79 results on '"Tarner, I. H."'
Search Results
2. Facettenreichtum des Morbus Whipple
- Author
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Sluszniak, M., Tarner, I. H., Thiele, A., and Schmeiser, T.
- Published
- 2019
- Full Text
- View/download PDF
3. Classification, categorization and essential items for digital ulcer evaluation in systemic sclerosis: a DeSScipher/European Scleroderma Trials and Research group (EUSTAR) survey
- Author
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Blagojevic, J., Bellando-Randone, S., Abignano, G., Avouac, J., Cometi, L., Czirják, L., Denton, C. P., Distler, O., Frerix, M., Guiducci, S., Huscher, D., Jaeger, V. K., Lóránd, V., Maurer, B., Nihtyanova, S., Riemekasten, G., Siegert, E., Tarner, I. H., Vettori, S., Walker, U. A., Allanore, Y., Müller-Ladner, U., Del Galdo, F., Matucci-Cerinic, M., and EUSTAR co-workers
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- 2019
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- View/download PDF
4. Sensitivity to change of joint count composite indices in 72 patients with systemic sclerosis
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Lóránd, V., Nagy, G., Bálint, Z., Komjáti, D., Minier, T., Kumánovics, G., Nelli Farkas, Tarner, I. H., Möller-Ladner, U., Czirják, L., and Varjú, C.
- Subjects
Arthritis, Rheumatoid ,Scleroderma, Systemic ,Rheumatology ,Antirheumatic Agents ,Immunology ,Quality of Life ,Humans ,Immunology and Allergy ,Joints ,Severity of Illness Index ,Follow-Up Studies - Abstract
We validated the responsiveness of joint count composite indices (JCCIs) in 72 patients with systemic sclerosis (SSc).Changes in Disease Activity Score of 28 Joints using ESR and CRP (DAS28-ESR, DAS28-CRP), Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI) were evaluated in a one-year follow-up study. Charts of patients including swollen/tender joint counts, laboratory signs of inflammation, and visual analogue scales referring to disease activity, severity and pain were also blindly categorized by two rheumatologists as improved, unchanged or deteriorated. These categories were used as references for the determination of effect size (ES) and standardised response mean (SRM).Articular inflammation improved in 15, deteriorated in 12, and remained unchanged in 45 (63%) patients with SSc based on the concordant opinion of two clinical investigators. All four JCCIs were sensitive to changes (ES1; SRM1). The correlation between changes in JCCIs and the physicians' evaluation was high (r0.68; p0.001). Arthritis was predominantly prone to change in patients with high JCCIs, impaired functional status, anti-RNA polymerase III antibodies and patients on DMARD therapy. Synovitis was more prevalent in patients with early diffuse SSc, and tended to improve during the follow-up.All four JCCIs were sensitive to changes, if tender/swollen joints were present at baseline. Articular inflammation was most prone to change in patients with high JCCIs, impaired functional status and already decreased health-related quality of life at baseline.
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- 2021
5. Retrospective comparison of drug treatment of joint involvement in systemic sclerosis: 6.18
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Lóránd, V., Huscher, D., Frerix, M., Abignano, G., Allanore, Y., Avouac, J., Del Galdo, F., Denton, C., Distler, O., Guiducci, S., Jaeger, V. K., Matucci-Cerinic, M., Maurer, B., Nihtyanova, S., Riemekasten, G., Siegert, E., Tarner, I. H., Valentini, G., Vettori, S., Walker, U. A., Müller-Ladner, U., and Czirják, L.
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- 2015
6. Use of vasoactive/vasodilating drugs for systemic sclerosis (SSc)-related digital ulcers (DUs) in expert tertiary centres: results from the analysis of the observational real-life DeSScipher study
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Blagojevic, Jelena, Abignano, Giuseppina, Avouac, Jérôme, Cometi, L, Frerix, Marc, Bellando-Randone, Silvia, Guiducci, Serena, Bruni, Cosimo, Huscher, Dörte, Jaeger, V K, Lóránd, Veronika, Maurer, Britta, Nihtyanova, Svetlana, Riemekasten, Gabriela, Siegert, Elise, Tarner, I H, Vettori, Serena, Walker, U A, Czirják, László, Denton, C P, Distler, Oliver, Allanore, Yannick, Müller-Ladner, Ulf, Moggi-Pignone, Alberto, Matucci-Cerinic, Marco, Del Galdo, Francesco, EUSTAR co-workers, University of Zurich, and Blagojevic, Jelena
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2745 Rheumatology ,10051 Rheumatology Clinic and Institute of Physical Medicine ,610 Medicine & health - Published
- 2020
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7. Localized expression of an anti-TNF single-chain antibody prevents development of collagen-induced arthritis
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Smith, R, Tarner, I H, Hollenhorst, M, Lin, C, Levicnik, A U, Fathman, C G, and Nolan, G P
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- 2003
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8. S.9.1 Lung ultrasound for the screening of interstitial lung disease in SSc
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Akbayrak, E., Tarner, I. H., Müller-Ladner, U., and Dinser, R.
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- 2012
9. Multimodale rheumatologische Komplexbehandlung bei rheumatoider Arthritis – eine monozentrische Retrospektivanalyse
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Klemm, P., primary, Hudowenz, O., additional, Asendorf, T., additional, Müller-Ladner, U., additional, Lange, U., additional, and Tarner, I. H., additional
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- 2019
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10. Facettenreichtum des Morbus Whipple
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Sluszniak, M., primary, Tarner, I. H., additional, Thiele, A., additional, and Schmeiser, T., additional
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- 2018
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11. Preliminary analysis of the Very Early Diagnosis of Systemic Sclerosis (VEDOSS) EUSTAR multicentre study: evidence for puffy fingers as a pivotal sign for suspicion of systemic sclerosis
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Minier, T., Guiducci, S., Bellando-Randone, S., Bruni, C., Lepri, G., Czirjak, L., Distler, O., Walker, U. A., Fransen, J., Allanore, Y., Denton, C., Cutolo, M., Tyndall, A., Muller-Ladner, U., Matucci-Cerinic, M., Airo, P., Zingarelli, S., Ananieva, L., Desinova, O., Ancuta, C. M., Belibou, C. I., Avouac, J., Becvar, R., Skacelova, S., Beretta, L., Vigone, B., Caramaschi, P., Sabbagh, D., Carpentier, P., Damjanov, N., Simic-Pasalic, K., Distler, J. H. W., Farge-Bancel, D., Hadj-Khelifa, S., Foti, R., Di Gangi, M., De La Pena Lefebvre, P. G., Hachulla, E., Salvador, M. J., Kayser, C., Camargo, C. Z., Kumanovics, G., Li, M., Xu, D., Marasini, B., Belloli, L., Maurer, B., Mayer, M., Mihai, C., Gherghe, A. M., Riccieri, V., Stefanantoni, K., Salsano, F., Rosato, E., Senecal, J. -L., Koenig, M., Senet, P., Frances, C., Sipek, A., Stankovic, A., Stamenkovic, B., Smith, V., Tarner, I. H., Wiland, P., University of Zurich, and Matucci-Cerinic, Marco
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Male ,Anti-nuclear antibody ,Pulmonary Fibrosis ,2745 Rheumatology ,Scleroderma ,Microscopic Angioscopy ,Cohort Studies ,Antinuclear ,Immunology and Allergy ,skin and connective tissue diseases ,integumentary system ,10051 Rheumatology Clinic and Institute of Physical Medicine ,Middle Aged ,Connective tissue disease ,Autoantibodies ,Disease Activity ,Outcomes research ,Systemic Sclerosis ,Adult ,Antibodies, Antinuclear ,Early Diagnosis ,Female ,Fingers ,Humans ,Raynaud Disease ,Scleroderma, Systemic ,Skin Ulcer ,Telangiectasis ,Cohort ,2723 Immunology and Allergy ,musculoskeletal diseases ,medicine.medical_specialty ,Immunology ,610 Medicine & health ,General Biochemistry, Genetics and Molecular Biology ,Antibodies ,Rheumatology ,1300 General Biochemistry, Genetics and Molecular Biology ,Internal medicine ,medicine ,2403 Immunology ,business.industry ,Systemic ,Autoantibody ,medicine.disease ,Surgery ,stomatognathic diseases ,Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5] ,Observational study ,business ,Rheumatism - Abstract
Item does not contain fulltext OBJECTIVES: The EULAR (European League Against Rheumatism) Scleroderma Trials and Research Group (EUSTAR) has identified preliminary criteria for very early diagnosis of systemic sclerosis (SSc). Our aim was to assess the prevalence of each proposed diagnostic item in a large observational patient cohort with Raynaud's phenomenon (RP). METHODS: Baseline data of 469 RP patients enrolled into the Very Early Diagnosis of Systemic Sclerosis (VEDOSS) cohort are presented. RESULTS: 68% of all RP patients were antinuclear antibody (ANA) positive. ANA+ RP patients more frequently had previous or current puffy fingers (PuFi) (38.5% and 23.3%, p
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- 2014
12. National and Multinational Evidence-based Recommendations for Medical Pain Management in Inflammatory Joint Disease: Systematic Literature Research and Expert Opinion in the 3e Initiative
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Albrecht, K., Englbrecht, M., Baerwald, C., Feist, E., Fleck, M., Gromnica-Ihle, E., Koehler, L., Koetter, I., Kneitz, C., Krueger, K., Kuipers, J., Nuesslein, H., Rubbert-Roth, A., Wollenhaupt, J., Schneider, M., Manger, B., Mueller-Ladner, U., Tarner, I. H., Albrecht, K., Englbrecht, M., Baerwald, C., Feist, E., Fleck, M., Gromnica-Ihle, E., Koehler, L., Koetter, I., Kneitz, C., Krueger, K., Kuipers, J., Nuesslein, H., Rubbert-Roth, A., Wollenhaupt, J., Schneider, M., Manger, B., Mueller-Ladner, U., and Tarner, I. H.
