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Rheumatoid Arthritis: HELP
Articles from Barcelona
Based on 306 articles published since 2009
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These are the 306 published articles about Arthritis, Rheumatoid that originated from Barcelona during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13
1 Guideline Biologic Disease-modifying antirheumatic drug attributes in the first lines of treatment of rheumatoid arthritis. 2015 ACORDAR project. 2018

Muñoz-Fernández, Santiago / Bustabad Reyes, María Sagrario / Calvo Alén, Jaime / Castaño Sánchez, Manuel / Chamizo Carmona, Eugenio / Corominas, Héctor / Fernández-Llanio Comella, Nagore / Hidalgo Calleja, María Cristina / Pérez Venegas, José Javier / Rodríguez Heredia, José Manuel / Romero Yuste, Susana María / Ruiz-Esquide Torino, Virginia / Anonymous7660892. ·Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, San Sebastián de los Reyes, Madrid, España. Electronic address: santiago.munoz@salud.madrid.org. · Hospital Universitario de Canarias, Santa Cruz de Tenerife, España. · Hospital Universitario Araba, Vitoria, Álava, España. · Hospital Universitario Virgen de la Arrixaca, Murcia, España. · Hospital de Mérida , Mérida, Badajoz, España. · Hospital Moisés Broggi, Sant Joan Despí, Barcelona, España. · Hospital Arnau de Vilanova, Valencia, España. · Hospital Clínico de Salamanca, Salamanca, España. · Hospital de Jerez de la Frontera, Jerez de la Frontera, Cádiz, España. · Hospital Universitario de Getafe, Getafe, Madrid, España. · Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España. · Hospital Clínic i Provincial, Barcelona, España. ·Reumatol Clin · Pubmed #28065486.

ABSTRACT: OBJECTIVE: To date, between 17% and 35% of patients with rheumatoid arthritis (RA) do not respond as expected to the initial biological therapy. The objective of this project is to recognize and weigh the attributes of biologic DMARD (bDMARD) to identify the most appropriate for each case, in the first lines of treatment of RA (after inadequate response to at least one synthetic DMARD or previous bDMARD). METHODS: To recognize the possible attributes that could define the bDMARD, we performed a systematic search of the literature that recognized the possible attributes involving general aspects, pharmacology, efficacy, safety, management, and cost. Then a Delphi process was conducted with two rounds among a group of selected expert rheumatologists in the management of RA indicating the degree of agreement with the attributes identified in the literature. The project was completed between February and September 2015, indicating the degree of importance that was ascribed to each attribute. Two criteria were applied to determine the consistency of results: 1) based on the median and interquartile range; and 2) on the simultaneous compliance with mean, median, standard deviation, interquartile range and coefficient of variation. The agreement and final ratification of the expert panel were also determined. RESULTS: Eighty-three Spanish rheumatologists participated and completed both rounds of the Delphi process. In no case was the importance of the 77 attributes identified considered to be low; 75 of 77 (97.4%) were considered highly important and 76 of 77 (98.7%) were ratified. Fifteen attributes had the support of 100% of the working group. CONCLUSIONS: There was a high degree of agreement concerning the selected attributes. Fifteen of them had the support of 100% of the working group and could be considered the definition of the ideal bDMARD in the first lines of RA treatment.

2 Guideline Recommendations for the use of ultrasound and magnetic resonance in patients with rheumatoid arthritis. 2018

Möller, Ingrid / Loza, Estibaliz / Uson, Jacqueline / Acebes, Carlos / Andreu, Jose Luis / Batlle, Enrique / Bueno, Ángel / Collado, Paz / Fernández-Gallardo, Juan Manuel / González, Carlos / Jiménez Palop, Mercedes / Lisbona, María Pilar / Macarrón, Pilar / Maymó, Joan / Narváez, Jose Antonio / Navarro-Compán, Victoria / Sanz, Jesús / Rosario, M Piedad / Vicente, Esther / Naredo, Esperanza. ·Servicio de Reumatología, Instituto Poal de Reumatología, Barcelona, España. · Instituto de Salud Musculoesquelética, Madrid, España. Electronic address: estibaliz.loza@inmusc.eu. · Servicio de Reumatología, Hospital Universitario de Móstoles, Madrid, España. · Servicio de Reumatología, Hospital General de Villalba, Collado Villalba, Madrid, España. · Servicio de Reumatología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España. · Servicio de Reumatología, Hospital Universitario Sant Joan d'Alacant, Alicante, España. · Servicio de Radiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España. · Servicio de Reumatología, Hospital Universitario Severo Ochoa, Leganés, Madrid, España. · Servicio de Radiología, Hospital Universitario Severo Ochoa, Madrid, Madrid, España. · Servicio de Reumatología, Hospital General Universitario Gregorio Marañón, Madrid, España. · Hospital del Mar, Barcelona, España. · Servicio de Reumatología, Hospital Universitario Clínico San Carlos, Madrid, España. · Servicio de Reumatología, Hospital del Mar, Barcelona, España. · Servicio de Radiodiagnóstico, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. · Servicio de Reumatología, Hospital Universitario La Paz, idiPaz, Madrid, España. · Servicio Andaluz de Salud, Sevilla, España. · Servicio de Reumatología, Hospital Universitario de la Princesa, Madrid, España. ·Reumatol Clin · Pubmed #28029551.

ABSTRACT: OBJECTIVE: To develop evidence-based recommendations on the use of ultrasound (US) and magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA). METHODS: Recommendations were generated following a nominal group technique. A panel of experts, consisting of 15 rheumatologists and 3 radiologists, was established in the first panel meeting to define the scope and purpose of the consensus document, as well as chapters, potential recommendations and systematic literature reviews (we used and updated those from previous EULAR documents). A first draft of recommendations and text was generated. Then, an electronic Delphi process (2 rounds) was carried out. Recommendations were voted from 1 (total disagreement) to 10 (total agreement). We defined agreement if at least 70% of experts voted ≥7. The level of evidence and grade or recommendation was assessed using the Oxford Centre for Evidence-based Medicine Levels of Evidence. The full text was circulated and reviewed by the panel. The consensus was coordinated by an expert methodologist. RESULTS: A total of 20 recommendations were proposed. They include the validity of US and MRI regarding inflammation and damage detection, diagnosis, prediction (structural damage progression, flare, treatment response, etc.), monitoring and the use of US guided injections/biopsies. CONCLUSIONS: These recommendations will help clinicians use US and MRI in RA patients.

