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7. Induction of sustained remission in early inflammatory arthritis with the combination of infliximab plus methotrexate: the DINORA trial

Author

Stamm, Tanja Alexandra, Machold, Klaus Peter, Aletaha, Daniel, Alasti, Farideh, Lipsky, Peter, Pisetsky, David, Landewe, Robert, van der Heijde, Desiree, Sepriano, Alexandre, Aringer, Martin, Boumpas, Dimitri, Burmester, Gerd, Cutolo, Maurizio, Ebner, Wolfgang, Graninger, Winfried, Huizinga, Tom, Schett, Georg, Schulze-Koops, Hendrik, Tak, Paul-Peter, Martin-Mola, Emilio, Breedveld, Ferdinand, and Smolen, Josef

Published
2018
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11. Autologous Hematopoietic Stem Cell Transplantation vs Intravenous Pulse Cyclophosphamide in Diffuse Cutaneous Systemic Sclerosis: A Randomized Clinical Trial

Author

van Laar, Jacob M., Farge, Dominique, Sont, Jacob K., Naraghi, Kamran, Marjanovic, Zora, Larghero, Jérôme, Schuerwegh, Annemie J., Marijt, Erik W. A., Vonk, Madelon C., Schattenberg, Anton V., Matucci-Cerinic, Marco, Voskuyl, Alexandre E., van de Loosdrecht, Arjan A., Daikeler, Thomas, Kötter, Ina, Schmalzing, Marc, Martin, Thierry, Lioure, Bruno, Weiner, Stefan M., Kreuter, Alexander, Deligny, Christophe, Durand, Jean-Marc, Emery, Paul, Machold, Klaus P., Sarrot-Reynauld, Francoise, Warnatz, Klaus, Adoue, Daniel F. P., Constans, Joël, Tony, Hans-Peter, Del Papa, Nicoletta, Fassas, Athanasios, Himsel, Andrea, Launay, David, Lo Monaco, Andrea, Philippe, Pierre, Quéré, Isabelle, Rich, Éric, Westhovens, Rene, Griffiths, Bridget, Saccardi, Riccardo, van den Hoogen, Frank H., Fibbe, Willem E., Socié, Gérard, Gratwohl, Alois, and Tyndall, Alan

Published
2014
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12. Reply

Author

Gärtner, Miriam, Mandl, Peter, Radner, Helga, Supp, Gabriela, Machold, Klaus P., Aletaha, Daniel, and Smolen, Josef S.

Published
2014
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17. EULAR recommendations for terminology and research in individuals at risk of rheumatoid arthritis: report from the Study Group for Risk Factors for Rheumatoid Arthritis

Author

Gerlag, Danielle M, Raza, Karim, van Baarsen, Lisa G M, Brouwer, Elisabeth, Buckley, Christopher D, Burmester, Gerd R, Gabay, Cem, Catrina, Anca I, Cope, Andrew P, Cornelis, François, Dahlqvist, Solbritt Rantapää, Emery, Paul, Eyre, Stephen, Finckh, Axel, Gay, Steffen, Hazes, Johanna M, van der Helm-van Mil, Annette, Huizinga, Tom W J, Klareskog, Lars, Kvien, Tore K, Lewis, Cathryn, Machold, Klaus P, Rönnelid, Johan, Schaardenburg, Dirkjan van, Schett, Georg, Smolen, Josef S, Thomas, Sue, Worthington, Jane, and Tak, Paul P

Published
2012
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19. Contributors

