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  1. Article ; Online: The role of PET/CT in disease activity assessment in patients with large vessel vasculitis.

    Galli, Elena / Pipitone, Nicolò / Salvarani, Carlo

    Current opinion in rheumatology

    2023  Volume 35, Issue 3, Page(s) 194–200

    Abstract: Purpose of review: The aim of this article was to review the recent contributions on the role of PET in assessing disease activity in patients with large-vessel vasculitis (giant cell arteritis and Takayasu arteritis).: Recent findings: 18 FDG ( ... ...

    Abstract Purpose of review: The aim of this article was to review the recent contributions on the role of PET in assessing disease activity in patients with large-vessel vasculitis (giant cell arteritis and Takayasu arteritis).
    Recent findings: 18 FDG (fluorodeoxyglucose) vascular uptake in large-vessel vasculitis at PET shows moderate correlation with clinical indices, laboratory markers and signs of arterial involvement at morphological imaging. Limited data may suggest that 18 FDG (fluorodeoxyglucose) vascular uptake could predict relapses and (in Takayasu arteritis) the development of new angiographic vascular lesions. PET appears to be in general sensitive to change after treatment.
    Summary: While the role of PET in diagnosis large-vessel vasculitis is established, its role in evaluating disease activity is less clear-cut. PET may be used as an ancillary technique, but a comprehensive assessment, including clinical, laboratory and morphological imaging is still required to monitor patients with large-vessel vasculitis over time.
    MeSH term(s) Humans ; Positron Emission Tomography Computed Tomography ; Fluorodeoxyglucose F18 ; Takayasu Arteritis/diagnostic imaging ; Giant Cell Arteritis/diagnostic imaging ; Arteries ; Positron-Emission Tomography
    Chemical Substances Fluorodeoxyglucose F18 (0Z5B2CJX4D)
    Language English
    Publishing date 2023-03-02
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 1045317-9
    ISSN 1531-6963 ; 1040-8711
    ISSN (online) 1531-6963
    ISSN 1040-8711
    DOI 10.1097/BOR.0000000000000931
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  2. Article ; Online: Value of MRI in diagnostics and evaluation of myositis.

    Pipitone, Nicolò

    Current opinion in rheumatology

    2016  Volume 28, Issue 6, Page(s) 625–630

    Abstract: Purpose of review: This review aims at covering the role of muscle MRI in supporting the diagnosis of myositis, in aiding to differentiate it from other muscle disorders, and in monitoring myositis patients over time by assessing response to treatment ... ...

    Abstract Purpose of review: This review aims at covering the role of muscle MRI in supporting the diagnosis of myositis, in aiding to differentiate it from other muscle disorders, and in monitoring myositis patients over time by assessing response to treatment and by discriminating between muscle inflammation and chronic damage.
    Recent findings: MRI can assist in 'pattern recognition' of muscle involvement across numerous myopathies, including myositis. Novel applications of magnetic resonance such as cardiac MRI, MR elastography and blood oxigenation level-dependent magnetic resonance can shed light on different aspects of myositis and usefully complement conventional MRI in assessing patients with myositis.
    Summary: MRI can guide therapy by determining whether muscle weakness is related to edema (active inflammation) or muscle atrophy/fat replacement (chronic damage). There is a need to better standardize the assessment of MRI findings in myositis to provide defined outcome measures for use in clinical trials. VIDEO ABSTRACT.
    MeSH term(s) Chronic Disease ; Diagnosis, Differential ; Elasticity Imaging Techniques ; Humans ; Magnetic Resonance Imaging/methods ; Muscle Weakness/etiology ; Muscular Atrophy/complications ; Muscular Diseases/diagnostic imaging ; Myocarditis/diagnostic imaging ; Myositis/complications ; Myositis/diagnostic imaging ; Myositis/therapy
    Language English
    Publishing date 2016-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1045317-9
    ISSN 1531-6963 ; 1040-8711
    ISSN (online) 1531-6963
    ISSN 1040-8711
    DOI 10.1097/BOR.0000000000000326
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  3. Article ; Online: Steroid-sparing agents in polymyalgia rheumatica: how will they fit into the treatment paradigm?

