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8. The provisional OMERACT ultrasonography score for giant cell arteritis

Author

Dejaco, C, Ponte, C, Monti, S, Rozza, D, Scire, C, Terslev, L, Bruyn, G, Boumans, D, Hartung, W, Hocevar, A, Milchert, M, Dohn, U, Mukhtyar, C, Aschwanden, M, Bosch, P, Camellino, D, Chrysidis, S, Ciancio, G, D'Agostino, M, Daikeler, T, Dasgupta, B, De Miguel, E, Diamantopoulos, A, Duftner, C, Agueda, A, Fredberg, U, Hanova, P, Hansen, I, Hauge, E, Iagnocco, A, Inanc, N, Juche, A, Karalilova, R, Kawamoto, T, Keller, K, Keen, H, Kermani, T, Kohler, M, Koster, M, Luqmani, R, Macchioni, P, Mackie, S, Naredo, E, Nielsen, B, Ogasawara, M, Pineda, C, Schafer, V, Seitz, L, Tomelleri, A, Torralba, K, Van Der Geest, K, Warrington, K, Schmidt, W, Dejaco C., Ponte C., Monti S., Rozza D., Scire C. A., Terslev L., Bruyn G. A. W., Boumans D., Hartung W., Hocevar A., Milchert M., Dohn U. Mo., Mukhtyar C. B., Aschwanden M., Bosch P., Camellino D., Chrysidis S., Ciancio G., D'Agostino M. A., Daikeler T., Dasgupta B., De Miguel E., Diamantopoulos A. P., Duftner C., Agueda A., Fredberg U., Hanova P., Hansen I. To., Hauge E. -M., Iagnocco A., Inanc N., Juche A., Karalilova R., Kawamoto T., Keller K. K., Keen H. I., Kermani T. A., Kohler M. J., Koster M., Luqmani R. A., Macchioni P., Mackie S. L., Naredo E., Nielsen B. D., Ogasawara M., Pineda C., Schafer V. S., Seitz L., Tomelleri A., Torralba K. D., Van Der Geest K. S. M., Warrington K. J., Schmidt W. A., Dejaco, C, Ponte, C, Monti, S, Rozza, D, Scire, C, Terslev, L, Bruyn, G, Boumans, D, Hartung, W, Hocevar, A, Milchert, M, Dohn, U, Mukhtyar, C, Aschwanden, M, Bosch, P, Camellino, D, Chrysidis, S, Ciancio, G, D'Agostino, M, Daikeler, T, Dasgupta, B, De Miguel, E, Diamantopoulos, A, Duftner, C, Agueda, A, Fredberg, U, Hanova, P, Hansen, I, Hauge, E, Iagnocco, A, Inanc, N, Juche, A, Karalilova, R, Kawamoto, T, Keller, K, Keen, H, Kermani, T, Kohler, M, Koster, M, Luqmani, R, Macchioni, P, Mackie, S, Naredo, E, Nielsen, B, Ogasawara, M, Pineda, C, Schafer, V, Seitz, L, Tomelleri, A, Torralba, K, Van Der Geest, K, Warrington, K, Schmidt, W, Dejaco C., Ponte C., Monti S., Rozza D., Scire C. A., Terslev L., Bruyn G. A. W., Boumans D., Hartung W., Hocevar A., Milchert M., Dohn U. Mo., Mukhtyar C. B., Aschwanden M., Bosch P., Camellino D., Chrysidis S., Ciancio G., D'Agostino M. A., Daikeler T., Dasgupta B., De Miguel E., Diamantopoulos A. P., Duftner C., Agueda A., Fredberg U., Hanova P., Hansen I. To., Hauge E. -M., Iagnocco A., Inanc N., Juche A., Karalilova R., Kawamoto T., Keller K. K., Keen H. I., Kermani T. A., Kohler M. J., Koster M., Luqmani R. A., Macchioni P., Mackie S. L., Naredo E., Nielsen B. D., Ogasawara M., Pineda C., Schafer V. S., Seitz L., Tomelleri A., Torralba K. D., Van Der Geest K. S. M., Warrington K. J., and Schmidt W. A.

