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Article ; Online: Autoantibody Recognition of Natural and Homocysteinylated Alpha-1 Antitrypsin: Indirect Enzyme-Linked Immunosorbent Assay (ELISA) Quantification in Sera.

Colasanti, Tania / Conti, Fabrizio

Methods in molecular biology (Clifton, N.J.)

2023 Volume 2750, Page(s) 135–141

Abstract: In this chapter, indirect enzyme-linked immunosorbent assays (ELISAs) to quantitatively measure autoantibodies directed to human natural and homocysteinylated alpha-1 antitrypsin (anti-AATA and anti-HAATA, respectively) in serum are described. The ... ...

Abstract	In this chapter, indirect enzyme-linked immunosorbent assays (ELISAs) to quantitatively measure autoantibodies directed to human natural and homocysteinylated alpha-1 antitrypsin (anti-AATA and anti-HAATA, respectively) in serum are described. The illustrated ELISA protocols are slightly different, since the two protein forms have different biochemical features and, consequently, different affinity for the matrix (polystyrene microplate wells), so that specific experimental conditions have to be performed for the quantification of the serum antibody recognition.These procedures can be carried out to evaluate the anti-AATA and the anti-HAATA levels, testing serum samples, for research use.
MeSH term(s)	Humans ; Autoantibodies ; Enzyme-Linked Immunosorbent Assay ; Polystyrenes
Chemical Substances	Autoantibodies ; Polystyrenes
Language	English
Publishing date	2023-12-18
Publishing country	United States
Document type	Journal Article
ISSN	1940-6029
ISSN (online)	1940-6029
DOI	10.1007/978-1-0716-3605-3_13
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Conference proceedings ; Online: 21 Covid-19 and SLE – What do we know today?

Conti, Fabrizio

Abstracts

2020

Keywords	covid19
Publisher	Lupus Foundation of America
Publishing country	uk
Document type	Conference proceedings ; Online
DOI	10.1136/lupus-2020-la.21
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Management of patients with inflammatory rheumatic diseases after treatment failure with a first tumour necrosis factor inhibitor: A narrative review.

Caporali, Roberto / Conti, Fabrizio / Iannone, Florenzo

Modern rheumatology

2023 Volume 34, Issue 1, Page(s) 11–26

Abstract: The emergence of biologics with different modes of action (MoAs) and therapeutic targets has changed treatment patterns in patients with inflammatory rheumatic diseases. While tumour necrosis factor inhibitors (TNFis) are often utilized as the first ... ...

Abstract	The emergence of biologics with different modes of action (MoAs) and therapeutic targets has changed treatment patterns in patients with inflammatory rheumatic diseases. While tumour necrosis factor inhibitors (TNFis) are often utilized as the first biologic disease-modifying antirheumatic drug, some patients may not respond adequately (primary failure), fail to sustain response over time (secondary failure), or experience intolerable adverse events. Whether these patients would benefit more from cycling to a different TNFi or switching to a biologic with a different MoA is still unclear. We discuss here treatment outcomes of TNFi cycling versus MoA switching after treatment failure with a first TNFi in patients with inflammatory rheumatic diseases, focusing specifically on rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, and juvenile idiopathic arthritis. Treatment guidelines for these patients are ambiguous and, at times, contradictory in their recommendations. However, this is due to a lack of high-quality head-to-head data to definitively support cycling between TNFis after failure to a first-line TNFi over switching to a different MoA.
MeSH term(s)	Humans ; Tumor Necrosis Factor Inhibitors/therapeutic use ; Tumor Necrosis Factor-alpha ; Antirheumatic Agents/adverse effects ; Arthritis, Rheumatoid/drug therapy ; Treatment Failure
Chemical Substances	Tumor Necrosis Factor Inhibitors ; Tumor Necrosis Factor-alpha ; Antirheumatic Agents
Language	English
Publishing date	2023-12-20
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	2078157-X
ISSN	1439-7609 ; 1439-7595
ISSN (online)	1439-7609
ISSN	1439-7595
DOI	10.1093/mr/road033
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Article: Subcutaneously-Administered Infliximab in the Management of Rheumatoid Arthritis: A Short Narrative Review of Current Clinical Evidence.