    Ricordi, Caterina / Pipitone, Nicolò / Marvisi, Chiara / Muratore, Francesco / Salvarani, Carlo

    Expert review of clinical immunology

    2023  Volume 19, Issue 10, Page(s) 1195–1203

    Abstract: Introduction: Polymyalgia rheumatica is a common inflammatory rheumatic disease in subjects aged 50 years or older and classically presents with shoulder and/or pelvic girdle pain and prolonged morning stiffness. Glucocorticoids represent the standard ... ...

    Abstract Introduction: Polymyalgia rheumatica is a common inflammatory rheumatic disease in subjects aged 50 years or older and classically presents with shoulder and/or pelvic girdle pain and prolonged morning stiffness. Glucocorticoids represent the standard of treatment; glucocorticoid therapy is usually required for 1-2 years and often results in significant glucocorticoid-related side effects, especially in the elderly.
    Areas covered: In this review, we aimed to provide a comprehensive overview of the management of polymyalgia rheumatica, with a particular focus on adjunctive therapies to the standard glucocorticoid treatment.
    Expert opinion: Given the high frequency of disease relapses (one-third of patients) and the adverse events related to prolonged glucocorticoid use, the need for glucocorticoid-sparing agents remains an important issue in the management of polymyalgia rheumatica. In selected patients, who are at risk for glucocorticoid-related side effects or in those with glucocorticoid-refractory disease, the addition of a glucocorticoid-sparing agent, either a synthetic or biologic disease-modifying anti-rheumatic drug, may represent a reasonable and effective therapeutic approach.
    MeSH term(s) Aged ; Humans ; Polymyalgia Rheumatica/drug therapy ; Glucocorticoids/therapeutic use ; Giant Cell Arteritis/drug therapy ; Antirheumatic Agents/therapeutic use ; Steroids/therapeutic use
    Chemical Substances Glucocorticoids ; Antirheumatic Agents ; Steroids
    Language English
    Publishing date 2023-08-03
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2274260-8
    ISSN 1744-8409 ; 1744-666X
    ISSN (online) 1744-8409
    ISSN 1744-666X
    DOI 10.1080/1744666X.2023.2240519
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  4. Article: A glance into the future of myositis therapy.

    Chiapparoli, Ilaria / Galluzzo, Claudio / Salvarani, Carlo / Pipitone, Nicolò

    Therapeutic advances in musculoskeletal disease

    2022  Volume 14, Page(s) 1759720X221100299

    Abstract: The idiopathic inflammatory myopathies are chronic diseases of the skeletal muscle that comprise various conditions, including dermatomyositis, polymyositis, immune-mediated necrotizing myopathy, and the antisynthetase syndrome. Although there are a ... ...

    Abstract The idiopathic inflammatory myopathies are chronic diseases of the skeletal muscle that comprise various conditions, including dermatomyositis, polymyositis, immune-mediated necrotizing myopathy, and the antisynthetase syndrome. Although there are a number of distinguishing features, all these disorders are characterized by an immune and inflammatory response mainly directed against the muscle. Hence, therapy is geared toward curbing the autoimmune and inflammatory response. A quite wide range of medications are currently available to treat these disorders, but despite all therapeutic progress still a number of patients are unable to maintain a sustained remission. In this review article, we have marshaled a variety of potential therapeutic agents that may hold promise for the future treatment of the idiopathic inflammatory myopathies. It is to be expected that by increasing the therapeutic armamentarium with agents that have different mechanisms of action even challenging cases could be successfully managed, thus reducing disease burden and disability.
    Language English
    Publishing date 2022-05-24
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2516075-8
    ISSN 1759-7218 ; 1759-720X
    ISSN (online) 1759-7218
    ISSN 1759-720X
    DOI 10.1177/1759720X221100299
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  5. Article ; Online: Up-to-date treatment and management of myositis.