- Abstract
Background: In inflammatory joint disease, pain management is essential for sustaining the function of joints and maintaining the quality of life of affected patients. Beside disease modifying antirheumatic drugs and glucocorticoids for the treatment of inflammatory activity, pain medication is an important treatment module in the management of arthritis. It was the goal of this 3e (Evidence, Expertise, Exchange) initiative to develop evidence-based recommendations for pain management by pharmacotherapy. Materials and Methods: A total of 453 rheumatologists from 17 countries participated in the international 3e Initiative. The group of German experts comprised 66 participants. Using a Delphi process with 3 rounds of discussion, 10 international and 2 national clinical questions were selected regarding the use of pain medications in inflammatory joint disease. A systematic literature research (SLR) was performed in May 2010 for each question using Medline, EMBASE, Cochrane Library and the 2008/2009 EULAR/ACR abstracts. The national experts used the retrieved evidence to develop a set of national recommendations and assessed them for agreement and potential impact on clinical practice. Subsequently, the consensus recommendations were drafted. Results: A total of 49 242 references were identified, from which 167 studies were included in the systematic review. Based on this evidence, 12 recommendations and an algorithm for pharmacological management of pain were developed in response to the multinational questions. The recommendations related to the efficacy and safety of various analgesics, their use in different comorbidities and during pregnancy and lactation, the utility of pain measurement scales, as well as pain management. With regard to the 2 additional national questions, 34 out of 7 334 retrieved publications could be used to develop two recommendations on treatment monitoring and herbal medicine. Conclusion: 14 evidence-based recommendations and an algorithm
- Published
- 2015
13. SSc-overlap syndromes: a distinct clinical subgroup with significant differences in disease progression compared to lSSc and dSSc patients. Data of the German Network for Systemic Scleroderma (DNSS)
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Moinzadeh, P., Aberer, E., Ahmadi-Simab, K., Blank, N., Distler, J. W., Fierlbeck, G., Genth, E., Guenther, C., Hein, R., Henes, J., Herich, L., Herrgott, I., Koetter, I., Kreuter, A., Krieg, T., Kuhr, K., Lorenz, H. M., Meier, F., Melchers, I., Mensing, H., Mueller-Ladner, U., Pfeiffer, C., Riemekasten, G., Sardy, M., Schmalzing, M., Sunderkoetter, C., Susok, L., Tarner, I. H., Vaith, P., Worm, M., Zeidler, G., Hunzelmann, N., Moinzadeh, P., Aberer, E., Ahmadi-Simab, K., Blank, N., Distler, J. W., Fierlbeck, G., Genth, E., Guenther, C., Hein, R., Henes, J., Herich, L., Herrgott, I., Koetter, I., Kreuter, A., Krieg, T., Kuhr, K., Lorenz, H. M., Meier, F., Melchers, I., Mensing, H., Mueller-Ladner, U., Pfeiffer, C., Riemekasten, G., Sardy, M., Schmalzing, M., Sunderkoetter, C., Susok, L., Tarner, I. H., Vaith, P., Worm, M., Zeidler, G., and Hunzelmann, N.
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- 2014
14. SSC-OVERLAP SYNDROMES: A DISTINCT CLINICAL SUBGROUP WITH SIGNIFICANT DIFFERENCES IN DISEASE PROGRESSION COMPARED TO LSSC AND DSSC PATIENTS
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Moinzadeh, P., Aberer, E., Ahmadi-Simab, K., Blank, N., Distler, J. H. W., Fierlbeck, G., Genth, E., Guenther, C., Hein, R., Henes, J., Herich, L., Herrgott, I., Koetter, I., Kreuter, A., Krieg, T., Kuhr, K., Lorenz, H. -M., Meier, F., Melchers, I., Mensing, H., Mueller-Ladner, U., Pfeiffer, C., Riemekasten, G., Sardy, M., Schmalzing, M., Sunderkoetter, C., Susok, L., Tarner, I. H., Vaith, P., Worm, M., Wozel, G., Zeidler, G., Hunzelmann, N., Moinzadeh, P., Aberer, E., Ahmadi-Simab, K., Blank, N., Distler, J. H. W., Fierlbeck, G., Genth, E., Guenther, C., Hein, R., Henes, J., Herich, L., Herrgott, I., Koetter, I., Kreuter, A., Krieg, T., Kuhr, K., Lorenz, H. -M., Meier, F., Melchers, I., Mensing, H., Mueller-Ladner, U., Pfeiffer, C., Riemekasten, G., Sardy, M., Schmalzing, M., Sunderkoetter, C., Susok, L., Tarner, I. H., Vaith, P., Worm, M., Wozel, G., Zeidler, G., and Hunzelmann, N.
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- 2014
15. Evidence-based recommendations for the management of undifferentiated peripheral inflammatory arthritis (UPIA). The German perspective on the international 3e initiative
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Tarner, I. H., Albrecht, K., Fleck, M., Gromnica-Ihle, E., Keysser, G., Koehler, L., Koetter, I., Krueger, K., Kuipers, J., Nuesslein, H., Rubbert-Roth, A., Wollenhaupt, J., Schneider, M., Manger, B., Mueller-Ladner, U., Tarner, I. H., Albrecht, K., Fleck, M., Gromnica-Ihle, E., Keysser, G., Koehler, L., Koetter, I., Krueger, K., Kuipers, J., Nuesslein, H., Rubbert-Roth, A., Wollenhaupt, J., Schneider, M., Manger, B., and Mueller-Ladner, U.
- Abstract
Peripheral arthritis is the most common presenting complaint in clinical rheumatology. Unequivocal identification of the underlying entity can be difficult, particularly at an early stage. Such cases are commonly referred to as undifferentiated peripheral inflammatory arthritis (UPIA). Since evidence-based recommendations for the clinical management of UPIA are lacking, this international 3e initiative convened 697 rheumatologists from 17 countries to develop appropriate recommendations. Based on a systematic literature research in Medline, EMBASE, Cochrane Library, and the ACR/EULAR abstracts of 2007/2008, 10 multinational recommendations were developed by 3 rounds of a Delphi process. In Germany, a national group of experts worked on 3 additional recommendations using the same method. The recommendations were discussed among the members of the 3e initiative and the degree of consensus was analyzed as well as the potential impact of the recommendations on clinical practice. A total of 39,756 references were identified, of which 250 were systematically reviewed for the development of 10 multinational recommendations concerning differential diagnosis, diagnostic and prognostic value of clinical assessments, laboratory tests and imaging techniques, and monitoring of UPIA. In addition, 3 national recommendations on the diagnostic and prognostic value of a response to anti-inflammatory therapy on the analysis of synovial fluid and on enthesitis were developed by the German experts based on 35 out of 5542 references. The article translates the 2011 published original paper of the international 3e initiative (Machado et al., Ann Rheum Dis 70:15-24, 2011) and reports the methods and results of the national vote and the additional 3 national recommendations.
