Publications by authors named "Bahar Artim Esen"

Introduction: Psoriatic arthritis (PsA) is a heterogeneous disease with various manifestations such as dactylitis, enthesitis, spondylitis, and skin involvement. Minimal disease activity (MDA) has been successfully used in daily clinical practice and is considered a reasonable treatment target in patients with PsA. In this study, we aimed to evaluate the MDA status and associated factors in patients with PsA in our tertiary referral clinic.

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  • - This study examined the occurrence and effects of antinuclear antibodies (ANA) in patients with antiphospholipid antibodies (aPL) but without other systemic autoimmune diseases, using data from the APS ACTION Registry.
  • - Among the 430 analyzed patients, 56% tested positive for ANA, revealing significant links between ANA positivity and various autoimmune features like hematologic issues and joint involvement.
  • - Despite the presence of these autoimmune characteristics in ANA-positive patients, the study found no connection between ANA status and complications related to thrombosis or pregnancy; interestingly, ANA-negative patients had more pregnancies and live births.
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Objectives: We aimed to analyze the prevalence, mortality, and prognostic factors in systemic sclerosis (SSc) patients with pulmonary hypertension (PH) with or without interstitial lung disease (ILD).

Methods: The associations between mortality and demographics, transthoracic echocardiography, right heart catheterization (RHC), pulmonary functional parameters at baseline, and treatment modalities in two groups; patients with pulmonary arterial hypertension (PAH, PH without significant ILD) and PH + ILD were evaluated.

Results: The mean age of the patients was 56.

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Objectives: Inflammatory endothelial activation is a prominent feature of vascular involvement in Behçet's disease (BD), which is usually accompanied by a thrombotic tendency. Recent studies suggest an association between ABO blood groups and thrombotic vascular disease in those carrying non-O (A, B, and AB) groups. This study aimed to analyse the contribution of ABO blood groups to the vascular involvement in BD.

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Background/aim: In this prospective study, we aimed to investigate the association of serum (s) and urine (u) IP-10, galectin-9, and SIGLEC-1 with disease activity in patients with systemic lupus erythematosus (SLE).

Materials And Methods: Sixty-three patients with active SLE (31 renal, 32 extrarenal) were included. Thirty patients with inactive SLE (15 renal, 15 extrarenal), 17 with renal active AAV, and 32 healthy volunteers were selected as control groups.

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  • Systemic lupus erythematosus (SLE) significantly increases the risk of cardiovascular disease, prompting a study to evaluate traditional cardiovascular risk factors in SLE patients worldwide between 2015 and 2020.
  • The study included 3,401 SLE patients from 24 countries, predominantly women, revealing high rates of hypertension (35.6%), obesity (23.7%), and hyperlipidaemia (19.8%), with poor control of these risk factors across the board.
  • Notably, patients with antiphospholipid syndrome had higher prevalence of cardiovascular risks but showed better control of blood pressure and lipid levels compared to those without, highlighting international discrepancies in risk factor management.
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Background/aim: B-cell depletion with rituximab (RTX) is widely used as a rescue therapy in patients with systemic sclerosis (SSc). The aim herein was to analyze the progress of disease-related outcomes after RTX therapy in severe SSc patients.

Materials And Methods: Included in this study were 27 SSc patients who were followed-up between 2012 and 2020 and received at least 1 cycle of RTX for active disease, despite receiving standard immunosuppressives (ISs).

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Background/aim: In this cross-sectional study, it was aimed to test the predictive value of noncriteria antiphospholipid antibodies (aPL) in addition to the global antiphospholipid syndrome score (GAPSS) in predicting vascular thrombosis (VT) in a cohort of patients with APS and aPL (+) systemic lupus erythematosus (SLE).

Material And Methods: This study included 50 patients with primary APS, 68 with SLE/APS, and 52 with aPL (+) SLE who were classified according to VT as VT ± pregnancy morbidity (PM), PM only or aPL (+) SLE. Antiphospholipid serology consisting of lupus anticoagulant (LA), anticardiolipin (aCL) immunoglobulin G (IgG)/IgM/IgA, antibeta2 glycoprotein I (aβ2GPI) IgG/IgM/IgA, antiphosphatidylserine/prothrombin (aPS/PT) IgG/IgM and antidomain-I (aDI) IgG was determined for each patient.

