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Öğe Are Biologic Agents Effective on the Treatment of Secondary Amyloidosis: A Multicenter Report on Turkish Rheumatoid Arthritis and Ankylosing Spondylitis Patients(Wiley, 2014) Pamuk, Omer Nuri; Kalyoncu, Umut; Aksu, Kenan; Donmez, Salim; Pehlivan, Yavuz; Cagatay, Yonca; Omma, Ahmet[Abstract Not Available]Öğe The Comparative One-Year Drug Survival Rate of Tumor Necrosis Factor Inhibitors in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis; Results from Turkbio Registry(Clinical & Exper Rheumatology, 2014) Sari, Ismail; Kalyoncu, Umut; Onat, Ahmet Mesut; Pamuk, Omer Nuri; Karadag, Omer; Kisacik, Bunyamin; Senel, Soner[Abstract Not Available]Öğe The Comparative One-Year Drug Survival Rate of Tumor Necrosis Factor Inhibitors in Patients with Rheumatoid arthritis and ankylosing spondylitis; results from Turkbio Registry.(Wiley, 2014) Sari, Ismail; Kalyoncu, Umut; Onat, Ahmet Mesut; Pamuk, Omer Nuri; Karadag, Omer; Kisacik, Bunyamin; Krogh, Niels Steen[Abstract Not Available]Öğe DERIVATION AND VALIDATION OF A NEW STILL ACTIVITY SCORE (SAS)(Bmj Publishing Group, 2019) Kalyoncu, Umut; Kasifoglu, Timucin; Omma, Ahmet; Bes, Cemal; Cinar, Muhammet; Emmungil, Hakan; Kucuksahin, Orhan[Abstract Not Available]Öğe Derivation and validation of adult Still Activity Score (SAS)(Elsevier France-Editions Scientifiques Medicales Elsevier, 2023) Kalyoncu, Umut; Kasifoglu, Timucin; Omma, Ahmet; Bes, Cemal; Cinar, Muhammet; Emmungil, Hakan; Kucuksahin, OrhanObjectives: Adult-onset Still's disease (AOSD) is a multi-systemic, autoinflammatory disorder. Several activity scores have been proposed but none of them have been adopted universally. Our aim was to create a clinician-friendly activity scoring system by using simple clinical and laboratory parameters.Methods: AODS patients, according to Yamaguchi criteria, were included in this cross-sectional, multi-center study. Derivation and validation cohorts were constituted. Demographic, clinical, and laboratory evaluation at the study visit; patients' and physicians' global assessments of disease activity (both VAS/Likert scale) were recorded. To develop the score, an ordinal logistic regression model was used to determine independent predictors of physicians' global assessments of disease activity. Clinically and statistically significant variables were weighted according to regression coefficients. Then, performance of the score was tested on the validation cohort. Results: A total of 197 consecutive AOSD patients (125 in derivation, 72 in validation cohorts) were included. Final Still Activity Score was fever (2 points), arthralgia (2 points, plus 1 point if arthritis was present in >= 2 joints), neutrophilia >= 65% (1 point) and ferritin >= 350 ng/mL (1 point) (maximum of 7 points). The SAS yielded an AUC value of 0.98 (0.96-1.00) in the derivation cohort and 0.91 (95%CI: 0.85-0.98) in the validation cohort to discriminate high AOSD activity from moderate-inactive AOSD. The correlation of SAS with PGA was 83% for the derivation cohort and 76% for the validation cohort. Conclusions: SAS has shown a good test performance to distinguish active AOSD patients from others. SAS may be a useful method for evaluating the disease activity of AOSD patients in daily practice.(c) 2022 Socie acute accent te acute accent franc , aise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.Öğe Epidemiological characteristics of hepatitis B and C in patients with inflammatory arthritis: Implications from treasure database(Turkish League Against Rheumatism, 2023) Ersozlu, Emine Duygu; Ekici, Mustafa; Coskun, Belkis Nihan; Badak, Suade Ozlem; Bilgin, Emre; Kalyoncu, Umut; Yagiz, BurcuObjectives: This study aimed to evaluate the hepatitis B (HBV) and C (HCV) frequency and clinical characteristics among patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) who receive biological treatments.Patients and methods: The observational study was conducted with patients from the TReasure database, a web-based prospective