A5006079113- Systemic Sclerosis and Related Diseases
- Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Rheumatoid Arthritis Research and Therapies
- Dermatologic Treatments and Research
- Inflammatory Myopathies and Dermatomyositis
- Mast cells and histamine
- Systemic Lupus Erythematosus Research
- Autoimmune and Inflammatory Disorders Research
- Connective Tissue Growth Factor Research
- Lymphoma Diagnosis and Treatment
- Chronic Lymphocytic Leukemia Research
- Diagnosis and Treatment of Venous Diseases
- Cardiovascular Function and Risk Factors
- Autoimmune Bullous Skin Diseases
- Pulmonary Hypertension Research and Treatments
- Dupuytren's Contracture and Treatments
- Medical Imaging and Pathology Studies
- Urticaria and Related Conditions
- Skin Diseases and Diabetes
- Bone and Joint Diseases
- Eosinophilic Esophagitis
- Spondyloarthritis Studies and Treatments
- Monoclonal and Polyclonal Antibodies Research
- Eosinophilic Disorders and Syndromes
- Fibromyalgia and Chronic Fatigue Syndrome Research
Leiden University Medical Center
2016-2025
Leiden University
2017-2023
Mongolian National University
2023
Mongolian National University of Medical Sciences
2023
Azienda Ospedaliera Universitaria Pisana
2022
University of Pisa
2022
University Medical Center
2020
Center for Rheumatology
2016-2019
University of Florence
2019
Rambam Health Care Campus
2019
Several treatment strategies have proven value in the amelioration of rheumatoid arthritis (RA), but optimal strategy for preventing long-term joint damage and functional decline is unclear. We undertook this study to compare clinical radiographic outcomes 4 different strategies, with intense monitoring all patients.In a multicenter, randomized trial, 508 patients were allocated 1 strategies: sequential disease-modifying antirheumatic drug monotherapy (group 1), step-up combination therapy...
<h3>Objectives:</h3> To compare the occurrence of drug-free remission, functional ability and radiological damage after 4 years response-driven treatment according to four different strategies for rheumatoid arthritis (RA). <h3>Methods:</h3> Patients with recent-onset, active RA (n = 508) were randomly assigned strategies: (1) sequential monotherapy; (2) step-up combination therapy; (3) initial therapy prednisone (4) infliximab. Treatment was adjusted based on 3-monthly disease activity...
Abstract Objective To determine associations of methotrexate (MTX) efficacy and toxicity with single‐nucleotide polymorphisms (SNPs) in genes coding for folate pathway enzymes patients early rheumatoid arthritis (RA). Methods Patients (n = 205) active RA received MTX at an initial dosage 7.5 mg/week, which was increased to 15 mg/week combined folic acid (1 mg/day) after 4 weeks. If the Disease Activity Score 44 joints (DAS44) >2.4 3 months, 25 mg/week. evaluated 6 months compared...
To develop a matrix model for the prediction of rapid radiographic progression (RRP) in subpopulations patients with recent-onset rheumatoid arthritis (RA) receiving different dynamic treatment strategies.Data from 465 RA randomised to receive initial monotherapy or combination therapy were used. Predictors RRP (increase Sharp-van der Heijde score > =5 after 1 year) identified by multivariate logistic regression analysis. For subpopulations, estimated risk per group and number needed treat...
Several treatment strategies have proven value in the amelioration of rheumatoid arthritis (RA), but optimal strategy for preventing long-term joint damage and functional decline is unclear. We undertook this study to compare clinical radiographic outcomes 4 different strategies, with intense monitoring all patients.In a multicenter, randomized trial, 508 patients were allocated 1 strategies: sequential disease-modifying antirheumatic drug monotherapy (group 1), step-up combination therapy...
