BackgroundThe recent EULAR recommendations [1,2] suggest using JAK-inhibitors (JAKis) for treating RA patients. These drugs include both selective (upadactinib and filgotinib) and unselective (tofacitinib and baricitinib) JAKis.ObjectivesTo describe JAKis’ discontinuation rate and to determine predictors of JAKIs’ discontinuation in a real life setting.MethodsAll patients with RA treated with JAKis were prospectively followed up for at least 12 months in this multicentric study carried out on 23 Italian centres. For each patient, the following variables were collected: sex, age, disease duration, smoking, BMI, comorbidities (diabetes, hypertension, hypercholesterolemia, cancer, major cardiovascular events), positive RF/ACPA, cDMARDs at baseline, prednisone at baseline, previous use of JAKis, discontinuation, time to discontinuation, JAKis line of treatment, DAS28-ESR at baseline, 6 and 12 months. Statistical analyses were performed using R (2022.12.0).Results864 patients were included (Table 1). 487 (55.2%) received baricitinib, 213 (24.6%) tofacitinib, 111 (12.8%) upadacitinib and 62 (7.2%) filgotinib. 192 (22.2%) patients discontinued JAKis after a median time of 334 days (IQR 154.5-879.5). Among them, a statistical difference was found between selective-JAKis and other JAKis (p=0.03, 14.6% of selective JAKis vs 85.4% of other JAKis); finally unselective JAKis were discontinued later than selective JAKis (p<0.001, median 401.5 days, IQR 197.5-976 for unselective JAKis vs median 74 days, IQR 129-212 for selective JAKis). Discontinuation’s causes are reported inFigure 1. Notably, VZV infection determined JAKis withdrawal in 4 patients and pulmonary embolism/deep venous thrombosis in 6 patients (both with baricitinib). Regarding discontinuations’ causes, no differences between selective JAKis and other JAKis were found with factor logistic regression model. At multivariate analysis, predictors of discontinuation were prednisone at baseline (OR 1.48, p=0.03), treatment with unselective JAKis (OR 1.79, p=0.01), and line of treatment (OR 1.29 p<0.001).ConclusionOur study showed that only a minority of patients discontinued JAKis. Among discontinuation‘s causes, no differences between selective JAKis and other JAKis were found. Predictors of JAKis discontinuation were prednisone at baseline, treatment with unselective JAKis and line of treatment (with more advanced lines of treatment associated with a higher risk of discontinuation).References[1] Smolen JS, et al. Ann Rheum Dis 2020.[2] Smolen JS, et al. Ann Rheum Dis 2023.Table 1.General features of 864 RA patientsVariableN (%)Mean age at baseline (SD) (N=863)58.79 (12.84)Females678 (78.47)Mean BMI (Kg/cm2) at baseline (SD) (N=626)25.19 (3.79)Smoking (N=799)Yes151 (18.89)No504 (63.01)Former144 (18.02)Positive RF (N=809)533 (65.88)Positive ACPA (N=796)498 (61.56)Diabetes (N=770)70 (9.09)Hypertension (N=771)302 (39.17)Hypercholesterolemia (N=769)196 (25.49)Previous MACE (N=768)47 (6.12)Previous cancer (N=770)42 (5.45)Disease duration (months), (median, IQR) (N=855)77 (30-157)Mean DAS28-ESR at baseline (SD) (N=746)5.29 (1.06)cDMARDs at baseline (N=781)287 (36.75)PDN at baseline (N=780)444 (56.92)Median dosage (IQR) of PDN (mg/day)5.00 (4.00-5.00)JAKis naïve (N=853)731 (85.70)Line of JAKis treatment 1^247 (26.59) 2^211 (24.42) 3^181 (20.64) 4^111 (12.84) 5^65 (7.52) 6^29 (3.35) 7^12 (1.39) 8^3 (0.35) 9^2 (0.23) 10^3 (0.35)Patients who discontinued JAKis192 (22.2)Time to discontinuation (days), (median, IQR) (N=863)334 (154.5-879.5)Legends to Table 1:RA: rheumatoid arthritis; SD: standard deviation; BMI: Body Mass Index; RF: Rheumatoid Factor; ACPA: Autoantibodies against citrullinated peptides/proteins; MACE: Major cardiovascular events; PDN: prednisone; IQR: interquartile range; DAS28-ESR: Disease Activity Score-28 for Rheumatoid Arthritis with ESR; cDMARDs: