Adherence to treatment and associated factors in rheumatoid arthritis patients: a cross-sectional study from Iran.

The aim of this study is to evaluate adherence to treatment and its related risk factors among a sample of rheumatoid arthritis patients (RA) attending the rheumatology outpatient clinic of Kermanshah university of medical sciences. In this cross-sectional study, RA patients were asked to complete the Morisky questionnaire and 19-item compliance questionnaire for rheumatology (CQR). Patients were divided into two groups: adherent and non-adherent to treatment, based on the CQR questionnaire results. Demographic and clinical characteristics (age, sex, marital status, education level, economical condition, occupational status, place of residence, underlying diseases, type, and number of drugs) were compared between the two groups to investigate possible risk associations for poor adherence. 257 patients completed the questionnaires (mean age: 43.22, 80.2% female). 78.6% were married, 54.9% were housekeepers, 37.7% had tertiary education, 61.9% had moderate economic status, and 73.2% were residents of an urban area with a large population. Prednisolone was the most commonly used drug followed by non-steroidal anti-inflammatory drugs, sulfasalazine, hydroxychloroquine, and methotrexate. The mean score of the Morisky questionnaire was 5.528 (standard deviation=1.79). 105 patients (40.9%) were adherent to treatment based on the CQR questionnaire. High education level (college or university) was correlated with non-adherence to treatment [27 (25.71%) vs 70 (46.05%), p=0.004]. We concluded that the prevalence of non-adherence to treatment is 59.1% in rheumatoid arthritis patients in Kermanshah, Iran. Having a higher education level is a risk factor for poor treatment adherence. Other variables could not predict treatment adherence.

Comparison of clinicodemographic characteristics and pattern of vascular involvement in 126 patients with Takayasu arteritis: a report from Iran and Turkey.

Takayasu arteritis (TA) is an extremely uncommon vasculitis that primarily affects the aorta and its branches. Due to the genetic and ethnicity effect, a diverse array of TA clinical manifestations has been reported worldwide. The purpose of the present study was to compare the clinicodemographic characteristics and pattern of vascular involvement of Iranian and Turkish TA patients. This study was a retrospective, cross-sectional investigation of 126 TA patients in Iran and Turkey. All of the variables analyzed were extracted from historical medical records. In 126 TA patients, the ratio of females to males was 8.6:1, and the average age at onset of disease was 30.5±11.1 years. Fatigue (49.2%) and a weak or absent pulse (79.4%) were the most prevalent symptoms and signs, respectively. The most prevalent angiographic classifications were types V and I in Iranian patients (41.09%) and type I in the Turkish population (47.7%) The left subclavian artery was the vessel most frequently affected by TA (66.6%). Our findings indicated that there were no significant differences between the two countries in terms of clinicodemographic characteristics or vascular involvement. Some clinical manifestations, such as claudication, were more prevalent in the Turkish population due to a higher incidence of occlusive lesions in the right subclavian artery.

Disseminated cutaneous herpes simplex infection after COVID-19 vaccination in a rheumatoid arthritis patient: a case report and review.

Since COVID-19 vaccination started in December 2020, different side effects were reported. This case report describes the possibility of developing disseminated herpes simplex infection after COVID-19 vaccine in a patient with rheumatoid arthritis. In this case report, we describe a 63-year-old Iranian female. She was a known case of seronegative rheumatoid arthritis and presented with generalized papulo-pustular itchy and painful skin lesions which appeared about seven days after the second dose of Sinopharm BIBP COVID-19 vaccine (BIBP-CorV). A biopsy of the skin lesions revealed acantholysis, neutrophils, and enlarged keratinocytes with eosinophilic intra-nuclear inclusions. Findings were consistent with herpes simplex infection. She was successfully treated by acyclovir. Disseminated cutaneous herpes simplex infection may have been triggered by COVID-19 vaccination. Reactivation of herpes virus after COVID-19 vaccines was reported in both rheumatic patients and other individuals. Whether having an underlying autoimmune inflammatory disorder could be an additional risk factor is still unknown.

Successful treatment of COVID-19 induced neutrophilic myositis with intravenous immunoglobulin and corticosteroids: a case report.

Neutrophilic myositis (NM) is an inflammatory disorder predominantly characterized by neutrophilic infiltration in the muscles, which is suggested to be an extracutaneous manifestation of neutrophilic dermatosis (ND). NM is a rare disorder which has been occasionally reported in association with hematologic and inflammatory disorders. This case report describes a 45-year-old woman who presented with gradual muscle weakness developed after coronavirus disease 2019 (COVID-19) infection. Electromyography and nerve conduction velocity findings were compatible with inflammatory myopathy and muscle biopsy revealed neutrophilic infiltration. She was successfully treated with intravenous immunoglobulin, prednisolone 1 mg/kg/day and azathioprine 150 mg/day. In conclusion, the COVID-19 infection itself and the drugs used to treat it can cause a number of muscle disorders. Awareness of muscular involvement in COVID-19 infected patients is important for early diagnosis and appropriate treatment.