Iannone, Florenzo / Conti, Fabrizio / Cauli, Alberto / Farina, Alberto / Caporali, Roberto

Journal of inflammation research

2022 Volume 15, Page(s) 3259–3267

Abstract: The first subcutaneous (SC) formulation of infliximab CT-P13 has been authorized for the treatment of rheumatoid arthritis (RA) in Europe in 2019. Later, in 2020, approved indications were extended also to ankylosing spondylitis, psoriatic arthritis, ... ...

Abstract	The first subcutaneous (SC) formulation of infliximab CT-P13 has been authorized for the treatment of rheumatoid arthritis (RA) in Europe in 2019. Later, in 2020, approved indications were extended also to ankylosing spondylitis, psoriatic arthritis, psoriasis, Crohn's disease (CD) and ulcerative colitis (UC). The present review provides summary of the key features of SC infliximab, with particular focus on pharmacokinetic profile, clinical development program in comparison with the intravenous (IV) formulation, and the latest evidence in the literature. We conclude that SC infliximab represents a new and promising approach in the treatment of patients with RA, offering an optimized clinical profile and a more practical option in comparison to the IV formulation. Nevertheless, SC formulation can improve the use of national health systems resources (e.g., through the time of healthcare workers not having to supervise infusions) and facilitate social distancing measures during the COVID-19 pandemic, as the patient can self-inject the medicine at home without going to the hospital. The limitations of the SC infliximab are mainly due to the limited experience of use in clinical practice and the absence of long-term drug retention data.
Language	English
Publishing date	2022-06-01
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2494878-0
ISSN	1178-7031
ISSN	1178-7031
DOI	10.2147/JIR.S240593
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Article: Validation of Qualisex questionnaire to evaluate sexual dysfunction in women affected by fibromyalgia.

Gioia, Chiara / Dolcini, Giulio / Iannuccelli, Cristina / Favretti, Martina / Franculli, Daniele / Sarzi-Puttini, Piercarlo / Conti, Fabrizio / Priori, Roberta / Di Franco, Manuela

Clinical and experimental rheumatology

2024

Abstract: Objectives: Fibromyalgia (FM) may have consequences on sexual life. The objective was to validate the Qualisex questionnaire in the assessment of sexual dysfunction in women affected by FM.: Methods: We consecutively enrolled FM women (American ... ...

Abstract	Objectives: Fibromyalgia (FM) may have consequences on sexual life. The objective was to validate the Qualisex questionnaire in the assessment of sexual dysfunction in women affected by FM. Methods: We consecutively enrolled FM women (American College of Rheumatology-ACR 2016) referring to our Fibromyalgia Clinic, from 2020 to 2022. Demographic, clinical data and evaluation of FM symptoms severity (Revised Fibromyalgia Impact Questionnaire (R-FIQ), Symptoms Severity Scale-SSS, Widespread Pain Index-WPI) were assessed. Hospital Anxiety and Depression Scale (HADS) and Qualisex questionnaire were anonymously administered. Qualisex includes 10 questions on different items of sexual life with higher scores suggestive of greater negative impact of the disease on sexuality. Results: The cohort was composed by 373 FM women. Cronbach's alpha test was used to validate Qualisex questionnaire (0.878). Moreover, we observed higher values of Qualisex in married women (p<0.001), in women with lower grade of education (p=0.002) and with lower sexual feeling with partner (p<0.001). Higher values of Qualisex Total score showed a positive correlation with HADS-A/D (p<0.001 r=0.312; p<0.001 r=0.542 respectively), VAS pain, VAS fatigue, VAS dryness (p<0.001 r=0,438; p<0.001 r=0.375; p<0.001 r=0.370 respectively) and relationship duration (p<0.001 r=0.202). Multivariate analysis revealed a significant influence of relationship duration, VAS pain, fatigue, dryness, HADS-A/D, R-FIQ and all Qualisex items, on Qualisex Total score corrected for patients' age (p<0.001). Conclusions: This study validated Qualisex questionnaire as a good test for the sexual disorders' evaluation in FM women. Its use allows the assessment of different factors associated with sexual dysfunction, showing an impact of FM on sexuality. Moreover, due to demotivation feelings, sexual dysfunction contributes to worsen patients' quality of life.
Language	English
Publishing date	2024-04-08
Publishing country	Italy
Document type	Journal Article
ZDB-ID	605886-3
ISSN	1593-098X ; 0392-856X
ISSN (online)	1593-098X
ISSN	0392-856X
DOI	10.55563/clinexprheumatol/a00yur
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Article ; Online: Fragility fractures in lupus patients: Associated factors and comparison of four fracture risk assessment tools.

