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Article ; Online: Effectiveness and safety of mycophenolate mofetil and rituximab combination therapy for immune idiopathic myopathies.

Campochiaro, Corrado / Farina, Nicola / De Luca, Giacomo / Batani, Veronica / Trignani, Giorgia / Vignale, Davide / Palmisano, Anna / Matucci-Cerinic, Marco / Dagna, Lorenzo

Arthritis research & therapy

2024 Volume 26, Issue 1, Page(s) 79

Abstract: ... creatine kinase was significantly decreased (p-value = 0.012). Cardiac imaging and enzymes monitoring showed ...

Abstract	Introduction: Idiopathic inflammatory myopathies (IIM) represent a rare and heterogenous group diseases, and their treatment is not fully defined yet. According to previous small case series, the combination of mycophenolate mofetil (MMF) and rituximab (RTX) may be effective in controlling difficult-to-treat patients. Our aim was to further explore the efficacy and safety of this combined approach in patients with IIM. Methods: Patients with IIM treated with the RTX/MMF combination in our Center were retrospectively identified. After the start of combination therapy, the efficacy was evaluated at 12 months (T12) according the 2016 ACR/EULAR response criteria for IIM. Cardiac imaging and pulmonary function tests were used to monitor disease activity in patients with myocarditis and interstitial lung disease, respectively. Adverse events were recorded over the follow-up period. Results: Among the 20 patients (median age 61 years; 70% female) included in the study, anti-synthetase syndrome was the most prevalent IIM subgroup (60%). At treatment start, muscle, heart, and lung were the most commonly actively affected organs. After 12 months, a moderate or major response was observed in all patients, and creatine kinase was significantly decreased (p-value = 0.012). Cardiac imaging and enzymes monitoring showed a reduction of heart inflammation, while pulmonary function tests improved in patients with lung involvement. No severe side effects were observed. Conclusion: Our data show that combination of RTX and MMF is effective and safe in patients with severe and refractory IIM. Therefore, this combined treatment might represent a feasible approach for difficult-to-treat IIM cases.
MeSH term(s)	Humans ; Female ; Middle Aged ; Male ; Rituximab/adverse effects ; Mycophenolic Acid/adverse effects ; Retrospective Studies ; Treatment Outcome ; Myositis/drug therapy ; Myositis/chemically induced
Chemical Substances	Rituximab (4F4X42SYQ6) ; Mycophenolic Acid (HU9DX48N0T)
Language	English
Publishing date	2024-04-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2107602-9
ISSN	1478-6362 ; 1478-6354
ISSN (online)	1478-6362
ISSN	1478-6354
DOI	10.1186/s13075-024-03310-z
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Article ; Online: Subclinical giant cell arteritis increases the risk of relapse in polymyalgia rheumatica.

De Miguel, Eugenio / Karalilova, Rositsa / Macchioni, Pierluigi / Ponte, Cristina / Conticini, Edoardo / Cowley, Sharon / Tomelleri, Alessandro / Monti, Sara / Monjo, Irene / Batalov, Zguro / Klinowski, Giulia / Falsetti, Paolo / Kane, David J / Campochiaro, Corrado / Hočevar, Alojzija

Annals of the rheumatic diseases

2024 Volume 83, Issue 3, Page(s) 335–341

Abstract: ... a relapse, 31 (62%) in the subclinical GCA group and 16 (16%) in the isolated PMR group (p<0.001 ... between relapsed and non-relapsed patients (32.4±15.6 vs 35.5±12.1 mg, respectively, p=0.722). Patients ... relapsed patients, with a mean dose at the third month of 10.0±5.2 versus 15.2±7.9 mg daily (p<0.001). No ...

