Publications by authors named "Irene Monjo"
Objectives: Giant cell arteritis (GCA) is a large/medium-vessel granulomatous vasculitis, and the PD-1/PD-L1 coinhibitory pathway seems to be implicated in its pathogenesis. CD4 T cells expressing high PD-1 levels, CD4+CXCR5-PD-1hi peripheral helper (Tph) and CD4+CXCR5+PD-1hi follicular helper T cells (Tfh), are key mediators of autoimmunity. Their frequencies are elevated in the peripheral blood of subjects with several autoimmune conditions but have not been investigated in GCA.
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- A distinct type of regulatory T cells, known as cTreg39+, play a role in reducing inflammation by converting pro-inflammatory adenine nucleotides into adenosine and their interaction with methotrexate (MTX) was studied in early rheumatoid arthritis (eRA).
- In a study involving 98 untreated eRA patients and 98 healthy controls, it was found that higher levels of cTreg39+ cells at baseline were associated with achieving low disease activity after 12 months of MTX treatment.
- The results indicate that MTX enhances the effectiveness of cTreg39+ cells while their baseline frequency can predict how well a patient will respond to MTX, suggesting that monitoring these cells could guide prompt treatment
Article Synopsis
- The study aimed to explore the formation of anti-drug antibodies (ADA) against infliximab (IFX) and how these relate to drug levels and patient outcomes in rheumatoid arthritis (RA) and spondyloarthritis (SpA).
- Serum samples were collected from 106 patients over time, and two different assays were used to detect ADA and measure IFX levels, with the drug-tolerant assay identifying ADA earlier than the drug-sensitive assay.
- Results showed that patients who developed ADA earlier had lower levels of IFX and shorter drug survival, suggesting early immunogenicity affects the treatment's effectiveness.
Objective: The aim of the present study was to determine the clinical significance of subclinical giant cell arteritis (GCA) in polymyalgia rheumatica (PMR) and ascertain its optimal treatment approach.
Methods: Patients with PMR who fulfilled the 2012 European Alliance of Associations for Rheumatology/American College of Rheumatology Provisional Classification Criteria for PMR, did not have GCA symptoms and were routinely followed up for 2 years and were stratified into two groups, according to their ultrasound results: isolated PMR and PMR with subclinical GCA. The outcomes (relapses, glucocorticoid use and disease-modifying antirheumatic drug treatments) between groups were compared.
Article Synopsis
- The study aimed to analyze the Disease Activity Score 28 (DAS28) and global assessments by patients (PGA) and physicians (PhGA) to better predict difficult-to-treat rheumatoid arthritis (D2TRA) classifications.
- Conducted from 2020 to 2022, the research involved 255 patients, categorizing them into D2TRA-inefficacy, D2TRA-other, and NoD2TRA based on their treatment responses to biological therapies.
- Results indicated that treatment trajectories showed significant changes in the first six months, with D2TRA-inefficacy patients exhibiting higher disease activity scores, while differentiating D2TRA-other cases proved more
Article Synopsis
- *%! Conducted with 86 patients using various biologic drugs, the study found that 86% of patients developed SARS-CoV-2 antibodies compared to 100% in healthy controls, with those on rituximab showing the weakest antibody response.
- *%! Although 14% of patients had no detectable antibodies, a subset of 30 patients evaluated for cellular response showed that 11 had a positive response, particularly those on rituximab,
Objective: To examine the performance of the new 2022 American College of Rheumatology (ACR)/EULAR giant cell arteritis (GCA) classification criteria for diagnosis in routine clinical care.
Methods: Multicentric retrospective observational study of patients referred to two ultrasound (US) fast track clinics. Patients with GCA were compared with unselected controls with suspected GCA.
Article Synopsis
- The study aimed to understand differences between patients with difficult-to-treat rheumatoid arthritis (D2TRA), focusing on those with treatment failures due to inefficacy versus other causes like adverse events or poor adherence.
- A total of 253 patients were analyzed, revealing no significant demographic differences between D2TRA patients and those who were successfully treated; however, those in the D2TRA-other group had fewer extra-articular manifestations.
- The findings suggest that patients categorized under D2TRA-other are similar to non-D2TRA patients at the beginning of treatment, indicating potential areas for better management and understanding of this condition.
Achievement rate and predictive factors of the recommended therapeutical target in patients with axial spondyloarthritis who remain on biological therapy: a prospective cohort study in Spain.
