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Papers by P. Conigliaro

Annals of the Rheumatic Diseases

BackgroundPsoriatic Arthritis (PsA) is a chronic inflammatory disease, characterized by both arti... more BackgroundPsoriatic Arthritis (PsA) is a chronic inflammatory disease, characterized by both articular and periarticular manifestations, usually associated with psoriasis. The identification of the correct therapy for patients is still a critical issue, but the use of biological drugs, such as TNFi (Tumor Necrosis Factor Inhibitors), modified the outcome of PsA patients even if there is great variability in the clinical efficacy. Since the response to drugs is a complex trait, the identification of genetic factors could help to define new genomic biomarkers for more effective and personalized therapy.ObjectivesThe aim of this study was to evaluate the potential role of polymorphisms in genes already known to be involved in PsA susceptibility (ERAP1, HCP5, IL10, MIR146, PSORS1C1, STAT4, TNFAIP3 and TRAF3IP2) as predictors of efficacy of treatment, in a cohort of Italian PsA patients, treated with first-line TNF-i, in particular with Etanercept (ETN) and Adalimumab (ADA).MethodsPolymo...

Annals of the Rheumatic Diseases

Background:Secukinumab (SEC) is the first interleukin-17A inhibitor showing efficacy in both anky... more Background:Secukinumab (SEC) is the first interleukin-17A inhibitor showing efficacy in both ankylosing spondylitis (AS) and psoriatic arthritis (PsA) in randomised trials, but real-life data are lacking.Objectives:In this prospective observational study, we evaluated the effectiveness and safety of SEC in patients with AS and PsA in a real-life setting.Methods:From September 2018 to September 2019, data were collected from 168 consecutive outpatients at baseline (T0) and at 6 (T6) and 12 months (T12) after starting SEC (39 AS, 23%; 129 PsA, 77%).Results:Significant improvement was seen at T6 and T12 for all clinical variables, including TJC, SJC, ESR, CRP, DAPSA, ASDAS-CRP, and BASDAI, as well as in patient-reported outcomes such as VAS-pain. By multivariable regression analysis, in AS patients high BASDAI at T0 correlated with diagnostic delay (R2=0.4; p=0.009) and peripheral joint involvement (R2=0.4; p=0.04). During follow-up, reduction of BASDAI positively correlated with high ...

European review for medical and pharmacological sciences, 2022

OBJECTIVE Micronutrient deficiencies (MNDs) are common among patients with certain chronic inflam... more OBJECTIVE Micronutrient deficiencies (MNDs) are common among patients with certain chronic inflammatory diseases. They are associated with a pro-inflammatory status and co-morbidities. However, no studies have specifically investigated MNDs in Spondyloarthritis (SpA). This paper aimed at analyzing the occurrence of anemia and deficiencies of ferritin (Fe), vitamin D [25(OH)D], vitamin B12 (B12), and folic acid (FA) in SpA patients. The interplay of MNDs with age, gender, and metabolic abnormalities was also explored. PATIENTS AND METHODS MNDs were evaluated in 220 SpA outpatients (137 females and 83 age-matched males) with psoriatic arthritis (PsA, n=110) and non-psoriatic SpA (n=110). Metabolic parameters were analyzed. Disease activity was assessed by either Disease Activity in PSoriatic Arthritis (DAPSA) or Ankylosing Spondylitis Disease Activity Score with C-Reactive Protein (ASDAS-CRP) as appropriate, while the functional status was evaluated using Health Assessment Questionnai...

Annals of the Rheumatic Diseases, 2020

Background:SpA patients experience a decreased quality of life due to social, emotional and relat... more Background:SpA patients experience a decreased quality of life due to social, emotional and relational life impairment in addition to pain, fatigue and joint damage. Sexual dysfunction (SD) is often neglected by both patients and clinicians, although articular and extra-articular manifestations of the disease can decrease the quality of sexual life. Previous findings showed that SD can affect from 27% to 67% of patients with rheumatic diseases. Data available on SD in rheumatic patients are poor and primarily focus on male ankylosing spondylitis patientsObjectives:The aim of this study is to evaluate, in a group of female SpA patients, the presence of SD, its relationship with extra-articular manifestations and to estimate the correlation between disease activity and sexual activity.Methods:52 SpA patients (including PsA, IBD-SpA and undifferentiated SpA-un-SpA) and 50 healthy controls (HC) were administered the Female Sexual Function Index (FSFI) questionnaire for the analysis of s...

Annals of the Rheumatic Diseases, 2020

The Italian Society for Rheumatology (SIR) comprises committees for Rheumatologists under the age... more The Italian Society for Rheumatology (SIR) comprises committees for Rheumatologists under the age of 40 (SIRyoung) and for Women in Rheumatology (Reumatologhe Donne – ReDO). As female representation is increasing in rheumatology worldwide [1], there has been interest in assessing gender-related issues.To describe the gender distribution among young members of SIR and academic positions in Rheumatology in Italy. To assess the expectations and needs of young rheumatologists with regard to their career.SIRyoung members developed a web-based survey which was distributed among SIR members under the age of 40 during the spring of 2019. Responses were collected and analysed anonymously. ReDO retrieved and analysed the data regarding academic positions in Italy in September 2019 from official data by “Ministry of Education, University and Research” (www.miur.it).Out of 478 SIR members under 40 (66.5% F), 113 (23.7%) completed the SIRyoung survey (62.1% F). Regarding career plans, male and female members responded: hospital physician (36.9% vs 37.8%), outpatient clinic physician (18.5% vs 28.3%), academic career (23.9% vs 22.8%), private practice (16.3% vs 9.4%), and industry (4.3 vs 1.6%), respectively. When asked about their interest in doing a fellowship in another national center or abroad, 60.8% of male and 72.8% of female respondents were interested but thought they could not afford it. Reasons reported by males and females were: working reasons, namely barriers to temporarily leave the workplace (61.3% vs 50.7%), family reasons (16.1% vs 25.4%), financial reasons (22.6% vs 16.5%), respectively. As for academic rheumatology in Italy, 113 positions were retrieved. Men held 64 positions (57%) and women 49 (43%). Full professors were mostly men (92%), while assistant professors were women in 65% of the cases (58% of those with a permanent position; 72% of those with a temporary position) (Figure) [2].Our study explored for the first time gender distribution and related issues in Rheumatology in Italy. Female representation accounts for two thirds of SIR members under 40. This could reflect the general trend of medical school being chosen more often by women than men. No differences were observed in the career expectations of male and female rheumatologists. Interestingly, nearly one fourth of female respondents were interested in academic career, confirming the trend toward female predominance observed for assistant professors. Therefore, it is likely that the next generation of full professors will have a balanced gender distribution, as it is already for associate professors. The choice of a fellowship is still hampered by several problems, but it seems that reasons for not pursuing such opportunities are similarly distributed in males and females. Although family reasons tend to be more frequent in female rheumatologists, this is not significant as compared to men. This could indicate that family affects career choices of both male and female rheumatologists. It is important that national societies promote surveys for the assessment of gender specific issues among their members, in order to identify unmet needs and design interventions for career support regardless of gender.[1]Andreoli L, et al. Joint, Bone, Spine: Revue du Rhumatisme. 2019;86(6):669-672.[2]Bosello SL, et al. Reumatismo 2020; in press.SIRyoung and ReDO wish to thank the Steering Committee of SIRLaura Andreoli: None declared, Stefano Alivernini: None declared, Alessia Alunno: None declared, Silvia Laura Bosello: None declared, Cecilia Chighizola: None declared, Paola Conigliaro: None declared, Elisa Gremese Speakers bureau: Abbvie, BMS, Celgene, Jannsen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB, Cristina Iannuccelli: None declared, Luca Quartuccio Consultant of: Abbvie, Bristol, Speakers bureau: Abbvie, Pfizer, Francesca Romana Spinelli Grant/research support from: Pfizer, Consultant of: Novartis, Gilead, Lilly, Sanofi, Celgene, Speakers bureau: Lilly, Marta Vadacca: None declared, Maria Sole Chimenti: None declared

