Publications by authors named "Gian D Sebastiani"

Article Synopsis
  • The study aimed to explore gender differences in the phenotypical expression of Behçet's disease (BD) using data from the International AIDA Network Registry, focusing on damage index, disease manifestations, and cardiovascular risk.
  • A total of 1024 patients (567 males and 457 females) were examined, revealing that males had a significantly higher overall damage index and more frequent occurrences of uveitis and vascular involvement, while females showed higher instances of arthralgia, arthritis, and CNS involvement.
  • Key factors associated with major organ involvement included male gender, treatment with biologic agents, origin from endemic regions, and longer disease duration, indicating a more severe course of BD in males compared to females.
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Background: In Italy, knee osteoarthritis (KOA) accounts for over 5 million prevalent cases and requires long-term multidisciplinary management. The most frequent KOA symptom is pain. The aim of the survey is to provide a national overview of the current management of moderate-to-severe pain associated with KOA from both clinicians' and patients' perspectives.

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  • The study aimed to understand physicians' preferences regarding diagnostic pathways and treatment priorities for systemic lupus erythematosus (SLE) through a discrete choice experiment (DCE).
  • A total of 95 clinicians, mainly rheumatologists, participated in the DCE, revealing that "referral time to a rheumatologist" was highly prioritized, especially in mild-moderate and severe SLE cases.
  • Results indicated a strong preference for treatments that prevent organ damage over other factors, with physician awareness about the critical need for timely diagnosis and prevention of damage in SLE management being consistent across different medical specialties.
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Objectives: Starting from the unmet need of early diagnosis and treatment in systemic lupus erythematosus (SLE), the study aims to explore patient preferences in diagnostic pathways and treatment modalities. It seeks to integrate clinical priorities with patient perspectives, providing an optimal approach to SLE treatment that remains uncertain.

Methods: A discrete choice experiment (DCE) has been conducted to investigate whether patient preferences align while maintaining consistent attributes and levels, providing a direct assessment of relative preferences and hypothetical treatment approaches in SLE.

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Purpose: The clinical relevance of human leukocyte antigen (HLA) subtypes such as HLA-B51 on Behçet's disease (BD)-related uveitis and non-infectious uveitis (NIU) unrelated to BD remains largely unknown.

Methods: Data were prospectively collected from the International AIDA Network Registry for BD and for NIU. We assessed differences between groups (NIU unrelated to BD and positive for HLA-B51, BD-related uveitis positive for HLA-B51 and BD-related uveitis negative for HLA-B51) in terms of long-term ocular complications, visual acuity (VA) measured by best corrected visual acuity (BCVA), anatomical pattern, occurrence of retinal vasculitis (RV) and macular edema over time.

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  • This study evaluated the effectiveness of a systemic score in predicting severe outcomes in patients with Still disease, including the risk of mortality and severe complications like macrophage activation syndrome.
  • Involving 597 patients, the study found that a higher systemic score significantly correlated with life-threatening outcomes, with scores of 7 or above indicating a greater risk.
  • Key components that were most predictive of severe outcomes included liver and lung involvement, emphasizing the importance of these factors in managing Still disease.
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Background: Intravenous iloprost has been widely used for the treatment of systemic sclerosis peripheral vasculopathy. No agreement has been found on the regimen and the dosage of intravenous iloprost in different scleroderma subset conditions. This study aimed to evaluate the modalities of intravenous iloprost administration within a large cohort of systemic sclerosis patients from the SPRING Registry and to identify any associated clinical-demographic, instrumental or therapeutic data.

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  • Psoriatic arthritis (PsA) is a long-lasting disease that affects people's joints and can cause various other health problems.
  • A group of 38 doctors in Italy looked at recent studies to come up with helpful tips on how to manage PsA.
  • They created 49 important statements that cover early diagnosis, different types of PsA, related health issues, and goals for treatment.
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Article Synopsis
  • - This study investigates whether pediatric-onset, adult-onset, and elderly-onset Still's disease are the same condition or different diseases by comparing demographic, clinical, and treatment response data across these age groups.
  • - Out of 411 patients surveyed, most were adults (76.4%), while 15.8% were pediatric and 7.8% were elderly, with significant differences found in symptoms like skin rash and arthritis being more prevalent in children, and pleuritis in the elderly.
  • - Overall, while some minor differences in symptoms and lab results were noted among the age groups, the study concludes that Still's disease has similar demographic and treatment characteristics across pediatric, adult, and elderly patients.
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: We aimed to analyse the incidence and severity of breakthrough infections (BIs) in rheumatoid arthritis (RA) patients after a COronaVIrus Disease 2019 (COVID-19) vaccination booster dose. : We enrolled 194 RA patients and 1002 healthcare workers (HCWs) as controls. Clinical, lifestyle and demographic factors were collected at the time of the third dose, and immunogenicity analyses were carried out in a subgroup of patients at 4-6 weeks after the third dose.