observational registry collecting data from 17 centers across Turkiye, between December 2017 and June 2021. From this database, 3,147 RA patients (2,502 males, 645 females; median age 56 years; range, 44 to 64 years) and 6,071 SpA patients (2,709 males, 3,362 females; median age 43 years; range, 36 to 52 years) were analyzed in terms of viral hepatitis, patient characteristics, and treatments used.Results: The screening rate for HBV was 97% in RA and 94.2% in SpA patients. Hepatitis B surface antigen (HBsAg) positivity rates were 2.6% and 2%, hepatitis B surface antibody positivity rates were 32.3% and 34%, hepatitis B core antibody positivity rates were 20.3% and 12.5%, HBV DNA (deoxyribonucleic acid) positivity rates were 3.5% and 12.5%, and antibody against HCV positivity rates were 0.8% and 0.3% in RA and SpA patients, respectively. The HBsAg-positive patients were older and had more comorbidities, including hypertension, diabetes, and coronary artery disease. In addition, rheumatoid factor (RF) positivity was more common in HBsAg-positive cases. The most frequently prescribed biologic disease-modifying antirheumatic drugs were adalimumab (28.5%), etanercept (27%), tofacitinib (23.4%), and tocilizumab (21.5%) in the RA group and adalimumab (48.1%), etanercept (31.4%), infliximab (22.6%), and certolizumab (21.1%) in the SpA group. Hepatitis B reactivation was observed in one RA patient during treatment, who received rituximab and prophylaxis with tenofovir.Conclusion: The epidemiological characteristics of patients with rheumatic diseases and viral hepatitis are essential for effective patient management. This study provided the most recent epidemiological characteristics from the prospective TReasure database, one of the comprehensive registries in rheumatology practice.Öğe GO-BEYOND: A REAL-WORLD PERSISTENCE STUDY WITH GOLIMUMAB IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS AND RHEUMATOID ARTHRITIS IN TURKEY(Bmj Publishing Group, 2019) Akar, Servet; Kalyoncu, Umut; Dalkili, Ediz; Emmungil, Hakan[Abstract Not Available]Öğe GO-BEYOND: a real-world study of persistence of golimumab in patients with axial spondyloarthritis and rheumatoid arthritis in Turkey(Future Medicine Ltd, 2021) Akar, Servet; Kalyoncu, Umut; Dalkilic, Ediz; Emmungil, Hakan; Aziz, Ayten; Esen, Yasemin; Koc, TubaAim: To evaluate the retention rate of golimumab (GLM) in patients with rheumatoid arthritis (RA) and axial spondyloarthritis (ax-SpA). Materials & methods: Patients had received/were receiving GLM as their first or second biological drug for at least 3 months. We recorded demographic and clinical data, data on drug continuation and disease activity. Patients were classified as biologic-naive and biologic-experienced. Results: The study included 60 RA and 269 ax-SpA patients. At month 24, the retention rates were 67.2 and 57.1% (biologic-naive and biologic-experienced RA) and 74.8 and 80.4% (anti-TNF-naive and -experienced ax-SpA). No significant differences in retention were observed between the biologic-naive and -experienced groups for either disease. Conclusion: The results of this study confirm the effectiveness of GLM in the treatment of RA and axSpA with good retention rates at 2 years in a real-world setting in Turkey.Öğe Items of Yamaguchi Criteria Might be Associated with Disease Severity and Prognosis in Adult-Onset Still's Disease(Wiley, 2015) Kalyoncu, Umut; Solmaz, Dilek; Emmungil, Hakan; Yazici, Ayten; Kasifoglu, Timucin; Kimyon, Gezmis; Balkarli, Ayse[Abstract Not Available]Öğe Methodology of a new inflammatory arthritis registry: TReasure(Tubitak Scientific & Technological Research Council Turkey, 2018) Kalyoncu, Umut; Tascilar, Etem Koray; Ertenli, Ali Ihsan; Dalkilic, Huseyin Ediz; Bes, Cemal; Kucuksahin, Orhan; Kasifoglu, TimucinBackground/aim: The TReasure registry, created in 2017, is an observational multicenter cohort that includes inflammatory arthritis patients. This article reviews the methodology and objectives of the TReasure registry established to collect data from rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients. Methodology: Fifteen rheumatology centers in Turkey will contribute data to the TReasure database. The actual proprietor of the database is the Hacettepe Rheumatology Association (HRD) and Hacettepe Financial Enterprises. Pharmaceutical companies that operate in Turkey (in alphabetical or er), Abbvie, Amgen, BMS, Celltrion Healthcare, Novartis, Pfizer, Roche, and UCB, support the TReasure registry. TReasure is a web-based database to which users connect through a URL (https://www.trials-network.org/treasure) with their unique identifier and passwords provided for data entry and access. TReasure records demographic and clinical features, comorbidities, radiology and laboratory results, measures of disease activity, and treatment data. Discussion: TReasure will provide us with various types of data, such as a cross-sectional view of the current nationwide status of the patients currently receiving these treatments, and retrospective data as much as allowed by the participating centers' records. Finally, a high-quality prospective dataset will be built over the ensuing years from patients with a new diagnosis of RA or SpA.Öğe A multicenter report of biologic agents for the treatment of secondary amyloidosis in Turkish rheumatoid arthritis and ankylosing spondylitis patients(Springer Heidelberg, 2016) Pamuk, Omer Nuri; Kalyoncu, Umut; Aksu, Kenan; Omma, Ahmet; Pehlivan, Yavuz; Cagatay, Yonca; Kucuksahin, OrhanIn this multicenter, retrospective study, we evaluated the efficacy and safety of biologic therapies, including anti-TNFs, in secondary (AA) amyloidosis patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA). In addition, the frequency of secondary amyloidosis in RA and AS patients in a single center was estimated. Fifty-one AS (39M, 12F, mean age: 46.7) and 30 RA patients (11M, 19F, mean age: 51.7) with AA amyloidosis from 16 different centers in Turkey were included. Clinical and demographical features of patients were obtained from medical charts. A composite response index (CRI) to biologic therapy-based on creatinine level, proteinuria and disease activity-was used to evaluate the efficacy of treatment. The mean annual incidence of AA amyloidosis in RA and AS patients was 0.23 and 0.42/1000 patients/year, respectively. The point prevalence in RA and AS groups was 4.59 and 7.58/1000, respectively. In RA group with AA amyloidosis, effective response was obtained in 52.2 % of patients according to CRI. RA patients with RF positivity and more initial disease activity tended to have higher response rates to therapy (p values, 0.069 and 0.056). After biologic therapy (median 17 months), two RA patients died and two developed tuberculosis. In AS group, 45.7 % of patients fulfilled the criteria of good response according to CRI. AS patients with higher CRP levels at the time of AA diagnosis and at the beginning of anti-TNF therapy had higher response rates (p values, 0.011 and 0.017). During follow-up after anti-TNF therapy (median 38 months), one patient died and tuberculosis developed in two patients. Biologic therapy seems to be effective in at least half of RA and AS patients with AA amyloidosis. Tuberculosis was the most important safety concern.Öğe Nationwide Experience With Off-Label Use of Interleukin-1 Targeting Treatment in Familial Mediterranean Fever Patients(Wiley, 2018) Akar, Servet; Cetin, Pinar; Kalyoncu, Umut; Karadag, Omer; Sari, Ismail; Cinar, Muhammed; Yilmaz, SedatObjectiveApproximately 30-45% of patients with familial Mediterranean fever (FMF) have been reported to have attacks despite colchicine treatment. Currently, data on the treatment of colchicine-unresponsive or colchicine-intolerant FMF patients are limited; the most promising alternatives seem to be anti-interleukin-1 (anti-IL-1) agents. Here we report our experience with the off-label use of anti-IL-1 agents in a large group of FMF patients. MethodsIn all, 21 centers from different geographical regions of Turkey were included in the