Annals of the Rheumatic Diseases, 2020

Psoriatic arthritis (PsA) is a chronic immune-mediated disease associated with psoriasis (PsO). O... more Psoriatic arthritis (PsA) is a chronic immune-mediated disease associated with psoriasis (PsO). Overexpression of inflammatory cytokines such as tumor necrosis factor (TNF)-α plays a key role in the pathogenic mechanisms. Golimumab (GLM) is a fully human monoclonal antibody IgG1k neutralizing TNF-α approved for PsA and PsO, but effectiveness evaluation in real life remains a crucial issue.In a real-life setting, to determine the survival rate of GLM (drug survival) at 48 months in the global population, in different clinical settings, and the effectiveness of GLM in improving joint symptoms and cutaneous manifestations in patients affected by moderate to severe PsA with cutaneous involvement.We collected retrospectively from 1 January 2014 to 31 December 2019 data from 105 patients affected by PsA, according to the Classification for Psoriatic Arthritis (CASPAR) criteria, who started treatment with GLM. Inclusion criteria were age > 18 years and had a diagnosis of PsA > 6 mont...

Annals of the Rheumatic Diseases, 2020

Background: Psoriatic arthritis (PsA) treatment paradigm has dramatically change during the last ... more Background: Psoriatic arthritis (PsA) treatment paradigm has dramatically change during the last 15 years, improving patients clinical outcomes and quality of life. We have now the possibility of a wide option among bDMARDs with different targets: TNF-inhibitors (TNFi), anti-IL17A inhibitors and anti-p40IL12/23. However, the choice of the “best” treatment in PsA patients is still a challenge in our daily clinical practice, making treatment decision a tricking issue. Objectives: Aim of the study was to retrospectively evaluate the distribution of clinical PsA subtypes and comorbidities among bDMARDs treated patients in the last 15 years in a monocentric cohort of the Rheumatology Unit, University of Rome Tor Vergata. Methods: Patients affected by PsA diagnosed by the CASPAR criteria and treated with a bDMARDs, in the last 15 years were enrolled. Clinical assessment included the presence of: oligo and/or polyarthritis and axial involvement (yes/no), enthesitis (yes/no), dactylitis (ye...

Annals of the Rheumatic Diseases, 2020

Diagnostic delay of spondyloarthritis (SpA) has been established even in combination with inflamm... more Diagnostic delay of spondyloarthritis (SpA) has been established even in combination with inflammatory bowel disease and may contribute to radiographic progression and disability.We aimed to evaluate diagnostic delay in enteropathic SpA (eSpA) and explore associated demographic, clinical, and radiographic characteristics.We analysed consecutive eSpA patients referred to the combined gastro-rheumatologic clinic of the University of Rome Tor Vergata. Diagnostic delay was defined as the time interval from the date of first symptoms to the date of diagnosis. Conventional radiography (CR) and magnetic resonance images (MRI) of sacroiliac (SI) joints and spine were performed in axial (ax)SpA patient and examined by two independent radiologists. MRI were assessed for the presence of active/chronic inflammatory lesions, disease activity by ASDAS and inflammatory markers. Statistical analyses were performed using Mann-Whitney, chi square/Fisher tests and covariance analysis (SPSS software).1...

Annals of the Rheumatic Diseases, 2021

Micronutrient deficiencies (MNDs) are common among patients with chronic inflammatory diseases. T... more Micronutrient deficiencies (MNDs) are common among patients with chronic inflammatory diseases. These are associated with a pro-inflammatory status and co-morbidities, and influenced by several factors, such as age and gender.No any study has investigated MNDs and their correlation with gender in Spondyloarthritis (SpA). With this purpose, this study analyzed the occurrence of anemia and the status of ferritin (Fe), vitamin D [25(OH)D], vitamin B12 (B12), and folic acid (FA) in a cohort of patients with SpA.Levels of Hb, Fe, 25(OH)D, B12, FA, were evaluated in 220 SpA outpatients (137 females and 83 age-matched males) with Psoriatic arthritis (PsA, n=110) and SpA (n=110). Disease activity was assessed by DAPSA or ASDAS-CRP as appropriate and functional status was evaluated with HAQ score. Body Mass Index (BMI) was selected as a metabolic clinic parameter.Male and female patients were similar for disease duration and severity as well as the distribution of diagnosis and treatments (T...

Annals of the Rheumatic Diseases, 2020

Background: Gender medicine aims at describing how diseases differ between men and women in terms... more Background: Gender medicine aims at describing how diseases differ between men and women in terms of epidemiology, clinical feature, therapeutic approach, treatment response and prognosis, psychological and social impact. Rheumatoid Arthritis (RA) affects women 2-3 times more than men. Female gender seems to be independently associated to a more refractory disease and a worst response to conventional synthetic Disease Modifying Anti-Rheumatic Drugs (csDMARDs) and biological DMARDs. Male patients achieve remission more often than females probably due to the higher number of tender joints reported by the latter. Objectives: In the light of the effect of Janus kinases inhibitors (JAKi) on pain, the objective of the study was to investigate whether gender might affect the achievement of remission or low disease activity in RA patients treated with baricitinib and tofacitinib. Methods: We performed a multicentric, prospective study on consecutive patients starting one of the two availabl...

