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Article ; Online: Treatment of Primary Angiitis of the Central Nervous System.

Bays, Alison M

2023 Volume 34, Issue 1, Page(s) 23–29

Abstract: Primary central nervous system vasculitis (PCNSV) is a vasculitis limited to the brain and spinal cord. Induction therapy often consists of steroids and cyclophosphamide. Maintenance therapy includes a prednisone taper and may be combined with ... ...

Abstract	Primary central nervous system vasculitis (PCNSV) is a vasculitis limited to the brain and spinal cord. Induction therapy often consists of steroids and cyclophosphamide. Maintenance therapy includes a prednisone taper and may be combined with medications such as azathioprine or mycophenolate mofetil. Relapse is common in PCNSV and an increased dose of steroids is often given, sometimes with a change in therapy. Medications such as rituximab and mycophenolate mofetil may be good alternatives in those who do not respond to initial treatment or who have relapse of disease. Mortality rates of 8% to 9% are reported in the literature.
MeSH term(s)	Humans ; Immunosuppressive Agents/therapeutic use ; Mycophenolic Acid/therapeutic use ; Vasculitis, Central Nervous System/diagnostic imaging ; Vasculitis, Central Nervous System/drug therapy ; Steroids/therapeutic use ; Recurrence
Chemical Substances	Immunosuppressive Agents ; Mycophenolic Acid (HU9DX48N0T) ; Steroids
Language	English
Publishing date	2023-08-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1314594-0
ISSN	1557-9867 ; 1052-5149
ISSN (online)	1557-9867
ISSN	1052-5149
DOI	10.1016/j.nic.2023.07.008
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Article: Large overlap in neutrophil transcriptome between lupus and COVID-19 with limited lupus-specific gene expression.

Najjar, Rayan / Rogel, Noga / Pineda, Jose Mario Bello / Wang, Xiaoxing / Tran, Megan / Bays, Alison / Mustelin, Tomas

Lupus science & medicine

2024 Volume 11, Issue 1

Abstract: Objectives: To illuminate the poorly understood aetiology of SLE by comparing the gene expression profile of SLE neutrophils with that of neutrophils from patients infected by SARS-CoV-2, a disease (COVID-19) with well-defined antigens and a similar ... ...

Abstract	Objectives: To illuminate the poorly understood aetiology of SLE by comparing the gene expression profile of SLE neutrophils with that of neutrophils from patients infected by SARS-CoV-2, a disease (COVID-19) with well-defined antigens and a similar type I interferon response. Methods: RNA sequencing of neutrophils from patients with SLE (n=15) and healthy controls (n=12) was analysed for differential gene expression and modulated pathways. The same analyses were performed on a similar neutrophil dataset from patients with SARS-CoV-2 infection (n=30) and healthy controls (n=8). Next, we carried out comparative analyses to identify common and unique transcriptional changes between the two disease contexts, emphasising genes regulated in opposite directions. Results: We identified 372 differentially expressed genes in SLE neutrophils compared with healthy donor neutrophils (≥2 fold, p<0.05), 181 of which were concordant with transcriptional changes in SARS-CoV-2-infected individuals compared with their respective healthy controls. In contrast, 118 genes demonstrated statistically significant alterations exclusive to SLE, including 28 genes that were differentially expressed in opposite directions in the two diseases. Conclusions: The substantial overlap between neutrophil responses in SLE and COVID-19 suggests that the unknown cause of SLE is functionally similar to a viral infection and drives a similar immune activation and type I interferon response. Conversely, the genes regulated in the opposite direction represent responses unique to SLE. These include tyrosylprotein sulfotransferase-1 and nucleic acid deaminases of the APOBEC family, which can catalyse cytosine-to-uridine editing of both RNA and DNA, and other RNA-modifying enzymes.
MeSH term(s)	Humans ; Neutrophils ; Transcriptome ; COVID-19/genetics ; SARS-CoV-2/genetics ; SARS-CoV-2/metabolism ; Lupus Erythematosus, Systemic/genetics ; RNA/metabolism ; Interferon Type I/genetics
Chemical Substances	RNA (63231-63-0) ; Interferon Type I
Language	English
Publishing date	2024-01-31
Publishing country	England
Document type	Journal Article
ZDB-ID	2779620-6
ISSN	2053-8790
ISSN	2053-8790
DOI	10.1136/lupus-2023-001059
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Article: Frequency of Allopurinol Dose Reduction in Hospitalized Patients With Gout Flares.

