Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Spinal Diseases: HELP
Articles by Juan D. Cañete
Based on 40 articles published since 2009
(Why 40 articles?)
||||

Between 2009 and 2019, J. D. Cañete wrote the following 40 articles about Spinal Diseases.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline Recommendations of the Spanish Society of Rheumatology on treatment and use of systemic biological and non-biological therapies in psoriatic arthritis. 2018

Torre Alonso, Juan Carlos / Díaz Del Campo Fontecha, Petra / Almodóvar, Raquel / Cañete, Juan D / Montilla Morales, Carlos / Moreno, Mireia / Plasencia-Rodríguez, Chamaida / Ramírez García, Julio / Queiro, Rubén. ·Unidad de Reumatología, Hospital Monte Naranco y Universidad de Oviedo, Oviedo, España. · Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España. · Unidad de Reumatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España. · Unidad de Artritis, Servicio de Reumatología, Hospital Clínic, Barcelona, España. · Servicio de Reumatología, Hospital Clínico Universitario de Salamanca, Salamanca, España. · Servicio de Reumatología, Parc Taulí Hospital Universitari, Sabadell, Barcelona, España. · Servicio de Reumatología, Hospital Universitario La Paz, IdiPaz, Madrid, España. · Unidad de Artritis, Servicio de Reumatología, IDIBAPS y Hospital Clínic, Barcelona, España. · Sección de Reumatología, Hospital Universitario Central de Asturias, Oviedo, España. Electronic address: rubenque7@yahoo.es. ·Reumatol Clin · Pubmed #29111261.

ABSTRACT: OBJECTIVE: The main purpose of this recommendation statement is to provide clinicians with the best available evidence and the best opinion agreed upon by the panelists for a rational use of synthetic disease modifying antirheumatic drugs (DMARDs) and biologicals in psoriatic arthritis (PsA) patients. The present document also focuses on important aspects in the management of PsA, such as early diagnosis, therapeutic objectives, comorbidities and optimization of treatment. METHODS: The recommendations were agreed by consensus by a panel of 8 expert rheumatologists, previously selected by the Spanish Society of Rheumatology (SER) through an open call. The phases of the work were: identification of key areas for updating the previous consensus, analysis and synthesis of scientific evidence (modified Oxford system, Centre for Evidence-based Medicine, 2009) and formulation of recommendations based on this evidence and by consensus techniques. RESULTS: Seventeen recommendations were issued for the treatment of PsA patients. Six of them were of general nature, ranging from the early diagnosis and treatment to the importance of assessing comorbidities. The other 11 were focused on the indications for DMARDs and biological therapy in the distinct clinical forms of the disease. Likewise, the situation of failure of the first biological is addressed and treatment algorithms and a table with the different biological therapies are also included. CONCLUSIONS: We present the update of SER recommendations for the treatment of PsA with DMARDs and biologics.

2 Guideline European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. 2016

Gossec, L / Smolen, J S / Ramiro, S / de Wit, M / Cutolo, M / Dougados, M / Emery, P / Landewé, R / Oliver, S / Aletaha, D / Betteridge, N / Braun, J / Burmester, G / Cañete, J D / Damjanov, N / FitzGerald, O / Haglund, E / Helliwell, P / Kvien, T K / Lories, R / Luger, T / Maccarone, M / Marzo-Ortega, H / McGonagle, D / McInnes, I B / Olivieri, I / Pavelka, K / Schett, G / Sieper, J / van den Bosch, F / Veale, D J / Wollenhaupt, J / Zink, A / van der Heijde, D. ·Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), Paris, France Department of rheumatology, AP-HP, Pitié Salpêtrière Hospital, Paris, France. · Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria Second Department of Medicine, Hietzing Hospital, Vienna, Austria. · Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands. · EULAR, representing People with Arthritis/Rheumatism in Europe (PARE), London, UK. · Research Laboratory and Clinical Division of Rheumatology, Department of Internal Medicine, University of Genova, Viale Benedetto, Italy. · Medicine Faculty, Paris Descartes University, Paris, France Rheumatology B Department, APHP, Cochin Hospital, Paris, France. · Leeds NIHR Musculoskeletal Biomedical Research Unit, LTHT, Leeds, UK Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. · Department of Clinical Immunology & Rheumatology, Amsterdam Rheumatology Center, Amsterdam, The Netherlands Atrium Medical Center, Heerlen, The Netherlands. · North Devon, UK. · Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria. · Rheumazentrum Ruhrgebiet, Herne and Ruhr-Universität Bochum, Herne, Germany. · Department of Rheumatology and Clinical Immunology, Charité-University Medicine Berlin, Germany. · Arthritis Unit, Department of Rheumatology, Hospital Clínic and IDIBAPS, Barcelona, Spain. · Belgrade University School of Medicine, Belgrade, Serbia. · Department of Rheumatology, St. Vincent's University Hospital and Conway Institute, University College Dublin, Dublin, Ireland. · Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden Sweden and School of Business, Engineering and Science, Halmstad University, Halmstad, Sweden. · Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Laboratory of Tissue Homeostasis and Disease, Skeletal Biology and Engineering Research Center, KU Leuven, Belgium Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium. · Department of Dermatology, University Hospital Münster, Münster, Germany. · A.DI.PSO. (Associazione per la Difesa degli Psoriasici)-PE.Pso.POF (Pan European Psoriasis Patients' Organization Forum), Rome, Italy. · Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK. · Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Italy. · Institute and Clinic of Rheumatology Charles University Prague, Czech Republic. · Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany. · Department of Rheumatology, Campus Benjamin Franklin, Charité, Berlin, Germany. · Ghent University Hospital, Ghent, Belgium. · Centre for Arthritis and Rheumatic Disease, Dublin Academic Medical Centre, St. Vincent's University Hospital, Dublin, Ireland. · Schoen Klinik Hamburg, Rheumatology and Clinical Immunology, Hamburg, Germany. · Department of Rheumatology and Clinical Immunology, German Rheumatism Research Centre Berlin, Charité-University Medicine Berlin, Germany. ·Ann Rheum Dis · Pubmed #26644232.

ABSTRACT: BACKGROUND: Since the publication of the European League Against Rheumatism recommendations for the pharmacological treatment of psoriatic arthritis (PsA) in 2012, new evidence and new therapeutic agents have emerged. The objective was to update these recommendations. METHODS: A systematic literature review was performed regarding pharmacological treatment in PsA. Subsequently, recommendations were formulated based on the evidence and the expert opinion of the 34 Task Force members. Levels of evidence and strengths of recommendations were allocated. RESULTS: The updated recommendations comprise 5 overarching principles and 10 recommendations, covering pharmacological therapies for PsA from non-steroidal anti-inflammatory drugs (NSAIDs), to conventional synthetic (csDMARD) and biological (bDMARD) disease-modifying antirheumatic drugs, whatever their mode of action, taking articular and extra-articular manifestations of PsA into account, but focusing on musculoskeletal involvement. The overarching principles address the need for shared decision-making and treatment objectives. The recommendations address csDMARDs as an initial therapy after failure of NSAIDs and local therapy for active disease, followed, if necessary, by a bDMARD or a targeted synthetic DMARD (tsDMARD). The first bDMARD would usually be a tumour necrosis factor (TNF) inhibitor. bDMARDs targeting interleukin (IL)12/23 (ustekinumab) or IL-17 pathways (secukinumab) may be used in patients for whom TNF inhibitors are inappropriate and a tsDMARD such as a phosphodiesterase 4-inhibitor (apremilast) if bDMARDs are inappropriate. If the first bDMARD strategy fails, any other bDMARD or tsDMARD may be used. CONCLUSIONS: These recommendations provide stakeholders with an updated consensus on the pharmacological treatment of PsA and strategies to reach optimal outcomes in PsA, based on a combination of evidence and expert opinion.

