scholarly journals Clinical features and outcomes of COVID-19 in patients with rheumatic diseases treated with biological and synthetic targeted therapies

2020 ◽  
Vol 79 (7) ◽  
pp. 988-990 ◽  
Author(s):  
Carlos Sanchez-Piedra ◽  
Cesar Diaz-Torne ◽  
Javier Manero ◽  
José M Pego-Reigosa ◽  
Íñigo Rúa-Figueroa ◽  
...  
Keyword(s):  
Clinical Features ◽  
Rheumatic Diseases ◽  
Targeted Therapies

scholarly journals AB0660 COVID-19 SHARES CLINICAL FEATURES WITH ANTI-MELANOMA DIFFERENTIATION ASSOCIATED PROTEIN 5 POSITIVE DERMATOMYOSITIS AND ADULT STILL’S DISEASE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1362.1-1362
Author(s):  
Y. Kondo ◽  
Y. Kaneko ◽  
H. Takei ◽  
H. Tamai ◽  
T. Takeuchi
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Clinical Features ◽  
Serum Ferritin ◽  
Rheumatic Diseases ◽  
Macrophage Activation ◽  
Cytokine Storm ◽  
Still’S Disease ◽  
Still's Disease ◽  
Adult Still's Disease

Background:The coronavirus disease 2019 (COVID-19), caused by a novel corona virus named SARS-CoV-2, has emerged as a global pandemic. Severe inflammatory process is one of main pathogenesis of COVID-19 and this involves cytokine storm along with overactivation of macrophage. On another front, cytokine storm with macrophage activation is frequently observed in various connective tissue diseases including dermatomyositis with positive antimelanoma differentiation-associated protein 5 (anti-MDA5) autoantibodies and adult Still’s disease. Macrophage activation during inflammatory states is partially characterized by an increased serum ferritin levels and hyperferritinaemia and characteristics shared by the three diseases are a topic of interest to rheumatologists, however, no study has evaluated anti-MDA5-positive dermatomyositis and adult Still’s disease in comparison to COVID-19.Objectives:The aim of this study was to highlight the homology and heterogeneity of COVID-19, anti-MDA5 dermatomyositis, and adult Still’s disease by comparing clinical pictures of each disease in order to discuss their respective pathogeneses.Methods:We reviewed consecutive, newly diagnosed, untreated patients with COVID-19, anti-MDA5 dermatomyositis, or adult Still’s disease. We compared their clinical, laboratory, and radiological characteristics, including the prevalence of macrophage activation syndrome and lung involvement in each disease.Results:The numbers of patients with COVID-19, anti-MDA5 dermatomyositis, and adult-onset Still’s disease with hyperferritinaemia (serum ferritin ≥ 500ng/dL) who were included for main analysis were 22, 14, and 59, respectively. COVID-19 and adult Still’s disease both featured hyperinflammatory status, such as high fever and elevated serum C-reactive protein, whereas COVID-19 and anti-MDA5 dermatomyositis both presented with severe interstitial lung disease and hypoxaemia. While two-thirds of the patients in each group met the criteria for macrophage-activated syndrome that is used in systemic juvenile idiopathic arthritis, the HScore, an indicator of haemophagocytic lymphohistiocytosis, was low in anti-MDA5 dermatomyositis and COVID-19 even in severe or critical cases. The findings of chest computed tomography were similar between COVID-19 and anti-MDA5 dermatomyositis (Figure 1).Conclusion:COVID-19 shared clinical features with rheumatic diseases characterised by hyperferritinaemia, including anti-MDA5 dermatomyositis and adult Still’s disease. These findings should be investigated further in order to shed light on the pathogenesis of not only COVID-19 but also the aforementioned rheumatic diseases.References:[1]Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. (2020) 395: 1033-4.[2]Gono T, Sato S, Kawaguchi Y, et al. Anti-MDA5 antibody, ferritin and IL-18 are useful for the evaluation of response to treatment in interstitial lung disease with anti-MDA5 antibody-positive dermatomyositis. Rheumatology (Oxford). 2012; 51(9):1563-70.Figure 1.Imaging characteristics of chest CT scans in patients with COVID-19, anti-MDA5 dermatomyositis, and adult Still’s disease A)Bilateral ground-glass and consolidative opacities with peripheral distribution in COVID-19. B)Bilateral ground-glass opacities with peripheral consolidations in anti-MDA5 dermatomyositis. C)Pleural effusion with pleural thickening on the left side in adult Still’s disease.Disclosure of Interests:Yasushi Kondo: None declared., Yuko Kaneko: None declared., Hisoshi Takei: None declared., Hiroya Tamai: None declared., Tsutomu Takeuchi Grant/research support from: received research grants outside the submitted work from Abbvie, Astra Zeneca, Bristol Myers Squibb, Chugai Pharmaceutical, Eisai Pharmaceutical, Janssen Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, Novartis, Takeda Pharmaceutical, Abbott Japan Co., Ltd., Astellas Pharma, Ltd., Daiichi Sankyo, Pfizer, Sanofi–Aventis, Santen Pharmaceutical, Teijin Pharma Ltd., Asahikasei Pharma Corp., SymBio Pharmaceuticals Ltd., Celtrion, Nipponkayaku Co. Ltd., Eli Lilly Japan, and Taisho Toyama Pharmaceutical.