Reumatismo, 2018

Rheumatological systemic autoimmune diseases, such as connective tissue diseases, rheumatoid arth... more Rheumatological systemic autoimmune diseases, such as connective tissue diseases, rheumatoid arthritis or spondyloarthritis, are characterized by the presence of joint involvement associated with extra-articular manifestations. Among them, cutaneous diseases are often the most relevant and representative clinical manifestation, as in psoriatic arthritis, scleroderma or systemic lupus erythematosus. In this context, it is useful for rheumatologists to understand better skin diseases and their histopathological features. Evaluation of skin biopsy specimens can be helpful not only to confirm the diagnosis in both classic and clinically atypical variants, but also to improve further our knowledge of the pathogenetic mechanisms and the close link between skin and articular diseases. In this review, we discuss the clinical features, diagnostic evaluation and the histopathological features of skin manifestation of the most relevant rheumatological autoimmune diseases.

Journal of Immunology Research, 2019

Autoimmune diseases (AIDs) are complex diseases characterized by persistent or recurrent inflamma... more Autoimmune diseases (AIDs) are complex diseases characterized by persistent or recurrent inflammation, alteration of immune response, and production of specific autoantibodies. It is known that different AIDs share several susceptibility genetic loci. Tumor necrosis factor alpha inducible protein 3 (TNFAIP3) encodes the ubiquitin-modifying enzyme A20, which downregulates inflammation by restricting NF-κB, a transcription factor that regulates expression of various proinflammatory genes. Variants in TNFAIP3 gene have been described as associated with susceptibility to several AIDs. Here, we analyzed two TNFAIP3 polymorphisms in Italian patients with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and primary Sjogren’s syndrome (pSS), to verify if the genetic variability of TNFAIP3 gene is involved in genetic predisposition to AIDs also in the Italian population. We recruited 313 SLE patients, 256 RA patients, 195 pSS patients, and 236 healthy controls. Genotyping of rs...

Saturday, 16 JUNE 2018, 2018

SAT0306-Figure 1. The increased thickness and the presence of Doppler signals in the A1 pulley in... more SAT0306-Figure 1. The increased thickness and the presence of Doppler signals in the A1 pulley in a digit with dactylitis in longitudinal (A and B) and transverse (C and D) Results: Half of the A1 pulleys with dactylitic digits had Doppler signals (10/20, 50%), which was less common in A2 (6/20 (30%)) and A4 pulleys (6/20 (30%)) (figure). The digits without dactylitis had Doppler signals less frequently (A1: 1/19 (5%); A2: 1/19 (5%) A4: 1/19 (5%)) A1, A2 and A4 pulleys were significantly thicker in dactylitis fingers compared to fingers without dactylitis, both in longitudinal and transverse planes (table 1). Conclusions: This study demonstrates that pulleys contribute to the pathogenesis of dactylitis with increased vascularity and thickening, probably due to the micro-enthesitis at the level where the flexor tendons are exposed to high mechanical stress. This is important to understand the anatomical basis of a complex disease feature in PsA, dactylitis Disclosure of Interest: None declared

Poster Presentations, 2017

References: [1] Baraliakos, X. et al. High prevalence of anti-CD74 antibodies specific for the HL... more References: [1] Baraliakos, X. et al. High prevalence of anti-CD74 antibodies specific for the HLA class II-associated invariant chain peptide (CLIP) in patients with axial spondyloarthritis. Ann. Rheum. Dis. 1-5 (2013). [2] Baerlecken, N. T. et al. Autoantibodies against CD74 in spondyloarthritis. Ann.

Poster Presentations, 2017

Collagen type II (CII) is the most abundant protein found in cartilage. We have produced a single... more Collagen type II (CII) is the most abundant protein found in cartilage. We have produced a single chain variable fragment (scFv) antibodies specific to CII modified by reactive oxygen species (ROS), namely anti-ROS-CII scFv. Previously, we have demonstrated the ability of anti-ROS-CII scFv to localise exclusively and deliver payload drugs to the arthritic joint in mice models of rheumatoid arthritis 2. Objectives: To test our hypothesis that anti-ROS-CII association with MV might i) target delivery of MV to inflamed joint and/or ii) enhance the avidity of the scFv (several scFv can be loaded in each MV) and may thus increase localisation and enhance therapeutic efficacy. Methods: Cy5.5 labeled Anti-ROS-CII scFv were loaded on fluorescently labelled human PMN MV by aqueous energy dissemination using a sonic dismembrator 3-4. Anti-ROS-CII scFv MV incorporation was confirmed by Imagestream X analysis. Anti-ROS-CII scFv MV were tested by ELISA to assess the retention of antibody binding capabilities. Results: Positive incorporation of Anti-ROS-CII scFv upon MV was observed by flow cytometric analysis. ELISA demonstrated the ability of the anti-ROS-CII loaded MV to bind strongly to ROS-CII following incorporation into MV. Conclusions: In this study, we have demonstrated a simple, efficient and cost effective way of antibody targeting that retains antibody function. Such technology has the potential to increase efficacy of existing therapies by ensuring specific targeting. Future in vivo studies will assess the ability of the Anti-ROS-CII scFv MV to localise to arthritic joints. References: [1] Headland, S. E. et al. Neutrophil-derived microvesicles enter cartilage and protect the joint in inflammatory arthritis. Science Translational Medicine, 7(315), (2015). [2] Hughes, C. et al. Human single-chain variable fragment that specifically targets arthritic cartilage. Arthritis and Rheumatism 62(4), 1007-1016 (2010). [3] Dalli, J. et al. Microparticle alpha-2-macroglobulin enhances pro-resolving responses and promotes survival in sepsis.