conventional Disease-modifying antirheumatic agents; JAKis: JAK inhibitors.Acknowledgements:NIL.Disclosure of InterestsMaddalena Larosa: None declared, Alarico Ariani: None declared, Dario Camellino Speakers bureau: Abiogen, GSK, Paid instructor for: Mylan, Andrea Becciolini: None declared, Gerolamo Bianchi: None declared, Eleonora Di Donato: None declared, Giuditta Adorni: None declared, Daniele Santilli: None declared, Gianluca Lucchini: None declared, Massimo Reta: None declared, Olga Addimanda: None declared, Alberto Lo Gullo: None declared, elisa visalli: None declared, Rosario Foti: None declared, Giorgio Amato: None declared, Francesco De Lucia: None declared, antonella farina: None declared, Francesco Girelli: None declared, Simone Bernardi: None declared, Giulio Ferrero: None declared, Romina Andracco: None declared, Marino Paroli: None declared, Natalia Mansueto: None declared, rosalba caccavale: None declared, Patrizia Del Medico: None declared, Aldo Molica Colella: None declared, Veronica Franchina: None declared, Francesco Molica Colella: None declared, Federica Lumetti: None declared, Gilda Sandri: None declared, Carlo Salvarani: None declared, Marta Priora: None declared, Aurora Ianniello: None declared, Valeria Nucera: None declared, Francesca Ometto: None declared, Ilaria Platé: None declared, eugenio arrigoni: None declared, Alessandra Bezzi: None declared, Maria Cristina Focherini: None declared, Fabio Mascella: None declared, Vincenzo Bruzzese: None declared, Palma Scolieri: None declared, Simone Parisi: None declared, Maria Chiara Ditto: None declared, Enrico Fusaro: None declared, Viviana Ravagnani: None declared, Rosetta Vitetta: None declared, Alessia Fiorenza: None declared, Guido Rovera: None declared, Alessandro Volpe: None declared, Antonio Marchetta: None declared, Matteo Colina: None declared, Elena Bravi: None declared.
BackgroundCurrent and previous EULAR recommendations (1,2) suggest using JAK-inhibitors (JAKis) for treating Rheumatoid Arthritis (RA). However, little is known about differences of patients who are JAK-inhibitors (JAKis) naïve and patients who have already experienced at least one JAKi.ObjectivesTo analyse differences between JAK-naïve and JAKis not naive patients in a real life setting.MethodsAll patients with RA on JAKis were prospectively followed up for 12 months in this multicentric study conducted in 23 centres. For each patient, the following variables were recorded: sex, age, disease duration at JAKi prescription, smoking, BMI, comorbidities, positive RF/ACPA, DAS28-ESR at baseline, 6 and 12 months, cDMARDs and prednisone at baseline, JAKis discontinuation, JAK-naïve. Statistics were performed by R (2022.12.0).Results864 patients were included (Table 1). Among them, 731 (84.60%) were JAKis naïve, whereas 122 (14.12%) were not naïve (missing data in 11-1.27%-patients). 473 (55.22%) patients were treated with baricitinib (JAK-naïve were 412, 87.3%), 213 (24.6%) with tofacitinib (JAKis-naïve 187, 87.79%), 111 (12.84%) with upadacitinib (JAKis-naïve 78.37%) and 62 (7.17%) with filgotinib (JAKis-naïve 72.58%). Significant differences between JAKis-naïve and not naïve were found for hypercholesterolemia (p=0.04), hypertension (p=0.02), previous cancer (p<0.001), disease duration (p<0.001), line of treatment (p<0.001). No difference was found for JAKis discontinuation (p=0.13)(Table 1).ConclusionOur data suggest that line of treatment and disease duration result higher in JAKis not naive compared to naïve ones. Notably, JAKis naïve and not naïve did not differ regarding drug discontinuation, suggesting a similar retention rate irrespective of previous JAKis.References[1] Smolen JS, et al. Ann Rheum Dis 2020.