3 Guideline Recommendations for infectious disease screening in migrants to Western Europe with inflammatory arthropathies before starting biologic agents. Results from a multidisciplinary task force of four European societies (SIR, SER, SIMET, SEMTSI) facing the largest impact of the flow of migrants today. 2017

Bartalesi, Filippo / Scirè, Carlo / Requena-Méndez, Ana / Abad, Miguel Angel / Buonfrate, Dora / Caporali, Roberto / Conti, Fabrizio / Diaz-Gonzalez, Federico / Fernández-Espartero, Cruz / Martinez-Fernandez, Carmen / Mascarello, Marta / Generali, Elena / Minisola, Giovanni / Morrone, Aldo / Muñoz, José / Richi, Patricia / Sakellariou, Gariffalia / Salas Coronas, Joaquin / Spinicci, Michele / Castelli, Francesco / Bartoloni, Alessandro / Bisoffi, Zeno / Gimenez-Sanchez, Francisco / Muñoz-Fernandez, Santiago / Matucci-Cerinic, Marco. ·SOD Malattie Infettive e Tropicali, Careggi Hospital, Florence, Italy. · Rheumatology Unit, Department of Medical Sciences, University of Ferrara, and Epidemiology Unit, Italian Society for Rheumatology, Milano, Italy. · Barcelona Institute for Global Health (ISGlobal-CRESIB), Hospital Clínic, Universitat de Barcelona, Spain. · Division of Rheumatology, Hospital Virgen del Puerto, Plasencia, Spain. · Centre for Tropical Diseases, Sacro Cuore Hospital, Negrar, Verona, Italy. · Division of Rheumatology, University of Pavia, IRCCS S. Matteo Foundation, Pavia, Italy. · Department of Internal Medicine and Medical Specialties, Rheumatology Unit, Sapienza University, Rome, Italy. · Department of Medicine, Universidad de La Laguna, Division of Rheumatology, Hospital Universitario de Canarias, La Laguna, Spain. · Servicio de Reumatologia, Hospital Universitario de Mostoles, Madrid, Spain. · Research Unit, Spanish Society of Rheumatology, Madrid, Spain. · Infectious Diseases Unit, University Hospital of Trieste, Italy. · Division of Rheumatology, San Camillo Hospital, Rome, Italy. · General Directorate, San Camillo Hospital, Rome, Italy. · Division of Rheumatology, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, Spain. · University Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Italy. · Unidad de Vacunación Internacional, Instituto Hispalense de Pediatría, Granada; and Spanish Society of Tropical Medicine and International Health, Spain. · Department of Experimental and Clinical Medicine, Division of Rheumatology AOUC, University of Florence, Italy. marco.matuccicerinic@unifi.it. ·Clin Exp Rheumatol · Pubmed #28516869.

ABSTRACT: OBJECTIVES: Inflammatory arthritis needs infectious disease screening before starting a biologic agent, however, few data are known about migrant patients, who represent a peculiar population which requires a multidisciplinary approach among international health specialists and should also be considered by health authorities. For this reason, the Italian and Spanish Societies of Rheumatology (SIR and SER) and Tropical Medicine (SIMET and SEMTSI) promoted a multidisciplinary task force in order to produce specific recommendations about screening and advices to be considered in migrant patients with inflammatory arthritis candidate to receive biological therapy, according to their geographical origin. METHODS: The experts provided a prioritised list of research questions and the eligible spectrum of inflammatory arthritis, biologic drugs and infectious disease were defined in order to perform a systematic literature review. A search was made in Medline, Embase and Cochrane library, updated to March 2015. Ubiquitous infections and HBV, HCV, HIV and tuberculosis that are already considered in national and international recommendations, were not included. The strength of each recommendation was determined. RESULTS: The task force members agreed on 7 overarching principles. The risk of reactivation of selected potentially latent infectious disease was addressed in migrants with inflammatory arthritis candidates for biologics was considered and 15 potentially relevant infections were identified. CONCLUSIONS: Fifteen disease-specific recommendations were formulated on the basis of high level of agreement among the experts panel.

4 Guideline Recommendations by the Spanish Society of Rheumatology for the management of patients diagnosed with rheumatoid arthritis who cannot be treated with methotrexate. 2017

García-Vicuña, Rosario / Martín-Martínez, María Auxiliadora / Gonzalez-Crespo, María Rosa / Tornero-Molina, Jesús / Fernández-Nebro, Antonio / Blanco-García, Francisco Javier / Blanco-Alonso, Ricardo / Marsal-Barril, Sara / Anonymous11400886. ·Servicio de Reumatología, Hospital Universitario de la Princesa, IIS-IP, Madrid, España. · Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España. · Servicio de Reumatología, Hospital 12 de Octubre, Madrid, España. · Servicio de Reumatología, Hospital Universitario de Guadalajara, Guadalajara, España. · Servicio de Reumatología, Hospital Universitario Regional de Málaga, Málaga, España. · Servicio de Reumatología, Complejo Hospitalario A Coruña, A Coruña, España. · Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla, Santander, España. · Servicio de Reumatología, Hospital Universitario Vall d'Hebron, Barcelona, España. Electronic address: smarsal@grr.pcb.ub.cat. ·Reumatol Clin · Pubmed #27825791.

ABSTRACT: To establish a set of recommendations for the management of patients diagnosed with rheumatoid arthritis (RA) who cannot be treated with methotrexate (MTX) due to contraindications, drug toxicity or lack of adherence, and to establish therapeutic strategies more effective and safer in these RA patients. A qualitative analysis of the scientific evidence available to June 2015. The 2-round Delphi technique of consensus was used to collect and establish expert opinion based on the participants' clinical experience when only low quality evidence was available. A total of eighteen recommendations were developed for the management of this patient profile. Fourteen of these recommendations were related to drug safety aspects. Recommendations on contraindication and toxicity of MTX have been updated. The experts recommend the use of biological monotherapy, a preferred treatment option, in patients whose profiles reveal a contraindication, intolerance or circumstances that prevent us against the use of MTX. There is some high-quality scientific evidence that supports contraindication and establishes certain conditions of MTX use in RA patients with specific clinical profiles.

5 Guideline 2014 update of the Consensus Statement of the Spanish Society of Rheumatology on the use of biological therapies in rheumatoid arthritis. 2015

Sanmartí, Raimon / García-Rodríguez, Susana / Álvaro-Gracia, José María / Andreu, José Luis / Balsa, Alejandro / Cáliz, Rafael / Fernández-Nebro, Antonio / Ferraz-Amaro, Iván / Gómez-Reino, Juan Jesús / González-Álvaro, Isidoro / Martín-Mola, Emilio / Martínez-Taboada, Víctor Manuel / Ortiz, Ana M / Tornero, Jesús / Marsal, Sara / Moreno-Muelas, José Vicente. ·Servicio de Reumatología, Hospital Clínic de Barcelona, Barcelona, España. Electronic address: sanmarti@clinic.ub.es. · Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España. · Servicio de Reumatología, Hospital Universitario de la Princesa, Madrid, España. · Servicio de Reumatología, Hospital Universitario Puerta de Hierro, Madrid, España. · Servicio de Reumatología, Hospital Universitario La Paz, Madrid, España. · Servicio de Reumatología, Hospital Universitario Virgen de las Nieves, Granada, España. · Unidad de Gestión Clínica de Reumatología, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, España. · Servicio de Reumatología, Hospital Universitario de Canarias, Tenerife, España. · Servicio de Reumatología, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, España. · Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España. · Servicio de Reumatología, Hospital Universitario de Guadalajara, Guadalajara, España. · Servicio de Reumatología, Hospital Universitario Vall d́Hebron, Barcelona, España. · Servicio de Reumatología, Hospital Universitario Vall d́Hebron, Barcelona, España; Sociedad Española de Reumatología, Madrid, España. ·Reumatol Clin · Pubmed #26051464.

