Publications by authors named "Elefante E"
Objectives: Lung ultrasound (LUS) has been proposed as a useful tool for the assessment of interstitial lung disease (ILD) in connective tissue diseases. However, there are no studies investigating the significance of pleural irregularities (PI) on LUS in primary Sjögren's disease (SjD) patients. The aim of this study was to explore the role of PI for the assessment of SjD-related lung involvement.
View Article and Find Full Text PDFThe prevalence of Interstitial Lung Disease (ILD) and risk factors for its development in patients with primary Sjögren's syndrome (pSS) are still debated, possibly due to the existence of heterogeneous pSS-related ILD phenotypes. The aims of this study were: 1. To investigate the prevalence and predictive factors for ILD development in a single-center pSS cohort; 2.
View Article and Find Full Text PDFObjective: To assess the impact of different disease activity patterns-long quiescent (LQ), chronically active (CA) and relapsing-remitting (RR)-on health-related quality of life (HRQoL) in a cohort of patients with systemic lupus erythematosus (SLE).
Methods: A retrospective, monocentric analysis of prospectively collected data. Adult SLE outpatients were enrolled between 2017 and 2021.
Objectives: To analyse the response to immunosuppressants (IS) in extrarenal flares of SLE to determine the most appropriate timing during follow-up for a change in therapeutic strategy.
Methods: Observational cohort study including a total of 81 patients with SLE with extrarenal flares requiring a change in IS over the period 2015-2022. Baseline clinical variables were described, and follow-up data at 1, 3, 6 and 12 months time-points were collected.
Hyperinflammatory Coronavirus disease 2019 (COVID-19) and rapidly-progressive interstitial lung diseases (RP-ILD) secondary to inflammatory myopathies (IIM) present important similarities. These data support the use of anti-rheumatic drugs for the treatment of COVID-19. The aim of this study was to compare the efficacy of combining baricitinib and pulse steroids with the Standard of Care (SoC) for the treatment of critically ill COVID-19 patients.
View Article and Find Full Text PDFObjectives: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of systemic pauci-immune necrotising vasculitides involving small vessels, characterised by the presence of specific ANCA autoantibodies directed to leukocyte proteinase 3 (PR3-ANCA) or myeloperoxidase (MPO-ANCA) and subdivided into three clinical entities: granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA). The aetiology of AAV is unknown and many genetic, epigenetic and environmental factors have been reported to be involved in pathogenesis. Smoking is widely recognised as a risk factor for the development of many autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus.
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- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that presents with various symptoms and follows a pattern of flare-ups and remissions.
- The development of SLE involves a combination of genetic, hormonal, environmental, and other factors, with the exact mechanisms still not fully understood.
- The review focuses on how environmental factors influence both the occurrence of SLE and the severity of the disease in diagnosed patients.
Objectives: Undifferentiated connective tissue diseases (UCTDs) are systemic autoimmune conditions that cannot be diagnosed nor classified as defined CTD; the majority maintains an undifferentiated profile (stable UCTD, sUCTD) over time. Data on long-term outcomes of sUCTD are lacking.
Methods: Retrospective longitudinal analysis of an inception cohort of 141 patients with sUCTD.
Article Synopsis
- The study examined pregnancy outcomes in women with autoimmune rheumatic diseases (ARD) enrolled in the Italian P-RHEUM.it cohort from 2018 to 2023, focusing on maternal and infant health.
- Results showed that out of 866 pregnancies, 15.6% experienced maternal disease flares, 30.1% had obstetrical complications, and 91.7% resulted in live births, with a relatively low rate of perinatal deaths and complications.
- The research concluded that effective preconception counseling and proper medication management during pregnancy may help reduce disease-related risks, suggesting that outcomes for women with ARD were comparable to those in the general obstetric population.
Article Synopsis
- * The analysis involved reviewing data from 422 patients, where 102 received BEL. Key findings included significant improvements in disease control, with 47% of patients achieving low disease activity after 6 months, increasing to 75% after 12 months.
- * The study concluded that BEL is effective for managing SLE and is increasingly being used earlier in treatment, which can lead to lower glucocorticoid (GC) dosages over time compared to later treatment strategies.
Article Synopsis
- - Systemic lupus erythematosus (SLE) is a complex autoimmune disease known for diverse symptoms affecting multiple body systems, and its clinical course can vary greatly among patients.
- - Recent research advancements have improved SLE management and treatment, but many challenges—like understanding its causes and effective therapies—still exist for both patients and healthcare providers.
- - The 2023 updates focus on important topics such as biomarkers, clinical outcomes, co-existing conditions, and new treatment strategies based on real-world evidence.
Systemic Lupus Erythematosus (SLE) imposes a great burden on the lives of patients. Patients' and physicians' concerns about the disease diverge considerably. Physicians focus on controlling disease activity to prevent damage accrual, while patients focus on symptoms that impact on Health-Related Quality of Life (HRQoL).
View Article and Find Full Text PDFObjectives: Fatigue is prevalent in people with inflammatory rheumatic and musculoskeletal diseases (I-RMDs) and recognised as one of the most challenging symptoms to manage. The existence of multiple factors associated with driving and maintaining fatigue, and the evidence about what improves fatigue has led to a multifaceted approach to its management. However, there are no recommendations for fatigue management in people with I-RMDs.
