four perinatal deaths (0.5%) occurred. Among 790 newborns, 31 (3.9%) were small-for-gestational-age and 169 (21.4%) had perinatal complications. Exclusive maternal breast feeding was received by 404 (46.7%) neonates. The Edinburgh Postnatal Depression Scale was compiled by 414 women (52.4%); 89 (21.5%) scored positive for emotional distress., Conclusions: Multiple factors including preconception counselling and treat-to-target with pregnancy-compatible medications may have contributed to mitigate disease-related risk factors, yielding limited disease flares, good pregnancy outcomes and frequency of complications which were similar to the Italian general obstetric population. Disease-specific issues need to be further addressed to plan preventative measures., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2024
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38. Effect of Additional Treatments Combined with Conventional Therapies in Pregnant Patients with High-Risk Antiphospholipid Syndrome: A Multicentre Study.

Author

Ruffatti A, Tonello M, Hoxha A, Sciascia S, Cuadrado MJ, Latino JO, Udry S, Reshetnyak T, Costedoat-Chalumeau N, Morel N, Marozio L, Tincani A, Andreoli L, Haladyj E, Meroni PL, Gerosa M, Alijotas-Reig J, Tenti S, Mayer-Pickel K, Simchen MJ, Bertero MT, De Carolis S, Ramoni V, Mekinian A, Grandone E, Maina A, Serrano F, Pengo V, and Khamashta MA

Subjects
Administration, Oral, Adult, Antibodies, Anticardiolipin blood, Antibodies, Antiphospholipid blood, Birth Rate, Combined Modality Therapy, Female, Humans, Hydroxychloroquine therapeutic use, Immunoglobulins, Intravenous therapeutic use, Live Birth, Plasma Exchange, Pregnancy, Pregnancy Complications drug therapy, Pregnancy Outcome, Retrospective Studies, Risk, Steroids administration & dosage, Steroids therapeutic use, Thrombosis drug therapy, Antiphospholipid Syndrome therapy, Lupus Coagulation Inhibitor blood
Abstract

The effect of additional treatments combined with conventional therapy on pregnancy outcomes was examined in high-risk primary antiphospholipid syndrome (PAPS) patients to identify the most effective treatment strategy. The study's inclusion criteria were (1) positivity to lupus anticoagulant alone or associated with anticardiolipin and/or anti-β2 glycoprotein I antibodies; (2) a history of severe maternal-foetal complications (Group I) or a history of one or more pregnancies refractory to conventional therapy leading to unexplained foetal deaths not associated with severe maternal-foetal complications (Group II). Two different additional treatments were considered: oral-low-dose steroids (10-20 mg prednisone daily) and/or 200 to 400 mg daily doses of hydroxychloroquine and parenteral-intravenous immunoglobulins at 2 g/kg per month and/or plasma exchange. The study's primary outcomes were live birth rates and pregnancy complications. A total of 194 pregnant PAPS patients attending 20 tertiary centres were retrospectively enrolled. Hydroxychloroquine was found to be linked to a significantly higher live birth rate with respect to the other oral treatments in the Group II patients. The high (400 mg) versus low (200 mg) doses of hydroxychloroquine ( p  = 0.036) and its administration before versus during pregnancy ( p  = 0.021) were associated with a significantly higher live birth rate. Hydroxychloroquine therapy appeared particularly efficacious in the PAPS patients without previous thrombosis. Parenteral treatments were associated with a significantly higher live birth rate with respect to the oral ones ( p  = 0.037), particularly in the Group I patients. In conclusion, some additional treatments were found to be safe and efficacious in high-risk PAPS pregnant women., Competing Interests: None., (Schattauer GmbH Stuttgart.)

Published
2018
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39. Prospectively-followed pregnancies in patients with inflammatory arthritis taking biological drugs: an Italian multicentre study.

Author

Bazzani C, Scrivo R, Andreoli L, Baldissera E, Biggioggero M, Canti V, Gerosa M, Pontikaki I, Ramoni V, Trespidi L, Zatti S, Caporali R, Gorla R, Iannone F, Lojacono A, Meroni P, Montecucco C, Motta M, Sabbadini MG, Valesini G, and Tincani A

Subjects
Abnormalities, Drug-Induced etiology, Abortion, Spontaneous etiology, Adult, Anti-Inflammatory Agents adverse effects, Arthritis diagnosis, Arthritis immunology, Biological Products adverse effects, Chronic Disease, Female, Humans, Italy, Live Birth, Pregnancy, Pregnancy Complications diagnosis, Pregnancy Complications immunology, Prospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Tumor Necrosis Factor-alpha antagonists & inhibitors, Tumor Necrosis Factor-alpha immunology, Anti-Inflammatory Agents therapeutic use, Arthritis drug therapy, Biological Products therapeutic use, Pregnancy Complications drug therapy
Abstract

Objectives: Information on new drugs does not include their possible effects on pregnancy because pregnant women are excluded from clinical trials. Although not classified as teratogenic in animals, limited data is available on biological anti-rheumatic agents and their safety in human pregnancy. The aim of the study is to evaluate the safety of biological drugs in pregnant patients with chronic arthritis., Methods: Pregnancy outcome and maternal disease variations were prospectively followed in six Italian Rheumatology Centres. Patients exposed to biological agents during the periconceptional period or during pregnancy were included in the study. The occurrence of congenital malformations as well as the obstetric and neonatal outcomes were assessed., Results: Between 1999 and 2013 we identified 79 exposed pregnancies in 67 women affected by different rheumatic diseases with peripheral chronic arthritis. At the time of the start of pregnancy, 56 patients were taking etanercept, 13 adalimumab, 3 infliximab, 2 each certolizumab-pegol and rituximab, 1 each golimumab, anakinra and abatacept. Biological treatment was stopped after a mean of 41 days since documented pregnancy. Live births were reported in 66% of pregnancies. The rate of spontaneous pregnancy loss was 20%. Only one congenital malformation was reported., Conclusions: TNF-alpha inhibitors can be considered safe in the periconception period, representing a possible therapeutic choice also in young women affected by an aggressive form of chronic arthritis and hoping for a pregnancy. Reports of exposure during 2nd/3rd trimester are still limited and suggest caution. Experience with abatacept, tocilizumab, anakinra and rituximab in pregnancy is insufficient.

Published
2015

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