Huang, Irvin J / Bays, Alison M / Liew, Jean W

The Journal of rheumatology

2020 Volume 48, Issue 3, Page(s) 467–468

MeSH term(s)	Allopurinol/therapeutic use ; Drug Tapering ; Gout/drug therapy ; Gout Suppressants/therapeutic use ; Humans ; Hyperuricemia/drug therapy ; Symptom Flare Up
Chemical Substances	Gout Suppressants ; Allopurinol (63CZ7GJN5I)
Language	English
Publishing date	2020-10-15
Publishing country	Canada
Document type	Letter ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	194928-7
ISSN	1499-2752 ; 0315-162X
ISSN (online)	1499-2752
ISSN	0315-162X
DOI	10.3899/jrheum.201142
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Article: Public Interest in COVID-19 Therapeutics for High-Risk Populations During the Omicron Era: A Google Trends Analysis.

Degirmenci, Huseyin Berk / Oh, Jinseo / Bays, Alison M / Thomason, Jenna L / Liew, Jean W

Cureus

2022 Volume 14, Issue 12, Page(s) e32684

Abstract: Therapies for COVID-19 prevention or treatment continue to play a significant role for individuals who are not able to mount an adequate immune response after COVID-19 vaccination and/or in patients who are at high-risk for severe outcomes of COVID-19 ... ...

Abstract	Therapies for COVID-19 prevention or treatment continue to play a significant role for individuals who are not able to mount an adequate immune response after COVID-19 vaccination and/or in patients who are at high-risk for severe outcomes of COVID-19 infection. As these modalities have become more available, it is important to assess the public's interest in these agents to ensure both patients and physicians are aware of the therapeutics available to them. Google Trends is a freely available tool that researchers can use for monitoring public interest by analyzing trends in search queries during disease outbreaks. In this descriptive study, we used Google Trends to investigate the public interest in two COVID-19 therapeutics which received Food and Drug Administration (FDA) emergency use authorization in December 2021: Paxlovid, an antiviral medication used for COVID-19 treatment, and Evusheld, a combination of two monoclonal antibodies against COVID-19 used for COVID-19 prophylaxis. We analyzed search queries in the first half of 2022. Our analysis included search queries that include ''Paxlovid'', ''Evusheld'', ''COVID treatment'' and ''COVID prophylaxis'' at the national and state levels in the US. We found that while the number of COVID-19 cases rose during the period of interest, Evusheld searches remained stagnant despite a concurrent increase in Paxlovid searches. These findings potentially represent low public interest or awareness about Evusheld, which can be addressed through public health initiatives to ensure improved distribution.
Language	English
Publishing date	2022-12-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.32684
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Article ; Online: The Usefullness of Subclavian Artery Ultrasound Assessment in Giant Cell Arteritis Evaluation.

Oshinsky, Charles / Bays, Alison M / Sacksen, Ingeborg / Jernberg, Elizabeth / Zierler, R Eugene / Pollock, P Scott

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases

2022 Volume 29, Issue 1, Page(s) 43–46

Abstract: Objective: Vascular ultrasound has been increasingly used to diagnose giant cell arteritis (GCA). The temporal and axillary arteries are commonly evaluated. However, the usefulness of including the subclavian artery remains unclear. This study ... ...

