The management of patients with immuno-rheumatological diseases has profoundly changed during the COVID-19 pandemic and telemedicine has played an important role in the disease follow-up. In addition to monitoring disease activity and any adverse events, especially infectious events, assessing the psychological situation of the patient can be fundamental. Furthermore, COVID-19 has a serious impact on mental health and, since the beginning of the pandemic, a significantly higher incidence of anxiety disorders and depressive symptoms especially in younger people was observed. In this study, we evaluated the incidence of depressive disorders, anxiety, and fibromyalgia (FM) in our patients with rheumatoid arthritis and psoriatic arthritis during the lockdown period due to the COVID-19 pandemic and we validate the use of telemedicine in the clinical management of these patients. Mental and physical stress during the COVID-19 pandemic can greatly worsen FM symptoms and intensify patients’ suffering without a clinical flare of the inflammatory disease for patients affected by rheumatoid arthritis. Telemedicine has allowed us to identify patients who needed a face-to-face approach for therapeutic reevaluation even if not related to a flare of the inflammatory disease. Even if our data does not allow us to draw definitive conclusions regarding the effectiveness of telemedicine as greater than or equal to the standard face-to-face approach, we continue to work by modifying our approach to try to ensure the necessary care in compliance with safety and, optimistically, this tool will become an important part of rheumatic disease management.

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Background: In systemic sclerosis (SSc) patients, dry eye syndrome (DES) is the most frequent ocular feature. The aim of this study was to investigate ocular DES-related SSc patients and to establish any correlation with the severity of the disease. Methods: Retrospectively, data from 60 patients with SSc underwent ophthalmic examination, where non-invasive film tear break-up time (NIF-TBUT), tear film lipid layer thickness (LLT), anesthetic-free Schirmer test I, tear osmolarity measurement (TearLab System), and modified Rodnan skin score (mRSS) data were collected. The visual analog scale (VAS) and Symptom Assessment in Dry Eye (SANDE) methods were utilized. The results were correlated with mRSS and the duration of SSc. Results: Severe DES occurred in 84% of cases, and was more severe in women. The eyelids were involved in 86.6%, secondary to meibomian gland disease (MGD). A direct correlation was found between the tear osmolarity (mean 328.51 ± 23.8 SD) and skin score (mRSS) (r = 0.79; p < 0.01). Significantly reduced NIF-TBUT, LLT, and Schirmer test I values were observed in the case of severe skin involvement. Conclusions: SSc patients show lipid tear dysfunction related to the severity and duration of the disease due to inflammation and the subsequent atrophy of the meibomian glands.

Purpose: Dry eye disease (DED) involves up to 50% of the global population. The present study compared efficacy, tolerability and safety of the novel Respilac artificial tears containing Lipidure and hypromellose (HPMC) to the widely used Nextal artificial tears, HPMC-based, for the treatment of moderate DED in contact lenses (CL) wearers.Methods: In a prospective, single-center, randomized investigation, 30 patients aged ≥18 years, diagnosed with moderate DED and wearing CL were randomly assigned to Respilac (n=15) or to Nextal group (n=15). Patients self-administrated one drop of Respilac or Nextal in both eyes 3-times daily for 21 days. Changes in endpoints (Visual Analogue Scale (VAS) score for ocular tolerability, Symptom Assessment iN Dry Eye (SANDE) score, Non-Invasive First Break-Up Time (NIF-BUT) results, Tear analysis value, Meibography results, CL tolerability results were investigated, comparing treatment groups and time-points evaluations. Adverse events (AEs) were also recorded and evaluated.Results: VAS scores decreased with time (p<0.001) in both groups showing no statistically significant difference among them (p=0.13). Improvements were also detected, from screening to end-of-treatment, by SANDE scores for severity and frequency (p<0.001) and by Tear analysis results (p<0.001) with no observed difference between Nextal and Respilac arm. NIF-BUT, Meibography and CL tolerability values showed to be non-significantly affected by treatment nor by time. No AEs were detected.Conclusion: According to the study results, Respilac showed to be effective, safe and well-tolerated for the treatment of moderate DED in CL wearers. Lipidure-based ophthalmic solution resulted not inferior to the currently used Nextal.