Secukinumab as a potential trigger of inflammatory bowel disease in ankylosing spondylitis or psoriatic arthritis patients.

OBJECTIVE: Real-world secukinumab gastrointestinal-related adverse events (GIRAE) data during treatment for AS and PsA are lacking. We aimed to obtain this through baseline evaluation of pre-existing IBD rates and predictors of GIRAE. METHODS: Patient electronic and paper records commencing secukinumab from 10 UK hospitals between 2016 and 2019 were reviewed. GIRAE after initiation were defined as: definite [objective evidence of IBD (biopsy proven), clear temporal association, resolution of symptoms on drug withdrawal, no alternative explanation felt more likely], probable (as per definite, but without biopsy confirmation) or possible (gastrointestinal symptoms not fulfilling definite or probable criteria). RESULTS: Data for all 306 patients started on secukinumab were analysed: 124 (40.5%) AS and 182 (59.5%) PsA. Twenty-four of 306 (7.8%) experienced GIRAE after starting secukinumab. Amongst patients who developed GIRAE, four (1.3%) had definite, seven (2.3%) probable and 13 (4.2%) possible IBD. All definite cases were patients with AS and stopped secukinumab; two had pre-existing IBD and two (0.7%) were de novo cases of which one required surgical intervention. Seven patients (2.3%) had pre-existing diagnoses of IBD prior to initiation, of which five patients experienced GIRAE. CONCLUSION: Absolute rates of new IBD in patients starting secukinumab are low. The majority of patients developing new GIRAE did not develop objective evidence of IBD or stop therapy. For patients with pre-existing IBD and AS the risk of GIRAE is much higher, and prescribing alternatives should be considered.

Streptococcus-associated vasculitis: A role for antibiotic therapy?

Numerous post-Streptococcal syndromes (PSS) have been described in the literature. The role of antibiotic therapy in the management of PSS is best established with acute rheumatic fever. We present a patient with streptococcus-associated medium vessel vasculitis with multiple flares despite immunosuppressive therapy that achieved a sustained remission with long term oral penicillin V 250 mg twice daily.

Biomarkers discovery in cancer--up-dates in methodology.

Biomarkers are biomolecules that can indicate normal/pathological processes, or physiological responses to therapy. Due to the serum abundance in proteins, such as albumin and lypo/glycoproteins, biomarkers are difficult to assess. Serum biomarkers identification can contribute to personalized medicine and improve cancer diagnostic and prognostic. The paper summarizes some of the proteomics techniques and the workflow used for protein signatures identification associated to cancer development. Thus, biomarkers validated for prostatic, breast, cervical or lung cancers are presented as examples for clinical application of serum markers. In spite of the continuous research efforts, there are only few validated biomarkers that have proved a good predictive power in cancer. Modern technology and the combination of various techniques used for proteins quantification represent important means for the identification and validation of new biomarkers.

Differentiation of patients with chronic lombosciatica due to disc hernia using gait analysis techniques.

UNLABELLED: Nowadays gait analysis represent a modern technique used as a useful tool in the assessment of patients with locomotors disease. AIM: To make a differentiation of patients with chronic sciatica due to disc hernia using gait analysis techniques. MATERIAL AND METHOD: Study was prospective, with consecutive selection of subjects according to eligibility criteria, using a control group. The number of subjects was 47: 28 patients and 19 healthy subjects. The patients were characterized clinically, imagistically and biomechanically. The biomechanically evaluation was made with VICON MX optical motion capture system. Our data of interest were: temporo-spatial and kinematic parameters. These data were factorial analyzed with a principal component extraction technique, resulting 10 variables, which characterized the system variability in 94.67%. Next step was represented by a hierarchical cluster analysis for sub-group identification. RESULTS: We have differentiated two clusters. The two clusters were individualized regarding the temporo-spatial parameters (opposite foot contact, step width) as well as the kinematic parameters (maximum upward rotation in stance of pelvis, maximum adduction of the hip in stance, maximum abduction of the hip in swing, maximum plantar flexion angle in swing, total sagittal plane excursion of the ankle). CONCLUSIONS: The two clusters can be defined as following: cluster 1: reduced stance phase and mainly distal problems (of the ankle); cluster 2: normal stance phase duration, severely low step width and mainly proximal problems (pelvic belt).