current study. The medical records of all FMF patients who had used anti-IL-1 treatment for at least 6 months were reviewed. ResultsIn total, 172 FMF patients (83 [48%] female, mean age 36.2 years [range 18-68]) were included in the analysis; mean age at symptom onset was 12.6 years (range 1-48), and the mean colchicine dose was 1.7 mg/day (range 0.5-4.0). Of these patients, 151 were treated with anakinra and 21 with canakinumab. Anti-IL-1 treatment was used because of colchicine-resistant disease in 84% and amyloidosis in 12% of subjects. During the mean 19.6 months of treatment (range 6-98), the yearly attack frequency was significantly reduced (from 16.8 to 2.4; P < 0.001), and 42.1% of colchicine-resistant FMF patients were attack free. Serum levels of C-reactive protein, erythrocyte sedimentation rate, and 24-hour urinary protein excretion (5,458.7 mg/24 hours before and 3,557.3 mg/24 hours after) were significantly reduced. ConclusionAnti-IL-1 treatment is an effective alternative for controlling attacks and decreasing proteinuria in colchicine-resistant FMF patients.Öğe A Nationwide Experience with the Off Label Use of Interleukin 1 Targeting Treatment in Familial Mediterranean Fever Patients(Wiley, 2016) Akar, Servet; Cetin, Pinar; Kalyoncu, Umut; Karadag, Omer; Sari, Ismail; Cinar, Muhammed; Yilmaz, Sedat[Abstract Not Available]Öğe Preferences of inflammatory arthritis patients for biological disease-modifying antirheumatic drugs in the first 100 days of the COVID-19 pandemic(Tubitak Scientific & Technological Research Council Turkey, 2021) Kalyoncu, Umut; Pehlivan, Yavuz; Akar, Servet; Kasifoglu, Timucin; Kimyon, Gezmis; Karadag, Omer; Dalkilic, EdizBackground/aim: To evaluate treatment adherence and predictors of drug discontinuation among patients with inflammatory arthritis receiving bDMARDs within the first 100 days after the announcement of the COVID-19 pandemic. Materials and methods: A total of 1871 patients recorded in TReasure registry for whom advanced therapy was prescribed for rheumatoid arthritis (RA) or spondyloarthritis (SpA) within the 3 months (6-9 months for rituximab) before the declaration of COVID-19 pandemic were evaluated, and 1394 (74.5%) responded to the phone survey. Patients' data regarding demographic, clinical characteristics and disease activity before the pandemic were recorded. The patients were inquired about the diagnosis of COVID-19, the rate of continuation on bDMARDs, the reasons for treatment discontinuation, if any, and the current general disease activity (visual analog scale, [VAS]). Results: A total of 1394 patients (493 RA [47.3% on anti-TNF] patients and 901 SpA [90.0% on anti-TNF] patients) were included in the study. Overall, 2.8% of the patients had symptoms suggesting COVID-19, and 2 (0.15%) patients had PCR-confirmed COVID-19. Overall, 18.1% of all patients (13.8% of the RA and 20.5% of the SpA; p = 0.003) discontinued their bDMARDs. In the SpA group, the patients who discontinued bDMARDs were younger (40 [21-73] vs. 44 years [20-79]; p = 0.005) and had higher general disease activity; however, no difference was relevant for RA patients. Conclusion: Although the COVID-19 was quite uncommon in the first 100 days of the pandemic, nearly one-fifth of the patients discontinued bDMARDs within this period. The long-term effects of the pandemic should be monitored.Öğe Response rate of initial conventional treatments, disease course, and related factors of patients with adult-onset Still's disease: Data from a large multicenter cohort(Academic Press Ltd- Elsevier Science Ltd, 2016) Kalyoncu, Umut; Solmaz, Dilek; Emmungil, Hakan; Yazici, Ayten; Kasifoglu, Timucin; Kimyon, Gezmis; Balkarli, AyseBackground: Adult-onset Still's disease (AOSD) is a rare condition, and treatment choices are frequently dependent on expert opinions. The objectives of the present study were to assess treatment modalities, disease course, and the factors influencing the outcome of patients with AOSD. Methods: A multicenter study was used to reach sufficient