Abstract	Objective: The aim of the present study was to determine the clinical significance of subclinical giant cell arteritis (GCA) in polymyalgia rheumatica (PMR) and ascertain its optimal treatment approach. Methods: Patients with PMR who fulfilled the 2012 European Alliance of Associations for Rheumatology/American College of Rheumatology Provisional Classification Criteria for PMR, did not have GCA symptoms and were routinely followed up for 2 years and were stratified into two groups, according to their ultrasound results: isolated PMR and PMR with subclinical GCA. The outcomes (relapses, glucocorticoid use and disease-modifying antirheumatic drug treatments) between groups were compared. Results: We included 150 patients with PMR (50 with subclinical GCA) with a median (IQR) follow-up of 22 (20-24) months. Overall, 47 patients (31.3 %) had a relapse, 31 (62%) in the subclinical GCA group and 16 (16%) in the isolated PMR group (p<0.001). Among patients with subclinical GCA, no differences were found in the mean (SD) prednisone starting dosage between relapsed and non-relapsed patients (32.4±15.6 vs 35.5±12.1 mg, respectively, p=0.722). Patients with subclinical GCA who relapsed had a faster prednisone dose tapering in the first 3 months compared with the non-relapsed patients, with a mean dose at the third month of 10.0±5.2 versus 15.2±7.9 mg daily (p<0.001). No differences were found between relapsing and non-relapsed patients with subclinical GCA regarding age, sex, C reactive protein and erythrocyte sedimentation rate. Conclusions: Patients with PMR and subclinical GCA had a significantly higher number of relapses during a 2-year follow-up than patients with isolated PMR. Lower starting doses and rapid glucocorticoid tapering in the first 3 months emerged as risk factors for relapse.
MeSH term(s)	Humans ; Giant Cell Arteritis/diagnostic imaging ; Giant Cell Arteritis/drug therapy ; Giant Cell Arteritis/complications ; Polymyalgia Rheumatica/complications ; Prednisone/therapeutic use ; Glucocorticoids/therapeutic use ; Recurrence
Chemical Substances	Prednisone (VB0R961HZT) ; Glucocorticoids
Language	English
Publishing date	2024-02-15
Publishing country	England
Document type	Journal Article
ZDB-ID	7090-7
ISSN	1468-2060 ; 0003-4967
ISSN (online)	1468-2060
ISSN	0003-4967
DOI	10.1136/ard-2023-224768
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Article ; Online: Gene transfer for ocular neovascularization and macular edema.

Campochiaro, P A

Gene therapy

2012 Volume 19, Issue 2, Page(s) 121–126

Abstract: Diseases complicated by abnormal growth of vessels or excessive leakage are the most prevalent cause of moderate or severe vision loss in developed countries. Recent progress unraveling the molecular pathogenesis of several of these disease processes has ...

Abstract	Diseases complicated by abnormal growth of vessels or excessive leakage are the most prevalent cause of moderate or severe vision loss in developed countries. Recent progress unraveling the molecular pathogenesis of several of these disease processes has led to new drug therapies that have provided major benefits to patients. However, those treatments often require frequent intraocular injections, and despite monthly injections, some patients have a suboptimal response. Gene transfer of antiangiogenic proteins is an alternative approach that has the potential to provide long-term suppression of neovascularization (NV) and/or excessive vascular leakage in the eye. Studies in animal models of ocular NV have demonstrated impressive results with a number of transgenes, and a clinical trial in patients with advanced neovascular age-related macular degeneration has provided proof-of-concept. Two ongoing clinical trials, one using an adeno-associated viral (AAV) vector to express a vascular endothelial growth factor-binding protein and another using a lentiviral vector to express endostatin and angiostatin, will provide valuable information that should help to inform future trials and provide a foundation on which to build.
MeSH term(s)	Angiogenesis Inhibitors/genetics ; Angiogenesis Inhibitors/therapeutic use ; Angiostatins/genetics ; Clinical Trials as Topic ; Dependovirus ; Endostatins/genetics ; Eye/blood supply ; Gene Transfer Techniques ; Genetic Therapy ; Genetic Vectors ; Humans ; Macular Edema/genetics ; Macular Edema/therapy ; Neovascularization, Pathologic/genetics ; Neovascularization, Pathologic/therapy ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Vascular Endothelial Growth Factor A/genetics
Chemical Substances	Angiogenesis Inhibitors ; Endostatins ; VEGFA protein, human ; Vascular Endothelial Growth Factor A ; Angiostatins (86090-08-6)
Language	English
Publishing date	2012-02
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1191036-7
ISSN	1476-5462 ; 0969-7128
ISSN (online)	1476-5462
ISSN	0969-7128
DOI	10.1038/gt.2011.164
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Article ; Online: The effectiveness of tocilizumab and its comparison with tumor necrosis factor alpha inhibitors for Takayasu Arteritis: A systematic review and meta-analysis.