3 Guideline Recommendations for the coordinated management of psoriatic arthritis by rheumatologists and dermatologists: a Delphi study. 2014

Cañete, J D / Daudén, E / Queiro, R / Aguilar, M D / Sánchez-Carazo, J L / Carrascosa, J M / Carretero, G / García-Vivar, M L / Lázaro, P / López-Estebaranz, J L / Montilla, C / Ramírez, J / Rodríguez-Moreno, J / Puig, L. ·Servicio de Reumatología, Hospital Clínic de Barcelona e IDIBAPS, Barcelona, Spain. · Servicio de Dermatología, IIS-Princesa, Hospital Universitario La Princesa, Madrid, Spain. · Servicio de Reumatología, Hospital Universitario Central de Asturias, Oviedo, Spain. · Técnicas Avanzadas de Investigación en Servicios de Salud (TAISS), Madrid, Spain. · Servicio de Dermatología, Hospital General de Valencia, Valencia, Spain. · Servicio de Dermatología, Hospital Universitari Germans Trias y Pujol, Badalona, Barcelona, Spain. · Servicio de Dermatología, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Spain. · Servicio de Reumatología, Hospital Universitario Basurto, Bilbao, Spain. · Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain. · Servicio de Reumatología, Hospital Universitario de Salamanca, Salamanca, Spain. · Servicio de Reumatología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. · Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Electronic address: lpuig@santpau.cat. ·Actas Dermosifiliogr · Pubmed #24657018.

ABSTRACT: Psoriatic arthritis, a chronic inflammatory musculoskeletal disease that is associated with psoriasis, causes joint erosions, accompanied by loss of function and quality-of-life. The clinical presentation is variable, with extreme phenotypes that can mimic rheumatoid arthritis or ankylosing spondylitis. Because psoriasis usually presents before psoriatic arthritis, the dermatologist plays a key role in early detection of the latter. As many treatments used in psoriasis are also used in psoriatic arthritis, treatment recommendations should take into consideration the type and severity of both conditions. This consensus paper presents guidelines for the coordinated management of psoriatic arthritis by rheumatologists and dermatologists. The paper was drafted by a multidisciplinary group (6rheumatologists, 6dermatologists, and 2epidemiologists) using the Delphi method and contains recommendations, tables, and algorithms for the diagnosis, referral, and treatment of patients with psoriatic arthritis.

4 Guideline European League Against Rheumatism recommendations for the management of psoriatic arthritis with pharmacological therapies. 2012

Gossec, L / Smolen, J S / Gaujoux-Viala, C / Ash, Z / Marzo-Ortega, H / van der Heijde, D / FitzGerald, O / Aletaha, D / Balint, P / Boumpas, D / Braun, J / Breedveld, F C / Burmester, G / Cañete, J D / de Wit, M / Dagfinrud, H / de Vlam, K / Dougados, M / Helliwell, P / Kavanaugh, A / Kvien, T K / Landewé, R / Luger, T / Maccarone, M / McGonagle, D / McHugh, N / McInnes, I B / Ritchlin, C / Sieper, J / Tak, P P / Valesini, G / Vencovsky, J / Winthrop, K L / Zink, A / Emery, P / Anonymous2420706. ·Paris Descartes University, Paris, France. laure.gossec@cch.aphp.fr ·Ann Rheum Dis · Pubmed #21953336.

ABSTRACT: BACKGROUND: Psoriatic arthritis (PsA) is a clinically heterogeneous disease. Clear consensual treatment guidance focused on the musculoskeletal manifestations of PsA would be advantageous. The authors present European League Against Rheumatism (EULAR) recommendations for the treatment of PsA with systemic or local (non-topical) symptomatic and disease-modifying antirheumatic drugs (DMARD). METHODS: The recommendations are based on evidence from systematic literature reviews performed for non-steroidal anti-inflammatory drugs (NSAID), glucocorticoids, synthetic DMARD and biological DMARD. This evidence was discussed, summarised and recommendations were formulated by a task force comprising 35 representatives, and providing levels of evidence, strength of recommendations and levels of agreement. RESULTS: Ten recommendations were developed for treatment from NSAID through synthetic DMARD to biological agents, accounting for articular and extra-articular manifestations of PsA. Five overarching principles and a research agenda were defined. CONCLUSION: These recommendations are intended to provide rheumatologists, patients and other stakeholders with a consensus on the pharmacological treatment of PsA and strategies to reach optimal outcomes, based on combining evidence and expert opinion. The research agenda informs directions within EULAR and other communities interested in PsA.

5 Editorial The link between obesity and psoriatic arthritis. 2012

Cañete, Juan D / Mease, Philip. · ·Ann Rheum Dis · Pubmed #22798633.

ABSTRACT: -- No abstract --

6 Review Effectiveness of conventional disease-modifying antirheumatic drugs in psoriatic arthritis: A systematic review. 2018

Maese, Jesús / Díaz Del Campo, Petra / Seoane-Mato, Daniel / Guerra, Mercedes / Cañete, Juan D. ·Grupo de Trabajo Reumatología Basada en la Evidencia, Sociedad Española de Reumatología, Madrid, España. Electronic address: jmaese@telefonica.net. · Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España. · Departamento de Reumatología, Hospital Clínic de Barcelona e IDIBAPS Barcelona, España. ·Reumatol Clin · Pubmed #28089501.

ABSTRACT: BACKGROUND: Due to the clinical heterogeneity of psoriatic arthritis (PsA), recommendations have been developed by international groups to guide therapeutic decisions of the rheumatologist. The objective of the current systematic review (RS) was to evaluate the evidence of efficacy of disease-modifying antirheumatic drugs (DMARDs) in PsA. METHODS: Literature search in Medline, EMBASE, Cochrane Library, from 2008 to 2014. We included RS, randomized clinical trials and observational studies, in patients with PsA and an evaluation of efficiency of conventional DMARDs (methotrexate, sulfasalazine, leflunomide), according to the following outcomes: peripheral and axial symptoms; peripheral radiological damage; enthesitis according to power Doppler ultrasound or magnetic resonance imaging (enthesitis count before and after therapy); dactylitis; uveitis. RESULTS: Title and abstract were used to retrieve 1,662 documents for this review (Medline, n=433; EMBASE n=1,132; Cochrane, n=97), and 48 studies were selected for detailed reading; finally, 8 studies were included. CONCLUSIONS: Since the studies included are not robust, and there are arguments to support the effectiveness of methotrexate, the evidence observed with the treatment of DMARDs in PsA is not conclusive.

7 Review The effect of smoking on clinical and structural damage in patients with axial spondyloarthritis: A systematic literature review. 2017

Villaverde-García, Virginia / Cobo-Ibáñez, Tatiana / Candelas-Rodríguez, Gloria / Seoane-Mato, Daniel / Campo-Fontecha, Petra Díaz Del / Guerra, Mercedes / Muñoz-Fernández, Santiago / Cañete, Juan D. ·Rheumatology Department, Hospital Universitario de Móstoles, Universidad Francisco de Vitoria, Río Júcar s/n, 28935 Móstoles, Madrid, Spain. Electronic address: virginia.villaverde@yahoo.es. · Rheumatology Department, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, Madrid, Spain. · Rheumatology Department, Hospital Universitario Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain. · Research Unit, Spanish Society of Rheumatology, Madrid, Spain. · Arthritis Unit. Rheumatology Department, Hospital Clinic de Barcelona and IDIBAPS, Barcelona, Spain. ·Semin Arthritis Rheum · Pubmed #27979416.

ABSTRACT: OBJECTIVES: To evaluate the association between smoking and clinical parameters and structural damage in axial spondyloarthritis (axSpA). METHODS: We systematically searched MEDLINE, EMBASE and Cochrane Library till November 2015. We selected articles that analysed the smoking impact on disease activity, functional status, structural damage, physical mobility and life quality. Independent extraction of articles by 2 authors using predefined data fields was performed. Studies quality was graded according to the Oxford Level of Evidence scale. RESULTS: A total of 17 articles were selected for inclusion: 2 case-control, 11 cross-sectional and 4 prospective cohort studies, which analysed 4694 patients. Weak evidence suggested a smoking effect on pain, overall assessment of health, disease activity, physical mobility and life quality in ankylosing spondylitis (AS). Moderate-good evidence revealed higher HAQ-AS among smokers (0.025units/y; 95% CI: 0.0071-0.0429; p = 0.007). Every additional unit of ASDAS resulted in an increase of 1.9 vs. 0.4 mSASSS units/2y in AS smokers vs. non-smokers. Good evidence revealed that cigarette smoking and smoking intensity was associated with spinal radiographic progression in axSpA [mSASSS ≥2 units/2y: OR = 2.75, 95% CI: 1.25-6.05, p=0.012; mSASSS progression in heavy smokers (>10 cigarettes/d): OR = 3.57, 95% IC: 1.33-9.60, p = 0.012]. CONCLUSIONS: Published data indicate that smoking has a dose-dependent impact on structural damage progression in axSpA. There is worse HAQ among AS smokers compared to non-smokers. Respect to pain, overall assessment of health, disease activity, physical mobility and life quality, although the evidence level is poor, all evidence points in the same direction: smoking AS patients are worse than non-smoking.