[2] Smolen JS, et al. Ann Rheum Dis 2023.Table 1.Differences between JAKis naïve and not naïve patientsTotalTotal (N=864)JAKis naive (N=731)JAKis not naïve (N=122)P valueN (%)N (%)N(%)Mean age at baseline (SD) (N=852)58.83 (12.87)58.54 (12.92)60.61 (12.45)0.10Females (N=853)668 (78.31)564 (77.15)104 (85.25)0.05Mean BMI (Kg/cm2) (SD) (N=616)25.15 (3.77)25.18 (3.62)25.02 (4.46)0.68Smoking (N=788)0.13 Yes150 (19.03)135 (19.97)15 (13.39) No496 (62.94)425 (62.87)71 (63.39) Former142 (18.02)116 (17.16)26 (23.31)Positive RF (N=800)527 (65.89)444 (64.91)83 (71.55)0.16Positive ACPA (N=787)491 (62.39)411 (61.43)80 (67.80)0.19Diabetes (N=760)68 (8.95)56 (8.78)12 (9.84)0.71Hypertension (N=761)297 (39.03)238 (37.25)59 (48.36)0.02Hypercholesterolemia (N=759)195 (25.36)155 (24.29)40 (33.06)0.04Previous MACE (N=758)47 (6.20)39 (6.13)8 (6.56)0.86Previous cancer (N=760)42 (5.52)39 (6.10)3 (2.48)<0.001Disease duration (months), (median, IQR) (N=844)76 (29-155)71 (24-142.50)142 (69-226)<0.001Mean DAS28-ESR at baseline (SD) (N=736)5.29 (1.06)5.27 (1.09)5.40 (0.89)0.22cDMARDs at baseline (N=771)280 (36.31)235 (36.21)45 (36.89)0.88PDN at baseline (N=438)438 (50.69)368 (57.38)70 (56.79)0.90Median dosage (IQR) of PDN (mg/day) (N= 438)5 (4.00-5.00)2.50 (0.00-5.00)4.00 (0.00-5-00)0.08Line of JAKis treatment (N=853)<0.001 1^244 (28.60)244 (33.38)0 (0.00) 2^211 (24.74)207 (28.32)4 (3.28) 3^175 (20.63)172 (23.53)(3.28) 4^109 (12.78)56 (7.66)53 (3.44) 5^65 (7.62)32 (4.38)33 (27.05) 6^28 (3.28)12 (1.64)6 (13.11) 7^12 (1.41)6 (0.82)6 (4.92) 8^3 (0.35)1 (0.14)2 (1.64) 9^2 0.23)1 (0.14)1 (0.82) 10^3 (0.35)0 (0.00)(2.46)Patients who discontinued JAKis (N=853)192 (22.51)158 (21.61)34 (27.87)0.13SD: standard deviation; BMI: Body Mass Index; RF: Rheumatoid Factor; ACPA: Autoantibodies against citrullinated proteins; MACE: Major cardiovascular events; PDN: prednisone; IQR: interquartile range; DAS28-ESR: Disease Activity Score-28 for Rheumatoid Arthritis with ESR; cDMARDs: conventional Disease-modifying antirheumatic agents; JAKis: JAK inhibitors.Acknowledgements:NIL.Disclosure of InterestsMaddalena Larosa: None declared, Andrea Becciolini: None declared, Elena Bravi: None declared, Dario Camellino Speakers bureau: Abiogen, GSK, Paid instructor for: Mylan, Ilaria Platé: None declared, eugenio arrigoni: None declared, Francesca Ometto: None declared, Eleonora Di Donato: None declared, Giuditta Adorni: None declared, Gianluca Lucchini: None declared, Daniele Santilli: None declared, Alessandra Bezzi: None declared, Maria Cristina Focherini: None declared, Fabio Mascella: None declared, Vincenzo Bruzzese: None declared, Palma Scolieri: None declared, Simone Parisi: None declared, Enrico Fusaro: None declared, Maria Chiara Ditto: None declared, Viviana Ravagnani: None declared, Gilda Sandri: None declared, Carlo Salvarani: None declared, Marta Priora: None declared, Marino Paroli: None declared, rosalba caccavale: None declared, Romina Andracco: None declared, Natalia Mansueto: None declared, Matteo Colina: None declared, Massimo Reta: None declared, Olga Addimanda: None declared, Alberto Lo Gullo: None declared, elisa visalli: None declared, Rosario Foti: None declared, Giorgio Amato: None declared, Francesco De Lucia: None declared, antonella farina: None declared, Francesco Girelli: None declared, Patrizia Del Medico: None declared, Aldo Molica Colella: None declared, Veronica Franchina: None declared, Francesco Molica Colella: None declared, Federica Lumetti: None declared, Aurora Ianniello: None declared, Valeria Nucera: None declared, Rosetta Vitetta: None declared, Alessia Fiorenza: None declared, Guido Rovera: None declared, Alessandro Volpe: None declared, Giulio Ferrero: None declared, Antonio Marchetta: None declared, Simone Bernardi: None declared, Gerolamo Bianchi: None declared, Alarico Ariani: None declared.
