Rheumatology-Rhumatologie
6.0K views | +0 today
Follow
 
Scooped by Gilbert C FAURE
onto Rheumatology-Rhumatologie
Scoop.it!

Association AFLAR sur Twitter

Association AFLAR sur Twitter | Rheumatology-Rhumatologie | Scoop.it
Soirée Grand Public "comprendre l'arthrose" musée de Grenoble #EGArthrose2015 pic.twitter.com/hhxXVkLd9X
more...
No comment yet.
Your new post is loading...
Your new post is loading...
Scooped by Gilbert C FAURE
Scoop.it!

RHUMATOLOGIE - RHEUMATOLOGY

Obviously a topic of interest for so many people:

for the patient, it includes aching muscles, tendons and joints..

for MDs and researchers, it covers degenerative diseases as well as arthritis, often associated with various autoimmune diseases (see autoimmunity http://www.scoop.it/t/autoimmunity)

fortunately, new diagnostic tools are available

https://www.scoop.it/t/rheumatology-rhumatologie?q=diagnosis

and new biotherapies 

https://www.scoop.it/t/rheumatology-rhumatologie?q=therapy

allowed to improve the prognosis and the quality of life of patients

Gilbert C FAURE's insight:

January 2016

still few viewers (#650) for this topic, but >1280 posts and 2000 views

much less than other immunology topics, but growing!


October 2016 1500 scoops and almost 3K views

January 2018 1700 scoops and #5K views

more...
No comment yet.
Scooped by Gilbert C FAURE
Scoop.it!

