scholarly journals Targeted anti-inflammatory therapy effect on various indicators of the psoriatic arthritis activity: Moscow Unified Arthritis Registry (MUAR) data

2021 ◽  
Vol 5 (2) ◽  
pp. 78-83
Author(s):  
K.A. Lytkina ◽  
◽  
G.V. Lukina ◽  
E.N. Koltsova ◽  
E.I. Shmidt ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Certolizumab Pegol ◽  
Genetically Engineered ◽  
Targeted Drugs ◽  
Biological Drugs ◽  
Synthetic Drugs ◽  
Das 28 ◽  
Therapy Effect ◽  
Anti Inflammatory ◽  
The Impact

Background: the number of genetically engineered biological drugs and targeted synthetic drugs for the treatment of psoriatic arthritis (PA) is rapidly increasing. Data on their comparative efficacy is limited. The results of individual studies suggest that the drugs may show different efficacy concerning different disease manifestations (arthritis, spondylitis, entesitis, cutaneous and nail lesions). Aim: to compare the effect of targeted drugs on the results achieved in different PA domains in real clinical practice. Patients and Methods: the data were taken from the Moscow Unified Arthritis Registry (MUAR). We analyzed treatment episodes in which there was a completed visit no earlier than 6 months from therapy initiation with targeted drug (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, tofacitinib, ustekinumab). Drug comparison was carried out according to the achieved values of the DAS-28, BASDAI, MASES, LEI, DLQI, PASI and BSA indices. The most significant confounders (factors that characterize the patient and are significantly related to the studied indicator) were established for each group of indicators to eliminate the impact of differences between patients who received different drugs. The comparisons were adjusted for confounders. Results: the analysis included 184 treatment episodes with targeted drugs in 156 patients with PA. There were no significant differences between the drugs in their effect on the following domains: «joints» domain (DAS-28), «spine/entheses» domain (BASDAI, MASKS, LEI), «skin» domain (DLQI, PASI, BSA). Conclusion: the achieved values of activity indicators concerning the involvement of joint, spine, entheses and skin in patients with PA didn’t significantly differ when treated with various targeted drugs. KEYWORDS: psoriatic arthritis, enthesitis, spondylitis, sacroiliitis, targeted therapy, treatment efficacy, confounder. FOR CITATION: Lytkina K.A., Lukina G.V., Koltsova E.N. et al. Targeted anti-inflammatory therapy effect on various indicators of the psoriatic arthritis activity: Moscow Unified Arthritis Registry (MUAR) data. Russian Medical Inquiry. 2021;5(2):78–83. DOI: 10.32364/2587-6821- 2021-5-2-78-83.

scholarly journals AB0769 THE IMPACT OF BODY MASS INDEX ON DISEASE ACTIVITY AND ENTHESITIS IN PSORIATIC ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1682.2-1683
Author(s):  
S. Ganhão ◽  
B. M. Fernandes ◽  
S. Garcia ◽  
F. Pinheiro ◽  
M. Rato ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Body Mass ◽  
Negative Impact ◽  
Public Health Problem ◽  
Continuous Variables ◽  
Das 28 ◽  
The Mean ◽  
The Impact