    Pipitone, Nicolò / Salvarani, Carlo

    Current opinion in rheumatology

    2020  Volume 32, Issue 6, Page(s) 523–527

    Abstract: Purpose of review: Myositis, or idiopathic inflammatory myopathy, is an overarching concept that includes dermatomyositis, polymyositis, immune-mediated necrotizing myopathy and the antisynthetase syndrome. Glucocorticoids are still considered the ... ...

    Abstract Purpose of review: Myositis, or idiopathic inflammatory myopathy, is an overarching concept that includes dermatomyositis, polymyositis, immune-mediated necrotizing myopathy and the antisynthetase syndrome. Glucocorticoids are still considered the mainstay of treatment of myositis but some patients require add-on immunosuppressive therapy because of insufficient response to glucocorticoids, relapses when glucocorticoids are tapered, or because they incur glucocorticoid-related side effects.
    Recent findings: The goal of this article was to review (PubMed search from January 2019 through June 2020) the efficacy and safety of standard and novel agents used in adult dermatomyositis, polymyositis, immune-mediated necrotizing myopathy and the antisynthetase syndrome.
    Summary: Established therapies beyond glucocorticoids continue to have a major role in managing patients with myositis. In addition, novel agents are being tried for refractory manifestations of myositis.
    MeSH term(s) Anti-Inflammatory Agents/therapeutic use ; Biological Products/therapeutic use ; Dermatomyositis/drug therapy ; Disease Management ; Glucocorticoids/therapeutic use ; Humans ; Myositis/drug therapy ; Polymyositis/drug therapy ; Treatment Outcome
    Chemical Substances Anti-Inflammatory Agents ; Biological Products ; Glucocorticoids
    Language English
    Publishing date 2020-07-30
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1045317-9
    ISSN 1531-6963 ; 1040-8711
    ISSN (online) 1531-6963
    ISSN 1040-8711
    DOI 10.1097/BOR.0000000000000745
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  6. Article ; Online: Comparing treatment options for large vessel vasculitis.

    Macaluso, Federica / Marvisi, Chiara / Castrignanò, Paola / Pipitone, Nicolò / Salvarani, Carlo

    Expert review of clinical immunology

    2022  Volume 18, Issue 8, Page(s) 793–805

    Abstract: Introduction: Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are the major forms of large vessel vasculitis (LVV). Glucocorticoids represent the cornerstone of LVV treatment, however, relapses and recurrences frequently occur when they are ... ...

    Abstract Introduction: Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are the major forms of large vessel vasculitis (LVV). Glucocorticoids represent the cornerstone of LVV treatment, however, relapses and recurrences frequently occur when they are tapered or stopped, determining a prolonged exposure to glucocorticoids and a subsequent increased risk of glucocorticoid-related side effects. Therefore, conventional and biologic immunosuppressive drugs have been proposed to obtain a glucocorticoid-sparing effect.
    Areas covered: We searched PubMed® using the keywords 'giant cell arteritis/drug therapy' and 'Takayasu Arteritis/drug therapy' OR 'Takayasu Arteritis/surgery' This review focuses on the management of LVV, based on the current evidence while highlighting the differences in terms of therapeutic management of TAK and GCA.
    Expert opinion: Conventional disease modifying anti-rheumatic drugs, such as methotrexate or azathioprine, are recommended in association to glucocorticoids for selected GCA and all TAK patients. Two randomized placebo-controlled trials recently demonstrated the efficacy of tocilizumab in reducing relapses and cumulative prednisone dosage in GCA patients with newly diagnosed or relapsing disease. Observational evidence and two small randomized controlled trials support the use of TNF-alpha inhibitors and tocilizumab as glucocorticoid-sparing agents in relapsing TAK, albeit high-quality evidence regarding the management of TAK is still lacking.
    MeSH term(s) Biological Products/therapeutic use ; Giant Cell Arteritis/diagnosis ; Giant Cell Arteritis/drug therapy ; Glucocorticoids/therapeutic use ; Humans ; Immunosuppressive Agents/therapeutic use ; Recurrence ; Takayasu Arteritis/diagnosis ; Takayasu Arteritis/drug therapy
    Chemical Substances Biological Products ; Glucocorticoids ; Immunosuppressive Agents
    Language English
    Publishing date 2022-06-29
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2274260-8
    ISSN 1744-8409 ; 1744-666X
    ISSN (online) 1744-8409
    ISSN 1744-666X
    DOI 10.1080/1744666X.2022.2092098
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  7. Article ; Online: 18F-FDG PET-CT versus contrast enhanced CT for the diagnosis of fever of unknown origin.