Author

Abelson, Abby G., Abraham, Mary, Abramson, Steven B., Adachi, Jonathan D., Aggarwal, Rohit, Akira, Shizuo, Aletaha, Daniel, Ashraf Ali, Amjid, Allem, Kavitta B., Almehthel, Mohammed, Almohaya, Mohammed, Riera Alonso, Elena, Amigo, Mary-Carmen, Aringer, Martin, Arkema, Elizabeth V., Ascherman, Dana P., Atamas, Sergei P., Atkinson, Timothy J., Azeez, Maha A., Baer, Alan N., Baraliakos, Xenofon, Bardin, Thomas, Barnsley, Leslie, Barr, Andrew J., Bathon, Joan M., Belch, Jill J.F., Bellido, Teresita, Ben-Artzi, Ami, Benedetti, Fabrizio, Bennell, Kim L., Bennett, Sarah E., Berard, Roberta A., Berenbaum, Francis, Berman, Brian, Bermas, Bonnie L., Elizabeth Berry, Alice, Bertsias, George, Bhana, Suleman, Bhattacharyya, Shamik, Bilginer, Yelda, Bleasel, Jane F., Block, Joel A., Böhm, Markus, Bonelli, Michael, Boumpas, Dimitrios T., Bozec, Aline, Brasington, Richard D., Braun, Jürgen, Brouwer, Elisabeth, Brown, Jacques P., Brown, Matthew A., Brown, Matthew L., Buch, Maya H., Buckley, Christopher D., Bugbee, William D., Burmester, Gerd-Rüdiger, Burns, Jane C., Burr, David B., Buttgereit, Frank, Buxbaum, Joel N., Bykerk, Vivian P., Calabrese, Cassandra, Calabrese, Leonard H., Callen, Jeffrey P., Carr, Andrew J., Carrino, John A., Cavallo, Sabrina, Cervera, Ricard, Chang, Christopher, Chang, Joyce C., Chaon, Benjamin C., Chaudhary, Prateek, Choi, Hyon K., Choy, Ernest H.S., Christopher-Stine, Lisa, Chung, Lorinda, Ciccia, Francesco, Clauw, Daniel J., Clinch, Jacqui, Clowse, Megan E.B., Coghlan, John (Gerry), Colbert, Robert A., Conaghan, Philip G., Cooper, Cyrus, Costello, Wendy, Costenbader, Karen H., Cox, George L.D., Creamer, Paul, Cronstein, Bruce N., Cross, Raymond K., Curtis, Jeffrey R., D'Adamo, Chris, D'Agati, Vivette D., Daikh, David I., Dakin, Stephanie G., Dalbeth, Nicola, Davis, Aileen M., D'Cruz, David P., Eduardo de Barros Branco, Carlos, de Boer, Berber, De Craemer, Ann-Sophie, de Jesus, Adriana A., De Vita, Salvatore, de Wit, Maarten, Deal, Chad L., Deane, Kevin D., Dellaripa, Paul F., Dennison, Elaine, Denton, Christopher P., DiCarlo, Edward F., Distler, Oliver, Donlan, Pamela, Doyle, Tracy J., du Preez, Hannah, Dyer, George S.M., Eastell, Richard, Ehrchen, Jan, Elewaut, Dirk, Emery, Paul, Emmerling, Max R., Espinosa, Gerard, Espinoza, Luis R., Eyre, Stephen, Fanouriakis, Antonis, Farber, Joshua, Fasth, Anders, Feist, Eugen, Feldman, Candace H., Fernandez-Ruiz, Ruth, Filer, Andrew, Fiorentino, David F., Fisher, Benjamin A., Fisk, John D., Flajnik, Martin F., Forbess, Lindsy, Fox, David A., Frech, Tracy M., Frisaldi, Elisa, Gabay, Cem, Gadina, Massimo, Gandolfo, Saviana, Garelick, Daniela, Gay, Steffen, Geifman, Nophar, George, Michael D., Eric Gershwin, M., Ghadiali, Jay, Gilis, Elisabeth, Gold, Deborah T., Gold, Garry E., Goldbach-Mansky, Raphaela, Gómez-Puerta, José A., Goodman, Susan M., Gordon, Caroline, Gordon, Sharon, Gossec, Laure, Grainger, Andrew