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    Biological and targeted-synthetic disease-modifying anti-rheumatic drugs with concomitant methotrexate or leflunomide in rheumatoid arthritis: real-life TReasure prospective data
    (Clinical & Exper Rheumatology, 2021) Kimyon, G.; Kalyoncu, U.; Kiraz, S.; Bes, C.; Coskun, N.; Yagiz, B.; Kucuksahin, O.
    Objective To determine the real-life efficacy, safety, and drug-retention rates of leflunomide (LEF) or methotrexate (MTX) as a synthetic DMARD used in combination with biological DMARDs for rheumatoid arthritis (RA). Methods The TReasure database is a web-based, prospective, observational cohort of RA and spondyloarthritis patients from 17 centres in different regions of Turkey and data entry was enabled since December 2017. Until May 2019,2556 RA patients on biologic treatment were recorded. Demographic and RA-related data of 1526 patient either received LEF or MTX were compared, efficacy of both drugs compared by RA-disease activity composite indices. Reasons fordrug discontinuation also recorded. Drug retention rates were compared with Kaplan-Meier curves (log-rank test). Results Of 2556 RA patients 1526 (59.7%) were receiving concomitant LEE (n=646, 42 3%; median follow up 35 months) or concomitant MTX (n=880, 573%; median follow-up 32 months) at the time of initiation to their first bDMARDs. The LEE group were older and had longer disease duration, proportion of females and seropositive patients was higher in this group. In the LEE group, non-anti-TNF agents were used in higher rate. Remission rates, changes in composite indices and rate of comorbidities and adverse events were similar in both groups. The retention rate of LEE + non-anti-TNF b/tsDMARDs was higher compared to MTX + anti-TNF bDMARDs (p=0.002, log-rank). Rates of adverse events were similar in both groups. Conclusion LEE in combination with either anti TNF or non anti DIF drugs appears as an effective and safe therapeutic option at least as MIX.
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    Biological and targeted-synthetic disease-modifying antirheumatic drugs with concomitant methotrexate or leflunomide in rheumatoid arthritis: Real-life TReasure prospective data
    (Clinical and Experimental Rheumatology S.A.S., 2021) Kimyon, G.; Kalyoncu, U.; Kiraz, S.; Bes, C.; Coskun, N.; Yagiz, B.; Kucuksahin, O.
    Objective To determine the real-life efficacy, safety, and drug-retention rates of leflunomide (LEF) or methotrexate (MTX) as a synthetic DMARD used in combination with biological DMARDs for rheumatoid arthritis (RA). Methods The TReasure database is a web-based, prospective, observational cohort of RA and spondyloarthritis patients from 17 centres in different regions of Turkey and data entry was enabled since December 2017. Until May 2019, 2556 RA patients on biologic treatment were recorded. Demographic and RA-related data of 1526 patient either received LEF or MTX were compared, efficacy of both drugs compared by RA-disease activity composite indices. Reasons fordrug discontinuation also recorded. Drug retention rates were compared with Kaplan-Meier curves (log-rank test). Results Of 2556 RA patients 1526 (59.7%) were receiving concomitant LEF (n=646, 42.3%; median follow up 35 months) or concomitant MTX (n=880, 57.3%; median follow-up 32 months) at the time of initiation to their first bDMARDs. The LEF group were older and had longer disease duration, proportion of females and seropositive patients was higher in this group. In the LEF group, non-anti-TNF agents were used in higher rate. Remission rates, changes in composite indices and rate of comorbidities and adverse events were similar in both groups. The retention rate of LEF + non-anti-TNF b/tsDMARDs was higher compared to MTX + anti–TNF bDMARDs (p=0.002, log-rank). Rates of adverse events were similar in both groups. Conclusion LEF in combination with either anti-TNF or non-anti-TNF drugs appears as an effective and safe therapeutic option at least as MTX. © Copyright CliniCal and ExpErimEntal rhEumatology 2021.
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    BIOSIMILAR INFLIXIMAB EXPERIENCE IN SPONDYLOARTRITIS PATIENTS: TREASURE REAL LIFE RESULTS
    (Bmj Publishing Group, 2020) Bilge, N. S. Yasar; Kasifoglu, T.; Kiraz, S.; Ertenli, A. I.; Dalkilic, E.; Bes, C.; Emmungil, H.
    [Abstract Not Available]
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    Clinical and laboratory factors associated with bamboo spine in patients with axial spondyloarthritis: are there clues for bamboo spine?
    (Clinical & Exper Rheumatology, 2023) Atagunduz, P.; Kiraz, S.; Akar, S.; Kucuksahin, O.; Erden, A.; Aksoy, A.; Coskun, B. N.
    Objective To analyse the clinical and laboratory factors associated with bamboo spine. Methods Data of patients fulfilling the 2009 ASAS classification criteria for axial spondyloarthritis, registered in the national, multicentre, longitudinal, and observational database of TReasure was analysed. Radiographs were assessed using the Bath Ankylosing Spondylitis Radiologic Index (BASRI). Data of patients with a bamboo spine (Group 1) was compared to data derived from patients with a longstanding disease of at least 15 years but no syndesmophytes (Group 2). Results Out of the 5060 patients, 1246 had eligible radiographs. There were 111 patients (8.9%) with a bamboo spine. Male sex was more common among patients with bamboo spine. The median BMI of 27.7 (25.8-31.1) in Group1 was higher than the BMI of 25.9 (22.9-29.2) in Group 2 (p<0.001). Hip arthritis, present or documented by a physician, was more common in Group 1 [(58/108 (53.7%) vs. 35/103 (34%), p=0.004]. There was a tendency towards a more prevalent enthesitis in these patients [29.1% (25/86) vs. 15.9%(11/69), p=0.054]. HLA-B27 status did not differ between groups. Smoking was more prevalent in Group 1. Multivariate logistic regression analysis revealed that male sex, body mass index, hip arthritis, and enthesitis are associated with bamboo spine in axSpA. Conclusion Bamboo spine was more common in the male sex and associated with a delay in diagnosis, high BMI, hip involvement, and enthesitis. The constellation of increased body weight, hip arthritis, and enthesitis may imply that mechanical stress contributes to radiographic damage in the presence of chronic inflammation.