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- 2014
16. EUSTAR biobanking: recommendations for the collection, storage and distribution of biospecimens in scleroderma research
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Beyer, C, Distler, J H W, Allanore, Y, Aringer, M, Avouac, J, Czirják, L, Cutolo, M, Damjanov, N, Del Galdo, F, Fligelstone, K, Guiducci, S, Kowal-Bielecka, O, van Laar, J M, Martucci-Cerinic, M, Müller-Ladner, U, Riemekasten, G, Tarner, I H, Tyndall, A, Kennedy, A T, Valentini, G, Vettori, S, Walker, U A, Denton, C, Distler, O, Beyer, C, Distler, J H W, Allanore, Y, Aringer, M, Avouac, J, Czirják, L, Cutolo, M, Damjanov, N, Del Galdo, F, Fligelstone, K, Guiducci, S, Kowal-Bielecka, O, van Laar, J M, Martucci-Cerinic, M, Müller-Ladner, U, Riemekasten, G, Tarner, I H, Tyndall, A, Kennedy, A T, Valentini, G, Vettori, S, Walker, U A, Denton, C, and Distler, O
- Abstract
The European League Against Rheumatism Scleroderma Trials and Research Group (EUSTAR) has established an online database with clinical data of currently more than 8200 patients with systemic sclerosis (SSc). In addition to clinical research, EUSTAR fosters biomolecular studies to develop novel biomarkers and therapies for SSc. High-quality biospecimens are the basis for successful biomolecular studies. The EUSTAR biobanking group has therefore developed recommendations to standardise the collection, storage and distribution of SSc biospecimens at EUSTAR centres. These recommendations consider the scientific challenges associated with biomolecular research in SSc and the organisational requirements of EUSTAR. They were approved by the EUSTAR executive committee as well as the EUSTAR board. Once they become effective, these recommendations will be the basis for international EUSTAR studies with large numbers of SSc biospecimens. These recommendations might also be followed by other SSc consortia to enable exchange of biosamples between different SSc initiatives and might serve as a template for biobanking initiatives in other rheumatic diseases.
- Published
- 2011
17. Dysbalance of angiogenic and angiostatic mediators in patients with mixed connective tissue disease
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Distler, J H W, Strapatsas, T, Huscher, D, Dees, C, Akhmetshina, A, Kiener, H P, Tarner, I H, Maurer, B, Walder, M, Michel, B, Gay, S, Smolen, J S, Müller-Ladner, U, Schett, G, Distler, O, Distler, J H W, Strapatsas, T, Huscher, D, Dees, C, Akhmetshina, A, Kiener, H P, Tarner, I H, Maurer, B, Walder, M, Michel, B, Gay, S, Smolen, J S, Müller-Ladner, U, Schett, G, and Distler, O
- Abstract
/st> Molecular factors modulating angiogenic responses are dysregulated in patients with MCTD and SSc with increases of VEGF in MCTD and SSc and selective upregulation of endostatin in MCTD. Furthermore, high serum levels of VEGF might characterise patients with MCTD with a more severe course of the disease with increased prevalence of PAH and myositis.
- Published
- 2011
18. Cell culture and passaging alters gene expression pattern and proliferation rate in rheumatoid arthritis synovial fibroblasts
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Neumann, E, Riepl, B, Knedla, A, Lefèvre, S, Tarner, I H, Grifka, J, Steinmeyer, J, Schölmerich, J, Gay, S, Müller-Ladner, U, Neumann, E, Riepl, B, Knedla, A, Lefèvre, S, Tarner, I H, Grifka, J, Steinmeyer, J, Schölmerich, J, Gay, S, and Müller-Ladner, U
- Abstract
INTRODUCTION: Rheumatoid arthritis synovial fibroblasts (RASF) are key players in synovial pathophysiology and are therefore examined extensively in various experimental approaches. We evaluated, whether passaging during culture and freezing has effects on gene expression and cell proliferation. METHODS: RASF were passaged for up to 8 passages. RNA was isolated after each passage and cDNA arrays were performed to evaluate the RNA expression pattern during passaging. In addition, doubling time of the cells was also measured. RESULTS: From passages 2-4, mRNA expression did not change significantly. Gene expression in RASF started to change in passages 5-6 with 7-10% differentially expressed genes. After passages 7-8, more than 10% of the genes were differentially expressed. The doubling rate was constant for up to 5 passages and decreased after passages 6-8. After freezing, gene expression of the second passage is comparable to gene expression prior to freezing. CONCLUSIONS: The results of this study show, that experiments, which examine gene expression of RASF and shall reflect or imitate an in vivo situation, should be limited to early culture passages to avoid cell culture effects. It is not necessary to stop culturing SF after a few passages, but to keep the problems of cell culture in mind to avoid false positive results. Especially, when large-scale screening methods on mRNA level are used. Of note, freezing does not affect gene expression substantially.
- Published
- 2010
19. THU0354 The Effects of Manual Mobilisation on the Mobility of the Thoracic Spine in Patients with Ankylosing Spondylitis
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Meier, F. M., primary, Sperling, M., additional, Tarner, I. H., additional, Müller-Ladner, U., additional, and Lange, U., additional
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- 2013
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20. The Role of Corticosteroids for Pain Relief in Persistent Pain of Inflammatory Arthritis: A Systematic Literature Review
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TARNER, I. H., primary, ENGLBRECHT, M., additional, SCHNEIDER, M., additional, van der HEIJDE, D. M., additional, and MULLER-LADNER, U., additional
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- 2012
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21. Measuring Pain and Efficacy of Pain Treatment in Inflammatory Arthritis: A Systematic Literature Review
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ENGLBRECHT, M., primary, TARNER, I. H., additional, van der HEIJDE, D. M., additional, MANGER, B., additional, BOMBARDIER, C., additional, and MULLER-LADNER, U., additional
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- 2012
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22. Multinational evidence-based recommendations for pain management by pharmacotherapy in inflammatory arthritis: integrating systematic literature research and expert opinion of a broad panel of rheumatologists in the 3e Initiative
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Whittle, S. L., primary, Colebatch, A. N., additional, Buchbinder, R., additional, Edwards, C. J., additional, Adams, K., additional, Englbrecht, M., additional, Hazlewood, G., additional, Marks, J. L., additional, Radner, H., additional, Ramiro, S., additional, Richards, B. L., additional, Tarner, I. H., additional, Aletaha, D., additional, Bombardier, C., additional, Landewe, R. B., additional, Muller-Ladner, U., additional, Bijlsma, J. W. J., additional, Branco, J. C., additional, Bykerk, V. P., additional, da Rocha Castelar Pinheiro, G., additional, Catrina, A. I., additional, Hannonen, P., additional, Kiely, P., additional, Leeb, B., additional, Lie, E., additional, Martinez-Osuna, P., additional, Montecucco, C., additional, Ostergaard, M., additional, Westhovens, R., additional, Zochling, J., additional, and van der Heijde, D., additional
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- 2012
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23. S.9.1 Lung ultrasound for the screening of interstitial lung disease in SSc
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Barskova, T., primary, Gargani, L., additional, Conforti, M. L., additional, Guiducci, S., additional, Bruni, C., additional, Moggi Pignone, A., additional, Picano, E., additional, Matucci Cerinic, M., additional, Doveri, M., additional, Agoston, G., additional, Moreo, A., additional, Musca, F., additional, Bruschi, E., additional, Epis, O., additional, Bellando Randone, S., additional, Bazzichi, L., additional, Bombardieri, S., additional, Varga, A., additional, Sicari, R., additional, Akbayrak, E., additional, Tarner, I. H., additional, Muller-Ladner, U., additional, Dinser, R., additional, Stamenkovic, B., additional, Stankovic, A., additional, Dimic, A., additional, Damjanov, N., additional, Nedovic, J., additional, Menkovic, D., additional, Stojanovic, S., additional, and Milenkovic, S., additional
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- 2012
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24. Entzündlich rheumatische Erkrankungen und Osteoporose
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Tarner, I. H., additional
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- 2012
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25. Dysbalance of angiogenic and angiostatic mediators in patients with mixed connective tissue disease
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Distler, J. H. W., primary, Strapatsas, T., additional, Huscher, D., additional, Dees, C., additional, Akhmetshina, A., additional, Kiener, H. P., additional, Tarner, I. H., additional, Maurer, B., additional, Walder, M., additional, Michel, B., additional, Gay, S., additional, Smolen, J. S., additional, Muller-Ladner, U., additional, Schett, G., additional, and Distler, O., additional
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- 2011
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26. Adoptive cellular gene therapy of autoimmune arthritis using a combination of lentivirally transduced dendritic cells
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Purath, U, primary, Creusot, R J, additional, Garrison Fathman, C, additional, Muller-Ladner, U, additional, Neumann, E, additional, and Tarner, I H, additional
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- 2010
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27. Nationale und multinationale evidenzbasierte Empfehlungen für die medikamentöse Schmerztherapie der entzündlichen Gelenkerkrankungen: systematische Literaturrecherche und Expertenmeinung in der 3e Initiative.
