131 results on '"Katsimbri P"'
Search Results
2. Persistence on subcutaneous tocilizumab as monotherapy or in combination with synthetic disease-modifying anti-rheumatic drugs in rheumatoid arthritis patients in Greece (EMBRACE study): a multicenter, post-marketing, non-interventional, observational trial
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Athanassiou, Panagiotis, Katsimbri, Pelagia, Bounas, Andreas, Gazi, Sοusana, Sarikoudis, Theodosios, Syrigou, Victoria, and Boumpas, Dimitrios
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- 2024
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3. P88 Baseline factors associated with subsequent development of incident nephritis in patients with systemic lupus erythematosus: a retrospective cohort study
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Dimitrios T Boumpas, Antonis Fanouriakis, Dionysis Nikolopoulos, Sofia Flouda, Pelagia Katsimbri, Katerina Chavatza, Spyridon Katechis, and Noemin Kapsala
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Immunologic diseases. Allergy ,RC581-607 - Published
- 2024
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4. Churg–Strauss syndrome‐associated heart failure and left ventricular thrombosis
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Sotiria Liori, Eleftherios Samiotis, Dionysia Birba, Pelagia Katsimbri, Maria Mademli, Eleni Bakola, Georgios Tsivgoulis, Estela Quris, Michael Bonios, Maria Kalabaliki, Dimitrios Farmakis, John Parissis, and Alexandra Frogoudaki
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Eosinophilic granulomatosis with polyangiitis ,Churg–Strauss syndrome ,Heart failure ,Left ventricular thrombus ,Myocarditis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract We present a case of a 47‐year‐old woman with a history of asthma and mononeuritis who presented with shortness of breath and fatigue. Heart failure was diagnosed and echocardiography revealed large floating thrombi attached to the left ventricular walls. Cardiac magnetic resonance imaging showed evidence of myocarditis and angiitis. Blood count revealed eosinophilia. She was diagnosed with eosinophilic granulomatosis with polyangiitis or Churg–Strauss syndrome (CSS) according to recently updated criteria. Medical management with specific aetiology (anticoagulation or immunosuppression) and heart failure treatment resulted in clinical improvement. We further discuss the diagnostic approach of CSS with cardiovascular complications and therapeutic management.
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- 2023
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5. Endothelial glycocalyx and microvascular perfusion are associated with carotid intima-media thickness and impaired myocardial deformation in psoriatic disease
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Ikonomidis, Ignatios, Pavlidis, George, Lambadiari, Vaia, Rafouli-Stergiou, Pinelopi, Makavos, George, Thymis, John, Kostelli, Gavriella, Varoudi, Maria, Katogiannis, Konstantinos, Theodoropoulos, Konstantinos, Katsimbri, Pelagia, Parissis, John, and Papadavid, Evangelia
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- 2022
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6. The Effect of a Ketogenic Diet versus Mediterranean Diet on Clinical and Biochemical Markers of Inflammation in Patients with Obesity and Psoriatic Arthritis: A Randomized Crossover Trial
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Vaia Lambadiari, Pelagia Katsimbri, Aikaterini Kountouri, Emmanouil Korakas, Argyro Papathanasi, Eirini Maratou, George Pavlidis, Loukia Pliouta, Ignatios Ikonomidis, Sofia Malisova, Dionysios Vlachos, and Evangelia Papadavid
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psoriasis ,psoriatic arthritis ,obesity ,diet intervention ,Mediterranean diet ,Ketogenic diet ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
The effect of different diet patterns on psoriasis (PSO) and psoriatic arthritis (PSA) is unknown. Τhe aim of our study was to evaluate the effectiveness of a Mediterranean diet (MD) and Ketogenic diet (KD), in patients with PSO and PSA. Twenty-six patients were randomly assigned to start either with MD or KD for a period of 8 weeks. After a 6-week washout interval, the two groups were crossed over to the other type of diet for 8 weeks. At the end of this study, MD and KD resulted in significant reduction in weight (p = 0.002, p < 0.001, respectively), in BMI (p = 0.006, p < 0.001, respectively), in waist circumference (WC) (p = 0.001, p < 0.001, respectively), in total fat mass (p = 0.007, p < 0.001, respectively), and in visceral fat (p = 0.01, p < 0.001, respectively), in comparison with baseline. After KD, patients displayed a significant reduction in the Psoriasis Area and Severity Index (PASI) (p = 0.04), Disease Activity Index of Psoriatic Arthritis (DAPSA) (p = 0.004), interleukin (IL)-6 (p = 0.047), IL-17 (p = 0.042), and IL-23 (p = 0.037), whereas no significant differences were observed in these markers after MD (p > 0.05), compared to baseline. The 22-week MD–KD diet program in patients with PSO and PSA led to beneficial results in markers of inflammation and disease activity, which were mainly attributed to KD.
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- 2024
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7. Patterns and factors associated with pneumococcal vaccination in a prospective cohort of 1,697 patients with rheumatoid arthritis
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Konstantinos Thomas, Argyro Lazarini, Evripidis Kaltsonoudis, Paraskevi V. Voulgari, Alexandros A. Drosos, Argyro Repa, Ainour Molla Ismail Sali, Prodromos Sidiropoulos, Panagiota Tsatsani, Sousana Gazi, Kalliopi Fragkiadaki, Maria G. Tektonidou, Petros P. Sfikakis, Pelagia Katsimbri, Dimitrios Boumpas, Evangelia Argyriou, Kyriaki A. Boki, Konstantina Karagianni, Christina Katsiari, Gerasimos Evangelatos, Alexios Iliopoulos, Eleftheria P. Grika, Panagiotis G. Vlachoyiannopoulos, Theodoros Dimitroulas, Alexandros Garyfallos, Konstantinos Melissaropoulos, Panagiotis Georgiou, Constantinos Georganas, Periklis Vounotrypidis, Konstantinos Ntelis, Maria Areti, George D. Kitas, and Dimitrios Vassilopoulos
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rheumatoid arthritis ,vaccination ,biological therapy ,infections ,comorbidities ,Medicine (General) ,R5-920 - Abstract
IntroductionPatients with rheumatoid arthritis (RA) are at increased risk for serious infections. Pneumococcal vaccination is among the most important preventive measures, however, vaccine uptake is suboptimal. We explored the rate and factors associated with pneumococcal vaccination in a contemporary RA cohort.Materials and methodsMulti-center, prospective, RA cohort study in Greece. Patient and disease characteristics and influenza and pneumococcal vaccinations were documented at baseline and 3 years later.ResultsOne thousand six hundred and ninety-seven patients were included and 34.5% had already received at least one pneumococcal vaccine at baseline. Among 1,111 non-vaccinated patients, 40.1% received pneumococcal vaccination during follow-up, increasing the vaccine coverage to 60.8%. By multivariate analysis, positive predictors for pneumococcal vaccination included prescription of influenza vaccine (OR = 33.35, 95% CI: 18.58–59.85), history of cancer (OR = 2.35, 95% CI: 1.09–5.06), bDMARD use (OR = 1.85, 95% CI: 1.29–2.65), seropositivity (OR = 1.47, 95% CI: 1.05–2.05), and high disease activity (DAS28-ESR, OR = 1.33, 95% CI: 1.17–1.51). Male sex (OR = 0.65, 95% CI: 0.43–0.99) was a negative predictor for pneumococcal vaccination during follow-up.DiscussionDespite increasing rates of pneumococcal vaccine coverage, 40% of RA patients remain unvaccinated. Severe disease, bDMARD use, comorbidities, and more importantly flu vaccination were the most significant factors associated with pneumococcal vaccination, emphasizing the currently unmet need for cultivating a “vaccination culture” in RA patients.
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- 2023
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8. Clinical response trajectories and drug persistence in systemic lupus erythematosus patients on belimumab treatment: A real-life, multicentre observational study
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Myrto Nikoloudaki, Dionysis Nikolopoulos, Sofia Koutsoviti, Irini Flouri, Noemin Kapsala, Argyro Repa, Pelagia Katsimbri, Evangelos Theotikos, Sofia Pitsigavdaki, Katerina Pateromichelaki, Antonios Bertsias, Antonia Elezoglou, Prodromos Sidiropoulos, Antonis Fanouriakis, Dimitrios Boumpas, and George Bertsias
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lupus ,low disease activity ,remission ,flares ,organ damage ,biologics ,Immunologic diseases. Allergy ,RC581-607 - Abstract
ObjectiveTo obtain real-world data on outcomes of belimumab treatment and respective prognostic factors in patients with systemic lupus erythematosus (SLE).MethodsObservational study of 188 active SLE patients (median disease duration 6.2 years, two previous immunosuppressive/biological agents) treated with belimumab, who were monitored for SLEDAI-2K, Physician Global Assessment (PGA), LLDAS (lupus low disease activity state), remission (DORIS/Padua definitions), SELENA-SLEDAI Flare Index, SLICC/ACR damage index and treatment discontinuations. Group-based disease activity trajectories were modelled followed by multinomial regression for predictive variables. Drug survival was analysed by Cox-regression.ResultsAt 6, 12 and 24 months, LLDAS was attained by 36.2%, 36.7% and 33.5%, DORIS-remission by 12.3%, 11.6% and 17.8%, and Padua-remission by 21.3%, 17.9% and 29.0%, respectively (attrition-corrected). Trajectory analysis of activity indices classified patients into complete (25.5%), partial (42.0%) and non-responder (32.4%) groups, which were predicted by baseline PGA, inflammatory rash, leukopenia and prior use of mycophenolate. During median follow-up of 15 months, efficacy-related discontinuations occurred in 31.4% of the cohort, especially in patients with higher baseline PGA (hazard ratio [HR] 2.78 per 1-unit; 95% CI 1.32-5.85). Conversely, PGA improvement at 3 months predicted longer drug retention (HR 0.57; 95% CI 0.33-0.97). Use of hydroxychloroquine was associated with lower risk for safety-related drug discontinuation (HR 0.33; 95% CI 0.13-0.85). Although severe flares were reduced, flares were not uncommon (58.0%) and contributed to treatment stops (odds ratio [OR] 1.73 per major flare; 95% CI 1.09-2.75) and damage accrual (OR 1.83 per mild/moderate flare; 95% CI 1.15-2.93).ConclusionsIn a real-life setting with predominant long-standing SLE, belimumab was effective in the majority of patients, facilitating the achievement of therapeutic targets. Monitoring PGA helps to identify patients who will likely benefit and stay on the treatment. Vigilance is required for the prevention and management of flares while on belimumab.