Ceccarelli, Fulvia / Olivieri, Giulio / Orefice, Valeria / Picciariello, Licia / Natalucci, Francesco / Conti, Fabrizio

Lupus

2023 Volume 32, Issue 11, Page(s) 1320–1327

Abstract: Objective: Osteoporosis (OP) and fragility fractures (FF) are common comorbidities in patients with systemic lupus erythematosus (SLE). This study aimed to (1) assess the prevalence of these conditions in a cohort of SLE patients (2) evaluate the risk ... ...

Abstract	Objective: Osteoporosis (OP) and fragility fractures (FF) are common comorbidities in patients with systemic lupus erythematosus (SLE). This study aimed to (1) assess the prevalence of these conditions in a cohort of SLE patients (2) evaluate the risk factors associated with FF, and (3) compare the accuracy of four different FF risk assessment algorithms to determine which performs better in this specific rheumatologic population. Materials and methods: We conducted a cross-sectional study with SLE women who underwent bone mineral density assessment by dual-energy X-ray absorptiometry (DEXA) within 3 months of their last visit. Conventional radiology methods were used to evaluate the presence of FF. The 10-year risk of osteoporotic fractures was estimated using four tools: DeFRA, FRAX (adjusted for GC dosage), GARVAN, and QFracture. The comparison of these computational tools was analyzed by the area under the receiver operating characteristic (ROC) curves. Results: We analyzed 86 SLE patients with a median age of 56 years (IQR 12.1) and a median age at diagnosis of 34 years (IQR 17.2). The median T-score values at the femoral neck and lumbar spine were -1.6 (IQR 0.9) and -1.7 (IQR 1.1), respectively. Of the patients, 33 (38.4%) had OP, with 13 patients (15.1%) experiencing FF. Univariate analysis showed that the presence of FF was associated with thrombocytopenia ( Conclusions: OP is a common comorbidity in SLE patients, even in younger patients. FF appears to be more frequent in patients with hematologic involvement. The comparison of the four algorithms shows that DeFRA is the most accurate tool and should be applied to SLE patients.
MeSH term(s)	Humans ; Female ; Child ; Cross-Sectional Studies ; Risk Assessment/methods ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/epidemiology ; Osteoporosis/diagnosis ; Osteoporosis/epidemiology ; Osteoporosis/etiology ; Osteoporotic Fractures/epidemiology ; Osteoporotic Fractures/etiology ; Bone Density ; Risk Factors ; Absorptiometry, Photon/methods
Language	English
Publishing date	2023-09-12
Publishing country	England
Document type	Journal Article
ZDB-ID	1154407-7
ISSN	1477-0962 ; 0961-2033
ISSN (online)	1477-0962
ISSN	0961-2033
DOI	10.1177/09612033231202701
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Article ; Online: Tapering and discontinuation of glucocorticoids in patients with rheumatoid arthritis treated with tofacitinib.

Spinelli, Francesca Romana / Garufi, Cristina / Mancuso, Silvia / Ceccarelli, Fulvia / Truglia, Simona / Conti, Fabrizio

Scientific reports

2023 Volume 13, Issue 1, Page(s) 15537

Abstract: Although the rapid onset of effect of glucocorticoids (GCs) allows rapid control of rheumatoid arthritis (RA) symptoms, their chronic use may be associated with several adverse events. The 2022 update of EUALR recommendations for the management of ... ...