Abstract	Objective: Vascular ultrasound has been increasingly used to diagnose giant cell arteritis (GCA). The temporal and axillary arteries are commonly evaluated. However, the usefulness of including the subclavian artery remains unclear. This study investigated whether inclusion of the subclavian artery in addition to the temporal and axillary arteries in the ultrasound evaluation of GCA improves the accuracy of the examination beyond ultrasonography of the temporal and axillary arteries alone. Methods: We formed a fast-track clinic to use ultrasound to rapidly evaluate patients with suspected GCA. In this cohort study, patients referred for new concern for GCA received a vascular ultrasound for GCA. Subclavian intima-media thickness (IMT) cutoffs of 1.0 and 1.5 mm were retrospectively assessed. Results: Two hundred thirty-seven patients were referred to the fast-track clinic from November 2017 to August 2021. One hundred sixty-eight patients received an ultrasound for concern for new GCA. With a subclavian IMT cutoff of 1.5 mm, inclusion of the subclavian artery did not identify any patients with GCA who were not otherwise found to have positive temporal and/or axillary artery examinations, and at this cutoff, there was 1 false-positive result. A subclavian IMT cutoff of 1.0 mm identified several subjects diagnosed with GCA who had otherwise negative ultrasounds, but most subjects with an isolated subclavian IMT greater than 1.0 mm had false-positive results, and the specificity of this cutoff was poor. Conclusion: Inclusion of the subclavian artery in the ultrasound assessment of GCA at 2 different cutoffs rarely contributed to the accurate diagnosis of GCA and increased the rate of false-positive results.
MeSH term(s)	Humans ; Giant Cell Arteritis/diagnostic imaging ; Subclavian Artery/diagnostic imaging ; Temporal Arteries/diagnostic imaging ; Cohort Studies ; Retrospective Studies ; Carotid Intima-Media Thickness ; Ultrasonography/methods
Language	English
Publishing date	2022-09-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	1283266-2
ISSN	1536-7355 ; 1076-1608
ISSN (online)	1536-7355
ISSN	1076-1608
DOI	10.1097/RHU.0000000000001909
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Article: Expression of L1 retrotransposons in granulocytes from patients with active systemic lupus erythematosus.

Ukadike, Kennedy C / Najjar, Rayan / Ni, Kathryn / Laine, Amanda / Wang, Xiaoxing / Bays, Alison / Taylor, Martin S / LaCava, John / Mustelin, Tomas

Mobile DNA

2023 Volume 14, Issue 1, Page(s) 5

Abstract: Background: Patients with systemic lupus erythematosus (SLE) have autoantibodies against the L1-encoded open-reading frame 1 protein (ORF1p). Here, we report (i) which immune cells ORF1p emanates from, (ii) which L1 loci are transcriptionally active, ( ... ...

Abstract	Background: Patients with systemic lupus erythematosus (SLE) have autoantibodies against the L1-encoded open-reading frame 1 protein (ORF1p). Here, we report (i) which immune cells ORF1p emanates from, (ii) which L1 loci are transcriptionally active, (iii) whether the cells express L1-dependent interferon and interferon-stimulated genes, and (iv) the effect of inhibition of L1 ORF2p by reverse transcriptase inhibitors. Results: L1 ORF1p was detected by flow cytometry primarily in SLE CD66b Conclusions: We identified L1Hs loci that are transcriptionally active in SLE neutrophils, and a reduction in the epigenetic silencing mechanisms that normally counteract L1 transcription. SLE neutrophils contained L1-encoded ORF1p protein, as well as activation of the type I interferon system, which was inhibited by treatment with reverse transcriptase inhibitors. Our findings will enable a deeper analysis of L1 dysregulation and its potential role in SLE pathogenesis.
Language	English
Publishing date	2023-05-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2536054-1
ISSN	1759-8753
ISSN	1759-8753
DOI	10.1186/s13100-023-00293-7
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Article ; Online: Pharmacologic Therapies for Rheumatologic and Autoimmune Conditions.

Bays, Alison M / Gardner, Gregory

The Medical clinics of North America

2016 Volume 100, Issue 4, Page(s) 719–731

Abstract: Disease-modifying antirheumatic drugs (DMARDs) are commonly prescribed by rheumatologists to reduce disease activity and induce remission in autoimmune conditions such as systemic lupus erythematosus and rheumatoid arthritis. Steroids are sometimes used ... ...