Press Release - News - Histogenics

Press Release - News - Histogenics | Rheumatology-Rhumatologie | Scoop.it
View printer-friendly version << Back Histogenics Announces Top-Line Results From Phase 3 Clinical Trial of NeoCart® in Patients With Knee Cartilage Damage             ‒ Phase 3 Clinical Trial of NeoCart Did Not Meet Primary Endpoint of a Statistically Significant Improvement in Pain and Function in a Dual Threshold Responder Analysis One Year After Treatment as Compared to Microfracture ‒             ‒ NeoCart Demonstrated Statistically Significant and Clinically Meaningful Improvements on Dual Threshold Responder Analysis Six Months After Treatment and Nearly All Pain and Function Measures Compared to Microfracture One and Two Years After Treatment ‒             ‒ Data Compared Favorably to Other Products on the Market or in Development Per Guidance from the U. S. Food and Drug Administration ‒             ‒ Company to Discuss Plans for Submission of Biologics License Application with U.S. Food and Drug Administration ‒             ‒ Company to Host Conference Call and Webcast Today at 8:30 a.m. ET ‒ WALTHAM, Mass., Sept. 05, 2018 (GLOBE NEWSWIRE) -- Histogenics Corporation (Histogenics) (Nasdaq: HSGX), a leader in the development of restorative cell therapies that may offer rapid-onset pain relief and restored function, today announced that its Phase 3 clinical trial of NeoCart did not meet the primary endpoint of a statistically significant improvement in pain and function in a dual threshold responder analysis one year after treatment as compared to microfracture.  In the modified Intent to Treat (mITT) population (which excludes those patients who were randomized but not treated with NeoCart), 74.2% of the NeoCart patients exhibited clinically meaningful improvements in pain and function compared to 62.0% of microfracture patients at one year (p=0.071).  However, in this mITT population, patients treated with NeoCart achieved a statistically significant improvement in pain and function (p=0.018) six months after treatment as compared to patients treated with microfracture.  Both NeoCart and microfracture were well tolerated and exhibited strong safety profiles.  “Based on the totality of the data generated in the Phase 3 clinical trial, we continue to believe in NeoCart’s potential as a treatment for knee cartilage damage.  When we designed our Phase 3 clinical trial in 2009, we set a very high clinical bar for NeoCart and narrowly missed hitting the trial’s primary endpoint with statistical significance by only two microfracture responders out of the 249 patients that participated in the trial.  While the NeoCart treatment group exhibited a response as early as three months after treatment that continued through two years, the microfracture response rate was better than expected, which impacted the statistics.  We are encouraged by the results and believe we have a meaningfully differentiated product that, if approved, can compete effectively and provide physicians and patients with a beneficial treatment option that may grow the market,” said Adam Gridley, President and Chief Executive Officer of Histogenics.  “We continue to analyze the data and are in the process of scheduling a meeting with the FDA to discuss the results and prepare for a potential submission of a biologics license application for NeoCart.  We wish to acknowledge and thank the patients and investigators who participated in the trial and shared their positive experiences with NeoCart,” stated Mr. Gridley. The NeoCart Phase 3 clinical trial is believed to be the largest and first prospectively designed, randomized clinical trial in North America evaluating the safety and efficacy of a restorative cell therapy to treat knee cartilage damage.  It is also believed to be the only trial with a dual threshold responder analysis endpoint.  As part of the prospective data analysis, Histogenics collected a variety of patient reported outcome endpoints, including all measures of the Knee Injury and Osteoarthritis Outcomes Score (KOOS) and the International Knee Documentation Committee (IKDC) score, which are validated, patient-centered assessments of pain and function that are commonly used in current clinical trials of cartilage therapies.  On all but one of these measures, two of which are being utilized as primary endpoints in ongoing clinical trials by third parties in the U.S. for other therapies, NeoCart demonstrated statistically significant superiority versus microfracture at one and two years. The Phase 3 clinical trial is the first study prospectively enrolled consistent with current U.S. Food and Drug Administration (FDA) guidance, which provides for the use of microfracture as a comparator treatment in trials to repair knee cartilage damage.  The published FDA guidance also specifically calls for a study population that, given the clinical limitations and variable results of microfracture, we believe provides more favorable results than what is typically seen in microfracture in both the literature and a real-world setting.  “We are pleased with the overall performance of NeoCart in this Phase 3 clinical trial and the data confirm the feedback we have received from several of the investigators who participated in the trial.  Most importantly, patients treated with NeoCart displayed an early and sustained recovery from pain and return to function that was clinically meaningful.  The data from this trial are also consistent with results seen in prior clinical trials of NeoCart as well as the biomechanical data generated as part of our collaboration with Cornell University,” said Lynne Kelley, M.D., Chief Medical Officer of Histogenics.  “While we are continuing to analyze the data, we have already seen a number of important results, including a statistically significant improvement of NeoCart compared to microfracture in lesion sizes of greater than 2 cm and patients with higher body mass index.  We think that results such as these will be an important part of our planned discussions with the FDA, as well as with clinicians if NeoCart is approved,” continued Dr. Kelley. There are approximately 1.2 million arthroscopic procedures conducted each year to treat knee cartilage defects in the U.S., with less than half of eligible patients currently electing to receive treatment.  Based on the data generated to date, NeoCart may offer many of these patients a safe and effective alternative, subject to FDA approval. “As a physician who treats patients with knee cartilage damage, I am keenly aware of the limitations of current treatment approaches for this common and underserved condition,” said David C. Flanigan, MD Associate Professor, Department of Orthopedics, Director, Cartilage Restoration Program at The Ohio State University Wexner Medical Center, and a high-enrolling investigator in the Phase 3 clinical trial.  “The pain and loss of function associated with uncorrected knee cartilage lesions can significantly limit these patients’ ability to maintain their daily routines and often leads to other more serious comorbidities over time.  The rapid recovery for patients who received this cartilage tissue implant compared to those who underwent microfracture indicates that implants, such as NeoCart, may be an attractive alternative for patients seeking a better quality of life and faster return to function,” continued Dr. Flanigan.  The primary endpoint for the Phase 3 clinical trial was a dual-threshold responder analysis measuring the improvement in KOOS pain and IKDC function scores for each patient treated with NeoCart compared to those treated with microfracture one year after the time of treatment.  Dual-threshold responders were defined as patients who, relative to their baseline measurements, had at least a 12-point improvement in the KOOS pain sub-score assessment and a 20-point improvement in the IKDC subjective assessment.  The trial also evaluated additional pain, quality of life, and function outcomes using all five measures of KOOS subscales, including Sports and Recreation.  The change from baseline and the relative change between the NeoCart and microfracture arms was also measured at one year which contrasts with clinical trials of other products, either on the market or in development, that measured these changes at two years.  Efficacy and safety will continue to be followed out to three years, and Histogenics expects to further track patients for future planned analyses, including patients from prior clinical trials who received a NeoCart treatment. Demographics for both study arms were similar and represent a patient population that was intended to ensure that microfracture would respond favorably, including patients with an average age of approximately 39 years old and a Body Mass Index (BMI) of approximately 27.  Furthermore, the mean lesion size was 2.1 cm in the NeoCart arm and 1.8 cm in the microfracture arm.  There were no other significant differences between the treatment arms. The results with respect to the primary endpoint (dual threshold responder analysis one year after treatment) are summarized below:             NeoCart Microfracture       Positive Responders Responder Rate Positive Responders Responder Rate Difference   ITT 121/170 71.2% 49/79 62.0% 9.2 p=0.1877 mITT 121/163 74.2% 49/79 62.0% 12.2 P=0.0714 As Treated 120/162 74.1% 50/80 62.5% 11.6 p=0.0735 Per Protocol 118/155 76.1% 43/65 66.2% 10.0 p=0.1362               Key additional findings from the clinical trial include: NeoCart demonstrated statistically significant improvements in pain and function at both one and two years after treatment as measured by changes in the KOOS and IKDC scores.       KOOS pain score (mITT Population) Change from Baseline (NeoCart Baseline = 54.0; Microfracture Baseline = 52.4)   NeoCart Microfracture   Visit N Mean N Mean P-Value 3-months 160 24.1 75 22.4 0.0487* 6-months 157 28.6 75 27.0 0.0819 1-year 158 31.4 72 28.7 0.0239* 2-years 87 32.2 34 28.9 0.0080* 3-years 39 34.3 16 30.7 0.1071 * Statistically significant                            IKDC subjective knee exam score (mITT Population) Change from Baseline (NeoCart Baseline = 40.3; Microfracture Baseline = 40.0)   NeoCart Microfracture   Visit N Mean N Mean P-Value 3-months 159 13.7 76 14.5 0.9686 6-months 156 24.4 74 22.4 0.1572 1-year 158 33.1 71 28.3 0.0126* 2-years 87 35.3 34 30.2 0.0366* 3-years 38 39.9 16 32.6 0.2691 * Statistically significant                       NeoCart, the most advanced therapy from Histogenics restorative cell therapy platform, is functional cartilage that combines breakthroughs in bio-engineering, biomaterials and cell processing to enhance the autologous cartilage repair process.  NeoCart, which is one of the most rigorously studied restorative cell therapies for orthopedic use, merges a patient’s own cells with a fortified three-dimensional scaffold designed to accelerate healing and reduce pain.  NeoCart’s ability to function like cartilage at the time of treatment may enable patients to return to work and daily activities more rapidly than currently available treatment options such as microfracture.  