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- 2023
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9. Serious infections in ANCA-associated vasculitides in the biologic era: real-life data from a multicenter cohort of 162 patients
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Konstantinos Thomas, Evangelia Argyriou, Noemin Kapsala, Alexandros Panagiotopoulos, Aglaia Chalkia, Emilia Hadziyannis, Kyriaki Boki, Pelagia Katsimbri, Dimitrios T. Boumpas, Panagiota Giannou, Dimitrios Petras, and Dimitrios Vassilopoulos
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ANCA vasculitis ,Infections ,Rituximab ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Serious infections (SI) are common in patients with ANCA-associated vasculitides (AAV) like granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). Real-life data regarding their incidence and predisposing factors—after the introduction of B cell depleting agents—are limited while data quantifying the risk per treatment modality and year of the disease are missing. Here, we aim to describe in details the incidence and the risk factors for SI in a contemporary AAV cohort. Methods Multicenter, observational, retrospective study of AAV patients followed in three tertiary referral centers. Results We included 162 patients with GPA (63%) and MPA (37%), males 51.9%, mean age 60.9 years, ΑΝCA+ 86%, and generalized disease 80%. During follow-up (891.2 patient-years, mean 5.4 years), 67 SI were recorded in 50 patients at an incidence rate of 7.5 per 100 patient-years. The SI incidence rate was higher during induction with cyclophosphamide (CYC) compared to rituximab (RTX, 19.3 vs. 11.3 per 100 patient-years, respectively) while it was lower and comparable between RTX and other regimens (5.52 vs. 4.54 per 100 patient-years, respectively) in the maintenance phase. By multivariate analysis, plasmapheresis (PLEX) and/or dialysis was a strong predictor for an SI during the 1st year after diagnosis (OR = 3.16, 95% CI 1.001–9.96) and throughout the follow-up period (OR = 5.21, 95% CI 1.93–14.07). In contrast, a higher baseline BVAS (OR = 1.11, 95% CI 1.01–1.21) was associated with SI only during the 1st year. Conclusions In this real-life study of patients with AAV, the SI incidence was higher during CYC compared to RTX induction while there was no difference between RTX and other agents used for maintenance therapy. Higher disease activity at baseline and need for PLEX and/or dialysis were independent factors associated with an SI.
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- 2021
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10. The association of bullous pemphigoid with dipeptidyl-peptidase 4 inhibitors: a ten-year prospective observational study
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Vaia Lambadiari, Aikaterini Kountouri, Foteini Kousathana, Emmanouil Korakas, Georgios Kokkalis, Sofia Theotokoglou, Lina Palaiodimou, Pelagia Katsimbri, Ignatios Ikonomidis, Konstantinos Theodoropoulos, and Evangelia Papadavid
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Bullous pemphigoid ,Dipeptidyl-peptidase 4 inhibitors ,Vildagliptin ,Gliptins ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Abstract Background Bullous pemphigoid is the most common bullous chronic autoimmune skin disease. Recent studies have suggested dipeptidyl-peptidase 4 inhibitors as possible predisposing agents of bullous pemphigoid. The objective of our study was to prospectively estimate the association between gliptins and the development of bullous pemphigoid. Methods We conducted a prospective study which included all patients diagnosed with biopsy-proven bullous pemphigoid in the Dermatology Department of our hospital between April 1, 2009 and December 31,2019. The diagnosis of bullous pemphigoid was based on specific clinical, histological and immunological features. Results Overall 113 consecutive patients (age 75 ± 13 years, 62 females) with the diagnosis of bullous pemphigoid were enrolled. Seventy-six patients (67.3%) suffered from type 2 Diabetes and 52 (46%) were treated with dipeptidyl-peptidase 4 inhibitors. The most frequent prescribed gliptin was vildagliptin, being administered to 45 cases (39.8% of total patients enrolled, 86.5% of the patients treated with gliptins). Gliptins were withdrawn immediately after the diagnosis of bullous pemphigoid, which together with steroid administration led to remission of the rash. Conclusions This study revealed that treatment with dipeptidyl-peptidase 4 inhibitors, especially vildagliptin, is significantly associated with an increased risk of bullous pemphigoid development.
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- 2021
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11. Retrospective analysis of bevacizumab-induced arthralgia and clinical outcomes in ovarian cancer patients. Single center experience
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Maria Kaparelou, Michalis Liontos, Pelagia Katsimbri, Aggeliki Andrikopoulou, Alikistis Papatheodoridi, Anastasios Kyriazoglou, Aristotelis Bamias, Flora Zagouri, and Meletios Athanasios Dimopoulos
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Bevacizumab ,Arthralgia ,Ovarian cancer ,Vascular endothelial growth factor ,Targeted therapy ,Joint manifestation ,Gynecology and obstetrics ,RG1-991 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Joint manifestations are ill-defined adverse events that were frequently reported of bevacizumab in ovarian cancer patients. The aim of this study is to describe the incidence and severity of joint manifestations among bevacizumab treated patients as well as their relation to clinical outcomes. Methods: Medical charts of all ovarian cancer patients that received bevacizumab from 2012 through 2017 were reviewed. Joint manifestations were staged. Kaplan-Meier Survival curves were generated; survival differences were estimated. Results: 76 Patients diagnosed with stage III or IV ovarian cancer were included. 23 patients (30.3%) developed joint manifestations, 12 of them had Grade I, 4 Grade II and 7 Grade III. Only 3 patients developed arthritis. In 8 cases (34.8%) one joint was affected and in the remaining 15, multiple sites. Median number of bevacizumab cycles to arthralgia development was 7. 3 patients were managed with corticosteroids or methotrexate, all had grade 3 AEs. The remaining received common analgesics. Median duration of the AE was 4.8 months. 7 patients discontinued bevacizumab due to AE. In all but 3 patients AE was finally resolved. Median number of bevacizumab cycles received, frequency of treatment completion or treatment discontinuation due to disease progression did not differ significantly among patients that developed joint manifestations or not. Median PFS and median OS did not differ statistical significantly. Conclusion: Joint manifestations are common AEs in bevacizumab treated ovarian cancer patients and led to treatment discontinuation in 9% of the patients. However, this has not adversely affected the clinical outcome of the patients. Further research is needed for the appropriate management of these patients.
