Impact of vitamin D on rheumatoid arthritis: real or just patient’s perception?

Aim: In this study, our aims were to identify vitamin D levels in rheumatoid arthritis (RA) individuals as compared to controls and the impact of vitamin D levels on both objective and subjective assessments in RA patients. Methods: The current study was a prospective case-control study conducted on 108 RA patients and 50 age-gender matched healthy controls. We first compared the levels of vitamin D among the RA patients and controls. Demographic and clinical data, parameters of disease activity, inflammatory markers, rheumatoid factor and anti-cyclic citrullinated peptide seropositivity and radiological damage scores were recorded in RA patients. These patients were also demanded to complete RA Quality of Life Questionnaire (RAQoL), fatigue severity scale (FSS)  and Health Assessment Questionnaire (HAQ).Results: D vitamin levels in RA patients were significantly lower than healthy controls (p=0.001). Vitamin D deficiency was determined in 73% of the RA patients and 52% of the controls. Vitamin D deficiency was not associated with disease activity (p=0.862). There was no significant relationship among vitamin D levels and all subjective and objective assessments (p>0.05 for all ). Conclusion: Vitamin D deficiency was common in RA participants than normal population. However, it was not shown that there was a significant relationship between vitamin D levels and objective and subjective assessments of disease, including disease activity, inflammatory markers, rheumatoid factor and anti-cyclic citrullinated peptide seropositivity, radiological damage scores, RAQoL, FSS and HAQ

Evaluation of hepatitis serology and frequency of viral reactivation in patients with inflammatory arthritis receiving biologic agents: a multicenter observational study

To evaluate of hepatitis serology and reactivation frequency in patients with rheumatic disease receiving biologic agents. Our study included patients with inflammatory rheumatic diseases from 23 centers, who were followed up with biological therapy. Demographic and clinical characteristics of the patients, duration of drug use and hepatitis serology and the state of viral reactivation were analyzed. A total of 4060 patients, 2095 being males, were included in our study. Of the patients, 2463 had Ankylosing Spondylitis (AS), 1154 had Rheumatoid Arthritis (RA), 325 had Psoriatic Arthritis (PsA), and 118 had other inflammatory rheumatic diseases. When the viral serology of the patients was evaluated, 79 patients (2%) who were identified as HBs Ag positive, 486 (12%) patients who were HBs Ag negative and anti-HBc IgG positive and 20 patients (0.5%) who were anti-HCV positive. When evaluated on a disease-by-disease basis, the rate of HBsAg was found to be 2.5% in RA, 2% in AS and 0.9% in PsA. Viral reactivation was detected in 13 patients while receiving biologic agents. HBs Ag was positive in nine patients with reactivation and negative in four patients. Anti-HBc IgG, however, was positive. Six of these patients had AS, four had RA, and three had PsA. The development of hepatitis reactivation in 11.4% of HBs Ag positive patients and 0.82% of anti-HBc IgG positive patients due to the use of biologic agents is an important problem for this group of patients. Antiviral prophylaxis is recommended to be started especially in patients who are HBs Ag positive and who are using biologic agents due to viral reactivation. Therefore, it is important to carry out hepatitis screenings before biologic agent treatment and to carefully evaluate the vaccination and prophylaxis requirements