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Background/aim: The aim of this study is to evaluate the baseline F18-FDG PET/CT findings of individuals diagnosed with giant cell arteritis (GCA) and to explore its association with clinical findings and classification criteria.

Materials And Methods: We analysed data from patients who underwent F18-FDG PET/CT scans to investigate large vessel (LV) involvement between 2010 and 2019. Only patients with a clinical diagnosis of GCA and at least 6 months of follow-up were included.

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  • Idiopathic inflammatory myositis (IIM) is a rare disease that can affect not just muscles but also other body parts, and the study looks at how a special scan called PET/CT can help in understanding it better.
  • The researchers studied IIM patients who were actively getting treatment and compared their test results with those of non-IIM patients who had cancer to see how accurate the scans were.
  • The findings suggest that the PET/CT scans showed more signs of muscle activity in IIM patients compared to those without IIM, meaning the scans could be useful for checking how severe the disease is.
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  • The study looked at why patients with systemic lupus erythematosus (SLE) are hospitalized and found that about 10% of them go to the hospital each year, with most costs coming from these hospital visits.
  • Out of 161 patients analyzed, most were women, and many were hospitalized multiple times, usually for about 25 days.
  • The biggest reasons for hospital stays were active disease, infections, and complications from SLE, with infection leading to more readmissions and longer hospital stays.
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Background: Long-term anticoagulant therapy is generally recommended for thrombotic antiphospholipid syndrome (TAPS) patients, however it may be withdrawn or not introduced in routine practice.

Objectives: To prospectively evaluate the risk of thrombosis recurrence and major bleeding in non-anticoagulated TAPS patients, compared to anticoagulated TAPS, and secondly, to identify different features between those two groups.

Patients/methods: Using an international registry, we identified non-anticoagulated TAPS patients at baseline, and matched them with anticoagulated TAPS patients based on gender, age, type of previous thrombosis, and associated autoimmune disease.

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Objective: In this study, our pregnant systemic lupus erythematosus (SLE) cohort, which was under medical surveillance of both our Rheumatology and Obstetrics departments, was analyzed. We intended to determine the effects of pregnancy on disease activity and the correlation between disease flares and adverse pregnancy outcomes.

Methods: One hundred sixty eight pregnancy data involving 136 patients with SLE were examined.

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  • This study evaluated the clinical, laboratory, and genetic characteristics of patients with AA amyloidosis, primarily focusing on those with inflammatory rheumatic diseases.
  • A total of 174 patients were analyzed, revealing that familial Mediterranean fever (FMF) was the leading cause of AA amyloidosis, with a significant portion carrying the p.M694V genetic variant.
  • The study found that kidney function at admission strongly predicted disease progression and mortality rates increased with more severe organ involvement, emphasizing the importance of early diagnosis and treatment to manage the disease effectively.
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Objective: To develop new antiphospholipid syndrome (APS) classification criteria with high specificity for use in observational studies and trials, jointly supported by the American College of Rheumatology (ACR) and EULAR.

Methods: This international multidisciplinary initiative included four phases: (1) Phase I, criteria generation by surveys and literature review; (2) Phase II, criteria reduction by modified Delphi and nominal group technique exercises; (3) Phase III, criteria definition, further reduction with the guidance of real-world patient scenarios, and weighting via consensus-based multicriteria decision analysis, and threshold identification; and (4) Phase IV, validation using independent adjudicators' consensus as the gold standard.

Results: The 2023 ACR/EULAR APS classification criteria include an entry criterion of at least one positive antiphospholipid antibody (aPL) test within 3 years of identification of an aPL-associated clinical criterion, followed by additive weighted criteria (score range 1-7 points each) clustered into six clinical domains (macrovascular venous thromboembolism, macrovascular arterial thrombosis, microvascular, obstetric, cardiac valve, and hematologic) and two laboratory domains (lupus anticoagulant functional coagulation assays, and solid-phase enzyme-linked immunosorbent assays for IgG/IgM anticardiolipin and/or IgG/IgM anti-β-glycoprotein I antibodies).