Annals of the Rheumatic Diseases, 2016

Background Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy commonly associated wi... more Background Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy commonly associated with psoriasis. Minimal disease activity (MDA) and remission represent treatment targets. However, their assessment is to date an unmet need in PsA patients. Objectives Aim of the study was to prospectively evaluate MDA and remission in PsA patients who were treated with subcutaneous TNF inhibitors (iTNF), every 3/6 months for 2 years. Methods Clinical and laboratory data from 221 PsA patients were analyzed (F:M=1.3, age 55±13 years, disease duration 12.3±6.1 years) at baseline (T0), after 22 (T22), 54 (T54) and 104 (T104) weeks from the beginning of TNFi (adalimumab n=94; etanercept n=84; golimumab n=43). Values of DAS28-CRP, CPDAI, and DAPSA were calculated, and MDA/remission were assessed at the all the time points. MDA was defined as the occurrence of 5/7 criteria, while remission was assessed as DAS28-CRP<2.6, DAPSA≤3.3, and CPDAI<2. Occurrences of comorbidities such as cardio-vascular, renal, respiratory, infectious, metabolic, neuropsychiatric and thyroid diseases were registered. Concomitant therapies (steroids and csDMARDs) and predictive factors of remission were analyzed in accordance with the above-mentioned scores. The Chi-square test was used to compare the remission rate at the follow-up and to analyze the predictive factors. Cohen's kappa analysis was performed to measure the concordance between clinimetric scores: kappa ≥0.6 was considered as a good agreement and kappa ≥0.8 was considered as an excellent agreement. Results Prevalence of patients on DAS28 and DAPSA remission was significantly higher at T104 comparing to T0, T22 and T54 while patients on MDA and CPDAI remission were more frequent at T104 compared with T0 and T22 (Figure1A). At all the time points, a good concordance between MDA and DAS28<2.6 occurred (k=0.63) and an excellent concordance was obtained between MDA, CPDAI<2 and DAPSA≤3.3 (k=0.81). At T22, patients with thyreopathies achieved the CPDAI remission in a lower percentage compared to patients without thyreopathies (P=0.02, OR=3.3) (Figure 1B). At T104, the female sex was associated with a lower prevalence of patients on DAS28 remission (P=0.005, OR=2.3) and MDA (P=0.01, OR=2.7) while a lower percentage of patients with metabolic comorbidities was on DAS28 remission with the respect to patients without them (P=0.02, OR=3.3) (Figure1B). Patients on concomitant steroid therapy were fewer at T22/54/104 with the respect to T0 (P<0.0001 for all the comparisons) while the rate of patients on csDMARDs was lower at T104 compared with T0 (P<0.01). Conclusions In clinical practice, MDA and remission were achieved in a high prevalence of PsA patients during TNFi treatment with a rate that increased from 22 to 104 weeks. Tapering of the concomitant treatment was thus allowed. Predictors as thyreopathies, female sex, and metabolic comorbidities were associated with a lower probability to achieve clinical remission. Disclosure of Interest None declared

Annals of the Rheumatic Diseases, 2016

Background The goals of treatment in Rheumatoid Arthritis (RA) are remission and low disease acti... more Background The goals of treatment in Rheumatoid Arthritis (RA) are remission and low disease activity (LDA); therefore, it is important to identify reliable predictive factors of these targets so that treatment can be tailored. Objectives We aimed at identifying positive and negative predictive factors of remission and LDA in RA patients treated in real practice with first line anti-TNF drugs. Methods Retrospective analysis of DAS28 remission/LDA in 308 RA patients treated for two years with first line anti-TNF drugs from January 2008 to December 2014: [female n=251 (81.5%), age 55±13 years, disease duration 7.6±8.4 years, rheumatoid factor (RF, n=220 (71.4%)), anti-citrullinated antibodies (ACPA, n=214 (69.5%)), baseline C-reactive protein (CRP, 11.4±16.5 (mg/L)), baseline DMARDs (n=225 (73.1%)), baseline steroid (n=160 (51.9%)), Adalimumab (n=109 (35.4%)), Etanercept (n=177 (57.5%)), other anti-TNF (n=22 (7.1%))]. Predictive factors considered for achievement of remission and LDA were: gender, age at the time of anti-TNF treatment (cut-off >54 yrs old, n=139 (45.1%)), age at onset >65 yrs old (n=27 (8.8%)), early arthritis (n=99 (32.1%)), baseline negative CRP (n=150 (48.7%), RF/ACPA positivity, good/moderate EULAR response at 6 months (n=169 (54.9%)), presence of any comorbidity (n=210 (68.2%)), cardiovascular comorbidity (n=83 (26.9%)), metabolic syndrome (n=26 (8.4%)), infectious (n=49 (15.9%)), thyreopathies (n=64 (20.8%)), concomitant DMARDs/steroid treatment. Intention to treat, ROC-curve, univariate and multivariate analysis by logistic regression were performed. Selection of the variables to be included in the multivariate analysis was performed on the basis of their statistical significance in the univariate analysis. Results In the univariate analysis positive predictors of remission and LDA at 6 months, 1 year and 2 years of anti-TNF treatments were identified as follows (Figure 1A): male gender, age at the time of anti-TNF treatment <54 yrs old, age at onset <65 yrs old, early arthritis, baseline negative CRP levels, good/moderate EULAR response at 6 months and concomitant DMARDs treatment. Negative predictors were presence of any comorbidity, cardiovascular comorbidity and metabolic syndrome. In the multivariate analysis the only significant positive predictor of remission and LDA at 6 months, 1 and 2 years of treatment was the negative CRP levels at baseline (Figure 1B). Conclusions Negative CRP levels prior to commence anti-TNF treatments in RA patients appeared to be a reliable predictor of remission and LDA in clinical practice. Disclosure of Interest None declared

Clinical and Experimental Immunology, 2016

Summary Rheumatoid arthritis (RA) is a systemic autoimmune disease resulting in chronic inflammat... more Summary Rheumatoid arthritis (RA) is a systemic autoimmune disease resulting in chronic inflammation of the synovium and consequent cartilage and bone erosion. RA is associated strongly with the presence of rheumatoid factor (RF), and consists of clinical subsets of anti-citrullinated protein antibody (ACPA)-positive and -negative patients. This study was designed to evaluate whether relevant single nucleotide polymorphisms (SNPs) associated with RA and other autoimmune disorders are related to RF, ACPA and clinical phenotype in a cohort of biologic drugs naive Italian RA patients; 192 RA patients and 278 age-matched healthy controls were included. Clinical and laboratory data were registered. We analysed a total of 12 single nucleotide polymorphisms (SNPs) in signal transducer and activator of transcription-4 (STAT-4), interleukin (IL)-10, psoriasis susceptibility 1 candidate 1 (PSORS1C1), protein tyrosine phosphatase, non-receptor type 2 (PTPN2), endoplasmic reticulum aminopeptida...