BackgroundRecently, the new class of drugs, namely targeted synthetic (ts) DMARDs, has broadened the possibilities of treating rheumatoid arthritis (RA). In particular, Janus Kinase inhibitors (JAKi) are used in RA and are currently represented by four drugs: baricitinib, tofacitinib, upadacitinib and filgotinib. One of the first to be used in Italy was baricitinib, a JAKi acting on JAK1 and JAK2.ObjectivesThe aim of this study was to evaluate the clinical efficacy of baricitinib in a real-life setting in a cohort of RA patients.MethodsThis multicenter retrospective observational study included patients from 25 rheumatology centers diagnosed with RA and treated with baricitinib. The following were recorded for each patient: gender; age; duration of disease; presence of rheumatoid factor and anti-citrulline antibodies; concomitant treatment with conventional synthetic (cs) DMARDs; previous treatments with biological (b) or ts DMARDs. In order to evaluate the clinical efficacy, the retention rate was evaluated, calculated by means of the Kaplan-Meier method. The variables under examination were reported as frequencies and median with relative interquartile range.ResultsWe included 478 patients of which 380 (79.5%) were female. 286 (60.1%) patients tested positive for rheumatoid factor (RF) and 264 (55,2%) for anti-citrulline antibody (ACPA). The parameters analyzed are shown in Table 1. 105 (22.0%) patients were treated with baricitnib as first line (after csDMARD), the remaining patients had failed at least one bDMARD and 9 (1.9%) also failed a tsDMARD. In 34,7% of cases baricitinib was used as monotherapy, the most frequently used csDMARD was methotrexate (29.2%). The median period of therapy was 674 days (298-1087).The survival rate at 6 months was 94.6%, at 12 months it was 87,9%, at 24 months was 81.7% and at 48 months was 53.4% (Figure 1).The main causes that led to the discontinuation of baricitinib therapy were: primary ineffectiveness (7,3%), secondary ineffectiveness (4.2%) and adverse events (3,7% 5 TEP/DVT). The concomitant steroid therapy seems to be a negative prognostic factor (HR 1,65 95% CI 1.03-2.63; p=0.035) as well as the line of therapy (HR 1.35 95% CI 1.15-1.58; p=0.000).Table 1.CharacteristicsValueM:F98:380Age, median [IQR] yrs60 [51-70]Smokers, n (%) (**)YesFormerNo84 (18,8)76 (17,0)288 (64,2)Body Mass Index, median [IQR] kg/m^2 (*)24,8 [23,0-27,0]Disease Duration, median [IQR], months78 [32-163]RF positivity, n (%)286 (60,1)ACPA positivity, n (%)264 (55,2)SJC, median [IQR]5 [3-8]TJC, median [IQR]8 [4-12]ESR, median [IQR], mm/h33 [20-46]CRP, median [IQR], mg/dl1,3 [0,5-2,9]VAS Patient (0-100), median [IQR]70 [50-80]DAS28, median [IQR]5,4 [4,8-6,1]Line of treatment, [IQR]2 [2-3]Concomitant csDMARDs use, n (%)MTXLFNSSZHCQ140 (29,2)11 (2,3)3 (0,6)12 (2,5)Concomitant steroids use, n (%)237 (49,6)Steroids dose (PDN-Eq), median, mg/die5 [4-5]Prior bDMARDs use, n (%)TNFiIL6iIL1iCD20iCD80i164 (34,3)84 (17,6)08 (1,7)54 (11,3)Prior tsDMARDs use, n (%)Tofacitinib9 (1,9)Concomitant relevant disease, n (%)DiabetesHypercholesterolemiaMACEArterial HypertensionCancer36 (7,5)119 (24,9)28 (5,9)179 (37,4)24 (5,0)Figure 1.4 year retention rate of baricitinibConclusionThe efficacy of baricitinib in the treatment of RA in a real-life context appears consistent with what was reported by the pivotal studies. Furthermore, from this preliminary experience, seropositivity and combo therapy seems to not correlate with a better retention rate, while concomitant steroid therapy and line of treatment are a negative prognostic factor.References[1] Guidelli GM et al. Clin Exp Rheumatol. 2021 Jul-Aug;39(4):868-873.[2] Spinelli FR et al. Clin Exp Rheumatol. 2021 May-Jun;39(3):525-531.