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  • The study aimed to compare COVID-19 outcomes among patients with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and spondyloarthritis (SPA) before vaccination, given conflicting data on their prognosis.
  • Analysis of the CONTROL-19 Database revealed that SLE and RA patients had similar severe outcome rates, while SPA patients had better outcomes than those with SLE.
  • Key risk factors for severe outcomes in SLE patients included being over 65, having hypertension, and using prednisone, while hydroxychloroquine use appeared to reduce risk.
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Article Synopsis
  • The study focuses on patients with Still's disease to identify clinical and laboratory signs associated with macrophage activation syndrome (MAS), a serious complication.
  • Out of 414 patients examined, 39 (9.4%) developed MAS, with several significant variables like liver involvement and high ferritin levels linked to its occurrence.
  • Multivariate analysis revealed that having hepatomegaly and monoarthritis were directly associated with MAS, while factors like a normal platelet count were protective against its development.
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Behçet's disease (BD) is a heterogeneous multifactorial autoinflammatory disease characterized by a plethora of clinical manifestations. Cutaneous lesions are considered hallmarks of the disease. However, their evolution over time and a thorough description are scarcely reported in non-endemic regions.

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Introduction: Interstitial lung diseases (ILDs) are diseases characterised by excessive deposition of collagen matrices in the pulmonary interstitium. Some of them are considered idiopathic (idiopathic pulmonary fibrosis - IPF), others are related to known pathologies such as connective tissue diseases (CTDs-ILD). Patient affected by ILD and features referable to CTD, not satisfying CTD criteria, are called Interstitial pneumonia with autoimmune features (IPAF) patients.

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  • The study focuses on the role of rheumatoid factor (RF) isotypes in diagnosing and predicting outcomes for rheumatoid arthritis (RA), aiming to improve diagnostic accuracy through a literature review and meta-analysis.
  • It involved analyzing 36 articles with data on 7,517 patients, highlighting that testing all RF isotypes gives the best sensitivity, while the IgA isotype offers the highest specificity and positive likelihood ratio.
  • Despite these findings, the study concluded that while RF isotyping can enhance diagnostic accuracy, it does not provide meaningful prognostic information due to inconsistent data.
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  • A study assessed the clinical characteristics and treatment effectiveness of methotrexate (MTX) in patients with Still's disease, focusing on changes in disease activity and inflammatory markers.
  • Among the 171 patients studied, MTX was commonly used with glucocorticoids (GCs), and many showed significant improvement, with 38.6% achieving clinical remission and reduced inflammation.
  • The results suggest that MTX is effective in managing Still's disease symptoms, reducing the need for GCs, though some patients discontinued MTX due to side effects or lack of efficacy.
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Introduction: This paper describes the creation and preliminary results of a patient-driven registry for the collection of patient-reported outcomes (PROs) and patient-reported experiences (PREs) in Behçet's disease (BD).

Methods: The project was coordinated by the University of Siena and the Italian patient advocacy organization SIMBA (Associazione Italiana Sindrome e Malattia di Behçet), in the context of the AIDA (AutoInflammatory Diseases Alliance) Network programme. Quality of life, fatigue, socioeconomic impact of the disease and therapeutic adherence were selected as core domains to include in the registry.

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Objectives: To present the results of a Delphi consensus survey among Italian rheumatologists on adherence to therapy in people with rheumatic and musculoskeletal diseases (RMDs) in Italy and the role of digital health.

Methods: A taskforce of 12 rheumatologists comprehensively discussed the applicability of the 2020 EULAR Points to Consider (PtCs) for Italian rheumatology practice and formulated 44 new country-specific statements. Through an on-line survey, the panellists voted on their level of agreement with the statements using a 10-point Likert scale (0: no agreement; 10: total agreement).

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Objective: To describe demographic, clinical and laboratory features of systemic sclerosis sine scleroderma (ssSSc) in a large multicentre systemic sclerosis (SSc) cohort.

Methods: Data involving 1808 SSc patients from Italian Systemic sclerosis PRogression INvestiGation registry were collected. The ssSSc was defined by the absence of any cutaneous sclerosis and/or puffy fingers.

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Objective: A subanalysis of the multicentre Early Lupus inception cohort was performed to investigate the real-world Glucocorticoids (GCs) Use in newly diagnosed systemic lupus erythematosus (SLE) Patients (GULP).

Methods: Patients starting prednisone (PDN) ≥5 mg/day and concomitant hydroxychloroquine or immunosuppressant within 12 months of SLE classification were enrolled. Core set variables were recorded at baseline and every 6 months, including changes in PDN dose, European Consensus Lupus Activity Measurement (ECLAM) and Systemic Lupus International Collaborating Clinics damage index.

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Article Synopsis
  • Psoriasis requires a team approach for effective management, particularly involving dermatologists and rheumatologists for patients with both psoriasis and psoriatic arthritis.* -
  • A group of experts has developed recommendations on when it's essential for these specialists to collaborate, either together or sequentially, based on different healthcare settings.* -
  • The recommendations include organizing a joint care unit for dermatology and rheumatology, outlining a patient journey that can guide future healthcare strategies for diagnosing and treating psoriasis.*
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