Prediction and benefits of minimal disease activity in patients with psoriatic arthritis and active skin disease in the ADEPT trial

Objectives: To determine the proportion of patients with psoriatic arthritis in the Adalimumab Effectiveness in Psoriatic Arthritis trial achieving minimal disease activity (MDA) and its individual components at 1 or more visits over 144 weeks, identify baseline predictors of MDA achievement, and evaluate the association of MDA status with independent quality of life (QoL)-related patient-reported outcomes (PROs). Methods: Univariate and multivariate analyses were used to identify the baseline characteristics that predicted achievement of MDA at individual time points (weeks 12 through 144) or sustained MDA (achievement of MDA at 2 consecutive time points 12 weeks apart). The association of independent QoL-related PROs with MDA achievement was evaluated at weeks 24 and 144. Results: In univariate analyses, higher baseline patient assessment of pain, tender joint count (TJC), enthesitis and Health Assessment Questionnaire-Disability Index (HAQ-DI) score were significantly associated with lower likelihood of achieving MDA at later time points. Multivariate analyses confirmed higher baseline HAQ-DI as a significant predictor for failure to achieve MDA at later time points. Achievement of sustained MDA was associated with lower baseline TJC and HAQ-DI score. Achievement of different MDA components appeared to be treatment dependent. MDA achievers had significantly better QoL-related PROs and greater improvements in PROs from baseline to week 24 compared with non-achievers. Conclusions: Higher HAQ-DI score was the most consistent baseline factor that decreased the likelihood of achieving MDA and sustained MDA at later time points. Achieving MDA was associated with better independent QoL-related PROs

Predicting adherence to therapy in rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis: a large cross-sectional study.

Objective: This analysis explored the association of treatment adherence with beliefs about medication, patient demographic and disease characteristics and medication types in rheumatoid arthritis (RA), psoriatic arthritis (PsA) or ankylosing spondylitis (AS) to develop adherence prediction models. Methods: The population was a subset from ALIGN, a multicountry, cross-sectional, self-administered survey study in adult patients (n=7328) with six immune-mediated inflammatory diseases who were routinely receiving systemic therapy. Instruments included Beliefs about Medicines Questionnaire (BMQ) and 4-item Morisky Medication Adherence Scale (MMAS-4 Results: A total of 3390 rheumatological patients were analysed (RA, n=1943; PsA, n=635; AS, n=812). Based on the strongest significant associations, the adherence prediction models included type of treatment, age, race (RA and AS) or disease duration (PsA) and medication beliefs (RA and PsA, BMQ-General Conclusions: For the first time, simple medication adherence prediction models for patients with RA, PsA and AS are available, which may help identify patients at high risk of non-adherence to systemic therapies. Trial registration number: ACTRN12612000977875

Low incidence of inflammatory bowel disease adverse events in adalimumab clinical trials across nine different diseases

OBJECTIVE: Adalimumab is approved for treatment of Crohn's disease and ulcerative colitis. Thus, we postulated that exacerbation or new-onset of inflammatory bowel disease (IBD) would be rare events in patients treated with adalimumab for non-IBD indications. This analysis evaluated the incidence of IBD adverse events (AEs) across adalimumab trials. METHODS: IBD AE rates in 75 adalimumab clinical trials in rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, pediatric enthesitis-related arthritis, uveitis, hidradenitis suppurativa, adult and pediatric psoriasis, psoriatic arthritis, non-psoriatic arthritis peripheral spondyloarthritis (pSpA), axial spondyloarthritis (axSpA), including non-radiographic axSpA and ankylosing spondylitis, were analyzed. Search terms for IBD AEs (new onset or worsening/flare) included IBD, ulcerative colitis, Crohn's disease, and ulcerative proctitis. RESULTS: This analysis included 24,114 patients, representing 36,508 patient-years (PY) of adalimumab exposure. The overall rate (95% CI) of IBD AEs in adalimumab-treated patients was 0.1 (0.1-0.2)/100 PY (41 events), ranging from no events (psoriatic arthritis, uveitis, and pediatric trials) to 0.8 (0.2-2.2)/100 PY in pSpA; the rate of IBD in axSpA was 0.6 (0.4-1.0)/100 PY. During placebo-controlled trials, the overall IBD rate was 0.1 (0.0-0.3)/100 PY for adalimumab (3 events in 6781 patients; 2752 PY of exposure) and 0.1 (0.0-0.4)/100 PY for placebo (1 event in 3493 patients; 1246 PY of exposure) groups; IBD rates in axSpA were 0.5 (0.1-1.4)/100 PY and 0.6 (0.0-3.1)/100 PY, respectively. CONCLUSION: The rates of IBD AEs in adalimumab clinical trials were generally low across the evaluated diseases, including axSpA; all events occurred in adult patients

Effectiveness of adalimumab in the treatment of scalp and nail affection in patients with moderate to severe plaque psoriasis in routine clinical practice

