ObjectiveTo explore the impact of early versus late-onset psoriasis (PsO) on the disease characteristics of psoriatic arthritis (PsA) in a large-multicentre cohort. MethodsThe data from a multicentre psoriatic arthritis database was analysed. Patients were grouped according to age at psoriasis onset (early onset; <40 years of age, late-onset; >40 years of age) and disease characteristics of the groups were compared by adjusting for BMI and PsA duration, where necessary. Results At the time of analyses, 1634 patients were recruited [62.8% females; early onset 1108 (67.8%); late-onset, 526 (32.2%)]. The late-onset group was more over-weight [66.8% vs. 86.8%, p<0.001; adjusted for age -aOR 1.55 (1.11-2.20; 95% CI)]. The early onset group had more scalp psoriasis at onset (56.7% vs. 43.0%, p<0.001), whereas extremity lesions were more common in the late-onset group (63.8% vs. 74.2%, p<0.001). Axial disease in males and psoriatic disease family history in females were significantly higher in the early onset group [38.0% vs. 25.4%; p=0.005; adjusted for PsA duration -aOR 1.76 (1.19-2.62; 95% CI) / 39.5% vs. 30.1%; p=0.003; OR 1.51 (1.15-1.99; 95% CI), respectively]. Psoriatic disease activity parameters, patient-physician reported outcomes and HAQ-DI scores were similar in both groups. Conclusion Clinical features of PsA may be affected by the age at onset of PsO. Different genetic backgrounds in early and late-onset PsO may be driving the differences in psoriasis and PsA phenotypes.

Background/aim To evaluate treatment adherence and predictors of drug discontinuation among patients with inflammatory arthritis receiving bDMARDs within the first 100 days after the announcement of the COVID-19 pandemic. Materials and methods A total of 1871 patients recorded in TReasure registry for whom advanced therapy was prescribed for rheumatoid arthritis (RA) or spondyloarthritis (SpA) within the 3 months (6–9 months for rituximab) before the declaration of COVID-19 pandemic were evaluated, and 1394 (74.5%) responded to the phone survey. Patients’ data regarding demographic, clinical characteristics and disease activity before the pandemic were recorded. The patients were inquired about the diagnosis of COVID-19, the rate of continuation on bDMARDs, the reasons for treatment discontinuation, if any, and the current general disease activity (visual analog scale, [VAS]). Results A total of 1394 patients (493 RA [47.3% on anti-TNF] patients and 901 SpA [90.0% on anti-TNF] patients) were included in the study. Overall, 2.8% of the patients had symptoms suggesting COVID-19, and 2 (0.15%) patients had PCR-confirmed COVID-19. Overall, 18.1% of all patients (13.8% of the RA and 20.5% of the SpA; p = 0.003) discontinued their bDMARDs. In the SpA group, the patients who discontinued bDMARDs were younger (40 [21–73] vs. 44 years [20–79]; p = 0.005) and had higher general disease activity; however, no difference was relevant for RA patients. Conclusion Although the COVID-19 was quite uncommon in the first 100 days of the pandemic, nearly one-fifth of the patients discontinued bDMARDs within this period. The long-term effects of the pandemic should be monitored.

ÖZET Çalışma, romatolojik hastalıklarda sosyal destek ve bakım veren yükü düzeylerinin belirlenmesi amacıyla tanımlayıcı olarak yapıldı. Çalışmaya 271 hasta ve yakını dahil edildi. Çalışmanın verileri, araştırmacılar tarafından hazırlanan "Hasta Tanıtım Formu", "Hasta Yakını Tanıtım Formu" ile "Sağlığı Değerlendirme Anketi (HAQ)", "Çok Boyutlu Algılanan Sosyal Destek Ölçeği" ve "Bakım Veren Yükü Ölçeği" ile toplandı. Verilerin değerlendirilmesinde, Mann Whitney U, Kruskal Wallis ve Spearman korelasyon analizleri yapıldı. Hasta yakınlarının %82.3'ü kadın, hastaya yakınlığının ise çoğunluğunda eş/çocuk olduğu belirlendi. Hastalık tanısı açısından bakım yükünde anlamlı fark bulunamadı (p>0.05). Hastaların aktif hastalığı, eklem deformitesi, sistemik tutulumu, artmış semptom şiddetinin, bakım verenlerin ise; kötü ekonomik durumu, hasta ile birlikte yaşaması, bakım verme süresinin fazlalığı ve sosyal destek düzeyinin düşüklüğü bakım yükünü artıran faktörler olarak belirlendi. Fiziksel kısıtlılığın eşlik ettiği kronik hastalıklarda, hastanın olduğu kadar hastaya bakım verenin de olumsuz etkileneceği unutulmamalıdır.

Due to toxicity, most disease-modifying antirheumatic drugs (DMARDs) and non-steroidal anti-inflammatory drugs (NSAIDs) should not be administered in rheumatoid arthritis (RA) patients with chronic renal failure (CRF). Biological DMARDs are an effective RA treatment, but, their effects and safety on renal function are uncertain. Biologic therapies for RA and renal insufficiency are understudied. The study included 27 individuals with an eGFR of 60 ml/min/1.73 m2 for more than three months who were determined to have CRF among 700 patients with RA who used biological therapies and had regular visits between 2011 and 2018. The mean age of our patients was 63.58, and 70.37% of the patients were women. The mean duration of renal failure was 5.73±2.08 years. Renal failure was diagnosed following RA in 77.7% of the patients, with a mean time between diagnosis and renal failure of 11.52±7.35 years. The first three causes of renal failure were drug toxicity (25.9%), hypertension (HT) (25.9%), and diabetes mellitus (DM) (18.5%). Tumor necrosis factor inhibitors (TNFi) were the first and most commonly used biologic agents (66.6%). The most commonly used agent among TNFi was etanercept (44.4%). CRP and DAS-28 values reduced during a median 36-month biological agent follow-up period. When creatinine and eGFR values were examined at the first and last visit, creatinine decreased and eGFR increased. In this study, in which CRF progression improved, we intended to establish the efficacy, safety, and effect of biologic therapies on renal failure progression.

Objectives: To investigate remission with ultrasound (US) in patients with Rheumatoid arthritis (RA) according to different clinical remission criteria. Methods: A total of 105 patients with RA who were in remission for at least 6 months according to disease activity score in the 28 joints using C-reactive protein (DAS28-CRP) were included in the study. US remission rates were analyzed according to different remission criteria [DAS28-CRP, DAS28 using erythrocyte sedimentation rate (DAS28-ESR), clinical disease activity index (CDAI), simplified DAI (SDAI), and the 2011 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Boolean remission criteria]. US remission was determined as power doppler (PD) US score = 0. Results: Remission rates achieved for each remission criteria were 100%, 82.9%, 55.2%, 58.1% and 42.9% and US remission rates were 57.1%, 57.5%, 53.4%, 55.7%, 57.7% for DAS28 CRP, DAS 28 ESR, CDAI, SDAI, 2011 ACR/EULAR remission criteria, respectively. When the patients compared for the US findings between remission and non-remission patients according to the different clinical remission criteria, no difference was found (p &gt; 0.05). Conclusions: This study shows that clinical remission criterias are not sensitive enough to accurately detect remission and there was no increase in the US remission rates as per the stricter remission criteria. Using US in addition to the clinical criteria would prove to be more useful in evaluating remission.