Publications by authors named "Melanie Aureal"
Article Synopsis
- The study aims to assess the risk of global infections in patients with psoriatic arthritis (PsA) and axial spondyloarthritis who are treated with targeted therapies.
- They systematically reviewed data from 60 randomized controlled trials with over 20,000 patients to analyze the rates of infections linked to various treatments.
- Findings revealed a moderate increase in overall infection risk, particularly in patients with axial spondyloarthritis, mainly driven by the use of TNF and IL-17 inhibitors, but there was no notable increase in serious infections.
Objective: To estimate the incidence of infections among patients with psoriatic arthritis (PsA) or axial spondyloarthritis (axSpA), two distinct phenotypes included in the large group of spondyloarthritis (SpA), treated with tumour necrosis-factor-inhibitors, interleukin-17-inhibitors, Janus kinase-inhibitors, IL-23 or IL-12/23-inhibitors (IL-12/23i), phosphodiesterase 4-inhibitors or cytotoxic T-lymphocyte associated protein 4-Ig.
Methods: A meta-analysis of randomised controlled trials (RCTs), open-label extension and observational studies was conducted. Serious infections were defined as infections that were life-threatening, required intravenous antibiotics and/or hospitalisation.
Rheumatoid arthritis is characterized by synovial inflammation and irreversible bone erosions, both highlighting the immense reciprocal relationship between the immune and bone systems, designed osteoimmunology two decades ago. Osteoclast-mediated resorption at the interface between synovium and bone is responsible for the articular bone erosions. The main triggers of this local bone resorption are autoantibodies directed against citrullinated proteins, as well as pro-inflammatory cytokines and the receptor activator of nuclear factor-κB ligand, that regulate both the formation and activity of the osteoclast, as well as immune cell functions.
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- Chronic non-bacterial osteomyelitis (CNO) is a rare inflammatory bone disorder, with its multifocal form known as Chronic Recurrent Multifocal Osteomyelitis (CRMO), which the study examines across a cohort of patients in Europe and India.
- The research found no demographic differences by country, but patients in India experienced significantly longer diagnosis times and different rates of functional impairment, while raised acute phase reactants did not correlate with symptoms or treatment success.
- The study highlights variations in clinical presentation and treatment responses, emphasizing the need for more understanding of CNO/CRMO, as NSAIDs were used frequently with lower efficacy in Italy compared to other countries.