    Pipitone, Nicolò / Casali, Massimiliano / Salvarani, Carlo

    European journal of internal medicine

    2021  Volume 93, Page(s) 26–27

    MeSH term(s) Fever of Unknown Origin/diagnostic imaging ; Fever of Unknown Origin/etiology ; Fluorodeoxyglucose F18 ; Humans ; Positron Emission Tomography Computed Tomography ; Positron-Emission Tomography ; Radiopharmaceuticals
    Chemical Substances Radiopharmaceuticals ; Fluorodeoxyglucose F18 (0Z5B2CJX4D)
    Language English
    Publishing date 2021-09-27
    Publishing country Netherlands
    Document type Journal Article ; Comment
    ZDB-ID 1038679-8
    ISSN 1879-0828 ; 0953-6205
    ISSN (online) 1879-0828
    ISSN 0953-6205
    DOI 10.1016/j.ejim.2021.09.006
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  8. Article ; Online: Treatment of inflammatory myopathies.

    Pipitone, Nicolò / Salvarani, Carlo

    Expert review of clinical immunology

    2018  Volume 14, Issue 7, Page(s) 607–621

    Abstract: Introduction: The idiopathic inflammatory myopathies (IIM) dermatomyositis (DM) and polymyositis (PM) are chronic diseases affecting the striated muscles with variable involvement of other organs. Glucocorticoids are considered the cornerstone of ... ...

    Abstract Introduction: The idiopathic inflammatory myopathies (IIM) dermatomyositis (DM) and polymyositis (PM) are chronic diseases affecting the striated muscles with variable involvement of other organs. Glucocorticoids are considered the cornerstone of treatment, but some patients require adjunctive immunosuppressive agents because of insufficient response to glucocorticoids, flares upon glucocorticoid tapering, or glucocorticoid-related adverse events. Areas covered: The aim of this article was to review (PubMed search until February 2018) the evidence on established and new therapies derived from randomized controlled trials (RCTs) on adult DM and PM. In addition, key data from open-label trials, case reports, and abstracts were included where data from RCT were lacking. Expert commentary: Numerous synthetic and biological immunosuppressive agents are currently available to treat the IIM, sometimes in combination. The choice of the specific medication in the individual patient depends upon the disease phenotype and patient's characteristics. Exercise improves muscle performance without causing disease flares and should be an integral part of the treatment of the IIM. Prompt diagnosis and treatment can lead to better outcome.
    MeSH term(s) Animals ; Antirheumatic Agents/therapeutic use ; Biological Products/therapeutic use ; Dermatomyositis/therapy ; Exercise ; Glucocorticoids/therapeutic use ; Humans ; Muscle, Striated/pathology ; Myositis/therapy ; Polymyositis/therapy ; Randomized Controlled Trials as Topic
    Chemical Substances Antirheumatic Agents ; Biological Products ; Glucocorticoids
    Language English
    Publishing date 2018-07-03
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2274260-8
    ISSN 1744-8409 ; 1744-666X
    ISSN (online) 1744-8409
    ISSN 1744-666X
    DOI 10.1080/1744666X.2018.1491307
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Cardiac involvement in the adult primary vasculitides.

