Positive predictors for long-term drug survival of infliximab in real life were identified. Their impact on treatment management should be addressed in further prospective trials.

No abstract

No abstract

Objectives To describe new-onset inflammatory bowel diseases (new IBD) in patients treated with interleukin 17 inhibitors (IL-17i), to assess their incidence and to identify their risk factors in real life. Methods A French national registry (MISSIL) aimed to report all cases of new IBD in patients treated with IL-17i from January 2016 to December 2019. Using the estimated number of patients treated by IL-17 in France during the study period, the annual incidence rates of new IBD was reported in IL-17i-treated patients. A case–control study was performed with two controls per new IBD case matched by gender, age and underlying inflammatory disease. Results 31 cases of new IBD under IL-17i were collected: 27 patients treated for spondyloarthritis and 4 patients for psoriasis. All were observed with secukinumab (SEK). The median time to onset of new IBD symptoms was 4.0 (1.5–7.5) months. SEK was discontinued in all patients. The evolution was favourable with complete resolution (17/31), improvement (7/31) or stabilization (5/31). 2 patients died: one due to a massive myocardial infarction and one due to post-colectomy complications. The incidence of new IBD decreased from 0.69/100 PY (7/1010) in 2016, to 0.08/100PY (6/7951) in 2019. No previous treatment with etanercept (OR = 0.33, IC95% 0.14–0.80, p= 0.014) and low number of previous biological therapies (OR = 0.67, 95%CI 0.47–0.94, p= 0.021) were significantly associated with new IBD. Conclusion The incidence of new IBD was low and decreased from 2016 to 2019. The outcome was favourable in 24 out of 31 patients, but two patients died.

О р и г и н а л ь н ы е и с с л е д о в а н и я 1 Национальный Центр кардиологии и терапии (НЦКТ) им. академика М. Миррахимова, Бишкек, Кыргызская Республика; 2 ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»,

systemic lupus erythematosus (SLE) largely depends on migration of pulmonary artery smooth muscle cells (PASMCs). In this study, we tested whether IgG from SLE with PAH have stimulatory effects on PASMC migration. Methods Sera from 6 SLE patients, including 1 with PAH, and 7 healthy subjects were collected, and IgG was purified using protein A or protein G. PASMC migration was examined by a Boyden chamber method. Lamellipodia formation and antibody binding sites in the cells were examined by immunocytochemistry. Identification of anti-enolase1 antibodies was performed by immunoprecipitation, western blotting, mass spectrometry, and ELISA. Results IgG from SLE with PAH significantly increased migration of PASMCs than those without PAH in a concentration dependent manner (p<0.001). After incubation with IgG, the number of cells with lamellipodia, which represents rearrangement of the cytoskeleton necessary to migration, was 1.4-fold higher in SLE with PAH than those without PAH (p<0.01). In immunocytochemistry, IgG from SLE with PAH were colocalized with b-tubulin in the cytoplasm of PASMCs, and western blotting showed that the antibodies bound to a~50 kD protein in the lysates, which was subsequently identified as enolase1 reported to be involved in cell migration. Furthermore, the titer of IgG anti-enolase1 antibodies was 1.5-fold higher in SLE patients with PAH than those without PAH. Conclusions IgG from a patient with SLE accompanied by PAH promoted a migration of PASMCs, which is possibly ascribed to autoantibodies to enolase1.

No abstract

BackgroundSystemic lupus erythematosus (SLE) is a devastating disease affecting different organs, ultimately leading to organ failure and death. To date, there are no data regarding the real-life picture of SLE in Kyrgyzstan.ObjectivesAnalysis of SLE outcome in Kyrgyz patients under long-term observation.MethodsThe study involved 50 patients under prospective study treated in the NCCIM from January 2012 to August 2016 with SLE at the age of 27 years (median - 27 [23; 36])., with disease duration about 1 year (median - 1 [0.3, 3.0]), including 45 women and 5 men. The outcome of SLE was estimated as the number of exacerbations based on the SFI index (moderate or severe), irreversible organ damage by SDI, death, remission (complete or drug related). Remission was defined as complete if for the patients, who were not receiving any treatment, no clinical and immunological SLE activity was recorded. Drug remission was registered when clinical and immunological disease activity was absent in patients receiving supporting doses of prednisolone (from 5 mg to 10 mg) and receiving the following cytostatic drugs: 200 - 400 mg per day of PLQ or 100 - 150 mg per day of AZA or 7.5 mg of MTX per week.ResultsDuring the 3-year-long dynamic monitoring, in 50 patients observed 2 years after the initial examination 62 cases of exacerbation of SLE were registered (median, 2.0 [1.5, 2.5]). Out of these there were 36 severe (58%) and 26 moderate outbreaks (42%). Severe exacerbations were mainly related to kidneys - in 42 patients (84%), 7 out of which experienced simultaneous exacerbation of articular syndrome, 5 lupus dermatitis, 2 patients had CNS damage in the form of visual and audial hallucinatory syndrome with encephalopathy and bilateral pyramidal insufficiency (1) and encephalopathy with anxiety disorders (1). Moderate exacerbations were mainly caused by the lesions of skin and joints (20), myositis (1), in one case there was a necrotizing vasculitis of the lower extremities. The main causes of SLE breakouts were: for 33 patients (66%) - low compliance (when the patients themselves stop taking GC and cytostatics), for the remaining 17 patients (34%) - exacerbation of the SLE process.Towards the end of monitoring the development SDI was the result of accumulation of organ damage caused by the disease itself (61%) as a result of: ischemic stroke (3), reduced GFR less than 50 ml per minute (4) due to heavy lupus nephritis, paresis of the right motor oculi (1), changes in the retina (1), pulmonary fibrosis (1), and pulmonary arterial hypertension (1). Over the entire period of careful dynamic study of the 50 patients no fatalities were recorded. Remission was achieved in 10 patients (20%) out of 50. The majority of patients had drug remission (9), except for one patient with baseline nephritis, dermatitis, arthritis, which was in complete remission during three years.ConclusionsDuring the three years of medical observations remission was achieved in 20% of patients, most of them with drug remission (90%). 62 cases of SLE exacerbation...