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  • - The study aimed to create new and more specific classification criteria for antiphospholipid syndrome (APS) in collaboration with the American College of Rheumatology (ACR) and EULAR, using a detailed four-phase methodology.
  • - The new criteria require at least one positive antiphospholipid antibody test and assign points across six clinical and two laboratory domains, classifying patients with a minimum of 3 points in both areas as having APS.
  • - Compared to the older Sapporo criteria, the 2023 ACR/EULAR criteria showed a significant increase in specificity (99% vs. 86%) but slightly lower sensitivity (84% vs. 99%), demonstrating a more refined approach to diagnosing APS.
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Background: Rituximab (RTX) is being used for both induction and maintenance of anti-neutrophil cytoplasmic antibody (ANCA) -associated vasculitis. However, the efficacy of RTX for the granulomatous findings of granulomatosis with polyangiitis (GPA) has not been demonstrated as clearly as its vasculitic manifestations.

Case Summary: A 46-year-old man was diagnosed in 2019 with GPA with constitutional symptoms, bilateral mastoiditis, prostatic necrosis, nodules in both lungs, pauci-immune necrotizing glomerulonephritis and high level of PR3-ANCA.

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Objectives: Our primary objective was to quantify damage burden measured by Damage Index for Antiphospholipid Syndrome (DIAPS) in aPL-positive patients with or without a history of thrombosis in an international cohort (the APS ACTION cohort). Secondly, we aimed to identify clinical and laboratory characteristics associated with damage in aPL-positive patients.

Methods: In this cross-sectional study, we analysed the baseline damage in aPL-positive patients with or without APS classification.

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Background: Data on use of interleukin (IL)-1 blockers in kidney transplant recipients (KTRs) with familial Mediterranean fever (FMF) are very limited. We aimed to evaluate the efficacy and safety of anakinra and canakinumab in the transplantation setting.

Methods: In this retrospective cohort study, we included KTRs who suffered from AA amyloidosis caused by FMF and treated with anakinra or canakinumab (study group, n = 36).

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Background/purpose: APS ACTION Registry was created to study the outcomes of patients with persistently positive antiphospholipid antibodies (aPL) with or without other systemic autoimmune disease (SAIDx). Given that immunosuppression (IS) is used for certain aPL manifestations, for example, thrombocytopenia (TP), our primary objective was to describe the indications for IS in aPL-positive patients without other SAIDx. Secondly, we report the type of IS used in patients with selected microvascular or non-thrombotic aPL manifestations.

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Objective: The skin pathergy test (SPT) is an important tool in the diagnosis of Behçet disease (BD), but its decreasing sensitivity over years has resulted in less frequent use in the clinical practice. This study aimed to improve the sensitivity of the SPT without compromising its specificity.

Methods: BD patients, patients with other inflammatory diseases, recurrent aphthous stomatitis, and healthy controls comprised the study group.

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Background: Systemic lupus erythematosus (SLE) is an autoimmune disease with a variety of organ/system involvement. Respiratory system involvement is common in these patients and usually manifests itself by disorders of the lung parenchyma, pleura, pulmonary vasculature or diaphragm. In this study, we sought to determine the frequency of interstitial lung disease (ILD) in patients with SLE and associated risk factors.

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Objective: Herein, we aimed to evaluate the frequency and clinical features of AA amyloidosis in patients with PsA followed up in our tertiary referral clinic.

Methods: We retrospectively evaluated PsA patients classified according to CASPAR classification criteria followed-up in our tertiary referral clinic for AA amyloidosis. The literature search was also done by three independent researchers using the keywords "psoriatic arthritis AND amyloidosis", "spondyloarthritis AND amyloidosis", "AA amyloidosis", "secondary amyloidosis".

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Objective: Sensitivity and specificity of SLE classification criteria may vary in different populations and clinical settings. In this study, we aimed to compare the performances of three criteria sets/rules (1997, 2012, and 2019) in a large cohort of patients and relevant diseased controls.

Methods: The medical records of consecutive SLE patients and diseased controls were reviewed for clinical and laboratory features relevant to all sets of criteria.

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