Abstract

Objectives To develop an Outcome Measures in Rheumatology (OMERACT) ultrasonography score for monitoring disease activity in giant cell arteritis (GCA) and evaluate its metric properties. Methods The OMERACT Instrument Selection Algorithm was followed. Forty-nine members of the OMERACT ultrasonography large vessel vasculitis working group were invited to seven Delphi rounds. An online reliability exercise was conducted using images of bilateral common temporal arteries, parietal and frontal branches as well as axillary arteries from 16 patients with GCA and 7 controls. Sensitivity to change and convergent construct validity were tested using data from a prospective cohort of patients with new GCA in which ultrasound-based intima-media thickness (IMT) measurements were conducted at weeks 1, 3, 6, 12 and 24. Results Agreement was obtained (92.7%) for the OMERACT GCA Ultrasonography Score (OGUS), calculated as follows: sum of IMT measured in every segment divided by the rounded cut-off values of IMTs in each segment. The resulting value is then divided by the number of segments available. Thirty-five members conducted the reliability exercise, the interrater intraclass correlation coefficient (ICC) for the OGUS was 0.72-0.84 and the median intrareader ICC was 0.91. The prospective cohort consisted of 52 patients. Sensitivity to change between baseline and each follow-up visit up to week 24 yielded standardised mean differences from -1.19 to -2.16, corresponding to large and very large magnitudes of change, respectively. OGUS correlated moderately with erythrocyte sedimentation rate, C reactive protein and Birmingham Vasculitis Activity Score (corr coeff 0.37-0.48). Conclusion We developed a provisional OGUS for potential use in clinical trials.

Published
2023

16. Reply to: 'Herpes zoster seven days after SARS-CoV-2 vaccination in a patient with ankylosing spondylitis under adalimumab' by Josef Finsterer

Author

Maranini, B., Ciancio, G., Cultrera, R., and Govoni, M.

Subjects
COVID-19 Vaccines, SARS-CoV-2, Vaccination, Adalimumab, Socio-culturale, COVID-19, LS6_12, LS6_11, Herpes Zoster, COVID-19 vaccine, Herpes zoster, Rheumatology, Rheumatology, Humans, Spondylitis, Ankylosing, LS6_1, COVID-19 vaccine
Abstract

Not available

Published
2022
Full Text
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27. Italian consensus recommendations for the management of hepatitis C infection in patients with rheumatoid arthritis

Author

Sebastiani, M, Milazzo, L, Atzeni, F, Vacchi, C, Manfredi, A, Quartuccio, L, Scire, C, Gaeta, G, Lapadula, G, Armignacco, O, Tavio, M, D'Angelo, S, Meroni, P, Bazzichi, L, Grassi, W, Mathieu, A, Mastroianni, C, Sagnelli, E, Santantonio, T, Foppa, C, Puoti, M, Sarmati, L, Airo, P, Epis, O, Scrivo, R, Gargiulo, M, Riva, A, Ciancio, G, Zehender, G, Taliani, G, Meroni, L, Sollima, S, Sarzi-Puttini, P, Galli, M, Sebastiani M., Milazzo L., Atzeni F., Vacchi C., Manfredi A., Quartuccio L., Scire C., Gaeta G. B., Lapadula G., Armignacco O., Tavio M., D'Angelo S., Meroni P., Bazzichi L., Grassi W., Mathieu A., Mastroianni C., Sagnelli E., Santantonio T., Foppa C. U., Puoti M., Sarmati L., Airo P., Epis O. M., Scrivo R., Gargiulo M., Riva A., Ciancio G., Zehender G., Taliani G., Meroni L., Sollima S., Sarzi-Puttini P., Galli M., Sebastiani, M, Milazzo, L, Atzeni, F, Vacchi, C, Manfredi, A, Quartuccio, L, Scire, C, Gaeta, G, Lapadula, G, Armignacco, O, Tavio, M, D'Angelo, S, Meroni, P, Bazzichi, L, Grassi, W, Mathieu, A, Mastroianni, C, Sagnelli, E, Santantonio, T, Foppa, C, Puoti, M, Sarmati, L, Airo, P, Epis, O, Scrivo, R, Gargiulo, M, Riva, A, Ciancio, G, Zehender, G, Taliani, G, Meroni, L, Sollima, S, Sarzi-Puttini, P, Galli, M, Sebastiani M., Milazzo L., Atzeni F., Vacchi C., Manfredi A., Quartuccio L., Scire C., Gaeta G. B., Lapadula G., Armignacco O., Tavio M., D'Angelo S., Meroni P., Bazzichi L., Grassi W., Mathieu A., Mastroianni C., Sagnelli E., Santantonio T., Foppa C. U., Puoti M., Sarmati L., Airo P., Epis O. M., Scrivo R., Gargiulo M., Riva A., Ciancio G., Zehender G., Taliani G., Meroni L., Sollima S., Sarzi-Puttini P., and Galli M.

