• MeSH
• Fatty Liver, Alcoholic diagnosis   etiology   complications   therapy   MeSH
• Azathioprine administration & dosage   MeSH
• Biological Therapy methods   MeSH
• Pemphigoid, Bullous * drug therapy   complications   MeSH
• Antibodies, Monoclonal, Humanized therapeutic use   MeSH
• Comorbidity MeSH
• Middle Aged MeSH
• Humans MeSH
• Prednisone administration & dosage   MeSH
• Arthritis, Psoriatic drug therapy   complications   MeSH
• Psoriasis * drug therapy   complications   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

BACKGROUND: Corticosteroids are among the few effective treatments for knee osteoarthritis, but short duration of action limits their utility. EP-104IAR, a long-acting formulation of fluticasone propionate for intra-articular injection, optimises the action of fluticasone propionate through novel diffusion-based extended-release technology. The SPRINGBOARD trial assessed the efficacy, safety, and pharmacokinetics of EP-104IAR in people with knee osteoarthritis. METHODS: SPRINGBOARD was a randomised, vehicle-controlled, double-blind, phase 2 trial done at 12 research sites in Denmark, Poland, and Czech Republic. We recruited adults aged 40 years or older with primary knee osteoarthritis (Kellgren-Lawrence grade 2-3) who reported Western Ontario and McMaster Universities Osteoarthritis Arthritis Index (WOMAC) pain scores of at least 4 and no more than 9 out of 10. Participants were randomly assigned (1:1) to receive one intra-articular dose of 25 mg EP-104IAR or vehicle control. Randomisation was done via interactive web-based access to a central predefined computer-generated list with block size of six (allocated by clinical site). Participants and assessors were masked to treatment allocation. Participants were followed up for 24 weeks. The primary outcome was the difference between groups in change in WOMAC pain score from baseline to week 12, analysed in all participants who were randomly assigned and received treatment. Safety, including laboratory analyses, and pharmacokinetics from quantification of fluticasone propionate in peripheral blood were assessed in all participants who received a dose of randomly assigned treatment. A person with lived experience of knee osteoarthritis was involved in study interpretation and writing of the report. This trial is registered with ClinicalTrials.gov, NCT04120402, and the EU Clinical Trials Register, EudraCT 2021-000859-39, and is complete. FINDINGS: Between Sept 10, 2021, and Nov 16, 2022, 1294 people were screened for eligibility, and 319 were randomly assigned to EP-104IAR (n=164) or vehicle control (n=155). One participant in the EP-104IAR group was excluded from all analyses because treatment was not administered due to an adverse event. 318 participants (135 [42%] male and 183 [58%] female, 315 [99%] White) received randomly assigned treatment and were included in the primary analysis and safety analysis (EP-104IAR, n=163; vehicle control, n=155). At week 12, least squares mean change in WOMAC pain score from baseline was -2·89 (95% CI -3·22 to -2·56) in the EP-104IAR group and -2·23 (-2·56 to -1·89) in the vehicle control group, with a between-group difference of -0·66 (-1·11 to -0·21; p=0·0044); a significant between-group difference persisted to week 14. 106 (65%) of 163 participants in the EP-104IAR group had one or more treatment-emergent adverse event compared with 89 (57%) of 155 participants in the vehicle control group. Effects on serum glucose and cortisol concentrations were minimal and transient. There were no treatment-emergent deaths or treatment-related serious adverse events. Plasma concentrations of fluticasone propionate showed a blunted initial peak with terminal half-life of approximately 18-20 weeks. INTERPRETATION: These phase 2 results suggest that EP-104IAR has the potential to offer clinically meaningful pain relief in knee osteoarthritis for an extended period of up to 14 weeks, longer than published data for currently marketed corticosteroids. There were minimal effects on glucose and cortisol, and stable fluticasone propionate concentrations in plasma. The safety and efficacy of EP-104IAR will be further evaluated in phase 3 trials, including the possibility of bilateral and repeat dosing with EP-104IAR. FUNDING: Eupraxia Pharmaceuticals. TRANSLATION: For the Danish translation of the abstract see Supplementary Materials section.

• MeSH
• Osteoarthritis, Knee * drug therapy   MeSH
• Adult MeSH
• Double-Blind Method MeSH
• Fluticasone * administration & dosage   pharmacokinetics   therapeutic use   adverse effects   MeSH
• Injections, Intra-Articular MeSH
• Delayed-Action Preparations MeSH
• Middle Aged MeSH
• Humans MeSH
• Pain Measurement MeSH
• Aged MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Clinical Trial, Phase II MeSH
• Multicenter Study MeSH
• Randomized Controlled Trial MeSH
• Geographicals
• Czech Republic MeSH
• Denmark MeSH
• Poland MeSH

Podpořeno grantem MZ ČR – RVO (FNOl, 00098892) a IGA_LF_2023_037. Vitamin/hormon D představuje látku s významnou rolí v dětské revmatologii. Mimo dlouho známé protiinfekční efekty je studována jeho protizánětlivá funkce. V randomizované dvojitě zaslepené placebem kontrolované studii u adolescentů se systémovým lupus erythematodes (SLE) bylo zjištěno, že substituce vitaminu D vedla ke snížení aktivity nemoci a redukci únavy pacientů. V případě nesystémové juvenilní idiopatické artritidy (JIA) se jedná o biomarker, který společně s dalšími klinickými a laboratorními znaky hraje roli v predikci inaktivního onemocnění. Publikace studující periodickou horečku s aftózní stomatitidou, faryngitidou a krční lymfadenitidou (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis, PFAPA) přinesla poznatek o asociaci nízkých hladin vitaminu D s delším trváním atak a kratšími intervaly mezi atakami. Toto minireview shrnuje poznatky o roli vitaminu D v dětské revmatologii a upozorňuje na možnosti substituce vitaminu D v rutinní klinické praxi.