Abstract	Although the rapid onset of effect of glucocorticoids (GCs) allows rapid control of rheumatoid arthritis (RA) symptoms, their chronic use may be associated with several adverse events. The 2022 update of EUALR recommendations for the management of patients with RA suggests to reduce and discontinue oral GCs as quickly as possible. Considering GCs as a "bridging therapy" to promptly reduce symptoms and control inflammation, fast-acting drugs such as tofacitinib could allow faster and safer tapering of GCs. The purpose of this pilot study was to evaluate the steroid-sparing effect of adding tofacitinib in patients with RA inadequately responsive to methotrexate taking concomitant GCs. In this open-label pilot study, we enrolled patients with moderate to severe RA on a stable dose of prednisone (5-12.5 mg/day) who started treatment with tofacitinib. After 1 month, in patients who achieved at least a moderate EULAR response (decrease of > 1.2 in DAS28_CRP), GCs was tapered according to a predetermined schedule until complete discontinuation at week 12. Disease activity was assessed after 4, 12, 24 and 48 weeks of treatment. The primary endpoint was the percentage of patients discontinuing GCs after 12 weeks of tofacitinib treatment. We enrolled 30 patients (26 F: 4 M, mean age 60 ± 13 years, mean disease duration 13.2 ± 7.8 years). The primary endpoint was achieved: 9 patients (30%) discontinued GCs at week-12. At week-24, other 12 patients (46%) withdrew GCs. The median prednisone dose decreased from 5 mg/day (interquartile range 5-10 mg) to 2.5 (0-5) mg/day at week 12 and 48 (p < 0.00001 vs baseline). At week 48, 12 out of 30 patients (40%) had discontinued prednisone. The percentage of patients achieving remission or low disease activity increased throughout the follow-up without any difference between patients who discontinued or not the GC. In this cohort of long-standing RA patients treated with tofacitinib, the discontinuation of glucocorticoids was achievable in up to 30% of patients. These results should encourage rheumatologists to consider GCs tapering and discontinuation of GCs, as suggested by the 2022 EULAR recommendations, an achievable goal.
MeSH term(s)	Humans ; Middle Aged ; Aged ; Glucocorticoids/adverse effects ; Prednisone/adverse effects ; Pilot Projects ; Arthritis, Rheumatoid/drug therapy
Chemical Substances	Glucocorticoids ; Prednisone (VB0R961HZT) ; tofacitinib (87LA6FU830)
Language	English
Publishing date	2023-09-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-42371-z
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Article ; Online: Exercise-induced modulation of Interferon-signature: a therapeutic route toward management of Systemic Lupus Erythematosus.

Spinelli, Francesca Romana / Berti, Riccardo / Farina, Gabriele / Ceccarelli, Fulvia / Conti, Fabrizio / Crescioli, Clara

Autoimmunity reviews

2023 Volume 22, Issue 10, Page(s) 103412

Abstract: Systemic Lupus Erythematosus (SLE) is a multisystemic autoimmune disorder characterized by flares-ups/remissions with a complex clinical picture related to disease severity and organ/tissue injury, which, if left untreated, may result in permanent damage. ...

Abstract	Systemic Lupus Erythematosus (SLE) is a multisystemic autoimmune disorder characterized by flares-ups/remissions with a complex clinical picture related to disease severity and organ/tissue injury, which, if left untreated, may result in permanent damage. Enhanced fatigue and pain perception, worsened quality of life (QoL) and outcome are constant, albeit symptoms may differ. An aberrant SLE immunoprofiling, note as "interferon (IFN)α-signature", is acknowledged to break immunotolerance. Recently, a deregulated "IFNγ-signature" is suggested to silently precede/trigger IFNα profile before clinical manifestations. IFNα- and IFNγ-over-signaling merge in cytokine/chemokine overexpression exacerbating autoimmunity. Remission achievement and QoL improvement are the main goals. The current therapy (i.e., corticosteroids, immunosuppressants) aims to downregulate immune over-response. Exercise could be a safe treatment due to its ever-emerging ability to shape and re-balance immune system without harmful side-effects; in addition, it improves cardiorespiratory capacity and musculoskeletal strength/power, usually impaired in SLE. Nevertheless, exercise is not yet included in SLE care plans. Furthermore, due to the fear to worsening pain/fatigue, SLE subjects experience kinesiophobia and sedentary lifestyle, worsening physical health. Training SLE patients to exercise is mandatory to fight inactive behavior and ameliorate health. This review aims to focus the attention on the role of exercise as a non-pharmacological therapy in SLE, considering its ability to mitigate IFN-signature and rebalance (auto)immune response. To this purpose, the significance of IFNα- and IFNγ-signaling in SLE etiopathogenesis will be addressed first and discussed thereafter as biotarget of exercise. Comments are addressed on the need to make aware all SLE care professional figures to promote exercise for health patients.
MeSH term(s)	Humans ; Quality of Life ; Interferon-alpha/therapeutic use ; Cytokines/therapeutic use ; Lupus Erythematosus, Systemic/drug therapy ; Autoimmunity
Chemical Substances	Interferon-alpha ; Cytokines
Language	English
Publishing date	2023-08-18
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2144145-5
ISSN	1873-0183 ; 1568-9972
ISSN (online)	1873-0183
ISSN	1568-9972
DOI	10.1016/j.autrev.2023.103412
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Article ; Online: Should we vaccinate during an active rheumatic disease?

