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Article ; Online: Is it time to say goodbye to weekly rituximab in ANCA vasculitis?

Pinto, Benzeeta / Dhooria, Aadhaar

2020 Volume 39, Issue 10, Page(s) 3153–3154

MeSH term(s)	Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ; Antibodies, Antineutrophil Cytoplasmic ; Biological Products ; Granulomatosis with Polyangiitis ; Humans ; Rituximab
Chemical Substances	Antibodies, Antineutrophil Cytoplasmic ; Biological Products ; Rituximab (4F4X42SYQ6)
Language	English
Publishing date	2020-08-26
Publishing country	Germany
Document type	Letter ; Comment
ZDB-ID	604755-5
ISSN	1434-9949 ; 0770-3198
ISSN (online)	1434-9949
ISSN	0770-3198
DOI	10.1007/s10067-020-05360-5
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Article: The master of masquerade: A case series of unusual presentations of cutaneous tuberculosis in the immunocompromised host.

Kaimal, Sowmya / Chacko, Ancy / Pinto, Benzeeta / Antony, Meryl

The Indian journal of tuberculosis

2021 Volume 68, Issue 4, Page(s) 540–543

Abstract: Cutaneous tuberculosis is known for its varied presentations, especially in the setting of immunosuppression. Clinical manifestations can be modified by the site of involvement as well as the type of cutaneous tuberculosis in a particular patient. ... ...

Abstract	Cutaneous tuberculosis is known for its varied presentations, especially in the setting of immunosuppression. Clinical manifestations can be modified by the site of involvement as well as the type of cutaneous tuberculosis in a particular patient. Although cutaneous tuberculosis only accounts for a small percentage (1-2%) of extrapulmonary cases, it is encountered fairly frequently in dermatology practice in an endemic country like India. These cases are being presented to highlight unusual presentations of well-known forms of cutaneous TB (TB gumma and erythema induratum of Bazin) and rare morphologies (panniculitis) in immunosuppressed individuals, thereby emphasizing the need for the dermatologist in a TB-endemic country to be constantly vigilant.
MeSH term(s)	Erythema Induratum ; Humans ; Immunocompromised Host ; India/epidemiology ; Tuberculosis, Cutaneous/diagnosis
Language	English
Publishing date	2021-06-21
Publishing country	India
Document type	Case Reports ; Journal Article
ZDB-ID	603129-8
ISSN	0019-5707 ; 0019-5705
ISSN	0019-5707 ; 0019-5705
DOI	10.1016/j.ijtb.2021.06.014
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Article ; Online: COVID-19 Pandemic in Women–Rheumatologist’s Perspective

Pinto, Benzeeta / Roongta, Rashmi

Indian Journal of Cardiovascular Disease in Women WINCARS

2020 Volume 5, Issue 03, Page(s) 250–255

Abstract: Abstract COVID-19 has caused unprecedented challenges to every field. Rheumatic diseases (RD) are more common in women compared with men. Patients with RD are predisposed to infections both because of their disease and immunosuppressive medication. The ... ...

Abstract	Abstract COVID-19 has caused unprecedented challenges to every field. Rheumatic diseases (RD) are more common in women compared with men. Patients with RD are predisposed to infections both because of their disease and immunosuppressive medication. The severity of COVID-19 in women is less as compared with men among the general population. It is not known if the risk is higher in women with RD compared with other women. Currently, published data of COVID-19 in RD suggests similar or mildly increased risk in patients with RD but sex disaggregated data is not available. In this article, we review the current evidence of COVID-19 in RD with an emphasis on women.
Keywords	covid19
Language	English
Publisher	Georg Thieme Verlag KG
Publishing country	de
Document type	Article ; Online
ISSN	2455-7854
DOI	10.1055/s-0040-1717045
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Article: COVID-19 Pandemic in Women–Rheumatologist’s Perspective

Pinto, Benzeeta / Roongta, Rashmi

Indian Journal of Cardiovascular Disease in Women - WINCARS

(COVID-19: Women’s Health Issues)

2020 Volume 5, Issue 03, Page(s) 250–255

Abstract: COVID-19 has caused unprecedented challenges to every field. Rheumatic diseases (RD) are more common in women compared with men. Patients with RD are predisposed to infections both because of their disease and immunosuppressive medication. The severity ... ...

