Abstract:
OBJECTIVES:The aims of this study were to define the risk of serious bacterial infections in patients receiving specific biological disease-modifying anti-rheumatic drugs (bDMARDs) and evaluating the effect of concomitant synthetic DMARDs (sDMARDs) in a large population-based sample of rheumatoid arthritis (RA) deriving from an administrative health database. METHODS:Data were extracted from health databases of Lombardy Region, Italy (2004-2013), as a part of the RECord-linkage On Rheumatic Diseases (RECORD) study. Patients with RA treated with approved bDMARDs were included. Hospitalisations for bacterial infections were evaluated by hospital discharge forms. The association between drug exposure and infections was assessed by survival models, with time-dependent covariates. Results are presented as hazard ratios (HR) and 95%CI, crude and adjusted for pre-specified confounders (sex, age, disease duration, Charlson Comorbidity Index, previous biologics, previous infections, use of methotrexate, leflunomide, corticosteroids, non-steroidal anti-inflammatory drugs). RESULTS:4,656 RA patients with at least one bDMARD prescription were included, for a total of 7,601 biological courses; 3,603 (77.4%) women with a mean (SD) age of 55.8 (12.7) years. Crude incidence rate of hospitalised infection ranged from 0.14 to 2.95 per 1000 person-years. After multivariable adjustment, abatacept users (HR 0.29, 95%CI 0.10-0.82) had significantly lower risk of infections compared to etanercept. Concurrent treatment with methotrexate (0.72, 0.52-0.99) reduced the overall risk of infection while glucocorticoids increased it (1.09 per mg/day, 1.06-1.11). CONCLUSIONS:In RA patients treated with bDMARDs, abatacept was associated with the lowest risk of infections; overall risk was mitigated by concomitant methotrexate and increased by glucocorticoids in a dose-dependent manner.
journal_name
Clin Exp Rheumatoljournal_title
Clinical and experimental rheumatologyauthors
Carrara G,Bortoluzzi A,Sakellariou G,Silvagni E,Zanetti A,Govoni M,Scirè CAsubject
Has Abstractpub_date
2019-01-01 00:00:00pages
60-66issue
1eissn
0392-856Xissn
1593-098Xpii
12628journal_volume
37pub_type
杂志文章abstract:OBJECTIVE:To determine the serum levels of galectin-3 (Gal-3) and galectin-3 binding protein (G3BP) and to evaluate the associations between clinical features and these levels in patients with Behçet's disease (BD). METHODS:Fifty patients with BD (mean age 40.6 +/- SEM 1.4 years; 21 males, 29 females; 26 active and 24...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVE:The epidemiology of giant cell arteritis (GCA) may indicate a pathogenetic relationship between GCA and female sex hormone metabolism; GCA is two to four times more common in women compared with men. Our previous analyses gave no support for the hypothesis that the pathogenesis of GCA should be related to som...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVES:To assess the clinical spectrum of severe bacterial infections presenting as cutaneous vasculitis (CV) in a defined population. METHODS:Unselected series of 766 patients with CV diagnosed at a single university referral center. RESULTS:An underlying severe bacterial infection was diagnosed in 27 (22 men/5 ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVES:To describe differences in clinical presentation between men and women in a large group of patients with early (<3 years' duration) systemic sclerosis (SSc) according to disease subsets. METHODS:A cross-sectional analysis of the prospective EULAR Scleroderma Trial and Research database (EUSTAR) was performe...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2018-07-01 00:00:00
abstract::Fatigue and generalised pain are debilitating symptoms that negatively impact the quality of life in patients with systemic lupus erythematosus (SLE) and primary Sjögren's syndrome (pSS). Chronic widespread musculoskeletal pain and fatigue are the clinical hallmarks of fibromyalgia (FM), a clinical entity which can be...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to compare the cognitive function of antiphospholipid antibody (aPL)-negative systemic lupus erythematosus (SLE) and aPL-positive non-SLE patients. METHODS:Twenty aPL-negative SLE and 20 aPL-positive non-SLE female patients with no history of overt neuropsychiatric manifestations t...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVES:To determine if experienced health care providers (HCPs) can recognise patients with fibromyalgia (FM) based on a limited set of personality items, exploring the existence of a FM personality. METHODS:From the 240-item NEO-PI-R personality questionnaire, 8 HCPs from two different countries each selected 20 ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2017-05-01 00:00:00
abstract::The antiperinuclear factor (APF) test is as sensitive and specific for rheumatoid arthritis as the classical rheumatoid factor tests. Five European laboratories decided to perform a consensus study on the interlaboratory variability of the APF test. They used different donor cells, different conjugates and different c...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::We describe two cases, a 28-year-old woman and a 46-year-old man, with mouth and genital ulcers with inflamed cartilage (chondritis of the nose and ears) (MAGIC syndrome). The conditions of both patients were resolved by treatment with corticosteroid and colchicine. We also review the English literature related to thi...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2006-09-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2000-05-01 00:00:00
abstract::A female patient diagnosed with ankylosing spondylitis experienced a new onset acute iritis following the initiation of etanercept therapy and recurrent episodes of iritis continues during the treatment of etanercept. Etanercept-associated iritis was suspected. Anti-TNF therapies can alleviate uveitis in some studies,...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:Physical disabilities generally cause severe disturbances in a patient's body image perception. The aim of the present study was to investigate different aspects of body image, including sexual dissatisfaction, in women with rheumatoid arthritis (RA) in relation to their subjective impression of handicap. ME...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVES:Early arthritis clinics (EAC) aim to improve rheumatoid arthritis (RA) outcomes by tailoring treatment targeting to remission. Our aim was to analyse disease course and relevant predictors over 2 years in early arthritis; we also assessed the applicability of the "treat-to-target approach" in a real-life EAC...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2018-09-01 00:00:00
