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Öğe Are There Any Clues to Predict Bamboo Spine in Axial Spondyloarthritis?(Wiley, 2020) Atagündüz, Pamir; Kiraz, Sedat; Akar, Servet; Küçükşahin, Orhan; Erden, Abdulsamet; Coşkun, Nihan; Kalyoncu, Umut; Mercan, Rıdvan[No Abstract Available]Öğe Koronavirüs Hastalığı-2019 Hastalarının Tırnak Dibi Kapilleroskopisi ile Değerlendirilmesi(2022) Erden, Abdulsamet; Küçükşahin, Orhan; Akınc, Esragül; Armağan, Berkan; Özdemir, Bahar; Karakaş, Özlem; Güven, Serdar CanAmaç: Mikrovaskülopati, Koronavirüs hastalığı-2019 (COVID-19) hastalığı komplikasyonlarında rol alan mekanizmalardan biridir. Tırnak dibi kapilleroskopisi (TDK) mikrovasküleriteyi değerlendirmede kullanılan non-invaziv bir yöntemdir. COVID-19 hastalarında endotel disfonksiyonu ve mikrovaskülopatinin saptanmasında yol gösterici olabilir. Gereç ve Yöntem: Şiddetli akut solunum yolu sendromu-CoV-2 testi pozitif çıkmış 54 hastaya TDK yapıldı ve hastalar kapiller yoğunluk, mimari ve morfoloji açısından değerlendirildi. Anormal ve normal kapilleroskopi bulguları olan hastalar COVID-19 klinik semptomları açısından karşılaştırıldı. Bulgular: Çalışmaya alınan hastaların %72’si erkek, yaş ortalaması ise 35,6±11,6 idi. Toplamda 22 hastada (%41) anormal kapilleroskopik değişikliklerden en az 1 tanesi vardı. Kapilleroskopik yaygın anormallikler ise sırasıyla, perikapiller ödem (%43), genişlemiş ve dilate kapil (%24), tortiyozite kapiller (%22) oldu. Hastaların %17’sinde hiperenflamatuvar yanıt görüldü ve 1 hastada yoğun bakım ihtiyacı oldu. Anormal kapilleroskopik değişliği olan hastalarda hiperenflamatuvar yanıt, antisitokin kullanımı ve tromboz sıklığı artmıştı. Sonuç: COVID-19 hastalarında anormal kapilleroskopik bulgular sıklıkla gözlenmiştir. Anormal kapilleroskopik bulguları olan hastalarda hiperenflamatuvar yanıt ve antisitokin ilaç kullanımı sıklığının artması hiperenflamasyon ile mikrovaskülopati arasında bir ilişki olabileceğini düşündürmektedir. TDK’nın, COVID-19 hastalığı klinik tutulumları ile ilişkisini değerlendirmek için daha fazla çalışmaya ihtiyaç vardır.Öğe Predicting extra-musculoskeletal and peripheral manifestations and their role on biologic treatment in patients with axial spondyloarthritis: TReasure experience(Turkish League Against Rheumatism (TLAR), 2025) Durak Ediboglu, Elif; Kalyoncu, Umut; Solmaz, Dilek; Yasar Bilge, Sule; Yılmaz, Sedat; Bes, Cemal; Erden, AbdulsametObjectives: This study aimed to examine the frequency and associated factors of extra-musculoskeletal manifestations (EMMs) and peripheral manifestations in an axial spondyloarthritis (axSpA) cohort and their impact on the choice of first biologic treatment. Patients and methods: A total of 1,687 patients with axSpA (978 males, 709 females; mean age: 38.5±11 years) who started their first biologic disease modifying antirheumatic drug (bDMARD) were included from a national prospective database of TReasure between its inception and 2018-2021. Demographic and clinical characteristics, disease-related features, and treatment patterns were compared between patients with and without EMMs or peripheral involvement. Results: Of the patients, 1,283 had radiographic axSpA (r-axSpA), while 404 had nonradiographic axSpA (nr-axSpA). Acute anterior uveitis (AAU) was the most common (11.4%) EMM, and older age, female sex, human leukocyte antigen B27 (HLA-B27) positivity, and a lower Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score were associated with AAU. Female sex, methotrexate use, dactylitis, and higher Ankylosing Spondylitis Disease Activity Score (ASDAS)-serum C-reactive protein (CRP) scores were related to psoriasis (PsO). Inflammatory bowel disease (IBD) and PsO were negatively associated with HLA-B27 positivity. Enthesitis was the most frequent (28.2%) peripheral manifestations, and peripheral