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Albrecht, K., Englbrecht, M., Baerwald, C., Feist, E., Fleck, M., Gromnica-Ihle, E., Köhler, L., Kötter, I., Kneitz, C., Krüger, K., Kuipers, J., Nüßlein, H., Rubbert-Roth, A., Wollenhaupt, J., Schneider, M., Manger, B., Müller-Ladner, U., and Tarner, I. H.
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- 2015
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28. Molekulare physikalische Medizin in der Rheumatologie: Fake oder Realität.
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Tarner, I. H. and Lange, U.
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- 2014
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29. Osteometabolic and Osteogenetic Pattern of Turkish Immigrants in Germany.
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Tarner, I. H., Erkal, M. Z., Obermayer-Pietsch, B. M., Hofbauer, L. C., Bergmann, S., Goettsch, C., Madlener, K., Müller-Ladner, U., and Lange, U.
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VITAMIN D deficiency , *BONE metabolism , *OSTEOPOROSIS genetics , *IMMIGRANTS , *BONE density , *VITAMIN D receptors , *DUAL-energy X-ray absorptiometry - Abstract
Introduction: The etiology of osteoporosis comprises environmental and genetic factors. This study investigated vitamin D deficiency and specific genetic alterations of bone metabolism in a group of 183 Turkish immigrants in Germany in comparison with 46 age and sex matched healthy German controls (females in both groups were pre-menopausal). Methods: Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Serum levels of osteologic parameters were determined after overnight fasting. Polymorphisms of the vitamin D receptor (VDR) and lactase genes were genotyped using genomic DNA from peripheral leukocytes. Statistical analysis comprised student's t-test, Mann-Whitney rank sum test, Chi-square analysis and Fisher's exact test. Results: Severe 25-OH D ³ hypovitaminosis (83.1 %) and elevated parathyroid hormone (82 %) were common among immigrants. Osteoporosis but not osteopenia was more prevalent in immigrants. Among immigrants with osteoporosis, TRAP5b was elevated in 26.7 %, and β-crosslaps in 13.3 %. Only the FokI FF VDR-gene-polymorphism was significantly more prevalent among immigrants. In contrast, Ff-genotyped Turkish women exhibited significantly decreased BMD. Lactase polymorphisms were significantly more common among immigrants (84.2 % vs. 30.4 %) and the CC genotype was commonly associated with reduced BMD (41.6 %) but rarely osteoporosis (8.4 %). Conclusions: Vitamin D deficiency, secondary hyperparathyroidism and osteoporosis are common among Turkish immigrants in Germany. Thus, in this population osteologic parameters and BMD should be analyzed and deficiencies be treated. Specifically, the VDR gene polymorphism FokI Ff is of clinical value in identifying females at risk of osteoporosis. In contrast, LCT polymorphisms, though common, do not appear to be a risk factor. [ABSTRACT FROM AUTHOR]
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- 2012
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30. Evidenzbasierte Empfehlungen einer nationalen Expertenrunde zum Einsatz von Methotrexat bei entz�ndlich-rheumatischen Erkrankungen.
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Tarner, I. H., Manger, B., Fleck, M., Gromnica-Ihle, E., Key�er, G., K�hler, L., K�tter, I., Kr�ger, K., Kuipers, J., Lorenz, H.-M., N��lein, H., Rau, R., Rubbert, A., Schr�der, J. O., Wollenhaupt, J., and M�ller-Ladner, U.
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- 2009
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31. Einfluss einer seriellen niedrig dosierten Radonstollen-Hyperthermie auf zentrale Zytokine des Knochenmetabolismus bei ankylosierender Spondylitis.
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Lange, U., Neumann, N., Kürten, B., Müller-Ladner, U., and Tarner, I. H.
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- 2012
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32. Dysbalance of angiogenic and angiostatic mediators in patients with mixed connective tissue disease
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Distler, J H W, Strapatsas, T, Huscher, D, Dees, C, Akhmetshina, A, Kiener, H P, Tarner, I H, Maurer, B, Walder, M, Michel, B, Gay, S, Smolen, J S, Müller-Ladner, U, Schett, G, and Distler, O
- Subjects
3. Good health
33. Dysbalance of angiogenic and angiostatic mediators in patients with mixed connective tissue disease
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Strapatsas, T., Gay, S., Walder, M., Distler, J. H. W., Distler, O., Schett, G., Dees, C., Smolen, J. S., Tarner, I. H., Michel, B., Maurer, B., Huscher, D., Mü, ller-ladner, U., Akhmetshina, A., and Kiener, H. P.
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34. Use of vasoactive/vasodilating drugs for systemic sclerosis (SSc)-related digital ulcers (DUs) in expert tertiary centres: results from the analysis of the observational real-life DeSScipher study
- Author
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Silvia Bellando-Randone, Ulrich A. Walker, Marc Frerix, Svetlana I. Nihtyanova, Veronika Lóránd, Marco Matucci-Cerinic, Ingo H. Tarner, Serena Vettori, Veronika K. Jaeger, Ulf Müller-Ladner, Giuseppina Abignano, Jérôme Avouac, G. Riemekasten, Cosimo Bruni, Oliver Distler, L. Czirják, Yannick Allanore, Alberto Moggi-Pignone, F. Del Galdo, Jelena Blagojevic, Laura Cometi, Dörte Huscher, Christopher P. Denton, Britta Maurer, Serena Guiducci, Elise Siegert, Blagojevic, Jelena, Abignano, G, Avouac, J, Cometi, L, Frerix, M, Bellando-Randone, S, Guiducci, S, Bruni, C, Huscher, D, Jaeger, V K, Lóránd, V, Maurer, B, Nihtyanova, S, Riemekasten, G, Siegert, E, Tarner, I H, Vettori, S, Walker, U A, Czirják, L, Denton, C P, Distler, O, Allanore, Y, Müller-Ladner, U, Moggi-Pignone, A, Matucci-Cerinic, M, and Del Galdo, F
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Adult ,Male ,Drug ,medicine.medical_specialty ,Combination therapy ,Sildenafil ,Vasodilator Agents ,media_common.quotation_subject ,Digital ulcer ,Sildenafil Citrate ,Fingers ,chemistry.chemical_compound ,Rheumatology ,Internal medicine ,Skin Ulcer ,medicine ,Humans ,Iloprost ,Prospective Studies ,Aged ,media_common ,Wound Healing ,Scleroderma, Systemic ,business.industry ,Bosentan ,General Medicine ,Management ,Systemic sclerosis ,Middle Aged ,Europe ,Treatment Outcome ,chemistry ,cGMP-specific phosphodiesterase type 5 ,Drug Therapy, Combination ,Female ,Observational study ,business ,medicine.drug - Abstract
DeSScipher is the first European multicentre study on management of systemic sclerosis (SSc), and its observational trial 1 (OT1) evaluated the efficacy of different drugs for digital ulcer (DU) prevention and healing. The aim of this study was to assess current use of vasoactive/vasodilating agents for SSc-related DU in the expert centres by analysing the baseline data of the DeSScipher OT1.Baseline characteristics of patients enrolled in the OT1 and data regarding DU were analysed.The most commonly used drugs, in both patients with and without DU, were calcium channel blockers (CCBs) (71.6%), followed by intravenous iloprost (20.8%), endothelin receptor antagonists (ERAs) (20.4%) and phosphodiesterase 5 (PDE-5) inhibitors (16.5%). Of patients, 32.6% with DU and 12.8% without DU received two drugs (p 0.001), while 11.5% with DU and 1.9% without DU were treated with a combination of three or more agents (p 0.001). Sixty-five percent of the patients with recurrent DU were treated with bosentan and/or sildenafil. However, 64 out of 277 patients with current DU (23.1%) and 101 (23.6%) patients with recurrent DU were on CCBs alone.Our study shows that CCBs are still the most commonly used agents for DU management in SSc. The proportion of patients on combination therapy was low, even in patients with recurrent DU: almost one out of four patients with current and recurrent DU was on CCBs alone. Prospective analysis is planned to investigate the efficacy of different drugs/drug combinations on DU healing and prevention. Key Points • The analysis of DeSScipher, the first European multicentre study on management of SSc, has shown that the most commonly used vasoactive/vasodilating drugs for DU were CCBs, followed by intravenous Iloprost, ERAs and PDE-5 inhibitors. • More than half of the patients with recurrent DU received bosentan and/or sildenafil. • However, the proportion of patients on combination therapy of more than one vasoactive/vasodilating drug was low and almost one out of four patients with current and recurrent DU was on CCBs alone.
