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Spinal Diseases: HELP
Articles by Pal Geher
Based on 9 articles published since 2010
(Why 9 articles?)

Between 2010 and 2020, P. Geher wrote the following 9 articles about Spinal Diseases.
+ Citations + Abstracts
1 Guideline 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. 2017

van der Heijde, Désirée / Ramiro, Sofia / Landewé, Robert / Baraliakos, Xenofon / Van den Bosch, Filip / Sepriano, Alexandre / Regel, Andrea / Ciurea, Adrian / Dagfinrud, Hanne / Dougados, Maxime / van Gaalen, Floris / Géher, Pál / van der Horst-Bruinsma, Irene / Inman, Robert D / Jongkees, Merryn / Kiltz, Uta / Kvien, Tore K / Machado, Pedro M / Marzo-Ortega, Helena / Molto, Anna / Navarro-Compàn, Victoria / Ozgocmen, Salih / Pimentel-Santos, Fernando M / Reveille, John / Rudwaleit, Martin / Sieper, Jochen / Sampaio-Barros, Percival / Wiek, Dieter / Braun, Jürgen. ·Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. · Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands. · Department of Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands. · Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany. · Department of Rheumatology, Ghent University and Ghent University Hospital, Ghent, Belgium. · NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal. · Department of Rheumatology, University Hospital Zurich, Zurich Switzerland. · Diakonhjemmet Hospital, Oslo, Norway. · Paris Descartes University, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France. · INSERM (U1153), PRES Sorbonne Paris-Cité, Paris, France. · Semmelweis University, Budapest, Hungary. · Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands. · University of Toronto, Toronto, Ontario, Canada. · Patient Research Partner, Amsterdam, The Netherlands. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Centre for Rheumatology & MRC Centre for Neuromuscular Diseases, University College London, London, UK. · NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, UK. · Leeds Institute of Rheumatic and Musculoskeletal Disease, University of Leeds, Leeds, UK. · Department of Rheumatology, University Hospital La Paz, IdiPaz, Madrid, Spain. · Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Erciyes University, Kayseri, Turkey. · NOVA Medical School, NOVA University of Lisbon, Lisboa, Portugal. · The University of Texas-Health McGovern Medical School, Dallas, USA. · Klinikum Bielefeld, Bielefeld, Germany. · Gent University, Gent, Belgium. · Charité University Medicine, Berlin, Germany. · Department of Rheumatology, Campus Benjamin Franklin, Charité, Berlin, Germany. · Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. · EULAR PARE Patient Research Partner and Chair of EULAR PARE, Berlin, Germany. ·Ann Rheum Dis · Pubmed #28087505.

ABSTRACT: To update and integrate the recommendations for ankylosing spondylitis and the recommendations for the use of tumour necrosis factor inhibitors (TNFi) in axial spondyloarthritis (axSpA) into one set applicable to the full spectrum of patients with axSpA. Following the latest version of the European League Against Rheumatism (EULAR) Standardised Operating Procedures, two systematic literature reviews first collected the evidence regarding all treatment options (pharmacological and non-pharmacological) that were published since 2009. After a discussion of the results in the steering group and presentation to the task force, overarching principles and recommendations were formulated, and consensus was obtained by informal voting. A total of 5 overarching principles and 13 recommendations were agreed on. The first three recommendations deal with personalised medicine including treatment target and monitoring. Recommendation 4 covers non-pharmacological management. Recommendation 5 describes the central role of non-steroidal anti-inflammatory drugs (NSAIDs) as first-choice drug treatment. Recommendations 6-8 define the rather modest role of analgesics, and disprove glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) for axSpA patents with predominant axial involvement. Recommendation 9 refers to biological DMARDs (bDMARDs) including TNFi and IL-17 inhibitors (IL-17i) for patients with high disease activity despite the use (or intolerance/contraindication) of at least two NSAIDs. In addition, they should either have an elevated C reactive protein and/or definite inflammation on MRI and/or radiographic evidence of sacroiliitis. Current practice is to start with a TNFi. Switching to another TNFi or an IL-17i is recommended in case TNFi fails (recommendation 10). Tapering, but not stopping a bDMARD, can be considered in patients in sustained remission (recommendation 11). The final two recommendations (12, 13) deal with surgery and spinal fractures. The 2016 Assessment of SpondyloArthritis international Society-EULAR recommendations provide up-to-date guidance on the management of patients with axSpA.