    Pazzola, Giulia / Pipitone, Nicolò / Salvarani, Carlo

    Expert review of clinical immunology

    2020  Volume 16, Issue 10, Page(s) 985–991

    Abstract: Introduction: Heart involvement in vasculitis is rare, but potentially severe. The ascertainment of cardiac disease in vasculitis is complex and requires an integrated multidisciplinary approach involving the Rheumatologist, Radiologist, Cardiologist, ... ...

    Abstract Introduction: Heart involvement in vasculitis is rare, but potentially severe. The ascertainment of cardiac disease in vasculitis is complex and requires an integrated multidisciplinary approach involving the Rheumatologist, Radiologist, Cardiologist, and Heart surgeon.
    Areas covered: the authors searched PubMed using the keywords 'heart'[Mesh] and vasculitis"[Mesh].
    Expert opinion: Virtually any vasculitis can affect the heart, but cardiac involvement is more common in some vasculitides such as Takayasu arteritis, polyarteritis nodosa, and eosinophilic granulomatosis with polyangiitis. Immunosuppressive treatment and when indicated surgery can improve the prognosis.
    MeSH term(s) Adult ; Cardiac Surgical Procedures ; Eosinophilic Granuloma/diagnosis ; Eosinophilic Granuloma/therapy ; Heart/physiology ; Heart Diseases/diagnosis ; Heart Diseases/therapy ; Humans ; Immunosuppressive Agents/therapeutic use ; Prognosis ; Takayasu Arteritis/diagnosis ; Takayasu Arteritis/therapy ; Vasculitis/diagnosis ; Vasculitis/therapy
    Chemical Substances Immunosuppressive Agents
    Language English
    Publishing date 2020-12-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2274260-8
    ISSN 1744-8409 ; 1744-666X
    ISSN (online) 1744-8409
    ISSN 1744-666X
    DOI 10.1080/1744666X.2021.1823219
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  10. Article ; Online: Rare forms of inflammatory myopathies - part I, generalized forms.

    Galluzzo, Claudio / Chiapparoli, Ilaria / Corrado, Ada / Cantatore, Francesco Paolo / Salvarani, Carlo / Pipitone, Nicolò

    Expert review of clinical immunology

    2022  Volume 19, Issue 2, Page(s) 169–183

    Abstract: Introduction: The idiopathic inflammatory myopathies traditionally comprise dermatomyositis, polymyositis, immune-mediated necrotizing myopathy, anti-synthetase syndrome, and inclusion body myositis. In this review, we aimed to cover the less common ... ...

    Abstract Introduction: The idiopathic inflammatory myopathies traditionally comprise dermatomyositis, polymyositis, immune-mediated necrotizing myopathy, anti-synthetase syndrome, and inclusion body myositis. In this review, we aimed to cover the less common forms of generalized myositis.
    Areas covered: We identified rare forms of widespread myositis on the basis of list provided by the homepage of the Neuromuscular disease center of Washington University, USA and on the basis of the authors' knowledge. We searched PubMed® and EMBASE® for relevant articles on these forms with the aim of providing as much as possible information on their clinical manifestations as well as guidance on their work-up and treatment.
    Expert opinion: There is substantial heterogeneity among the various rare forms of generalized myositis in terms of their frequency and characterization. Some forms are reasonably well defined, while others may not represent truly well-defined diseases, but rather variants of other myopathies. The landscape of rare forms appears to have evolved over time, with some forms now being better characterized, while others, such as SARS-Cov-2- and immune checkpoint inhibitor-related myositis have come to the fore only in recent years. Knowledge about rare forms of myositis can aid in their recognition and treatment.
    MeSH term(s) Humans ; COVID-19 ; SARS-CoV-2 ; Myositis/diagnosis ; Myositis/therapy ; Polymyositis ; Myositis, Inclusion Body ; Autoantibodies
    Chemical Substances Autoantibodies
    Language English
    Publishing date 2022-12-12
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 2274260-8
    ISSN 1744-8409 ; 1744-666X
    ISSN (online) 1744-8409
    ISSN 1744-666X
    DOI 10.1080/1744666X.2023.2154656
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