8 Review Benefit of health education by a training nurse in patients with axial and/or peripheral psoriatic arthritis: A systematic literature review. 2016

Candelas, G / Villaverde, V / García, S / Guerra, M / León, M J / Cañete, J D. ·Rheumatology Unit, Hospital Clínico de San Carlos, Madrid, Spain. gcandelasrod@yahoo.es. · Rheumatology Unit, Hospital Universitario de Móstoles, Madrid, Spain. · Research Unit, Spanish Society of Rheumatology, Madrid, Spain. · Rheumatology Unit, Hospital Universitario Príncipe de Asturias, Alacalá De Henares, Madrid, Spain. · Rheumatology unit, Hospital Clinic de Barcelona, Barcelona, Spain. ·Rheumatol Int · Pubmed #27544392.

ABSTRACT: The aim of this study was to systematically review the literature available about the benefit of health education by a training nurse in patients with axial and/or peripheral psoriatic arthritis in the framework of the drawing up of the axial spondyloarthritis and psoriatic arthritis guidelines of the "Spanish Society of Rheumatology". Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, Medline/PubMed, CINAHL) were systematically searched from inception to 2014 using medical subject headings and keywords. Only articles in English, Spanish and French were included. The patients studied had to be diagnosed of psoriatic arthritis (all ages, both sexes) with axial involvement and/or peripheral arthritis who had received health education by a specialized nurse. We included in the search randomized clinical trials, cohort observational studies, descriptive studies and case series and qualitative research studies. Measured outcomes were those related to the education provided in a nursing consultation such as increased adherence to biological therapy, conducting exercises, smoking cessation and patient satisfaction. Eight studies were included, five randomized clinical trials with moderate level of quality and three intervention studies with no control group with low level of quality. Meta-analyses were not undertaken due to clinical heterogeneity. According to our results, it can be concluded that although there is little evidence on the role of a trained nurse in patients with psoriatic arthritis, this role can be beneficial to the patients because it can increase the rate of adherence to treatment prescribed by a rheumatologist, promotes patient self-management of their disease and increases patient satisfaction.

9 Review Anti-TNF discontinuation and tapering strategies in patients with axial spondyloarthritis: a systematic literature review. 2016

Navarro-Compán, Victoria / Plasencia-Rodríguez, Chamaida / de Miguel, Eugenio / Balsa, Alejandro / Martín-Mola, Emilio / Seoane-Mato, Daniel / Cañete, Juan D. ·Department of Rheumatology, IdiPaz, University Hospital La Paz, mvictoria.navarroc@gmail.com. · Department of Rheumatology, IdiPaz, University Hospital La Paz. · Research Unit, Spanish Society of Rheumatology, Madrid and. · Department of Rheumatology, Hospital Clinic and IDIBAPS, Barcelona, Spain. ·Rheumatology (Oxford) · Pubmed #26998860.

ABSTRACT: OBJECTIVE: The aim was to evaluate whether anti-TNF discontinuation and tapering strategies are efficacious for maintaining remission or low disease activity (LDA) in patients with axial spondyloarthritis. METHODS: A systematic literature review up to September 2014 was performed using Medline, EMBASE and Cochrane databases. Longitudinal studies evaluating the efficacy of discontinuation/tapering of anti-TNF therapy to maintain clinical response achieved after receiving a standard dose of the same drug were included. The results were grouped according to the type of strategy (discontinuation or tapering) evaluated. RESULTS: Thirteen studies out of 763 retrieved citations were included. Overall, published data are scarce and the level of evidence of the studies is weak. Five studies provided evidence for assessing discontinuation strategy. The frequency of patients developing flare during the follow-up period ranged between 76 and 100%. The median (range) follow-up period was 52 (36-52) weeks and time to flare 16 (6-24) weeks. Additionally, eight studies evaluating tapering strategy were selected. The percentage of patients maintaining LDA or remission was reported in five studies and ranged between 53 and 100%. The remaining three studies reported the mean change in BASDAI and CRP after reducing the anti-TNF dose and did not observe any relevant increase in these parameters. CONCLUSION: Published data indicate that a tapering strategy for anti-TNF therapy is successful in maintaining remission or LDA in most patients with axial spondyloarthritis. However, a discontinuation strategy is not recommended because it leads to flare in most cases. Further studies with an appropriate design covering the whole spectrum of the disease are required to confirm these results.

10 Review Multidisciplinary dermatology-rheumatology management for patients with moderate-to-severe psoriasis and psoriatic arthritis: a systematic review. 2016

Cobo-Ibáñez, Tatiana / Villaverde, Virginia / Seoane-Mato, Daniel / Muñoz-Fernández, Santiago / Guerra, Mercedes / Del Campo, Petra Díaz / Cañete, Juan D. ·Rheumatology Department, Hospital Universitario Infanta Sofía, Paseo de Europa 34, 28702, San Sebastián de Los Reyes, Madrid, Spain. mtcoboiba@yahoo.es. · Rheumatology Department, Hospital Universitario de Móstoles, Río Júcar s/n, 28935, Móstoles, Madrid, Spain. virginia.villaverde@yahoo.es. · Research Unit, Spanish Society of Rheumatology, Marqués de Duero 5, 1º, 28001, Madrid, Spain. daniel.seoane@ser.es. · Rheumatology Department, Hospital Universitario Infanta Sofía, Paseo de Europa 34, 28702, San Sebastián de Los Reyes, Madrid, Spain. Santiago.munoz@salud.madrid.org. · Research Unit, Spanish Society of Rheumatology, Marqués de Duero 5, 1º, 28001, Madrid, Spain. mercedes.guerra@ser.es. · Research Unit, Spanish Society of Rheumatology, Marqués de Duero 5, 1º, 28001, Madrid, Spain. petra.diaz@ser.es. · Rheumatology Department, Hospital Clinic de Barcelona e IDIBAPS, Calle Villarroel 170, 08036, Barcelona, Spain. jcanete@clinic.ub.es. ·Rheumatol Int · Pubmed #26438388.

ABSTRACT: The aim of the study was to analyze the efficacy and satisfaction of multidisciplinary dermatology-rheumatology management for patients with moderate-to-severe psoriasis and psoriatic arthritis (PsA). We conducted a systematic literature search in MEDLINE, EMBASE, and Cochrane Library up to September 2015. Selection criteria include (1) adult patients with moderate-to-severe psoriasis and PsA, (2) assessed in a multidisciplinary consultation, (3) comparison with routine separate consultations, and (4) outcome measures to evaluate efficacy and/or satisfaction. Meta-analyses, systematic reviews, clinical trials, cohort studies, and case series were included. The quality of the studies included was graded according to the Oxford Level of Evidence scale. Of 195 articles, three studies complied with the inclusion criteria: two case series and one descriptive study in which 506 patients were evaluated. Patients were referred to the multidisciplinary consultation from dermatology and rheumatology consultations in all but one study, in which primary care was also involved. The reason for the referral was to confirm the diagnosis and/or treatment. Patients were evaluated on a weekly and monthly basis in two and one study, respectively. The evidence obtained is scarce but suggests the efficacy of multidisciplinary consultations in terms of improved skin and joint symptoms after changing treatment (82-56 %), showing higher scores for this type of consultation compared to the usual [4.91 vs. 2.85 (0-5)] and a high level of satisfaction among patients (94 % "very satisfied"). However, waiting times were higher. With the limited evidence found, multidisciplinary management seems to be more effective and more satisfactory for patients with moderate-to-severe psoriasis and PsA than conventional consultations, though this could not be conclusively demonstrated. The results of this review support the benefit of implementing this type of consultation.