abstract::Behçet's disease (BD) is a multisystem inflammatory vasculitis of unknown etiology and pathogenesis. Coexistence of BD along with hematological malignancies is extremely rare. We describe a patient diagnosed with BD and chronic myelomonocytic leukaemia (CMML) with trisomy 8. This case suggests that trisomy 8 may be in...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:Professional Practice Assessment (PPA) has become an obligation for all physicians in France, however its modalities remain unclear. The objective of this work was to evaluate the feasibility and accuracy of a PPA for private practice rheumatologists performed in the context of a network. METHODS:A list of i...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVES:Antibodies directed to citrullinated proteins are highly specific for rheumatoid arthritis (RA). Citrullination is catalyzed by peptidylarginine deiminase (PAD) enzymes. The current study examined the mRNA expression of PADI2 and PADI4 in bone marrow (BM) CD34+ cells from RA patients. METHODS:CD34+ cells we...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To search for molecular evidence of Chlamydial infection in systemic lupus erythematosus (SLE) subjects and to assess if there is an association of this infectious agent with coronary artery calcification (CAC), a marker of total atherosclerotic burden. METHODS:28 SLE subjects had blood samples drawn and DNA...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVES:We investigated the association of the T-786C single nucleotide polymorphism (SNP) of the endothelial nitric oxide synthase gene (NOS3), which is characterised by reduced expression of the enzyme in response to shear stress or interleukin-10 stimulation and significantly associated with coronary heart diseas...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2015-09-01 00:00:00
abstract::Systemic sclerosis remains a challenging disease despite progress that has taken place in the management of organ-based complications. Overall management strategies need to take into account the features of the disease that are common to almost all patients such as skin involvement, gastro-oesophageal manifestations a...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2014-03-01 00:00:00
abstract::There is a clear need to assess patients presenting with a new onset of inflammatory peripheral arthritis and/or back pain early. Indeed, the clinical presentation of rheumatoid arthritis (RA) is not always characteristic but its early diagnosis is crucial to prevent irreversible structural damage. Likewise low back p...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2009-07-01 00:00:00
abstract::Several cases of patients with concomitant SLE and HIV infection have been reported in the literature; however, the effect of immunosuppressive therapy on HIV replication has not been described. We present the case of a 46 y/o woman with a ten-year history of HIV infection who was treated with IV cyclophosphamide for ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2000-07-01 00:00:00
abstract::The CD28/CTLA4-B7-family plays an important role in T-cell costimulation and is crucial for IL-2 production and tolerance induction. The costimulatory molecule B7-BB1 (CD80) is expressed on activated antigen presenting cells, but its expression on peripheral blood mononuclear cells is very low. Here we report a patien...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1996-11-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:1993-03-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2003-09-01 00:00:00
abstract::Two inflammatory cytokines, IL-23 and IL-17A, produced by myeloid cells and different lymphocyte subsets, were found to play important pathogenic functions in several inflammation-related cancers. In colorectal cancer, elevated expression of IL-23, IL-23 receptor and IL-17A has been linked to adverse prognostic outcom...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2015-07-01 00:00:00
abstract::The lack of successful translation of basic research discoveries into safe and effective treatments for chronic pain patients has led to increased scrutiny of the preclinical models used in pain research, particularly for osteoarthritis, where there is a significant disconnect between the animal models used to study t...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2017-09-01 00:00:00
abstract::An infant with erythematous rash born from a mother with silicone breast implants is described. The diagnosis of possible neonatal lupus was suggested based on the presence of the skin rash and positive Ro/SS-A antibodies in the infant and positive ANA and Ro/SS-A in the mother. ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1995-07-01 00:00:00
abstract::The lung diffusing capacity for carbon monoxide was determined by the single breath method (DLCOsb) before, during, and after immersion of the left hand in cold water in four groups of subjects: (i) normal individuals; (ii) subjects with idiopathic Raynaud's disease; (iii) patients with progressive systemic sclerosis ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to compare the discontinuation rates of tofacitinib and biologics (tumour necrosis factor inhibitors (TNFi), abatacept, rituximab, and tocilizumab) in rheumatoid arthritis (RA) patients considering inadequate responses (IRs) to previous treatment(s). METHODS:Randomised controll...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,meta分析,评审
doi:
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVES:The health problems of patients with rheumatoid arthritis and fibromyalgia are mostly invisible to others, which can lead to a discrepancy between patients' and spouses' appraisals of the severity of the health problems. As a consequence, some patients may feel 'invalidation' from their spouse, such as not b...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2011-11-01 00:00:00