ABSTRACT: OBJECTIVE: To establish recommendations for the management of patients with rheumatoid arthritis (RA) to serve as a reference for all health professionals involved in the care of these patients, and focusing on the role of available synthetic and biologic disease-modifying antirheumatic drugs (DMARDs). METHODS: Consensual recommendations were agreed on by a panel of 14 experts selected by the Spanish Society of Rheumatology (SER). The available scientific evidence was collected by updating three systematic reviews (SR) used for the EULAR 2013 recommendations. A new SR was added to answer an additional question. The literature review of the scientific evidence was made by the SER reviewer's group. The level of evidence and the degree of recommendation was classified according to the Oxford Centre for Evidence-Based Medicine system. A Delphi panel was used to evaluate the level of agreement between panellists (strength of recommendation). RESULTS: Thirteen recommendations for the management of adult RA were emitted. The therapeutic objective should be to treat patients in the early phases of the disease with the aim of achieving clinical remission, with methotrexate playing a central role in the therapeutic strategy of RA as the reference synthetic DMARD. Indications for biologic DMARDs were updated and the concept of the optimization of biologicals was introduced. CONCLUSIONS: We present the fifth update of the SER recommendations for the management of RA with synthetic and biologic DMARDs.

6 Editorial The Big Data Sjögren Consortium: a project for a new data science era. 2019

Acar-Denizli, Nihan / Kostov, Belchin / Ramos-Casals, Manuel / Anonymous2721516. ·Department of Statistics, Faculty of Science and Letters, Mimar Sinan Güzel Sanatlar Üniversitesi, Istanbul, Turkey. nihan.acar@msgsu.edu.tr. · Department of Statistics and Operational Research, Universitat Politècnica de Catalunya, Barcelona, and Primary Healthcare Transversal Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. · Sjögren's Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Barcelona; Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, and Department of Medicine, University of Barcelona, Spain. mramos@clinic.cat. ·Clin Exp Rheumatol · Pubmed #31464669.

ABSTRACT: -- No abstract --

7 Editorial What lies in the near future for the treatment of rheumatoid arthritis? 2017

Corominas, Hèctor / Shmerling, Robert H. ·Division of Rheumatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States; Servei de Reumatologia, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, Spain. Electronic address: vancor@yahoo.com. · Division of Rheumatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States. ·Reumatol Clin · Pubmed #28495361.

ABSTRACT: -- No abstract --

8 Review Phenotyping Sjögren's syndrome: towards a personalised management of the disease. 2018

Brito-Zerón, Pilar / Retamozo, Soledad / Ramos-Casals, Manuel. ·Autoimmune Diseases Unit, Dept. of Medicine, Hospital CIMA-Sanitas, Barcelona; and Sjögren's Syndrome Research Group (AGAUR), Lab. of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Dept. of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain. · Sjögren's Syndrome Res.Group (AGAUR), Lab. of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Dept.of Autoimmune Diseases, ICMiD, Hosp. Clínic, Barcelona, Spain; Hosp.Privado Univ.de Córdoba, Inst.Univ. de Ciencias Biomédicas de Córdoba (IUCBC), Argentina. · Sjögren's Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona; and University of Barcelona, Spain. mramos@clinic.ub.es. ·Clin Exp Rheumatol · Pubmed #30156544.

ABSTRACT: Sjögren's syndrome (SS) is a systemic autoimmune disease that mainly targets the exocrine glands. The disease overwhelmingly affects women around 30-60 years old, and more than 95% of patients present with oral and/or ocular dryness, although they may also develop a wide number of organ-specific systemic manifestations. The variable presentation is often linked to the influence of multiple personal determinants. In this review, we analyse the main geoepidemiological, immunological and histopathological determinants involved in the phenotypic expression of SS. With respect to sicca involvement, some patients (Asian, young-onset diagnosis, males and Ro-carriers) present with a less pronounced involvement in contrast to others with more pronounced dryness (seronegative, isolated La-carriers). With respect to the risk of developing systemic disease/poor outcomes, we propose a phenotypic-driven prognostic classification into patients at low risk (elderly-onset diagnosis, seronegative, isolated La-carriers), moderate risk (Black/African-american, young-onset diagnosis, Ro-carriers) and high risk (males, high focus score or presence of germinal centers in histopathological studies, RF-carriers, cryoglobulinaemic and hypocomplementaemic patients). Phenotype-based clustering of systemic autoimmune diseases may help physicians to offer a more personalised, cost-effective medical care of patients affected by these complex chronic diseases.

9 Review Liquid biopsies to guide therapeutic decisions in rheumatoid arthritis. 2018

Coras, Roxana / Narasimhan, Rekha / Guma, Monica. ·Department of Medicine, School of Medicine, La Jolla, California; University of California San Diego, San Diego, California; Department of Medicine, Autonomous University of Barcelona, Bellaterra, Barcelona, Spain. · Department of Medicine, School of Medicine, La Jolla, California; University of California San Diego, San Diego, California. · Department of Medicine, School of Medicine, La Jolla, California; University of California San Diego, San Diego, California; Department of Medicine, Autonomous University of Barcelona, Bellaterra, Barcelona, Spain. Electronic address: mguma@ucsd.edu. ·Transl Res · Pubmed #30092207.

ABSTRACT: Rheumatoid arthritis (RA) is a systemic, immune-mediated inflammatory disease that has transitioned from a debilitating disease to a chronic, controllable disease. This has been possible due to the introduction of new treatment strategies like "treat-to-target," in which the clinician treats the patient aggressively enough to reach low disease activity or remission, and the introduction of new therapeutic agents, such as biological therapies, which can lead to the prevention of damage by early diagnosis and initiation of treatment. Attention is now being directed toward identifying the optimal treatment for each patient, one that will be the most efficient and have the least number of side effects. Much work has been done to find serologic and synovial biomarkers of response to various RA treatments. Proteomics, genomics and, in the past few years, metabolomics, have all been used in the quest of identifying these biomarkers. Blood-based liquid biopsies provide a minimally invasive alternative to synovial biopsies to identify cellular and molecular signatures that can be used to longitudinally monitor response and allow for personalized medicine approach. Liquid biopsies are comprised of cell-free DNA, immune circulating cells, and extracellular vesicles, and are being increasingly and successfully used in the field of oncology for diagnosis, progression, prognosis, and prediction of response to treatment. Recently, researchers have also begun investigating the usefulness of liquid biopsies in the field of rheumatology; in this review, we will focus on the potential of liquid biopsy blood samples as biomarkers of response to treatment in patients with RA.