Abstract

Objectives: The recent introduction of direct-acting antiviral agents (DAAs) which can eliminate Hepatitis C virus (HCV) had revolutionized the treatment of HCV infections also in a complex clinical setting such as the patients with rheumatoid arthritis (RA). HCV elimination is also opportune due to the availability of more efficient immunosuppressive drugs, whose effect on the course of HCV infection is largely unknown. Methods: Consensus process was endorsed by the Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) to review the available evidence and produce practical, hospital-wide recommendations. The consensus panel consisted of 18 infectious diseases consultants, 20 rheumatologists and one clinical epidemiologist, who used the criteria of the Oxford Centre for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations. Results: A core-set of statements about management of patients with RA and infection by HCV have been developed to help clinicians in their clinical practice. Conclusions: A screening for HCV should be performed in all RA patients and it is mandatory before starting an immunosuppressive therapy. Finally, a DAA treatment should be considered in all HCV-infected patients.Significance and Innovations HCV antibodies should be investigated at the time of diagnosis of RA and, in any case, before starting immunosuppressive therapy with disease-modifying antirheumatic drugs (DMARDs). HCV eradication with DAA should be attempted as soon as possible, depending on patient conditions allowing a continuous oral treatment lasting 8–12 weeks Conventional and biological DMARDs are allowed in patients with HCV infection, but they should be used cautiously in presence of advanced liver disease.

Published
2019

28. Radiotherapy in cancer and rheumathoid arthritis patients: cancer treatment or control of articular flares? We can achieve both

Author

Fiorica, F., Ciancio, G., Giuliani, J., Bonetti, A., Berretta, M., Guarneri, C., Giorgi, C., Furini, F., Guerra, V., and Govoni, M.

Subjects
Male, Radiotherapy, Cancer, Rheumatoid arthritis, NO, Arthritis, Rheumatoid, Antirheumatic Agents, Neoplasms, Radiotherapy, Rheumatoid arthritis, Cancer, Humans, Female, Aged, Retrospective Studies
Abstract

The study was aimed to investigate the role of radiotherapy (RT) as a risk factor for reactivation or worsening of symptoms in patients affected by rheumatoid arthritis (RA) PATIENTS AND METHODS: This is a single-center retrospective observational study on RA patients who developed cancer requiring RT during the course of the disease. The control group consisted of RA patients with cancer who did not undergo RT. In both groups, the disease activity was evaluated at baseline and at 6 and 12 months through the DAS28 index. A relapse was defined as an increase of20% in DAS28. A radiotherapist evaluated total and daily doses and timing of radiation. Acute and late toxicity was defined as events occurring within 90 days from the start and more than 90 days after the completion of RT, respectively.Seventy-two RA patients (38F/34M; mean age: 70±9 years; mean disease duration: 13±9 years), 29 (40.2%) of whom received radiotherapy (mean age 72.9±9 years), were enrolled. The most frequent malignancies were breast (27.2%), thyroid (9.8%), and skin (7%). Between radio-treated and non-radio-treated patients, no significant differences in RA reactivation (6/29 vs. 17/43; p=0.12) or mean exacerbation time (6.7 ± 4.9 months compared to 6.4 ± 4.1 months; p=0.78) were found. Overall, RT was well tolerated with low rates of both acute and late toxicity.In RA patients, RT was well tolerated and not associated with an increased risk of articular flares. Properly designed prospective clinical studies with a larger number of patients should be performed to confirm these data.