Background:Overweight/obesity has increased exponentially in the last decades, becoming a huge Public Health problem. Moreover, an increase in adipose tissue is associated with an increased production of several proinflammatory cytokines and acute phase reactants. Higher BMI has been related with new bone formation including syndesmophytes and enthesophytes. In fact, besides rheumatologic conditions including Psoriatic Arthritis (PsA), enthesopathy can be a consequence of several clinical conditions including metabolic syndrome, mechanical injuries and degeneration.Objectives:To evaluate the effect of body mass index (BMI) on disease activity scores and enthesitis scores in Psoriatic Arthritis.Methods:Retrospective study including all the patients with PsA meeting the CASPAR criteria, beginning first-line biologic therapy at our centre. Demographic and clinical data were collected from the Portuguese database Reumapt. Statistical analysis was performed with SPSS. Continuous variables were compared through Spearman/Pearson correlations.Results:The mean BMI was 26.8 (SD 0.5). In our sample of 119 PsA patients, 21.5% were overweight and 8.3% were obese. The mean age of patients was 46.3 ± 1.03 years; 60 female and 59 male. The median disease duration was 6.8 (0.3-33.8) years. At baseline mean (SD) disease activity variables were: DAS 28 4vESR 4.9 (0.2), ESR 33.2 (2.3) mm/h; CRP 2.35 (0.3) mg/dL, BASDAI 6.6 (0.2), ASDAS 3.9 (0.1), BASMI 3.7 (0.2), BASFI 5.8 (0.3), MASES 1.9 (0.3), SPARCC 2.3 (0.3). There were statistically significant positive correlations between BMI and MASES at baseline (p=0.024, r=0.411) but there weren’t with SPARCC, DAS 28 4vESR, ESR, CRP, BASDAI, ASDAS, BASMI and BASFI.Conclusion:The data showed that patients with higher BMI values had higher enthesitis scores suggesting that overweight/obesity may have a negative impact on enthesopathy. Further studies are still needed to further understand that possible relationship.References:[1]Bakirci S, Dabague J, Eder L, McGonagle D, Aydin SZ. The role of obesity on inflammation and damage in spondyloarthritis: a systematic literature review on body mass index and imaging. Clin Exp Rheumatol. 2019 Apr 29.Disclosure of Interests:Sara Ganhão: None declared, Bruno Miguel Fernandes: None declared, Salomé Garcia: None declared, Filipe Pinheiro: None declared, Maria Rato: None declared, Eva Mariz: None declared, Miguel Bernardes Speakers bureau: Abbvie, Amgen, Biogen, Eli-Lilly, Glaxo-Smith-Kline, Pfizer, Janssen, Novartis, Lúcia Costa: None declared

scholarly journals Comparative efficacy of genetically engineered biological drugs in real clinical practice according to the Moscow Unified Arthritis Registry (MUAR) data

2021 ◽  
Vol 5 (2) ◽  
pp. 58-63
Author(s):  
E.A. Rosochkina ◽  
◽  
G.V. Lukina ◽  
E.N. Koltsova ◽  
K.A. Lytkina ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Ankylosing Spondylitis ◽  
Certolizumab Pegol ◽  
Genetically Engineered ◽  
Comparative Efficacy ◽  
Biological Drugs ◽  
Reactive Protein ◽  
Activity Preservation ◽  
New Treatment ◽  
Real Clinical Practice

Background: the list expansion of genetically engineered biological drugs (GEBD) used for the treatment of ankylosing spondylitis (AS) determines the relevance of studies aimed at comparing them and determining their place in this disease treatment. Real clinical practice studies are the preferred source of this data type. Aim: to evaluate the efficacy of various GEBD in patients with AS according to the Moscow Unified Arthritis Registry (MUAR). Material and methods: the analysis of the MUAR data was carried out. These included clinical cases with GEBD, for which there were data of a completed visit after 6 months or more after the treatment initiation. Parameters values achieved during treatment with various drugs were analyzed. The comparison was conducted during a multivariate analysis with adjustments for the identified confounders. Non-clinical parameters that were reliably and independently associated with the achieved BASDAI index (CRP) values were considered as confounders. Results: the study included 363 treatment episodes with GEBP in 361 patients. As mutually independent significant predictors of the achieved ASDAS (confounders) values, GEBD treatment duration were established until the evaluation of indicators (p<0.001) and the age of the patient (p=0.006). Significant association between the established values of the studied parameters and the used GEBD were found for the achieved ASDAS (p=0.033) and ESR (p=0.007) values. In a pairwise drug comparison using the conservative Šidák correction, the achieved values of ASDAS and ESR during infliximab and adalimumab administration were significantly less than during certolizumab pegol administration. Conclusion: infliximab, adalimumab, etanercept, certolizumab pegol, golimumab, secukinumab in real clinical practice demonstrate generally similar clinical efficacy in the treatment of AS. The effect of golimumab and secukinumab, recently introduced into clinical practice, does not significantly differ from the effect produced by long-term TNF-α inhibitors. Certain disease activity preservation in a significant part of patients gives grounds to continue the search for new treatment methods. KEYWORDS: ankylosing spondylitis, genetically engineered biological drugs, tumor necrosis factor inhibitors, C-reactive protein, confounders, registry. FOR CITATION: Rosochkina E.A., Lukina G.V., Koltsova E.N. et al. Comparative efficacy of genetically engineered biological drugs in real clinical practice according to the Moscow Unified Arthritis Registry (MUAR) data. Russian Medical Inquiry. 2021;5(2):58–63. DOI: 10.32364/2587-6821-2021-5-2-58-63.