10 Review Antinuclear antibodies and cancer: A literature review. 2018

Vlagea, Alexandru / Falagan, Sandra / Gutiérrez-Gutiérrez, Gerardo / Moreno-Rubio, Juan / Merino, María / Zambrana, Francisco / Casado, Enrique / Sereno, María. ·Immunology Department, Hospital Clinic, Barcelona, Spain. · Infanta Sofía University Hospital, SS de los Reyes, Madrid, Spain. · Infanta Sofia University Hospital, Madrid, Spain; IMDEA Molecular Oncology, IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain. · Infanta Sofía University Hospital, SS de los Reyes, Madrid, Spain. Electronic address: maria.sereno@salud.madrid.org. ·Crit Rev Oncol Hematol · Pubmed #29891110.

ABSTRACT: Antinuclear antibodies (ANAs) are a spectrum of autoantibodies targeted to various nuclear and cytoplasmic components of the cells. They are very useful as serological markers for different autoimmune disease, like systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), scleroderma, polymyositis, or mixed connective tissue disease. In these years, an increasing attention has been focussed in the relationship between tumours and autoimmunity. Different authors have demonstrated that ANAs are presented, not only in autoimmune diseases, also in serum of patients with different types of cancers. These data suggested that ANAs could be involved in the pathogenesis of cancer as well as other premalignant disease. In this review, we are going to describe all data reported about the presence of these antibodies in samples from patients with cancer as well as the potential role of some of these proteins in early detection and prognosis.

11 Review Anakinra for the treatment of rheumatoid arthritis: a safety evaluation. 2018

Ramírez, Julio / Cañete, Juan D. ·a Arthritis Unit, Rheumatology Department , Hospital Clinic, and IDIBAPs , Barcelona , Spain. ·Expert Opin Drug Saf · Pubmed #29883212.

ABSTRACT: INTRODUCTION: The anti-interleukin-1 receptor antagonist, anakinra, was approved for the treatment of rheumatoid arthritis (RA) more than 12 years ago. However, its adverse effects are not well known. Areas covered: We review the safety profile of anakinra, analyzing clinical trials, observational studies, and registry data. Expert opinion: Due to its lower efficacy compared with other biological therapies approved for RA and its daily subcutaneous administration, anakinra is used only marginally for the treatment of RA. This has limited the experience with this drug in RA, with a lack of data from long-term observational studies or registries. From the five clinical trials performed, and given the unfeasibility of developing new studies of anakinra in RA, it may be concluded that site injection reactions, infections at higher doses (>100 mg), and immunogenicity are the most frequent adverse events related to anakinra administration.

12 Review A2A Adenosine Receptor Agonists and their Potential Therapeutic Applications. An Update. 2018

Guerrero, Angel. ·Department of Biological Chemistry and Molecular Modelling, Institute of Advanced Chemistry of Catalonia (CSIC), 08034 Barcelona, Spain. ·Curr Med Chem · Pubmed #29532748.

ABSTRACT: BACKGROUND: Adenosine is an endogenous purine nucleoside, which mediates a variety of important biological processes and diseases, such as vasodilation, inflammation, cancer, wound healing, ischemia reperfusion injury, Parkinson disease, infectious diseases, and other CNS disorders. Particularly important are the A2A receptors that have been expressed in the lung, liver, heart, cardiovascular tissues, leukocytes, neutrophils, and endothelial cells. This review provides an update of the latest A2A receptor agonists developed in the period 2005-2017, their selectivity regarding other adenosine receptors and their potential therapeutic applications. METHODS: I have conducted an extensive search from the most common bibliographic databases for critically review the most recent works on the A2A receptor agonists and their therapeutic applications in inflammation, asthma and chronic obstructive pulmonary disease, myocardial perfusion imaging, sepsis, rheumatoid arthritis, and wound healing, among others. RESULTS: In the last decade, a great deal of effort has been devoted to develop adenosine receptor agonists and antagonists for treatment of a number of diseases. Thus, for A2A receptor agonists more than 130 papers and reviews have been found, many of them highlighting the usefulness of these compounds in the field. CONCLUSIONS: Although so far many of the A2A receptor agonists have failed in clinical trials due to their side effects, some of them have been approved for protection against cardiac ischemia-reperfusion injury and anemia. The recently reported crystal structure of the human A2A receptor in complex with the agonist UK-432097 is a fundamental keystone for the development of new and selective A2A ligands with new therapeutic applications.

13 Review Tocilizumab in the treatment of adult rheumatoid arthritis. 2018

Sanmartí, Raimon / Ruiz-Esquide, Virginia / Bastida, Carla / Soy, Dolor. ·Arthritis Unit, Rheumatology Service, Hospital Clinic of Barcelona, Barcelona, Catalonia, Spain. · Pharmacy Service, Hospital Clinic of Barcelona, Barcelona, Catalonia, Spain. ·Immunotherapy · Pubmed #29495891.

ABSTRACT: Rheumatoid arthritis (RA) is the most prevalent immune-mediated chronic rheumatic disease and is associated with joint destruction and disability. Therapeutic strategies, including biological disease-modifying antirheumatic drugs (bDMARDs) have improved the prognosis and quality of life of RA patients. Tocilizumab (TCZ) is a humanized monoclonal antibody against IL-6 receptor licensed in 2009 that has demonstrated clinical efficacy in various adult RA populations. RA management guidelines and recommendations consider TCZ as one of the bDMARDS indicated after methotrexate or other conventional synthetic DMARDs and/or TNF inhibitors failure in adult RA. Of particular interest is the demonstration of its effectiveness in monotherapy in comparison with other bDMARDs. Recent observational studies have shown good results for the safety profile of TCZ with no new alert signals.

14 Review Adult onset Still's Disease. 2018

Narváez, Javier. ·Servicio de Reumatología, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España. Electronic address: fjnarvaez@bellvitgehospital.cat. ·Med Clin (Barc) · Pubmed #29241877.

ABSTRACT: Adult onset Still's disease is a rare systemic condition at the crossroads between auto-inflammatory syndromes and autoimmune diseases, with considerable heterogeneity in terms of clinical presentation, evolution and severity. This article reviews the main advances and lesser known aspects of this entity related to its clinical spectrum (atypical cutaneous lesions, unusual manifestations, macrophage activation syndrome, disease phenotypes), the emerging controversy around its association with delayed malignancy, the search for new biomarkers for its diagnosis, evaluation of prognosis (clinical factors, prognostic indexes and biomarkers to identify patients at risk of severe organ failure or life-threatening complications), and the determinants in the choice of biological treatment.