Misra, Durga Prasanna / Singh, Kritika / Rathore, Upendra / Patro, Pallavi / Tomelleri, Alessandro / Campochiaro, Corrado / Agarwal, Vikas / Sharma, Aman

Autoimmunity reviews

2023 Volume 22, Issue 3, Page(s) 103275

Abstract: Takayasu arteritis (TAK) refractory to conventional disease-modifying anti-rheumatic drugs (DMARDs) is commonly treated with biologic DMARDs such as tocilizumab or tumor necrosis factor-alpha inhibitors (TNFi). The 2021 American College of Rheumatology ( ... ...

Abstract	Takayasu arteritis (TAK) refractory to conventional disease-modifying anti-rheumatic drugs (DMARDs) is commonly treated with biologic DMARDs such as tocilizumab or tumor necrosis factor-alpha inhibitors (TNFi). The 2021 American College of Rheumatology (ACR) recommendations preferred TNFi to tocilizumab. Therefore, we conducted a systematic review with meta-analysis to assess the evidence base for tocilizumab in TAK by updating a previous systematic review on DMARDs in TAK through searches on MEDLINE, Pubmed Central, Scopus, major international Rheumatology conference abstracts, and clinical trial databases from January 2021 to November 2022. Thirty-five studies involving 1082 TAK [one randomized controlled trial (RCT), eleven controlled and twenty-one uncontrolled studies, most of moderate to high quality] had evaluated tocilizumab in TAK. The RCT of tocilizumab versus placebo failed to meet its primary end-point of superiority of tocilizumab on an intention-to-treat analysis (hazard ratio 0.41, 95%CI 0.15-1.10) but successfully met the secondary end-point of superiority on per-protocol analysis (hazard ratio 0.34, 95%CI 0.11-1.00). A meta-analysis of six studies identified similar rates of clinical remission [risk ratio (RR) tocilizumab vs TNFi 1.03, 95%CI 0.91-1.17)], angiographic stabilization (RR 1.00, 95%CI 0.72-1.40) or adverse events (RR 0.84, 95%CI 0.54-1.31) with tocilizumab or TNFi. A meta-analysis of three studies identified superior clinical response (RR 1.55, 95%CI 1.15-2.10) and adverse effect profile (RR 0.45, 95%CI 0.25-0.80) with tocilizumab than cyclophosphamide. Pooled data from uncontrolled studies identified clinical response in 85%(95%CI 79-91%) and angiographic stabilization in 82% (95%CI 68-94%). Our study suggests similar evidence for treating TAK with tocilizumab or TNFi, contrary to the ACR 2021 recommendations.
MeSH term(s)	Humans ; Tumor Necrosis Factor-alpha/therapeutic use ; Takayasu Arteritis/drug therapy ; Antibodies, Monoclonal, Humanized/adverse effects ; Antirheumatic Agents/therapeutic use ; Immunologic Factors/therapeutic use
Chemical Substances	tocilizumab (I031V2H011) ; Tumor Necrosis Factor-alpha ; Antibodies, Monoclonal, Humanized ; Antirheumatic Agents ; Immunologic Factors
Language	English
Publishing date	2023-01-15
Publishing country	Netherlands
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	2144145-5
ISSN	1873-0183 ; 1568-9972
ISSN (online)	1873-0183
ISSN	1568-9972
DOI	10.1016/j.autrev.2023.103275
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Zs.A 5913: Show issues

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Article ; Online: Combinations of scleroderma hallmark autoantibodies associate with distinct clinical phenotypes.