scholarly journals Psoriatic arthritis: pathogenetic features and innovative therapies

2019 ◽  
Vol 56 (6) ◽  
pp. 685-691 ◽  
Author(s):  
A. M. Lila ◽  
E. L. Nasonov ◽  
T. V. Korotaeva
Keyword(s):  
Psoriatic Arthritis ◽  
Clinical Manifestations ◽  
Treat To Target ◽  
Management Decision ◽  
High Tech ◽  
Biological Drugs ◽  
Basic Principles ◽  
Tnf Α ◽  
Anti Inflammatory ◽  
Factor Α

The paper considers the modern concepts of the etiology and pathogenesis of psoriatic arthritis (PsA). The latter is currently indicated as a T-cell-mediated disease that is based on the activation of cellular immunity, followed by the hyperproduction and imbalance of key pro- and anti-inflammatory cytokines, such as tumor necrosis factor-α (TNF- α), interleukin-1β (IL-1β), IL-6, IL-12/23, and IL-17. The paper presents the basic principles of diagnosis and clinical manifestations of the disease and notes the importance of screening questionnaires, the use of which allows specialists to diagnose PsA early, by actively identifying articular complaints, the characteristic clinical and radiological signs of damage to the joint, spine, and entheses. It is pointed out that the key target of pharmacotherapy for PsA is to achieve remission or minimal activity of the main clinical manifestations of the disease, to slow down or prevent its radiographic progression, to increase the length and quality of life in patients, and to reduce the risk of comorbidities. The authors characterize the major groups of used drugs: nonsteroidal anti-inflammatory drugs, conventional and targeted synthetic disease-modifying antirheumatic drugs, and biological drugs (inhibitors of TNF-α, IL-12/23, and IL-17). The key Treat-to-target principles of patient management are considered; it is noted that strict control over disease activity and treatment results provides suppression of all major clinical manifestations of PsA. The paper also shows the basic principles of the creation and further development of the All-Russian Registry of PsA patients, which makes it possible to optimize management decision-making on the provision of high-tech medical care and drugs for this cohort of patients.

scholarly journals Psoriasis: a personalized approach to therapy. The preferred choice of systemic agents considering comorbid pathologies

2020 ◽  
pp. 28-34
Author(s):  
N. N. Potekaev ◽  
O. V. Zhukova ◽  
S. I. Artemyeva
Keyword(s):  
Safety Profile ◽  
High Efficiency ◽  
Genetically Engineered ◽  
Cardiovascular Risks ◽  
Biological Drugs ◽  
Promising Area ◽  
Negative Effect ◽  
Personalized Approach ◽  
High Level ◽  
The Impact