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- 2022
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12. Longitudinal myocardial deformation and its improvement after treatment has an additive prognostic value to SCORE2 in psoriasis: a 4-year follow-up study
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Ikonomidis, I, primary, Makavos, G, additional, Lambadiari, V, additional, Koliou, G A, additional, Pavlidis, G, additional, Thymis, J, additional, Rafouli-Stergiou, P, additional, Kostelli, G, additional, Katogiannis, K, additional, Kountouri, A, additional, Lazarou, V, additional, Theodoropoulos, K, additional, Frogoudaki, A, additional, Katsimbri, P, additional, and Papadavid, E, additional
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- 2023
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13. Serious infections in ANCA-associated vasculitides in the biologic era: real-life data from a multicenter cohort of 162 patients
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Thomas, Konstantinos, Argyriou, Evangelia, Kapsala, Noemin, Panagiotopoulos, Alexandros, Chalkia, Aglaia, Hadziyannis, Emilia, Boki, Kyriaki, Katsimbri, Pelagia, Boumpas, Dimitrios T., Giannou, Panagiota, Petras, Dimitrios, and Vassilopoulos, Dimitrios
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- 2021
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14. The association of bullous pemphigoid with dipeptidyl-peptidase 4 inhibitors: a ten-year prospective observational study
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Lambadiari, Vaia, Kountouri, Aikaterini, Kousathana, Foteini, Korakas, Emmanouil, Kokkalis, Georgios, Theotokoglou, Sofia, Palaiodimou, Lina, Katsimbri, Pelagia, Ikonomidis, Ignatios, Theodoropoulos, Konstantinos, and Papadavid, Evangelia
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- 2021
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15. Transition to severe phenotype in systemic lupus erythematosus initially presenting with non-severe disease: implications for the management of early disease
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Myrto Kostopoulou, Aggelos Banos, Sofia Flouda, Pelagia Katsimbri, John Boletis, Dionysis S Nikolopoulos, Antigoni Pieta, and Katerina Chavatza
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Immunologic diseases. Allergy ,RC581-607 - Abstract
Objective Changes in the care of patients with SLE dictate a re-evaluation of its natural history and risk factors for disease deterioration and damage accrual. We sought to decipher factors predictive of a deterioration in phenotype (‘transition’) in patients initially presenting with non-severe disease.Methods Patients from the ‘Attikon’ cohort with disease duration ≥1 year were included. Disease at diagnosis was categorised as mild, moderate or severe, based on the British Isles Lupus Assessment Group manifestations and physician judgement. ‘Transition’ in severity was defined as an increase in category of severity at any time from diagnosis to last follow-up. Multivariable logistic regression was performed to identify baseline factors associated with this transition.Results 462 patients were followed for a median (IQR) of 36 (120) months. At diagnosis, more than half (56.5%) had a mild phenotype. During disease course, transition to more severe forms was seen in 44.2%, resulting in comparable distribution among severity patterns at last follow-up (mild 28.4%, moderate 33.1%, severe 38.5%). Neuropsychiatric involvement at onset (OR 6.33, 95% CI 1.22 to 32.67), male sex (OR 4.53, 95% CI 1.23 to 16.60) and longer disease duration (OR 1.09 per 1 year, 95% CI 1.04 to 1.14) were independently associated with transition from mild or moderate to severe disease. Patients with disease duration ≥3 years who progressed to more severe disease had more than 20-fold increased risk to accrue irreversible damage.Conclusion Almost half of patients with initially non-severe disease progress to more severe forms of SLE, especially men and patients with positive anti-double-stranded DNA or neuropsychiatric involvement at onset. These data may have implications for the management of milder forms of lupus.
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- 2020
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16. Correction: Disease duration, age at diagnosis and organ damage are important factors for cardiovascular disease in SLE
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Myrto Kostopoulou, Aggelos Banos, Sofia Flouda, Pelagia Katsimbri, John Boletis, Dionysis S Nikolopoulos, Antigoni Pieta, and Katerina Chavatza
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Immunologic diseases. Allergy ,RC581-607 - Published
- 2020
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17. Differential effects of inhibition of interleukin 1 and 6 on myocardial, coronary and vascular function
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Ikonomidis, Ignatios, Pavlidis, George, Katsimbri, Pelagia, Andreadou, Ioanna, Triantafyllidi, Helen, Tsoumani, Maria, Varoudi, Maria, Vlastos, Dimitrios, Makavos, George, Kostelli, Gavriella, Βenas, Dimitrios, Lekakis, John, Parissis, John, Boumpas, Dimitrios, Alexopoulos, Dimitrios, and Iliodromitis, Efstathios
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- 2019
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18. Treatment patterns and achievement of the treat-to-target goals in a real-life rheumatoid arthritis patient cohort: data from 1317 patients
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Konstantinos Thomas, Argiro Lazarini, Evripidis Kaltsonoudis, Alexandros Drosos, Ioannis Papalopoulos, Prodromos Sidiropoulos, Panagiota Tsatsani, Sousana Gazi, Lina Pantazi, Kyriaki A. Boki, Pelagia Katsimbri, Dimitrios Boumpas, Kalliopi Fragkiadaki, Maria Tektonidou, Petros P. Sfikakis, Konstantina Karagianni, Lazaros I. Sakkas, Eleftheria P. Grika, Panagiotis G. Vlachoyiannopoulos, Gerasimos Evangelatos, Alexios Iliopoulos, Theodoros Dimitroulas, Alexandros Garyfallos, Konstantinos Melissaropoulos, Panagiotis Georgiou, Maria Areti, Constantinos Georganas, Periklis Vounotrypidis, George D. Kitas, and Dimitrios Vassilopoulos
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Diseases of the musculoskeletal system ,RC925-935 - Abstract
Background: Data regarding the real-life predictors of low disease activity (LDA) in rheumatoid arthritis (RA) patients are limited. Our aim was to evaluate the rate and predictors of LDA and treatment patterns in RA. Methods: This was a multicenter, prospective, RA cohort study where patients were evaluated in two different time points approximately 12 months apart. Statistical analysis was performed in order to identify predictors of LDA while patterns of disease-modifying anti-rheumatic drug [DMARDs; conventional synthetic (csDMARD) or biologic (bDMARD)] and glucocorticoid (GC) use were also recorded. Results: The total number of patients included was 1317 (79% females, mean age: 62.9 years, mean disease duration: 10.3 years). After 1 year, 57% had achieved LDA (DAS28ESR3.2), 21% initiated (among csDMARDs users) and 22% switched (among bDMARDs users) their bDMARDs. Conclusion: In a real-life RA cohort, during 1 year of follow-up, 43% of patients do not reach treatment targets while only ~20% of those with active RA started or switched their bDMARDs. Male sex, younger age, lower HAQ, body mass index and co-morbidity index were independent factors associated with LDA while use of GCs or ⩾2 bDMARDs were negative predictors.
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- 2020
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19. Real Life Efficacy and Safety of Secukinumab in Biologic-Experienced Patients With Psoriatic Arthritis
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Kalliopi Klavdianou, Argyro Lazarini, Alexandros Grivas, Dimitrios Tseronis, Christina Tsalapaki, Panagiota Rapsomaniki, Katerina Antonatou, Konstantinos Thomas, Dimitrios Boumpas, Pelagia Katsimbri, and Dimitrios Vassilopoulos
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psoriatic arthritis ,secukinumab ,tumor necrosis factor inhibitors ,biologic agents ,real world evidence ,ustekinumab ,Medicine (General) ,R5-920 - Abstract
Background: Real world evidence data regarding secukinumab (SEC) use in biologic-experienced patients with psoriatic arthritis (PsA) are scarce.Objectives: To assess the real life survival, safety and efficacy of SEC in biologic-experienced patients with PsA.Methods: All biologic-experienced PsA patients treated with SEC in 2 University Rheumatology Units were included (3/2016-12/2018). Patients' and disease characteristics were recorded at baseline and during SEC therapy.Results: 75 patients were included; 76% were females with a mean age of 53.9 years, median disease duration of 6.7 years and median SEC treatment duration of 11.1 months. At baseline, 97% had peripheral arthritis, 42% axial involvement, 22% enthesitis, and 12% dactylitis. Regarding previous biologic exposure, 48 (64%) had been exposed to anti-tumor necrosis factor (TNF) agents only, 5 (7%) to the interleukin (IL)-12/23 inhibitor (Ustekinumab-UST) only while 22 (29%) both to anti-TNFs and UST. Fifty-three percent received SEC in combination with non-biologics and 35% with glucocorticoids, respectively. During follow-up, statistically significant improvement in different disease activity indices were noted (DAS28-CRP, DAPSA, BASDAI). SEC survival rate at the end of follow-up was 64% (48/75), without difference between patients exposed to anti-TNFs only (67%) vs. anti-TNFs and UST (68%) as well as to 1 vs. ≥2 anti-TNFs. The rate of serious adverse events and serious infections during follow-up was 4.8 and 1.2/100 patient-years, respectively.Discussion: In real life, in biologic-experienced patients with PsA, SEC displayed a high retention rate, regardless of the type, and number of previous biologics (anti-TNFs ± anti-IL12/23), without significant side effects.
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- 2020
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20. Apremilast Improves Endothelial Glycocalyx Integrity, Vascular and Left Ventricular Myocardial Function in Psoriasis
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Ignatios Ikonomidis, George Pavlidis, Nikolaos Kadoglou, George Makavos, Konstantinos Katogiannis, Aikaterini Kountouri, John Thymis, Gavriella Kostelli, Irini Kapniari, Konstantinos Theodoropoulos, John Parissis, Pelagia Katsimbri, Evangelia Papadavid, and Vaia Lambadiari
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psoriasis ,phosphodiesterase 4 ,apremilast ,endothelial glycocalyx ,perfused boundary region ,myocardial deformation ,Medicine ,Pharmacy and materia medica ,RS1-441 - Abstract
The phosphodiesterase 4 inhibitor apremilast is used for the treatment of psoriasis. We investigated the effects of apremilast on endothelial glycocalyx, vascular and left ventricular (LV) myocardial function in psoriasis. One hundred and fifty psoriatic patients were randomized to apremilast (n = 50), anti-tumor necrosis factor-α (etanercept; n = 50), or cyclosporine (n = 50). At baseline and 4 months post-treatment, we measured: (1) Perfused boundary region (PBR), a marker of glycocalyx integrity, in sublingual microvessels with diameter 5–25 μm using a Sidestream Dark Field camera (GlycoCheck). Increased PBR indicates damaged glycocalyx. Functional microvascular density, an index of microvascular perfusion, was also measured. (2) Pulse wave velocity (PWV-Complior) and (3) LV global longitudinal strain (GLS) using speckle-tracking echocardiography. Compared with baseline, PBR5–25 μm decreased only after apremilast (−12% at 4 months, p < 0.05) whereas no significant changes in PBR5–25 μm were observed after etanercept or cyclosporine treatment. Compared with etanercept and cyclosporine, apremilast resulted in a greater increase of functional microvascular density (+14% versus +1% versus −1%) and in a higher reduction of PWV. Apremilast showed a greater increase of GLS (+13.5% versus +7% versus +2%) than etanercept and cyclosporine (p < 0.05). In conclusion, apremilast restores glycocalyx integrity and confers a greater improvement of vascular and myocardial function compared with etanercept or cyclosporine after 4 months.
