Polyarthritis flare in patient with ankylosing spondylitis treated with infliximab

Over the last ten years, the treatment of seronegative spondyloarthropathies has changed dramatically with the introduction of the anti-tumor necrosis factor alpha (TNFα) agents. Nevertheless, there is a growing number of studies describing several adverse reactions in patients treated with biological agents. In the present report we describe the case of a 22-year-old male patient with ankylosing spondylitis who developed a "paradoxic" adverse reaction, while receiving infliximab

AdS/QCD: The Relevance of the Geometry

We investigate the relevance of the metric and of the geometry in five-dimensional models of hadrons. Generically, the metric does not affect strongly the results and even flat space agrees reasonably well with the data. Nevertheless, we observe a preference for a decreasing warp factor, for example AdS space. The Sakai-Sugimoto model reduces to one of these models and the level of agreement is similar to the one of flat space. We also consider the discrete version of the five-dimensional models, obtained by dimensional deconstruction. We find that essentially all the relevant features of "holographic" models of QCD can be reproduced with a simple 3-site model describing only the states below the cut-off of the theory.Comment: 25 pages + appendix. v2 minor changes and Refs. adde

Eight-year retention rate of first-line tumor necrosis factor inhibitors in spondyloarthritis : A multi-center retrospective analysis

Objective. To evaluate the 8-year survival of the first TNF inhibitor (TNFi) in patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA), identify the predictive factors for withdrawal, and compare the discontinuation rates for infliximab, etanercept, and adalimumab. Methods. We evaluated PsA and axSpA patients treated with a first-line TNFi between 2005 and 2015 at four Italian tertiary centres. 8-year drug survival was calculated by Kaplan-Meier method and risk for discontinuation among treatment groups compared by stratified log-rank test. Univariate and multivariate Cox proportional hazard models were developed to examine predictors of withdrawal. Results. Out of 614 patients (316 axSpA, 298 PsA), 203 received adalimumab, 131 etanercept, and 280 infliximab, with similar frequencies in axSpA and PsA subgroups. The cumulative 8-year retention rate in the whole population was 55.1% (57.2 and 51.9% and for axSpA and PsA, respectively; p=NS). No significant differences were observed in drug persistence among individual TNFi in either group. Male sex (HR 0.595, 95% CI 0.405-0.875; p=0.008) and concomitant methotrexate use (HR 0.648, 95% CI 0.426-0.985; p=0.042) were associated with a lower risk of withdrawal in PsA and high baseline BASDAI (HR 0.9842 95% CI 0.9708-0.9980; p=0.028) in axSpA. No difference was found in the comparative analysis of reasons for discontinuation between PsA and axSpA. Conclusion. We reported that the real-life 8-year retention rate of the first TNFi in axSpA and PsA is over 50%, with no significant differences between axSpA and PsA and irrespective of the individual TNFi