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- 2019
35. Vasodilators and low-dose acetylsalicylic acid are associated with a lower incidence of distinct primary myocardial disease manifestations in systemic sclerosis: results of the DeSScipher inception cohort study
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László Czirják, Brigitte Krummel-Lorenz, Carina Mihai, Serena Fasano, Giuseppina Abignano, Serena Guiducci, Gabriele Valentini, Rosaria Irace, Armando Gabrielli, Francesco Del Galdo, Britta Maurer, Ivan Foeldvari, Ulrich A. Walker, Svetlana I. Nihtyanova, Alessandra Vacca, Dörte Huscher, Ulf Mueller-Ladner, Marc Frerix, Jérôme Avouac, Veronika K. Jaeger, Christopher P. Denton, Oliver Distler, Marco Matucci-Cerinic, Ingo H. Tarner, T. Schmeiser, L. Ananieva, Simona Rednic, Sergey Moiseev, Ana Maria Gherghe, Yannick Allanore, Antonella Riccardi, Elise Siegert, Joerg Henes, Gabriela Riemekasten, Veronika Lóránd, Valentina Messiniti, Valentini, G., Huscher, D., Riccardi, A., Fasano, S., Irace, R., Messiniti, V., Matucci-Cerinic, M., Guiducci, S., Distler, O., Maurer, B., Avouac, J., Tarner, I. H., Frerix, M., Riemekasten, G., Siegert, E., Czirjak, L., Lorand, V., Denton, C. P., Nihtyanova, S., Walker, U. A., Jaeger, V. K., Del Galdo, F., Abignano, G., Ananieva, L. P., Gherghe, A. M., Mihai, C., Henes, J. C., Schmeiser, T., Vacca, A., Moiseev, S., Foeldvari, I., Gabrielli, A., Krummel-Lorenz, B., Rednic, S., Allanore, Y., and Mueller-Ladner, U.
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,preventative role of vasodilator therapy ,Vasodilator Agents ,Immunology ,primary myocardial disease in scleroderma ,Vasodilation ,General Biochemistry, Genetics and Molecular Biology ,Ventricular Function, Left ,03 medical and health sciences ,Ventricular Dysfunction, Left ,0302 clinical medicine ,Rheumatology ,Fibrosis ,Internal medicine ,medicine ,Immunology and Allergy ,Humans ,Survival analysis ,Proportional Hazards Models ,030203 arthritis & rheumatology ,Heart Failure ,Ejection fraction ,Scleroderma, Systemic ,Aspirin ,Proportional hazards model ,business.industry ,Incidence (epidemiology) ,Incidence ,Arrhythmias, Cardiac ,Middle Aged ,medicine.disease ,030104 developmental biology ,Heart failure ,cardiovascular system ,Cardiology ,Female ,Endothelin receptor ,business ,Cardiomyopathies - Abstract
ObjectivesTo investigate the influence of vasodilator drugs on the occurrence of features depending on myocardial ischaemia/fibrosis (ventricular arrhythmias, Q waves, cardiac blocks, pacemaker implantation, left ventricular ejection fraction (LVEF) Methods601 patients with SSc were enrolled from 1 December 2012 to 30 November 2015 and had a second visit 0.5–4 years apart. 153 received no vasodilators; 448 received vasodilator therapy (ie, calcium channel blockers and/or ACE inhibitors or angiotensin II receptor blockers or combinations of them), 89 of them being also treated with either endothelin receptor antagonists or PDE5 inhibitors or prostanoids. Associations between the occurrence of myocardial disease manifestations and any demographic, disease and therapeutic aspect were investigated by Cox regression analysis. A Cox frailty survival model with centre of enrolment as random effect was performed.ResultsDuring 914 follow-up patient-years, 12 ventricular arrhythmias, 5 Q waves, 40 cardiac blocks, 6 pacemaker implantations and 19 reduced LVEF and/or congestive heart failure (CHF) occurred. In multivariate Cox regression analysis, vasodilator therapy was associated with a lower incidence of ventricular arrhythmias (p=0.03); low-dose acetylsalicylic acid (ASA) with a lower incidence of cardiac blocks and/or Q waves and/or pacemaker implantation (p=0.02); active disease with a higher incidence of LVEF ConclusionsThe present study might suggest a preventative effect on the occurrence of distinct myocardial manifestations by vasodilator therapy and low-dose ASA.
- Published
- 2019
36. Classification, categorization and essential items for digital ulcer evaluation in systemic sclerosis: a DeSScipher/European Scleroderma Trials and Research group (EUSTAR) survey
- Author
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Blagojevic, Jelena, Bellando-Randone, Silvia, Abignano, Giuseppina, Avouac, Jérôme, Cometi, L, Czirják, László, Denton, Christopher P, Distler, Oliver, Frerix, Marc, Guiducci, Serena, Huscher, Dörte, Jaeger, Veronika K, Lóránd, Veronika, Maurer, Britta, Nihtyanova, Svetlana, Riemekasten, Gabriela, Siegert, Elise, Tarner, Ingo H, Vettori, Serena, Walker, Ulrich A, Allanore, Yannick, Müller-Ladner, Ulf, Del Galdo, Francesco, Matucci-Cerinic, Marco, EUSTAR co-workers, University of Zurich, Blagojevic, Jelena, Blagojevic, J., Bellando-Randone, S., Abignano, G., Avouac, J., Cometi, L., Czirják, L., Denton, C. P., Distler, O., Frerix, M., Guiducci, S., Huscher, D., Jaeger, V. K., Lóránd, V., Maurer, B., Nihtyanova, S., Riemekasten, G., Siegert, E., Tarner, I. H., Vettori, S., Walker, U. A., Allanore, Y., Müller-Ladner, U., Del Galdo, F., and Matucci-Cerinic, M.
- Subjects
0301 basic medicine ,Male ,lcsh:Diseases of the musculoskeletal system ,Observational Trial ,2745 Rheumatology ,Digital ulcer ,Categorisation ,Scleroderma ,Systemic sclerosi ,0302 clinical medicine ,Surveys and Questionnaires ,Immunology and Allergy ,Prospective Studies ,10051 Rheumatology Clinic and Institute of Physical Medicine ,Digital ulcers ,Middle Aged ,Calcium Channel Blockers ,Classification ,3. Good health ,Clinical Practice ,Categorization ,2723 Immunology and Allergy ,Systemic sclerosis ,Drug Therapy, Combination ,Female ,Research Article ,Adult ,medicine.medical_specialty ,Immunology ,610 Medicine & health ,Sildenafil Citrate ,Fingers ,03 medical and health sciences ,Rheumatology ,Skin Ulcer ,medicine ,Humans ,In patient ,European Union ,Iloprost ,030203 arthritis & rheumatology ,2403 Immunology ,Scleroderma, Systemic ,business.industry ,Bosentan ,Essential item ,medicine.disease ,030104 developmental biology ,Essential items ,Physical therapy ,Observational study ,lcsh:RC925-935 ,business - Abstract
Background: A consensus on digital ulcer (DU) definition in systemic sclerosis (SSc) has been recently reached (Suliman et al., J Scleroderma Relat Disord 2:115-20, 2017), while for their evaluation, classification and categorisation, it is still missing. The aims of this study were to identify a set of essential items for digital ulcer (DU) evaluation, to assess if the existing DU classification was useful and feasible in clinical practice and to investigate if the new categorisation was preferred to the simple distinction of DU in recurrent and not recurrent, in patients with systemic sclerosis (SSc).Methods: DeSScipher is the largest European multicentre study on SSc. It consists of five observational trials (OTs), and one of them, OT1, is focused on DU management. The DeSScipher OT1 items on DU that reached ≥ 60% of completion rate were administered to EUSTAR (European Scleroderma Trials and Research group) centres via online survey. Questions about feasibility and usefulness of the existing DU classification (DU due to digital pitting scars, to loss of tissue, derived from calcinosis and gangrene) and newly proposed categorisation (episodic, recurrent and chronic) were also asked.Results: A total of 84/148 (56.8%) EUSTAR centres completed the questionnaire. DeSScipher items scored by ≥ 70% of the participants as essential and feasible for DU evaluation were the number of DU defined as a loss of tissue (level of agreement 92%), recurrent DU (84%) and number of new DU (74%). For 65% of the centres, the proposed classification of DU was considered useful and feasible in clinical practice. Moreover, 80% of the centres preferred the categorisation of DU in episodic, recurrent and chronic to simple distinction in recurrent/not recurrent DU.Conclusions: For clinical practice, EUSTAR centres identified only three essential items for DU evaluation and considered the proposed classification and categorisation as useful and feasible. The set of items needs to be validated while further implementation of DU classification and categorisation is warranted.Trial registration: Observational trial on DU (OT1) is one of the five trials of the DeSScipher project (ClinicalTrials.gov; OT1 Identifier: NCT01836263, posted on April 19, 2013).