Objectives: To evaluate changes in bone mineral density (BMD) the hands, hip and spine after 1 2 years of follow-up, relation to antirheumatic antiresorptive therapies disease demographic variables patients with recent-onset rheumatoid arthritis (RA). Methods: Changes BMD measured metacarpals 2–4 by digital x -ray radiogrammetry dual energy absorptiometry were assessed at baseline follow-up 218 RA from BeSt study, who received one four treatment strategies: sequential monotherapy (group 1);...
Objectives: To compare the efficacy of Disease Activity Score (DAS)-driven therapy and routine care in patients with recent-onset rheumatoid arthritis. Methods: Patients arthritis receiving traditional antirheumatic from either BeSt study, a randomised controlled trial comparing different treatment strategies (group A), or two Early Arthritis Clinics B) were included. In group A, systematic DAS-driven adjustments aimed to achieve low disease activity (DAS ⩽2.4). B, was left discretion...
Abstract Objective Among patients with rheumatoid arthritis (RA), there is a high degree of interindividual variability in the response to methotrexate (MTX) treatment. This study was undertaken explore polymorphisms genes contributing antiinflammatory adenosine release as novel predictors MTX treatment outcome. Methods In 205 newly diagnosed RA, 5 coding for enzymes related were analyzed. All received standardized (up 25 mg per week orally), combined folic acid. efficacy evaluated by...
Abstract Objective To evaluate the efficacy of infliximab plus methotrexate (MTX) as induction therapy in patients with early rheumatoid arthritis (RA). Methods Disease‐modifying antirheumatic drug (DMARD)–naive active, RA who were included group 4 BeSt study initially treated (3 mg/kg) combination MTX (25 mg/week). The Disease Activity Score (DAS) was measured every 3 months. In persistent low disease activity (DAS ≤2.4) for at least 6 months, dosage tapered and finally discontinued; then...
Abstract Objective In classic studies on the genetic background of antibody production, major histocompatibility complex (MHC) has been shown to act as most prominent immune response gene that controls magnitude and specificity production. The strongest risk factor for rheumatoid arthritis (RA), human MHC HLA–DRB1 shared epitope (SE) alleles, predisposes antibodies against citrullinated proteins (ACPAs). ACPA levels are higher in SE‐positive patients with RA than SE‐negative RA. aim present...
To compare the clinical and radiological efficacy of initial vs delayed treatment with methotrexate (MTX) infliximab (IFX) in patients recent onset rheumatoid arthritis (RA).In a post hoc analysis BeSt study (for Behandel Stratagieen, Dutch for strategies), 117 who started MTX+IFX were compared 67 after failing (disease activity score (DAS)>2.4; median delay to IFX: 13 months) on > or =3 traditional DMARDs. If DAS remained >2.4, protocol dictated IFX dose increases 6, 7.5 10 mg/kg. In case <...
To determine the association of HLA-DRB1, rheumatoid factor (RF), and anti-citrullinated protein antibody (ACPA) status with progression joint damage in early arthritis (RA) treated according to different treatment strategies.The present study was conducted using data from BeSt (Behandelstrategieën voor Reumatoide Artritis [treatment strategies for arthritis]), a randomized trial comparing 4 targeted (toward achievement Disease Activity Score [DAS] < or =2.4) strategies: sequential...
Abstract Objective To evaluate societal costs and quality‐adjusted life years (QALYs) of treatment strategies for patients with recent‐onset active rheumatoid arthritis (RA). Methods Patients (n = 508) were randomly allocated to 1 4 strategy groups: sequential monotherapy, step‐up combination therapy, initial therapy prednisone, or infliximab. For 2 years, reported cost utility measures. Results Average QALYs (ideally 2.00) groups 1–4 1.29, 1.31, 1.32, 1.41, respectively, the British EuroQol...
<h3>Objectives:</h3> We examined the effects of four different treatment strategies on bone mineral density (BMD) in patients with recently diagnosed, active rheumatoid arthritis (RA) and influence disease-related demographic factors BMD loss after 1 year follow-up BeSt trial. <h3>Methods:</h3> measurements lumbar spine total hip were performed 342 recent onset RA at baseline year. Multivariable regression analyses to determine independent associations between disease parameters...