Annals of the Rheumatic Diseases, 2015

ABSTRACT

Annals of the Rheumatic Diseases

BackgroundPsoriatic Arthritis (PsA) is a chronic inflammatory disease, characterized by both arti... more BackgroundPsoriatic Arthritis (PsA) is a chronic inflammatory disease, characterized by both articular and periarticular manifestations, usually associated with psoriasis. The identification of the correct therapy for patients is still a critical issue, but the use of biological drugs, such as TNFi (Tumor Necrosis Factor Inhibitors), modified the outcome of PsA patients even if there is great variability in the clinical efficacy. Since the response to drugs is a complex trait, the identification of genetic factors could help to define new genomic biomarkers for more effective and personalized therapy.ObjectivesThe aim of this study was to evaluate the potential role of polymorphisms in genes already known to be involved in PsA susceptibility (ERAP1, HCP5, IL10, MIR146, PSORS1C1, STAT4, TNFAIP3 and TRAF3IP2) as predictors of efficacy of treatment, in a cohort of Italian PsA patients, treated with first-line TNF-i, in particular with Etanercept (ETN) and Adalimumab (ADA).MethodsPolymo...

Annals of the Rheumatic Diseases

Background:Secukinumab (SEC) is the first interleukin-17A inhibitor showing efficacy in both anky... more Background:Secukinumab (SEC) is the first interleukin-17A inhibitor showing efficacy in both ankylosing spondylitis (AS) and psoriatic arthritis (PsA) in randomised trials, but real-life data are lacking.Objectives:In this prospective observational study, we evaluated the effectiveness and safety of SEC in patients with AS and PsA in a real-life setting.Methods:From September 2018 to September 2019, data were collected from 168 consecutive outpatients at baseline (T0) and at 6 (T6) and 12 months (T12) after starting SEC (39 AS, 23%; 129 PsA, 77%).Results:Significant improvement was seen at T6 and T12 for all clinical variables, including TJC, SJC, ESR, CRP, DAPSA, ASDAS-CRP, and BASDAI, as well as in patient-reported outcomes such as VAS-pain. By multivariable regression analysis, in AS patients high BASDAI at T0 correlated with diagnostic delay (R2=0.4; p=0.009) and peripheral joint involvement (R2=0.4; p=0.04). During follow-up, reduction of BASDAI positively correlated with high ...

European review for medical and pharmacological sciences, 2022

OBJECTIVE Micronutrient deficiencies (MNDs) are common among patients with certain chronic inflam... more OBJECTIVE Micronutrient deficiencies (MNDs) are common among patients with certain chronic inflammatory diseases. They are associated with a pro-inflammatory status and co-morbidities. However, no studies have specifically investigated MNDs in Spondyloarthritis (SpA). This paper aimed at analyzing the occurrence of anemia and deficiencies of ferritin (Fe), vitamin D [25(OH)D], vitamin B12 (B12), and folic acid (FA) in SpA patients. The interplay of MNDs with age, gender, and metabolic abnormalities was also explored. PATIENTS AND METHODS MNDs were evaluated in 220 SpA outpatients (137 females and 83 age-matched males) with psoriatic arthritis (PsA, n=110) and non-psoriatic SpA (n=110). Metabolic parameters were analyzed. Disease activity was assessed by either Disease Activity in PSoriatic Arthritis (DAPSA) or Ankylosing Spondylitis Disease Activity Score with C-Reactive Protein (ASDAS-CRP) as appropriate, while the functional status was evaluated using Health Assessment Questionnai...

Annals of the Rheumatic Diseases, 2020

Background:SpA patients experience a decreased quality of life due to social, emotional and relat... more Background:SpA patients experience a decreased quality of life due to social, emotional and relational life impairment in addition to pain, fatigue and joint damage. Sexual dysfunction (SD) is often neglected by both patients and clinicians, although articular and extra-articular manifestations of the disease can decrease the quality of sexual life. Previous findings showed that SD can affect from 27% to 67% of patients with rheumatic diseases. Data available on SD in rheumatic patients are poor and primarily focus on male ankylosing spondylitis patientsObjectives:The aim of this study is to evaluate, in a group of female SpA patients, the presence of SD, its relationship with extra-articular manifestations and to estimate the correlation between disease activity and sexual activity.Methods:52 SpA patients (including PsA, IBD-SpA and undifferentiated SpA-un-SpA) and 50 healthy controls (HC) were administered the Female Sexual Function Index (FSFI) questionnaire for the analysis of s...

Annals of the Rheumatic Diseases, 2020

The Italian Society for Rheumatology (SIR) comprises committees for Rheumatologists under the age... more The Italian Society for Rheumatology (SIR) comprises committees for Rheumatologists under the age of 40 (SIRyoung) and for Women in Rheumatology (Reumatologhe Donne – ReDO). As female representation is increasing in rheumatology worldwide [1], there has been interest in assessing gender-related issues.To describe the gender distribution among young members of SIR and academic positions in Rheumatology in Italy. To assess the expectations and needs of young rheumatologists with regard to their career.SIRyoung members developed a web-based survey which was distributed among SIR members under the age of 40 during the spring of 2019. Responses were collected and analysed anonymously. ReDO retrieved and analysed the data regarding academic positions in Italy in September 2019 from official data by “Ministry of Education, University and Research” (www.miur.it).Out of 478 SIR members under 40 (66.5% F), 113 (23.7%) completed the SIRyoung survey (62.1% F). Regarding career plans, male and female members responded: hospital physician (36.9% vs 37.8%), outpatient clinic physician (18.5% vs 28.3%), academic career (23.9% vs 22.8%), private practice (16.3% vs 9.4%), and industry (4.3 vs 1.6%), respectively. When asked about their interest in doing a fellowship in another national center or abroad, 60.8% of male and 72.8% of female respondents were interested but thought they could not afford it. Reasons reported by males and females were: working reasons, namely barriers to temporarily leave the workplace (61.3% vs 50.7%), family reasons (16.1% vs 25.4%), financial reasons (22.6% vs 16.5%), respectively. As for academic rheumatology in Italy, 113 positions were retrieved. Men held 64 positions (57%) and women 49 (43%). Full professors were mostly men (92%), while assistant professors were women in 65% of the cases (58% of those with a permanent position; 72% of those with a temporary position) (Figure) [2].Our study explored for the first time gender distribution and related issues in Rheumatology in Italy. Female representation accounts for two thirds of SIR members under 40. This could reflect the general trend of medical school being chosen more often by women than men. No differences were observed in the career expectations of male and female rheumatologists. Interestingly, nearly one fourth of female respondents were interested in academic career, confirming the trend toward female predominance observed for assistant professors. Therefore, it is likely that the next generation of full professors will have a balanced gender distribution, as it is already for associate professors. The choice of a fellowship is still hampered by several problems, but it seems that reasons for not pursuing such opportunities are similarly distributed in males and females. Although family reasons tend to be more frequent in female rheumatologists, this is not significant as compared to men. This could indicate that family affects career choices of both male and female rheumatologists. It is important that national societies promote surveys for the assessment of gender specific issues among their members, in order to identify unmet needs and design interventions for career support regardless of gender.[1]Andreoli L, et al. Joint, Bone, Spine: Revue du Rhumatisme. 2019;86(6):669-672.[2]Bosello SL, et al. Reumatismo 2020; in press.SIRyoung and ReDO wish to thank the Steering Committee of SIRLaura Andreoli: None declared, Stefano Alivernini: None declared, Alessia Alunno: None declared, Silvia Laura Bosello: None declared, Cecilia Chighizola: None declared, Paola Conigliaro: None declared, Elisa Gremese Speakers bureau: Abbvie, BMS, Celgene, Jannsen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB, Cristina Iannuccelli: None declared, Luca Quartuccio Consultant of: Abbvie, Bristol, Speakers bureau: Abbvie, Pfizer, Francesca Romana Spinelli Grant/research support from: Pfizer, Consultant of: Novartis, Gilead, Lilly, Sanofi, Celgene, Speakers bureau: Lilly, Marta Vadacca: None declared, Maria Sole Chimenti: None declared

