Assuntos
Mononeuropatias , Vasculite Reumatoide , Cardiomiopatia de Takotsubo , Humanos , Cardiomiopatia de Takotsubo/diagnóstico , Cardiomiopatia de Takotsubo/complicações , Cardiomiopatia de Takotsubo/fisiopatologia , Feminino , Mononeuropatias/diagnóstico , Mononeuropatias/etiologia , Mononeuropatias/tratamento farmacológico , Vasculite Reumatoide/diagnóstico , Vasculite Reumatoide/tratamento farmacológico , Resultado do Tratamento , Índice de Gravidade de Doença , Idoso , Pessoa de Meia-Idade , Eletrocardiografia , Antirreumáticos/uso terapêuticoRESUMO
Objectives: This study aims to investigate the effect of age on disease activity and biological treatment in patients with ankylosing spondylitis (AS). Patients and methods: A total of 811 AS patients registered in the TURKBIO registry database between 2011 and 2019 were categorized according to their age at the time of entry into the registry and assigned to one of two groups: young patients, defined as <60 years of age (n=610), and those aged ≥60 years (n=201) were recorded as elderly patients. Demographic, clinical, and laboratory characteristics, along with disease activity markers and other follow-up parameters, as well as current and prior treatments, were electronically recorded during each visit using open-source software. Results: The mean age of the elderly patients was 67±5.8 years, while the mean age of the younger patients was 49.2±10.9 years. Male predominance was lower in the older AS group compared to the younger AS group (p=0.002). During follow-up period, 397 patients (comprising 318 young and 79 elderly individuals) had a history of using at least one biological disease-modifying agent (bDMARD). There was no significant difference between the groups in terms of DMARD and bDMARD-use distributions. First tumor necrosis factor inhibitor (TNFi) retention rates were found to be similar in both groups over 10 years of follow-up. Adverse events were found to be similar in young (19.9%) and elderly (26.8%) AS patients. Conclusion: Research in the TURKBIO cohort reveals that both older and younger patients with AS exhibited similar disease activity levels with comparable treatment approaches. Moreover, the results of TNFi treatments in elderly patients were the same as those observed in younger patients, with no notable increase in safety concerns.
RESUMO
Clinical data on the use of tumour necrosis factor inhibitors (TNFi) in late-onset ankylosing spondylitis (LoAS) are limited. The present study aimed to evaluate efficacy, safety, and treatment adherence associated with the initial use of TNFi therapy in biologic naive patients diagnosed with LoAS. Patients whose age of onset was ≥ 45 years and < 45 years were classified as having LoAS and YoAS, respectively, based on the age of symptom onset. There were 2573 patients with YoAS and 281 LoAS. Baseline disease activity measures were similar between the groups. No significant differences were seen between the two groups in response to treatment and in remaining on the first TNFi at 6, 12 and 24 months. In the LoAS group, the analysis showed that TNFi discontinuation was linked to VAS pain score (HR 1.04; 95% CI 1.01-1.06). Patient groups had similar rates of adverse events (YoAS: 8.7% vs. LoAS: 11.7%). In both biologic naive LoAS and YoAS patients, the study showed that the initial TNFi therapy was equally effective and safe.
Assuntos
Sistema de Registros , Espondilite Anquilosante , Humanos , Espondilite Anquilosante/tratamento farmacológico , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Resultado do Tratamento , Inibidores do Fator de Necrose Tumoral/uso terapêutico , Inibidores do Fator de Necrose Tumoral/efeitos adversos , Idade de Início , Antirreumáticos/uso terapêutico , Antirreumáticos/efeitos adversos , Fator de Necrose Tumoral alfa/antagonistas & inibidoresAssuntos
Doenças do Sistema Nervoso Central , Sarcoidose , Humanos , Sarcoidose/complicações , Sarcoidose/diagnóstico por imagem , Sarcoidose/diagnóstico , Doenças do Sistema Nervoso Central/complicações , Doenças do Sistema Nervoso Central/diagnóstico por imagem , Doenças do Sistema Nervoso Central/diagnóstico , Masculino , Feminino , Febre Uveoparotídea/complicações , Febre Uveoparotídea/diagnóstico por imagem , Febre Uveoparotídea/diagnóstico , Pessoa de Meia-Idade , Imageamento por Ressonância Magnética , AdultoAssuntos
Humanos , Masculino , Pessoa de Meia-Idade , Gota/complicações , Gota/diagnóstico , Osteólise , ReumatologiaAssuntos
Distrofia Muscular de Duchenne , Espondilartrite , Espondilite Anquilosante , Humanos , Antígeno HLA-B27/genética , Distrofia Muscular de Duchenne/complicações , Distrofia Muscular de Duchenne/genética , Espondilartrite/complicações , Espondilartrite/genética , Espondilite Anquilosante/complicaçõesAssuntos