11 Review Tumour necrosis factor inhibitor monotherapy vs combination with MTX in the treatment of PsA: a systematic review of the literature. 2015

Behrens, Frank / Cañete, Juan D / Olivieri, Ignazio / van Kuijk, Arno W / McHugh, Neil / Combe, Bernard. ·CIRI/Division of Rheumatology and Fraunhofer Institute IME, Translational Medicine and Pharmacology, Goethe University, Frankfurt/Main, Germany, Arthritis Unit, Rheumatology Department, Hospital Clinic and IDIBAPS, Barcelona, Spain, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Italy, Rheumatology Department, Reade/Jan van Breemen Research Institute, Amsterdam, The Netherlands, Rheumatology Department, Royal National Hospital for Rheumatic Diseases, Bath, UK and Departement de Rhumatologie Hôpital Lapeyronie-Université Montpellier I, UMR 5535, Montpellier, France behrens@ciri-clinical.de. · CIRI/Division of Rheumatology and Fraunhofer Institute IME, Translational Medicine and Pharmacology, Goethe University, Frankfurt/Main, Germany, Arthritis Unit, Rheumatology Department, Hospital Clinic and IDIBAPS, Barcelona, Spain, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Italy, Rheumatology Department, Reade/Jan van Breemen Research Institute, Amsterdam, The Netherlands, Rheumatology Department, Royal National Hospital for Rheumatic Diseases, Bath, UK and Departement de Rhumatologie Hôpital Lapeyronie-Université Montpellier I, UMR 5535, Montpellier, France. ·Rheumatology (Oxford) · Pubmed #25349441.

ABSTRACT: OBJECTIVES: The aim of this study was to review the available evidence on TNF inhibitor monotherapy vs combination therapy with MTX in PsA. METHODS: A literature search was conducted up to and including October 2013 for randomized controlled trials (RCTs) and observational studies comparing TNF inhibitor monotherapy vs combination therapy with MTX in patients with PsA. Key information was extracted from the abstracts and/or full text of the articles retrieved. RESULTS: Eleven published articles and three conference abstracts were retrieved, reporting on six RCTs of four TNF inhibitors. Most RCTs found no differences in efficacy for peripheral arthritis between patients treated with or without MTX. However, the studies were not powered to answer this question. Some data suggest that concomitant MTX may reduce the progression of structural damage. No significant differences in other outcomes have been reported. Data on TNF inhibitor monotherapy vs MTX combination therapy were reported from six registries. Three registries reported that the use of concomitant MTX did not affect the efficacy of TNF inhibitor therapy. Data from three European Union registries suggest that TNF inhibitor (especially mAbs) drug survival is superior in patients taking concomitant MTX, while one Canadian registry reported no difference. CONCLUSION: Available evidence on the efficacy and safety of TNF inhibitor monotherapy vs add-on MTX therapy shows little or no improvement with combination therapy, although the use of concomitant MTX appears to prolong TNF inhibitor drug survival of mAb TNF inhibitors. Registries and observational studies have the potential to fill some of the knowledge gaps in this area.

12 Review [Biopathology of the synovial membrane in psoriatic arthritis]. 2012

Cañete, Juan D. ·Unidad de Artritis, Servicio de Reumatología, Hospital Clínic de Barcelona, Barcelona, España. jcanete@clinic.ub.es ·Reumatol Clin · Pubmed #22317849.

ABSTRACT: The study of the pathobiology of the synovium in psoriatic arthritis has identified morphological, cellular and molecular differences from rheumatoid arthritis. Here we review some processes that are more characteristic or have greater intensity in psoriatic arthritis, such as vascular patterns, angiogenesis and the role of the innate immune cells. We highlight in detail the finding that interleukin (IL) 17, whose role in the pathophysiology appears relevant, is produced mainly by mast cells and neutrophils in different target tissues of psoriatic arthritis, as well as the synovium, skin and axial joints. On the other hand, we try to understand the complexity of the study of the pathophysiology of psoriatic synovitis, which presents multiple interactions between cells and molecules that can vary depending on the phenotype and the stage of the disease in each patient and requires a complex methodological approach.

13 Review Morphea associated with the use of adalimumab: a case report and review of the literature. 2012

Ramírez, Julio / Hernández, M Victoria / Galve, Javier / Cañete, Juan D / Sanmartí, Raimon. ·Arthritis Unit, Department of Rheumatology, Hospital Clinic, University of Barcelona, Villarroel 170, Stairway 11, 2nd Floor, 08036, Barcelona, Spain. julramga@hotmail.com ·Mod Rheumatol · Pubmed #22095405.

ABSTRACT: Therapy with TNF blockers may induce cutaneous adverse events, but the development of morphea, a localized scleroderma lesion, is extremely infrequent. We describe a 37-year-old man with ankylosing spondylitis treated with adalimumab who developed morphea lesions in the lower limbs after 12 months of treatment. Adalimumab was discontinued, which resulted in progressive improvement in the skin lesions, with only mild hyperpigmentation remaining. We also review reports of morphea and other adverse cutaneous events related to anti-TNF treatment.

14 Review Development of alopecia areata after biological therapy with TNF-alpha Blockers: description of a case and review of the literature. 2009

Hernández, M V / Nogués, S / Ruiz-Esquide, V / Alsina, M / Cañete, J D / Sanmartí, R. · ·Clin Exp Rheumatol · Pubmed #19917182.

ABSTRACT: -- No abstract --

15 Clinical Trial Ultrasound evaluation of greater trochanter pain syndrome in patients with spondyloarthritis: are there any specific features? 2014

Ramírez, Julio / Pomés, Isaac / Sobrino-Guijarro, Beatriz / Pomés, Jaume / Sanmartí, Raimón / Cañete, Juan D. ·Arthritis Unit, Rheumatology Department, Hospital Clínic, Barcelona, Spain, julramga@gmail.com. ·Rheumatol Int · Pubmed #24448681.

ABSTRACT: Although greater trochanter pain syndrome (GTPS) is a prevalent cause of musculoskeletal pain in the general population, there is lack of imaging studies searching for differential features of inflammatory enthesitis in GTPS. We analyzed the features of GTPS using sonography and magnetic resonance imaging (MRI) to identify useful differential signs between spondyloarthritis (SpA) and other inflammatory or non-inflammatory musculoskeletal diseases. All patients with unilateral GTPS attended by our Arthritis Unit between February 2011 and March 2012 were included. Patients were classified as having SpA or mechanical (without inflammatory musculoskeletal disease) GTPS. Rheumatoid arthritis (RA) patients were also included as inflammatory controls. Ultrasound scans of the painful and contralateral, asymptomatic, greater trochanter were made. We assessed the gluteus medius and gluteus minimus tendons for signs suggestive of tendinopathy. Random MRI of the same regions was made in a subgroup of patients to validate the ultrasound findings. A total of 107 patients with unilateral GTPS were included, of whom 96 were female, with a mean age of 61.6 years: 34 had SpA, 48 had non-inflammatory musculoskeletal disease, and 25 had RA. No specific sonographic features for SpA were found. Pathological findings were more frequent in patients without musculoskeletal inflammatory disease (mainly bursitis and erosions). A large number of alterations were found in the asymptomatic side (around 40 % had cortical irregularities and 20 % bursa effusion). Signs of enthesopathy were more prevalent in the gluteus minimus tendon, regardless of the diagnosis (54.2 % had erosions, 39.3 % bursitis, 38.3 % calcifications and 37.4 % tendinosis). No patient had power Doppler signal. Age was the main factor in the appearance of tendinopathy. MRI confirmed the changes detected by ultrasound in all 40 patients evaluated. GTPS in patients with SpA has similar sonographic findings to those observed in patients with RA and patients without musculoskeletal inflammatory disease. Neither sonography nor MRI was clinically useful in classifying GTPS as a manifestation of SpA.

16 Article Impact of cardiovascular risk factors on the achievement of therapeutic goals in psoriatic arthritis: is there any association? 2018

Queiro, Rubén / Cañete, Juan D. ·Rheumatology Division, Hospital Universitario Central de Asturias, Avenida de Roma s/n, 33011, Oviedo, Spain. rubenque7@yahoo.es. · Rheumatology Division, Arthritis Unit, Hospital Clinic, Barcelona, Spain. ·Clin Rheumatol · Pubmed #29380165.

