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    Anti-interleukin-1 treatment in 26 patients with refractory familial mediterranean fever
    (Springer, 2017) Kucuksahin, Orhan; Yildizgoren, Mustafa Turgut; Ilgen, Ufuk; Ates, Askin; Kinikli, Gulay; Turgay, Murat; Erten, Sukran
    Objective: To investigate the effect of anti-interleukin-1 (anti-IL-1) treatment on the frequency and severity of attacks and other disease-related clinical parameters and to evaluate the adverse effects associated with anti-IL-1 treatment in 26 patients with refractory familial mediterranean fever (FMF).Methods: The study included 26 FMF patients followed up in our centre using colchicine for 4 months to 30 years. The treatment was switched to anti-IL-1 treatment for various reasons; 20 cases were resistant to colchicine, 8 were intolerant to colchicine, and 3 had prolonged arthritis under colchicine. Clinical response was monitored through the number of attacks, and laboratory inflammation was monitored through erythrocyte sedimentation rate, C-reactive protein, and serum amyloid A concentrations. Colchicine resistance was defined as at least two attacks/month together with C-reactive protein and serum amyloid A levels above the normal range between attacks. The colchicine dose was increased to 2mg/day before they were considered colchicine-resistant.Results: 24 patients used anakinra (100mg/day), and 2 used canakinumab (150mg/month), for -36 months. Sixteen patients with colchicine resistance had no attacks under anti-IL-1 treatment, and 4 had decreased frequency and duration of attacks. Seven of 8 patients intolerant to colchicine used anakinra, and 6 were attack-free under treatment, while 1 using canakinumab had attacks under treatment. One patient with prolonged arthritis used canakinumab but arthritis showed progression and the treatment was changed to IL-6 inhibitor. Three patients had injection site erythema and one had fatigue with anti-IL-1 treatment. Topical steroids with systemic antihistaminics were sufficient for symptom control in two cases, but canakinumab treatment was given due to severe injection site erythema in one case.Conclusion: Anti-IL-1 agents are rational treatment modalities in patients resistant or intolerant to colchicine. Anti-IL-1 agents can control FMF attacks quite effectively and they have a promising role in the treatment of FMF.
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    SMOKING MAY BE RELATED TO SACROILIITIS IN ENTEROPATHIC ARTHRITIS PATIENTS: TREASURE REAL-LIFE PRELIMINARY DATA
    (Bmj Publishing Group, 2019) Kucuksahin, Orhan; Erden, Abdulsamet; Ilgen, Ufuk; Kiraz, Sedat; Ertenli, Ali Ihsan; Bilge, Nazife Sule Yasar; Kasifoglu, Timucin
    [Abstract Not Available]
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    Tuberculin Skin Test and Quantiferon®-TB Gold In-Tube Test for Latent Tuberculosis Before Biologic Treatments: Lower Agreement Rate in Spondyloarthropathies Compared to Rheumatoid Arthritis
    (Wiley, 2019) Ilgen, Ufuk; Turan, Sezin; Emmungil, Hakan; Sari, Alper; Erden, Abdulsamet; Kilic, Levent; Karadag, Omer
    [Abstract Not Available]
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    Tuberculin skin test before biologic and targeted therapies: does the same rule apply for all?
    (Springer Heidelberg, 2022) Ilgen, Ufuk; Karadag, Omer; Emmungil, Hakan; Kucuksahin, Orhan; Koca, Suleyman Serdar; Erden, Abdulsamet; Bes, Cemal
    This study aimed to compare Tuberculin Skin Test (TST) and QuantiFERON (R)-TB Gold In-Tube (QFT-GIT) test in rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients scheduled for biological and targeted synthetic disease modifying anti-rheumatic drugs (DMARDs) in a Bacillus Calmette-Guerin-vaccinated population. Adult RA (n = 206) and SpA (n = 392) patients from the TReasure database who had both TST and QFT-GIT prior to initiation of biological and targeted synthetic DMARDs were included in the study. Demographic and disease characteristics along with pre-biologic DMARD and steroid use were recorded. The distribution of TST and performance with respect to QFT-GIT were compared between RA and SpA groups. Pre-biologic conventional DMARD and steroid use was higher in the RA group. TST positivity rates were 44.2% in RA and 69.1% in SpA for a 5 mm cutoff (p < 0.001). Only 8.9% and 15% of the patients with RA and SpA, respectively, tested positive by QFT-GIT. The two tests poorly agreed in both groups at a TST cutoff of 5 mm and increasing the TST cutoff only slightly increased the agreement. Among age, sex, education and smoking status, pre-biologic steroid and conventional DMARD use, disease group, and QFT-GIT positivity, which were associated with a 5 mm or higher TST, only disease group (SpA) and QFT-GIT positivity remained significant in multiple logistic regression. TST positivity was more pronounced in SpA compared to that in RA and this was not explainable by pre-biologic DMARD and steroid use. The agreement of TST with QFT-GIT was poor in both groups. Using a 5 mm TST cutoff for both diseases could result in overestimating LTBI in SpA.