Psoriasis is a chronic inflammatory skin disease that is currently viewed as a systemic process due to its association with many comorbid conditions. With the appearance of genetically engineered biological drugs (GEBDs), the treatment of psoriasis has undergone significant changes due to their high efficiency and favorable safety profile. It has been clinically proven that the use of this type of therapy has a positive effect, including on comorbid diseases. However, it must be highlighted that some types of drugs can have a negative effect on the course of these conditions. The characteristics of each individual drug, such as the rate of onset of remission, long-term efficacy, safety profile and effect on comorbidities are different. A better understanding of these characteristics leads to the correct personalized choice of therapy, hence to improved survival of drugs, patient satisfaction and minimization of the impact of psoriasis on the quality of life of patients.This article examines the efficacy and safety of biological drugs in patients with psoriasis, discusses their effect on concomitant diseases pathogenetically associated with psoriasis.To date it is known that the signaling pathway IL-23 / IL-17 plays a key role in the pathogenesis of psoriasis. Promising results are shown by the use of a biological drug aimed at inhibiting IL-23, namely the IL-23 blocker guselkumab. In addition to the high level of therapeutic response in psoriasis, other properties oa the drug have been identified - it has also shown efficacy in patients with concomitant Crohn's disease. Studies describe positive responses in the guselkumab treatment of psoriasis with “difficult” localisations, psoriatic arthritis and Hidradenitis Suppurativa, and its use in patients with cardiovascular risks did not lead to any manifestations of negative dynamics. Thus, further study of the effect of the IL-23 blocker on comorbid pathologies in psoriasis is a promising area. 

scholarly journals The impact of the presence of fibromyalgia on fatigue in patients with psoriatic arthritis: comparison with controls

2019 ◽  
Vol 60 (1) ◽  
Author(s):  
Yasemin Ulus ◽  
Yesim Akyol ◽  
Ayhan Bilgici ◽  
Omer Kuru
Keyword(s):  
Psoriatic Arthritis ◽  
Visual Analogue Scale ◽  
Disease Activity ◽  
Analogue Scale ◽  
Univariate Analysis ◽  
American College Of Rheumatology ◽  
Pain Scores ◽  
Das 28 ◽  
Significant Difference ◽  
The Impact

Abstract Background Coexisting fibromyalgia (FM) to psoriatic arthritis (PsA) has been identified and it has been associated with more severe symptoms, impaired function, and greater disability. It was aimed to explore the effect of the presence of FM on fatigue in patients with PsA comparing with controls. Methods Fifty patients with PsA and 34 sex-age matched controls were enrolled. In patients; pain was assessed by Visual Analogue Scale, disease activity by DAS-28, enthesitis by The Leeds Enthesitis Index. Fatigue level of all participants was evaluated by Multidimensional Assessment of Fatigue. In all participants, FM was determined according to 2010 American College of Rheumatology criteria. Results Seventeen patients with PsA (34%) and 4 controls (11.8%) were diagnosed with FM and all of them were women. There was significant difference between the patients and controls in terms of presence of FM (p < 0.05). Patients’ fatigue scores were significantly higher than controls’ (p = 0.001). There were significant differences between the PsA patients with and without FM with regard to gender, enthesitis, DAS-28 and pain scores (p < 0.05); fatigue scores (p < 0.001). The significant effect of the presence of FM on fatigue was found by univariate analysis of variance in patients (p < 0.001). Conclusion It was observed that FM presence and fatigue were more common in PsA patients than controls and comorbid FM had significant effect on fatigue in these patients. Physicians should be aware of the possibility of concomitant FM in patients with PsA.

Familial Mediterranean Fever (FMF) and Pregnancy: Literature Review

2020 ◽  
pp. 4-12
Author(s):  
П.О. Соцкий
Keyword(s):  
Familial Mediterranean Fever ◽  
Pregnancy Outcomes ◽  
Interleukin 1 ◽  
Genetically Engineered ◽  
Biological Drugs ◽  
Colchicine Resistance ◽  
Evolutionary View ◽  
Mediterranean Fever ◽  
The Impact ◽  
Colchicine Therapy