2 Review Comparative efficacy and safety of biosimilar infliximab and other biological treatments in ankylosing spondylitis: systematic literature review and meta-analysis. 2014

Baji, Petra / Péntek, Márta / Szántó, Sándor / Géher, Pál / Gulácsi, László / Balogh, Orsolya / Brodszky, Valentin. ·Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, 1093, Budapest, Hungary, petra.baji@uni-corvinus.hu. ·Eur J Health Econ · Pubmed #24832835.

ABSTRACT: OBJECTIVES: To compare the efficacy and safety of infliximab-biosimilar with other biological drugs for the treatment of active ankylosing spondylitis (AS). METHODS: Systematic literature review for randomized controlled trials (RCTs) with adalimumab, etanercept, golimumab, infliximab and infliximab-biosimilar in AS was performed and indirect meta-analysis (Bayesian mixed treatment comparison) was carried out. The proportion of patients reaching 20% improvement by the assessment of Spondyloarthritis International Society response criteria (ASAS20) at weeks 12 and 24 was used as efficacy endpoints, and the occurrence of serious adverse events at week 24 was applied to compare the safety of the biologicals. RESULTS: Altogether, 13 RCTs, identified by the systematic literature search, were included in the analysis. Results on the ASAS20 efficacy endpoint were reported for week 12 in 12 RCTs involving 2,395 patients, and for week 24 in 5 RCTs comprising 1,337 patients. All the five biological agents proved to be significantly superior to placebo. Infliximab showed the highest odds ratio (OR) of 7.2 (95% CI 3.68-13.19) compared to placebo, followed by infliximab-biosimilar with OR 6.25 (95% CI 2.55-13.14), both assessed at week 24. No significant difference was found between infliximab-biosimilar and other biological treatments regarding their efficacy and safety. CONCLUSIONS: This is the first study which includes a biosimilar drug in the meta-analysis of biological treatments in AS. The results have proven the similar efficacy and safety profile of infliximab-biosimilar treatment compared to other biologicals.

3 Article Improved clinical, functional and work outcomes in spondyloarthritides during real-life adalimumab treatment in central-eastern Europe. 2016

Szántó, Sándor / Poór, Gyula / Opris, Daniela / Iaremenko, Oleg / Procházková, Leona / Kuuse, Reet / Nagy, Orsolya / Chernyshov, Valentyn / Géher, Pál. ·Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary. · National Institute of Rheumatology & Physiotherapy, Budapest, Hungary. · "Sf. Maria" Clinical Hospital, Bucharest, Romania. · National Medical University, Kyiv, Ukraine. · Rheumatology Division, 2nd Department of Internal Medicine, St Anne's University Hospital Brno, Brno, Czech Republic. · Tartu University Hospital, Tartu, Estonia. · AbbVie Ltd, Budapest, Hungary. · AbbVie Biopharmaceuticals GmbH, Minsk, Belarus. · Hospitaller Brothers of St John of God Hospital, Budapest, Hungary. ·J Comp Eff Res · Pubmed #27417564.

ABSTRACT: AIM: Adalimumab effectiveness on clinical, functional and work-related outcomes was evaluated in patients with active ankylosing spondylitis or psoriatic arthritis treated in routine clinical practice in central-eastern Europe. METHODS: Patients (n = 555) were followed for 12 months. Primary end point was percentage of patients with a treatment response (≥50% decrease from baseline in Bath Ankylosing Spondylitis Disease Activity Index or ≥1.2 point decrease from baseline in Disease Activity Index-28 joint for axial or peripheral symptoms, respectively). Functional status was evaluated by the Bath Ankylosing Spondylitis Functional Index and Health Assessment Questionnaire Disability Index. Working ability was evaluated by the Work Productivity and Activity Impairment Questionnaire - Specific Health Problem. RESULTS: 76.1% of patients with axial symptoms and 83.5% with peripheral symptoms achieved a treatment response. Frequency of extra-articular manifestations decreased. Improvements were observed in functional status and workability. No new safety signals were observed. CONCLUSION: Adalimumab was effective and well tolerated during real-world use in central-eastern Europe.