Clinical features of squamous cell lung cancer with targetable gene alterations in a nationwide genomic screening network in Japan (LC-SCRUM-Japan).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 9057-9057
Author(s):  
Eri Sugiyama ◽  
Shingo Matsumoto ◽  
Nobuaki Kobayashi ◽  
Hiromi Aono ◽  
Masato Shingyoji ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Clinical Features ◽  
Squamous Cell ◽  
Cell Lung Cancer ◽  
Targeted Therapies ◽  
Clinical Characteristics ◽  
Genetic Alterations ◽  
Squamous Cell Lung Cancer ◽  
Genomic Screening ◽  
Gene Alterations

9057 Background: Molecular-targeted therapies for precision medicine in squamous cell lung cancer (SqLC) have not yet been established. To identify precise patients for targeted therapies and to reveal their clinical characteristics, we have operated clinical sequencing of advanced SqLCs in our nationwide genomic screening project in Japan (LC-SCRUM-Japan) since March 2015. Methods: As of December 2016, 190 institutions across Japan were participating and 263 advanced SqLC patients had been enrolled in this project. Submitted tumor samples were subjected to a next-generation sequencing system, Oncomine™ Comprehensive Assay, enabling the simultaneous analysis of 143 cancer-related genes. Results: The median age of the 263 patients was 74 years (range, 27-87 years). Two hundred thirty (87%) were male and most patients (97%) were smokers. Among 211 available samples, potentially targetable gene alterations were detected in 58 (27%). Based on these gene alterations, the patients were subdivided into 4 groups, consisting of 25 (12%) with genetic alterations of FGFR family (FGFR type; 23 FGFR1 amplifications, 1 FGFR2 amplification and 1 FGFR3 fusion), 20 (9%) with genetic alterations of the PI3K pathway (PI3K type; 10 PIK3CA mutations, 8 PTEN mutations and 2 AKT mutations), 15 (7%) with other oncogene alterations (KRAS/EGFR/ALK type; 10 KRAS mutations, 3 EGFR mutations and 2 ALK fusions) and others. Comparative analyses of clinical characteristics between the 4 types showed that brain metastases were significantly more frequent in the FGFR type than the others (24% vs. 5%, p = 0.0007), and females (40% vs. 11%, p = 0.0009) and never-smokers (21% vs. 3%, p = 0.0004) were significantly frequent in the KRAS/EGFR/ALK type compared to the others. The prognostic significance of these genetic alterations has not yet been evaluated because of short follow-up time (median, 8.5 months). Conclusions: A series of potentially targetable gene alterations have been identified in SqLC patients. The SqLC patients had distinct clinical features according to the molecular subtypes, and genotype-directed therapeutic strategy should be developed for the individual subtypes.

scholarly journals Analysis of clinical features and prognostic factors in Chinese patients with rheumatic diseases in an intensive care unit