Published
2021

39. Correction

Author

Sebastiani, M, Milazzo, L, Atzeni, F, Vacchi, C, Manfredi, A, Quartuccio, L, Scire, C, Gaeta, GB, Lapadula, G, Armignacco, O, Tavio, M, D'Angelo, S, Meroni, P, Bazzichi, L, Grassi, W, Mathieu, A, Mastroianni, C, Sagnelli, E, Santantonio, T, Uberti Foppa, C, Puoti, M, Sarmati, L, Airo, P, Epis, OM, Scrivo, R, Gargiulo, M, Riva, A, Ciancio, G, Zehender, G, Taliani, G, Meroni, L, Sollima, S, Sarzi-Puttini, P, Galli, M, Sebastiani, M, Milazzo, L, Atzeni, F, Vacchi, C, Manfredi, A, Quartuccio, L, Scire, C, Gaeta, Gb, Lapadula, G, Armignacco, O, Tavio, M, D'Angelo, S, Meroni, P, Bazzichi, L, Grassi, W, Mathieu, A, Mastroianni, C, Sagnelli, E, Santantonio, T, Uberti Foppa, C, Puoti, M, Sarmati, L, Airo, P, Epis, Om, Scrivo, R, Gargiulo, M, Riva, A, Ciancio, G, Zehender, G, Taliani, G, Meroni, L, Sollima, S, Sarzi-Puttini, P, and Galli, M

Published
2019

40. Italian consensus guidelines for the management of hepatitis B virus infections in patients with rheumatoid arthritis [Prise en charge de l'infection par le virus de l'hépatite B chez les patients atteints de polyarthrite rhumatoïde: conférence de consensus italienne]

Author

Sebastiani, M, Atzeni, F, Milazzo, L, Quartuccio, L, Scire', C, Gaeta, G, Lapadula, G, Armignacco, O, Tavio, M, Olivieri, I, Meroni, P, Bazzichi, L, Grassi, W, Mathieu, A, Mastroianni, C, Sagnelli, E, Santantonio, T, Uberti Foppa, C, Puoti, M, Sarmati, L, Airo, P, Epis, O, Scrivo, R, Gargiulo, M, Riva, A, Manfredi, A, Ciancio, G, Zehender, G, Taliani, G, Meroni, L, Sollima, S, Sarzi-Puttini, P, Galli, M, Sebastiani M., Atzeni F., Milazzo L., Quartuccio L., Scire' C., Gaeta G. B., Lapadula G., Armignacco O., Tavio M., Olivieri I., Meroni P., Bazzichi L., Grassi W., Mathieu A., Mastroianni C., Sagnelli E., Santantonio T., Uberti Foppa C., Puoti M., Sarmati L., Airo P., Epis O. M., Scrivo R., Gargiulo M., Riva A., Manfredi A., Ciancio G., Zehender G., Taliani G., Meroni L., Sollima S., Sarzi-Puttini P., Galli M., Sebastiani, M, Atzeni, F, Milazzo, L, Quartuccio, L, Scire', C, Gaeta, G, Lapadula, G, Armignacco, O, Tavio, M, Olivieri, I, Meroni, P, Bazzichi, L, Grassi, W, Mathieu, A, Mastroianni, C, Sagnelli, E, Santantonio, T, Uberti Foppa, C, Puoti, M, Sarmati, L, Airo, P, Epis, O, Scrivo, R, Gargiulo, M, Riva, A, Manfredi, A, Ciancio, G, Zehender, G, Taliani, G, Meroni, L, Sollima, S, Sarzi-Puttini, P, Galli, M, Sebastiani M., Atzeni F., Milazzo L., Quartuccio L., Scire' C., Gaeta G. B., Lapadula G., Armignacco O., Tavio M., Olivieri I., Meroni P., Bazzichi L., Grassi W., Mathieu A., Mastroianni C., Sagnelli E., Santantonio T., Uberti Foppa C., Puoti M., Sarmati L., Airo P., Epis O. M., Scrivo R., Gargiulo M., Riva A., Manfredi A., Ciancio G., Zehender G., Taliani G., Meroni L., Sollima S., Sarzi-Puttini P., and Galli M.