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- 2022
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21. AB0625 THE ATTRIBUTION OF NEUROPSYCHIATRIC EVENTS IN SYSTEMIC LUPUS ERYTHEMATOSUS: DATA FROM “ATTIKON” LUPUS COHORT
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Nikolopoulos, D., primary, Kapsala, N., additional, Gioti, O., additional, Flouda, S., additional, Pieta, A., additional, Chavatza, K., additional, Karageorgas, T., additional, Tseronis, D., additional, Katsimbri, P., additional, Boumpas, D., additional, and Fanouriakis, A., additional
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- 2023
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22. Proceedings of the 24th Paediatric Rheumatology European Society Congress: Part three
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Erato Atsali, Dimitra Kassara, Pelagia Katsimbri, Sorina Boiu, Dimitrios T. Boumpas, Vana Papaevangelou, Olena A. Oshlyanska, Ludmila I. Omelchenko, Tatiana A. Ljudvik, Katerina Bouchalova, Marcel Schüller, Jana Franova, Jarmila Skotakova, Marie Macku, Antoni Fellas, Fiona Hawke, Derek Santos, Andrea Coda, Anthi Kelempisioti, Paula Keskitalo, Virpi Glumoff, Petri Kulmala, Paula Vahasalo, Mohammed A. Mozaffar, Asraa K. Turkistani, Samaa O. Sangoof, Vladislav Sevostyanov, Elena Zholobova, Evangelia Bountouvi, konstantinos Theodoropoulos, Renata Moutsiou, Christina Tsalapaki, Talia Diaz, Sofia Osorio, Maria Teresa Braña, Yuridiana Ramirez, Luis Aparicio, Andres Rodriguez, Enrique Faugier, Rocio Maldonado, Maria Francesca Gicchino, Carmela Granato, Giulia Macchini, Daniela Capalbo, Alma Nunzia Olivieri, Nathan Hasson, Achille Marino, Sona Narula, Melissa Lerman, Maria Amelia Muñoz Calonge, Sara Maria Murias Loza, Rosa Maria Alcobendas, Agustin Remesal, Esmeralda Núñez-Cuadros, Rocio Galindo Zavala, Gisela Díaz-Cordovés Rego, Cristina Antúnez Fernández, Yaiza García Molina, Antonio L. Urda Cardona, Nihal Sahin, Habibe S. Durmus, Ayse S. Pinarbasi, Zubeyde Gunduz, Muammer H. Poyrazoglu, Zehra F. Karaman, Turhan Oktem, Mithat Oner, Ruhan Dusunsel, Gordana Susic, Tamara Krstajic, Dragana Vujovic, Nedeljko Radlovic, Zoran Lekovic, Dusica Novakovic, Gordana Milosevski Lomic, Karina Mördrup, Gunilla Hesselstrand, Iva Sorić, Lovro Lamot, Mandica Vidovic, Mirta Lamot, Miroslav Harjacek, Eva Adank, Elvira Cannizzaro Schneider, Eiman Abdalla, Irfan Ullah, L. Jeyaseelan, Reem Abdwani, Laila A. L. Shaqsi, Ibrahim A. l. Zakwani, Antonis Fanouriakis, Mahesh Janarthanan, Dhanarathnamoorthy Vetrichelvan, P. Ramachandran, Sangeetha Geminiganesan, Dinesh Kumar, Subba Rao, Eleni-Maria Papatesta, Despoina Maritsi, Irini Eleftheriou, Maria Tsolia, Olga Vougiouka, Mustafa Çakan, Nuray Aktay Ayaz, Şerife Gül Karadağ, Gonca Keskindemirci, Vladimir Keltsev, Lyudmila Grebenkina, Kwang Nam Kim, Jong Gyun Ahn, Young Dae Kim, Maria Cristina Maggio, Rolando Cimaz, Maria Concetta Failla, Piera Dones, Mirella Collura, Giovanni Corsello, Jung-Woo Rhim, Ki-Hwan Kim, Soo-Young Lee, Seung-Beom Han, Jin-Han Kang, Jae-Hee Chung, Soo-Jung Lee, Dae-Chul Jeong, Andrei Santimov, Regina Rupp, Igor Alekseev, Natalya Plutova, Ekaterina Moskvina, Marina Kruchina, Aleksandra Tarasenko, Natalya Sokolova, Ekaterina Saveleva, Ilia Bogdanov, Dmitrii Ivanov, Tatiana Kandrina, Olga Kopanevich, Anastasiia Grafskaia, Natalia Ignateva, Daria Pulukchu, Natalia Pavlova, Olga Kalashnikova, Tatiana Kornishina, Margarita Dubko, Vyacheslav Chasnyk, Mikhail Kostik, Shama Sowdagar, Janani Sankar, Venkateswari Ramesh, Iulia E. Szabo, Claudia Sirbe, Cristina Pamfil, Laura Damian, Simona Rednic, Maria Deac, Mihaela Sparchez, Ileana Filipescu, Mirela Parvu, Dumitrita Balint, and Ancuta Nicoara
- Subjects
Pediatrics ,RJ1-570 ,Diseases of the musculoskeletal system ,RC925-935 - Published
- 2017
- Full Text
- View/download PDF
23. The Effect of Antioxidant and Anti-Inflammatory Capacity of Diet on Psoriasis and Psoriatic Arthritis Phenotype: Nutrition as Therapeutic Tool?
- Author
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Pelagia Katsimbri, Emmanouil Korakas, Aikaterini Kountouri, Ignatios Ikonomidis, Elias Tsougos, Dionysios Vlachos, Evangelia Papadavid, Athanasios Raptis, and Vaia Lambadiari
- Subjects
inflammation ,immunity ,nutrients ,antioxidants ,diet ,obesity ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Chronic inflammation and increased oxidative stress are contributing factors to many non-communicable diseases. A growing body of evidence indicates that dietary nutrients can activate the immune system and may lead to the overproduction of pro-inflammatory cytokines. Fatty acids as macronutrients are key players for immunomodulation, with n-3 polyunsaturated fatty acids having the most beneficial effect, while polyphenols and carotenoids seem to be the most promising antioxidants. Psoriasis is a chronic, immune-mediated inflammatory disease with multifactorial etiology. Obesity is a major risk factor for psoriasis, which leads to worse clinical outcomes. Weight loss interventions and, generally, dietary regimens such as gluten-free and Mediterranean diet or supplement use may potentially improve psoriasis’ natural course and response to therapy. However, data about more sophisticated nutritional patterns, such as ketogenic, very low-carb or specific macro- and micro-nutrient substitution, are scarce. This review aims to present the effect of strictly structured dietary nutrients, that are known to affect glucose/lipid metabolism and insulin responses, on chronic inflammation and immunity, and to discuss the utility of nutritional regimens as possible therapeutic tools for psoriasis and psoriatic arthritis.
- Published
- 2021
- Full Text
- View/download PDF
24. Differences in coronary flow reserve and flow-mediated dilation between plaque psoriasis and psoriatic arthritis
- Author
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Ikonomidis, I, primary, Pavlidis, G, additional, Katogiannis, K, additional, Kapniari, I, additional, Theodoropoulos, K, additional, Kountouri, A, additional, Kostelli, G, additional, Tsilivarakis, D, additional, Thymis, J, additional, Katsimbri, P, additional, Parissis, J, additional, Filippatos, G, additional, Lambadiari, V, additional, and Papadavid, E, additional
- Published
- 2022
- Full Text
- View/download PDF
25. Biologics improve endothelial, vascular and left ventricular myocardial function in patients with psoriatic arthritis
- Author
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Ikonomidis, I, primary, Pavlidis, G, additional, Katogiannis, K, additional, Kapniari, I, additional, Theodoropoulos, K, additional, Kountouri, A, additional, Kostelli, G, additional, Tsilivarakis, D, additional, Thymis, J, additional, Katsimbri, P, additional, Parissis, J, additional, Filippatos, G, additional, Lambadiari, V, additional, and Papadavid, E, additional
- Published
- 2022
- Full Text
- View/download PDF
26. The biology of normal bone remodelling
- Author
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Katsimbri, P.