Clark, Kristina E N / Campochiaro, Corrado / Host, Lauren V / Sari, Alper / Harvey, Jennifer / Denton, Christopher P / Ong, Voon H

Scientific reports

2022 Volume 12, Issue 1, Page(s) 11212

Abstract: Systemic sclerosis (SSc) is characterized by the presence of SSc-specific or SSc-associated antibodies (SSc-Abs): anti-topoisomerase I (ATA), anti-centromere (ACA), anti-RNA polymerase III (ARA), anti-U3RNP (U3RNP), anti-U1RNP (U1RNP), anti-PmScl (PmScl), ...

Abstract	Systemic sclerosis (SSc) is characterized by the presence of SSc-specific or SSc-associated antibodies (SSc-Abs): anti-topoisomerase I (ATA), anti-centromere (ACA), anti-RNA polymerase III (ARA), anti-U3RNP (U3RNP), anti-U1RNP (U1RNP), anti-PmScl (PmScl), anti-Ku (Ku) and anti-Th/To (Th/To), each being associated with specific clinical features and prognosis. The detection of more than one SSc-Abs in SSc patients is rare and only few data about these patients' clinical phenotype is available. The aim of our study was to evaluate the frequency and the disease's features associated with the presence of > 1 SSc-Abs positivity in a large cohort of SSc patients. The autoantibody profiles of 2799 SSc patients from February 2001 to June 2017 were retrospectively reviewed. Patients with > 1 SSc-Abs were identified. Clinical features were collected and compared to a large historical cohort of SSc patients with single SSc-Ab positivity. SSc patients were excluded if previously treated with rituximab, intravenous immunoglobulins or stem cell transplantation. Non-parametric tests were used for statistical analysis. Nearly 5% of SSc patients from our cohort had ≥ 2 autoantibody positivity, and 2.3% (n = 72) had ≥ 2 SSc-Abs positivity. Th e most common combination was U1RNP and ATA (35%). These patients were younger than patients with single autoantibody positivity and showed more commonly a diffuse cutaneous SSc form. They also had higher rates of overlap features compared to ATA patients. Other combinations included U1RNP and ACA (13%), ATA and ACA (7%) and U1RNP and PmScl (5%). In our study we observed that, while infrequently, SSc patients can present with a combination of two SSc-Abs and that the double positivity can influence their clinical phenotype compared to patients with single SSc-Ab positivity. The importance of re-testing SSc-Abs in patients with changing clinical phenotypes was also highlighted, as this may confer a differing risk stratification.
MeSH term(s)	Antibodies, Antinuclear ; Autoantibodies ; Humans ; Phenotype ; Retrospective Studies ; Scleroderma, Localized ; Scleroderma, Systemic/complications
Chemical Substances	Antibodies, Antinuclear ; Autoantibodies
Language	English
Publishing date	2022-07-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-15062-4
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Article ; Online: High proton pump inhibitor exposure increases risk of calcinosis in systemic sclerosis.

Host, Lauren V / Campochiaro, Corrado / Afonso, Ana / Nihtyanova, Svetlana I / Denton, Christopher P / Ong, Voon H

Rheumatology (Oxford, England)

2020 Volume 60, Issue 2, Page(s) 849–854

Abstract: ... had calcinosis, while in those on high doses of PPI calcinosis was present in 39% (P = 0.003 ... significantly with longer PPI exposure [odds ratio (OR) 1.04, 95% CI: 1.02, 1.06; P < 0.001], longer disease ... duration (OR 1.08, 95% CI: 1.05, 1.12; P < 0.001) and greater age (OR 1.03, CI: 1.01, 1.05; P = 0.010 ...

