Publications by authors named "Musters A"
Background: Despite the widespread off-label use of methotrexate (MTX) for the treatment of atopic dermatitis (AD), there is limited high-quality evidence on dosing regimens and existing guidelines do not provide clear recommendations regarding dosing strategies.
Objective: The aim of this study was to achieve international consensus among AD experts to standardize the dosing regimen for MTX treatment in adults and children with AD.
Methods: An electronic Delphi (eDelphi) study was conducted from October 2021 to September 2022.
Background: Narrowband ultraviolet B (NB-UVB) phototherapy is commonly prescribed for patients with moderate-to-severe atopic eczema (AE). The efficacy of NB-UVB, however, has not yet properly been established, as current evidence is of low certainty. Our aim is to assess the short-term and long-term (cost-)effectiveness and safety of NB-UVB in adult AE patients by performing a pragmatic, multicenter, prospective, randomized, open-label, blinded-endpoint (PROBE) trial.
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- The study explores how patients on immunosuppressants (ISPs) respond to SARS-CoV-2 infections compared to healthy controls, particularly looking at antibody levels post-infection.
- Patients with immune-mediated inflammatory diseases (IMIDs) on different ISP therapies showed variable antibody responses, with those on anti-CD20 and sphingosine-1 phosphate therapies having lower antibody levels.
- Despite lower antibody titers, the breakthrough infections in these patients were mostly mild, indicating that ISPs may not severely impede the overall immune response to SARS-CoV-2.
Background: Although B-cell depleting therapy in rheumatoid arthritis (RA) is clearly effective, response is variable and does not correlate with B cell depletion itself.
Methods: The B-cell receptor (BCR) repertoire was prospectively analyzed in peripheral blood samples of twenty-eight RA patients undergoing rituximab therapy. Timepoints of achieved BCR-depletion and -repopulation were defined based on the percentage of unmutated BCRs in the repertoire.
Background: The noninflammatory immunoglobulin G4 (IgG4) is linked to tolerance and is unique to humans. Although poorly understood, prolonged antigenic stimulation and IL-4-signaling along the T helper 2-axis may be instrumental in IgG4 class switching. Recently, repeated SARS-CoV-2 mRNA vaccination has been linked to IgG4 skewing.
View Article and Find Full Text PDFThe reconstruction of clonal families (CFs) in B-cell receptor (BCR) repertoire analysis is a crucial step to understand the adaptive immune system and how it responds to antigens. The BCR repertoire of an individual is formed throughout life and is diverse due to several factors such as gene recombination and somatic hypermutation. The use of Adaptive Immune Receptor Repertoire sequencing (AIRR-seq) using next generation sequencing enabled the generation of full BCR repertoires that also include rare CFs.
View Article and Find Full Text PDFBackground: Evidence on the (long-term) safety of systemic immunomodulating therapies in atopic dermatitis (AD) generated by real-world data is sparse.
Objectives: To describe real-world reported adverse drug reactions (AEs) related to systemic immunomodulating therapy in patients with AD and to compare the incidence rates of AEs with the Summaries of Product Characteristics (SmPCs).
Methods: We conducted an observational prospective multi-centre cohort study, using the TREAT NL registry.
Article Synopsis
- The study investigates how combining methotrexate with adalimumab treatment affects drug concentration and response in psoriasis patients.
- A population PK-PD model was created from data collected over 49 weeks from 59 patients, revealing that methotrexate cotreatment reduces the development of antidrug antibodies, which can enhance the effectiveness of adalimumab.
- Overall, the findings suggest that using methotrexate alongside adalimumab can lead to better treatment outcomes by increasing adalimumab levels and potentially improving clinical responses.
Background: Patients with immune-mediated inflammatory diseases (IMIDs) on immunosuppressants (ISPs) may have impaired long-term humoral immune responses and increased disease activity after SARS-CoV-2 infection. We aimed to investigate long-term humoral immune responses against SARS-CoV-2 and increased disease activity after a primary SARS-CoV-2 infection in unvaccinated IMID patients on ISPs.
Methods: IMID patients on active treatment with ISPs and controls (i.
Virtual Reality Experience during Labour (VIREL); a qualitative study.
BMC Pregnancy Childbirth
April 2023
Background: There is increasing evidence that virtual reality (VR) is effective in the reduction of labour pain. The implementation of alternative methods like VR to reduce labour pain can contribute to reduce patient request for pharmacological pain management methods and associated side effects. The aim of this study is to examine women's experiences, preferences and satisfaction in regard to the use of VR during labour.
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- Sequencing B-cell and T-cell receptors helps us learn about the immune response but doesn't give details on their affinity or specificity.
- A new multiscale model is presented to better understand B-cell repertoires by comparing simulated results with actual experimental data.
- Findings indicate that clonal abundance doesn't necessarily correlate with affinity, and even low-abundance clones may possess high affinity, guiding future research approaches.
For patients with immune-mediated inflammatory diseases (IMIDs), concerns exist about increased disease activity after vaccination. We aimed to assess changes in disease activity after SARS-CoV-2 vaccination in patients with IMIDs, and determine risk factors for increased disease activity. In this substudy of a prospective observational cohort study (Target-to-B!), we included patients with IMIDs who received a SARS-CoV-2 vaccine.