2018 ◽  
Vol 40 (1) ◽  
pp. 63-66 ◽  
Author(s):  
Meiying Wang ◽  
Shengyuan Su ◽  
Jiyang Lv ◽  
Gengmin Zhou ◽  
Qingwen Wang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Clinical Features ◽  
Rheumatic Diseases ◽  
Chinese Patients

scholarly journals Role of targeted therapies in rheumatic patients on COVID-19 outcomes: results from the COVIDSER study

RMD Open ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. e001925
Author(s):  
Jose María Álvaro Gracia ◽  
Carlos Sanchez-Piedra ◽  
Javier Manero ◽  
María Ester Ruiz-Lucea ◽  
Laura López-Vives ◽  
...  
Keyword(s):  
Rheumatic Disease ◽  
Rheumatic Diseases ◽  
Targeted Therapies ◽  
Disease Diagnosis ◽  
Sociodemographic Factors ◽  
Inflammatory Rheumatic Diseases ◽  
Increased Risk ◽  
Related Hospitalisation ◽  
Observational Cohort ◽  
Synthetic Dmards

ObjectivesTo analyse the effect of targeted therapies, either biological (b) disease-modifying antirheumatic drugs (DMARDs), targeted synthetic (ts) DMARDs and other factors (demographics, comorbidities or COVID-19 symptoms) on the risk of COVID-19 related hospitalisation in patients with inflammatory rheumatic diseases.MethodsThe COVIDSER study is an observational cohort including 7782 patients with inflammatory rheumatic diseases. Multivariable logistic regression was used to estimate ORs and 95% CIs of hospitalisation. Antirheumatic medication taken immediately prior to infection, demographic characteristics, rheumatic disease diagnosis, comorbidities and COVID-19 symptoms were analysed.ResultsA total of 426 cases of symptomatic COVID-19 from 1 March 2020 to 13 April 2021 were included in the analyses: 106 (24.9%) were hospitalised and 19 (4.4%) died. In multivariate-adjusted models, bDMARDs and tsDMARDs in combination were not associated with hospitalisation compared with conventional synthetic DMARDs (OR 0.55, 95% CI 0.24 to 1.25 of b/tsDMARDs, p=0.15). Tumour necrosis factor inhibitors (TNF-i) were associated with a reduced likelihood of hospitalisation (OR 0.32, 95% CI 0.12 to 0.82, p=0.018), whereas rituximab showed a tendency to an increased risk of hospitalisation (OR 4.85, 95% CI 0.86 to 27.2). Glucocorticoid use was not associated with hospitalisation (OR 1.69, 95% CI 0.81 to 3.55). A mix of sociodemographic factors, comorbidities and COVID-19 symptoms contribute to patients’ hospitalisation.ConclusionsThe use of targeted therapies as a group is not associated with COVID-19 severity, except for rituximab, which shows a trend towards an increased risk of hospitalisation, while TNF-i was associated with decreased odds of hospitalisation in patients with rheumatic disease. Other factors like age, male gender, comorbidities and COVID-19 symptoms do play a role.

The systemically unwell child

2013 ◽  
pp. 108-115
Author(s):  
Athimalaipet V. Ramanan ◽  
Jonathan D. Akikusa
Keyword(s):  
Clinical Features ◽  
Rheumatic Diseases ◽  
Clinical Problem ◽  
Differential Diagnoses ◽  
Laboratory Features ◽  
Appropriate Therapy ◽  
Paediatric Rheumatic Diseases ◽  
Common Clinical Problem ◽  
Diagnostic Pitfalls ◽  
Routine Investigations

The systemically unwell child is a common clinical problem in paediatrics. In most cases the cause is infection, and the child will usually improve spontaneously or following appropriate therapy. When routine investigations fail to reveal an aetiology and the child remains unwell, the differential diagnoses should be broadened to include, among others, paediatric rheumatic diseases. This chapter provides a brief overview of these conditions focusing on key clinical features, common diagnostic pitfalls, and investigations important in their diagnosis. The important rheumatologic differentials of systemic illness in children according to the age at which they typically occur and a summary of the key clinical and laboratory features of these conditions are presented. Once rheumatologic differentials relevant to the age of the child under evaluation are identified, they can be refined based on knowledge of the incidence and clinical and laboratory features of the diseases concerned.

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