15 Review Cytokines as therapeutic targets in primary Sjögren syndrome. 2018

Retamozo, Soledad / Flores-Chavez, Alejandra / Consuegra-Fernández, Marta / Lozano, Francisco / Ramos-Casals, Manuel / Brito-Zerón, Pilar. ·Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, CELLEX-IDIBAPS, Spain; Hospital Privado Universitario de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Córdoba, Argentina; Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas (INICSA-UNC-CONICET), Córdoba, Argentina; Department of Autoimmune Diseases, ICMiD, Hospital Clínic Barcelona, Spain. · Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, CELLEX-IDIBAPS, Spain; Biomedical Research Unit 02, Clinical Epidemiology Research Unit, UMAE, Specialties Hospital, Western Medical Center, Mexican Institute for Social Security (IMSS), Guadalajara, Mexico; Postgraduate Program of Medical Science, University Center for Biomedical Research (CUIB), University of Colima, Colima, Mexico; Department of Autoimmune Diseases, ICMiD, Hospital Clínic Barcelona, Spain. · Immunoreceptors del Sistema Innat I Adaptatiu, Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. · Immunoreceptors del Sistema Innat I Adaptatiu, Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Servei d'Immunologia, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Biomedicine, School of Medicine, University of Barcelona, Barcelona, Spain. Electronic address: flozano@clinic.ub.es. · Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, CELLEX-IDIBAPS, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain; Department of Autoimmune Diseases, ICMiD, Hospital Clínic Barcelona, Spain. Electronic address: mramos@clinic.ub.es. · Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, CELLEX-IDIBAPS, Spain; Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA-Sanitas, Barcelona, Spain; Department of Autoimmune Diseases, ICMiD, Hospital Clínic Barcelona, Spain. ·Pharmacol Ther · Pubmed #29092775.

ABSTRACT: Primary Sjögren syndrome (SjS) is a systemic autoimmune disease that may affect 1 in 1000 people (overwhelmingly women) and that can be a serious disease with excess mortality due to severe organ-specific involvements and the development of B cell lymphoma; systemic involvement clearly marks the disease prognosis, and strongly suggests the need for closer follow-up and more robust therapeutic management. Therapy is established according to the organ involved and severity. As a rule, the management of systemic SjS should be organ-specific, with glucocorticoids and immunosuppressive agents limited to potentially-severe involvements; unfortunately, the limited evidence available for these drugs, together with the potential development of serious adverse events, makes solid therapeutic recommendations difficult. The emergence of biological therapies has increased the therapeutic armamentarium available to treat primary SjS. Biologics currently used in SjS patients are used off-label and are overwhelmingly agents targeting B cells, but the most recent studies are moving on into the evaluation of targeting specific cytokines involved in the SjS pathogenesis. The most recent etiopathogenic advances in SjS are shedding some light in the search for new highly-selective biological therapies without the adverse effects of the standard drugs currently used (corticosteroids and immunosuppressant drugs). This review summarizes the potential pharmacotherapeutic options targeting the main cytokine families involved in the etiopathogenesis of primary SjS and analyzes potential insights for developing new therapies.

16 Review Synovial tissue research: a state-of-the-art review. 2017

Orr, Carl / Vieira-Sousa, Elsa / Boyle, David L / Buch, Maya H / Buckley, Christopher D / Cañete, Juan D / Catrina, Anca I / Choy, Ernest H S / Emery, Paul / Fearon, Ursula / Filer, Andrew / Gerlag, Danielle / Humby, Frances / Isaacs, John D / Just, Søren A / Lauwerys, Bernard R / Le Goff, Benoit / Manzo, Antonio / McGarry, Trudy / McInnes, Iain B / Najm, Aurélie / Pitzalis, Constantino / Pratt, Arthur / Smith, Malcolm / Tak, Paul P / Thurlings, Rogier / Fonseca, João E / Veale, Douglas J / Tas, Sander W. ·Centre for Arthritis and Rheumatic Disease, University College Dublin, Dublin Academic Medical Centre, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. · Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal. · University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, California 92093, USA. · Leeds Musculoskeletal Biomedical Research Unit, University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK. · Rheumatology Research Group, University of Birmingham, Edgbaston, Birmingham, West Midlands B15 2TT, UK. · Arthritis Unit, Rheumatology Department, Hospital Clínic, IDIBAPS, Villarroel, 170, 08036 Barcelona, Spain. · Rheumatology Unit, Department of Medicine (Solna), Karolinska Institute and Karolinska University Hospital, 171 76 Stockholm, Sweden. · Cardiff University School of Medicine, Institute of Infection and Immunity, 1 st Floor, Tenovus Building, Heath Park, Cardiff CF14 4XN, UK. · Department of Molecular Rheumatology, Trinity College Dublin, University of Dublin, College Green, Dublin 2, Ireland. · Department of Clinical Immunology &Rheumatology, Amsterdam Rheumatology and Immunology Centre, Academic Medical Centre, University of Amsterdam, Room F4-105, POBox 22700, 1100 DE, Amsterdam, Netherlands. · Clinical Unit Cambridge, GlaxoSmithKline, Cambridge, UK. · Centre for Experimental Medicine and Rheumatology, John Vane Science Centre, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK. · Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK. · Department of Medicine, Svendborg Hospital, Odense University Hospital, Valdemarsgade 53, 5700 Svendborg, Denmark. · Université catholique de Louvain and Department of Rheumatology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Bruxelles, Belgium. · Rheumatology Unit, Nantes University Hospital, Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France. · Rheumatology and Translational Immunology Research Laboratories (LaRIT), Division of Rheumatology, IRCCS Policlinico San Matteo Foundation/University of Pavia, P.le Golgi 19, 27100 Pavia, Italy. · Institute of Infection, Immunity and Inflammation, College of Medicine, Veterinary and Life Sciences University of Glasgow, 120 University Avenue, Glasgow G12 8TA, UK. · Rheumatology, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia. · GlaxoSmithKline, Cambridge, UK. · Institute for Molecular Life Sciences, RadboudUMC, Theodoor Craanenlaan 11, Nijmegen 6525 GA, Netherlands. ·Nat Rev Rheumatol · Pubmed #28701760.

ABSTRACT: The synovium is the major target tissue of inflammatory arthritides such as rheumatoid arthritis. The study of synovial tissue has advanced considerably throughout the past few decades from arthroplasty and blind needle biopsy to the use of arthroscopic and ultrasonographic technologies that enable easier visualization and improve the reliability of synovial biopsies. Rapid progress has been made in using synovial tissue to study disease pathogenesis, to stratify patients, to discover biomarkers and novel targets, and to validate therapies, and this progress has been facilitated by increasingly diverse and sophisticated analytical and technological approaches. In this Review, we describe these approaches, and summarize how their use in synovial tissue research has improved our understanding of rheumatoid arthritis and identified candidate biomarkers that could be used in disease diagnosis and stratification, as well as in predicting disease course and treatment response.

17 Review Safety profile of biological therapies for treating rheumatoid arthritis. 2017

Cañete, Juan D / Hernández, Ma Victoria / Sanmartí, Raimon. ·a Arthritis Unit, Rheumatology Department , Hospital Clinic and IDIBAPS , Barcelona , Spain. ·Expert Opin Biol Ther · Pubmed #28657381.