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundPsoriatic arthritis (PsA) is an inflammatory rheumatic disease characterized by different phenotypes in terms of joint involvement. Apremilast, PDE4 competitive inhibitor, has been introduced in the treatment of adult psoriatic arthritis (PsA) with moderate disease activity. Musculoskeletal ultrasound (MUS) is useful in the assessment of disease, treatment response and follow up in PsA patients. Choosing an effective and safe treatment over time is an increasingly urgent goal given the greater availability of indicated drugs.ObjectivesThe aim of this study is to evaluate if MUS assessment before apremilast treatment can improvement its retention rate.MethodsWe enrolled consecutive patients affected by PsA (according to the CASPAR Criteria) from 15 rheumatology centers. The following data were recorded for each patient: age, gender, duration of disease, DAPSA; smoke, comorbilities; concomitant treatment; duration of therapy with apremilast; reason of sospensione, PsA phenotype (poliarticular or oligoarticular) (Table 1). All patients were divided in two subset according to the presence of a MUS assessment before apremilast treatment. The differentes between two groups were calculated by means of the Mann-Whitney and Chi-quadro tests. The Kaplan Meier curve and Cox analysis assessed the retention rate and associated factors. P values < 0.05 were considered statistically significant.ResultsON Three hundred and fifty patients (m/f: 198/152; median age 60 years, IQR 52-67 years), 40% received MUS examination. In the MUS group there was a moderate disease (medium 22,9 IQR 18,2-29 vs 26,9 IQR 20,3-33,9; p=0,0006) and a prevalence of the oligoarticular pattern (73% vs 44%, p<0,0001). The retention rate was statistically higher in MUS group (Figure 1) (HR 0,57 IC95% 0,35-0,95; p=0,03).Table 1.No USYes USP-valueNumber216140-Age (years)61[54-69]58[50-65]0,0016Gender (M:F)85:13167:73NssSmoke (%)23,434,80,0198BMI (kg/m^2)25,7[23,4-29,8]26,1[23,7-29,0]nssDuration of disese PsA (months)44[13-95]37[12-78]nssDuration of disese PsO (months)13[0-83]30[0-93}nssComorbility (%)47,739,3nssSwollen joints8[4-12]4[3-7]<0,000001Tender joints3[2-5]2,5[2-4]0,0434PCR (mg/dl)2,9[0,8-5,2]1,0[0,7-3,0]0,0057DAPSA27,0[20,4-34,2]22,9[18,2-29,0]0,0004Concomitant treatment (%)13,427,10,0012Naive biologic (%)80,668,60,0100Oligoarticolar pattern (%)36,163,6<0,0001Figure 1.A: Psoriatic arthritis. Longitudinal volar scan of the interphalageal prossimal joint. Tenosinovitis of the flexor tendons()B: Psoriatic arthritis. Transversal volar scan of the interphalageal prossimal joint. Tenosinovitis of the flexor tendons ()ConclusionIn PSA patients treated with apremilast, MUS assessment at baseline was associated with an higher retetion rate. MUS could be useful in the PsA treatment algorithm in order to better identify those patients whose characteristics are favourable to apremilast response.References[1]\Ramona Lucchetti et al. IMAJ 2021 JULY;23(7): 412-415.[2]\Fulvia Ceccarelli et al. Clin Rheumatol. 2019 Nov;38(11):3145-3151Acknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundTo date only few real-world setting studies evaluated apremilast efficacy in psoriatic arthritis (PsA). Enthesitis and dactylitis are difficult-to-treat features of PsA leading to disability and affecting quality of life.ObjectivesThe aims of this study is to evaluate the leed enthesitis index (LEI) and dactlitis index (DAI) at 6 and 12 month in patients on treatment with apremilast.MethodsAll PsA consecutive patients treated with apremilast in fifteen Italian rheumatological referral centers were enrolled. Anamnestic data, treatment history, and PsA disease activity (DAPSA), LEI, DAI at baseline (T0), 6 month (T1) and 12 months (T2) were recorded. The Mann-Whitney test and chi-squared tests assessed the differences between independent group, whereas the Wilcoxon matched pairs signed-rank test assessed the differences between dependent samples. A p-value<0.05 was considered statistically significant.Resultsthe total cohort consisted of 209 patients (M/F 94/105) of whom 72 (34.4%) (M/F 29:43) patients