Histogenics is in the process of requesting a meeting with the FDA to discuss the data and a potential BLA submission.  In addition, Histogenics intends to present the complete study results at upcoming medical conferences and will seek to have the data published in one or more peer reviewed journals. Conference Call and Webcast Information Histogenics management will host a conference call on Wednesday, September 5, 2018 at 8:30am EDT.  A question-and-answer session will follow Histogenics’ remarks.  To participate on the live call, please dial  (877) 930-8064 (domestic) or (253) 336-8040 (international) and provide the conference ID 8764946 five to ten minutes before the start of the call. To access a live audio webcast of the presentation on the “Investor Relations” page of the Histogenics website, please click here. A replay of the webcast will be archived on Histogenics’ website for approximately 60 days following the presentation. About Histogenics Corporation Histogenics (Nasdaq:  HSGX) is a leader in the development of restorative cell therapies that may offer rapid-onset pain relief and restored function.  Histogenics’ lead investigational product, NeoCart, is designed to rebuild a patient’s own knee cartilage to treat pain at the source and potentially prevent a patient’s progression to osteoarthritis.  NeoCart is one of the most rigorously studied restorative cell therapies for orthopedic use.  NeoCart is designed to perform like articular hyaline cartilage at the time of treatment, and as a result, may provide patients with more rapid pain relief and accelerated recovery as compared to the current standard of care. Histogenics’ technology platform has the potential to be used for a broad range of additional restorative cell therapy indications.  For more information on Histogenics and NeoCart, please visit www.histogenics.com. Forward-Looking Statements Various statements in this release are “forward-looking statements” under the securities laws.  Words such as, but not limited to, “anticipate,” “believe,” “can,” “could,” “expect,” “estimate,” “design,” “goal,” “intend,” “may,” “might,” “objective,” “plan,” “predict,” “project,” “target,” “likely,” “should,” “will,” and “would,” or the negative of these terms and similar expressions or words, identify forward-looking statements.  Forward-looking statements are based upon current expectations that involve risks, changes in circumstances, assumptions and uncertainties. Important factors that could cause actual results to differ materially from those reflected in Histogenics’ forward-looking statements include, among others:  NeoCart’s potential as a treatment for knee cartilage damage; expectations regarding the timing and success of discussions with the FDA regarding the submission of a biologics license application for NeoCart; the timing, associated expenses and ability to obtain and maintain regulatory approval of NeoCart or any product candidates, and the labeling for any approved products; the market size and potential patient population in markets where Histogenics’ and its partners expect to compete; updated or refined data based on Histogenics’ continuing review and quality control analysis of clinical data; the scope, progress, timing, expansion, and costs of developing and commercializing Histogenics’ product candidates; the ability to obtain and maintain regulatory approval regarding the comparability of critical NeoCart raw materials following its technology transfer and manufacturing location transition; Histogenics’ expectations regarding its expenses and revenue; Histogenics’ ability to obtain additional debt or equity capital and other factors that are described in the “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” sections of Histogenics’ Annual Report on Form 10-K for the year ended December 31, 2017 and Quarterly Report on Form 10-Q for the quarter ended June 30, 2018, which are on file with the SEC and available on the SEC’s website at www.sec.gov.  In addition to the risks described above and in Histogenics’ Annual Report on Form 10-K and Quarterly Reports on Form 10-Q, Current Reports on Form 8-K and other filings with the SEC, other unknown or unpredictable factors also could affect Histogenics’ results. There can be no assurance that the actual results or developments anticipated by Histogenics will be realized or, even if substantially realized, that they will have the expected consequences to, or effects on, Histogenics.  Therefore, no assurance can be given that the outcomes stated in such forward-looking statements and estimates will be achieved. All written and verbal forward-looking statements attributable to Histogenics or any person acting on its behalf are expressly qualified in their entirety by the cautionary statements contained or referred to herein.  Histogenics cautions investors not to rely too heavily on the forward-looking statements Histogenics makes or that are made on its behalf.  The information in this release is provided only as of the date of this release, and Histogenics undertakes no obligation, and specifically declines any obligation, to update or revise publicly any forward-looking statements, whether as a result of new information, future events or otherwise.  Contacts: Investor Relations: Tel: +1 (781) 547-7909 InvestorRelations@histogenics.com Media Relations: Glenn Silver, Lazar Partners Ltd. Tel: + 1 (646) 871-8485 gsilver@lazarpartners.com Histogenics Corporation
more...
No comment yet.
Rescooped by Gilbert C FAURE from Osteoporosis New drugs Review
Scoop.it!