ABSTRACT: INTRODUCTION: Biological agents such as tumor necrosis factor inhibitors (TNFi), abatacept, rituximab and tocilizumab have proven efficacy in RA. However, these agents are also associated with adverse events so further data is essential to detect them at the earliest stage possible. Areas covered: Herein, the authors review the safety profile of biological therapy, including TNFi and non-TNF agents including abatacept (ABA), rituximab (RTX) and tocilizumab (TCZ). The authors analyze both published articles and congress communications including clinical trials, meta-analyses, observational studies, data from registries and spontaneous clinical reports. The authors classify studies according to the most common and relevant adverse events associated with biological agents. Expert opinion: Biological therapies have a reasonable safety profile and, globally, the benefits far outweigh the possible risk of adverse events. Currently, the risk of serious infections is low and no increased risk in solid malignancies or cardiovascular events have been found after a long clinical experience with these therapies. However, there are still potential risks as well as concerns of immunogenicity induced by TNFi. More studies are required to understand these risks, design safer drugs, and implement pharmacogenomics into the clinic. This will lead to a more personalized medicine in the future.

18 Review Vitamin D and Sjögren syndrome. 2017

Garcia-Carrasco, Mario / Jiménez-Herrera, Erick Alejandro / Gálvez-Romero, Jose Luis / de Lara, Luis Vázquez / Mendoza-Pinto, Claudia / Etchegaray-Morales, Ivet / Munguía-Realpozo, Pamela / Ruíz-Argüelles, Alejandro / Jose, Rosas / Vera-Recabarren, Mauricio / Cervera, Ricard. ·Systemic Autoimmune Diseases Research Unit, General Regional Hospital No. 36, Instituto Mexicano del Seguro Social, Puebla, Mexico; Department of Rheumatology and Immunology, Medicine School, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico. · Systemic Autoimmune Diseases Research Unit, General Regional Hospital No. 36, Instituto Mexicano del Seguro Social, Puebla, Mexico. · Department of Inmuno-allergology, Puebla Regional Hospital, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, ISSSTE, Puebla, Mexico. · Department of Experimental Medicine, Medicine School, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico. · Department of Rheumatology, Centro Medico Nacional La Raza, Instituto Mexicano del Seguro Social, Puebla, Mexico. · Laboratorios Clinicos de Puebla, Puebla, Mexico; Universidad de las Américas Puebla, Puebla, Mexico. · Department of Rheumatology, Marina Baixa Hospital, Villajoyosa, Alicante, Spain. · Department of Dermatology, Indisa Clinic, Santiago de Chile, Chile. · Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Catalonia, Spain. Electronic address: rcervera@clinic.ub.es. ·Autoimmun Rev · Pubmed #28411165.

ABSTRACT: The immunomodulatory effects of vitamin D have been extensively studied in the context of autoimmunity. Multiple studies have demonstrated a high prevalence of vitamin D deficiency in autoimmune diseases. Recently, a possible protective role of vitamin D in autoimmunity has been described; however, this function remains controversial. Few studies have investigated the role of vitamin D in patients with Sjögren syndrome (SS). In this review, we compiled the main features of SS pathogenesis, the vitamin D immunomodulatory effects and the possible interaction between both. Data suggests that vitamin D may play a role in the SS pathogenesis. In addition, vitamin D low levels have been found in SS patients, which are associated with extra-glandular manifestations, such as lymphoma or neuropathy, suggesting a possible benefit effect of vitamin D in SS.

19 Review Cell-based Tolerogenic Therapy, Experience from Animal Models of Multiple Sclerosis, Type 1 Diabetes and Rheumatoid Arthritis. 2017

Stojanovic, Ivana / Dimitrijevic, Mirjana / Vives-Pi, Marta / Mansilla, Maria Jose / Pujol-Autonell, Irma / Rodríguez-Fernandez, Silvia / Palova-Jelínkova, Lenka / Funda, David P / Gruden-Movsesijan, Alisa / Sofronic-Milosavljevic, Ljiljana / Hilkens, Catharien M U / Martinez-Caceres, Eva / Miljkovic, Djordje. ·Department of Immunology, Institute for Biological Research "Sinisa Stankovis", University of Belgrade, Belgrade, Serbia. · Immunology Division, Germans Trias i Pujol University Hospital, Department of Cellular Biology, Physiology, and Immunology, Universitat Autònoma Barcelona, Campus Can Ruti, 08916 Barcelona, Spain. · SOTIO a.s., Prague, Czech Republic. · Department of Immunology and Gnotobiology, Institute of Microbiology of the CAS,v.v.i., Prague, Czech Republic. · Department for Immunology and Immunoparasitology, Institute for the Application of Nuclear Energy - INEP, University of Belgrade, Belgrade, Serbia. · Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, NE2 4HH, United Kingdom. · Institute for Biological Research "Sinisa Stankovic", Department of Immunology, Despota Stefana 142, 11000 Belgrade, Serbia. ·Curr Pharm Des · Pubmed #28201972.

ABSTRACT: Cell-based tolerogenic therapy is a promising approach for the treatment of autoimmune diseases and transplant rejection. Regulatory T cells and tolerogenic dendritic cells have been particularly explored in the treatment of various autoimmune disorders in experimental models of disease. Although some of these cells have already been tested in a limited number of clinical trials, there is still a need for preclinical research on tolerogenic cells in animal models of autoimmunity. This review will focus on the relevance of data obtained from studies in experimental animal models for the use of tolerogenic cell-based therapy in humans. Also, perspectives for further improvement of tolerogenic cell preparation towards enhanced suppressive activity and stability of the cells will be discussed.

20 Review Is there potential for therapeutic drug monitoring of biologic agents in rheumatoid arthritis? 2017

Bastida, Carla / Ruíz, Virginia / Pascal, Mariona / Yagüe, Jordi / Sanmartí, Raimon / Soy, Dolors. ·Pharmacy Department, Hospital Clinic Barcelona, Barcelona, Spain. · Arthritis Unit, Rheumatology Department, Hospital Clinic Barcelona, Barcelona, Spain. · Immunology Department, CDB, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Spain. ·Br J Clin Pharmacol · Pubmed #27990682.

ABSTRACT: The use of biologics has significantly changed the management of rheumatoid arthritis over the last decade, becoming the cornerstone treatment for many patients. The current therapeutic arsenal consists of just under 10 biologic agents, with four different mechanisms of action. Several studies have demonstrated a large interindividual pharmacokinetic variability, which translates to unpredictability in clinical response among individuals. The present review focuses on the pharmacokinetics and pharmacodynamics of biologic agents approved for rheumatoid arthritis. The literature relating to their concentration-effect relationship and the use of pharmacokinetic-pharmacodynamic modelling to optimize drug regimens is analysed. Due to the scarcity and complexity of these studies, the current dosing strategy is based on clinical indexes/aspects. In general, dose individualization for biologics should be implemented increasingly in clinical practice as there is a direct benefit for treated rheumatoid arthritis patients. Moreover, there is an indirect benefit in terms of cost-effectiveness.