ABSTRACT: Cardiovascular risk factors (CVRFs) have been related to poorer responses to systemic therapy in psoriatic arthritis (PsA). We aimed to evaluate the potential association between CVRFs and the achievement of therapeutic goals in PsA patients receiving systemic therapy. A cross-sectional study was carried out at 25 rheumatology outpatient clinics in Spain. PsA patients with established disease who were treated with conventional and biologic systemic therapies were included. The treatment goals measured were minimal disease activity (MDA) and very low disease activity (VLDA) responses. The relationship between MDA/VLDA and CVRFs was evaluated by uni- and multivariate models. Of a total of 227 patients, 133 (58.6%) and 26 (11.5%) patients were in MDA and VLDA, respectively. Tobacco use (crude OR 0.54), sedentary lifestyle (crude OR 1.95), hyperuricemia (crude OR 2.01) and obesity (crude OR 1.54) were related to the likelihood of MDA in the univariate model (p < 0.25), while in multivariate analysis, a sedentary lifestyle (OR 3.13, 95%CI 1.50-6.53; p = 0.002) increased the odds of having reached MDA. Obesity (crude OR 2.2) and dyslipidaemia (crude OR 1.80) were associated with VLDA in univariate analysis, whereas dyslipidaemia (OR 5.3, 95%CI 1.7-16.6; p = 0.004) increased the odds of VLDA in the multivariate model. We found no association between the number of CVRFs and the MDA/VLDA responses. In this cross-sectional, multicentre study, we could not find any relationship between CVRFs and lower odds of achieving stringent therapeutic goals in PsA. In any case, patients with psoriatic disease should be encouraged to maintain healthy lifestyle habits.

17 Article Recommendations for the use of methotrexate in psoriatic arthritis. 2018

Cañete, Juan D / Ariza-Ariza, Rafael / Bustabad, Sagrario / Delgado, Concepción / Fernández-Carballido, Cristina / García Llorente, José Francisco / Loza, Estíbaliz / Montilla, Carlos / Naranjo, Antonio / Pinto, José A / Queiro, Rubén / Ramírez, Julio / Tornero-Molina, Jesús. ·Servicio de Reumatología, Hospital Clínic de Barcelona e IDIBAPS, Barcelona, España. · Departamento de Reumatología, Hospital Universitario Virgen Macarena, Sevilla, España. · Departamento de Reumatología, Hospital Universitario de Canarias, Santa Cruz de Tenerife, España. · Departamento de Reumatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España. · Departamento de Reumatología, Hospital General Universitario de Elda, Elda, Alicante, España. · Departamento de Reumatología, Hospital de Galdakao-Usansolo, Galdácano, Vizcaya, España. · Instituto de Salud Musculoesquelética, Madrid, España. Electronic address: estibaliz.loza@inmusc.eu. · Departamento de Reumatología, Hospital Universitario de Salamanca, Salamanca, España; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España. · Departamento de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Gran Canaria, España; Universidad de Las Palmas de Gran Canaria, Gran Canaria, España. · Departamento de Reumatología, Complejo Hospitalario Universitario de A Coruña, La Coruña, España. · Departamento de Reumatología, Hospital Universitario Central de Asturias, Oviedo, España. · Departamento de Reumatología, Hospital de Guadalajara, Guadalajara, España; Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Madrid, España. ·Reumatol Clin · Pubmed #29050840.

ABSTRACT: OBJECTIVES: To develop recommendations for the management of methotrexate (MTX) in psoriatic arthritis (PsA), based on best evidence and experience. METHODS: A group of 12 experts on MTX use was selected. The coordinators formulated 14 questions about the use of MTX in PsA patients (indications, efficacy, safety and cost-effectiveness). A systematic review was conducted to answer the questions. Using this information, inclusion and exclusion criteria were established, as were the search strategies (Medline, EMBASE and the Cochrane Library were searched). Two different reviewers selected the articles. Evidence tables were created. At the same time, European League Against Rheumatism and American College of Rheumatology abstracts were evaluated. Based on this evidence, the coordinators proposed 12 preliminary recommendations that the experts discussed and voted on in a nominal group meeting. The level of evidence and grade of recommendation were established using the Oxford Centre for Evidence Based Medicine and the level of agreement with the Delphi technique (2 rounds). Agreement was established if at least 80% of the experts voted yes (yes/no). RESULTS: A total of 12 preliminary recommendations on the use of MTX were proposed, 9 of which were accepted. One was included in a different recommendation and another 2 were not voted on and were thereafter clarified in the main text. CONCLUSIONS: These recommendations aim to answer frequent questions and help in decision making strategies when treating PsA patients with MTX.

18 Article Minimal disease activity and impact of disease in psoriatic arthritis: a Spanish cross-sectional multicenter study. 2017

Queiro, Rubén / Cañete, Juan D / Montilla, Carlos / Abad, Miguel / Montoro, María / Gómez, Susana / Cábez, Ana / Anonymous5760901. ·Department of Rheumatology, HU, Central de Asturias, Av. Roma, s/n, 33011, Oviedo, Asturias, Spain. rubenque7@yahoo.es. · Department of Rheumatology, HU, Clinic and IDIBAPS, C/Villarroel, 170-08036, Barcelona, Spain. · Department of Rheumatology, HU, Parque Natural de las Batuecas 17, Cabrerizos, Salamanca, Cp 37193, Spain. · Department of Rheumatology HU, Virgen del Puerto, Paraje Valcorchero s/n, 10600, Plasencia, Spain. · Medical Department, Pfizer, Avenida de Europa, 20 B, 28108, Alcobendas, Madrid, Spain. ·Arthritis Res Ther · Pubmed #28356155.

ABSTRACT: BACKGROUND: Patients with psoriatic arthritis (PsA) experience functional impairment and reduced quality of life, and thus patient global assessment in PsA is explained mainly by the physical, but also by the psychological, aspect of the disease. To assess the prevalence of minimal disease activity (MDA) in Spanish patients with PsA, we examined their characteristics and the association between MDA and the impact of the disease as assessed by the PsA Impact of Disease (PsAID) questionnaire. METHODS: A cross-sectional multicenter study was carried out in patients who fulfilled the Classification for Psoriatic Arthritis (CASPAR) criteria with at least 1 year of disease duration, and who were treated with biological or conventional synthetic (cs) disease-modifying anti-rheumatic drugs (DMARDs) according to routine clinical practice in Spain. Patients were considered in MDA if they met at least 5/7 of the MDA criteria. The association between MDA and the recently developed PsAID questionnaire was also recorded. RESULTS: Of 227 patients included, 133 (58.6%) were in the MDA state (52% with antitumor necrosis factor (anti-TNF)α monotherapy, 24% with csDMARD monotherapy, and 24% with anti-TNFα in combination with csDMARD). Using multivariate logistic regression analysis, male gender (odds ratio (OR) 2.74, p = 0.001), a sedentary lifestyle (OR 3.13, p = 0.002), familial history of PsA (OR 0.38, p = 0.036), C-reactive protein (CRP) level (OR 0.92, p = 0.010), and use of corticoids (OR 0.33, p = 0.007) were considered features related to MDA. MDA patients had a significantly lower impact of the disease according to PsAID (mean total score (SD): MDA 3.3 (3.1) vs. non-MDA 7.1 (5.2); p < 0.001). CONCLUSIONS: Nearly 60% of Spanish PsA patients achieve MDA in routine clinical practice. MDA remains one of the most useful therapeutic targets for PsA since patients who reached this state also had a significantly lower impact of disease according to PsAID.

19 Article Determinants of Patient-Physician Discordance in Global Assessment in Psoriatic Arthritis: A Multicenter European Study. 2017

Desthieux, Carole / Granger, Benjamin / Balanescu, Andra Rodica / Balint, Peter / Braun, Jürgen / Canete, Juan D / Heiberg, Turid / Helliwell, Philip S / Kalyoncu, Umut / Kvien, Tore K / Kiltz, Uta / Niedermayer, Dora / Otsa, Kati / Scrivo, Rossana / Smolen, Josef / Stamm, Tanja A / Veale, Douglas J / de Vlam, Kurt / de Wit, Maarten / Gossec, Laure. ·Sorbonne Universités, UPMC University Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), AP-HP, Hôpital Pitié Salpêtrière, Paris, France. · University of Medicine and Pharmacy Carol Davila and St Maria Hospital, Bucharest, Romania. · National Institute of Rheumatology and Physiotherapy, Budapest, Hungary. · Ruhrgebiet, Herne and Ruhr-Universität Bochum, Herne, Germany. · Hospital Clínic and IDIBAPS, Barcelona, Spain. · Østfold University College, Halden, and Regional Research Support, Oslo University Hospital, Oslo, Norway. · University of Leeds, Leeds, UK. · Hacettepe University, Ankara, Turkey. · Diakonhjemmet Hospital, Oslo, Norway. · Tallinn Central Hospital, Tallinn, Estonia. · Sapienza Università di Roma, Rome, Italy. · III Medical University of Vienna, Vienna, Austria. · Dublin Academic Medical Centre and St Vincent's University Hospital, Dublin, Ireland. · University Hospitals Leuven, Leuven, Belgium. · Patient Research Partner, People with Arthritis/Rheumatism in Europe, Zurich, Switzerland. ·Arthritis Care Res (Hoboken) · Pubmed #27998026.