Receptor becomes a ligand to control bone remodelling

Receptor becomes a ligand to control bone remodelling | Rheumatology-Rhumatologie | Scoop.it
The protein RANKL is released by bone-forming cells called osteoblasts, and binds to its receptor, RANK, on osteoclast cells to trigger bone removal. It emerges that the pathway can act in reverse to stimulate bone formation.

Via Krishan Maggon
more...
No comment yet.
Scooped by Gilbert C FAURE
Scoop.it!

JCI Insight - Identification of enhanced IFN-γ signaling in polyarticular juvenile idiopathic arthritis with mass cytometry

more...
No comment yet.
Suggested by Société Francaise d'Immunologie
Scoop.it!

Highlights from EULAR 2018: Current and Future Perspectives in the Cytokine Signalling Blockade

Highlights from EULAR 2018: Current and Future Perspectives in the Cytokine Signalling Blockade | Rheumatology-Rhumatologie | Scoop.it
Increasing the understanding of Cytokine Signalling science and its implications for clinical management of rheumatoid arthritis patients...
more...
No comment yet.
Suggested by LIGHTING
Scoop.it!

Methotrexate BAFFles anti-drug antibodies

Methotrexate BAFFles anti-drug antibodies | Rheumatology-Rhumatologie | Scoop.it
Combining TNF inhibition with methotrexate treatment is an effective therapeutic approach for patients with rheumatoid arthritis and reduces the likelihood of the patient developing ‘resistance’ to the TNF inhibitor. But how does methotrexate suppress the production of anti-drug antibodies and how can we tell which patients will develop resistance?
more...
No comment yet.
Scooped by Gilbert C FAURE
Scoop.it!

Frontiers | It Takes “Guts” to Cause Joint Inflammation: Role of Innate-Like T Cells | Immunology

Frontiers | It Takes “Guts” to Cause Joint Inflammation: Role of Innate-Like T Cells | Immunology | Rheumatology-Rhumatologie | Scoop.it
Innate-like T cells such as invariant natural killer T (iNKT) cells and mucosal associated T (MAIT) cells, characterized by a semi-invariant T cell receptor and restriction towards MHC-like molecules (CD1 and MR1 respectively), are a unique unconventional immune subset acting at the interface of innate and adaptive immunity. Highly represented at barrier sites and capable of rapidly producing substantial amounts of cytokines, they serve a pivotal role as first line responders towards microbial infections. In contrast, it was demonstrated that innate-like T cells can be skewed towards a predominant pro-inflammatory state and consequently are involved in a number of auto-immune and inflammatory diseases, like inflammatory bowel diseases (IBD) and rheumatic disorders such as spondyloarthritis (SpA) and rheumatoid arthritis (RA). Interestingly, there is link between gut and joint disease as they often co-incide and share certain aspects of the pathogenesis such as established genetic risk factors, a critical role for pro-inflammatory cytokines such as TNF-α, IL-23 and IL-17 and therapeutic susceptibility. In this regard dysregulated IL-23/IL-17 responses appear to be crucial in both debilitating pathologies and innate-like T cells likely act as key player. In this review, we will explore the remarkable features of iNKT cells and MAIT cells, and discuss their contribution to immunity and combined gut-joint disease.
more...
No comment yet.
Scooped by Gilbert C FAURE
Scoop.it!

Leukocyte trafficking between stromal compartments: lessons from rheumatoid arthritis | Nature Reviews Rheumatology

more...
No comment yet.
Rescooped by Gilbert C FAURE from Top Selling Monoclonal Antibodies 2014
Scoop.it!

Multi-omics monitoring of drug response in rheumatoid arthritis in pursuit of molecular remission

Multi-omics monitoring of drug response in rheumatoid arthritis in pursuit of molecular remission | Rheumatology-Rhumatologie | Scoop.it
Little information is available on molecular changes in response to treatment of rheumatoid arthritis (RA). Here the authors report a multi-omics study collecting patients' transcriptome, proteome, and immunophenotype data to help understand the impact of drug treatments on RA molecular phenotypes.

Via Krishan Maggon
more...
No comment yet.
Rescooped by Gilbert C FAURE from Autoimmune diseases (Lupus, RA), Vaccines and Stem Cell Therapies Highlights
Scoop.it!

Ability of disease-modifying antirheumatic drugs to prevent or delay rheumatoid arthritis onset: a systematic literature review and meta-analysis

Ability of disease-modifying antirheumatic drugs to prevent or delay rheumatoid arthritis onset: a systematic literature review and meta-analysis | Rheumatology-Rhumatologie | Scoop.it
Background Recent advances in knowledge of the pathogenesis of rheumatoid arthritis (RA) has led to promoting very early intervention.

Objectives To assess the efficacy of therapeutic interventions in preventing or delaying RA onset with a systematic literature review (SLR) and meta-analysis (MA).

Via Krishan Maggon
more...
No comment yet.
Rescooped by Gilbert C FAURE from Autoimmune diseases (Lupus, RA), Vaccines and Stem Cell Therapies Highlights
Scoop.it!

Personalized medicine — a new reality in psoriatic arthritis?

Personalized medicine — a new reality in psoriatic arthritis? | Rheumatology-Rhumatologie | Scoop.it
Some patients with psoriatic arthritis are refractive to one biologic therapy but not to others, and a strategy for selecting the right therapy for each patient is needed. The findings of a new study highlight the potential benefit of stratifying patients by their immunophenotype to select the...