- Published
- 2018
37. FRI0446 Severe Heart Disease in Systemic Sclerosis: Prevalence, Risk Factors and Current Treatment. A Eustar-Desscipher Study
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Ingo H. Tarner, Serena Vettori, Ulrich A. Walker, Ulf Mueller-Ladner, Suzana Jordan, L. Czirják, Marc Frerix, Veronika Lóránd, Elise Siegert, Marco Matucci-Cerinic, Yannick Allanore, Gabriele Valentini, F. Del Galdo, Christopher P. Denton, Giovanna Cuomo, G. Riemekasten, Oliver Distler, Veronika K. Jaeger, Vettori, Serena, Cuomo, Giovanna, Jaeger, V. K., Frerix, M., Siegert, E., Lorand, V., Jordan, S., Riemekasten, G., Allanore, Y., Czirjak, L., Tarner, I. H., Distler, O., Denton, C. P., Matucci Cerinic, M., Del Galdo, F., Walker, U. A., Mueller Ladner, U., and Valentini, G.
- Subjects
medicine.medical_specialty ,Univariate analysis ,Myocarditis ,Heart disease ,business.industry ,Immunology ,Disease ,medicine.disease ,Sudden death ,General Biochemistry, Genetics and Molecular Biology ,Surgery ,Rheumatology ,Internal medicine ,Heart failure ,medicine ,Immunology and Allergy ,business ,Rheumatism ,Cause of death - Abstract
Background Heart disease in patients with systemic sclerosis (SSc) can cause manifestations such as cardiac blocks (CBs), ventricular arrhythmias (VA), and congestive heart failure (CHF) which may require a pacemaker/defibrillator implant, are the cause of death or sudden death (SD) in about 20% of patients and can be referred to as severe heart disease (SHD). The European League against Rheumatism – Scleroderma Trial and Research (EUSTAR) database provides an unique opportunity to address this topic. The results of such analysis are instrumental for the DeSScipher project, an EU funded project devoted to decipher the optimal management of SSc . Objectives To investigate the prevalence of each SHD manifestation and their associations with demographic, serological, clinical and therapeutic aspects in a large series of adult SSc patients. Methods Seven EUSTAR-DeSScipher centers provided clinical charts at study entry including all the items of SHD. The prevalence of any and each SHD manifestation was calculated. The associations with demographic, serological, clinical features and treatment with vasodilators, i.e. calcium channel blockers (CCBs) and /or ACE inhibitors (ACEi), were investigated by univariate analysis and confirmed by multivariate logistic regression analysis. Results At July 6th 2012, 1119 SSc patients from the 7 EUSTAR centers had no missing data (995 females, 164 males; median age 53.6 years, range 14-86). Out of them, 211 patients (19%) had at least 1 SHD manifestation, 152 patients had CBs (14%), 71 had VA (6%), 132 had CHF (12%), and 27 received a pacemaker/defibrillator implant (2%). CBs were the only SHD manifestation in 100 patients, VA in 31, and CHF in 80. No association was found between SHD and clinical (diffuse or limited) and serological (ACA or anti-Scl-70) subset. No association was found between either CHF or pacemaker/defibrillator implant and any other disease feature. In multiple logistic regression analysis, CBs were associated with bibasilar lung fibrosis at chest X-Ray (OR=2.6; 95%CI=1-6.4; p=0.04), while VA were associated with increased CPK levels (OR=11; 95%CI=1-117; p=0.02) and, unexpectedly, current CCB use (OR 10; 95%CI 1.4-76.1; p=0.02). Conclusions This is the first study devoted to investigate SHD in a large series of carefully assessed SSc patients. SHD was detected in about 19% of the cases, CBs in 14%, VA in 6%, CHF in 12%. Pacemaker/defibrillator implant was needed in 2.4%. These data highlight the importance of an accurate heart assessment in SSc patients. Moreover, the associations between VA and CPK elevation and current CCB use should stimulate the clinician to avoid these drugs in patients with myositis/myocarditis. Acknowledgements The DeSScipher project was funded by the European Community9s Framework Programme 7 (FP7-HEALTH-2012.2.4.4-2 - Observational trials in rare diseases) under grant agreement N° 305495 Disclosure of Interest S. Vettori Grant/research support from: Roche, Consultant for: Phadia Thermofisher, Pfizer, Abbvie, G. Cuomo: None declared, V. Jaeger: None declared, M. Frerix: None declared, E. Siegert: None declared, V. Lorand: None declared, S. Jordan: None declared, G. Riemekasten: None declared, Y. Allanore: None declared, L. Czirjak: None declared, I. Tarner: None declared, O. Distler Grant/research support from: 4D Science, Actelion, Active Biotec, Bayer-Schering, Biogen, Biovitrium, BMS, Boehringer Ingelheim Pharma, EpiPharm, Ergonex, GSK, Inventiva, Medac, Novartis, Pfizer, Pharmacyclics, Roche/Genentech, Sanofi/Genzyme, Serodapharm, Sinoxa and United BioSource Corporation, Consultant for: 4D Science, Actelion, Active Biotec, Bayer-Schering, Biogen, Biovitrium, BMS, Boehringer Ingelheim Pharma, EpiPharm, Ergonex, GSK, Inventiva, Medac, Novartis, Pfizer, Pharmacyclics, Roche/Genentech, Sanofi/Genzyme, Serodapharm, Sinoxa and United BioSource Corporation, C. Denton: None declared, M. Matucci-Cerinic: None declared, F. Del Galdo: None declared, U. Walker: None declared, U. Mueller-Ladner: None declared, G. Valentini: None declared
- Published
- 2015
38. Use of vasoactive/vasodilating drugs for systemic sclerosis (SSc)-related digital ulcers (DUs) in expert tertiary centres: results from the analysis of the observational real-life DeSScipher study.
- Author
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Blagojevic J, Abignano G, Avouac J, Cometi L, Frerix M, Bellando-Randone S, Guiducci S, Bruni C, Huscher D, Jaeger VK, Lóránd V, Maurer B, Nihtyanova S, Riemekasten G, Siegert E, Tarner IH, Vettori S, Walker UA, Czirják L, Denton CP, Distler O, Allanore Y, Müller-Ladner U, Moggi-Pignone A, Matucci-Cerinic M, and Del Galdo F
- Subjects
- Adult, Aged, Bosentan therapeutic use, Drug Therapy, Combination, Europe, Female, Humans, Iloprost therapeutic use, Male, Middle Aged, Prospective Studies, Scleroderma, Systemic diagnosis, Sildenafil Citrate therapeutic use, Skin Ulcer diagnosis, Treatment Outcome, Wound Healing drug effects, Fingers pathology, Scleroderma, Systemic drug therapy, Skin Ulcer drug therapy, Vasodilator Agents therapeutic use
- Abstract
Introduction: DeSScipher is the first European multicentre study on management of systemic sclerosis (SSc), and its observational trial 1 (OT1) evaluated the efficacy of different drugs for digital ulcer (DU) prevention and healing. The aim of this study was to assess current use of vasoactive/vasodilating agents for SSc-related DU in the expert centres by analysing the baseline data of the DeSScipher OT1., Method: Baseline characteristics of patients enrolled in the OT1 and data regarding DU were analysed., Results: The most commonly used drugs, in both patients with and without DU, were calcium channel blockers (CCBs) (71.6%), followed by intravenous iloprost (20.8%), endothelin receptor antagonists (ERAs) (20.4%) and phosphodiesterase 5 (PDE-5) inhibitors (16.5%). Of patients, 32.6% with DU and 12.8% without DU received two drugs (p < 0.001), while 11.5% with DU and 1.9% without DU were treated with a combination of three or more agents (p < 0.001). Sixty-five percent of the patients with recurrent DU were treated with bosentan and/or sildenafil. However, 64 out of 277 patients with current DU (23.1%) and 101 (23.6%) patients with recurrent DU were on CCBs alone., Conclusions: Our study shows that CCBs are still the most commonly used agents for DU management in SSc. The proportion of patients on combination therapy was low, even in patients with recurrent DU: almost one out of four patients with current and recurrent DU was on CCBs alone. Prospective analysis is planned to investigate the efficacy of different drugs/drug combinations on DU healing and prevention. Key Points • The analysis of DeSScipher, the first European multicentre study on management of SSc, has shown that the most commonly used vasoactive/vasodilating drugs for DU were CCBs, followed by intravenous Iloprost, ERAs and PDE-5 inhibitors. • More than half of the patients with recurrent DU received bosentan and/or sildenafil. • However, the proportion of patients on combination therapy of more than one vasoactive/vasodilating drug was low and almost one out of four patients with current and recurrent DU was on CCBs alone.
