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The article discusses a study which proposes a machine-learning approach to cardiovascular risk prediction among patients with psoriatic arthritis (PsA). Topics covered include findings which confirm that machine-learning (ML) techniques can help address the poor performance of traditional CV risk algorithms in these patients, the higher sensitivity in PsA patients exhibited by ML models, and the ability of ML to make effective CV predictions in PsA patients.

Objective To establish clinical consensus for the optimal placement of TNF inhibitor (TNFi) in DMARDs-naïve RA patients. Methods The steering group was composed of 15 Italian rheumatologists expert in the field of RA, who proposed and selected by consensus the clinically relevant questions on the role of TNFi treatment in DMARDs-naïve RA patients. The question was rephrased according to the population, intervention, comparison and outcome statement. The available scientific evidence on this topic were collected by updating the systematic literature reviews used for the EULAR 2013 recommendations up to January 2016. The aspects evaluated in the studies concerned clinical efficacy, radiographic structural damage and safety. After the systematic literature review the expert panel formulated a consensus statement, and a modified Delphi panel evaluated the level of agreement between panellists (strength of recommendation). Results From a total of 1080 records we have included 6 studies, 2 randomized clinical trials and 4 open-label extension trials. Evidence from publications generated three statements for the final consensus document. The systematic literature review and the consensus statements developed showed that, for patients with early RA and in the presence of a treat-to-target strategy, the immediate use of anti-TNFi compared with an early (within 12 weeks) step-up to anti-TNF therapy did not confer a significant advantage regarding clinical, functional and radiographic outcomes. Conclusion The most appropriate placement of the TNFi therapy in the treatment algorithm of early RA still remains a challenging clinical question that needs to be further addressed. [ABSTRACT FROM AUTHOR]

The article discusses research which examined effects of hydroxychloroquine (HCQ) treatment on serum markers of endothelial injury and neoangiogenesis, NEMO videocapillaroscopy score, and giant capillaries score in patients with systemic sclerosis (SS). Topics explored include the HCQ dosage administered to SS patients in the study, the demographic and clinical characteristics recorded, and the outcomes observed following HCQ treatment.

The article reports on a case of a 71-year-old male who was presented to a hospital due to repeated episodes of loss of consciousness that are worsening in intensity and frequency. He had a medical history of rheumatoid arthritis (RA), chronic obstructive pulmonary disease, hypertension, and benign prostatic hyperplasia. He was eventually diagnosed with methotrexate-induced dysautonomia and was treated with leflunomide (LEF).

Objectives. To validate the clinical significance of anti-IFI16 autoantibodies in SSc and assess their associations with serological markers of SSc.Methods. A semi-quantitative ELISA was used to detect anti-IFI16 autoantibodies in the sera of 344 SSc patients from seven Italian hospitals and 144 healthy controls. SSc-associated autoantibodies [anti-RNA polymerase III (anti-RNAP III) antibodies, anti-centromere, anti-topo I] and IF patterns were evaluated using commercial assays. Statistical analyses were performed to test clinical and serological associations.Results. The results of this study confirm a significant prevalence (29%) of anti-IFI16 antibodies in the SSc population (n = 344). Anti-IFI16 antibodies were also detected in 30% of the SSc patients who tested negative for both ACAs and anti-topo I (anti-Scl70) antibodies. In this subgroup of patients, anti-IFI16 antibodies were significantly associated with the limited cutaneous form of SSc with a sensitivity of 40% and a specificity of 81%. Moreover, analysis of the distribution of anti-RNAP III antibodies vs anti-IFI16 in the same SSc population showed that they were mutually exclusive. IIF revealed no association between anti-IFI16 and fluoroscopic patterns, due to a lack of IFI16 autoantigen in HEp-2 cells. Anti-IFI16 antibody levels were also significantly associated with heart involvement.Conclusions. Anti-IFI16 autoantibodies are frequently detected in SSc, displaying clinical and laboratory associations, and being particularly useful for diagnosis and disease classification in patients who are negative for other SSc serological markers. [ABSTRACT FROM PUBLISHER]

Introduction Erectile dysfunction ( ED) prevalence in men with systemic sclerosis ( SSc) is high and can be considered a manifestation of endothelium damage. Aim This study aims to correlate ED with endothelial dysfunction and digital vascular damage in SSc patients. Main Outcome Measures The main outcome measures were erectile function, Doppler indices of cavernous arteries, flow-mediated dilation ( FMD), capillaroscopic damage, skin perfusion, and digital pulsatility. Methods In 23 SSc patients, erectile function was investigated using the International Index of Erectile Function-5 ( IIEF-5). Doppler indices of cavernous arteries, peak systolic velocity ( PSV), end-diastolic velocity ( EDV), and resistive index ( RI) were measured at the penoscrotal junction before and after pharmacostimulation with 20 mg prostaglandin E1. FMD and nailfold videocapillaroscopy ( NVC) were used to evaluate endothelial dysfunction and capillaroscopic damage. Skin perfusion and digital sphygmic waves were measured by laser Doppler perfusion imaging ( LDPI) and digital photoplethysmography ( PPG), respectively. Results IIEF-5 score was reduced in 83% of patients. PSV was reduced in 96%, while EDV was increased in 48% of patients. A positive correlation was observed between IIEF-5 score and FMD ( r = 0.71, P < 0.0001) and between the former and PSV ( r = 0.76, P < 0.0001). A negative correlation was observed between EDV and FMD ( r = −0.509, P < 0.01). FMD and Doppler indices were reduced with capillaroscopic damage progression. A positive correlation exists between LDPI perfusion and IIEF-5 score ( r = 0.743, P < 0.0001) and between the former and PSV ( r = 0.714, P < 0.0001), while a negative correlation is observed between LDPI perfusion and EDV ( r = −0.677, P < 0.0001). A positive correlation exists between PPG pulsatility and IIEF-5 score ( r = 0.752, P < 0.0001) and between the former and PSV ( r = 0.747, P < 0.0001), while negative correlation is observed between PPG pulsatility and EDV ( r = −0.689, P < 0.0001). Conclusion In SSc patients, ED correlates with endothelial dysfunction and digital microvascular damage. [ABSTRACT FROM AUTHOR]