arthritis, dactylitis, and enthesitis were independent predictor of each other. In addition, dactylitis and peripheral arthritis were related to more frequent use of conventional disease modifying antirheumatic drugs. In addition, IBD history was associated with less frequent use of etanercept. Older age, less use of sulfasalazine, the absence of enthesitis, and lower Bath Ankylosing Spondylitis Functional Disease Index (BASFI) scores were associated with secukinumab use. Conclusion: Acute anterior uveitis was associated with HLA-B27 positivity, while PsO or IBD were negatively associated with HLA-B27 in patients with axSpA. Peripheral manifestations appeared to be related to each other. Among EMMs, we found that only IBD had an effect on the bDMARD preference. © 2025, Turkish League Against Rheumatism (TLAR). All rights reserved.Öğe Smoking May Be Related to Sacroiliitis in Enteropathic Arthritis Patients: Treasure Real-Life Preliminary Data(Bmj Publishing Group, 2019) Küçükşahin, Orhan; Erden, Abdulsamet; İlgen, Ufuk; Kiraz, Sedat; Ertenli, Ali İhsan; Bilge, Nazife Sule Yasar; Kalyoncu, Umut; Mercan, Rıdvan[No Abstract Available]Öğe The predictors of paradoxical reactions, especially psoriasis, to biologic therapy-findings from the TReasure database: a 5-year follow-up study(Oxford Univ Press, 2023) Yagiz, Burcu; Lermi, Nihal; Coskun, Belkis N.; Dalkilic, Ediz; Kiraz, Sedat; Erden, Abdulsamet; Ertenli, IhsanObjectives The objectives of this study were to assess the clinical characteristics, predictive factors, and practical algorithms of paradoxical reactions (PRs), specifically paradoxical psoriasis (PP). Methods The TReasure database is a web-based prospective observational cohort comprised of patients with RA and SpA from 17 centres around Turkey since 2017. A cohort study and a case-control study nestled within the cohort were identified. Results In total, 2867 RA and 5316 SpA patients were evaluated. The first biologic agent was found to have caused PRs in 60% of the 136 patients (1.66%) who developed the PRs. The median time interval between the PRs and biological onset was 12 months (range 1-132 months, mean 21 months). The most common types of PP, constituting 92.6% of PRs, were pustular (60.3%) and palmoplantar (30.9%). Adalimumab (30.9%), infliximab (19%) and etanercept (17.4%) were the most common agents causing the PP. In the treatment of most PP patients (73.2%), switching biologic agents was favoured, with TNF inhibitor (TNFi) chosen in 46.03% and non-TNFi in 26.9% of cases. The three most frequently selected drugs were etanercept (24.6%), secukinumab (9.5%) and adalimumab (8.7%). Only 5.17% of patients who switched to another TNFi showed progression. The odds ratios (s) for SSZ, HCQ, and LEF use were significantly higher in RA controls than in PP patients (P = 0.033, OR = 0.15; P = 0.012, OR = 0.15; and P = 0.015, OR = 0.13, respectively). In the PP group with SpA, the number of smokers was significantly higher (P = 0.003, OR: 2.0, 95% CI: 1.05, 3.81). Conclusion Contrary to expectations based on earlier research suggesting that paradoxical reactions develop with the class effect of biological agents, the response of patients who were shifted to another TNFi was favourable.Öğe Tocilizumab as a first line biologic agent in rheumatoid arthritis patients with inadequate response to disease-modifying anti-rheumatic drugs: Real life experience from the TReasure Registry(Clinical and Experimental Rheumatology S.A.S., 2024) Karadag, Omer; Farisogullari, Bayram; Yagiz, Burcu; Erden, Abdulsamet; Ademoglu, Zeliha; Kimyon, Gezmis; Sule Bilge, NazifeTo evaluate the retention rate, treatment response and safety of tocilizumab (TCZ) as first-line biologic treatment in rheumatoid arthritis (RA) patients with inadequate response to disease-modifying anti-rheumatic drugs (DMARD-IR). Methods The