Vitamin/hormone D plays an important role in pediatric rheumatology. Besides its antiinfectious effects, antiinflammatory function is currently studied. Randomised double-blind placebo-controlled study in adolescents with systemic lupus erythematosus (SLE) revealed, that vitamin D supplementation led to decrease in disease activity and to reduction of fatigue. In nonsystemic juvenile idiopathic arthritis (JIA), vitamin D is a biomarker, which in combination with other clinical and laboratory markers plays a role in prediction of outcome (inactive disease). Study on periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome (PFAPA) detected association of low vitamin D levels with longer episode duration and shorter time between episodes. This paper review an information on vitamin D role in pediatric rheumatology and highlights possibilities of vitamin D supplementation in routine clinical practice.

• MeSH
• Biomarkers MeSH
• Child MeSH
• Arthritis, Juvenile diagnosis   MeSH
• Clinical Studies as Topic MeSH
• Humans MeSH
• Vitamin D Deficiency pathology   MeSH
• Rheumatic Diseases * diagnosis   drug therapy   pathology   MeSH
• Lupus Erythematosus, Systemic drug therapy   MeSH
• Vitamin D * analysis   administration & dosage   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

Background and Aim: Osteoarthritis is a degenerative chronic disease that affects the joints, it is strongly associated with age and affects the quality of life and fatigue in addition to its associated pain, stiffness, and loss of mobility. This study aimed to evaluate the daily fatigue score among patients with osteoarthritis. Methods: A cross-sectional descriptive study was conducted among patients with osteoarthritis who were invited from three Rheumatology clinics. The fatigue scale (FACIT version) was used in addition to biochemical data collected from patients' records.Result: A total of 370 patients were included in the final data analysis and a negative significant relationship between fatigue score with age, BMI, duration of the disease, and ESR (P<.0.05) were found. Significant differences in the fatigue scores were also found between groups of gender, glucosamine previous use, and former steroid injection.Conclusion: The severity of fatigue among osteoarthritis patients was higher in females than males. The medication used either analgesics or supplements for the patients with OA was not significant to improve the severity of fatigue. The severity of fatigue was more common in groups of patients that had one co-morbid than the patients who had more than one co-morbid.

• MeSH
• Glucosamine MeSH
• Hyaluronic Acid MeSH
• Humans MeSH
• Osteoarthritis * complications   MeSH
• Cross-Sectional Studies MeSH
• Fatigue MeSH
• Vitamin D MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH

Autoři prezentují případ 43leté pacientky s entezitickou formou psoriatické artritidy, HLA B 27 pozitivní. Po selhání konvenční léčby byla zahájena léčba subkutánním infliximabem (Remsima v dávce 120 mg s.c. á 14 dní). Klinický efekt u nemocné byl výborný a již po několika týdnech léčby se její základní onemocnění dostalo do remise. Po 6 měsících léčby došlo k vzestupu jaterních testů, které dosáhly až na hodnoty AST 4,53 μkat/l, ALT 7,89 μkat/l. V té době také pozitivní antinukleární protilátky (ANA) 1 : 160. Bylo pojato podezření na vznik autoimunitní hepatitidy (AIH). Při urgentně provedené biopsii byla tato hypotéza potvrzena. Byla zjištěna akutní hepatitida s četnými plazmocyty a eozinofily se středně intenzivní portální/interface a významnou lobulární aktivitou a přemosťujícími nekrózami (centro-centrální, centro-portální), fokálně s krvácením, se známkami regenerace jaterního parenchymu. V další části publikace autoři podávají přehled o AIH, která může patřit mezi autoimunitní onemocnění indukovaná biologickou léčbou. Jsou prezentována zjednodušená kritéria pro autoimunitní hepatitidu a algoritmus vyšetření při podezření na AIH. Dále je diskutována strategie léčby, která je rozdělena na fázi indukční a udržovací. Lékem první volby v indukční fázi jsou glukokortikoidy většinou podávané v dávce 0,5 mg/kg/den. Lékem první volby v udržovací fázi je azathioprin. Cílem léčby je navození biochemické remise do 6 měsíců od zahájení léčby. Dlouhodobá prognóza AIH je nejistá a u části pacientů je nutné počítat s dlouhodobou léčbou někdy i celoživotní. Nutnost transplantace jater je ale vzácná.