Series title	COVID-19: Women’s Health Issues
Abstract	COVID-19 has caused unprecedented challenges to every field. Rheumatic diseases (RD) are more common in women compared with men. Patients with RD are predisposed to infections both because of their disease and immunosuppressive medication. The severity of COVID-19 in women is less as compared with men among the general population. It is not known if the risk is higher in women with RD compared with other women. Currently, published data of COVID-19 in RD suggests similar or mildly increased risk in patients with RD but sex disaggregated data is not available. In this article, we review the current evidence of COVID-19 in RD with an emphasis on women.
Keywords	COVID 19 in women ; rheumatic diseases ; immunosuppressants
Language	English
Publishing date	2020-09-01
Publisher	Thieme Medical and Scientific Publishers Private Ltd.
Publishing place	Stuttgart ; New York
Document type	Article
ISSN	2455-7854
ISSN (online)	2455-7854
DOI	10.1055/s-0040-1717045
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Article ; Online: Expanding spectrum of DADA2: a review of phenotypes, genetics, pathogenesis and treatment.

Pinto, Benzeeta / Deo, Prateek / Sharma, Susmita / Syal, Arshi / Sharma, Aman

Clinical rheumatology

2021 Volume 40, Issue 10, Page(s) 3883–3896

Abstract: Deficiency of adenosine deaminase 2 (DADA2) is a monogenic disease caused by biallelic mutations in ADA2 gene (previously CECR1). The aim of this review was to describe the clinical phenotypes, genetics, pathogenesis and treatment of DADA2. ADA2 is ... ...

Abstract	Deficiency of adenosine deaminase 2 (DADA2) is a monogenic disease caused by biallelic mutations in ADA2 gene (previously CECR1). The aim of this review was to describe the clinical phenotypes, genetics, pathogenesis and treatment of DADA2. ADA2 is highly expressed on myeloid cells and deficiency leads to polarisation of macrophages to an M1 inflammatory type and activation of neutrophils. The pathogenesis of immunological and haematological manifestations is less clear. The spectrum of clinical presentations varies widely from asymptomatic individual to severe vasculitis, several autoinflammatory, immunological and haematological manifestations. Initially considered a childhood disease, the first presentation is now being reported well into adulthood. Vasculitis closely resembles polyarteritis nodosa. Livedoid reticularis/racemosa like skin rash and central nervous system involvement in the form of ischemic or haemorrhagic stroke are dominant manifestations. Immunological manifestations include hypogammaglobulinemia and recurrent infections. Lymphopenia is the most common haematological manifestation; pure red cell aplasia and bone marrow failure has been reported in severe cases. The disease is extremely heterogeneous with variable severity noted in patients with the same mutation and even within family members. Tumour necrosis factor inhibitors are currently the treatment of choice for vasculitic and inflammatory manifestations and also prevent strokes. Haematopoietic stem cell transplantation is a curative option for severe haematological manifestations like pure red cell aplasia, bone marrow failure and immunodeficiency. Further research is required to understand pathogenesis and all clinical aspects of this disease to enable early diagnosis and prompt treatment. Key Points • Deficiency of adenosine deaminase 2 (DADA2) is a monogenic disease caused by biallelic mutations in ADA2 gene. • The clinical features include vasculitis resembling polyarteritis nodosa, autoinflammation, haematological manifestations and immunodeficiency. • The severity varies widely from mild to fatal even in patients within a family and with the same mutation. • The treatment of choice for inflammatory and vasculitic disease is tumour necrosis factor α blockers. Bone marrow transplant may be considered for severe haematological disease.
MeSH term(s)	Adenosine Deaminase/genetics ; Adult ; Child ; Humans ; Immunologic Deficiency Syndromes ; Intercellular Signaling Peptides and Proteins ; Mutation ; Phenotype ; Polyarteritis Nodosa
Chemical Substances	Intercellular Signaling Peptides and Proteins ; ADA2 protein, human (EC 3.5.4.4) ; Adenosine Deaminase (EC 3.5.4.4)
Language	English
Publishing date	2021-03-31
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	604755-5
ISSN	1434-9949 ; 0770-3198
ISSN (online)	1434-9949
ISSN	0770-3198
DOI	10.1007/s10067-021-05711-w
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Article ; Online: Low-dose rituximab is efficacious in refractory idiopathic inflammatory myopathies.

Janardana, Ramya / Amin, S N / Rajasekhar, Liza / Pinto, Benzeeta / Kodishala, Chanakya / Selvam, Sumithra / Shobha, Vineeta

Rheumatology (Oxford, England)

2022 Volume 62, Issue 3, Page(s) 1243–1247

Abstract: Objectives: Rituximab (RTX) use early in the course of refractory idiopathic inflammatory myopathy (IIM) is not well studied. This study sought to determine the short-term efficacy of RTX in a registry-based cohort of refractory IIM.: Methods: ... ...

