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Background: In recent years, there has been an increase in the use of anti-TNF-α therapies in the treatment of rheumatological diseases. Aim: The aim of this study was to develop a subcutaneous anti- TNF-α treatment adherence scale and investigate and confirm the reliability and validity of this new instrument. This methodological study was performed in an university hospitals between April 2018 and March 2019. The sample of the study (n:165) consisted of individuals who were completed the first month of SC anti TNF-α treatment. The research data were collected by using an individual introduction form and the newly developed Anti TNF-α Treatment Adherence Scale. In the analysis of the data, the test-retest reliability analysis, validity analysis, factor analysis, structural equation model and internal consistency analysis were used. Results: The item-total test correlation values were determined to be between 0.33 and 0.71. In the fit index calculations, it was found that the Root Mean Square Error of Approximation was 0.10, Goodness of Fit Index was 0.999, Adjusted Goodness of Fit Index was 0.998, Comparative Fit Index was 0.926; and χ² was 2.670 (p<0.001). Cronbach α coefficient was calculated as 0.690 for factor 1, 0.765 for factor 2, 0.628 for factor 3 and 0.671 for the overall scale. Conclusion: In this study, Anti TNF-α Treatment Adherence Scale was determined that it is a valid and reliable scale. It is the first assessment tool that can be used in the evaluation of drug adherence in SC Anti-TNF-α treatment performed by patients / their relatives due to rheumatologic and all inflammatory diseases. [ABSTRACT FROM AUTHOR]

Objectives: Sjögren's syndrome (SS) is the most common autoimmune, multisystemic rheumatic disease. The wide spectrum of the signs and symptoms of SS often causes difficulties in diagnosis. Patients can apply with different complaints to general practitioners and many different specialists, apart from internists and ophthalmologists, who frequently encounter the disease. Our aim in this study was to evaluate the initial complaints of the patients who have been diagnosed with SS. Materials and Methods: Sixty-six patients who were diagnosed with primary SS according to 2012 or 2016 classification criteria were included in the study. The clinical and laboratory features were retrospectively evaluated. Results: The female/male ratio was 60/6. The initial complaint of most patients (n:34) was arthralgia or arthritis (51.51%). ANA was positive in 56 patients (84.84%), RF in 19 (28.78%), but not evaluated in 7 (10.6%), anti-SS-A in 29 (43.93%), and anti-SS-B in 16 (24.24%). Sixty-three patients had a positive Schirmer test. Minor salivary gland biopsy was obtained in 42 patients, and 28 had biopsy findings consistent with SS. Conclusion: SS is a common disease with a wide variety of clinical presentations. A detailed evaluation of patients is necessary to provide an accurate diagnosis and proper care. [ABSTRACT FROM AUTHOR]