- Published
- 2020
- Full Text
- View/download PDF
39. [Multimodal rheumatologic complex treatment of rheumatoid arthritis-a monocentric retrospective analysis].
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Klemm P, Hudowenz O, Asendorf T, Müller-Ladner U, Lange U, and Tarner IH
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- Disability Evaluation, Humans, Retrospective Studies, Severity of Illness Index, Surveys and Questionnaires, Antirheumatic Agents therapeutic use, Arthritis, Rheumatoid therapy
- Abstract
Background: Multimodal rheumatologic complex treatment (MRCT, operation and procedures classification system, OPS code 8‑983) is a specific concept of acute inpatient care (DRG I97Z) for treatment of patients with rheumatic diseases, degenerative diseases and/or chronic pain syndromes suffering from exacerbated pain and functional impairment., Objective: A monocentric retrospective analysis of the effects of MRCT on pain and functional status in patients with rheumatoid arthritis (RA) was conducted., Methods: A total of 103 treatment episodes in 75 patients with proven RA who received MRCT between 2014 and 2017 were included in the analysis. The changes in pain intensity were evaluated using a numerical rating scale (NRS), the functional limitations as assessed by the Hanover function questionnaire (FFbH) and the health assessment questionnaire (HAQ) and the disease activity (disease activity score of 28 joints, DAS28) before and after MRCT episodes. In addition, the patient characteristics and the course of the disease were documented and a univariate analysis of the influence of these factors on the parameters activity and function was performed., Results: In patients with RA, the MRCT resulted in a significant amelioration of pain (p < 0.0001), a significant improvement of functional capacity (FFbH p = 0.0013, HAQ p = 0.1396) and a significant reduction of disease activity (DAS28 p < 0.0001). Different aspects of the disease and its previous course (e. g. disease duration, type and number of previous anti-rheumatic drugs, current medication) did not have a significant effect on the response., Conclusion: This retrospective monocentric analysis proved the efficacy of MRCT with respect to the inpatient treatment period in a large cohort of RA patients. This treatment concept not only improved pain and function (FFbH) but also significantly reduced the disease activity.
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- 2019
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40. [The rich diversity of Whipple's disease].
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Sluszniak M, Tarner IH, Thiele A, and Schmeiser T
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- Adult, Anti-Bacterial Agents therapeutic use, Diagnosis, Differential, Humans, Polymerase Chain Reaction, Trimethoprim, Sulfamethoxazole Drug Combination, Tropheryma, Whipple Disease classification, Whipple Disease diagnosis
- Abstract
Whipple's disease (WD) is a rare, chronic multiorgan disease which can caused by Tropheryma whipplei, a ubiquitous gram positive bacterium. Detection of T. whipplei is mostly performed histologically using periodic acid-Schiff (PAS) staining in affected tissues to visualize characteristic PAS-positive macrophages and by the polymerase chain reaction (PCR). Clinically, WD is often characterized by gastrointestinal symptoms (diarrhea, colic-like abdominal pain and weight loss). Arthritis is a common presentation of WS, often leading to a misdiagnosis of seronegative rheumatoid arthritis and as a consequence to immunosuppressive therapy. The clinical presentation of WD is highly polymorphic affecting different organ systems (e. g. cardiac or neurological manifestation) and making an appropriate clinical diagnosis and even the diagnostic process itself difficult. This article reports on three cases presenting with completely different leading symptoms (initially misdiagnosed as seronegative rheumatoid arthritis, spondyloarthritis and adult onset of Still's disease, respectively) that illustrate the rich diversity of WD. The cases were chosen to draw attention to the fact that although WD is mainly associated with the field of gastroenterology and gastrointestinal (GI) involvement is common, it may appear without GI symptoms. In cases of a clinical suspicion of WD, diagnostic efforts should be made to detect the bacterium in the affected organ. The German S2k guidelines on GI infections and WD published in January 2015 summarized the current state of the art for WD. The currently recommended primary treatment is antibiotics that can infiltrate the cerebrospinal fluid, e. g. ceftriaxone, followed by cotrimoxazole, which should be maintained over several months.
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- 2019
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- View/download PDF
41. [Molecular effects of physical therapy. What's new?].
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Lange U, Tarner IH, Dischereit G, and Müller-Ladner U
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- Adaptation, Physiological immunology, Humans, Models, Immunological, Motor Activity immunology, Treatment Outcome, Cytokines immunology, Exercise, Immunologic Factors immunology, Physical Therapy Modalities, Rheumatic Diseases immunology, Rheumatic Diseases therapy
- Abstract
Modern molecular medicine offers the possibility to investigate the potential influences of different methods of physical therapy on pivotal mechanisms and mediators of the inflammatory processes of rheumatic diseases and interactions between cells of the immune system and bone. Based on recent studies, it could be shown that modulation of these regulatory systems can be achieved by various physiotherapeutics.
- Published
- 2015
- Full Text
- View/download PDF
42. [Modern disease-modifying antirheumatic drugs].
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Müller-Ladner U, Richter K, and Tarner IH
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- Arthritis, Rheumatoid diagnosis, Humans, Treatment Outcome, Antibodies, Monoclonal administration & dosage, Antirheumatic Agents administration & dosage, Arthritis, Rheumatoid drug therapy, Biological Factors administration & dosage
- Abstract
The term modern disease-modifying antirheumatic drugs (DMARD) includes not only the constantly growing family of DMARDs for chronic inflammatory rheumatic diseases but also the repositioning of established drugs in updated and novel algorithms of the different entities. The usual precursor for these developments is rheumatoid arthritis for which completely revised and updated guidelines have been published not only in Germany but also on the European level. In addition, label extensions to existing drugs have been granted for connective tissue diseases and vasculitides, e.g. anti-CD20 antibodies for antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitides and belimumab for systemic lupus erythematosus. Moreover, several novel drugs, especially of the biologics class, have been either introduced in clinical rheumatology or are close to being licensed and include ustekinumab for psoriatic arthritis, granulocyte growth inhibitors and janus kinase inhibitors for rheumatoid arthritis and atacicept for systemic lupus erythematosus. With the termination of the patent for several biologics, a new momentum also took place: the approval of the so-called biosimilars which has already initiated intensive discussions not only with respect to "similar" effects and side effects but also with respect to their potential impact on economical aspects.
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- 2015
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43. [Evidence-based recommendations for the management of undifferentiated peripheral inflammatory arthritis (UPIA). The German perspective on the international 3e initiative].
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Tarner IH, Albrecht K, Fleck M, Gromnica-Ihle E, Keyßer G, Köhler L, Kötter I, Krüger K, Kuipers J, Nüßlein H, Rubbert-Roth A, Wollenhaupt J, Schneider M, Manger B, and Müller-Ladner U
- Subjects
- Aged, Antirheumatic Agents adverse effects, Antirheumatic Agents therapeutic use, Arthritis classification, Arthritis drug therapy, Arthritis, Rheumatoid classification, Arthritis, Rheumatoid drug therapy, Delphi Technique, Diagnosis, Differential, Female, Germany, Humans, Magnetic Resonance Imaging, Male, Predictive Value of Tests, Prognosis, Ultrasonography, Arthritis diagnosis, Arthritis, Rheumatoid diagnosis, Evidence-Based Medicine
- Abstract
Introduction: Peripheral arthritis is the most common presenting complaint in clinical rheumatology. Unequivocal identification of the underlying entity can be difficult, particularly at an early stage. Such cases are commonly referred to as undifferentiated peripheral inflammatory arthritis (UPIA). Since evidence-based recommendations for the clinical management of UPIA are lacking, this international 3e initiative convened 697 rheumatologists from 17 countries to develop appropriate recommendations., Methods: Based on a systematic literature research in Medline, EMBASE, Cochrane Library, and the ACR/EULAR abstracts of 2007/2008, 10 multinational recommendations were developed by 3 rounds of a Delphi process. In Germany, a national group of experts worked on 3 additional recommendations using the same method. The recommendations were discussed among the members of the 3e initiative and the degree of consensus was analyzed as well as the potential impact of the recommendations on clinical practice., Results: A total of 39,756 references were identified, of which 250 were systematically reviewed for the development of 10 multinational recommendations concerning differential diagnosis, diagnostic and prognostic value of clinical assessments, laboratory tests and imaging techniques, and monitoring of UPIA. In addition, 3 national recommendations on the diagnostic and prognostic value of a response to anti-inflammatory therapy on the analysis of synovial fluid and on enthesitis were developed by the German experts based on 35 out of 5542 references., Conclusions: The article translates the 2011 published original paper of the international 3e initiative (Machado et al., Ann Rheum Dis 70:15-24, 2011) and reports the methods and results of the national vote and the additional 3 national recommendations.