<h3>Objectives:</h3> To determine the efficacy of subsequent disease modifying antirheumatic drug (DMARD) therapies after initial methotrexate (MTX) failure in patients with recent onset rheumatoid arthritis (RA), treated according to DAS for 2 years. <h3>Methods:</h3> In groups 1 and BeSt study, 244 RA were initially MTX 15–25 mg/week. Patients who discontinued because insufficient clinical response (disease activity score, >2.4) or toxicity classified as "MTX failures." group 1, these...
<h3>Objective</h3> To evaluate the effect of disease activity and antirheumatic treatment on blood pressure (BP) in patients with recent-onset rheumatoid arthritis (RA). <h3>Methods</h3> 508 RA were randomised to receive (1) sequential monotherapy, (2) step-up combination therapy, (3) initial prednisone or (4) infliximab. Systolic diastolic BP (SBP, DBP), score (DAS) body mass index (BMI) evaluated every 3 months. A linear mixed model was used SBP DBP each group during year 1, adjusting for...
(1) Hypothesis testing of the potency rituximab (RTX) in preventing fibrotic complications and (2) assessing acceptability feasibility RTX early systemic sclerosis (SSc).A small, 24-month, randomised, double-blind, placebo-controlled, single-centre trial patients with SSc diagnosed <2 years was conducted. Patients received or placebo infusions at t=0, t=15 days t=6 months. were clinically evaluated every 3 months, lung function tests high-resolution CT other visit. Skin biopsies taken...
To evaluate the prevalence of anti-extractable nuclear antigen (anti-ENA) antibodies in Dutch SSc patients and predictive power combination specific anti-ENA nailfold videocapillaroscopy (NVC) patterns to improve identification with high risk for cardiopulmonary involvement.A total 287 (79%) from Leiden SSc-Cohort had data available on NVC-pattern (no SSc-specific, early, active, late) antibodies. Associations between anti-ENA/NVC combinations parameters were explored using logistic...
Objective The greatest genetic effect reported for systemic sclerosis (SSc) lies in the major histocompatibility complex (MHC) locus. Leveraging largest SSc genome-wide association study, we aimed to fine-map this region identify novel human leucocyte antigen (HLA) variants associated with susceptibility and its main clinical serological subtypes. Methods 9095 patients 17 584 controls genotyped were used impute test single-nucleotide polymorphisms (SNPs) across MHC, classical HLA alleles...
Abstract Objective To investigate the effectiveness of 4 different treatment strategies for recent‐onset rheumatoid arthritis (RA) on 2‐year patient‐reported outcomes, including functioning and quality life. Methods A total 508 patients with RA were randomly assigned to 1) sequential monotherapy, 2) step‐up combination therapy, both starting methotrexate, 3) initial a tapered high‐dose prednisone, or 4) therapy methotrexate infliximab. Treatment was adjusted every 3 months if Disease...
<b>Objective:</b> To determine treatment preferences among patients with recent onset rheumatoid arthritis participating in a randomised controlled trial comparing four therapeutic strategies. <b>Methods:</b> A questionnaire was sent to all 508 participants of the BeSt trial, treated for an average 2.2 years either sequential monotherapy (group 1), step-up combination therapy 2), initial tapered high-dose prednisone 3), or infliximab 4). Treatment adjustments were made every 3 months achieve...
<h3>Objectives:</h3> Osteoporosis is a well-known extra-articular phenomenon in patients with uncontrolled, long-standing rheumatoid arthritis (RA). In the present study, extent of osteoporosis and reduced bone mineral density (BMD) disease-related demographic factors that are associated BMD were examined recently diagnosed, active RA. <h3>Methods:</h3> total hip lumbar spine was measured using dual-energy <i>x</i> ray absorptiometry 381 diagnosed RA, who had never been treated DMARDs or...