patient numbers. The diagnosis of AOSD was based on the Yamaguchi criteria. The data collected included patient age, gender, age at the time of diagnosis, delay time for the diagnosis, typical AOSD rash, arthralgia, arthritis, myalgia, sore throat, lymphadenopathy, hepatomegaly, splenomegaly, pleuritic, pericarditis, and other rare findings. The laboratory findings of the patients were also recorded. The drugs initiated after the establishment of a diagnosis and the induction of remission with the first treatment was recorded. Disease patterns and related factors were also investigated. A multivariate analysis was performed to assess the factors related to remission. Results: The initial data of 356 patients (210 females; 59%) from 19 centers were evaluated. The median age at onset was 32 (16-88) years, and the median follow-up time was 22 months (0-180). Fever (95.8%), arthralgia (94.9%), typical AOSD rash (66.9%), arthritis (64.6%), sore throat (63.5%), and myalgia (52.8%) were the most frequent clinical features. It was found that 254 of the 306 patients (83.0%) displayed remission with the initial treatment, including corticosteroids plus methotrexate with or without other disease-modifying antirheumatic drugs. The multivariate analysis revealed that the male sex, delayed diagnosis of more than 6 months, failure to achieve remission with initial treatment, and arthritis involving wrist/elbow joints were related to the chronic disease course. Conclusion: Induction of remission with initial treatment was achieved in the majority of AOSD patients. Failure to achieve remission with initial treatment as well as a delayed diagnosis implicated a chronic disease course in AOSD. (C) 2016 Elsevier Ltd. All rights reserved.Öğe Short Term Efficacy of Tumor Necrosis Factor Inhibitors in Patients with non-radiographic Axial Spondylarthritis and ankylosing Spondylitis; Results from Turkbio Registry.(Wiley, 2014) Cetin, Pinar; Kalyoncu, Umut; Kisacik, Bunyamin; Sari, Ismail; Solmaz, Dilek; Karadag, Omer; Onat, Ahmet Mesut[Abstract Not Available]Öğe Uveitis-related Factors in Patients With Spondyloarthritis: TReasure Real-Life Results(Elsevier Science Inc, 2021) Bilge, Nazife Sule Yasar; Kalyoncu, Umut; Atagunduz, Pamir; Dalkilic, Ediz; Pehlivan, Yavuz; Kucuksahin, Orhan; Bes, CemalPURPOSE: Spondyloarthritis (SpA) is a group of diseases with overlapping skeletal and extra-articular features. Acute anterior uveitis (AAU) is the most common extra-articular manifestation of SpA. The relation between AAU and SpA is well defined in the current literature. Our study aims to analyze the frequency and factors associated with AAU in different forms of SpA in a large nationwide cohort of Turkish SpA patients. DESIGN: Retrospective cohort study. METHODS: The data were obtained from the TReasure database, which compiles data from records of the web-based Rheumatoid Arthritis (RA) and SpA patients treated with biological disease-modifying anti-rheumatismal drugs from different regions of Turkey. The clinical characteristics of SpA and uveitis are recorded. RESULTS: Data of the 4,297 SpA patients were included in the study. Overall, 475 of 4,297 patients (11.0%) had experienced 1 or more episodes of uveitis. SpA patients with older age (P<.001), a smoking history (P=.004), delayed diagnosis (P=.001), longer disease duration (P<.001), arthritis (P<.001), positive HLA-B27 (P<.001), a family history of SpA (P<.001), and radiographic damage (presence of sacroiliitis, syndesmophytes, bamboo spine, hip involvement) (P<.001 for all) more commonly had uveitis. On the other hand, uveitis was less prevalent in patients with psoriasis and psoriatic arthritis (P<.001 for both). CONCLUSION: Uveitis may be the key feature leading to SpA diagnosis. Patients with radiographic damage and long disease duration have an increased risk for uveitis in both male and female SpA patients. Patients with uveitis should be referred to a rheumatologist for a thorough evaluation of SpA. ((C) 2021 Elsevier Inc. All rights reserved.)