- Published
- 2017
- Full Text
- View/download PDF
27. Spinal and Pelvic MDCT using “iDose5” Iterative Reconstruction Algorithm in Patients with Psoriatic Spondyloarthritis: Diagnostic Capabilities and Image Quality in Relation to Radiation Exposure
- Author
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Bizimi, V., additional, Plousi, A., additional, Tseronis, D., additional, Katsimbri, P., additional, Sideri, N.S., additional, Efstathopoulos, E., additional, Boumpas, D., additional, Papakonstantinou, O., additional, and Kelekis, N., additional
- Published
- 2022
- Full Text
- View/download PDF
28. No association of psoriasis with autoimmune thyroiditis
- Author
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Vassilatou, E., Papadavid, E., Papastamatakis, P., Alexakos, D., Koumaki, D., Katsimbri, P., Hadjidakis, D., Dimitriadis, G., and Rigopoulos, D.
- Published
- 2017
- Full Text
- View/download PDF
29. Retrospective analysis of bevacizumab-induced arthralgia and clinical outcomes in ovarian cancer patients. Single center experience
- Author
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Kaparelou, M. Liontos, M. Katsimbri, P. Andrikopoulou, A. Papatheodoridi, A. Kyriazoglou, A. Bamias, A. Zagouri, F. Dimopoulos, M.A.
- Abstract
Background: Joint manifestations are ill-defined adverse events that were frequently reported of bevacizumab in ovarian cancer patients. The aim of this study is to describe the incidence and severity of joint manifestations among bevacizumab treated patients as well as their relation to clinical outcomes. Methods: Medical charts of all ovarian cancer patients that received bevacizumab from 2012 through 2017 were reviewed. Joint manifestations were staged. Kaplan-Meier Survival curves were generated; survival differences were estimated. Results: 76 Patients diagnosed with stage III or IV ovarian cancer were included. 23 patients (30.3%) developed joint manifestations, 12 of them had Grade I, 4 Grade II and 7 Grade III. Only 3 patients developed arthritis. In 8 cases (34.8%) one joint was affected and in the remaining 15, multiple sites. Median number of bevacizumab cycles to arthralgia development was 7. 3 patients were managed with corticosteroids or methotrexate, all had grade 3 AEs. The remaining received common analgesics. Median duration of the AE was 4.8 months. 7 patients discontinued bevacizumab due to AE. In all but 3 patients AE was finally resolved. Median number of bevacizumab cycles received, frequency of treatment completion or treatment discontinuation due to disease progression did not differ significantly among patients that developed joint manifestations or not. Median PFS and median OS did not differ statistical significantly. Conclusion: Joint manifestations are common AEs in bevacizumab treated ovarian cancer patients and led to treatment discontinuation in 9% of the patients. However, this has not adversely affected the clinical outcome of the patients. Further research is needed for the appropriate management of these patients. © 2022 The Author(s)
- Published
- 2022
30. First Diagnosis of Systemic Lupus Erythematosus in Hospitalized Patients: Clinical Phenotypes and Pitfalls for the Non-Specialist
- Author
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Kapsala, N. Nikolopoulos, D. Flouda, S. Chavatza, A. Tseronis, D. Aggelakos, M. Katsimbri, P. Bertsias, G. Fanouriakis, A. Boumpas, D.T.
- Abstract
Background: Prompt recognition of systemic lupus erythematosus (SLE) in hospitalized patients presenting with severe disease is essential to initiate treatment. We sought to characterize the phenotype of hospitalized patients with new-onset SLE and estimate potential diagnostic delays. Methods: An observational study of 855 patients (“Attikon” SLE cohort). Clinical phenotype was categorized according to the leading manifestation that led to hospitalization. Disease features, time to diagnosis, classification criteria, and the SLE Risk Probability Index (SLERPI) were recorded for each patient. Results: There were 191 patients (22.3% of the total cohort) hospitalized due to manifestations eventually attributed to SLE. Main causes of admission were neuropsychiatric syndromes (21.4%), cytopenias (17.8%), nephritis (17.2%), and thrombotic events (16.2%). Although 79.5% of patients were diagnosed within 3 months from hospitalization, in 39 patients diagnosis was delayed, particularly in those with hematological manifestations. At hospitalization, a SLERPI >7 (indicating high probability for SLE) was found in 87.4% of patients. Patients missed by the SLERPI had fever, thrombotic or neuropsychiatric manifestations not included in the algorithm. Lowering the SLERPI threshold to 5 in patients with fever or thrombotic events increased the diagnostic rate from 88.8% to 97.9% in this subgroup, while inclusion of all neuropsychiatric events yielded no additional diagnostic value. Conclusion: One in five patients with new-onset SLE manifest disease presentations required hospitalization. Although early diagnosis was achieved in the majority of cases, in approximately 20%, diagnosis was delayed. A lower SLERPI cut-off (≥5) in patients with fever or thrombosis could enhance early diagnosis. © 2021
- Published
- 2022
31. Apremilast Improves Endothelial Glycocalyx Integrity, Vascular and Left Ventricular Myocardial Function in Psoriasis
- Author
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Ikonomidis, I. Pavlidis, G. Kadoglou, N. Makavos, G. Katogiannis, K. Kountouri, A. Thymis, J. Kostelli, G. Kapniari, I. Theodoropoulos, K. Parissis, J. Katsimbri, P. Papadavid, E. Lambadiari, V.
- Abstract
The phosphodiesterase 4 inhibitor apremilast is used for the treatment of psoriasis. We investigated the effects of apremilast on endothelial glycocalyx, vascular and left ventricular (LV) myocardial function in psoriasis. One hundred and fifty psoriatic patients were randomized to apremilast (n = 50), anti-tumor necrosis factor-α (etanercept; n = 50), or cyclosporine (n = 50). At baseline and 4 months post-treatment, we measured: (1) Perfused boundary region (PBR), a marker of glycocalyx integrity, in sublingual microvessels with diameter 5–25 µm using a Sidestream Dark Field camera (GlycoCheck). Increased PBR indicates damaged glycocalyx. Functional microvascular density, an index of microvascular perfusion, was also measured. (2) Pulse wave velocity (PWV-Complior) and (3) LV global longitudinal strain (GLS) using speckle-tracking echocardiography. Compared with baseline, PBR5–25 µm decreased only after apremilast (−12% at 4 months, p < 0.05) whereas no significant changes in PBR5–25 µm were observed after etanercept or cyclosporine treatment. Compared with etanercept and cyclosporine, apremilast resulted in a greater increase of functional microvascular density (+14% versus +1% versus −1%) and in a higher reduction of PWV. Apremilast showed a greater increase of GLS (+13.5% versus +7% versus +2%) than etanercept and cyclosporine (p < 0.05). In conclusion, apremilast restores glycocalyx integrity and confers a greater improvement of vascular and myocardial function compared with etanercept or cyclosporine after 4 months. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- Published
- 2022
32. Dysphagia Caused by Chronic Laryngeal Edema
- Author
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Delides, Alexander, Sakagiannis, George, Maragoudakis, Pavlos, Gouloumi, Αlina-Roxani, Katsimbri, Pelagia, Giotakis, Ioannis, and Panayiotides, John G.
- Published
- 2015
- Full Text
- View/download PDF
33. Apremilast improves endothelial glycocalyx and microvascular perfusion: a possible protective mechanism against COVID-19
- Author
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Ikonomidis, I, primary, Pavlidis, G, additional, Thymis, J, additional, Rafouli-Stergiou, P, additional, Makavos, G, additional, Kostelli, G, additional, Katsimbri, P, additional, Lambadiari, V, additional, Parissis, J, additional, Kapniari, E, additional, Katogiannis, K, additional, Kountouri, A, additional, Korakas, E, additional, Theodoropoulos, K, additional, and Papadavid, E, additional
- Published
- 2021
- Full Text
- View/download PDF
34. Endothelial glycocalyx integrity and microvascular perfusion are associated with novel echocardiographic markers and carotid intima-media thickness in patients with psoriasis
- Author
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Ikonomidis, I, primary, Pavlidis, G, additional, Thymis, J, additional, Rafouli-Stergiou, P, additional, Makavos, G, additional, Kostelli, G, additional, Vrettou, A R, additional, Frogoudaki, A, additional, Katsimbri, P, additional, Lambadiari, V, additional, Parissis, J, additional, Iliodromitis, E, additional, Theodoropoulos, K, additional, Kapniari, E, additional, and Papadavid, E, additional
- Published
- 2021
- Full Text
- View/download PDF
35. The effect of antioxidant and anti-inflammatory capacity of diet on psoriasis and psoriatic arthritis phenotype: Nutrition as therapeutic tool?
- Author
-
Katsimbri, P. Korakas, E. Kountouri, A. Ikonomidis, I. Tsougos, E. Vlachos, D. Papadavid, E. Raptis, A. Lambadiari, V.