В обзоре обобщается текущая информация о влиянии семейной средиземноморской лихорадки (ССЛ) и ее лечения на исходы беременности, анализируется вопрос гипотетической тератогенности колхицина. В случае резистентности/непереносимости колхицина обсуждается возможность использования других лекарственных средств во время беременности, в том числе, генно-инженерных биологических препаратов, среди которых при ССЛ наиболее предпочтительны ингибиторы интерлейкина 1. Представлена эволюция взглядов на необходимость проведения пренатальной диагностики хромосомных аномалий плода пациенткам с ССЛ, получающим колхицин во время зачатия и беременности, а также в тех случаях, когда колхицинотерапия проводилась мужьям во время зачатия их женами. Акцент сделан на аспектах безопасности терапии, основные положения которых представлены в клинических рекомендациях по лечению ССЛ Европейской антиревматической лиги (EULAR,2016). Согласно этим рекомендациям, прием колхицина не должен быть прекращен во время зачатия, беременности или лактации; имеющаяся на сегодняшний день доказательная база не подтверждает необходимость выполнения амниоцентеза. The review summarizes current information on the impact of FMF and its treatment on pregnancy outcomes, and analyses the hypothetical teratogenicity of colchicine. In the case of colchicine resistance/intolerability, the possibility of using other drugs during pregnancy, including genetically engineered biological drugs, among which interleukin 1 inhibitors are preferred for FMF. An evolutionary view is presented on the need for amniocentesis in FMF patients receiving colchicine during conception and pregnancy, as well as in cases where colchicine therapy was performed to husbands during conception with their wives. Emphasis is placed on the safety aspects of therapy, the main provisions of which are presented in the clinical recommendations for the treatment of FMF of the European Anti-Rheumatic League (EULAR, 2016). According to these recommendations, colchicine should not be discontinued during conception, pregnancy or lactation; today’s evidence does not support amniocentesis.

The Effect of Biologic and Targeted Synthetic Drugs on Work- and Productivity-related Outcomes for Patients with Psoriatic Arthritis: A Systematic Review

2018 ◽  
Vol 45 (8) ◽  
pp. 1124-1130 ◽  
Author(s):  
Nicolas Iragorri ◽  
Mark Hofmeister ◽  
Eldon Spackman ◽  
Glen S. Hazlewood
Keyword(s):  
Systematic Review ◽  
Psoriatic Arthritis ◽  
Statistical Significance ◽  
Certolizumab Pegol ◽  
Work Productivity ◽  
Pooled Analysis ◽  
Risk Of Bias ◽  
Double Blind ◽  
Synthetic Drugs ◽  
Visual Analog Scales

Objective.To systematically review the effects of biologic therapies for psoriatic arthritis [secukinumab, ustekinumab, adalimumab, etanercept, certolizumab pegol (CZP), apremilast, golimumab (GOL), or infliximab (IFX)] on work productivity.Methods.A systematic review of Medline, EMBASE, CENTRAL, and ClinicalTrials.gov was conducted to identify randomized controlled trials reporting on work productivity outcomes at the end of the placebo-controlled double-blind period.Results.There were 7959 records identified. Full text of 377 records was further assessed for eligibility, of which 5 trials were included. All included trials were assessed with the Cochrane Risk of Bias Tool, and 4 out of 5 were judged to be of low risk of bias in most domains. Improvements in self-assessed work productivity were observed in 5 trials (IFX, GOL, CZP, ustekinumab, and apremilast), ranging from a mean difference of −0.9 to −1.8 on a 1–10 scale of self-assessed work productivity (negative change represents improvement), although statistical significance of the results was not reported for CZP and apremilast. Treatment with CZP resulted in a statistically significant reduction in absenteeism (200 mg) and presenteeism (200 and 400 mg). IFX and GOL reported a nonsignificant reduction of absenteeism. The Work Productivity Survey, the Work Limitations Questionnaire, and visual analog scales were used to measure work productivity.Conclusion.Treatment with IFX, GOL, CZP, ustekinumab, and apremilast resulted in improvements in self-reported work productivity. A pooled analysis was not possible because of the clinical heterogeneity of the trials and variability in outcome reporting.