Annals of the Rheumatic Diseases, 2020

Psoriatic arthritis (PsA) is a chronic immune-mediated disease associated with psoriasis (PsO). O... more Psoriatic arthritis (PsA) is a chronic immune-mediated disease associated with psoriasis (PsO). Overexpression of inflammatory cytokines such as tumor necrosis factor (TNF)-α plays a key role in the pathogenic mechanisms. Golimumab (GLM) is a fully human monoclonal antibody IgG1k neutralizing TNF-α approved for PsA and PsO, but effectiveness evaluation in real life remains a crucial issue.In a real-life setting, to determine the survival rate of GLM (drug survival) at 48 months in the global population, in different clinical settings, and the effectiveness of GLM in improving joint symptoms and cutaneous manifestations in patients affected by moderate to severe PsA with cutaneous involvement.We collected retrospectively from 1 January 2014 to 31 December 2019 data from 105 patients affected by PsA, according to the Classification for Psoriatic Arthritis (CASPAR) criteria, who started treatment with GLM. Inclusion criteria were age > 18 years and had a diagnosis of PsA > 6 mont...

Annals of the Rheumatic Diseases, 2020

Background: Psoriatic arthritis (PsA) treatment paradigm has dramatically change during the last ... more Background: Psoriatic arthritis (PsA) treatment paradigm has dramatically change during the last 15 years, improving patients clinical outcomes and quality of life. We have now the possibility of a wide option among bDMARDs with different targets: TNF-inhibitors (TNFi), anti-IL17A inhibitors and anti-p40IL12/23. However, the choice of the “best” treatment in PsA patients is still a challenge in our daily clinical practice, making treatment decision a tricking issue. Objectives: Aim of the study was to retrospectively evaluate the distribution of clinical PsA subtypes and comorbidities among bDMARDs treated patients in the last 15 years in a monocentric cohort of the Rheumatology Unit, University of Rome Tor Vergata. Methods: Patients affected by PsA diagnosed by the CASPAR criteria and treated with a bDMARDs, in the last 15 years were enrolled. Clinical assessment included the presence of: oligo and/or polyarthritis and axial involvement (yes/no), enthesitis (yes/no), dactylitis (ye...

Annals of the Rheumatic Diseases, 2020

Diagnostic delay of spondyloarthritis (SpA) has been established even in combination with inflamm... more Diagnostic delay of spondyloarthritis (SpA) has been established even in combination with inflammatory bowel disease and may contribute to radiographic progression and disability.We aimed to evaluate diagnostic delay in enteropathic SpA (eSpA) and explore associated demographic, clinical, and radiographic characteristics.We analysed consecutive eSpA patients referred to the combined gastro-rheumatologic clinic of the University of Rome Tor Vergata. Diagnostic delay was defined as the time interval from the date of first symptoms to the date of diagnosis. Conventional radiography (CR) and magnetic resonance images (MRI) of sacroiliac (SI) joints and spine were performed in axial (ax)SpA patient and examined by two independent radiologists. MRI were assessed for the presence of active/chronic inflammatory lesions, disease activity by ASDAS and inflammatory markers. Statistical analyses were performed using Mann-Whitney, chi square/Fisher tests and covariance analysis (SPSS software).1...

Annals of the Rheumatic Diseases, 2021

Micronutrient deficiencies (MNDs) are common among patients with chronic inflammatory diseases. T... more Micronutrient deficiencies (MNDs) are common among patients with chronic inflammatory diseases. These are associated with a pro-inflammatory status and co-morbidities, and influenced by several factors, such as age and gender.No any study has investigated MNDs and their correlation with gender in Spondyloarthritis (SpA). With this purpose, this study analyzed the occurrence of anemia and the status of ferritin (Fe), vitamin D [25(OH)D], vitamin B12 (B12), and folic acid (FA) in a cohort of patients with SpA.Levels of Hb, Fe, 25(OH)D, B12, FA, were evaluated in 220 SpA outpatients (137 females and 83 age-matched males) with Psoriatic arthritis (PsA, n=110) and SpA (n=110). Disease activity was assessed by DAPSA or ASDAS-CRP as appropriate and functional status was evaluated with HAQ score. Body Mass Index (BMI) was selected as a metabolic clinic parameter.Male and female patients were similar for disease duration and severity as well as the distribution of diagnosis and treatments (T...

Annals of the Rheumatic Diseases, 2020

Background: Gender medicine aims at describing how diseases differ between men and women in terms... more Background: Gender medicine aims at describing how diseases differ between men and women in terms of epidemiology, clinical feature, therapeutic approach, treatment response and prognosis, psychological and social impact. Rheumatoid Arthritis (RA) affects women 2-3 times more than men. Female gender seems to be independently associated to a more refractory disease and a worst response to conventional synthetic Disease Modifying Anti-Rheumatic Drugs (csDMARDs) and biological DMARDs. Male patients achieve remission more often than females probably due to the higher number of tender joints reported by the latter. Objectives: In the light of the effect of Janus kinases inhibitors (JAKi) on pain, the objective of the study was to investigate whether gender might affect the achievement of remission or low disease activity in RA patients treated with baricitinib and tofacitinib. Methods: We performed a multicentric, prospective study on consecutive patients starting one of the two availabl...