4 Article Comparison of two referral strategies for diagnosis of axial spondyloarthritis: the Recognising and Diagnosing Ankylosing Spondylitis Reliably (RADAR) study. 2013

Sieper, Joachim / Srinivasan, Shankar / Zamani, Omid / Mielants, Herman / Choquette, Denis / Pavelka, Karel / Loft, Anne Gitte / Géher, Pál / Danda, Debashish / Reitblat, Tatiana / Cantini, Fabrizio / Ancuta, Codrina / Erdes, Shandor / Raffayová, Helena / Keat, Andrew / Gaston, J S H / Praprotnik, Sonja / Vastesaeger, Nathan. ·Medical Department I, Rheumatology, Charite Campus Benjamin Franklin, Berlin, Germany. joachim.sieper@charite.de ·Ann Rheum Dis · Pubmed #23065731.

ABSTRACT: OBJECTIVE: To determine which of two referral strategies, when used by referring physicians for patients with chronic back pain (CBP), is superior for diagnosing axial spondyloarthritis (SpA) by rheumatologists across several countries. METHODS: Primary care referral sites in 16 countries were randomised (1 : 1) to refer patients with CBP lasting >3 months and onset before age 45 years to a rheumatologist using either strategy 1 (any of inflammatory back pain (IBP), HLA-B27 or sacroiliitis on imaging) or strategy 2 (two of the following: IBP, HLA-B27, sacroiliitis, family history of axial SpA, good response to non-steroidal anti-inflammatory drugs, extra-articular manifestations). The rheumatologist established the diagnosis. The primary analysis compared the proportion of patients diagnosed with definite axial SpA by referral strategy. RESULTS: Patients (N=1072) were referred by 278 sites to 64 rheumatologists: 504 patients by strategy 1 and 568 patients by strategy 2. Axial SpA was diagnosed in 35.6% and 39.8% of patients referred by these respective strategies (between-group difference 4.40%; 95% CI -7.09% to 15.89%; p=0.447). IBP was the most frequently used referral criterion (94.7% of cases), showing high concordance (85.4%) with rheumatologists' assessments, and having sensitivity and a negative predictive value of >85% but a positive predictive value and specificity of <50%. Combining IBP with other criteria (eg, sacroiliitis, HLA-B27) increased the likelihood for diagnosing axial SpA. CONCLUSIONS: A referral strategy based on three criteria leads to a diagnosis of axial SpA in approximately 35% of patients with CBP and is applicable across countries and geographical locales with presumably different levels of expertise in axial SpA.

5 Article Continuous efficacy of etanercept in severe and advanced ankylosing spondylitis: results from a 12-week open-label extension of the SPINE study. 2012

Dougados, Maxime / Braun, Jurgen / Szanto, Sandor / Combe, Bernard / Geher, Pal / Leblanc, Veronique / Logeart, Isabelle. ·Rheumatology B Department, Cochin Hospital, 27 rue du Faubourg Saint Jacques, Paris, France. maxime.dougados@cch.aphp.fr ·Rheumatology (Oxford) · Pubmed #22653382.

ABSTRACT: OBJECTIVE: To evaluate the longer-term efficacy of etanercept in patients with severe and advanced active AS. METHODS: Seventy-seven patients who completed the randomized, double-blind, placebo-controlled 12-week SPINE study enrolled in a 12-week open-label extension and received s.c. etanercept 50 mg once weekly. The etanercept/etanercept group received a total of 24 weeks treatment with etanercept (n = 38); the placebo/etanercept group received placebo during the double-blind study then 12 weeks' etanercept treatment during the open-label extension (n = 39). RESULTS: At the end of the open-label extension, BASDAI scores in the etanercept/etanercept group had further decreased beyond reductions observed during the double-blind study [mean (s.d.) change from baseline -37.6 (22.4) at end of extension vs -27.4 (23.8) at end of double-blind study]. Mean (s.d.) BASDAI scores also improved in the placebo/etanercept group once switched to etanercept [-28.6 (24.3) vs -15.0 (20.0)]. Similar trends were observed in BASFI and BASMI scores. In the placebo/etanercept group, total back pain decreased to similar levels achieved in the etanercept group in the double-blind study. Pain levels continued to decrease with longer-term etanercept therapy in the etanercept/etanercept group. CONCLUSION: Despite the improvements in symptoms and inflammatory markers observed shortly after initiation of once-weekly etanercept, there was no notable plateauing effect on patient-reported outcomes. Indeed, signs and symptoms of severe and advanced active AS continued to improve after up to 24 weeks, treatment with etanercept.