Abstract	Objectives: Rituximab (RTX) use early in the course of refractory idiopathic inflammatory myopathy (IIM) is not well studied. This study sought to determine the short-term efficacy of RTX in a registry-based cohort of refractory IIM. Methods: Registry-based observational data about IIM patients receiving RTX between 2018 and 2021 were included. Total improvement score was calculated from the core set measures as per International Myositis Assessment and Clinical Studies group (IMACS) at baseline, 6 months and 12 months of follow-up. Results: Forty-two patients (F:M, 29:13), with a mean (s.d.) age of 39.5 (11.5) years were studied. Majority of patients received RTX for refractory myositis, after a median (interquartile range) duration of 8 (4,18) months. Twenty-eight received RTX at a dosage of 1 g × two doses, while 14 received 500 mg × two doses with an interval of 15 days. At 6 months and 12 months post-RTX, the improvement was recorded in manual muscle testing (MMT-8) scores, physician global assessment (PGA), patient global assessment (PtGA) and median steroid dosage as compared with the baseline (P < 0.01 for all). A mean (s.d.) improvement of 44.5 (16) and 48.7 (19.2) in total improvement score was recorded at 6 and 12 months, respectively. The change in MMT-8, PGA and PtGA scores from baseline between the two dosage regimens of RTX were comparable at 6 and 12 months. Severe lower respiratory tract infections requiring hospitalization occurred in three patients of the cohort. Conclusion: RTX improved IMACS core set measures and had steroid sparing efficacy at 6 and 12 months in patients with IIM in this registry-based study. Rituximab as an induction regimen of two doses of 500 mg can be as efficacious as 1 g at 6 months and 12 months of follow-up.
MeSH term(s)	Humans ; Adult ; Rituximab ; Treatment Outcome ; Myositis ; Retrospective Studies
Chemical Substances	Rituximab (4F4X42SYQ6)
Language	English
Publishing date	2022-08-10
Publishing country	England
Document type	Journal Article
ZDB-ID	1464822-2
ISSN	1462-0332 ; 1462-0324
ISSN (online)	1462-0332
ISSN	1462-0324
DOI	10.1093/rheumatology/keac438
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Article ; Online: Sexual functioning and its correlates in premenopausal married Indian women with systemic lupus erythematosus.

Pinto, Benzeeta / Grover, Sandeep / Dhooria, Aadhaar / Rathi, Manish / Sharma, Aman

International journal of rheumatic diseases

2019 Volume 22, Issue 10, Page(s) 1814–1819

Abstract: Background: This study aimed to evaluate sexual functioning and its association with disease activity, damage, marital satisfaction, fatigue and psychiatric comorbidity in married women with systemic lupus erythematosus (SLE).: Methods: One hundred ... ...

Abstract	Background: This study aimed to evaluate sexual functioning and its association with disease activity, damage, marital satisfaction, fatigue and psychiatric comorbidity in married women with systemic lupus erythematosus (SLE). Methods: One hundred and twelve premenopausal married women with SLE were included in the study. Disease activity and damage were assessed using Safety of Estrogens in Lupus Erythematosus National Assessment Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) and Systemic Lupus International Collaborating Clinics/ American College of Rheumatology Damage Index (SDI) respectively. Female sexual function index (FSFI) and couple satisfaction index (CSI) were used to evaluate sexual function and marital satisfaction respectively. Depression, anxiety and fatigue were assessed using Patient Health Questionnaire 9 (PHQ9), Generalized Anxiety Disorder 7 (GAD7) and fatigue severity scale (FSS) respectively. Results: The mean age of the study group was 34.0 (SD 6.8) years. Mean SELENA-SLEDAI was 3.67 (SD 4.2) and mean SDI was 0.25 (SD 0.62). Median steroid dose at the time of evaluation was 7.5 mg/d of prednisolone. Based on FSFI total score, impaired sexual functioning was found in 60.7%. However, when the cut-off of different domains was considered, more than 90% of the participants reported problems in desire, arousal and lubrication. The mean CSI score was 130.39 ± 26.17. Eighteen patients (16.1%) had CSI lower than the cut-off score (104.5) suggestive of marital distress. On univariate analysis sexual function showed a correlation with marital satisfaction (r = .34, P < .001), dose of steroids(r = -.26, P = .008), disease activity (r = -.21, P = .027), depression (r = -.19, P = .039) and anxiety (r = -.201, P = .034). Conclusion: Sexual dysfunction is highly prevalent in premenopausal married females with SLE. Higher dose of steroids, disease activity, depression,anxiety and marital satisfaction were associated with poor sexual functioning in one or more domains.
MeSH term(s)	Adaptation, Psychological ; Adult ; Cross-Sectional Studies ; Female ; Health Status Indicators ; Humans ; Incidence ; India/epidemiology ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/physiopathology ; Lupus Erythematosus, Systemic/psychology ; Marital Status ; Middle Aged ; Premenopause ; Quality of Life ; Risk Factors ; Severity of Illness Index ; Sexual Dysfunction, Physiological/epidemiology ; Sexual Dysfunction, Physiological/etiology ; Sexual Dysfunction, Physiological/psychology ; Sexuality ; Women's Health ; Young Adult
Language	English
Publishing date	2019-08-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2426924-4
ISSN	1756-185X ; 1756-1841
ISSN (online)	1756-185X
ISSN	1756-1841
DOI	10.1111/1756-185X.13675
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Article ; Online: Fatigue and its correlates in Indian patients with systemic lupus erythematosus.

