Real-life Tolerability and Effectiveness of Adalimumab Biosimilar in Ankylosing Spondylitis: the Adalimumab Biosimilar Patient Registry Data.

Objective: Adalimumab is a well-established anti-tumor necrosis factor therapy for patients with ankylosing spondylitis (AS). An indigenously developed biosimilar adalimumab (bADA) (ZRC-3197; Exemptia) is approved for prescribing in India. In this article, we present the effectiveness and tolerability of this bADA in real-life Indian patients with AS from the Adalimumab Biosimilar Patient Registry (ASPIRE) (ISRCTN: 16838474).

Recent Advances in Idiopathic Inflammatory Myopathies (IIM) - Rapid Discoveries of Myositis-specific Antibodies (MSAS) and Myositis-Associated Antibodies (MAAS) - Moving Towards 'Precision Medicine'.

The progress in the understanding of inflammatory muscle diseases over the past several decades has been slow but steady. The classification given by Bohan and Peter's in 1975 was based on clinical features. It served well, but inadequacies were also obvious.

Real-Life Tolerability and Effectiveness of Adalimumab Biosimilar in Rheumatoid Arthritis: ASPIRE Registry Data.

Introduction: The TNF-α blocker adalimumab is a well-proven therapy for rheumatoid arthritis (RA). A biosimilar adalimumab (ZRC-3197; Exemptia™), a 'fingerprint match' to reference adalimumab, has been approved for prescription in India since 2014. Here, we report on the effectiveness and tolerability of this biosimilar adalimumab (bADA) from the Adalimumab Biosimilar Patient Registry [ASPIRE; ISRCTN16838474], which contains data from real-life RA patients from India.

Screening for latent tuberculosis infection among patients with rheumatoid arthritis in the era of biologics and targeted synthetic disease-modifying anti-rheumatic drugs in India, a high-burden TB country: The importance of Mantoux and Quantiferon-TB Gold tests.

Aim: To test the validity of an augmented tuberculosis skin test (a-TST) combined with Quantiferon TB-gold (QFTG) test for the screening of latent tuberculosis infection (LTBI) in patients with rheumatoid arthritis (RA) being considered for treatment with biologic disease-modifying anti-rheumatic drugs or targeted synthetic disease-modifying anti-rheumatic drugs.

Method: Standard TST using 1 tuberculin unit (TU) of purified protein derivative (PPD, RT23 strain) was carried out. If the positivity was less as compared to the general population, then a-TST using 10 TU PPD was employed.

Switching from Other Biologics to ZRC3197 (Adalimumab Biosimilar) in Patients with Spondyloarthropathy: A Prospective Evaluation from Real-Life Clinical Practice.

Tumour necrosis factor inhibitors (TNFi) like Infliximab, Etarnacept and Adalimumab have been successfully studied in controlled clinical trials and are currently recommended in the treatment of patients with spondyloarthropathy (SPA). Significant proportion of patients in clinical studies have, however, failed to achieve a desired clinical response, or, are discontinued from the therapy due to secondary inefficacy or side effects. Therefore, owing to the different molecular structures and routes of administration, switching from one TNFi to another is considered as in important option in SPA patients eligible to receive TNFi therapy.

Tuberculosis and biologics in rheumatology: A special situation.

India has a huge patient burden of rheumatic diseases (RDs) including rheumatoid arthritis. The use of biologics has transformed the treatment paradigm for RD; however, biologic treatment-related infections (especially tuberculosis [TB]) are an area of potential concern for TB-endemic nations like India. Anti-tumor necrosis factor (TNF) therapy impairs the physiological TNF-mediated signaling and may cause reactivation and dissemination of latent TB infection (LTBI).

Cost-effective use of investigations in developing countries.

In recent years, the cost of health care around the world has risen at a rate that is deemed unsustainable. It has been estimated that 20% of this could be saved by rationalising laboratory investigations and reducing inappropriate requisitioning of the investigations. There are several reasons for the excessive, redundant, inappropriate or unnecessary investigations and procedures, which in some instances are unethical practices.

Acute inflammatory ankle arthritis in northern India--Löfgren's syndrome or Poncet's disease?

Objectives: To analyse patients presenting with acute inflammatory ankle arthritis from an aetiological standpoint; whether they had Löfgren's syndrome (acute presentation of sarcoidosis), or Poncet's disease (reactive arthritis due to tuberculosis infection). An additional objective was to establish a simple, practical yet optimal algorithm for diagnostic approach and management of such patients.

Methods: The study included 18 patients from northern India presenting with isolated acute inflammatory ankle arthritis.

Vertebral sarcoid mimicking ankylosing spondylitis or just a co-incidence?

Objective: To illustrate that among the protean musculoskeletal manifestations of sarcoidosis back pain that could mimic inflammatory back pain of ankylosing spondylitis (AS), should also be considered.

Method: A case report of a HLA B27 negative patient with classical features of inflammatory back pain that was initially diagnosed as AS is being presented. He showed poor response to standard treatment with nonsteroidal anti-inflammatory drugs and physiotherapy exercises with increasing symptoms of pain, stiffness and development of typical posture of AS.

Acute abdomen in SLE.

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune connective tissue disease with protean manifestations. Most often it presents with mucocutaneous, musculoskeletal or renal involvement. In comparison, gastrointestinal (GI) manifestations of SLE are far less common.

Low-dose and high-dose methotrexate are two different drugs in practical terms.

Methotrexate (MTX) was originally synthesised as an anti-cancer drug. Soon it was also used in immunoinflammatory diseases, mainly in the field of rheumatology. However, the dose used in oncology is several-fold higher as compared to the dose used in systemic immunoinflammatory rheumatological diseases.

Preventing tuberculosis flare in patients with inflammatory rheumatic diseases receiving tumor necrosis factor-alpha inhibitors in India -- An audit report.

Objective: To test the efficacies of a strategy for preventing tuberculosis (TB) in Indian patients with inflammatory rheumatic diseases (IRD) treated with tumor necrosis factor-alpha (TNF-alpha) inhibitor.

Methods: The screening strategy included tuberculosis skin test (TST), QuantiFERON-TB Gold (QTG) test, standard chest radiograph, and contrast enhanced-computerized tomography of the chest (CT).

Results: Among 53 patients screened, 17 (32%) had >or= 1 test positive, with 5 (9.