- Abstract
Chronic inflammation and increased oxidative stress are contributing factors to many non-communicable diseases. A growing body of evidence indicates that dietary nutrients can activate the immune system and may lead to the overproduction of pro-inflammatory cytokines. Fatty acids as macronutrients are key players for immunomodulation, with n-3 polyunsaturated fatty acids having the most beneficial effect, while polyphenols and carotenoids seem to be the most promising antioxidants. Psoriasis is a chronic, immune-mediated inflammatory disease with multifactorial etiology. Obesity is a major risk factor for psoriasis, which leads to worse clinical outcomes. Weight loss interventions and, generally, dietary regimens such as gluten-free and Mediterranean diet or supplement use may potentially improve psoriasis’ natural course and response to therapy. However, data about more sophisticated nutritional patterns, such as ketogenic, very low-carb or specific macro-and micro-nutrient substitution, are scarce. This review aims to present the effect of strictly structured dietary nutrients, that are known to affect glucose/lipid metabolism and insulin responses, on chronic inflammation and immunity, and to discuss the utility of nutritional regimens as possible therapeutic tools for psoriasis and psoriatic arthritis. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
- Published
- 2021
36. Incidence, risk factors and validation of the RABBIT score for serious infections in a cohort of 1557 patients with rheumatoid arthritis
- Author
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Thomas, K. Lazarini, A. Kaltsonoudis, E. Voulgari, P.V. Drosos, A.A. Repa, A. Sali, A.M.I. Sidiropoulos, P. Tsatsani, P. Gazi, S. Evangelia, A. Boki, K.A. Katsimbri, P. Boumpas, D. Fragkiadaki, K. Tektonidou, M.G. Sfikakis, P.P. Karagianni, K. Sakkas, L.I. Grika, E.P. Vlachoyiannopoulos, P.G. Evangelatos, G. Iliopoulos, A. Dimitroulas, T. Garyfallos, A. Melissaropoulos, K. Georgiou, P. Areti, M. Georganas, C. Vounotrypidis, P. Georgiopoulos, G. Kitas, G.D. Vassilopoulos, D.
- Abstract
Objectives: Predicting serious infections (SI) in patients with rheumatoid arthritis (RA) is crucial for the implementation of appropriate preventive measures. Here we aimed to identify risk factors for SI and to validate the RA Observation of Biologic Therapy (RABBIT) risk score in real-life settings. Methods: A multi-centre, prospective, RA cohort study in Greece. Demographics, disease characteristics, treatments and comorbidities were documented at first evaluation and one year later. The incidence of SI was recorded and compared with the expected SI rate using the RABBIT risk score. Results: A total of 1557 RA patients were included. During follow-up, 38 SI were recorded [incidence rate ratio (IRR): 2.3/100 patient-years]. Patients who developed SI had longer disease duration, higher HAQ at first evaluation and were more likely to have a history of previous SI, chronic lung disease, cardiovascular disease and chronic kidney disease. By multivariate analysis, longer disease duration (IRR: 1.05; 95% CI: 1.005, 1.1), history of previous SI (IRR: 4.15; 95% CI: 1.7, 10.1), diabetes (IRR: 2.55; 95% CI: 1.06, 6.14), chronic lung disease (IRR: 3.14; 95% CI: 1.35, 7.27) and daily prednisolone dose ≥10 mg (IRR: 4.77; 95% CI: 1.47, 15.5) were independent risk factors for SI. Using the RABBIT risk score in 1359 patients, the expected SI incidence rate was 1.71/100 patient-years, not different from the observed (1.91/100 patient-years; P = 0.97). Conclusion: In this large real-life, prospective study of RA patients, the incidence of SI was 2.3/100 patient-years. Longer disease duration, history of previous SI, comorbidities and high glucocorticoid dose were independently associated with SI. The RABBIT score accurately predicted SI in our cohort. © 2020 The Author(s). Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
- Published
- 2021
37. Serious infections in ANCA-associated vasculitides in the biologic era: real-life data from a multicenter cohort of 162 patients
- Author
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Thomas, K. Argyriou, E. Kapsala, N. Panagiotopoulos, A. Chalkia, A. Hadziyannis, E. Boki, K. Katsimbri, P. Boumpas, D.T. Giannou, P. Petras, D. Vassilopoulos, D.
- Abstract
Background: Serious infections (SI) are common in patients with ANCA-associated vasculitides (AAV) like granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). Real-life data regarding their incidence and predisposing factors—after the introduction of B cell depleting agents—are limited while data quantifying the risk per treatment modality and year of the disease are missing. Here, we aim to describe in details the incidence and the risk factors for SI in a contemporary AAV cohort. Methods: Multicenter, observational, retrospective study of AAV patients followed in three tertiary referral centers. Results: We included 162 patients with GPA (63%) and MPA (37%), males 51.9%, mean age 60.9 years, ΑΝCA+ 86%, and generalized disease 80%. During follow-up (891.2 patient-years, mean 5.4 years), 67 SI were recorded in 50 patients at an incidence rate of 7.5 per 100 patient-years. The SI incidence rate was higher during induction with cyclophosphamide (CYC) compared to rituximab (RTX, 19.3 vs. 11.3 per 100 patient-years, respectively) while it was lower and comparable between RTX and other regimens (5.52 vs. 4.54 per 100 patient-years, respectively) in the maintenance phase. By multivariate analysis, plasmapheresis (PLEX) and/or dialysis was a strong predictor for an SI during the 1st year after diagnosis (OR = 3.16, 95% CI 1.001–9.96) and throughout the follow-up period (OR = 5.21, 95% CI 1.93–14.07). In contrast, a higher baseline BVAS (OR = 1.11, 95% CI 1.01–1.21) was associated with SI only during the 1st year. Conclusions: In this real-life study of patients with AAV, the SI incidence was higher during CYC compared to RTX induction while there was no difference between RTX and other agents used for maintenance therapy. Higher disease activity at baseline and need for PLEX and/or dialysis were independent factors associated with an SI. © 2021, The Author(s).
- Published
- 2021
38. The association of bullous pemphigoid with dipeptidyl-peptidase 4 inhibitors: a ten-year prospective observational study
- Author
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Lambadiari, V. Kountouri, A. Kousathana, F. Korakas, E. Kokkalis, G. Theotokoglou, S. Palaiodimou, L. Katsimbri, P. Ikonomidis, I. Theodoropoulos, K. Papadavid, E.
- Subjects
integumentary system ,sense organs ,skin and connective tissue diseases ,eye diseases - Abstract
Background: Bullous pemphigoid is the most common bullous chronic autoimmune skin disease. Recent studies have suggested dipeptidyl-peptidase 4 inhibitors as possible predisposing agents of bullous pemphigoid. The objective of our study was to prospectively estimate the association between gliptins and the development of bullous pemphigoid. Methods: We conducted a prospective study which included all patients diagnosed with biopsy-proven bullous pemphigoid in the Dermatology Department of our hospital between April 1, 2009 and December 31,2019. The diagnosis of bullous pemphigoid was based on specific clinical, histological and immunological features. Results: Overall 113 consecutive patients (age 75 ± 13 years, 62 females) with the diagnosis of bullous pemphigoid were enrolled. Seventy-six patients (67.3%) suffered from type 2 Diabetes and 52 (46%) were treated with dipeptidyl-peptidase 4 inhibitors. The most frequent prescribed gliptin was vildagliptin, being administered to 45 cases (39.8% of total patients enrolled, 86.5% of the patients treated with gliptins). Gliptins were withdrawn immediately after the diagnosis of bullous pemphigoid, which together with steroid administration led to remission of the rash. Conclusions: This study revealed that treatment with dipeptidyl-peptidase 4 inhibitors, especially vildagliptin, is significantly associated with an increased risk of bullous pemphigoid development. © 2021, The Author(s).
- Published
- 2021
39. Comparable or higher prevalence of comorbidities in antiphospholipid syndrome vs rheumatoid arthritis: A multicenter, case-control study
- Author
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Panopoulos, S. Thomas, K. Georgiopoulos, G. Boumpas, D. Katsiari, C. Bertsias, G. Drosos, A.A. Boki, K. Dimitroulas, T. Garyfallos, A. Papagoras, C. Katsimbri, P. Tziortziotis, A. Adamichou, C. Kaltsonoudis, E. Argyriou, E. Vosvotekas, G. Sfikakis, P.P. Vassilopoulos, D. Tektonidou, M.G.
- Abstract
Objectives: Evidence on comorbidity prevalence in antiphospholipid syndrome (APS) and its difference from high comorbidity burden rheumatic diseases is limited. Herein, we compare multiple comorbidities between APS and RA. Methods: A total of 326 patients from the Greek APS registry [237 women, mean age 48.7 (13.4) years, 161 primary APS (PAPS), 165 SLE-APS] were age/sex matched (1:2 ratio) with 652 patients from a Greek multicentre RA cohort of 3115 patients. Prevalence of cardiovascular (CV) risk factors, stroke, coronary artery disease (CAD), osteoporosis, diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), depression and neoplasms were compared between APS and RA patients using multivariate regression analysis. Results: Hyperlipidemia and obesity (BMI ≥ 30 kg/m2) were comparable while hypertension, smoking, stroke and CAD were more prevalent in APS compared with RA patients. Osteoporosis and depression were more frequent in APS, while DM, COPD and neoplasms did not differ between the two groups. Comparison of APS subgroups to 1:2 matched RA patients revealed that smoking and stroke were more prevalent in both PAPS and SLE-APS vs RA. Hypertension, CAD and osteoporosis were more frequent only in SLE-APS vs RA, whereas DM was less prevalent in PAPS vs RA. Hyperlipidaemia was independently associated with CV events (combined stroke and CAD) in PAPS and SLE-APS, while CS duration was associated with osteoporosis in SLE-APS. Conclusion: Comorbidity burden in APS (PAPS and SLE-APS) is comparable or higher than that in RA, entailing a high level of diligence for CV risk prevention, awareness for depression and CS exposure minimization. © 2020 The Author(s). Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
- Published
- 2021
40. Severe eosinophilic granulomatosis with polyangiitis responding to a combination of rituximab and mepolizumab
- Author
-
Tsioulos, Georgios, Kounatidis, Dimitris, Vallianou, Natalia G., Koufopoulos, Nektarios, Katsimbri, Pelagia, and Antoniadou, Anastasia
- Abstract
Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss Syndrome, is a multisystem antineutrophil cytoplasmic antibody (ANCA) positive vasculitis, characterized by the presence of chronic rhinosinusitis, asthma and prominent peripheral blood eosinophilia. Although the most commonly involved organ is the lung, followed by the skin, EGPA can affect any organ system. Herein, we present the complicated case of an 18-year-old male patient with severe life-threatening EGPA, with central nervous system, cardiac and gasterointestinal involvement, which was resistant to initial treatment with glucocorticoids and cyclophosphamide. The patient responded well, achieving complete remission after the addition of rituximab and mepolizumab to glucocorticoids and cyclophosphamide.