had an enthesitis with a median LEI of 3 and 65 patients (31.1%) had dactylitis with a median of DAI of 1; DAPSA at base line was 24.1 in the enthesitis group, and 27.2 in the dactylitis group(Table 1). Prior DMARDs use and concomitant DMARDs drugs were more common in LEI groups with respect to DAI group. Compared to base line, Apremilast 30 mg two times per day demonstrated at 6 and 12 months a significantly improvements in LEI(Figure 1a; p<0.001 for both T1 vs T0, T2 vs T1), DAI (Figure 1b;p<0.001 for both T1 vs T0, T2 vs T1) and DAPSA (Figure 1c; p<0.001 for both T1 vs T0, T2 vs T1). In the LEI group, 29 patients (28.7%) reached a remission with LEI=0 at six months and 40 (44%) patients had a sustained improvement with LEI=0 at 12 months. In the DAI group 45 patients (52.9%) had a remission of dactylitis at 6 months and 43 patients (56.6%) had no dactylitis at T1.ConclusionApremilast demonstrated significant and sustained efficacy in real-life Psa patients, including improvements in enthesitis and dactylitis for up to 12 months.References[1]Ariani A, Parisi S, Del Medico P et al. Apremilast retention rate in clinical practice: observations from an Italian multi-center study. Clin Rheumatol 2022 Oct;41(10):3219-3225.[2]de Vlam K, Toukap AN, Kaiser MJ. Real-World Efficacy and Safety of Apremilast in Belgian Patients with Psoriatic Arthritis: Results from the Prospective Observational APOLO Study Adv Ther. 2022 Feb;39(2):1055-1067.Table 1.Baseline CharacteristicTotal CohortDactylitis subgroupEnthesitic subgroupN2096572M:F94:10530:3529:43Age, median [IQR] yrs60[53-67]59[53-65]59[52-65]Smokers, n (%)YesFormerNoUnknown36 (17,2)27 (12,9)144 (68,9)2 (1,0)13 (20,0)10 (15,4)42 (64,6)011 (15,3)14 (19,4)47 (65,3)0Body Mass Index, median [IQR] kg/m^226,5[23,8-29,6] (*)27,1[23,7-29,9] (**)26,1[23,2-29,9] (***)PsA Duration, median [IQR], months50[19-97]42[15-85]51[15-85]PsO Duration, median [IQR], months72[28-140]84[21-141]67[17-142]SJC, median [IQR]3[2-4]3[2-4]3[2-4]TJC, median [IQR]5[3-8]5[3-7]6[4-12]LEI, median [IQR],--3[1-4]Dactylitis, median [IQR], fingers-1[1-2]-CRP, median [IQR], mg/dl1,8[0,7-4,8]2,3[1,0-5,0]3,6[0,9-6,7]PGA Patient (0-10), median [IQR]7[6-8]7[6-8]7[5-8]VAS pain (0-10), median [IQR]7[6-8]7[6-8]7[6-8]DAPSA, median [IQR]24,1[19,4-31,5]24,2[19,5-31,2]27,2[22,9-35,6]Concomitant csDMARDs use, n (%)49 (23,4)22 (33,8)19 (26,3)Prior bDMARDs use, n (%)69 (33,1)34 (52,3)20 (27,8)Concomitant relevant disease, n (%)94 (44,8)37 (56,9)31 (43,1)Figure 1.Acknowledgements:NIL.Disclosure of InterestsAlberto Lo Gullo Grant/research support from: BAYER, GALAPAGOS, NOVARTIS, Andrea Becciolini: None declared, Simone Parisi: None declared, Patrizia Del Medico: None declared, antonella farina: None declared, elisa visalli: None declared, Aldo Molica Colella: None declared, Federica Lumetti: None declared, rosalba caccavale: None declared, Palma Scolieri: None declared, Romina Andracco: None declared, Francesco Girelli: None declared, Elena Bravi: None declared, Matteo Colina: None declared, Alessandro Volpe: None declared, Aurora Ianniello: None declared, Maria Chiara Ditto: None declared, Valeria Nucera: None declared, Veronica Franchina: None declared, Ilaria Platé: None declared, eleonora Di Donato: None declared, Giorgio Amato: None declared, Carlo Salvarani: None declared, Lucia Gardelli: None declared, Gianluca Lucchini: None declared, Francesco De Lucia: None declared, Francesco Molica Colella: None declared, Daniele Santilli: None declared, Natalia Mansueto: None declared, Giulio Ferrero: None declared, Antonio Marchetta: None declared, eugenio arrigoni: None declared, Rosario Foti: None declared, Gilda Sandri: None declared, Vincenzo Bruzzese: None declared, Marino Paroli: None declared, Enrico Fusaro: None declared, ALARICO ARIANI: None declared.
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