Pinto, Benzeeta / Dhooria, Aadhaar / Grover, Sandeep / Jolly, Meenakshi / Raj, John Michael / Sharma, Aman

Clinical rheumatology

2020 Volume 40, Issue 3, Page(s) 905–911

Abstract: Fatigue is a disabling yet poorly understood symptom in patients with systemic lupus erythematosus (SLE). Many variables influence fatigue including physical function, pain, fibromyalgia and psychiatric comorbidity. Literature is conflicted on its ... ...

Abstract	Fatigue is a disabling yet poorly understood symptom in patients with systemic lupus erythematosus (SLE). Many variables influence fatigue including physical function, pain, fibromyalgia and psychiatric comorbidity. Literature is conflicted on its association with disease activity. To assess fatigue and its correlates among patients with SLE. Existent data from validation of Hindi LupusPRO study were utilized for this study. SLE patients were enrolled and underwent assessments of disease activity and damage (SELENA-SLEDAI and SLICC/ACR Damage Index (SDI)). Depression (Patient Health Questionnaire-9 (PHQ-9)), anxiety (Generalized Anxiety Disorder-7 (GAD-7)), fatigue (Fatigue Severity Scale (FSS)) and fibromyalgia were evaluated. Physical function and bodily pain were assessed using Short Form 36 (SF-36). Statistical analysis was done using the STATA version 14. A total of 140 females and 4 males with SLE with a mean age of 32.48 (SD 7.26) years were recruited. Median duration of illness was 3 years (IQR-4). Fatigue (FSS ≥ 4) was present in 74 (51.39%) participants. Prevalence of depression (PHQ-9 ≥ 10) and anxiety (GAD-7 ≥ 10) were 25% and 22.9%, respectively. Concomitant fibromyalgia was present in 8 participants (5.56%). Higher fatigue scores correlated with greater disease activity, shorter disease duration, worse physical function, bodily pain, depression and anxiety. On stepwise regression, disease duration, disease activity, bodily pain, depression and anxiety were independent predictors of fatigue (R
MeSH term(s)	Adult ; Anxiety/epidemiology ; Fatigue/epidemiology ; Female ; Humans ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/epidemiology ; Male ; Pain/epidemiology ; Quality of Life ; Severity of Illness Index
Language	English
Publishing date	2020-10-08
Publishing country	Germany
Document type	Journal Article
ZDB-ID	604755-5
ISSN	1434-9949 ; 0770-3198
ISSN (online)	1434-9949
ISSN	0770-3198
DOI	10.1007/s10067-020-05445-1
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Article ; Online: Occurrence and outcome of COVID-19 in AIRD patients on concomitant treatment with Tofacitinib- results from KRA COVID COHORT (KRACC) subset.

Chebbi, Pramod / Shobha, Vineeta / Rao, Vijay K / Haridas, Vikram / Janardana, Ramya / Pinto, Benzeeta / Kumar, Sharath / Patil, Abhishek / Tekkatte, Roopa / Salanke, Manasa / Mahendranath, K M

BMC rheumatology

2023 Volume 7, Issue 1, Page(s) 22

Abstract: Introduction: We assessed the risk factors and outcome of COVID-19 in patients with autoimmune rheumatic diseases(AIRD) who contracted infection while on background treatment with tofacitinib.: Methods: This is a non-interventional, cross-sectional, ... ...