- Published
- 2023
- Full Text
- View/download PDF
41. Effects of Interleukin 17A Inhibition on Myocardial Deformation and Vascular Function in Psoriasis
- Author
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Makavos, G. Ikonomidis, I. Andreadou, I. Varoudi, M. Kapniari, I. Loukeri, E. Theodoropoulos, K. Pavlidis, G. Triantafyllidi, H. Thymis, J. Parissis, J. Tsoumani, M. Rafouli-Stergiou, P. Katsimbri, P. Papadavid, E.
- Abstract
Background: Interleukin (IL)-17A activity is implicated in psoriasis. We investigated the effects of IL-17A inhibition on vascular and left ventricular (LV) function in patients with psoriasis. Methods: A total of 150 patients with psoriasis received either an anti-IL-17A agent (secukinumab, n = 50), cyclosporine (n = 50), or methotrexate treatment (n = 50). At baseline and after 4 and 12 months of treatment, we measured (1) LV global longitudinal strain (GLS), GLS rate (GLSR), GLSR at early diastole, LV twisting, and untwisting; (2) coronary flow reserve (CFR); (3) pulse wave velocity (PWV); and (4) malondialdehyde and protein carbonyl as markers of oxidative stress. Results: Compared with cyclosporine and methotrexate, anti-IL-17A treatment resulted in a greater increase in GLS at 4 and 12 months after treatment (10% and 14% with anti-IL-17A vs 2% and 2% with cyclosporine vs 4% and 4% with methotrexate, respectively), GLSR, GLSR at early diastole (45% and 41% vs 5% and 4% vs 7% and 9%, respectively), and LV twisting (32% and 28% vs 6% and 8% vs 7% and 6%, respectively) (P < 0.05). Anti-IL-17A treatment resulted in greater improvement of CFR and PWV than cyclosporine or methotrexate (P < 0.05). PWV increased after cyclosporine treatment (+11% at 4 and +14% and 12 months) (P < 0.05). Markers of oxidative stress were reduced only after anti-IL-17A treatment (P < 0.05). Changes of myocardial deformation markers and CFR after anti-IL-17A treatment correlated with a concomitant reduction of oxidative stress. Conclusions: In psoriasis, inhibition of IL-17A results in a greater improvement of vascular and myocardial function compared with cyclosporine or methotrexate treatment, indicating a beneficial effect on overall cardiovascular function. © 2019 Canadian Cardiovascular Society
- Published
- 2020
42. INCREASING RATES OF INFLUENZA VACCINATION COVERAGE IN RHEUMATOID ARTHRITIS PATIENTS: DATA FROM A MULTICENTER, LONGITUDINAL COHORT STUDY OF 1,406 PATIENTS
- Author
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Thomas, K. Lazarini, A. Kaltsonoudis, E. Drosos, A. and Repa, A. Sidiropoulos, P. Fragkiadaki, K. Tektonidou, M. and Sfikakis, P. Tsatsani, P. Gazi, S. Katsimbri, P. and Boumpas, D. Argyriou, E. Boki, K. Evangelatos, G. and Iliopoulos, A. Karagianni, K. Sakkas, L. Melissaropoulos, K. and Georgiou, P. Grika, E. Vlachoyiannopoulos, P. and Dimitroulas, T. Garyfallos, A. Georganas, C. Vounotrypidis, P. Ntelis, K. Areti, M. Kitas, G. D. Vassilopoulos, D.
- Published
- 2020
43. How does the joint dermatology–rheumatology clinic benefit both patients and dermatologists?
- Author
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Theodorakopoulou, E. Dalamaga, M. Katsimbri, P. Boumpas, D.T. Papadavid, E.
- Abstract
Psoriasis (Pso) and psoriatic arthritis (PsA) are chronic and debilitating diseases which often develop in the same patient and are linked to a wide range of comorbid conditions. Dermatologists and rheumatologists need to cooperate in combined clinics, especially when they deal with severe, recalcitrant disease, and multiple comorbidities. The clinical and research benefits of this collaboration have been previously described to contribute to a better and more sustainable health care system. To apply a more holistic approach of patients with Pso and PsA, we established the first dual care clinic in Greece, for Pso and PsA patients, based at Attikon General University Hospital. Hereby, we describe the infrastructure and operation of a combined Pso and PsA clinic (PPAC), in the national health care system of Greece, and its impact on the management of Pso and PsA. The PPAC is a single-day joint clinic, held once a week, which consists of three dermatologists and three rheumatologists. We present the results of 185 newly diagnosed patients between December 2018 and January 2019. Mean age of onset of Pso was 34 ± 16 years old and 47 ± 12 years old for PsA. Most patients suffered from severe plaque Pso (144/185, 78%) and asymmetric oligoarticular arthritis (59/185, 32%), for which they were receiving treatment with biologic agents (105/185, 57%). Many required monitoring for hypertension (74/185, 40%), dyslipidemia (69/185, 37%), diabetes (17/185, 9%), and depression (20/185, 11%). Patients reported high levels of care satisfaction (visual analogue scale: 86 ± 11.5), using the PPAC facility, compared to different referrals between specialties. This is the first joint dermatology–rheumatology clinic in Greece, providing comprehensive care in patients with Pso and PsA. Our results support the concept of combined clinics delivering better integrated care for such patients. © 2020 Wiley Periodicals LLC.
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- 2020
44. Treatment patterns and achievement of the treat-to-target goals in a real-life rheumatoid arthritis patient cohort: data from 1317 patients
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Thomas, K. Lazarini, A. Kaltsonoudis, E. Drosos, A. Papalopoulos, I. Sidiropoulos, P. Tsatsani, P. Gazi, S. Pantazi, L. Boki, K.A. Katsimbri, P. Boumpas, D. Fragkiadaki, K. Tektonidou, M. Sfikakis, P.P. Karagianni, K. Sakkas, L.I. Grika, E.P. Vlachoyiannopoulos, P.G. Evangelatos, G. Iliopoulos, A. Dimitroulas, T. Garyfallos, A. Melissaropoulos, K. Georgiou, P. Areti, M. Georganas, C. Vounotrypidis, P. Kitas, G.D. Vassilopoulos, D.
- Abstract
Background: Data regarding the real-life predictors of low disease activity (LDA) in rheumatoid arthritis (RA) patients are limited. Our aim was to evaluate the rate and predictors of LDA and treatment patterns in RA. Methods: This was a multicenter, prospective, RA cohort study where patients were evaluated in two different time points approximately 12 months apart. Statistical analysis was performed in order to identify predictors of LDA while patterns of disease-modifying anti-rheumatic drug [DMARDs; conventional synthetic (csDMARD) or biologic (bDMARD)] and glucocorticoid (GC) use were also recorded. Results: The total number of patients included was 1317 (79% females, mean age: 62.9 years, mean disease duration: 10.3 years). After 1 year, 57% had achieved LDA (DAS28ESR3.2), 21% initiated (among csDMARDs users) and 22% switched (among bDMARDs users) their bDMARDs. Conclusion: In a real-life RA cohort, during 1 year of follow-up, 43% of patients do not reach treatment targets while only ~20% of those with active RA started or switched their bDMARDs. Male sex, younger age, lower HAQ, body mass index and co-morbidity index were independent factors associated with LDA while use of GCs or ⩾2 bDMARDs were negative predictors. © The Author(s), 2020.
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- 2020
45. Transition to severe phenotype in systemic lupus erythematosus initially presenting with non-severe disease: Implications for the management of early disease
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Nikolopoulos, D.S. Nikolopoulos, D.S. Kostopoulou, M. Kostopoulou, M. Pieta, A. Flouda, S. Chavatza, K. Banos, A. Boletis, J. Katsimbri, P. Boumpas, D.T. Boumpas, D.T. Fanouriakis, A. Fanouriakis, A.
