Rheumatology international
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Review Meta Analysis
Comparative effectiveness of abatacept, apremilast, secukinumab and ustekinumab treatment of psoriatic arthritis: a systematic review and network meta-analysis.
To assess the comparative effectiveness and safety of novel biologic therapies in psoriatic arthritis (PsA) and to establish the position of the non-anti-tumor necrosis factor α (TNF-α) biologic drugs in the treatment regimen of the disease. A systematic review and network meta-analysis (NMA) was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) requirements. Two investigators identified the studies, abstracted data, and assessed the risk of bias independently. ⋯ Both in the overall population and in the analyzed subpopulations, secukinumab 300 mg was ranked the highest for the ACR20 response rate. Secukinumab 300 mg was the safest drug in terms of any AEs, and ustekinumab 90 mg presented the lowest overall risk of SAEs. Head-to-head trials and evaluation of comparative efficacy and safety between non-TNF-α biologics are warranted to inform clinical decision making with a relevant treatment paradigm.
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Monogenic autoinflammatory syndromes are a rare group of disorders characterized by periodic episodes of systemic inflammation of endogenous origin. Sometimes, these diseases may present with features akin to vasculitis. We conducted a literature review on such vasculitic manifestations in described monogenic autoinflammatory syndromes utilizing the Online Mendelian Inheritance in Man (OMIM), Medline, and Scopus databases. ⋯ Stimulator of interferon gene (STING)-associated vasculopathy of infancy (SAVI) is an interferonopathy that can mimic the presentation of medium-vessel or small-vessel vasculitis, whereas deficiency of adenosine deaminase 2 (DADA2) is another such mimic of medium-vessel vasculitis, associated in a significant number of patients with features of immunodeficiency. Occasional reports exist of vasculitic manifestations in tumor necrosis factor (TNF) receptor-associated periodic fever syndrome (TRAPS) and chronic infantile neurologic cutaneous and articular disorder (CINCA), whereas mevalonate kinase deficiency can also mimic the presentation of small- or medium-vessel vasculitis. Clinicians should be aware of the possibility of autoinflammatory disease presenting as vasculitis to diagnose and treat the same appropriately.
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Review
Expanding the therapeutic options for renal involvement in lupus: eculizumab, available evidence.
In this study, we aimed to systematically review available literature on the efficacy of eculizumab for the treatment of renal involvement in patients with systemic lupus erythematosus (SLE). We conducted a literature search developed a priori, to identify articles reporting clinical experience with the use of eculizumab in SLE patients, focusing on renal involvement. The search strategy was applied to Ovid MEDLINE, EMBASE, In-Process and Other Non-Indexed Citation, Cochrane Central Register of Controlled Trials and Scopus from 2006 to present. ⋯ All patients, regardless of the presence of concomitant LN, presented with severe hypocomplementemia and renal function impairment. All patients showed a sustained improvement of renal function and normalization of complement parameters after treatment with eculizumab[median follow-up 9 months (1-17)]. Despite the limitations of the currently available evidence, existing data are promising and provide preliminary support for the use of eculizumab in selected cases of SLE with renal involvement, especially in the presence of TMA, or in patients with refractory LN.
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Review Meta Analysis
Polymyalgia rheumatica and risk of coronary artery disease: a systematic review and meta-analysis of observational studies.
Several chronic inflammatory disorders, such as rheumatoid arthritis and systemic lupus erythematosus, are associated with an increased risk of coronary artery disease (CAD) as a result of accelerated atherosclerosis. However, the data on CAD risk of polymyalgia rheumatica (PMR), one of the most common chronic inflammatory disorders in older adults, remain unclear due to limited number of epidemiological studies. To further investigate this possible association, this systematic review and meta-analysis of observational studies was performed to compare the risk of CAD in patients with PMR versus subjects without it. ⋯ Four studies with 34,569 patients with PMR were identified and included in this meta-analysis. The pooled risk ratio of CAD in patients with PMR was 1.72 (95 % CI 1.21-2.45). The statistical heterogeneity of this meta-analysis was high with an I 2 of 97 %.
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Review Meta Analysis
Polymyalgia rheumatica and risk of coronary artery disease: a systematic review and meta-analysis of observational studies.
Several chronic inflammatory disorders, such as rheumatoid arthritis and systemic lupus erythematosus, are associated with an increased risk of coronary artery disease (CAD) as a result of accelerated atherosclerosis. However, the data on CAD risk of polymyalgia rheumatica (PMR), one of the most common chronic inflammatory disorders in older adults, remain unclear due to limited number of epidemiological studies. To further investigate this possible association, this systematic review and meta-analysis of observational studies was performed to compare the risk of CAD in patients with PMR versus subjects without it. ⋯ Four studies with 34,569 patients with PMR were identified and included in this meta-analysis. The pooled risk ratio of CAD in patients with PMR was 1.72 (95 % CI 1.21-2.45). The statistical heterogeneity of this meta-analysis was high with an I 2 of 97 %.