J., Grainger, Rebecca, Gravallese, Ellen M., Greenberg, Jeffrey D., Guglielmi, Luiza Guilherme, Gül, Ahmet, Gullapalli, Rao P., Guma, Monica, Gupta, Sarthak, Han, Shuhong, Hanly, John G., Hanson, Eric P., Haraoui, Boulos, Harley, John B., Haroun, Tayseer G., Hashkes, Philip J., Hasni, Sarfaraz A., Bassim Hassan, Andrew, Haupt, Lukas, Hausmann, Jonathan S., Hawker, Gillian A., Heiberg, Turid, Helfgott, Simon M., Hinman, Rana S., Hoffmann-Vold, Anna-Maria, Holroyd, Christopher R., Holt, Cathy, Horomanski, Audra, Huizinga, Thomas W.J., Humby, Frances, Elaine Husni, M., Hwang, Jonathan, Hyrich, Kimme, Inman, Robert D., Inoue, Dai, Isaac, Zacharia, Isaacs, John D., Isenberg, David, Iversen, Maura D., Jabs, Douglas A., James, Judith A., Jandali, Bochra, Kassim Javaid, M., Javier, Rose-Marie, Jefferis, Roy, Jeffries, Matlock A., Johnson, Sindhu R., Johnstone, Brian, Helena Jonsson, Anna, Joyce, Andrew A., Jung, Michelle, Kado, Ruba, Kaisho, Tsuneyasu, Kamal, Natasha, Kane, David, Kaplan, Mariana J., Karr, Timothy L., Kassimos, Dimitrios G., Kastner, Daniel L., Katz, Jeffrey N., Kawano, Mitsuhiro, Kay, Jonathan, Keating, Richard M., Kelly, Jennifer A., Kendler, David, Keyser, Randall E., Khamashta, Munther A., Khanna, Dinesh, Khokhar, Kiran, Kiefer, David, King, Lauren K., Kloppenburg, Margreet, Kolasinski, Sharon L., Kolstad, Kathleen D., Kottyan, Leah C., Byers Kraus, Virginia, Kronberger, Leo R.W., Kroopnick, Jeffrey M., Kvien, Tore K., LaBaer, Joshua, Lafyatis, Robert, Lakkis, Jay I., Landewé, Robert B.M., Langford, Carol A., Laster, Marciana L., Latourte, Augustin, Lau, Arthur N., Laurynenka, Viktoryia, Lavin, Robert A., Laxer, Ronald M., Li, Suzanne C., Liao, Katherine P., Lieberman, Scott M., Liew, Jean W., Littlejohn, Geoffrey O., Liu, Eva S., Lo, Lawrence, Lories, Rik J., Luger, Thomas A., Lundberg, Ingrid E., Luqmani, Raashid A., Machado, Pedro M., Machold, Klaus P., Ronald MacKenzie, C., Major, Tanya J., Malfait, Anne-Marie, Malley, Tamir, Manasson, Julia, March, Lyn M., Olivé Marqués, Alejandro, Márquez, Javier, Martin, Paul, Martínez-Lavín, Manuel, Matteson, Eric L., Mayes, Maureen D., McAlindon, Timothy, McCarthy, Edward F., McCarthy, Geraldine M., McDermott, Michael F., McDonnell, Patrick J., McGonagle, Dennis, Simon Meara, Alexa, Mehta, Jay J., Melville, Andrew R., Merola, Joseph F., Micheletti, Robert G., Michou, Laëtitia, Middleton, Rob, Midha, Disha, Mikdashi, Jamal A., Miller, Frederick W., Minden, Kirsten, Miner, Jonathan J., Minhas, Deeba, Helene Moe, Rikke, Möller, Ingrid, Mopuru, Renuka, Mortaji, Parisa, Mueller, Alisa A., Myasoedova, Elena, Namur, Gauthier, Naredo, Esperanza, Navarro-Compán, Victoria, Neerinckx, Barbara, Nelson, Amanda E., Nerviani, Alessandra, Nicolson, Philippa J.A., Nordal, Ellen B., Nöth, Ulrich, Ntatsaki, Eleana, Obenhuber, Tilman, Oddis, Chester V., Ogdie-Beatty, Alexis R., Omar, Ahmed, Ombrello, Michael