Abstract	Objective: To investigate the association between proton pump inhibitor (PPI) use and the presence and severity of calcinosis in SSc. Methods: We analysed data from two SSc cohorts from a single centre. Cohort 1 included 199 patients reviewed over 10 years, for whom retrospective data on PPI use and calcinosis were available. Cohort 2 was recruited prospectively and included 215 consecutive patients, who underwent clinical assessment. Outcomes of interest were presence of current calcinosis (CC) or calcinosis at any time (CAT). Results: The cohort 1 data analysis showed that among patients on standard dose PPI 20% had calcinosis, while in those on high doses of PPI calcinosis was present in 39% (P = 0.003). Analysis of the data from cohort 2 confirmed these findings, demonstrating that the odds of CAT increased significantly with longer PPI exposure [odds ratio (OR) 1.04, 95% CI: 1.02, 1.06; P < 0.001], longer disease duration (OR 1.08, 95% CI: 1.05, 1.12; P < 0.001) and greater age (OR 1.03, CI: 1.01, 1.05; P = 0.010). Multivariable logistic regression showed that higher exposure to PPI remained a significant predictor of calcinosis, with PPI exposure >10 years increasing the risk of CAT >6-fold, compared with no PPI (OR 6.37, 95% CI: 1.92, 21.17; P = 0.003) after adjusting for disease duration and antibodies. Conclusion: We confirm a significant association between high PPI exposure with severity of calcinosis in SSc. Given the clinical impact of calcinosis and reflux in SSc, PPI exposure as a potentially modifiable risk factor for calcinosis requires further evaluation.
MeSH term(s)	Age Factors ; Calcinosis/diagnosis ; Calcinosis/epidemiology ; Calcinosis/etiology ; Cohort Studies ; Dose-Response Relationship, Drug ; Female ; Gastroesophageal Reflux/drug therapy ; Gastroesophageal Reflux/etiology ; Humans ; Long Term Adverse Effects/diagnosis ; Long Term Adverse Effects/epidemiology ; Male ; Middle Aged ; Proton Pump Inhibitors/administration & dosage ; Proton Pump Inhibitors/adverse effects ; Risk Assessment/statistics & numerical data ; Scleroderma, Systemic/epidemiology ; Scleroderma, Systemic/immunology ; Scleroderma, Systemic/pathology ; Scleroderma, Systemic/physiopathology ; Severity of Illness Index ; United Kingdom/epidemiology
Chemical Substances	Proton Pump Inhibitors
Language	English
Publishing date	2020-08-09
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1464822-2
ISSN	1462-0332 ; 1462-0324
ISSN (online)	1462-0332
ISSN	1462-0324
DOI	10.1093/rheumatology/keaa332
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Article ; Online: Beyond very early systemic sclerosis: deciphering pre‑scleroderma and its trajectories to open new avenues for preventive medicine.

Lescoat, Alain / Bellando-Randone, Silvia / Campochiaro, Corrado / Del Galdo, Francesco / Denton, Christopher P / Farrington, Sue / Galetti, Ilaria / Khanna, Dinesh / Kuwana, Masataka / Truchetet, Marie-Elise / Allanore, Yannick / Matucci-Cerinic, Marco

The Lancet. Rheumatology

2023 Volume 5, Issue 11, Page(s) e683–e694

Abstract: The identification of individuals with systemic sclerosis in an oligosymptomatic phase preceding the very early manifestations of the disease represents a challenge in the search for a new window of opportunity in systemic sclerosis. This phase could be ... ...

Abstract	The identification of individuals with systemic sclerosis in an oligosymptomatic phase preceding the very early manifestations of the disease represents a challenge in the search for a new window of opportunity in systemic sclerosis. This phase could be identified in a clinical scenario as the pre-scleroderma phase, in which the disease would still be far from systemic sclerosis-related fibrotic or irreversible manifestations in skin or organs. In this Personal View, we discuss parameters and candidate definitions for a conceptual framework of pre-scleroderma, from the identification of populations at risk to autoantibodies and their potential functional activities. We discuss how this new paradigm of pre-scleroderma could represent a game-changing approach in the management of systemic sclerosis, allowing the treatment of patients at high risk of organ involvement or skin fibrosis before such events occur.
MeSH term(s)	Humans ; Scleroderma, Systemic/diagnosis ; Scleroderma, Localized/diagnosis ; Skin ; Autoantibodies ; Basidiomycota
Chemical Substances	Autoantibodies
Language	English
Publishing date	2023-09-26
Publishing country	England
Document type	Journal Article ; Review
ISSN	2665-9913
ISSN (online)	2665-9913
DOI	10.1016/S2665-9913(23)00212-6
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Article ; Online: Arthroscopic repair of glenoid rim fractures: a ligamentotaxis surgical technique.