Abstract	Introduction: We assessed the risk factors and outcome of COVID-19 in patients with autoimmune rheumatic diseases(AIRD) who contracted infection while on background treatment with tofacitinib. Methods: This is a non-interventional, cross-sectional, questionnaire based telephonic study which included consecutive AIRD patients on tofacitinib co-treatment. Data related to the AIRD subset, disease modifying anti rheumatic drugs(DMARDs) including glucocorticoids and comorbidities, was collected from 7 rheumatology centers across Karnataka during the second wave of COVID-19 pandemic. The information about COVID-19 occurrence and COVID-19 vaccination was recorded. Results: During the study period (Jun-July 2021), 335 AIRD patients (80.6% female) on treatment with tofacitinib were included. The mean duration of tofacitinib use was 3.4+/-3.1months. Thirty-six(10.75%) patients developed COVID-19. Diabetes mellitus (p = 0.04 (OR 2.60 (1.13-5.99)) was identified as a risk factor for COVID-19 in our cohort. Almost half of our cohort was COVID-19 vaccinated with at least one dose, with resultant decline in incidence of COVID-19(OR 0.15 (0.06-0.39) among the vaccinated. Recovery amongst COVID-19 infection group was 91.2%. Conclusions: The subset of AIRD patients who were on treatment with tofacitinib were found to have a higher rate of COVID-19 infection as compared to our KRACC cohort. Pre-existing comorbidity of diabetes mellitus was the significant risk factor in our cohort. This subset of the KRACC cohort shows RA patients had a lesser infection and PsA patients had a higher infection.
Language	English
Publishing date	2023-07-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2918121-5
ISSN	2520-1026 ; 2520-1026
ISSN (online)	2520-1026
ISSN	2520-1026
DOI	10.1186/s41927-023-00345-8
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Article ; Online: Long Term Outcomes in Idiopathic Inflammatory Myositis: An Observational Epidemiologic Study over 15 Years.

Janardana, Ramya / Kn, Sangeetha / Bhat, Vasudha / Balakrishnan, Divya / Raj, John Michael / Pinto, Benzeeta / K, Chanakya / Nadig, Raghunandan / Mahadevan, Anita / Shobha, Vineeta

Mediterranean journal of rheumatology

2023 Volume 34, Issue 4, Page(s) 513–524

Abstract: Background: We report a longitudinal observational cohort of idiopathic inflammatory myositis (IIM) focusing on the long-term clinical outcome and associated parameters.: Methods: IIM patients were classified as per Bohan and Peter criteria. In those ...

Abstract	Background: We report a longitudinal observational cohort of idiopathic inflammatory myositis (IIM) focusing on the long-term clinical outcome and associated parameters. Methods: IIM patients were classified as per Bohan and Peter criteria. In those with ≥ 24 months of follow-up; the treatment response, functional outcomes, and damage at last follow-up were recorded. Complete clinical response and clinical remission as defined by Oddis et al., was used to define outcomes at last follow-up. Results: The cohort consists of 175 patients, mean age 40.9 (+12.6) years, M:F 1:3.3; and the major subsets were dermatomyositis (44.6%), overlap myositis (25.7%), antisynthetase syndrome (6.3%), polymyositis (14.3%), and juvenile DM/OM (8.6%). Ninety-four patients have followed up for 24 months or more, with the median (IQR) of 65(35,100.7) months. Of them, 74.1% and 11.8% had complete and partial clinical responses respectively at the last follow-up. In our cohort 40.2% were off-steroids and 13.8% were in clinical remission at the last follow-up. Complete clinical response was associated with better functional outcomes and lesser damage as determined by HAQ-DI of 0[OR10.9; 95%CI (3.3,160)], MRS [OR 3.2; 95%CI (1.4,7.3)] and lesser MDI [OR 1.7; 95% CI (1.1,2.7)] respectively as compared to partial response (unadjusted analysis). Baseline parameters and IIM subsets did not significantly influence the functional outcome and damage. The mortality rate in our cohort is 24/175 (13.7%), the disease-specific mortality rate being 9.1%. Large majority of deaths were early, associated with active disease. Conclusion: We report good long-term outcomes in all major myositis subsets. Partial clinical response to treatment is associated with worse functional outcomes and damage accrual. Death occurs early in association with active disease.
Language	English
Publishing date	2023-08-28
Publishing country	Greece
Document type	Journal Article
ZDB-ID	3019943-8
ISSN	2529-198X ; 2459-3516
ISSN (online)	2529-198X
ISSN	2459-3516
DOI	10.31138/mjr.280823.lto
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