J., Omisade, Antonina, Onel, Karen B., Ong, Voon H., Orcel, Philippe, Orozco, Gisela, Orr, Carl, O'Shea, John J., Ospelt, Caroline, Østensen, Monika, Özen, Seza, Park, Elizabeth, Parker, Matthew J.S., Pathan, Ejaz, Patrono, Carlo, Perez-Chada, Lourdes M., Pijnenburg, Luc, Pillinger, Michael H., Pineda, Carlos, Pipitone, Nicolò, Pitzalis, Costantino, Poddubnyy, Denis, Pope, Janet E., Postolova, Anna, Price, Andrew J., Pryor, Katherine P., Quartuccio, Luca, Rackwitz, Lars, Radner, Helga, Rajendran, Aardra, Ramiro, Sofia, Raychaudhuri, Soumya, Redmond, Anthony C., Reeves, Westley H., Remmers, Elaine F., Requena, Luis, Reynolds, Gary, Reynolds, John A., Ribbens, Clio, Richards, Bethan, Richardson, Bruce, Richette, Pascal, Ritchlin, Christopher T., Ritter, Susan Y., Robinson, Philip C., Robinson, William H., Rogers, Valerie J., Romain, Paul L., Rosas, Ivan O., Rosenthal, Ann K., Rubin, Elka, Rudwaleit, Martin, Rutgers, Bram A., Rygg, Marite, Saag, Kenneth G., Salmon, Jane E., Salusky, Isidro B., Salvarani, Carlo, Sandell, Linda J., Sandhu, Vaneet K., Sandovici, Maria, Sand-Svartrud, Anne-Lene, Scanzello, Carla R., Schaible, Hans-Georg, Scher, Jose U., Schett, Georg, Schiffenbauer, Adam I., Schiller, Alan L., Schlesinger, Naomi, Schreiber, Benjamin E., Schwartz, Daniella M., Shaibani, Aziz, Sharma, Leena, Shmerling, Robert H., Siaton, Bernadette C., Siegel, Richard M., Sieghart, Daniela, Silverman, Stuart L., Simard, Julia F., Simmons, Barry P., Simms, Robert W., Singer, Nora G., Sirotich, Emily, Smith, Judith A., Smith, Stacy E., Smolen, Josef S., Solomon, Daniel H., Sparks, Jeffrey A., Stack, John, Stanley, David, Steen, Virginia D., Steere, Allen C., Stegeman, Coen A., Steiner, Günter, Steinert, Andre F., Stojan, George, Strand, Vibeke, Sufka, Paul, Sullivan, James K., Szulc, Pawel, Tang, Chen, Tang, Shiyu, Taylor, Peter C., Terkeltaub, Robert, Thomas, Afton R., Thorne, Jennifer E., Topping, Louise M., Toprover, Michael, Torralba, Karina, Touma, Zahi, Tremoulet, Adriana H., Trouw, Leendert, Tuan, Rocky S., Uçkay, Ilker, Umehara, Hisanori, van der Geest, Kornelis S.M., van der Heijde, Désirée, van Gaalen, Floris A., Van Mechelen, Margot, van Vollenhoven, Ronald F., Vandevelde, Claire Y.J., Varga, John, Vassilopoulos, Dimitrios, Veale, Douglas J., Verstappen, Gwenny M., Viatte, Sebastien, Vincent, Tonia L., Vital, Edward M., von Loga, Isabell S., Wahezi, Dawn M., Wallace, Daniel J., Wallace, Zachary S., Warburton, Gary, Watad, Abdulla, Watts, Richard A., Weinblatt, Michael E., Weir, Matthew R., Weisman, Michael H., Weiss, Pamela F., Branford White, Harriet, White, Kenneth E., Wilkinson, David J., Williams, David E., Williams, Richard, Wilson, Hannah, Winthrop, Kevin L., Witt, Claudia M., Witzmann, Gerhard, Wong, John B., Woolf, Anthony D., Paul Wordsworth, B., Xu, Huji, Yazdany, Jinoos, Young, David A., Young, Stephen P., Md Yusof, Md Yuzaiful, and Zhuang, Haoyang