Abstract	Disease-modifying antirheumatic drugs (DMARDs) are commonly prescribed by rheumatologists to reduce disease activity and induce remission in autoimmune conditions such as systemic lupus erythematosus and rheumatoid arthritis. Steroids are sometimes used in combination with DMARD therapy and should be used at the lowest effective dose for the least amount of time. There are many biologic agents available for use for inflammatory arthritis and other autoimmune conditions. Care should be taken when prescribing and managing DMARDS, steroids and biologic agents medications with a careful eye towards screening for infectious disease, vaccination, bone heath and lab monitoring.
MeSH term(s)	Adrenal Cortex Hormones/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Antirheumatic Agents/administration & dosage ; Antirheumatic Agents/adverse effects ; Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/drug therapy ; Autoimmune Diseases/drug therapy ; Biological Products/administration & dosage ; Biological Products/adverse effects ; Biological Products/therapeutic use ; Colchicine/therapeutic use ; Gout Suppressants/therapeutic use ; Humans ; Immunosuppressive Agents/administration & dosage ; Immunosuppressive Agents/adverse effects ; Immunosuppressive Agents/therapeutic use ; Methotrexate/therapeutic use
Chemical Substances	Adrenal Cortex Hormones ; Anti-Inflammatory Agents, Non-Steroidal ; Antirheumatic Agents ; Biological Products ; Gout Suppressants ; Immunosuppressive Agents ; Colchicine (SML2Y3J35T) ; Methotrexate (YL5FZ2Y5U1)
Language	English
Publishing date	2016-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	215710-x
ISSN	1557-9859 ; 0025-7125
ISSN (online)	1557-9859
ISSN	0025-7125
DOI	10.1016/j.mcna.2016.03.001
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Article ; Online: Non-English Language Preference Associated With Decreased Rheumatology Telehealth Use During the COVID-19 Pandemic.

Thomason, Jenna / Bays, Alison / Mantilla, Bryanna / Huang, Irvin / Najjar, Rayan / Singh, Namrata / Wysham, Katherine / Hughes, Grant

ACR open rheumatology

2022 Volume 4, Issue 5, Page(s) 385–394

Abstract: Objective: The study objective was to assess sociodemographic disparities in telehealth use among patients in an urban adult rheumatology clinic during the coronavirus disease 2019 (COVID-19) pandemic.: Methods: In this retrospective cohort study, ... ...

Abstract	Objective: The study objective was to assess sociodemographic disparities in telehealth use among patients in an urban adult rheumatology clinic during the coronavirus disease 2019 (COVID-19) pandemic. Methods: In this retrospective cohort study, patient-level sociodemographic data associated with all rheumatology visits in the following two periods were reviewed: pre-COVID-19 (March 1, 2019 to February 28, 2020) and COVID-19 (April 1, 2020 to March 31, 2021). Data were extracted from the electronic health record. Multivariable logistic regression analyses were performed to determine sociodemographic factors associated with video visits during the COVID-19 period. Results: In the pre-COVID-19 period, 1503 patients completed 3837 visits (100% in person). In the COVID-19 period, 1442 patients completed 3406 visits: 41% in person, 30% video, and 29% telephone only. Several factors were associated with decreased video use: preference for Spanish language (adjusted odds ratio [aOR] 0.27, 95% confidence interval [CI] 0.15-0.47) or other non-English languages (aOR 0.34, 95% CI 0.21-0.55), Black or African American race/ethnicity (aOR 0.50, 95% CI 0.35-0.73), Medicaid payer, and increasing age. Conclusion: Decreased video visit use among rheumatology patients was associated with non-English language preference, minority race/ethnicity, increasing age, and indicators of low income. Rapid deployment and expansion of telehealth during the COVID-19 pandemic likely has improved access for some but widened preexisting disparities for others. As medical care evolves toward ongoing digital care delivery, clarifying and addressing causes of telehealth disparities is essential for delivering equitable health care.
Language	English
Publishing date	2022-01-27
Publishing country	United States
Document type	Journal Article
ISSN	2578-5745
ISSN (online)	2578-5745
DOI	10.1002/acr2.11407
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Article: Expression of Envelope Protein Encoded by Endogenous Retrovirus K102 in Rheumatoid Arthritis Neutrophils.

Laine, Amanda / Wang, Xiaoxing / Ni, Kathryn / Smith, Sarah E B / Najjar, Rayan / Whitmore, Leanne S / Yacoub, Michael / Bays, Alison / Gale, Michael / Mustelin, Tomas

Microorganisms

2023 Volume 11, Issue 5

Abstract: Many patients suffering from autoimmune diseases have autoantibodies against proteins encoded by genomic retroelements, suggesting that normal epigenetic silencing is insufficient to prevent the production of the encoded proteins for which immune ... ...