COVID-19/diagnóstico por imagem , Creatina Quinase/metabolismo , Pulmão/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Miosite/diagnóstico por imagem , Adulto , Amidas/uso terapêutico , Antivirais/uso terapêutico , Proteína C-Reativa/metabolismo , COVID-19/diagnóstico , COVID-19/metabolismo , COVID-19/fisiopatologia , Teste de Ácido Nucleico para COVID-19 , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Glucocorticoides/uso terapêutico , Humanos , Hidroxicloroquina/uso terapêutico , Linfopenia/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Metilprednisolona/uso terapêutico , Miosite/metabolismo , Miosite/fisiopatologia , Pirazinas/uso terapêutico , SARS-CoV-2 , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: To determine limited joint mobility (LJM) of the hand in patients with systemic sclerosis (SSc). METHODS: LJM was evaluated with "prayer sign" and "tabletop sign" tests. LJM staging was done by Rosenbloom classification method. LJM (+) and LJM (-) patients were compared in terms of demographic findings (gender, age and duration of disease), laboratory results (ESR, CRP, anti-nuclear antibody (ANA), anti-topoisomerase I and anti-centromere), and modified Rodnan skin score (mRss) results. RESULTS: In our study, a total of 217 patients, including 113 patients with a diagnosis of SSc, and 104 as a healthy control group with similar age and gender distribution to these patients, were included. A total of 113 (F=98, M=15) patients (limited cutaneous SSc (lcSSc=71), diffuse cutaneous SSc (dcSSc=42)) were included in this study and LJM positivity was found in 66.4% (lcSSc=38, dcSSc=37). A statistically significant difference was observed in between lcSSc and dcSSc patients according to the presence of LJM (p<0.001). There was a moderate positivity relationship between LJM and mRss (lcSSc r=0.449, p<0.001; dcSSc r=0.565, p<0.001). CONCLUSIONS: In our study, it was found that LJM staging correlated with mRss and dcSSc patients had more severe LJM findings than lcSSc. We conclude that "prayer sign" and "tabletop sign" tests used in hand evaluation in SSc patients have similar clinical results with mRss and can be simple bedside tests in daily practice. Key Points ⢠This is the first study examining limited joint mobility (LJM) with "prayer sign" and "tabletop sign" tests in systemic sclerosis (SSc) patients. ⢠"Prayer sign" and "tabletop sign" tests can be easily performed in daily practice. ⢠We found Rosenbloom LJM staging correlated with modified Rodnan skin score. LJM of the hand can be a good prognostic indicator for early stage SSc patients.
Assuntos
Esclerodermia Difusa , Esclerodermia Limitada , Escleroderma Sistêmico , Mãos , Humanos , Esclerodermia Difusa/complicações , Esclerodermia Difusa/diagnóstico , Esclerodermia Limitada/complicações , Esclerodermia Limitada/diagnóstico , Escleroderma Sistêmico/complicações , PeleRESUMO
BACKGROUND: Ochronotic arthropathy (OcA) refers to excessive homogentisic acid (HGA) deposition in the musculoskeletal system. Our current understanding of OcA is limited, as there are less than a thousand alkaptonuria (AKU) cases reported in the literature. Herein, we investigated the rheumatological manifestations of OcA in a group of adult AKU patients. METHODS: Adult AKU patients with symptoms suggestive of OcA were included. Patients underwent a detailed rheumatological assessment. Laboratory testing, including autoantibodies and radiological investigations such as conventional X-rays, and magnetic resonance imaging (MRI) were performed. RESULTS: Eight out of 12 (66%) patients had symptoms consistent with OcA. The median age at OcA symptoms was 36 (27-48) years, and the presenting symptom was back pain in 87.5% of the patients. All patients had chronic back pain, and three (37.5%) had an inflammatory type of pain character. Radiographic sacroiliitis based on X-rays was present in 2 (25%) cases. MRI of the sacroiliac joints documented bone marrow edema in five (62.5%), and spinal MRI identified corner inflammatory lesions in three patients (37.5%). One patient (12.5%) had rheumatoid arthritis. Extra-articular involvement, including enthesitis (n = 1; 12.5%), interstitial lung disease (n = 1; 12.5%), and scleritis (n = 1; 12.5%), was also noted. CONCLUSION: The frequent occurrence of OcA-related inflammatory manifestations in our patients contradicts the conventional concept of OcA as a non-inflammatory disorder. The activation of inflammatory pathways, possibly by the HGA products, may responsible for this condition.Significance and innovationsAbout three-fourths of adult ochronotic arthropathy (OcA) patients in our group had associated inflammatory disease.OcA associated inflammatory diseases were showing a severe phenotypeNearly half of the OcA patients required early prosthesis operations compared to their healthy counterparts.