Objective: Persistent inflammation is an insidious and less studied feature of FMF. We investigated clinical determinants of persistent inflammation and its associations with individual damage items., Methods: This is a cross-sectional analysis of 917 FMF patients, who fulfilled the Tel Hashomer criteria and had at least 6 months' follow-up. Patients were stratified based on whether they had persistent inflammation. We used logistic regression analysis to investigate independent predictors of persistent inflammation and the associated individual damage items., Results: One hundred and forty-two (15%) patients had persistent inflammation. Active FMF (54%) was the most prominent reason for the persistent inflammation. Spondylarthritis (16%), other inflammatory arthritis (8%) and IBD (2%) were other frequent reasons. Male gender, history of exertional leg pain, inflammatory comorbidities, M694V homozygosity, colchicine resistance, lower education levels and musculoskeletal attack dominance were found to be the independent predictors of persistent inflammation. Earlier disease onset led to a tendency towards persistent inflammation. Patients with persistent inflammation were more likely to suffer damage. There is an increased risk of developing proteinuria, amyloidosis and renal insufficiency., Conclusion: We identified, for the first time, the predictors of persistent inflammation in adult FMF patients and related individual damage items of the Autoinflammatory Disease Damage Index. Persistent inflammation is insidious and one of the chief causes of damage; therefore, especially patients with these predictors should be followed up more closely. If detected, underlying inflammatory comorbidities should be assessed meticulously as early detection and proper treatment strategies may favourably impact the natural history of the disease., (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objectives: Changes in microbiota composition affect the aetiology and patho-genesis of chronic diseases, including Behçet's disease (BD). However, no studies have analysed the potential gut microbiota changes among different clinical forms of BD. This study evaluated the intestinal microbiota composition of patients with BD and healthy controls and also compared differences between patients with BD with respect to eye, mucocutaneous, and vascular involvement., Methods: In this prospective cohort study, 27 patients diagnosed with BD according to the International Study Group criteria and 10 age- and sex-matched healthy controls were included. Detailed intestinal microbiota analysis was performed., Results: There were no differences between the BD group and the control group in terms of alpha and beta microbial diversity and abundance indices (p>0.05). Actinomyces, Libanicoccus, Collinsella, Eggerthella, Enetrohabdus, Catenibacterium, and Enterobacter were significantly higher in the BD group than in the control group. In addition, Bacteroides, Cricetibacter, Alistipes, Lachnospira, Dielma, Akkermansia, Sutterella, Anaerofilum, Ruminococcease-UCG007, Acetanaerobacterium, and Copropaacter were lower in the BD group than in the control group. When we compared three different system involvement (eye, mucocutaneous, and vascular), the linear discriminant analysis effective size revealed a difference for the following genera: Lachnospiraceae NK4A136 in the uveitis group; Dialister, Intestinomonas, and Marvinbryantia in the mucocutaneous group; and Gemella in the vascular group., Conclusions: The composition of intestinal microbiota was significantly different in patients with BD compared with healthy adults. Ours is the first study to show differences in microbiota composition in isolated mucocutaneous, eye, and vascular involvement. These findings should be evaluated in a larger series.

Objectives: Defining predictors of damage would improve patient care. We applied damage indexes to patients with familial Mediterranean fever (FMF) and identified the predictors of damage., Methods: This is a cross-sectional analysis of 926 FMF patients, who fulfilled the Tel-Hashomer criteria and had at least six months of follow-up. Patients were stratified according to their damage status (damage vs. no damage) defined with autoinflammatory disease damage index (ADDI) and modified ADDI (excluding musculoskeletal pain). We used logistic regression analysis to investigate independent predictors of damage for both indexes., Results: Mean disease duration was 21.6±11.9 years. 527 patients (57%) had damage according to ADDI. Median ADDI score was 1 (0-11). Most common FMF-related damages were observed in musculoskeletal, reproductive and kidney domains. Female gender, inflammatory comorbidity, colchicine resistance, colchicine nonadherence, musculoskeletal attack dominance, diagnostic delay, follow-up time, and smoking history remained independent predictors of damage according to ADDI score. The rate of patients with damage defined by modified ADDI was only to 23%. M694V/M694V homozygosity, female gender, musculoskeletal attack dominance, colchicine resistance, persistent inflammation, follow up time and family history of amyloidosis were found to be predictors of damage according to modified ADDI score., Conclusions: Our study is the first to apply comprehensive damage indexes to FMF patients and identified predictors of damage. Factors linked to a severe FMF phenotype, including M694V homozygosity and persistent inflammation, were associated with only modified ADDI. Our findings justify the concerns about musculoskeletal pain and might point to the need for re-evaluation of ADDI for FMF patients.

Objective: To examine the prevalence of comorbid conditions in patients diagnosed with fibromyalgia., Methods: The retrospective cross-sectional study was conducted at Eskisehir Osmangazi University, Eskisehir, Turkey, and comprised data of fibromyalgia patients aged 18 years or more admitted between January 1, 2012 and August 15, 2016. Hospital's database was investigated using the International Classification of Diseases, 10th Revision codes to identify fibromyalgia cases and predetermined comorbid conditions. SPSS 21 was used for data analysis., Results: Of 509 patients, 51(10%) were males and 458(90%) were females with an overall mean age of 50.24±12.32 years. Of the total, 345(67.8%) patients had at least one comorbid disease, while 164(32.2%) had no comorbid disease. The most prevalent condition was cardiovascular diseases in 187(36.7%) patients followed by endocrine diseases in 157(30.8%)., Conclusions: Fibromyalgia is a disease that is seen to be increasing in frequency in recent years. It is useful to evaluate fibromyalgia patients with their comorbid conditions on their follow-up.