Via Krishan Maggon
more...
No comment yet.
Scooped by Gilbert C FAURE
Scoop.it!

In Rheumatoid Arthritis, Synovitis at Different Inflammatory Sites Is Dominated by Shared but Patient-Specific T Cell Clones

In Rheumatoid Arthritis, Synovitis at Different Inflammatory Sites Is Dominated by Shared but Patient-Specific T Cell Clones | Rheumatology-Rhumatologie | Scoop.it
Genetic and immunological evidence clearly points to a role for T cells in the pathogenesis of rheumatoid arthritis (RA). Selective targeting of such disease-associated T cell clones might be highly effective while having few side effects. However, such selective targeting may only be feasible if the same T cell clones dominate the immune response at different sites of inflammation. We leveraged high-throughput technology to quantitatively assess whether different T cell clones dominate the inflammatory infiltrate at various sites of inflammation in this prototypic autoimmune disease. In 13 RA patients, we performed quantitative next-generation sequencing–based human TCRβ repertoire analysis in simultaneously obtained samples from inflamed synovial tissue (ST) from distinct locations within one joint, from multiple joints, and from synovial fluid (SF) and peripheral blood (PB). Identical TCRβ clones dominate inflammatory responses in ST samples taken from different locations within a single joint and when sampled in different joints. Although overall ST–SF overlap was comparable to higher ST–ST values, the overlap in dominant TCRβ clones in ST–SF comparisons was much lower than ST–ST and comparable to the low ST–PB overlap. In individual RA patients, a limited number of TCRβ clones dominate the immune response in the inflamed ST regardless of the location within a joint and which joint undergoes biopsy; in contrast, there is limited overlap of ST with SF or PB TCR repertoires. This limited breadth of the T cell response in ST of the individual RA patient indicates that development of immunotherapies that selectively modulate dominant T cell responses might be feasible.
more...
No comment yet.
Scooped by Gilbert C FAURE
Scoop.it!

Osteoarthritis research: Joint effort to understand cartilage development

Osteoarthritis research: Joint effort to understand cartilage development | Rheumatology-Rhumatologie | Scoop.it
In patients with osteoarthritis, cartilage wears away, bone rubs against bone, causing swelling and stiffness. USC stem cell scientists have collaborated with colleagues to offer new insights on how gene activity drives the development of cartilage.
more...
No comment yet.
Rescooped by Gilbert C FAURE from Cancer Immunotherapy Review
Scoop.it!

Rheumatic immune-related adverse events from cancer immunotherapy

Rheumatic immune-related adverse events from cancer immunotherapy | Rheumatology-Rhumatologie | Scoop.it
Immunotherapy has revolutionized the treatment of cancer, but a rapid rise in the use of the family of therapeutic agents known as checkpoint inhibitors (CPIs) is associated with a new group of immune-related adverse events (irAEs) in almost any organ system. Among these irAEs, rheumatic complications are common and seem to have features that are distinct from irAEs in other organ systems, including a highly variable time of clinical onset and the capacity to persist, possibly indefinitely, even after cessation of CPI therapy. In this Review, mechanisms of action of CPIs and how they might cause rheumatic irAEs are described. Also covered are epidemiology and clinical descriptions of rheumatic irAEs, plus guiding principles for managing irAEs. Finally, we outline future directions that must be taken in response to a series of unanswered questions and unmet needs that now confront rheumatologists who are, or will be, engaged in this new area of rheumatology.

Via Krishan Maggon
more...
No comment yet.
Scooped by Gilbert C FAURE
Scoop.it!

Biologic refractory disease in rheumatoid arthritis: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis

Biologic refractory disease in rheumatoid arthritis: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis | Rheumatology-Rhumatologie | Scoop.it
Objectives Biologic disease-modifying antirheumatic drugs (bDMARDs) have revolutionised treatment and outcomes for rheumatoid arthritis (RA). The expanding repertoire allows the option of switching bDMARD if current treatment is not effective. For some patients, even after switching, disease control remains elusive. This analysis aims to quantify the frequency of, and identify factors associated with, bDMARD refractory disease.