Published
2018

50. Italian consensus Guidelines for the management of hepatitis B virus infections in patients with rheumatoid arthritis

Author

Sebastiani, M, Atzeni, F, Milazzo, L, Quartuccio, L, Scirè, C, Gaeta, G, Lapadula, G, Armignacco, O, Tavio, M, Olivieri, I, Meroni, P, Bazzichi, L, Grassi, W, Mathieu, A, Mastroianni, C, Sagnelli, E, Santantonio, T, Uberti Foppa, C, Puoti, M, Sarmati, L, Airò, P, Epis, O, Scrivo, R, Gargiulo, M, Riva, A, Manfredi, A, Ciancio, G, Zehender, G, Taliani, G, Meroni, L, Sollima, S, Sarzi-Puttini, P, Galli, M, Sebastiani M, Atzeni F, Milazzo L, Quartuccio L, Scirè C, Gaeta GB, Lapadula G, Armignacco O, Tavio M, Olivieri I, Meroni P, Bazzichi L, Grassi W, Mathieu A, Mastroianni C, Sagnelli E, Santantonio T, Uberti Foppa C, Puoti M, Sarmati L, Airò P, Epis OM, Scrivo R, Gargiulo M, Riva A, Manfredi A, Ciancio G, Zehender G, Taliani G, Meroni L, Sollima S, Sarzi-Puttini P, Galli M., Sebastiani, M, Atzeni, F, Milazzo, L, Quartuccio, L, Scirè, C, Gaeta, G, Lapadula, G, Armignacco, O, Tavio, M, Olivieri, I, Meroni, P, Bazzichi, L, Grassi, W, Mathieu, A, Mastroianni, C, Sagnelli, E, Santantonio, T, Uberti Foppa, C, Puoti, M, Sarmati, L, Airò, P, Epis, O, Scrivo, R, Gargiulo, M, Riva, A, Manfredi, A, Ciancio, G, Zehender, G, Taliani, G, Meroni, L, Sollima, S, Sarzi-Puttini, P, Galli, M, Sebastiani M, Atzeni F, Milazzo L, Quartuccio L, Scirè C, Gaeta GB, Lapadula G, Armignacco O, Tavio M, Olivieri I, Meroni P, Bazzichi L, Grassi W, Mathieu A, Mastroianni C, Sagnelli E, Santantonio T, Uberti Foppa C, Puoti M, Sarmati L, Airò P, Epis OM, Scrivo R, Gargiulo M, Riva A, Manfredi A, Ciancio G, Zehender G, Taliani G, Meroni L, Sollima S, Sarzi-Puttini P, and Galli M.

Abstract

Objectives Hepatitis B (HBV) infection, which is prevalent worldwide, is also frequently seen in patients with rheumatoid arthritis (RA). The Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) endorsed a national consensus process to review the available evidence on HBV management in RA patients and to produce practical, hospital-wide recommendations. Methods The consensus panel consisted of infectious disease consultants, rheumatologists and epidemiologists and used the criteria of the Oxford Center for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations. Results A core-set of statements has been developed to help clinicians in the management of patients with RA and HBV infection. Vaccination and prophylaxis of RA patients treated with biological drugs have been also discussed. Conclusions HBV infection is not rare in clinical practice; a screening for HBV in all patients with early arthritis is not universally accepted, while it is considered mandatory before starting any immunosuppressive or hepatotoxic treatment. In fact, a specific risk, associated with the use of biologic treatments, exists for patients with HBV infection, although longitudinal studies of viral reactivation are generally reassuring. RA patients with HBV infection should be referred to the hepatologist and correctly classified into active or inactive carriers. Patients with active hepatitis B should undergo antiviral treatment before starting immunosuppressive treatments. Occult HBV carriers should be monitored or receive prophylaxis on the basis of the risk of reactivation associated with the administered treatment.

Published
2017

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