21 Review Risk of malignancies using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a systematic review and meta-analysis. 2016

Bonovas, Stefanos / Minozzi, Silvia / Lytras, Theodore / González-Lorenzo, Marien / Pecoraro, Valentina / Colombo, Silvia / Polloni, Ilaria / Moja, Lorenzo / Cinquini, Michela / Marino, Valentina / Goletti, Delia / Matucci, Andrea / Tocci, Giuliano / Milano, Giuseppe Maria / Scarpa, Raffaele / Cantini, Fabrizio. ·a Humanitas Clinical and Research Center , Milan , Italy. · b Department of Epidemiology , Lazio Regional Health Service , Rome , Italy. · c Department of Experimental and Health Sciences , Universitat Pompeu Fabra , Barcelona , Spain. · d Centre for Research in Environmental Epidemiology , Barcelona , Spain. · e Hellenic Centre for Disease Control and Prevention , Athens , Greece. · f Department of Biomedical Sciences for Health , University of Milan , Milan , Italy. · g Clinical Epidemiology Unit, IRCCS Galeazzi Orthopedic Institute , Milan , Italy. · h Postgraduate School of Public Health , University of Milan , Milan , Italy. · i Methodology of Systematic Reviews and Guidelines Development Unit, Department of Oncology , IRCCS Mario Negri Institute for Pharmacological Research , Milan , Italy. · j Medical Department , Pfizer , Rome , Italy. · k Translational Research Unit, Department of Epidemiology and Preclinical Research , National Institute for Infectious Diseases , Rome , Italy. · l Immunoallergology Unit, Department of Biomedicine, Azienda Ospedaliero-Universitaria Careggi , Florence , Italy. · m Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology , University of Rome Sapienza, Sant'Andrea Hospital , Rome , Italy. · n IRCCS Neuromed , Pozzilli , Rome , Italy. · o Department of Pediatric Hematology, Oncology and Transplant Unit , IRCCS Ospedale Pediatrico Bambino Gesù , Rome , Italy. · p Rheumatology Research Unit, Department of Clinical Medicine and Surgery , University of Naples Federico II , Naples , Italy. · q Division of Rheumatology , Misericordia e Dolce Hospital , Prato , Italy. ·Expert Opin Drug Saf · Pubmed #27924644.

ABSTRACT: INTRODUCTION: Malignancies have been reported in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis, treated with anti-tumour necrosis factor (anti-TNF) agents. Areas covered: We conducted a systematic review of randomized controlled trials (RCTs) to determine the effect of anti-TNF agents on the occurrence of cancer (any type). Literature databases were searched up to May 2014 to identify relevant studies that evaluated adalimumab, certolizumab, etanercept, golimumab, or infliximab, compared with placebo or no treatment. Data on cancer occurrence were extracted at the maximum follow-up time reported. Expert opinion: Fifty-five RCTs with 20,631 patients met the eligibility criteria. Of these, 32 trials with 15,539 patients reported at least one case of cancer, for a total of 112 malignancies. The degree of variability between studies was consistent with what would be expected to occur by chance alone. There was no evidence of an association between anti-TNF agents and cancer risk (fixed-effects model (OR: 1.31, 95% CI: 0.89, 1.95); a random-effects model (OR: 1.16, 95% CI: 0.75, 1.81)). We found evidence of selective outcome reporting or publication bias suggesting that the pooled effect estimate for cancer may have been overestimated. The evidence is imprecise, and the risk of bias was high or unclear across primary studies.

22 Review Risk of infections using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a systematic review and meta-analysis. 2016

Minozzi, Silvia / Bonovas, Stefanos / Lytras, Theodore / Pecoraro, Valentina / González-Lorenzo, Marien / Bastiampillai, Anan Judina / Gabrielli, Eugenia Maria / Lonati, Andrea Carlo / Moja, Lorenzo / Cinquini, Michela / Marino, Valentina / Matucci, Andrea / Milano, Giuseppe Maria / Tocci, Giuliano / Scarpa, Raffaele / Goletti, Delia / Cantini, Fabrizio. ·a Department of Epidemiology , Lazio Regional Health Service , Rome , Italy. · b Humanitas Clinical and Research Center , Milan , Italy. · c Department of Experimental and Health Sciences , Universitat Pompeu Fabra , Barcelona , Spain. · d Centre for Research in Environmental Epidemiology , Barcelona , Spain. · e Hellenic Centre for Disease Control and Prevention , Athens , Greece. · f Clinical Epidemiology Unit , IRCCS Galeazzi Orthopedic Institute , Milan , Italy. · g Department of Biomedical Sciences for Health , University of Milan , Milan , Italy. · h Postgraduate School of Public Health , University of Milan , Milan , Italy. · i Methodology of Systematic Reviews and Guidelines Development Unit, Department of Oncology , IRCCS Mario Negri Institute for Pharmacological Research , Milan , Italy. · j Medical Department , Pfizer , Rome , Italy. · k Immunoallergology Unit, Department of Biomedicine, Azienda Ospedaliero-Universitaria Careggi , Florence , Italy. · l Department of Pediatric Hematology , Oncology and Transplant Unit, IRCCS Ospedale Pediatrico Bambino Gesù , Rome , Italy. · m Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology , University of Rome Sapienza , Sant'Andrea Hospital, Rome , Italy. · n IRCCS Neuromed , Pozzilli , Rome , Italy. · o Rheumatology Research Unit, Department of Clinical Medicine and Surgery , University of Naples Federico II , Naples , Italy. · p Translational Research Unit, Department of Epidemiology and Preclinical Research , National Institute for Infectious Diseases , Rome , Italy. · q Division of Rheumatology , Misericordia e Dolce Hospital , Prato , Italy. ·Expert Opin Drug Saf · Pubmed #27924643.

ABSTRACT: INTRODUCTION: Five anti-tumor necrosis factor (anti-TNF) agents have received regulatory approval for use in rheumatology: adalimumab, golimumab, infliximab, certolizumab, and etanercept. Apart from their well-documented therapeutic value, it is still uncertain to what extent they are associated with an increased risk of infectious adverse events. Areas covered: We conducted a systematic review and meta-analysis of published randomized studies to determine the effect of anti-TNF drugs on the occurrence of infectious adverse events (serious infections; tuberculosis; opportunistic infections; any infection). We searched Medline, Embase, and the Cochrane Library up to May 2014 to identify eligible studies in adult patients with rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis that evaluated anti-TNF drugs compared with placebo or no treatment. Expert opinion: Our study encompassed data from 71 randomized controlled trials involving 22,760 participants (range of follow-up: 1-36 months) and seven open label extension studies with 2,236 participants (range of follow-up: 6-48 months). Quantitative synthesis of the available data found statistically significant increases in the occurrence of any infections (20%), serious infections (40%), and tuberculosis (250%) associated with anti-TNF drug use, while the data for opportunistic infections were scarce. The quality of synthesized evidence was judged as moderate. Further evidence from registries and long-term epidemiological studies are needed to better define the relationship between anti-TNF agents and infection complications.