Published
2023
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20. Delays in assessment of patients with rheumatoid arthritis: variations across Europe

Author

Raza, Karim, Stack, Rebecca, Kumar, Kanta, Filer, Andrew, Detert, Jacqueline, Bastian, Hans, Burmester, Gerd R, Sidiropoulos, Prodromos, Kteniadaki, Eleni, Repa, Argyro, Saxne, Tore, Turesson, Carl, Mann, Herman, Vencovsky, Jiri, Catrina, Anca, Chatzidionysiou, Aikaterini, Hensvold, Aase, Rantapää-Dahlqvist, Solbritt, Binder, Alexa, Machold, Klaus, Kwiakowska, Brygida, Ciurea, Adrian, Tamborrini, Giorgio, Kyburz, Diego, and Buckley, Christopher D

Published
2011
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41. Uveitis- a rare disease often associated with systemic diseases and infections- a systematic review of 2619 patients

Author

Barisani-Asenbauer Talin, Maca Saskia M, Mejdoubi Lamiss, Emminger Wolfgang, Machold Klaus, and Auer Herbert

Subjects
Uveitis, Etiology, Systemic associations, Arthritis, Infections, Medicine
Abstract

Abstract Background Uveitis is an autoimmune disease of the eye that refers to any of a number of intraocular inflammatory conditions. Because it is a rare disease, uveitis is often overlooked, and the possible associations between uveitis and extra-ocular disease manifestations are not well known. The aim of this study was to characterize uveitis in a large sample of patients and to evaluate the relationship between uveitis and systemic diseases. Methods The present study is a cross-sectional study of a cohort of patients with uveitis. Records from consecutive uveitis patients who were seen by the Uveitis Service in the Department of Ophthalmology at the Medical University of Vienna between 1995 and 2009 were selected from the clinical databases. The cases were classified according to the Standardization of Uveitis Nomenclature Study Group criteria for Uveitis. Results Data were available for 2619 patients, of whom 59.9% suffered from anterior, 14.8% from intermediate, 18.3% from posterior and 7.0% from panuveitis. 37.2% of all cases showed an association between uveitis and extra-organ diseases; diseases with primarily arthritic manifestations were seen in 10.1% of all cases, non-infectious systemic diseases (i.e., Behçet´s disease, sarcoidosis or multiple sclerosis) in 8.4% and infectious uveitis in 18.7%. 49.4% of subjects suffering from anterior uveitis tested positively for the HLA-B27 antigen. In posterior uveitis cases 29% were caused by ocular toxoplasmosis and 17.7% by multifocal choroiditis. Conclusion Ophthalmologists, rheumatologists, infectiologists, neurologists and general practitioners should be familiar with the differential diagnosis of uveitis. A better interdisciplinary approach could help in tailoring of the work-up, earlier diagnosis of co-existing diseases and management of uveitis patients.

Published
2012
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43. Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: validation of a clinical activity score

Author

Aletaha, Daniel, Nell, Valerie PK, Stamm, Tanja, Uffmann, Martin, Pflugbeil, Stephan, Machold, Klaus, and Smolen, Josef S

Subjects
musculoskeletal diseases, Adult, Analysis of Variance, In Vitro Techniques, Middle Aged, Statistics, Nonparametric, Arthritis, Rheumatoid, Cohort Studies, Cross-Sectional Studies, Confidence Intervals, Linear Models, Humans, Female, Prospective Studies, skin and connective tissue diseases, Research Article, Acute-Phase Proteins, Aged
Abstract