BMJ Open
April 2022
Article Synopsis
- A study aimed to assess the frequency of sustained remission (R) and low disease activity (LDA) in axial spondyloarthritis (axSpA) patients undergoing long-term biological therapy in a Spanish hospital.
- Among the 186 patients studied, 76.8% achieved some form of disease improvement at least once, but only about 40% maintained sustained R/LDA over time, particularly when using specific measures.
- Factors such as being male, younger age at therapy initiation, and testing positive for HLA*B27 were identified as predictors for achieving sustained improvement in disease activity.
Objectives: The European Alliance of Associations for Rheumatology (EULAR) recommendations for the use of imaging in large vessel vasculitis establish that an imaging test supported by clinical pretest probability (PTP) is sufficient for the diagnosis of giant cell arteritis (GCA). Our objective was to determine the validity of the EULAR recommendations on the use of Colour duplex ultrasound (CDUS) in GCA after calculating the PTP.
Methods: We collected data of all patients referred to our fast-track clinic between 2016 and 2020.
Objectives: To analyse the role of body mass index (BMI) in the clinical response to biologic dis-ease-modifying anti-rheumatic drugs (bDMARDs) in patients with rheumatoid arthritis (RA). To per-form an in-depth analysis of the pathophysiology of obesity by assessing serum adipokine levels and their potential changes according to treatment.
Methods: This study involved 105 patients with RA starting tumour necrosis factor inhibitors (TNFi) or tocilizumab (TCZ).
Objectives: To determine the prevalence of cerebrovascular events (CVE) in giant cell arteritis (GCA) and to alert clinicians to the importance of early detection of CVE in this disease.
Methods: Retrospective observational study involving a cohort of GCA patients. Demographic, clinical and laboratory data were collected.
Objective: The protagonism of regulatory B cells seems to vary along the course of the disease in murine models of inflammatory conditions. Decreased numbers of circulating regulatory CD19+CD24hiCD38hi transitional (cTr) B cells have been described in patients with long-standing RA, thus our objective was to examine the frequency and evolution of cTr B cells in the peripheral blood of early RA (ERA) patients.
Methods: Freshly isolated peripheral blood mononuclear cells from 48 steroid- and DMARD-naïve ERA patients with a disease duration of <24 weeks and 48 healthy controls (HCs) were examined by flow cytometry.
Reduction in antidrug antibody levels after switching to rituximab in patients with rheumatoid arthritis with prior infliximab or adalimumab secondary failure.
Semin Arthritis Rheum
February 2020
Objective: A novel population of B helper cells, phenotypically CD4+CXCR5-PD-1hi, has been described in the synovial tissues and peripheral blood of seropositive RA patients, and termed 'peripheral helper T' (Tph) cells. Contrary to CD4+CXCR5+PD-1hi follicular helper T (Tfh), Tph cells are not located in lymphoid organs but accumulate in inflamed tissues. Our objective was to study the frequency of circulating Tph (cTph) and circulating Tfh cell counterparts (cTfh) in patients with early RA (eRA).
View Article and Find Full Text PDFThe effect of methotrexate versus other disease-modifying anti-rheumatic drugs on serum drug levels and clinical response in patients with rheumatoid arthritis treated with tumor necrosis factor inhibitors.
Clin Rheumatol
March 2019
To investigate the effect of concomitant conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) with adalimumab or infliximab on maintaining serum drug and clinical outcomes after the first year of treatment in patients with rheumatoid arthritis (RA). Second, to assess the influence of methotrexate (MTX) dose on these outcomes. Ninety-two patients with RA starting infliximab (n = 67) or adalimumab (n = 25) tumor necrosis factor inhibitor (TNFi) with available drug levels and clinical improvement assessment (European League Against Rheumatism [EULAR] response) after 12 months were included.
View Article and Find Full Text PDFAtherosclerosis as a potential pitfall in the diagnosis of giant cell arteritis.
Rheumatology (Oxford)
February 2018
Objectives: To explore whether the increase in the intima-media thickness (IMT) in arteriosclerotic disease correlates with the increase in the IMT in temporal arteries (TAs) and if that could mimic the US GCA halo sign.
Methods: Consecutive patients ⩾50 years old with high vascular risk and without signs or symptoms of GCA were included. The carotid US IMT measurements were obtained using a standardized software radiofrequency-tracking technology.