Methods Patients with RA starting first-line tumour necrosis factor inhibitor in the British Society for Rheumatology Biologics Register for RA from 2001 to 2014 were included. We defined patients as bDMARD refractory on the date they started their third class of bDMARD. Follow-up was censored at last follow-up date, 30 November 2016, or death, whichever came first. Switching patterns and stop reasons of bDMARDs were investigated. Cox regression identified baseline clinical factors associated with refractory disease. Multiple imputation of missing baseline data was used.

Results 867 of 13 502 (6%) patients were bDMARD refractory; median time to third bDMARD class of 8 years. In the multivariable analysis, baseline factors associated with bDMARD refractory disease included patients registered more recently, women, younger age, shorter disease duration, higher patient global assessment, higher Health Assessment Questionnaire score, current smokers, obesity and greater social deprivation.

Conclusions This first national study has identified the frequency of bDMARD refractory disease to be at least 6% of patients who have ever received bDMARDs. As the choice of bDMARDs increases, patients are cycling through bDMARDs quicker. The aetiopathogenesis of bDMARD refractory disease requires further investigation. Focusing resources, such as nursing support, on these patients may help them achieve more stable, controlled disease.
more...
No comment yet.
Suggested by LIGHTING
Scoop.it!

Rheumatoid arthritis and the mucosal origins hypothesis: protection turns to destruction

Rheumatoid arthritis and the mucosal origins hypothesis: protection turns to destruction | Rheumatology-Rhumatologie | Scoop.it
Preclinical rheumatoid arthritis (RA) is characterized by the presence of RA-related autoantibodies in the serum in the absence of clinical symptoms. This Review discusses the relationships during this period between mucosal alterations and the initiation of local and systemic anti-citrullinated protein antibody production.
more...
No comment yet.
Scooped by Gilbert C FAURE
Scoop.it!

Frontiers | The Initiation, but Not the Persistence, of Experimental Spondyloarthritis Is Dependent on Interleukin-23 Signaling | Immunology

Frontiers | The Initiation, but Not the Persistence, of Experimental Spondyloarthritis Is Dependent on Interleukin-23 Signaling | Immunology | Rheumatology-Rhumatologie | Scoop.it
IL-17A is a central driver of spondyloarthritis, its production was originally proposed to be IL-23 dependent. Emerging preclinical and clinical evidence suggests, however, that IL-17A and IL-23 have a partially overlapping but distinct biology. We aimed to assess the extent to which IL-17A-driven pathology is IL-23 dependent in experimental spondyloarthritis. Experimental spondyloarthritis was induced in HLA-B27/Huβ2m transgenic rats, followed by prophylactic or therapeutic treatment with an anti-IL23R antibody or vehicle control. Spondylitis and arthritis were scored clinically and hind limb swelling was measured. Draining lymph node cytokine expression levels were analyzed directly ex vivo, and IL-17A protein was measured upon restimulation with PMA/ionomycin. Prophylactic treatment with anti-IL23R completely protected against the development of both spondylitis and arthritis, while vehicle treated controls did develop spondylitis and arthritis. In a therapeutic study, anti-IL23R treatment failed to reduce the incidence or decrease the severity of experimental spondyloarthritis. Mechanistically, expression of downstream effector cytokines, including IL-17A and IL-22, was significantly suppressed in anti-IL23R versus vehicle treated rats in the prophylactic experiments. Accordingly, the production of IL-17A upon restimulation was reduced. In contrast, there was no difference in IL-17A and IL-22 expression after therapeutic anti-IL23R treatment. Targeting the IL-23 axi
more...
No comment yet.
Scooped by Gilbert C FAURE
Scoop.it!

Molecular mechanisms of autophagic memory in pathogenic T cells in human arthritis - ScienceDirect

Molecular mechanisms of autophagic memory in pathogenic T cells in human arthritis - ScienceDirect | Rheumatology-Rhumatologie | Scoop.it
T-cell resilience is critical to the immune pathogenesis of human autoimmune arthritis. Autophagy is essential for memory T cell generation and associ…
more...
No comment yet.
Scooped by Gilbert C FAURE
Scoop.it!

S100 proteins in rheumatic diseases

S100 proteins in rheumatic diseases | Rheumatology-Rhumatologie | Scoop.it
S100 proteins have many intracellular functions, as well as being extracellular signalling molecules in inflammation. A deeper understanding of this family of proteins could lead the way to diagnostic and prognostic biomarkers and novel therapeutic strategies.
more...
No comment yet.
Rescooped by Gilbert C FAURE from Osteoporosis New drugs Review
Scoop.it!