Abstract	Many patients suffering from autoimmune diseases have autoantibodies against proteins encoded by genomic retroelements, suggesting that normal epigenetic silencing is insufficient to prevent the production of the encoded proteins for which immune tolerance appears to be limited. One such protein is the transmembrane envelope (Env) protein encoded by human endogenous retrovirus K (HERV-K). We reported recently that patients with rheumatoid arthritis (RA) have IgG autoantibodies that recognize Env. Here, we use RNA sequencing of RA neutrophils to analyze HERV-K expression and find that only two loci with an intact open-reading frame for Env, HERV-K102, and K108 are expressed, but only the former is increased in RA. In contrast, other immune cells express more K108 than K102. Patient autoantibodies recognized endogenously expressed Env in breast cancer cells and in RA neutrophils but not healthy controls. A monoclonal anti-Env antibody also detected Env on the surface of RA neutrophils but very little on the surface of other immune cells. We conclude that HERV-K102 is the locus that produces Env detectable on the surface of neutrophils in RA. The low levels of HERV-K108 transcripts may contribute only marginally to cell surface Env on neutrophils or other immune cells in some patients.
Language	English
Publishing date	2023-05-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720891-6
ISSN	2076-2607
ISSN	2076-2607
DOI	10.3390/microorganisms11051310
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Article ; Online: Pharmacist-managed titration of urate-lowering therapy to streamline gout management.

Huang, Irvin J / Liew, Jean W / Morcos, Meredith B / Zuo, Silu / Crawford, Carol / Bays, Alison M

Rheumatology international

2019 Volume 39, Issue 9, Page(s) 1637–1641

Abstract: The treat-to-target approach for serum uric acid is the recommended model in gout management according to the 2012 American College of Rheumatology (ACR) guidelines. Adherence to urate-lowering therapy (ULT) can be difficult for patients due to barriers, ...

Abstract	The treat-to-target approach for serum uric acid is the recommended model in gout management according to the 2012 American College of Rheumatology (ACR) guidelines. Adherence to urate-lowering therapy (ULT) can be difficult for patients due to barriers, which include medication burden, financial hardship, and lack of medical literacy. Our aim was to create a pharmacist-managed referral for the titration of ULT to target serum uric acid (sUA) levels in a complex patient population. We utilized a clinical database to query patients seen at a rheumatology clinic over a 12-month period with an ICD-10 diagnosis for gout. The referral criteria were indications for ULT per the 2012 ACR guidelines. Rheumatology providers, consisting of attendings, fellows, and a physician assistant, were asked to refer the identified patients to the pharmacist-managed titration program. The intervention group consisted of 19 referred patients and the control group consisted of 28 non-referred patients. The baseline sUA (median (IQR)) at the time of referral was 8.8 (2) mg/dL for the intervention group and 7.6 (2.8) mg/dL for the control group (p = 0.2). At the end of the study period, the sUA was 6.1 (1.4) mg/dL for the intervention group and 6.8 (3.2) mg/dL for the control group (p = 0.08). At the end of the study period, 6 of 19 (32%) intervention group and 7 of 28 (25%) control group were at goal (p = 0.3). A newly instituted pharmacist-managed titration program was able to achieve lower average sUA levels in referred patients compared to demographically similar individuals who received standard gout management.
MeSH term(s)	Adult ; Aged ; Biomarkers/blood ; Databases, Factual ; Down-Regulation ; Female ; Gout/blood ; Gout/diagnosis ; Gout/drug therapy ; Gout Suppressants/administration & dosage ; Gout Suppressants/adverse effects ; Humans ; Hyperuricemia/blood ; Hyperuricemia/diagnosis ; Hyperuricemia/drug therapy ; Male ; Middle Aged ; Pharmacists ; Professional Role ; Program Evaluation ; Referral and Consultation ; Time Factors ; Treatment Outcome ; Uric Acid/blood ; Washington
Chemical Substances	Biomarkers ; Gout Suppressants ; Uric Acid (268B43MJ25)
Language	English
Publishing date	2019-05-30
Publishing country	Germany
Document type	Journal Article
ZDB-ID	8286-7
ISSN	1437-160X ; 0172-8172
ISSN (online)	1437-160X
ISSN	0172-8172
DOI	10.1007/s00296-019-04333-5
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