- Published
- 2014
- Full Text
- View/download PDF
44. [New therapy strategies].
- Author
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Müller-Ladner U and Tarner IH
- Subjects
- Drug Design, Humans, Antirheumatic Agents administration & dosage, Biological Products administration & dosage, Molecular Targeted Therapy methods, Rheumatic Diseases drug therapy
- Published
- 2013
- Full Text
- View/download PDF
45. [In-vitro study on dissection of inflamed synovial tissue by hydro-jet cutting].
- Author
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Wagner KH, Tarner IH, and Lange U
- Subjects
- Humans, In Vitro Techniques, Treatment Outcome, Arthroplasty methods, Hydrotherapy methods, Minimally Invasive Surgical Procedures methods, Synovitis pathology, Synovitis surgery, Therapeutic Irrigation methods
- Abstract
Surgical synovectomy is a useful therapeutic option for rheumatoid arthritis patients with ongoing active synovitis despite optimal medical therapy. The present experimental study evaluated the novel, minimally invasive surgical technique of hydro-jet cutting in vitro using synovial biopsies. Depending on the selected water pressure (30-100 bar) it is possible to achieve precise and selective dissection of the synovial membrane. It was found that application of a water jet at 60 bar for 15 s is ideal for dissecting the stratum synoviale from the stratum fibrosum without any alteration of the joint capsule. This finding was confirmed by histological analyses. This novel and precise dissection technique promises to be an excellent alternative to the established techniques of synovectomy in the near future.
- Published
- 2012
- Full Text
- View/download PDF
46. Preliminary criteria for the very early diagnosis of systemic sclerosis: results of a Delphi Consensus Study from EULAR Scleroderma Trials and Research Group.
- Author
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Avouac J, Fransen J, Walker UA, Riccieri V, Smith V, Muller C, Miniati I, Tarner IH, Randone SB, Cutolo M, Allanore Y, Distler O, Valentini G, Czirjak L, Müller-Ladner U, Furst DE, Tyndall A, and Matucci-Cerinic M
- Subjects
- Antibodies, Antinuclear blood, Delphi Technique, Diagnosis, Differential, Early Diagnosis, Edema etiology, Fingers, Humans, Microscopic Angioscopy, Raynaud Disease etiology, Scleroderma, Systemic complications, Scleroderma, Systemic immunology, Skin Diseases etiology, Scleroderma, Systemic diagnosis
- Abstract
Objective: To identify a core set of preliminary items considered as important for the very early diagnosis of systemic sclerosis (SSc)., Methods: A list of items provided by European League Against Rheumatism (EULAR) Scleroderma Trial and Research(EUSTAR) centres were subjected to a Delphi exercise among 110 experts in the field of SSc. In round 1, experts were asked to choose the items they considered as the most important for the very early diagnosis of SSc. In round 2, experts were asked to reconsider the items accepted after the first stage. In round 3, the clinical relevance of selected items and their importance as measures that would lead to an early referral process were rated using appropriateness scores., Results: Physicians from 85 EUSTAR centres participated in the study and provided an initial list of 121 items. After three Delphi rounds, the steering committee, with input from external experts, collapsed the 121 items into three domains containing seven items, developed as follows: skin domain (puffy fingers/puffy swollen digits turning into sclerodactily); vascular domain (Raynaud's phenomenon, abnormal capillaroscopy with scleroderma pattern) and laboratory domain (antinuclear, anticentromere and antitopoisomerase-I antibodies). Finally, the whole assembly of EUSTAR centres ratified with a majority vote the results in a final face-to-face meeting., Conclusion: The three Delphi rounds allowed us to identify the items considered by experts as necessary for the very early diagnosis of SSc. The validation of these items to establish diagnostic criteria is currently ongoing in a prospective observational cohort.
- Published
- 2011
- Full Text
- View/download PDF
47. [Biologics and cardiovascular risk].
- Author
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Tarner IH, Müller-Ladner U, and Hamm C
- Subjects
- Humans, Rheumatic Diseases complications, Antirheumatic Agents adverse effects, Antirheumatic Agents therapeutic use, Biological Products adverse effects, Biological Products therapeutic use, Cardiovascular Diseases chemically induced, Cardiovascular Diseases prevention & control, Rheumatic Diseases drug therapy
- Abstract
Over the course of the last decade, biologic response modifiers (biologics) have significantly broadened the therapeutic armamentarium in clinical rheumatology. In addition to their impressive efficacy, they have also received considerable attention regarding their adverse effects. In contrast to the risk of severe infections and malignancies, the cardiovascular risk of these drugs has provoked less vigilance. This article reviews the current data on the cardiovascular effects and adverse effects of biologics.
- Published
- 2010
- Full Text
- View/download PDF
48. [Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with the focus on rheumatoid arthritis. Integration of a systematic literature research with the expert opinion of a large international panel of rheumatologists within the framework of the 3e initiative].
- Author
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Tarner IH and Müller-Ladner U
- Subjects
- Antirheumatic Agents adverse effects, Contraindications, Dose-Response Relationship, Drug, Female, Humans, Immunosuppressive Agents adverse effects, Infant, Newborn, Methotrexate adverse effects, Pregnancy, Risk Factors, Antirheumatic Agents therapeutic use, Arthritis, Rheumatoid drug therapy, Evidence-Based Medicine, Immunosuppressive Agents therapeutic use, Methotrexate therapeutic use
- Published
- 2010
- Full Text
- View/download PDF
49. [Interdisciplinary emergencies in rheumatic diseases].
- Author
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Tarner IH
- Subjects
- Aged, Arthritis, Infectious therapy, Arthritis, Rheumatoid diagnosis, Arthroplasty, Replacement, Hip, Diabetes Mellitus, Type 2 diagnosis, Diagnosis, Differential, Escherichia coli Infections therapy, Fatal Outcome, Female, Humans, Intensive Care Units, Opportunistic Infections therapy, Osteoarthritis, Hip surgery, Postoperative Complications diagnosis, Pressure Ulcer complications, Pressure Ulcer diagnosis, Shock, Septic diagnosis, Shoulder Joint, Arthritis, Infectious diagnosis, Arthritis, Rheumatoid complications, Cooperative Behavior, Diabetes Mellitus, Type 2 complications, Emergencies, Escherichia coli Infections diagnosis, Interdisciplinary Communication, Opportunistic Infections diagnosis, Patient Care Team
- Abstract
Rheumatic disease can affect and severely damage vital organs and thus cause acute emergencies and life-threatening complications. As systemic diseases they can cause any presenting complaint commonly encountered in emergency medicine. Because of their relative rarity in general practice, a high level of vigilance is required in order to recognize an emergency caused by an underlying rheumatic disease in individual cases. The most important rheumatological emergencies comprise septic arthritis, gout, atlantoaxial subluxation, renal crisis and digital ulcers in systemic sclerosis, amaurosis fugax in giant cell arteritis, the catastrophic anti-phospholipid antibody syndrome and the pulmonary-renal syndrome. This article provides an overview over these rheumatological emergencies in order to aid recognition of these entities in individual cases and to thus facilitate immediate and adequate treatment, which is of vital importance for affected patients., (Georg Thieme Verlag KG Stuttgart, New York.)
- Published
- 2010
- Full Text
- View/download PDF
50. [Novel B-cell directed strategies for the treatment of rheumatic diseases].
- Author
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Tarner IH
- Subjects
- B-Lymphocytes drug effects, Humans, Rheumatic Diseases pathology, Antibodies, Monoclonal therapeutic use, B-Lymphocytes immunology, Rheumatic Diseases immunology, Rheumatic Diseases therapy
- Abstract
The clinical success of B-cell depletion using the anti-CD20 antibody rituximab has sparked a new era in the therapy of rheumatic diseases. A large variety of novel B-cell directed biologic agents has been developed recently. The new strategies not only aim at depleting B-cells (ocrelizumab, veltuzumab, ofatumumab, TRU-015) but also target essential survival and proliferation factors such as BAFF (belimumab, atacicept, briobacept), and are directed at modulating B-cell function via CD22 (epratuzumab), inhibition of costimulation (abatacept) and induction of tolerance (abetimus). Thus far, clinical trials indicate high efficacy comparable to rituximab as well as a good safety profile. This review summarizes the therapeutic mechanisms of the novel B-cell directed agents and the current status of clinical trials in rheumatic diseases.
- Published
- 2009
- Full Text
- View/download PDF
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