A national, multicenter, retrospective study evaluating retention rate and efficacy of tocilizumab treatment in patients with active rheumatoid arthritis who had an inadequate response to csDMARDs and/or TNF inhibitors.

BACKGROUND: To describe the disease activity and retention rate in rheumatoid arthritis (RA) patients with inadequate response (IR) to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and/or tumor necrosis factor inhibitors (TNFis) who were prescribed tocilizumab (TCZ) as first-line or second-line biologic treatment in real-world setting. METHODS: Data gathered from patients' files was used in a multicenter and retrospective context. Retention rates and the Disease Activity Score in 28 joints with CRP (DAS28-CRP) were evaluated at time points. The relationship of drug efficacy with factors such as smoking, obesity, and previous use of TNFis was also examined. RESULTS: One hundred and twenty-four patients with a median (IQR) RA duration of 3.7 (7.4) years were included. Mean (SD) age was52.9 (12.9) and 75% of the patients were female. TCZ retention rates in the 6th and 12th months were 94.1% and 86.6%, respectively. In all patients, DAS28-CRP level decreased significantly from baseline to Months 3 and 6. There was an increase in patients with remission and/or low disease activity and a decrease in patients with high disease activity at Month 3 and Month 6 (p < 0.001 for both). Disease activity was similar between subgroups based on body mass index, smoking status, and previous use of TNFis at any time point. Regression analysis showed that absence of concomitant corticosteroid treatment independently was associated with remission/LDA achievement at Month 6 [OR = 0.31, 95% CI (0.14- 0.72), p = 0.006], and Month 12 [OR = 0.35, 95% CI (0.13-0.94), p = 0.037]. Overall, 25 mild adverse events were reported. DISCUSSION: TCZ was found to be effective and safe in RA patients with IR to csDMARDs and/or TNFis. The drug retention rate was considered satisfactory with more than half of the patients continuing TCZ treatment at Month 12.

The importance of serum interleukin-20 levels in patients with Behçet's disease.

BACKGROUND: Behçet's disease (BD) is a complex multisystemic disease with an unknown origin, which presents with aphthous and genital ulcers, cutaneous lesions, arthritis, ocular lesions, and defects in the gastrointestinal and central nervous systems. OBJECTIVES: In this study, we examined the relationship between serum interleukin-20 (IL-20) levels and disease activity in BD patients. MATERIAL AND METHODS: A total of 45 BD patients diagnosed according to the BD diagnosis criteria determined by the International Study Group for Behçet's Disease were included in the study. Out of 45 patients, 17 had inactive BD and 28 had active BD. The control group consisted of 25 healthy subjects. The IL-20 levels of all the groups were detected and compared with each other. Serum IL-20, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were examined. RESULTS: The IL-20 levels of the active BD patient group were significantly higher than in the control group (p < 0.001) and in the inactive BD patient group (p < 0.001). No statistically significant difference was detected between the IL-20 levels of the control group and the inactive BD patient group (p = 0.2). CONCLUSIONS: Higher IL-20 levels in active BD patients, when compared to inactive BD patients and healthy controls indicate that the disease is an inflammatory one and IL-20 plays a role in the disease pathogenesis. Moreover, it can be concluded that IL-20 might have a role in the complex process of the settlement and activation of the disease.

Rectal Adenocarcinoma As An Uncommon Cause of Immunoglobulin A Vasculitis (Henoch-Schönlein Purpura).

Immunoglobulin A vasculitis (Henoch-Schönlein purpura) is an immunoglobulin A-mediated vasculitis of unknown cause, which is characterized by non-thrombocytopenic purpura, arthralgia, abdominal pain, and glomerulonephritis. It most commonly occurs in children, and usually follows a benign course. It can also affect adults and is probably related to malignancy. In this article, we report a case of rectal adenocarcinoma in an immunoglobulin A vasculitis with renal involvement.