ABSTRACT: OBJECTIVE: Patient-physician discordance in global assessment of disease activity concerns one-third of patients, but what does it reflect? We aimed to assess patient-physician discordance in psoriatic arthritis (PsA) and patient-reported domains of health (physical and psychological) associated with discordance. METHODS: We analyzed the PsAID (Psoriatic Arthritis Impact of Disease), a cross-sectional, multicenter European study of patients with PsA according to expert opinion. Patient global assessment (PGA) and physician global assessment (PhGA) were rated on a 0-10 numeric rating scale. Discordance was defined as the difference (PGA-PhGA) and as the absolute difference |PGA-PhGA| ≥3 points. Determinants of PGA-PhGA were assessed by a stepwise multivariate linear regression among 12 physical and psychological aspects of impact: pain, skin problems, fatigue, ability to work/leisure, functional incapacity, feeling of discomfort, sleep disturbance, anxiety/fear, coping, embarrassment/shame, social participation, and depressive affects. RESULTS: In 460 patients (mean ± SD age 50.6 ± 12.9 years, 52.2% female, mean ± SD disease duration 9.5 ± 9.5 years, mean ± SD Disease Activity Index for Psoriatic Arthritis score 30.8 ± 32.4, and 40.4% undergoing treatment with biologic agents), the mean ± SD PGA was higher than the mean PhGA, with a mean absolute difference of 1.9 ± 1.8 points. Discordance defined by |PGA-PhGA| ≥3 of 10 concerned 134 patients (29.1%), and 115 patients (85.8% of the patients with discordance) had PGA>PhGA. Higher fatigue (β = 0.14), lower self-perceived coping (β = 0.23), and impaired social participation (β = 0.16) were independently associated with a higher difference (PGA-PhGA). CONCLUSION: Discordance concerned 29.1% of these patient/physician dyads, mainly by PGA>PhGA. Factors associated with discordance were psychological rather than physical domains of health. Discordance was more frequent in patients in remission, indicating more work is needed on the patient perspective regarding disease activity.

20 Article Differing local and systemic inflammatory burden in polyarticular psoriatic arthritis and rheumatoid arthritis patients on anti-TNF treatment in clinical remission. 2017

Ramírez, Julio / Inciarte-Mundo, José / Cuervo, Andrea / Ruiz-Esquide, Virginia / Hernández, M Victoria / Sanmartí, Raimón / Cañete, Juan D. ·Arthritis Unit, Rheumatology Department, Hospital Clínic and IDIBAPS, Barcelona, Spain. · Arthritis Unit, Rheumatology Department, Hospital Clínic and IDIBAPS, Barcelona, Spain. jcanete@clinic.ub.es. ·Clin Exp Rheumatol · Pubmed #27749227.

ABSTRACT: OBJECTIVES: To analyse clinical, serological and sonographic differences between rheumatoid arthritis (RA) and polyarticular psoriatic arthritis (PsA) patients on anti-TNF therapy in clinical remission. METHODS: Angiogenic and proinflammatory cytokine serum levels were determined by multiplex ELISA in patients with RA and PsA in clinical remission (DAS28-ESR<2.6), clinically-active RA patients (DAS28>3.2) and healthy controls. Ultrasound (US) scans were made of both wrists and hands. RESULTS: 30 RA and 47 PsA patients in remission, 22 active RA patients and 20 healthy controls were included. PsA patients had significantly lower disease activity according to DAS28-ESR (p=0.006) but not according to DAS28-CRP (p=0.319), and lower serum levels of proinflammatory and angiogenic cytokines than RA patients in remission. PsA patients had cytokine levels similar to healthy controls, while RA patients in remission had similar levels to those of active RA patients. Globally, 31 (40.25%) patients in remission had a PD signal and 12 had SH>2 plus PD [1 PsA vs. 11 RA (p=0.0001)], meeting the criteria for ultrasound-defined active synovitis (UdAS). Patients with UdAS had significantly higher levels of IL-6, IL-20, PIGF and SDF1. More PsA patients were on tapered doses of anti-TNF (63.8%), and more frequently as monotherapy (72.3%), compared with RA patients (26.6% and 20%, respectively). CONCLUSIONS: Polyarticular PsA patients in remission had lower levels of local (US synovitis) and systemic inflammation than RA patients in remission, even though a significantly higher percentage of PsA patients were on tapered doses of anti-TNF, mainly in monotherapy.

21 Article Calprotectin and TNF trough serum levels identify power Doppler ultrasound synovitis in rheumatoid arthritis and psoriatic arthritis patients in remission or with low disease activity. 2016

Inciarte-Mundo, José / Ramirez, Julio / Hernández, Maria Victoria / Ruiz-Esquide, Virginia / Cuervo, Andrea / Cabrera-Villalba, Sonia Raquel / Pascal, Mariona / Yagüe, Jordi / Cañete, Juan D / Sanmarti, Raimon. ·Department of Rheumatology, Hospital Clinic, University of Barcelona, Carrer Villarroel 170, 08036, Barcelona, Spain. · Department of Immunology, Hospital Clinic, University of Barcelona, Barcelona, Spain. · Department of Rheumatology, Hospital Clinic, University of Barcelona, Carrer Villarroel 170, 08036, Barcelona, Spain. sanmarti@clinic.cat. ·Arthritis Res Ther · Pubmed #27391315.

ABSTRACT: BACKGROUND: Serum levels of calprotectin, a major S100 leucocyte protein, are associated with disease activity in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients. Higher drug trough serum levels are associated with good response in patients treated with tumour necrosis factor inhibitors (TNFi). Power Doppler ultrasound (PDUS) synovitis is predictive of flare and progression of structural damage in patients in clinical remission. The purpose of this study was to analyse the accuracy of calprotectin and TNFi trough serum levels in detecting PDUS synovitis in RA and PsA patients in clinical remission or with low disease activity who were receiving TNFi. METHODS: We conducted a cross-sectional study of 92 patients (42 with RA, 50 with PsA) receiving adalimumab (ADA), etanercept (ETN) or infliximab who were in remission or had low disease activity (28-joint Disease Activity Score based on erythrocyte sedimentation rate <3.2). Associations of calprotectin, TNFi trough serum levels and acute phase reactants with PDUS synovitis were assessed using correlation and linear regression analyses. The accuracy and discriminatory capacity in detecting PDUS synovitis was assessed using ROC curves. RESULTS: PDUS synovitis was found in 62.4 % of RA patients and 32 % of PsA patients. Both RA and PsA patients with PDUS synovitis had higher calprotectin levels and lower TNFi trough serum levels. Calprotectin positively correlated with ultrasound scores (all r coefficients >0.50 in RA). Calprotectin correlated with the PDUS synovitis score in patients treated with ADA and ETN. Using PDUS synovitis (yes or no) as the reference variable, calprotectin had an AUC of 0.826. The best cut-off was ≥1.66 μg/ml, with a likelihood ratio of 2.77. C-reactive protein (AUC 0.673) and erythrocyte sedimentation rate (AUC 0.731) had a lower discriminatory capacity. TNFi trough serum levels were significantly associated with PDUS synovitis (OR 0.67, 95 % CI 0.52-0.85, p < 0.001) but their accuracy (AUC <0.5) was less than that of calprotectin. TNFi trough serum levels were inversely correlated with calprotectin and PDUS synovitis in RA and PsA patients receiving ADA and ETN. CONCLUSIONS: Calprotectin and TNFi trough serum levels may help identify PDUS synovitis in RA and PsA patients in clinical remission or with low disease activity.