Corradini, A / Campochiaro, G / Gialdini, M / Rebuzzi, M / Baudi, P

Musculoskeletal surgery

2018 Volume 102, Issue Suppl 1, Page(s) 41–48

Abstract: ... differences in flexion, abduction, rotations and pain were reported compared to the contralateral side (p > 0 ...

Abstract	Purpose: Glenoid fractures occur as a result of direct impact of the humeral head against the glenoid rim following high-energy trauma. They frequently involve one-third of the glenoid surface with an oblique fracture rim from 2 to 6-7 o'clock, and they must not be confused with bony Bankart lesions. In medium-age patients, they are frequently associated with acute cuff tear while in older patients with chronic cuff tear: These conditions increase the instability of the shoulder if not treated. With this study, we reported the results of the arthroscopic ligamentotaxis technique treatment of acute antero-inferior glenoid fractures type IA of Ideberg with a cuff repair associated. Materials and methods: Eleven patients with IA Ideberg glenoid fracture were treated with ligamentotaxis technique. Mean age: 56 years (45-70); 80% dominant side; male/female: 1.2. Mean extension area of glenoid fracture: 25%. The fragment was fixated reinserting the labro-ligamentous complex with a single 2 o'clock anchor. In six patients (55%), a rotator cuff tear was present, repaired during the surgical intervention. Radiological assessment: X-rays and CT with PICO method to measure the glenoid area involved. Clinical assessment: VAS, constant score, Dash score and Rowe score. Results: After 30 months of follow-up (12-50), no differences in flexion, abduction, rotations and pain were reported compared to the contralateral side (p > 0.05). The mean normalized constant was 101 (60-123), and the mean Rowe was 93 (65-100). X-rays showed good healing without articular surface depressions or step in all cases. Two patients had a progression of gleno-humeral arthritis. Conclusion: Acute antero-inferior glenoid rim fractures are uncommon but they are increasing in over 55 years population (frequently associated with cuff tear). Correct classification and treatment are necessary to achieve good results. The X-ray assessment includes the Neer's trauma series and the CT study with PICO measurement of glenoid fragment size. Wrong treatment can lead to chronic instability, degenerative joint disease and poor results. The arthroscopic repair with ligamentotaxis is a good solution and permits the treatment of the associated rotator cuff tear. Arthroscopic technique imposes a long learning curve. CT can be used to confirm the anatomic reduction and the healing of the fracture but since it uses X-rays it must be reserved to comminuted fractures.
MeSH term(s)	Aged ; Arthroscopy/methods ; Female ; Fractures, Bone/surgery ; Glenoid Cavity/injuries ; Glenoid Cavity/surgery ; Humans ; Male ; Middle Aged
Language	English
Publishing date	2018-10-20
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2495458-5
ISSN	2035-5114 ; 2035-5106
ISSN (online)	2035-5114
ISSN	2035-5106
DOI	10.1007/s12306-018-0558-4
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Article ; Online: COVID-19 and systemic sclerosis: Rising to the challenge of a pandemic.

Denton, Christopher P / Campochiaro, Corrado / Bruni, Cosimo / Distler, Oliver / Iagnocco, Annamaria / Matucci Cerinic, Marco

Journal of scleroderma and related disorders

2020 Volume 6, Issue 1, Page(s) 58–65

Abstract: COVID-19, caused by infection of the novel coronavirus SARS-CoV-2, has caused a pandemic of enormous impact that has challenged healthcare and political system throughout the world. This new health emergency has occurred on top of the usual burden of ... ...