Reumatismo, 2018

Rheumatological systemic autoimmune diseases, such as connective tissue diseases, rheumatoid arth... more Rheumatological systemic autoimmune diseases, such as connective tissue diseases, rheumatoid arthritis or spondyloarthritis, are characterized by the presence of joint involvement associated with extra-articular manifestations. Among them, cutaneous diseases are often the most relevant and representative clinical manifestation, as in psoriatic arthritis, scleroderma or systemic lupus erythematosus. In this context, it is useful for rheumatologists to understand better skin diseases and their histopathological features. Evaluation of skin biopsy specimens can be helpful not only to confirm the diagnosis in both classic and clinically atypical variants, but also to improve further our knowledge of the pathogenetic mechanisms and the close link between skin and articular diseases. In this review, we discuss the clinical features, diagnostic evaluation and the histopathological features of skin manifestation of the most relevant rheumatological autoimmune diseases.

Journal of Immunology Research, 2019

Autoimmune diseases (AIDs) are complex diseases characterized by persistent or recurrent inflamma... more Autoimmune diseases (AIDs) are complex diseases characterized by persistent or recurrent inflammation, alteration of immune response, and production of specific autoantibodies. It is known that different AIDs share several susceptibility genetic loci. Tumor necrosis factor alpha inducible protein 3 (TNFAIP3) encodes the ubiquitin-modifying enzyme A20, which downregulates inflammation by restricting NF-κB, a transcription factor that regulates expression of various proinflammatory genes. Variants in TNFAIP3 gene have been described as associated with susceptibility to several AIDs. Here, we analyzed two TNFAIP3 polymorphisms in Italian patients with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and primary Sjogren’s syndrome (pSS), to verify if the genetic variability of TNFAIP3 gene is involved in genetic predisposition to AIDs also in the Italian population. We recruited 313 SLE patients, 256 RA patients, 195 pSS patients, and 236 healthy controls. Genotyping of rs...

Saturday, 16 JUNE 2018, 2018

SAT0306-Figure 1. The increased thickness and the presence of Doppler signals in the A1 pulley in... more SAT0306-Figure 1. The increased thickness and the presence of Doppler signals in the A1 pulley in a digit with dactylitis in longitudinal (A and B) and transverse (C and D) Results: Half of the A1 pulleys with dactylitic digits had Doppler signals (10/20, 50%), which was less common in A2 (6/20 (30%)) and A4 pulleys (6/20 (30%)) (figure). The digits without dactylitis had Doppler signals less frequently (A1: 1/19 (5%); A2: 1/19 (5%) A4: 1/19 (5%)) A1, A2 and A4 pulleys were significantly thicker in dactylitis fingers compared to fingers without dactylitis, both in longitudinal and transverse planes (table 1). Conclusions: This study demonstrates that pulleys contribute to the pathogenesis of dactylitis with increased vascularity and thickening, probably due to the micro-enthesitis at the level where the flexor tendons are exposed to high mechanical stress. This is important to understand the anatomical basis of a complex disease feature in PsA, dactylitis Disclosure of Interest: None declared

Poster Presentations, 2017

References: [1] Baraliakos, X. et al. High prevalence of anti-CD74 antibodies specific for the HL... more References: [1] Baraliakos, X. et al. High prevalence of anti-CD74 antibodies specific for the HLA class II-associated invariant chain peptide (CLIP) in patients with axial spondyloarthritis. Ann. Rheum. Dis. 1-5 (2013). [2] Baerlecken, N. T. et al. Autoantibodies against CD74 in spondyloarthritis. Ann.

Poster Presentations, 2017

Collagen type II (CII) is the most abundant protein found in cartilage. We have produced a single... more Collagen type II (CII) is the most abundant protein found in cartilage. We have produced a single chain variable fragment (scFv) antibodies specific to CII modified by reactive oxygen species (ROS), namely anti-ROS-CII scFv. Previously, we have demonstrated the ability of anti-ROS-CII scFv to localise exclusively and deliver payload drugs to the arthritic joint in mice models of rheumatoid arthritis 2. Objectives: To test our hypothesis that anti-ROS-CII association with MV might i) target delivery of MV to inflamed joint and/or ii) enhance the avidity of the scFv (several scFv can be loaded in each MV) and may thus increase localisation and enhance therapeutic efficacy. Methods: Cy5.5 labeled Anti-ROS-CII scFv were loaded on fluorescently labelled human PMN MV by aqueous energy dissemination using a sonic dismembrator 3-4. Anti-ROS-CII scFv MV incorporation was confirmed by Imagestream X analysis. Anti-ROS-CII scFv MV were tested by ELISA to assess the retention of antibody binding capabilities. Results: Positive incorporation of Anti-ROS-CII scFv upon MV was observed by flow cytometric analysis. ELISA demonstrated the ability of the anti-ROS-CII loaded MV to bind strongly to ROS-CII following incorporation into MV. Conclusions: In this study, we have demonstrated a simple, efficient and cost effective way of antibody targeting that retains antibody function. Such technology has the potential to increase efficacy of existing therapies by ensuring specific targeting. Future in vivo studies will assess the ability of the Anti-ROS-CII scFv MV to localise to arthritic joints. References: [1] Headland, S. E. et al. Neutrophil-derived microvesicles enter cartilage and protect the joint in inflammatory arthritis. Science Translational Medicine, 7(315), (2015). [2] Hughes, C. et al. Human single-chain variable fragment that specifically targets arthritic cartilage. Arthritis and Rheumatism 62(4), 1007-1016 (2010). [3] Dalli, J. et al. Microparticle alpha-2-macroglobulin enhances pro-resolving responses and promotes survival in sepsis.

