Publications by authors named "N Kougkas"
Monotherapy or combination therapy in PsA: current aspects.
Ther Adv Musculoskelet Dis
September 2024
Psoriatic arthritis (PsA) is an immune-mediated inflammatory disease with heterogeneity regarding its clinical features, mainly affecting the skin and the musculoskeletal system; additionally, extra-musculoskeletal manifestations and comorbidities are common, adding complexity to its treatment. In the last decades, a plethora of therapeutic options have been available, including conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs), biological DMARDs (bDMARDs), and targeted synthetic DMARDs (tsDMARDs), and many recommendations have been published regarding the proper use of them in patients with PsA. In rheumatoid arthritis, the combination of conventional with bDMARDs or tsDMARDs is a common and recommended practice, whereas in PsA there is scarce data about the benefit of this combination.
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- Differentiating between degenerative disc disease, diffuse idiopathic skeletal hyperostosis, and axial spondyloarthritis is challenging for patients with low back pain, necessitating a thorough evaluation of imaging features.
- A study reviewed 136 patients referred for low back pain to assess how inflammatory and degenerative traits differ among these conditions using methods like conventional radiographs and MRIs.
- Results showed that specific changes on imaging varied significantly across conditions, with distinct patterns in the lumbar, thoracic, and cervical spines, highlighting the need for careful diagnosis in clinical practice.
Objective: To present the characteristics of patients with potential difficult-to-treat (D2T) PsA.
Methods: We used data from the Greek multicentre registry of PsA patients. D2T PsA was defined as follows: patients with at least 6 months' disease duration, who have failed to at least one conventional synthetic DMARD and at least two biologic DMARDs/targeted synthetic DMARDs with a different mechanism of action and have either at least moderate disease activity (MODA) defined as DAPSA (Disease Activity index in PSoriatic Arthritis) >14, and/or are not at minimal disease activity (MDA).
Article Synopsis
- The JAK/STAT pathway plays a key role in various rheumatic diseases, leading to the development of JAK inhibitors for treatment, particularly in rheumatoid arthritis (RA).
- Filgotinib is a selective JAK1 inhibitor authorized for RA and ulcerative colitis, showing promising efficacy in clinical trials involving both treatment-naïve and experienced patients.
- Long-term studies indicate filgotinib improves disease activity and quality of life in RA, demonstrating non-inferiority to adalimumab, but also highlight potential risks for infectious side effects, excluding herpes zoster, which is infrequent.