View Article and Find Full Text PDFObjectives: To compare the cumulative incidence and disease severity of reported SARS-CoV-2 omicron breakthrough infections between patients with immune-mediated inflammatory diseases (IMID) on immunosuppressants and controls, and to investigate determinants for breakthrough infections.
Methods: Data were used from an ongoing national prospective multicentre cohort study on SARS-CoV-2 vaccination responses in patients with IMID in the Netherlands (Target-to-B! (T2B!) study). Patients wih IMID on immunosuppressants and controls (patients with IMID not on immunosuppressants and healthy controls) who completed primary immunisation were included.
Background: Rheumatoid arthritis (RA) is an autoimmune disease characterized by symmetrical peripheral polyarthritis in the hands and/or feet, leading to long-term disability if not treated effectively. RA is preceded by a preclinical phase, in which genetically predisposed individuals accumulate environmental risk factors, and during which autoimmunity develops, followed by the emergence of non-specific signs and symptoms before arthritis becomes manifest. Early treatment in at-risk individuals - i.
View Article and Find Full Text PDFBackground: Limited data are available on the effects of systemic immunomodulatory treatments on COVID-19 outcomes in patients with atopic dermatitis (AD).
Objective: To investigate COVID-19 outcomes in patients with AD treated with or without systemic immunomodulatory treatments, using a global registry platform.
Methods: Clinicians were encouraged to report cases of COVID-19 in their patients with AD in the Surveillance Epidemiology of Coronavirus Under Research Exclusion for Atopic Dermatitis (SECURE-AD) registry.
Background: The TREatment of ATopic eczema (TREAT) Registry Taskforce is a collaborative international network of registries collecting data of atopic eczema (AE) patients receiving systemic and phototherapy with the common goal to provide long-term real-world data on the effectiveness, safety and cost-effectiveness of therapies. A core dataset, consisting of domains and domain items with corresponding measurement instruments, has been developed to harmonize data collection.
Objectives: We aimed to give an overview of the status and characteristics of the eight established TREAT registries, and to perform a mapping exercise to examine the degree of overlap and pooling ability between the national registry datasets.
Background: In patients with rheumatoid arthritis (RA) different joints were shown to share the same dominant T-cell clones, suggesting shared characteristics of the inflammatory process and indicating that strategies to selectively target the antigen receptor might be feasible. Since T- and B-lymphocytes closely interact in adaptive responses, we analysed to what extent different joints also share dominant B-cell clones.
Methods: In 11 RA patients, quantitative B-cell receptor (BCR) repertoire analysis was performed in simultaneously obtained samples from inflamed synovial tissue (ST) from distinct locations within one joint, from multiple joints, from synovial fluid (SF) and peripheral blood (PB).
Background: Concerns have been raised regarding the risks of SARS-CoV-2 breakthrough infections in vaccinated patients with immune-mediated inflammatory diseases treated with immunosuppressants, but clinical data on breakthrough infections are still scarce. The primary objective of this study was to compare the incidence and severity of SARS-CoV-2 breakthrough infections between patients with immune-mediated inflammatory diseases using immunosuppressants, and controls (patients with immune-mediated inflammatory diseases not taking immunosuppressants and healthy controls) who had received full COVID-19 vaccinations. The secondary objective was to explore determinants of breakthrough infections of the delta (B.
View Article and Find Full Text PDF[Iatrogenic cecal perforation two days after a caesarian section].
Ned Tijdschr Geneeskd
February 2022
A 32-year-old healthy woman was seen two days after a complicated c-section with abdominal pain and vomiting. Inflammatory parameters were high and imaging showed a dilatated colon with intestinal pneumatosis. Surgical exploration showed an iatrogenic perforation of the coecum.
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- - The study investigates how specific immunosuppressive therapies affect the immune response to SARS-CoV-2 vaccination in patients with immune-mediated inflammatory disorders, focusing on the humoral immune response.
- - Conducted in the Netherlands with over 3,200 participants, the research compares the immune responses of patients on immunosuppressants to controls, including healthy individuals and those without systemic immunosuppressants.
- - Findings indicate that certain immunosuppressive treatments, like anti-CD20 therapy and S1P modulators, result in lower chances of achieving adequate immunity post-vaccination, regardless of the type of immune disorder present.
Article Synopsis
- Adalimumab is often used with methotrexate (MTX) for better treatment of rheumatoid arthritis and this study aimed to explore its effectiveness for chronic plaque psoriasis.
- The trial compared two groups: one receiving adalimumab alone and the other receiving adalimumab with MTX, analyzing factors like drug survival, response rates, and levels of antidrug antibodies.
- Results showed that the combination therapy led to fewer antidrug antibodies and a trend towards improved treatment response and drug survival, with no significant safety issues reported.
Background: Studies have suggested incremental short-term adverse events (AE) after repeated vaccination. In this report, we assessed occurrence and risk factors for short-term AEs following repeated SARS-CoV-2 vaccination in patients with various immune-mediated inflammatory diseases (IMIDs).
Methods: Self-reported daily questionnaires on AEs during the first 7 days after vaccination were obtained of 2259 individuals (2081 patients and 178 controls) participating in an ongoing prospective multicenter cohort study on SARS-CoV-2 vaccination in patients with various IMIDs in the Netherlands (T2B-COVID).