Annals of the Rheumatic Diseases, 2016

Background Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy commonly associated wi... more Background Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy commonly associated with psoriasis. Minimal disease activity (MDA) and remission represent treatment targets. However, their assessment is to date an unmet need in PsA patients. Objectives Aim of the study was to prospectively evaluate MDA and remission in PsA patients who were treated with subcutaneous TNF inhibitors (iTNF), every 3/6 months for 2 years. Methods Clinical and laboratory data from 221 PsA patients were analyzed (F:M=1.3, age 55±13 years, disease duration 12.3±6.1 years) at baseline (T0), after 22 (T22), 54 (T54) and 104 (T104) weeks from the beginning of TNFi (adalimumab n=94; etanercept n=84; golimumab n=43). Values of DAS28-CRP, CPDAI, and DAPSA were calculated, and MDA/remission were assessed at the all the time points. MDA was defined as the occurrence of 5/7 criteria, while remission was assessed as DAS28-CRP<2.6, DAPSA≤3.3, and CPDAI<2. Occurrences of comorbidities such as cardio-vascular, renal, respiratory, infectious, metabolic, neuropsychiatric and thyroid diseases were registered. Concomitant therapies (steroids and csDMARDs) and predictive factors of remission were analyzed in accordance with the above-mentioned scores. The Chi-square test was used to compare the remission rate at the follow-up and to analyze the predictive factors. Cohen's kappa analysis was performed to measure the concordance between clinimetric scores: kappa ≥0.6 was considered as a good agreement and kappa ≥0.8 was considered as an excellent agreement. Results Prevalence of patients on DAS28 and DAPSA remission was significantly higher at T104 comparing to T0, T22 and T54 while patients on MDA and CPDAI remission were more frequent at T104 compared with T0 and T22 (Figure1A). At all the time points, a good concordance between MDA and DAS28<2.6 occurred (k=0.63) and an excellent concordance was obtained between MDA, CPDAI<2 and DAPSA≤3.3 (k=0.81). At T22, patients with thyreopathies achieved the CPDAI remission in a lower percentage compared to patients without thyreopathies (P=0.02, OR=3.3) (Figure 1B). At T104, the female sex was associated with a lower prevalence of patients on DAS28 remission (P=0.005, OR=2.3) and MDA (P=0.01, OR=2.7) while a lower percentage of patients with metabolic comorbidities was on DAS28 remission with the respect to patients without them (P=0.02, OR=3.3) (Figure1B). Patients on concomitant steroid therapy were fewer at T22/54/104 with the respect to T0 (P<0.0001 for all the comparisons) while the rate of patients on csDMARDs was lower at T104 compared with T0 (P<0.01). Conclusions In clinical practice, MDA and remission were achieved in a high prevalence of PsA patients during TNFi treatment with a rate that increased from 22 to 104 weeks. Tapering of the concomitant treatment was thus allowed. Predictors as thyreopathies, female sex, and metabolic comorbidities were associated with a lower probability to achieve clinical remission. Disclosure of Interest None declared

Annals of the Rheumatic Diseases, 2016

Background The goals of treatment in Rheumatoid Arthritis (RA) are remission and low disease acti... more Background The goals of treatment in Rheumatoid Arthritis (RA) are remission and low disease activity (LDA); therefore, it is important to identify reliable predictive factors of these targets so that treatment can be tailored. Objectives We aimed at identifying positive and negative predictive factors of remission and LDA in RA patients treated in real practice with first line anti-TNF drugs. Methods Retrospective analysis of DAS28 remission/LDA in 308 RA patients treated for two years with first line anti-TNF drugs from January 2008 to December 2014: [female n=251 (81.5%), age 55±13 years, disease duration 7.6±8.4 years, rheumatoid factor (RF, n=220 (71.4%)), anti-citrullinated antibodies (ACPA, n=214 (69.5%)), baseline C-reactive protein (CRP, 11.4±16.5 (mg/L)), baseline DMARDs (n=225 (73.1%)), baseline steroid (n=160 (51.9%)), Adalimumab (n=109 (35.4%)), Etanercept (n=177 (57.5%)), other anti-TNF (n=22 (7.1%))]. Predictive factors considered for achievement of remission and LDA were: gender, age at the time of anti-TNF treatment (cut-off >54 yrs old, n=139 (45.1%)), age at onset >65 yrs old (n=27 (8.8%)), early arthritis (n=99 (32.1%)), baseline negative CRP (n=150 (48.7%), RF/ACPA positivity, good/moderate EULAR response at 6 months (n=169 (54.9%)), presence of any comorbidity (n=210 (68.2%)), cardiovascular comorbidity (n=83 (26.9%)), metabolic syndrome (n=26 (8.4%)), infectious (n=49 (15.9%)), thyreopathies (n=64 (20.8%)), concomitant DMARDs/steroid treatment. Intention to treat, ROC-curve, univariate and multivariate analysis by logistic regression were performed. Selection of the variables to be included in the multivariate analysis was performed on the basis of their statistical significance in the univariate analysis. Results In the univariate analysis positive predictors of remission and LDA at 6 months, 1 year and 2 years of anti-TNF treatments were identified as follows (Figure 1A): male gender, age at the time of anti-TNF treatment <54 yrs old, age at onset <65 yrs old, early arthritis, baseline negative CRP levels, good/moderate EULAR response at 6 months and concomitant DMARDs treatment. Negative predictors were presence of any comorbidity, cardiovascular comorbidity and metabolic syndrome. In the multivariate analysis the only significant positive predictor of remission and LDA at 6 months, 1 and 2 years of treatment was the negative CRP levels at baseline (Figure 1B). Conclusions Negative CRP levels prior to commence anti-TNF treatments in RA patients appeared to be a reliable predictor of remission and LDA in clinical practice. Disclosure of Interest None declared

Clinical and Experimental Immunology, 2016

Summary Rheumatoid arthritis (RA) is a systemic autoimmune disease resulting in chronic inflammat... more Summary Rheumatoid arthritis (RA) is a systemic autoimmune disease resulting in chronic inflammation of the synovium and consequent cartilage and bone erosion. RA is associated strongly with the presence of rheumatoid factor (RF), and consists of clinical subsets of anti-citrullinated protein antibody (ACPA)-positive and -negative patients. This study was designed to evaluate whether relevant single nucleotide polymorphisms (SNPs) associated with RA and other autoimmune disorders are related to RF, ACPA and clinical phenotype in a cohort of biologic drugs naive Italian RA patients; 192 RA patients and 278 age-matched healthy controls were included. Clinical and laboratory data were registered. We analysed a total of 12 single nucleotide polymorphisms (SNPs) in signal transducer and activator of transcription-4 (STAT-4), interleukin (IL)-10, psoriasis susceptibility 1 candidate 1 (PSORS1C1), protein tyrosine phosphatase, non-receptor type 2 (PTPN2), endoplasmic reticulum aminopeptida...

Annals of the Rheumatic Diseases, 2015

ABSTRACT