6 Article Nonsteroidal antiinflammatory drug intake according to the Assessment of SpondyloArthritis International Society Score in clinical trials evaluating tumor necrosis factor blockers: example of etanercept in advanced ankylosing spondylitis. 2012

Dougados, Maxime / Braun, Jurgen / Szanto, Sandor / Combe, Bernard / Geher, Pal / Leblanc, Véronique / Logeart, Isabelle. ·Paris-Descartes University, UPRES-EA 4058, AP-HP, Cochin Hospital, Paris 14, France. maxime.dougados@cch.aphp.fr ·Arthritis Care Res (Hoboken) · Pubmed #22006544.

ABSTRACT: OBJECTIVE: To evaluate the interest of the Assessment of SpondyloArthritis international Society (ASAS) nonsteroidal antiinflammatory drug (NSAID) score as a quality indicator and a potential outcome measure in clinical studies. METHODS: We used data from patients with active, advanced, axial ankylosing spondylitis refractory to NSAIDs. The study design was a 12-week, randomized, placebo-controlled period followed by a 12-week open-label extension. The ASAS-NSAID score was collected during 3 periods of interest (i.e., the 12 weeks preceding baseline, the 12 weeks of the placebo-controlled trial, and the 12 weeks of the open-label trial). RESULTS: For the 82 enrolled patients, the mean ± SD ASAS-NSAID score at baseline was similar between the 2 groups: 93 ± 76 and 74 ± 54 in the etanercept and placebo groups, respectively. There was no significant change in the ASAS-NSAID score during the first part of the trial, as recommended by the protocol. There was a statistically significant decrease in the ASAS-NSAID score during the second part of the trial with a relevant effect size (-0.56) in the placebo to etanercept group. CONCLUSION: This study confirms the feasibility and simplicity of the ASAS-NSAID score and suggests that such a score be integrated in all studies in spondylarthritis either to check the quality of the observed data (i.e., intergroup baseline characteristics) or to evaluate the NSAID-sparing effect of other therapies.

7 Article 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. 2011

Braun, J / van den Berg, R / Baraliakos, X / Boehm, H / Burgos-Vargas, R / Collantes-Estevez, E / Dagfinrud, H / Dijkmans, B / Dougados, M / Emery, P / Geher, P / Hammoudeh, M / Inman, R D / Jongkees, M / Khan, M A / Kiltz, U / Kvien, Tk / Leirisalo-Repo, M / Maksymowych, W P / Olivieri, I / Pavelka, K / Sieper, J / Stanislawska-Biernat, E / Wendling, D / Ozgocmen, S / van Drogen, C / van Royen, Bj / van der Heijde, D. ·Rheumazentrum Ruhrgebiet, Landgrafenstrasse 15, 44652 Herne, Germany. j.braun@rheumazentrum-ruhrgebiet.de ·Ann Rheum Dis · Pubmed #21540199.

ABSTRACT: This first update of the ASAS/EULAR recommendations on the management of ankylosing spondylitis (AS) is based on the original paper, a systematic review of existing recommendations and the literature since 2005 and the discussion and agreement among 21 international experts, 2 patients and 2 physiotherapists in a meeting in February 2010. Each original bullet point was discussed in detail and reworded if necessary. Decisions on new recommendations were made - if necessary after voting. The strength of the recommendations (SOR) was scored on an 11-point numerical rating scale after the meeting by email. These recommendations apply to patients of all ages that fulfill the modified NY criteria for AS, independent of extra-articular manifestations, and they take into account all drug and non-drug interventions related to AS. Four overarching principles were introduced, implying that one bullet has been moved to this section. There are now 11 bullet points including 2 new ones, one related to extra-articular manifestations and one to changes in the disease course. With a mean score of 9.1 (range 8-10) the SOR was generally very good.

