Tofacitinib (TOF) is the first Janus kinase (JAK) inhibitor approved for psoriatic arthritis (PsA). It has shown efficacy in patients refractory to anti-tumor necrosis factor-α in randomized ...controlled trials (RCTs). Our aim was to assess efficacy and safety of TOF in clinical practice.
This was an observational, open-label multicenter study of PsA patients treated with TOF due to inefficacy or adverse events of previous therapies. Outcome variables were efficacy, corticosteroid dose-sparing effect, retention rate, and safety. A comparative study of clinical features between our cohort of patients and those from the OPAL Beyond trial was performed.
There were 87 patients (28 women/59 men), with a mean age of 52.8 ± 11.4 years. All patients were refractory to biologic disease-modifying antirheumatic drugs (DMARDs) and/or to conventional synthetic DMARDs plus apremilast. TOF was started at 5 mg twice daily after a mean follow-up of 12.3 ± 9.3 years from PsA diagnosis. At first month, Disease Activity Score in 28 joints based on erythrocyte sedimentation rate (DAS28-ESR) decreased from median 4.8 (IQR 4.1-5.4) to 3.7 (IQR 2.8-4.7,
< 0.01), Disease Activity Index for Psoriatic Arthritis from median 28 (IQR 18.4-34.1) to 15.5 (IQR 10.1-25.7,
< 0.01), and C-reactive protein from median 1.9 (IQR 0.3-5.0) to 0.5 (IQR 0.1-2.2) mg/dL (
< 0.01). Also, TOF led to a significant reduction in prednisone dose. Mild adverse effects were reported in 21 patients (24.13%), mainly gastrointestinal symptoms. TOF retention rate at Month 6 was 77% (95% CI 65.2-86.3). Patients in clinical practice were older with longer disease duration and received biologic agents more commonly than those in the OPAL Beyond trial.
Data from clinical practice confirm that TOF seems to be effective, rapid, and relatively safe in refractory PsA despite clinical differences with patients in RCTs.
Chronic anterior uveitis in a patient with CREST syndrome Fuente Cosío, Sara; Arca Barca, Beatriz; Martínez García, Paula ...
Reumatología clinica (Barcelona),
November-December 2020, 2020-11-00, Letnik:
16, Številka:
6
Journal Article
Recenzirano
Systemic sclerosis is a connective tissue pathology with very heterogeneous clinical manifestations, associated in a small percentage with inflammatory eye diseases. In the specific case of uveitis, ...only isolated cases have been reported in the literature, especially in relation to the CREST syndrome. We present the case of a 53-year-old woman with CREST syndrome and chronic anterior uveitis, which we consider of clinical relevance given its low prevalence.
La esclerosis sistémica es una conectivopatía con unas manifestaciones clínicas muy heterogéneas, relacionándose en un pequeño porcentaje con enfermedades oculares inflamatorias. En el caso concreto de las uveítis, únicamente se han descrito casos aislados en la literatura, sobre todo con relación al síndrome de CREST. Presentamos el caso de una mujer de 53 años, con síndrome de CREST y uveítis anterior crónica, que consideramos de relevancia clínica dada su baja prevalencia.
A bacteriocin produced by Lactobacillus plantarum LL441 was selected from the inhibitory products of 75 mesophilic lactobacilli because of its potency and broad spectrum. It is a peptide of 3.5 kDa ...whose amino-terminal sequence is NH2-K-K-T-K-K-N-X-S-G-D-I-. It is bactericidal and, in some cases, bacteriolytic. The peptide, called plantaricin C, retained its activity after boiling, storage, and treatment at different pHs
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