Bijl, Marc / Westra, Johanna / Mancuso, Silvia / Bearzi, Pietro / Giacomelli, Roberto / Conti, Fabrizio

Autoimmunity reviews

2023 Volume 23, Issue 1, Page(s) 103426

Abstract: Timing of vaccination and its relationship with concomitant immunosuppressive therapy has been a matter of debate in the field of AutoImmune Inflammatory Rheumatic Diseases (AIIRD). Vaccination is crucial in the prevention of infections, which, in the ... ...

Abstract	Timing of vaccination and its relationship with concomitant immunosuppressive therapy has been a matter of debate in the field of AutoImmune Inflammatory Rheumatic Diseases (AIIRD). Vaccination is crucial in the prevention of infections, which, in the setting of AIIRD, are known risk factors for disease flare and expose patients to increase risk of complications and mortality. As evidenced from real-life studies, vaccines do not significantly affect disease activity. Conversely, disease activity (especially in Systemic Lupus Erythematosus) may predict for vaccine response: high disease activity correlates with decreased seroconversion. For this reason, according to the EULAR 2019 recommendation, vaccination should preferably be administered during quiescent AIIRD. Beside disease activity, background immunosuppressive therapy should be considered when performing vaccination, as different Disease Modifying Anti-Rheumatic Drugs (DMARDs) decrease vaccine immunogenicity. AIIRD patients should be vaccinated, independently from the vaccine type, before starting immunosuppression. If the patient is on active immunosuppressive therapy, the best window of opportunity to boost vaccine response is during AIIRD quiescence, as low disease activity increases seroconversion and allows safe immunosuppressant spacing. In conclusion, the majority of AIIRD patients should receive vaccination, preferably during quiescent disease and taking into consideration immunosuppressant spacing.
MeSH term(s)	Humans ; Antirheumatic Agents/administration & dosage ; Autoimmune Diseases ; Immunosuppressive Agents/administration & dosage ; Rheumatic Diseases/complications ; Rheumatic Diseases/drug therapy ; Vaccination
Chemical Substances	Antirheumatic Agents ; Immunosuppressive Agents
Language	English
Publishing date	2023-08-25
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2144145-5
ISSN	1873-0183 ; 1568-9972
ISSN (online)	1873-0183
ISSN	1568-9972
DOI	10.1016/j.autrev.2023.103426
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Article ; Online: HiJAKing SARS-CoV-2? The potential role of JAK inhibitors in the management of COVID-19.

Spinelli, Francesca Romana / Conti, Fabrizio / Gadina, Massimo

Science immunology

2020 Volume 5, Issue 47

Abstract: JAK kinase inhibitors are being investigated as a way of managing cytokine storm in severe COVID-19 patients. ...

Abstract	JAK kinase inhibitors are being investigated as a way of managing cytokine storm in severe COVID-19 patients.
MeSH term(s)	Animals ; Azetidines/therapeutic use ; Betacoronavirus/physiology ; Clinical Trials as Topic ; Coronavirus Infections/drug therapy ; Coronavirus Infections/immunology ; Humans ; Janus Kinase Inhibitors/therapeutic use ; Pandemics ; Pneumonia, Viral/drug therapy ; Pneumonia, Viral/immunology ; Sulfonamides/therapeutic use
Chemical Substances	Azetidines ; Janus Kinase Inhibitors ; Sulfonamides ; baricitinib (ISP4442I3Y)
Keywords	covid19
Language	English
Publishing date	2020-05-08
Publishing country	United States
Document type	Journal Article
ISSN	2470-9468
ISSN (online)	2470-9468
DOI	10.1126/sciimmunol.abc5367
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