23 Review Treating the Underlying Pathophysiology of Primary Sjögren Syndrome: Recent Advances and Future Prospects. 2016

Brito-Zerón, Pilar / Retamozo, Soledad / Gheitasi, Hoda / Ramos-Casals, Manuel. ·Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA-Sanitas, Barcelona, Spain. · Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, CELLEX-IDIBAPS, Barcelona, Spain. · Department of Autoimmune Diseases, ICMiD, Hospital Clínic, C/Villarroel, 170, 08036, Barcelona, Spain. · Centro Médico de Córdoba, Hospital Privado, Córdoba, Argentina. · Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, CELLEX-IDIBAPS, Barcelona, Spain. mramos@clinic.ub.es. · Department of Autoimmune Diseases, ICMiD, Hospital Clínic, C/Villarroel, 170, 08036, Barcelona, Spain. mramos@clinic.ub.es. · Department of Medicine, University of Barcelona, Barcelona, Spain. mramos@clinic.ub.es. ·Drugs · Pubmed #27844414.

ABSTRACT: Sjögren Syndrome (SS) is a systemic autoimmune disease with a wide clinical spectrum that extends from sicca symptoms of the mucosal surfaces to extra-glandular systemic manifestations. Understanding of the pathophysiology of primary SS has advanced over recent years, and this, in turn, has presented new targeted treatment options. We provide a brief, up-to-date description of the pathophysiology of SS and the main etiopathogenic pathways implicated in the disease process and review clinical evidence in support of new treatment options targeting these pathways, highlighting successes and failures, and concluding with a summary of gaps in knowledge and where future research should be focused. Direct and indirect B-cell targeted therapies are currently the most promising biological agents in primary SS, especially for systemic involvement, but other pathways (T-cell co-stimulation, cytokine-based therapies, intracellular pathways and gene therapies) are under development. The next 10 years may witness a disruptive therapeutic scenario in primary SS.

24 Review Sjögren syndrome. 2016

Brito-Zerón, Pilar / Baldini, Chiara / Bootsma, Hendrika / Bowman, Simon J / Jonsson, Roland / Mariette, Xavier / Sivils, Kathy / Theander, Elke / Tzioufas, Athanasios / Ramos-Casals, Manuel. ·Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA-Sanitas, Barcelona, Spain. · Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Barcelona, Spain. · Department of Autoimmune Diseases, ICMiD, Hospital Clínic, C/Villarroel, 170, 08036 Barcelona, Spain. · Rheumatology Unit, University of Pisa, Pisa, Italy. · Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. · Rheumatology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. · Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway. · Department of Rheumatology, Haukeland University Hospital, Bergen, Norway. · Université Paris Sud, INSERM, Paris, France. · Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, Paris, France. · Oklahoma Sjögren's syndrome Center of Research Translation, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA. · Department of Rheumatology, Malmö University Hospital, Lund University, Lund, Sweden. · Department of Pathophysiology, School of Medicine, National University of Athens, Athens, Greece. · Department of Medicine, University of Barcelona, Barcelona, Spain. ·Nat Rev Dis Primers · Pubmed #27383445.

ABSTRACT: Sjögren syndrome (SjS) is a systemic autoimmune disease that primarily affects the exocrine glands (mainly the salivary and lacrimal glands) and results in the severe dryness of mucosal surfaces, principally in the mouth and eyes. This disease predominantly affects middle-aged women, but can also be observed in children, men and the elderly. The clinical presentation of SjS is heterogeneous and can vary from sicca symptoms to systemic disease (characterized by peri-epithelial lymphocytic infiltration of the affected tissue or the deposition of the immune complex) and lymphoma. The mechanism underlying the development of SjS is the destruction of the epithelium of the exocrine glands, as a consequence of abnormal B cell and T cell responses to the autoantigens Ro/SSA and La/SSB, among others. Diagnostic criteria for SjS include the detection of autoantibodies in patient serum and histological analysis of biopsied salivary gland tissue. Therapeutic approaches for SjS include both topical and systemic treatments to manage the sicca and systemic symptoms of disease. SjS is a serious disease with excess mortality, mainly related to the systemic involvement of disease and the development of lymphomas in some patients. Knowledge of SjS has progressed substantially, but this disease is still characterized by sicca symptoms, the systemic involvement of disease, lymphocytic infiltration to exocrine glands, the presence of anti-Ro/SSA and anti-La/SSB autoantibodies and the increased risk of lymphoma in patients with SjS.

25 Review Anti-citrullinated peptide antibodies and their value for predicting responses to biologic agents: a review. 2016

Martin-Mola, Emilio / Balsa, Alejandro / García-Vicuna, Rosario / Gómez-Reino, Juan / González-Gay, Miguel Angel / Sanmartí, Raimon / Loza, Estíbaliz. ·Reumatology Department, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain. emartinmola.dmedical@gmail.com. · Rheumatology Unit, D-Médical Clinic, Príncipe de Vergara 44, 28001, Madrid, Spain. emartinmola.dmedical@gmail.com. · Reumatology Department, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain. · Reumatology Department, Hospital Universitario la Princesa, IIS-IP, Madrid, Spain. · Health Research Institute of Santiago de Compostela (IDIS), Clinical University Hospital of Santiago de Compostela, Santiago de Compostela, Spain. · Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Department, IDIVAL, Universidad de Cantabria, Santander, Spain. · Arthritis Unit, Rheumatology Service, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain. · Instituto de Salud Musculoesquelética, Madrid, Spain. ·Rheumatol Int · Pubmed #27271502.

ABSTRACT: Anti-citrullinated peptide antibodies (ACPAs) play an important pathogenic role both at the onset and during the disease course. These antibodies precede the clinical appearance of rheumatoid arthritis (RA) and are associated with a less favorable prognosis, both clinically and radiologically. The objective of this work was to conduct a comprehensive review of studies published through September 2015 of ACPAs' role as a predictor of the therapeutic response to the biological agents in RA patients. The review also includes summary of the biology and detection of ACPAs as well as ACPAs in relation to joint disease and CV disease and the possible role of seroconversion. The reviews of studies examining TNF inhibitors and tocilizumab yielded negative results. In the case of rituximab, the data indicated a greater probability of clinical benefit in ACPA(+) patients versus ACPA(-) patients, as has been previously described for rheumatoid factor. Nonetheless, the effect is discreet and heterogeneous. Another drug that may have greater effectiveness in ACPA(+) patients is abatacept. Some studies have suggested that the drug is more efficient in ACPA(+) patients and that those patients show greater drug retention. In a subanalysis of the AMPLE trial, patients with very high ACPA titers who were treated with abatacept had a statistically significant response compared to patients with lower titers. In summary, the available studies suggest that the presence of or high titers of ACPA may predict a better response to rituximab and/or abatacept. Evidence regarding TNFi and tocilizumab is lacking. However, there is a lack of studies with appropriate designs to demonstrate that some drugs are superior to others for ACPA(+) patients.

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