scholarly journals Effects of Wine Components in Inflammatory Bowel Diseases

Molecules ◽  
2021 ◽  
Vol 26 (19) ◽  
pp. 5891
Author(s):  
Josip Vrdoljak ◽  
Marko Kumric ◽  
Tina Ticinovic Kurir ◽  
Ivan Males ◽  
Dinko Martinovic ◽  
...  
Keyword(s):  
Large Scale ◽  
Human Subjects ◽  
Current Evidence ◽  
Biological Drugs ◽  
Biological Compounds ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Anti Inflammatory ◽  
Natural Foods ◽  
The Impact

With the rising prevalence of Inflammatory bowel disease (IBD) worldwide, and the rising cost of treatment with novel biological drugs, there is an increasing interest in various diets and natural foods as a potential way to control/modulate IBD. As recent data indicates that diet can modify the metabolic responses essential for the resolution of inflammation, and as wine compounds have been shown to provide substantial anti-inflammatory effect, in this review we aimed to discuss the current evidence concerning the impact of biological compounds present in wine on IBD. A number of preclinical studies brought forth strong evidence on the mechanisms by which molecules in wine, such as resveratrol or piceatannol, provide their anti-inflammatory, anti-oxidative, anti-tumor, and microbiota-modulation effects. However, concerning the effects of alcohol, it is still unclear how the amount of ethanol ingested within the framework of moderate wine consumption (1–2 glasses a day) affects patients with IBD, as human studies regarding the effects of wine on patients with IBD are scarce. Nevertheless, available evidence justifies the conductance of large-scale RCT trials on human subjects that will finally elucidate whether wine can offer real benefits to the IBD population.

scholarly journals Improvements in productivity at paid work and within the household, and increased participation in daily activities after 24 weeks of certolizumab pegol treatment of patients with psoriatic arthritis: results of a phase 3 double-blind randomised placebo-controlled study

2014 ◽  
Vol 74 (1) ◽  
pp. 44-51 ◽  
Author(s):  
A Kavanaugh ◽  
D Gladman ◽  
D van der Heijde ◽  
O Purcaru ◽  
P Mease
Keyword(s):  
Psoriatic Arthritis ◽  
Certolizumab Pegol ◽  
Leisure Activities ◽  
Controlled Study ◽  
Social Activities ◽  
Paid Work ◽  
Phase 3 ◽  
Double Blind ◽  
Household Productivity ◽  
The Impact

ObjectivesTo evaluate the effect of certolizumab pegol (CZP) on productivity outside and within the home, and on participation in family, social and leisure activities in adult patients with psoriatic arthritis (PsA).MethodsRAPID-PsA (NCT01087788) is a phase 3, double-blind, placebo-controlled trial. 409 patients with active PsA were randomised 1:1:1 to placebo, CZP 200 mg every 2 weeks (Q2W) or CZP 400 mg every 4 weeks (Q4W). The arthritis-specific Work Productivity Survey (WPS) assessed the impact of PsA on paid work and household productivity, and participation in social activities during the preceding month. WPS responses were compared between treatment arms using a non-parametric bootstrap-t method.ResultsAt baseline, 56.6%, 60.1% and 61.5% of placebo, CZP 200 mg Q2W and CZP 400 mg Q4W patients were employed. By week 24, employed CZP patients reported an average of 1.0–1.8 and 3.0–3.9 fewer days of absenteeism and presenteeism, respectively, per month compared with 1.0 and 0.3 fewer days for placebo patients (p<0.05). Within the home, by week 24, CZP patients reported an average of 3.0–3.5 household work days gained per month versus 1.0 day for placebo (p<0.05). CZP patients also reported fewer days with reduced household productivity or days lost for participation in family, social and leisure activities. Improvements with CZP were seen as early as week 4 and continued to week 24.ConclusionsCZP treatment significantly improved productivity at paid work and within the home, and resulted in greater participation in social activities for PsA patients.Trial registration numberNCT01087788.

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