Introduction Frequent assessments of rheumatoid arthritis (RA) disease activity allow timely adaptation of therapy, which is essential in preventing disease progression. However, values of acute phase reactants (APRs) are needed to calculate current composite activity indices, such as the Disease Activity Score (DAS)28, the DAS28-CRP (i.e. the DAS28 using C-reactive protein instead of erythrocyte sedimentation rate) and the Simplified Disease Activity Index (SDAI). We hypothesized that APRs make limited contribution to the SDAI, and that an SDAI-modification eliminating APRs – termed the Clinical Disease Activity Index (CDAI; i.e. the sum of tender and swollen joint counts [28 joints] and patient and physician global assessments [in cm]) – would have comparable validity in clinical cohorts. Method Data sources comprised an observational cohort of 767 RA patients (average disease duration 8.1 ± 10.6 years), and an independent inception cohort of 106 patients (disease duration 11.5 ± 12.5 weeks) who were followed prospectively. Results Our clinically based hypothesis was statistically supported: APRs accounted only for 15% of the DAS28, and for 5% of the SDAI and the DAS28-CRP. In both cohorts the CDAI correlated strongly with DAS28 (R = 0.89–0.90) and comparably to the correlation of SDAI with DAS28 (R = 0.90–0.91). In additional analyses, the CDAI when compared to the SDAI and the DAS28 agreed with a weighted kappa of 0.70 and 0.79, respectively, and comparably to the agreement between DAS28 and DAS28-CRP. All three scores correlated similarly with Health Assessment Questionnaire (HAQ) scores (R = 0.45–0.47). The average changes in all scores were greater in patients with better American College of Rheumatology response (P < 0.0001, analysis of variance; discriminant validity). All scores exhibited similar correlations with radiological progression (construct validity) over 3 years (R = 0.54–0.58; P < 0.0001). Conclusion APRs add little information on top (and independent) of the combination of clinical variables included in the SDAI. A purely clinical score is a valid measure of disease activity and will have its greatest merits in clinical practice rather than research, where APRs are usually always available. The CDAI may facilitate immediate and consistent treatment decisions and help to improve patient outcomes in the longer term.

Published
2005

44. Autologous Hematopoietic Stem Cell Transplantation vs Intravenous Pulse Cyclophosphamide in Diffuse Cutaneous Systemic Sclerosis

Author

van Laar, Jacob, Farge, Dominique, Sont, Jacob, Naraghi, Kamran, Marjanovic, Zora, Larghero, Jérôme, Schuerwegh, Annemie, Marijt, Erik, Vonk, Madelon, Schattenberg, Anton, Matucci-Cerinic, Marco, Voskuyl, Alexandre, van de Loosdrecht, Arjan, Daikeler, Thomas, Kötter, Ina, Schmalzing, Marc, Martin, Thierry, Lioure, Bruno, Weiner, Stefan, Kreuter, Alexander, Deligny, Christophe, DURAND, Jean-Marc, Emery, Paul, Machold, Klaus, Sarrot-Reynauld, Françoise, Warnatz, Klaus, Adoue, Daniel, Constans, Joël, Tony, Hans-Peter, Del Papa, Nicoletta, Fassas, Athanasios, Himsel, Andrea, Launay, David, Lo Monaco, Andrea, Philippe, Pierre, Quere, Isabelle, Rich, Éric, Westhovens, Rene, Griffiths, Bridget, Saccardi, Riccardo, van den Hoogen, Frank, Fibbe, Willem, Socie, Gérard, Gratwohl, Alois, Tyndall, Alan, Study Group, EBMT/EULAR Scleroderma, Service de Médecine Interne [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CIC - Biotherapie - Saint Louis ((CIC-BT 301)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], CHU Strasbourg, Département d'Oncologie et Hématologie [Strasbourg], Les Hôpitaux Universitaires de Strasbourg (HUS), Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Médecine interne et immunologie clinique [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Clinique de médecine interne, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Saint-André, Service de médecine interne [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Clermont-Ferrand, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Hopital Saint-Louis [AP-HP] (AP-HP), Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service d'hématologie clinique et de thérapie cellulaire [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), CHU Toulouse [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), and CHU Saint Louis [APHP]