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macromolecular substances - Abstract
Objective Changes in the care of patients with SLE dictate a re-evaluation of its natural history and risk factors for disease deterioration and damage accrual. We sought to decipher factors predictive of a deterioration in phenotype ('transition') in patients initially presenting with non-severe disease. Methods Patients from the 'Attikon' cohort with disease duration ≥1 year were included. Disease at diagnosis was categorised as mild, moderate or severe, based on the British Isles Lupus Assessment Group manifestations and physician judgement. 'Transition' in severity was defined as an increase in category of severity at any time from diagnosis to last follow-up. Multivariable logistic regression was performed to identify baseline factors associated with this transition. Results 462 patients were followed for a median (IQR) of 36 (120) months. At diagnosis, more than half (56.5%) had a mild phenotype. During disease course, transition to more severe forms was seen in 44.2%, resulting in comparable distribution among severity patterns at last follow-up (mild 28.4%, moderate 33.1%, severe 38.5%). Neuropsychiatric involvement at onset (OR 6.33, 95% CI 1.22 to 32.67), male sex (OR 4.53, 95% CI 1.23 to 16.60) and longer disease duration (OR 1.09 per 1 year, 95% CI 1.04 to 1.14) were independently associated with transition from mild or moderate to severe disease. Patients with disease duration ≥3 years who progressed to more severe disease had more than 20-fold increased risk to accrue irreversible damage. Conclusion Almost half of patients with initially non-severe disease progress to more severe forms of SLE, especially men and patients with positive anti-double-stranded DNA or neuropsychiatric involvement at onset. These data may have implications for the management of milder forms of lupus. © 2020 Lupus Science and Medicine. All right reserved.
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- 2020
46. Real Life Efficacy and Safety of Secukinumab in Biologic-Experienced Patients With Psoriatic Arthritis
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Klavdianou, K. Lazarini, A. Grivas, A. Tseronis, D. Tsalapaki, C. Rapsomaniki, P. Antonatou, K. Thomas, K. Boumpas, D. Katsimbri, P. Vassilopoulos, D.
- Abstract
Background: Real world evidence data regarding secukinumab (SEC) use in biologic-experienced patients with psoriatic arthritis (PsA) are scarce. Objectives: To assess the real life survival, safety and efficacy of SEC in biologic-experienced patients with PsA. Methods: All biologic-experienced PsA patients treated with SEC in 2 University Rheumatology Units were included (3/2016-12/2018). Patients' and disease characteristics were recorded at baseline and during SEC therapy. Results: 75 patients were included; 76% were females with a mean age of 53.9 years, median disease duration of 6.7 years and median SEC treatment duration of 11.1 months. At baseline, 97% had peripheral arthritis, 42% axial involvement, 22% enthesitis, and 12% dactylitis. Regarding previous biologic exposure, 48 (64%) had been exposed to anti-tumor necrosis factor (TNF) agents only, 5 (7%) to the interleukin (IL)-12/23 inhibitor (Ustekinumab-UST) only while 22 (29%) both to anti-TNFs and UST. Fifty-three percent received SEC in combination with non-biologics and 35% with glucocorticoids, respectively. During follow-up, statistically significant improvement in different disease activity indices were noted (DAS28-CRP, DAPSA, BASDAI). SEC survival rate at the end of follow-up was 64% (48/75), without difference between patients exposed to anti-TNFs only (67%) vs. anti-TNFs and UST (68%) as well as to 1 vs. ≥2 anti-TNFs. The rate of serious adverse events and serious infections during follow-up was 4.8 and 1.2/100 patient-years, respectively. Discussion: In real life, in biologic-experienced patients with PsA, SEC displayed a high retention rate, regardless of the type, and number of previous biologics (anti-TNFs ± anti-IL12/23), without significant side effects. © Copyright © 2020 Klavdianou, Lazarini, Grivas, Tseronis, Tsalapaki, Rapsomaniki, Antonatou, Thomas, Boumpas, Katsimbri and Vassilopoulos.
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- 2020
47. Tocilizumab improves oxidative stress and endothelial glycocalyx: A mechanism that may explain the effects of biological treatment on COVID-19
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Ikonomidis, I. Pavlidis, G. Katsimbri, P. Lambadiari, V. Parissis, J. Andreadou, I. Tsoumani, M. Boumpas, D. Kouretas, D. Iliodromitis, E.
- Abstract
We investigated the effects of tocilizumab on endothelial glycocalyx, a determinant of vascular permeability, and myocardial function in rheumatoid arthritis (RA). Eighty RA patients were randomized to tocilizumab (n = 40) or conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and glucocorticoids (GC) (n = 40) for 3 months. Forty healthy subjects with similar age and sex served as controls. We measured: (a)perfused boundary region (PBR) of the sublingual arterial microvessels (increased PBR indicates reduced glycocalyx thickness), (b)pulse wave velocity (PWV), (c)global LV longitudinal strain (GLS), (d)global work index (GWI) using speckle tracking echocardiography and e)C-reactive protein (CRP), malondialdehyde (MDA) and protein carbonyls (PCs) as oxidative stress markers at baseline and post-treatment. Compared to controls, RA patients had impaired glycocalyx and myocardial deformation markers (P < 0.05). Compared with baseline, tocilizumab reduced PBR(2.14 ± 0.2 versus 1.97 ± 0.2 μm; P < 0.05) while no significant differences were observed post-csDMARDs + GC(P > 0.05). Compared with csDMARDs + GC, tocilizumab achieved a greater increase of GLS, GWI and reduction of MDA, PCs and CRP(P < 0.05). The percent improvement of glycocalyx thickness (PBR) was associated with the percent decrease of PWV, MDA, PCs and the percent improvement of GLS and GWI(P < 0.05). Tocilizumab improves endothelial function leading to a greater increase of effective myocardial work than csDMARDs + GC through a profound reduction of inflammatory burden and oxidative stress. This mechanism may explain the effects of tocilizumab on COVID-19. Clinical trial registration: url: https://www.clinicaltrials.gov. Unique identifier: NCT03288584. © 2020
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- 2020
48. Evolving phenotype of systemic lupus erythematosus in Caucasians: low incidence of lupus nephritis, high burden of neuropsychiatric disease and increased rates of late-onset lupus in the ‘Attikon’ cohort
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Nikolopoulos, D. Kostopoulou, M. Pieta, A. Karageorgas, T. Tseronis, D. Chavatza, K. Flouda, S. Rapsomaniki, P. Banos, A. Kremasmenou, E. Tzavara, V. Katsimbri, P. Fanouriakis, A. Boumpas, D.T.
- Subjects
skin and connective tissue diseases - Abstract
Objective: This study aimed to analyse the phenotype of systemic lupus erythematosus (SLE) at first presentation and during follow-up in a newly established SLE cohort based at ‘Attikon’ University Hospital. The hospital combines primary, secondary and tertiary care for the region of Western Attica, Greece. Methods: This study comprised a mixed prevalent and incident cohort of 555 Caucasian patients diagnosed with SLE according to American College of Rheumatology 1997 criteria and/or the Systemic Lupus Erythematosus International Collaborating Clinics (SLICC) 2012 criteria. Demographic and clinical characteristics, patterns of severity, treatments and SLICC damage index were recorded for each patient at the time of diagnosis and at last evaluation. Results: The mean age at lupus diagnosis was 38.3 years (standard deviation = 15.6 years), with a median disease duration at last follow-up of two years (interquartile range 1-11). At initial presentation, the most common ‘classification’ manifestations were arthritis (73.3%), acute cutaneous lupus (65%) and unexplained fever (25%), while among symptoms not included in any criteria set, Raynaud’s phenomenon (33%) was the most common. Kidney and neuropsychiatric involvement as presenting manifestations were present in 10.3% and 11.5% cases, respectively. Irreversible damage accrual was present in 17.8% within six months of disease diagnosis, attributed mainly to thrombotic and neuropsychiatric disease. At last evaluation, 202 (36.4%) patients had developed severe disease, of whom more than half were treated with pulse cyclophosphamide. Conclusion: In this cohort of Caucasian patients, lupus nephritis is not as common as in older cohorts, while neuropsychiatric disease is emerging as a major frontier in lupus prevention and care. These data may help to document changes in the natural history and treatment of SLE over time and may have implications for its early recognition and management. © The Author(s) 2020.
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- 2020
49. Association of endothelial glycocalyx integrity and microvascular perfusion with novel echocardiographic markers and carotid intima-media thickness in patients with psoriasis
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Rafouli-Stergiou, P, primary, Ikonomidis, I, additional, Makavos, G, additional, Thymis, J, additional, Pavlidis, G, additional, Parissis, J, additional, Kostelli, G, additional, Vrettou, AR, additional, Frogoudaki, A, additional, Katsimbri, P, additional, and Papadavid, Ε, additional
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- 2021
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50. Inhibition of interleukin-6 by tocilizumab improves endothelial glycocalyx and myocardial work index in patients with rheumatoid arthritis
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Ikonomidis, I, primary, Pavlidis, G, additional, Katsimbri, P, additional, Thymis, J, additional, Birba, D, additional, Kostelli, G, additional, Katogiannis, K, additional, Makavos, G, additional, Andreadou, I, additional, Frogoudaki, A, additional, Vrettou, A.R, additional, Boumpas, D, additional, and Iliodromitis, E, additional
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- 2020
- Full Text
- View/download PDF
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