22 Article Association of IL1Β (-511 A/C) and IL6 (-174 G > C) polymorphisms with higher disease activity and clinical pattern of psoriatic arthritis. 2016

Cubino, N / Montilla, C / Usategui-Martín, R / Cieza-Borrela, C / Carranco, T / Calero-Paniagua, I / Quesada, A / Cañete, J D / Queiro, R / Sánchez, M D / Hidalgo, C / Martínez, O / Del Pino-Montes, J / Díaz-Álvarez, A / González-Sarmiento, R. ·Rheumatology Service, University Hospital-IBSAL, Salamanca, Spain. · Rheumatology Service, University Hospital-IBSAL, Salamanca, Spain. montillamorales.carlos@gmail.com. · Service of Rheumatology, Hospital Clínico Universitario de Salamanca, Paseo San Vicente 58-182, E-38007, Salamanca, Spain. montillamorales.carlos@gmail.com. · Molecular Medicine Unit-IBSAL, University of Salamanca-University Hospital-CSIC, Salamanca, Spain. · Rheumatology of Hospital Clinic de Barcelona, Barcelona, Spain. · Rheumatology Hospital Universitario Central de Asturias, HUCA, Oviedo, Barcelona, Spain. · Anesthesiology Service, University Hospital-IBSAL, Salamanca, Spain. · Institute for Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-CSIC, Salamanca, Spain. ·Clin Rheumatol · Pubmed #27188858.

ABSTRACT: The objective of this study is to analyze whether IL1β (-511G > A) and IL6 (-174 G > C) polymorphisms are associated with inflammatory activity, radiographic damage or clinical pattern of psoriatic arthritis (PsA). One hundred twenty-five patients classified as PsA according to the Classification of Psoriatic Arthritis (CASPAR) criteria were included. Patients were stratified according to their clinical pattern at inclusion as peripheral, axial, or mixed involvement. Disease activity in peripheral or mixed forms was measured using the number of swollen and tender joints, pain analog visual scale, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and disease activity score 28 (DAS28). Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used for axial and mixed forms, as were pain visual analog scale, ESR and CRP. Radiographic damage was evaluated using a modified Sharp score and modified stoke ankylosing spondylitis spinal score (SASSSm). The polymorphisms for the promoter region of IL1β (-511 G/A) and IL-6 (-174 G/C) were analyzed. The G allele of IL1B (-511G/A) polymorphism was associated with higher peripheral joint disease activity (OR 3.13; p < 0.0004; CI 95 % 1.43-6.82, p (corrected) <0.008), while the G allele of the IL6 (174G > C) polymorphism presented a strong trend to be associated with peripheral forms (70.86 %) (OR 1.89; p < 0.03; CI 95 % 1.06-3.39, p-corrected 0.05). In addition, this allele showed a lower association with HLA-B27 (15.78 %) compared with C allele (28.57 %) (OR 0.469; p = 0.02; CI 95 % 0.238-0.923, p-corrected 0.03). This study suggests that the G allele polymorphism of IL1B (-511 A/C) is associated with higher peripheral joint disease activity. On the other hand, the IL6 (-174 G/C) polymorphism showed a strong trend to be associated with the peripheral pattern of PsA.

23 Article Fatigue in psoriatic arthritis - a cross-sectional study of 246 patients from 13 countries. 2016

Gudu, Tania / Etcheto, Adrien / de Wit, Maarten / Heiberg, Turid / Maccarone, Mara / Balanescu, Andra / Balint, Peter V / Niedermayer, Dora S / Cañete, Juan D / Helliwell, Philip / Kalyoncu, Umut / Kiltz, Uta / Otsa, Kati / Veale, Douglas J / de Vlam, Kurt / Scrivo, Rossana / Stamm, Tanja / Kvien, Tore K / Gossec, Laure. ·Department of Rheumatology, Sorbonne universités, UPMC université Paris 06, institut Pierre-Louis d'épidémiologie et de santé publique, GRC-UPMC 08 (EEMOIS), Pitié-Salpêtrière Hospital, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Research Center of Rheumatic Diseases, University of Medicine and Pharmacy Carol Davila, St Maria Hospital, 011172 Bucharest, Romania. · Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, Inserm U1153, 75014 Paris, France. · Patient Research Partner, People with Arthritis/Rheumatism in Europe (PARE), 8802 Zurich, Switzerland. · Department of Health and Social Sciences, Østfold University College, Halden, Regional Research Support, Oslo University Hospital, 4950 Oslo, Norway. · Patient Research Partner, ADIPSO (Associazione per la Difesa degli Psoriasici)-PE.Pso.POF (Pan European Psoriasis Patients' Organization Forum), 00193 Rome, Italy. · Research Center of Rheumatic Diseases, University of Medicine and Pharmacy Carol Davila, St Maria Hospital, 011172 Bucharest, Romania. · 3rd Rheumatology Department, National Institute of Rheumatology and Physiotherapy, 1023 Budapest, Hungary. · Arthritis Unit, Department of Rheumatology, Hospital Clínic and IDIBAPS, 08036 Barcelona, Spain. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, LS7 4SA Leeds, UK. · Division of Rheumatology, Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey. · Rheumazentrum Ruhrgebiet, Herne and Ruhr-Universität Bochum, 44652 Herne, Germany. · Rheumatology Department, Tallinn Central Hospital, 10138 Tallinn, Estonia. · Dublin Academic Medical Centre, St Vincent's University Hospital, D4 Dublin, Ireland. · Department of Rheumatology, University Hospitals Leuven, 3000 Leuven, Belgium. · Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, 00185 Rome, Italy. · Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, 1090 Vienna, Austria. · Department of Rheumatology, Diakonhjemmet Hospital, No-0370 Oslo, Norway. · Department of Rheumatology, Sorbonne universités, UPMC université Paris 06, institut Pierre-Louis d'épidémiologie et de santé publique, GRC-UPMC 08 (EEMOIS), Pitié-Salpêtrière Hospital, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France. Electronic address: laure.gossec@aphp.fr. ·Joint Bone Spine · Pubmed #27055727.

ABSTRACT: OBJECTIVES: Fatigue is an aspect of psoriatic arthritis (PsA), which is important to patients. The objective was to evaluate magnitude of fatigue in PsA patients and to assess factors that might explain high levels of fatigue. METHODS: This was an ancillary analysis of a cross-sectional study in 13 countries of unselected PsA patients who fulfilled the CASPAR criteria. Patient-perceived importance of fatigue was assessed through a priority exercise. Levels of fatigue were assessed by a numeric rating scale (range 0-10). Factors potentially associated with fatigue>5/10: i.e., demographic variables (age, gender, disease duration, education level) and disease related characteristics including joint counts, C-reactive protein, skin psoriasis, axial involvement, enthesitis, dactylitis, structural damage, were assessed by univariate, multivariate logistic and multiple linear regression. RESULTS: In all, 246 patients were analysed: mean±standard deviation age 51.2±13.0years, mean disease duration 9.9±10.1years, mean DAS28 3.5±1.3. Fatigue was ranked second in patient-perceived importance, after pain. Magnitude of fatigue was high: mean fatigue 5.0±3.0. Fatigue>5/10 was well explained (variance explained 73%) by skin psoriasis (odds ratio 4.67 [95% confidence interval 1.05; 20.72]), tender joints (1.30 [1.01; 1.68]) and lower education level (1.09 [1.02; 1.23]). In the multiple linear regression model, fatigue was explained by skin psoriasis, tender joints, enthesitis, female gender, education level. CONCLUSIONS: Fatigue is a priority for PsA patients. Fatigue levels were high in these patients and fatigue>5/10 was mainly associated with disease-related factors but also patient-related variables, indicating that the etiology of fatigue in PsA is multifactorial.