The authors present a case of a 43-year-old female patient with enthesitis form of psoriatic arthritis, HLA-B27 positive. After the failure of conventional treatment, treatment with subcutaneous infliximab (Remsima 120 mg s.c. every 2 weeks) was initiated. The clinical effect was excellent and after several weeks of treatment, her underlying disease went into remission. After 6 months of treatment, the liver function tests rose to AST 4.53 μkat/l and ALT 7.89 μkat/l. At that time she also had positive antinuclear antibodies (ANA) 1:160. Autoimmune hepatitis (AIH) was suspected. On an urgent biopsy, this hypothesis was confirmed. Acute hepatitis with numerous plasmacytes and eosinophils with moderate portal/interface and significant lobular activity and bridging necroses (centro-central, centro-portal), focally with hemorrhage, with signs of liver parenchyma regeneration was found. In the next part of the publication, the authors give an overview of AIH, which may be one of the autoimmune diseases induced by biological therapy. Simplified criteria for autoimmune hepatitis and an algorithm for investigation in suspected AIH are presented. Furthermore, the treatment strategy is discussed, which is divided into induction and maintenance phases. The first choice drug in the induction phase is glucocorticoids, usually administered at a dose of 0.5 mg/kg/day. The drug of first choice in the maintenance phase is azathioprine. The goal of treatment is to induce biochemical remission within 6 months of initiation of treatment. The long-term prognosis of AIH is uncertain and some patients have to be treated for a long time, sometimes for life. However, the need for liver transplantation is rare.

• MeSH
• Hepatitis, Autoimmune * diagnosis   etiology   drug therapy   pathology   MeSH
• Adult MeSH
• HLA-B27 Antigen analysis   MeSH
• Infliximab pharmacology   therapeutic use   drug effects   MeSH
• Tumor Necrosis Factor Inhibitors * pharmacology   therapeutic use   MeSH
• Humans MeSH
• Drug-Related Side Effects and Adverse Reactions classification   MeSH
• Prednisone pharmacology   therapeutic use   MeSH
• Arthritis, Psoriatic diagnosis   drug therapy   complications   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

• Keywords
• upadacitinib,
• MeSH
• Diagnostic Imaging methods   MeSH
• Janus Kinase Inhibitors * pharmacology   therapeutic use   MeSH
• Tumor Necrosis Factor Inhibitors pharmacology   adverse effects   therapeutic use   MeSH
• Middle Aged MeSH
• Humans MeSH
• Methotrexate pharmacology   therapeutic use   MeSH
• Prednisone pharmacology   therapeutic use   MeSH
• Arthritis, Rheumatoid drug therapy   MeSH
• Sarcoidosis * etiology   drug therapy   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

• Keywords
• filgotinib,
• MeSH
• Janus Kinase Inhibitors * pharmacology   therapeutic use   MeSH
• Cardiovascular Diseases drug therapy   MeSH
• Middle Aged MeSH
• Humans MeSH
• Methotrexate pharmacology   therapeutic use   MeSH
• Prednisone pharmacology   therapeutic use   MeSH
• Arthritis, Rheumatoid * drug therapy   immunology   pathology   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Osteoarthritis, Knee drug therapy   MeSH
• Chondrogenesis drug effects   MeSH
• Glucocorticoids administration & dosage   pharmacology   therapeutic use   MeSH
• Evaluation Studies as Topic MeSH
• Cartilage, Articular drug effects   MeSH
• Osteoarthritis * etiology   drug therapy   MeSH
• Triamcinolone Acetonide administration & dosage   pharmacology   therapeutic use   MeSH

• MeSH
• Axial Spondyloarthritis diagnosis   therapy   MeSH
• Arthritis, Gouty diagnosis   etiology   MeSH
• Hydroxychloroquine administration & dosage   therapeutic use   MeSH
• Congresses as Topic MeSH
• Humans MeSH
• Osteoarthritis therapy   MeSH
• Arthritis, Psoriatic therapy   MeSH
• Rheumatic Diseases * diagnosis   therapy   MeSH
• Arthritis, Rheumatoid complications   therapy   MeSH
• Rituximab therapeutic use   MeSH
• Scleroderma, Systemic drug therapy   MeSH
• Lupus Erythematosus, Systemic etiology   prevention & control   therapy   MeSH
• Vitamin D therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Publication type
• News MeSH

• MeSH
• COVID-19 complications   MeSH
• Diagnosis, Differential MeSH
• Erythema etiology   MeSH
• Histological Techniques MeSH
• Comorbidity MeSH
• Skull pathology   MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Methotrexate administration & dosage   pharmacology   adverse effects   MeSH
• Methylprednisolone administration & dosage   MeSH
• Skull Neoplasms chemically induced   surgery   diagnosis   drug therapy   complications   pathology   radiotherapy   MeSH
• Healthcare-Associated Pneumonia MeSH
• Pulmonary Embolism MeSH
• Blister etiology   MeSH
• Recurrence MeSH
• Arthritis, Rheumatoid drug therapy   MeSH
• Aged MeSH
• Scalp pathology   MeSH
• Carcinoma, Squamous Cell * chemically induced   surgery   diagnosis   drug therapy   complications   pathology   radiotherapy   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Case Reports MeSH