Subjects
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; IMPORTANCE:High-dose immunosuppressive therapy and autologous hematopoietic stem cell transplantation (HSCT) have shown efficacy in systemic sclerosis in phase 1 and small phase 2 trials.OBJECTIVE:To compare efficacy and safety of HSCT vs 12 successive monthly intravenous pulses of cyclophosphamide.DESIGN, SETTING, AND PARTICIPANTS:The Autologous Stem Cell Transplantation International Scleroderma (ASTIS) trial, a phase 3, multicenter, randomized (1:1), open-label, parallel-group, clinical trial conducted in 10 countries at 29 centers with access to a European Group for Blood and Marrow Transplantation-registered transplant facility. From March 2001 to October 2009, 156 patients with early diffuse cutaneous systemic sclerosis were recruited and followed up until October 31, 2013.INTERVENTIONS:HSCT vs intravenous pulse cyclophosphamide.MAIN OUTCOMES AND MEASURES:The primary end point was event-free survival, defined as time from randomization until the occurrence of death or persistent major organ failure.RESULTS:A total of 156 patients were randomly assigned to receive HSCT (n = 79) or cyclophosphamide (n = 77). During a median follow-up of 5.8 years, 53 events occurred: 22 in the HSCT group (19 deaths and 3 irreversible organ failures) and 31 in the control group (23 deaths and 8 irreversible organ failures). During the first year, there were more events in the HSCT group (13 events [16.5%], including 8 treatment-related deaths) than in the control group (8 events [10.4%], with no treatment-related deaths). At 2 years, 14 events (17.7%) had occurred cumulatively in the HSCT group vs 14 events (18.2%) in the control group; at 4 years, 15 events (19%) had occurred cumulatively in the HSCT group vs 20 events (26%) in the control group. Time-varying hazard ratios (modeled with treatment × time interaction) for event-free survival were 0.35 (95% CI, 0.16-0.74) at 2 years and 0.34 (95% CI, 0.16-0.74) at 4 years.CONCLUSIONS AND RELEVANCE:Among patients with early diffuse cutaneous systemic sclerosis, HSCT was associated with increased treatment-related mortality in the first year after treatment. However, HCST conferred a significant long-term event-free survival benefit.TRIAL REGISTRATION:isrctn.org Identifier: ISRCTN54371254.

Published
2014

50. Interface Management between General Practitioners and Rheumatologists—Results of a Survey Defining a Concept for Future Joint Recommendations.

Author

Puchner, Rudolf, Edlinger, Michael, Mur, Erich, Eberl, Gabriele, Herold, Manfred, Kufner, Peter, Puchner, Antonia, Puchner, Stephan E., Redlich, Kurt, Alkin, Alois, and Machold, Klaus

Subjects
MEDICAL practice, RHEUMATOLOGISTS, HEALTH surveys, RHEUMATISM, QUESTIONNAIRES, FOLLOW-up studies (Medicine)
Abstract

Objective: To measure the views of general practitioners (GPs) and rheumatologists in a nationwide evaluation, so as to optimise their cooperation in managing patients with inflammatory rheumatic diseases. Methods: A questionnaire covering aspects of collaboration was sent, both by mail and/or by email, to all GPs and rheumatologists in Austria. Topics covered were (i) examinations and interventions to be performed before referral, (ii) the spectrum of diseases to be referred, and (iii) the role of GPs in follow-up and continuous management of patients. Results: 1,229 GPs of the 4,016 GPs (31%) and 110 of the 180 rheumatologists (61%) responded to the questionnaire. In cases of suspected arthritis, 99% of the GPs and 92% of the rheumatologists recommended specific laboratory tests, and 92% and 70%, respectively, recommended X-rays of affected joints before referral. Rheumatoid arthritis and spondyloarthritis, psoriatic arthritis and connective tissue disease were unanimously seen as indications for referral to a rheumatologist. Only 12% of rheumatologists felt responsible for the treatment of hand osteoarthritis and fibromyalgia. 80% of GPs and 85% of rheumatologists were of the opinion that treatment with disease-modifying drugs should be initiated by a specialist. Subsequent drug prescription and administration by GPs was supported by a majority of GPs and rheumatologists, with a concomitant rheumatologist follow-up every three to six months. Conclusion: The considerable consensus between the two professional groups constitutes a solid base for future joint recommendations, with the aim to accelerate the diagnostic process and the initiation of adequate therapy. [ABSTRACT FROM AUTHOR]

Published
2016
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