24 Article Patient global assessment in psoriatic arthritis - what does it mean? An analysis of 223 patients from the Psoriatic arthritis impact of disease (PsAID) study. 2016

Tälli, Sandra / Etcheto, Adrien / Fautrel, Bruno / Balanescu, Andra / Braun, Jurgen / Cañete, Juan D / de Vlam, Kurt / de Wit, Maarten / Heiberg, Turid / Helliwell, Philip / Kalyoncu, Umut / Kiltz, Uta / Maccarone, Mara / Niedermayer, Dora / Otsa, Kati / Scrivo, Rossana / Smolen, Josef S / Stamm, Tanja / Veale, Douglas J / Kvien, Tore K / Gossec, Laure. ·Sorbonne universités, UPMC université Paris 06, institut Pierre-Louis d'épidémiologie et de santé publique, 75013 Paris, France; AP-HP, Pitié-Salpêtrière hospital, department of rheumatology, 47-83, boulevard de l'Hôpital, 75013 Paris, France. · Paris Descartes university, department of rheumatology, Cochin hospital and epidemiology, 75014 Paris, France; Biostatistics unit, Sorbonne Paris Cité research center, Inserm U1153, 75004 Paris, France. · Research center of rheumatic diseases, Sf. Maria hospital, university of medicine and pharmacy Carol Davila, 011172 Bucharest, Romania. · Rheumazentrum Ruhrgebiet, 44649 Herne, Germany; Ruhr-Universität Bochum, 44801 Bochum, Germany. · Arthritis unit, department of rheumatology, hospital Clínic and IDIBAPS, 08036 Barcelona, Spain. · Department of rheumatology, university hospitals Leuven, 1348 Leuven, Belgium. · People with Arthritis/Rheumatism in Europe (PARE), 8000 Zurich, Switzerland. · Faculty of health and social studies, Oestfold university college, NO-1757 Halden, regional research support Oslo, university hospital Postbox 4956 Nydalen, NO-0424 Oslo, Norway. · Institute of rheumatic and musculoskeletal medicine, university of Leeds, LS2 9JT Leeds, United Kindom. · University faculty of medicine, division of rheumatology, 06560 Ankara, Turkey. · Associazione per la Difesa degli Psoriasici (ADIPSO) - Pan European Psoriasis Patients' Organization Forum (PE.Pso.POF), 00193 Rome, Italy. · 3rd rheumatology department, National institute of rheumatology and physiotherapy, 1051 Budapest, Hungary. · East-Tallinn central hospital, rheumatology department, 10001 Tallinn, Estonia. · Dipartimento di medicina interna e specialità mediche, reumatologia, Sapienza università di Roma, 00185 Rome, Italy. · Division of rheumatology, department of medicine 3, medical university of Vienna, 2nd department of medicine, Hietzing hospital, 1130 Vienna, Austria. · Division of rheumatology, department of medicine 3, medical university of Vienna, 2nd department of medicine, Hietzing hospital, 1130 Vienna, Austria; University of applied sciences FH Campus Wien, department of health, division of health assisting engineering, 1140 Vienna, Austria. · Dublin academic medical centre, Saint-Vincent's university hospital, Elm Park, Dublin 4, Ireland. · Department of rheumatology, Diakonhjemmet hospital, 0370 Oslo, Norway. · Sorbonne universités, UPMC université Paris 06, institut Pierre-Louis d'épidémiologie et de santé publique, 75013 Paris, France; AP-HP, Pitié-Salpêtrière hospital, department of rheumatology, 47-83, boulevard de l'Hôpital, 75013 Paris, France. Electronic address: laure.gossec@psl.aphp.fr. ·Joint Bone Spine · Pubmed #26677994.

ABSTRACT: OBJECTIVE: Patient global assessment is a key outcome measure in psoriatic arthritis. To explore the meaning of patient global assessment in psoriatic arthritis by examining associations to domains of health assessed by the Psoriatic arthritis impact of disease score. METHODS: Post-hoc analysis of a multicentre cross-sectional study of patients with psoriatic arthritis. Data collection included patient global assessment, specific joint and skin global patient assessments, Psoriatic arthritis impact of disease questions covering physical (including joints and skin), psychological and social impact, and other comparator outcomes. Univariate analyses (Pearson correlation) and multivariate linear regression were performed to explain patient global assessment and the specific joint and skin global patient assessments. RESULTS: Among 223 patients (mean age: 51.0 [standard deviation, ±13.3] years; mean disease duration: 9.9 [±10.1] years; mean swollen joint count: 4.1 [±5.1]; 84.3% with current psoriasis [mainly of less than 5% body surface area]), 50.2% were females. Mean patient global assessment was 4.8 (±2.7), mean joint and skin patient assessments were respectively 5.6 (±2.5) and 4.1 (±3.0). Intraclass correlation between patient global assessment and joint or skin patient assessment was respectively 0.71 (95% confidence interval, 0.64-0.77) and 0.52 (95% confidence interval, 0.42-0.60). In multivariate analyses, patient global assessment was explained (R(2) of model: 0.754) by coping (β = 0.287); pain (β = 0.240); work and/or leisure activities (β = 0.141); and anxiety (β = 0.109). CONCLUSIONS: Patient global assessment in psoriatic arthritis was explained mainly by physical, but also psychological aspects of the disease.

25 Article Differential Antigen-presenting B Cell Phenotypes from Synovial Microenvironment of Patients with Rheumatoid and Psoriatic Arthritis. 2015

Armas-González, Estefanía / Díaz-Martín, Ana / Domínguez-Luis, María Jesús / Arce-Franco, María Teresa / Herrera-García, Ada / Hernández-Hernández, María Vanesa / Bustabad, Sagrario / Usategui, Alicia / Pablos, José L / Cañete, Juan D / Díaz-González, Federico. ·From the Departamento de Farmacología, and Departamento de Medicina, Facultad de Medicina, and Centro para la Investigación Biomédica de las Islas Canarias, Instituto de Investigaciones Biomédicas, Universidad de La Laguna; Servicio de Reumatología, Hospital Universitario de Canarias, Tenerife; Servicio de Reumatología, and Instituto de Investigación, Hospital 12 de Octubre, Madrid; Servicio de Reumatología, Hospital Clinic, Barcelona, Spain.E. Armas-González, PhD; A. Díaz-Martín, PhD, Departamento de Farmacología, Facultad de Medicina, Universidad de La Laguna, and Servicio de Reumatología, Hospital Universitario de Canarias; M.J. Domínguez-Luis, PhD, Centro para la Investigación Biomédica de las Islas Canarias, and Instituto de Investigaciones Biomédicas, Universidad de la Laguna; M.T. Arce-Franco, PhD; A. Herrera-García, PhD; M.V. Hernández-Hernández, MD; S. Bustabad, MD, Servicio de Reumatología, Hospital Universitario de Canarias; A. Usategui, MD, Servicio de Reumatología, Hospital 12 de Octubre; J.L. Pablos, MD, Servicio de Reumatología, and Instituto de Investigación, Hospital 12 de Octubre; J.D. Cañete, MD, Servicio de Reumatología, Hospital Clinic; F. Díaz-González, MD, Departamento de Medicina, Facultad de Medicina, Universidad de La Laguna. ·J Rheumatol · Pubmed #26178284.

ABSTRACT: OBJECTIVE: To study the qualitative and quantitative phenotypic changes that occur in molecules involved in antigen presentation and costimulation in synovial B cells from rheumatoid arthritis (RA) and psoriatic arthritis (PsA). METHODS: The presence of HLA-DR, CD86, and CD40 in CD20+ cells was studied in RA synovium biopsies using immunohistochemistry and immunofluorescence. Expression was assessed by flow cytometry of the Class II molecules CD40, CD86, CD23, and CD27 on B cells from the synovial fluid (SF), with respect to peripheral blood, from 13 patients with RA and 15 patients with PsA. Expression of interferon-induced protein with tetratricopeptide repeats 4 (IFIT4) in immune-selected CD20+ cells from patients with RA was assessed by quantitative realtime PCR. RESULTS: Infiltrating synovial RA, B cells expressed HLA-DR, CD40, and CD86. Increased expression of CD86, HLA-DR, and HLA-DQ in B cells from SF was found in patients with RA and PsA. HLA-DP was also elevated in rheumatoid SF B cells; conversely, a significantly lower expression was observed in SF from patients with PsA. CD40 expression was increased in SF B cells from PsA, but not in patients with RA. Interestingly, CD20 surface expression level was significantly lower in SF B cells (CD19+, CD138-) from RA, but not in patients with PsA. CD27 upregulation and CD23 downregulation were observed in synovial B cells in both pathologies. Finally, a 4-fold increase in IFIT4 mRNA content was shown in B cells from SF in patients with RA. CONCLUSION: Synovial B cells from patients with RA and patients with PsA express different antigen-presenting cell phenotypes, suggesting that this cell type plays a dissimilar role in the pathogenesis of each disease.

Next