ALIGNed on adherence: subanalysis of adherence in immune-mediated inflammatory diseases in the DACH region of the global ALIGN study.

Non-adherence to medication is a challenging problem in daily clinical practice. To assess reasons for non-adherence in patients with chronic immune-mediated inflammatory diseases (IMIDs) in a direct comparison including evaluation of treatment necessity and concerns. ALIGN was a non-interventional, multicountry, multicentre, self-administered, cross-sectional, epidemiologic survey study. Here, we investigate the German, Austrian and Swiss (DACH) cohort. Six hundred thirty-one patients with different IMIDs (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, plaque psoriasis, Crohn's disease and ulcerative colitis) under systemic therapies were evaluated concerning adherence, beliefs of necessity and concerns towards treatment in patients with IMIDs. The DACH cohort had significantly different levels of adherence depending on the IMID (P < 0.05) and the type of therapy (P < 0.05). Based on the significant influence of concerns on treatment adherence (P < 0.05) and the high belief of treatment necessity, patients could be classified in four attitudinal segments, which were unequally distributed throughout various IMIDs. High concerns had a significant influence on non-adherence, whereas necessity did not. Older age, female sex, TNFi mono-, conventional combination and TNFi combination therapy are positively associated with adherence. In the DACH region, patients are less concerned about medication and believe in the necessity of treatment. Therefore, we suggest adapting the communication in the various patient groups

Secretion of RANTES and interleukin-8 by the human gastric epithelial cell line (MKN45) through modulation with cytokines

In this vitro study, the secretion of interleukin-8 (IL-8) and RANTES proteins by the MKN45 gastric epithetial cell line was examined using the ELISA technique after the cells had been stimulated with pro-inflammatory cytokines, I,e,II, I "α" ,TNF-α and IFN-γ, The chemokines demonstrated a timedependent increase in concentration after stimulation with the various cytokines, alone or in combination, IL-I α was the weakest stimuli while a combination of IL-I α, TNF-α and IFN-γ provided the strongest stimulation. The immunomodulatory effects of IL-4 and IL-13 on the chemokine protein secretion were also studied. Stimulation of the cells with IL-4 and IL-13 for an hour at relatively high concentrations (10 and 30 ng/ml) prior to stimulation with the combination of IL-I α, TNF-α and IFN –γ inhibited the secretion of RANTES protein but did not inhibit the secretion of IL-8 mRNA of protwin. This inplied that the chemokines might have different inbitiory pathways. IL-4 and IL-13 played an important role in decreasing certain inflammatory chemokines and this might have an important effect in decreasing gastric inflammation