TReasure Registry is a multicentre, web-based registry of RA and spondyloarthritis patients across Turkey. DMARD-IR RA patients who received TCZ as first-line biologic treatment were included in this registry for efficacy and safety. Demographic and clinical data, treatments, and adverse events were collected. Drug retention rate was estimated using Kaplan-Meier analysis. Results Among 642 RA patients who ever used TCZ, 258 DMARD-IR RA patients (male/female: 18.2%/81.8%, mean age, 54.41 years) received TCZ as first-line biologic. The median disease duration was 97 (range, 60 179) months and the median TCZ treatment duration was 15 (range, 6 28) months. At the 6th and 12th months of TCZ treatment, the decrease in disease activity scores from baseline was significant. The Kaplan-Meier analysis revealed the retention rate of TCZ at the 12th, 24th, 36th, and 60th months as 81.1%, 73.8%, 66.2%, and 63.6%, respectively. Fifty-seven (22%) patients discontinued TCZ; the main reason being primary or secondary inefficacy (n=29). Conclusion Over 80% drug retention rate at 12th month of TCZ treatment in this real-world study was concordant with previously conducted TCZ clinical studies. Significant reductions not only in the disease activity score-28 but also in the simplified disease activity index (SDAI) and clinical disease activity index (CDAI) scores, along with health assessment questionnaire (HAQ) scores, supported the impact of TCZ in RA management with a good safety profile. © 2024 Clinical and Experimental Rheumatology S.A.S.. All rights reserved.Öğe Tuberculin Skin Test and Quantiferon (R)-TB Gold In-Tube Test for Latent Tuberculosis Before Biologic Treatments: Lower Agreement Rate in Spondyloarthropathies Compared to Rheumatoid Arthritis(Wiley, 2019) İlgen, Ufuk; Turan, Sezin; Emmungil, Hakan; Sarı, Alper; Erden, Abdulsamet; Kılıç, Levent; Kalyoncu, Umut; Mercan, Rıdvan[No Abstract Available]Öğe Tuberculin skin test before biologic and targeted therapies: does the same rule apply for all?(Springer Heidelberg, 2022) İlgen, Ufuk; Karadağ, Ömer; Emmungil, Hakan; Küçükşahin, Orhan; Koca, Süleyman Serdar; Erden, Abdulsamet; Kalyoncu, Umut; Mercan, RıdvanThis study aimed to compare Tuberculin Skin Test (TST) and QuantiFERON (R)-TB Gold In-Tube (QFT-GIT) test in rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients scheduled for biological and targeted synthetic disease modifying anti-rheumatic drugs (DMARDs) in a Bacillus Calmette-Guerin-vaccinated population. Adult RA (n = 206) and SpA (n = 392) patients from the TReasure database who had both TST and QFT-GIT prior to initiation of biological and targeted synthetic DMARDs were included in the study. Demographic and disease characteristics along with pre-biologic DMARD and steroid use were recorded. The distribution of TST and performance with respect to QFT-GIT were compared between RA and SpA groups. Pre-biologic conventional DMARD and steroid use was higher in the RA group. TST positivity rates were 44.2% in RA and 69.1% in SpA for a 5 mm cutoff (p < 0.001). Only 8.9% and 15% of the patients with RA and SpA, respectively, tested positive by QFT-GIT. The two tests poorly agreed in both groups at a TST cutoff of 5 mm and increasing the TST cutoff only slightly increased the agreement. Among age, sex, education and smoking status, pre-biologic steroid and conventional DMARD use, disease group, and QFT-GIT positivity, which were associated with a 5 mm or higher TST, only disease group (SpA) and QFT-GIT positivity remained significant in multiple logistic regression. TST positivity was more pronounced in SpA compared to that in RA and this was not explainable by pre-biologic DMARD and steroid use. The agreement of TST with QFT-GIT was poor in both groups. Using a 5 mm TST cutoff for both diseases could result in overestimating LTBI in SpA.