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- This study assessed how well patients with systemic autoimmune diseases (SAD) follow their medication regimens, comparing pregnant women to non-pregnant women.
- Out of 200 enrolled patients, both groups showed generally good adherence to medications, but pregnant patients had a slightly higher adherence rate.
- Despite good adherence rates overall, around 30% of patients still struggled with following their prescriptions, highlighting the need for better communication and adherence monitoring, especially for non-pregnant women.
Lung involvement, especially interstitial lung disease, is a potentially severe extra-glandular manifestation of Primary Sjogren's Syndrome (pSS-ILD). ILD can manifest either as a late complication of pSS or anticipate sicca symptoms, likely reflecting two different patho-physiological entities. Presence of lung involvement in pSS subjects can remain subclinical for a long time; therefore, patients should be actively screened, and lung ultrasound is currently being investigated as a potential low cost, radiation-free, easily repeatable screening tool for detection of ILD.
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- SLE (Systemic Lupus Erythematosus) is primarily an autoimmune disease affecting women, but gender differences in its progression and treatment response are not fully understood.
- A study analyzed data from 417 SLE patients (51 men, 366 women) to investigate gender-related differences regarding disease onset, treatment, and long-term outcomes.
- Findings indicated men had a later disease onset and higher rates of specific conditions, while women experienced more hematological issues and used more azathioprine and glucocorticoids; however, overall disease outcomes were similar across genders, suggesting the need for close monitoring in both sexes.
Treat-to-target is a therapeutic approach based on adjustments to treatment at set intervals in order to achieve well-defined, clinically relevant targets. This approach has been successfully applied to many chronic conditions, and in rheumatology promising results have emerged for rheumatoid arthritis. For systemic lupus erythematosus (SLE), defining the most meaningful treatment targets has been challenging, due to disease complexity and heterogeneity.
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- - Systemic lupus erythematosus (SLE) is a long-lasting autoimmune disorder that can cause various symptoms and occurs in cycles of flare-ups and remission.
- - Recent research has revealed new information on SLE's underlying causes, potential biomarkers for diagnosis, and innovative treatment approaches to better manage the disease.
- - The review focuses on significant findings from 2022 regarding SLE, including insights into associated health issues and the reproductive health of individuals affected by the disease.
Article Synopsis
- - The study aimed to analyze extra-renal flares in Systemic Lupus Erythematosus (SLE), categorize them based on initial characteristics, and create a machine learning model to predict 'difficult to treat' (D2T) flares.
- - Researchers examined 420 SLE patients over five years, finding that 79 extra-renal flares were prevalent, mainly affecting the skin and joints, with a notable proportion classified as D2T due to insufficient remission rates after treatment.
- - The findings revealed that certain flare clusters, particularly those involving skin issues, had lower remission rates and required higher doses of glucocorticoids, emphasizing the need for better management strategies and supporting the potential
Behçet's Disease (BD) can be correlated with sleep impairment and fatigue, resulting in low quality of life (QoL); however, a comprehensive evaluation of this issue is still missing. We performed a systematic literature review (SLR) of existing evidence in literature regarding sleep quality in BD. Fifteen papers were included in the SLR.
View Article and Find Full Text PDFObjectives: Several studies show that age at onset has an impact on the clinical-serological presentation, comorbidities and disease course of patients with systemic lupus erythematosus (SLE). We evaluated whether, in patients with recent onset SLE, the age at onset correlates with clinical-serological manifestations and with comorbidities.
Methods: We analysed 171 patients with a SLE diagnosis obtained within 12 months of diagnosis enrolled in the Early Lupus project.
Primary Sjögren's syndrome (pSS) is a complex autoimmune disorder that particularly affects the salivary and lachrymal glands, generally causing a typical dryness of the eyes and of the mouth. The disease encompasses diverse clinical representations and is characterized by B-cell polyclonal activation and autoantibodies production, including anti-Ro/SSA. Recently, it has been suggested that autoantibody profiling may enable researchers to identify susceptible asymptomatic individuals in a pre-disease state.
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- This study investigates whether low-dose acetylsalicylic acid (LDASA) should be given to pregnant patients with Systemic Lupus Erythematosus (SLE) who have no history of kidney issues or positive antiphospholipid antibodies.
- Researchers analyzed 216 pregnancies from 187 patients, comparing outcomes between those treated with LDASA and those who were not; they found no significant differences in adverse pregnancy outcomes (APOs) between the two groups.
- While LDASA treatment did show a lower incidence of pre-eclampsia (2.4% vs 8.3%), the overall conclusion is that LDASA does not significantly reduce severe obstetric complications,
Objectives: The purpose of this study was to review the frequency and clinical presentation of the rarest clinical manifestations of systemic lupus erythematosus (SLE).
Methods: A list of 6 rare SLE manifestations were defined: gastrointestinal, liver, pulmonary, cardiac, ocular and neurological manifestations. Each topic was assigned to a pair of authors to perform a literature search and article review.