8 Article Efficacy of etanercept on rheumatic signs and pulmonary function tests in advanced ankylosing spondylitis: results of a randomised double-blind placebo-controlled study (SPINE). 2011

Dougados, M / Braun, J / Szanto, S / Combe, B / Elbaz, M / Geher, P / Thabut, G / Leblanc, V / Logeart, I. ·Paris-Descartes University, UPRES-EA 4058, and APHP, Rheumatology B Department, Cochin Hospital, Paris, France. maxime.dougados@cch.aphp.fr ·Ann Rheum Dis · Pubmed #21317434.

ABSTRACT: OBJECTIVES: Patients with advanced ankylosing spondylitis (AS) experience disability because of reduced spinal mobility and pulmonary function impairment. This placebo-controlled study evaluated the effect of etanercept (ETN) in patients with advanced AS. METHODS: A multicentre randomised double-blind placebo-controlled trial of 12 weeks' duration was performed. Patients had definite (modified New York criteria), active (Bath AS Disease Activity Index (BASDAI) ≥40), severe (radiological intervertebral bridges) AS refractory to non-steroidal anti-inflammatory drugs and were antitumour necrosis factor naive. They were treated with ETN 50 mg once weekly or identical placebo (PBO). RESULTS: Of the 95 patients screened, 82 were randomised to receive ETN (n=39) or PBO (n=43). At baseline the disease was active (mean BASDAI 61.0±13.4, C reactive protein (CRP) 20.7±25.5 mg/l) and severe (mean Bath AS Metrology Index (BASMI) 5.7±1.3, mSASSS 36.5±20.5); forced pulmonary vital capacity (FVC) was 3.3±0.7 l. Improvement in BASDAI (normalised net incremental area under the curve between baseline and week 12, primary end point) was significantly greater in the ETN group than in the PBO group (-19.8±16.5 vs -11.0±16.4, p=0.019). Moreover, at week 12, ETN gave better results than PBO for the BASDAI (-26.4±19.7 vs -14.4±19.7; p=0.008), total back pain (-29.2±24.0 vs -14.9±24.0; p=0.010), BASFI (-21.7±17.6 vs -10.1±17.6; p=0.004), BASMI (-0.6±0.6 vs -0.2±0.6; p=0.011), CRP level (-15.7±14.2 vs -1.3±14.2; p<0.001) and FVC (+160±280 ml vs -20±280 ml; p=0.006). CONCLUSIONS: ETN has short-term efficacy for patients with advanced AS, as was previously reported for less advanced disease. The efficacy is observed for the main symptoms (pain) and on markers of inflammation (CRP), as well as disease severity in terms of spinal mobility and pulmonary function.

9 Article Comparison of the Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire, the functional status (HAQ) and utility (EQ-5D) measures in psoriatic arthritis: results from a cross-sectional survey. 2010

Brodszky, V / Péntek, M / Bálint, P V / Géher, P / Hajdu, O / Hodinka, L / Horváth, G / Koó, E / Polgár, A / Seszták, M / Szántó, S / Ujfalussy, I / Gulácsi, L. ·Health Economics and Technology Assessment Research Centre, Corvinus University of Budapest, Budapest, Fovám tér 8, Hungary. valentin.brodszky@uni-corvinus.hu ·Scand J Rheumatol · Pubmed #20166848.

ABSTRACT: OBJECTIVES: To compare the Psoriatic Arthritis Quality of Life (PsAQoL) instrument, the Health Assessment Questionnaire (HAQ) as a measure of functional status, and the generic health status (utility) measure the EuroQoL (EQ-5D) in terms of ability to assess disease severity in psoriatic arthritis (PsA). METHODS: The differences between known groups and correlations of the PsAQoL, the HAQ and the EQ-5D with clinical measures were analysed in a sample of 183 PsA patients. RESULTS: Different severities of PsA determined by known groups were distinguished well by all three questionnaires; more severe disease was associated with significantly worse values of the instruments. The correlations revealed a strong relationship between each of the measures, and with the patients' pain on the visual analogue scale (VAS), the patient global VAS, and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and a weak relationship with the disease duration and the Psoriasis Area Severity Index (PASI). The PsAQoL also correlated strongly with the 28-joint Disease Activity Score (DAS28). CONCLUSIONS: The PsAQoL, the HAQ, and the EQ-5D are able to distinguish well across levels of PsA severity.