Abstract	COVID-19, caused by infection of the novel coronavirus SARS-CoV-2, has caused a pandemic of enormous impact that has challenged healthcare and political system throughout the world. This new health emergency has occurred on top of the usual burden of diseases, including systemic sclerosis, and has led to many unanticipated consequences. An early consequence of the pandemic was postponement of the Sixth Systemic Sclerosis World Congress that was recently completed as a successful virtual congress with more than 1000 delegates. In this article, we summarise the relevance and impact of COVID-19 from the perspective of systemic sclerosis. Shared concepts of pathogenesis are considered, and the relevant literature emerging about COVID-19 and systemic sclerosis summarised. The specific impact of this pandemic on delivery of optimal scleroderma care is considered, together with the broader effect on rheumatic and musculoskeletal diseases and the activities of European League Against Rheumatism. As the World continues to struggle against this new infectious disease, it is notable that expertise and growing understanding of systemic sclerosis has been able to help tackle COVID-19. Moreover, the essential adjustments to deliver clinical care and establishment of new ways of working due to the pandemic have offered potential avenues for future improvement in systemic sclerosis care.
Language	English
Publishing date	2020-10-18
Publishing country	England
Document type	Journal Article ; Review
ISSN	2397-1991
ISSN (online)	2397-1991
DOI	10.1177/2397198320963393
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Article ; Online: A multi-national survey to identify clinicians' perspectives concerning Proton Pump inhibitors in patients with systemic sclerosis.

Bandini, Giulia / Alunno, Alessia / Oliveira Pinheiro, Filipe / Campochiaro, Corrado / Galetti, Ilaria / Matucci Cerinic, Pietro / Ruaro, Barbara / Moggi Pignone, Alberto / Bellando Randone, Silvia / Dagna, Lorenzo / Matucci Cerinic, Marco / McMahan, Zsuzsanna H / Hughes, Michael

Seminars in arthritis and rheumatism

2024 Volume 67, Page(s) 152419

Abstract: Objectives: Proton Pump Inhibitors (PPIs) are widely used in SSc for gastroesophageal reflux disease (GERD). However, there is little evidence to support their empirical use and long-term safety has been questioned. Our objective was to better describe ... ...

Abstract	Objectives: Proton Pump Inhibitors (PPIs) are widely used in SSc for gastroesophageal reflux disease (GERD). However, there is little evidence to support their empirical use and long-term safety has been questioned. Our objective was to better describe clinicians' attitudes toward PPIs prescription and use in SSc patients. Methods: Clinicians involved in the care of SSc patients were invited through international physician networks and social media to participate in an online survey. Results: Responses from 227 clinicians from 36 countries were evaluable. The majority 'agreed' (41.4 %) or 'strongly agreed' (45.4 %) that GERD is a major cause of morbidity in SSc. Lifestyle modifications are seldom (16 %) considered effective. Only half 'agreed' (43 %) or 'strongly agreed' (11 %) there is solid evidence supporting PPIs efficacy in SSc. The most common reasons for PPIs prescription were symptomatic GERD unresponsive to lifestyle modification (95 %), objective evidence of GERD (82 %), and hoarseness or respiratory symptoms (71 %). There are variable concerns about PPIs long-term safety in SSc. The three highest (mean) reasons (0-10, here 10 is 'very concerned') were: small intestinal bacterial overgrowth (5.5), osteoporosis (5.4), and drug interactions (5.2). There are significant differences in attitudes towards surgery for refractory GERD, and concerns about potential complications. PPIs may have a putative role for disease modification (e.g., ILD and calcinosis), and the role of immunosuppression is uncertain for GI (gastrointestinal) disease in SSc. Conclusion: PPIs are frequently prescribed in SSc. Side effects are a recognized concern, especially regarding long-term therapy. There is significant variation in attitudes towards surgical intervention. Future research and practical treatment recommendation for PPIs in SSc are urgently needed.
Language	English
Publishing date	2024-02-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	120247-9
ISSN	1532-866X ; 0049-0172
ISSN (online)	1532-866X
ISSN	0049-0172
DOI	10.1016/j.semarthrit.2024.152419
Database	MEDical Literature Analysis and Retrieval System OnLINE

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