Advances in stem cell therapy for cartilage regeneration in osteoarthritis: Expert Opinion on Biological Therapy: Vol 0, No ja

Advances in stem cell therapy for cartilage regeneration in osteoarthritis: Expert Opinion on Biological Therapy: Vol 0, No ja | Rheumatology-Rhumatologie | Scoop.it
SCs have proven their potential and safety for OA treatment. Nevertheless, there are still many questions to be resolved before their widespread used in clinical practice, such as the treatment mechanism, the best cell source, the most appropriate processing method, the most effective dose and delivery procedure, and their efficacy. In this sense, long-term follow-up and larger randomized controlled trials utilizing standardized and established outcome scores are mandatory to make objective conclusions.

Keywords: osteoarthritis, cell therapy, mesenchymal stem cells, cartilage regeneration, scaffolds/hydrogels, growth factors

Via Krishan Maggon
more...
No comment yet.
Rescooped by Gilbert C FAURE from Osteoporosis New drugs Review
Scoop.it!

Biologics and stem cell‐based therapies for rotator cuff repair - Bianco - - Annals of the New York Academy of Sciences - Wiley Online Library

Biologics and stem cell‐based therapies for rotator cuff repair - Bianco - - Annals of the New York Academy of Sciences - Wiley Online Library | Rheumatology-Rhumatologie | Scoop.it
The rotator cuff is composed of several distinct muscles and tendons that function in concert to coordinate shoulder motion. Injuries to these tendons frequently result in permanent dysfunction and persistent pain. Despite considerable advances in operation techniques, surgical repair alone still does not fully restore rotator cuff function. This review focuses on recent research in the use of biologics and stem cell‐based therapies to augment repair, highlighting promising avenues for future work and remaining challenges. While a number of animal models are used for rotator cuff studies, the anatomy of the rotator cuff varies dramatically between species. Since the rodent rotator cuff shares the most anatomical features with the human, this review will focus primarily on rodent models to enable consistent interpretation of outcome measures.

Via Krishan Maggon
more...
No comment yet.
Scooped by Gilbert C FAURE
Scoop.it!

IL-17 in the immunopathogenesis of spondyloarthritis

IL-17 in the immunopathogenesis of spondyloarthritis | Rheumatology-Rhumatologie | Scoop.it
Evidence from genetic, experimental and clinical studies has accumulated to indicate a role for the IL-17 pathway in the pathogenesis of spondyloarthritis. This Review discusses how IL-17A and IL-17F and their cellular sources contribute to the immunopathology of these diseases.
more...
No comment yet.
Suggested by LIGHTING
Scoop.it!

Rheuminations by Adam Brown, MD on

Rheuminations by Adam Brown, MD on | Rheumatology-Rhumatologie | Scoop.it
Download past episodes or subscribe to future episodes of Rheuminations by Adam Brown, MD for free.
more...
No comment yet.
Scooped by Gilbert C FAURE
Scoop.it!

The role of neutrophil extracellular traps in rheumatic diseases

The role of neutrophil extracellular traps in rheumatic diseases | Rheumatology-Rhumatologie | Scoop.it
A growing body of evidence indicates that neutrophils and neutrophil extracellular traps (NETs) are involved in the progression of rheumatic diseases. This Review focuses on the role of NETs in systemic lupus erythematosus, vasculitis, rheumatoid arthritis and gout.
more...
No comment yet.
Rescooped by Gilbert C FAURE from Autoimmune diseases (Lupus, RA), Vaccines and Stem Cell Therapies Highlights
Scoop.it!

Can rheumatoid arthritis ever cease to exist: a review of various therapeutic modalities to maintain drug-free remission?

Can rheumatoid arthritis ever cease to exist: a review of various therapeutic modalities to maintain drug-free remission? | Rheumatology-Rhumatologie | Scoop.it
Therapies for rheumatoid arthritis (RA) were mostly aimed at reducing the pain, stiffness and further progression of joint destruction. However, with the advent of biologic agents that act against specific inflammatory cytokines contributing to RA pathogenesis ...

Via Krishan Maggon
more...
No comment yet.