K

Toxicity of Magnetic Chitosan Micro and Nanoparticles as Carriers for Biologically Active Substances

Abstract Nanoparticles of inorganic magnetic core surrounded by layers of functional coatings are potential representatives of nanostructures for immobilization of bio-substances. Magnetic nanoparticles (MNPs) are often bound in aggregates due to a strong magnetic dipole, which has a lot of advantages, such as large surface area for binding biologically active substances. Chitosan is a polysaccharide polymer that is non-toxic, hydrophilic, biocompatible and has hydroxy and amino groups in its structure. Because of these chemical and biological properties it is a desirable bio-product for immobilization of enzymes and for binding of other biologically active substances. Magnetic micro and nanoparticles were synthesized with chitosan by three different methods; microemulsion process, suspension cross-linking technique and covalent binding of chitosan. Toxic effect of the prepared magnetic particles was determined as well and was examined on five different bacterial cultures; Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus faecalis and Klebsiella pneumoniae. At concentrations of 10-30 mg of magnetic particles per 0.5 McFarland Standard solution of E. coli and per 400 CFU of S. aureus, P. aeruginosa, E. faecalis in K. pneumonia, no inhibition on the chosen bacterial cultures was detected

Continuing versus withdrawing ixekizumab treatment in patients with axial spondyloarthritis who achieved remission : efficacy and safety results from a placebo-controlled, randomised withdrawal study (COAST-Y)

Objectives: The objective of COAST-Y was to evaluate the effect of continuing versus withdrawing ixekizumab (IXE) in patients with axial spondyloarthritis (axSpA) who had achieved remission. Methods: COAST-Y is an ongoing, phase III, long-term extension study that included a double-blind, placebo (PBO)-controlled, randomised withdrawal-retreatment period (RWRP). Patients who completed the originating 52-week COAST-V, COAST-W or COAST-X studies entered a 24-week lead-in period and continued either 80 mg IXE every 2 (Q2W) or 4 weeks (Q4W). Patients who achieved remission (an Ankylosing Spondylitis Disease Activity Score (ASDAS)3.5 at any visit) after the 40-week RWRP, with time-to-flare as a major secondary endpoint. Results: Of 773 enrolled patients, 741 completed the 24-week lead-in period and 155 entered the RWRP. Forty weeks after randomised withdrawal, 83.3% of patients in the combined IXE (85/102, p<0.001), IXE Q4W (40/48, p=0.003) and IXE Q2W (45/54, p=0.001) groups remained flare-free versus 54.7% in the PBO group (29/53). Continuing IXE significantly delayed time-to-flare versus PBO, with most patients remaining flare-free for up to 20 weeks after IXE withdrawal. Conclusions: Patients with axSpA who continued treatment with IXE were significantly less likely to flare and had significantly delayed time-to-flare compared with patients who withdrew to PBO

Primerjava postopkov in karakterizacija magnetnih nanodelcev, prevlečenih s hitozanom

In this study, magnetic maghemite nanoparticles were prepared with the coprecipitation method, due to its simplicity and productivity. Thereafter, chitosan-coated magnetic nanoparticles were synthesized with three different methods, the micro-emulsion process, the suspension cross-linking technique and the covalent binding. Subsequently, a comparison of the used methods was done using various analyses such as Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), thermogravimetry (TGA), differential scanning calorimetry (DSC), vibrating-sample magnetometry (VSM) and dynamic light scattering (DLS). The characterization results from Fourier transform infrared (FTIR) spectroscopy and thermogravimetric analysis (TGA) indicated a successful binding of chitosan on the magnetic nanoparticles. SEM pictures showed that spherical structured particles with an increased particle size were obtained as the chitosan layer around the particles was increased. Considering that the magnetic-separation technique has the advantages of rapidity, high efficiency, cost-effectiveness and lack of negative effect on the biological activity, these carriers may be applied in enzyme immobilization.V prispevku je opisana enostavna priprava magnetnih nanodelcev, prevlečenih s hitozanom. Postopek je potekal v dveh stopnjah. V prvi smo sintetizirali magnetne nanodelce s koprecipitacijo železovih ionov. V drugi smo nanodelce prevlekli s hitozanom, da bi preprečili aglomeracijo, z uporabo treh različnih postopkov: z metodo mikroemulzije, metodo zamreženja in s kovalentno vezavo. Karakterizacija tako pripravljenih nanodelcev je bila izvedena s Fourierjevo transformacijsko infrardečo spektroskopijo (FTIR), z vrstično elektronsko mikroskopijo (SEM), s termogravimetrično analizo (TGA), z diferencialno dinamično kalorimetrijo (DSC), z analizo vibracijskega magnetometra (VSM) in dinamičnim sipanjem laserske svetlobe (DLS). Rezultati analiz FTIR in TGA so potrdili vezavo hitozana na magnetne nanodelce, medtem ko je bila oblika in debelina sloja hitozana določena s SEM-analizo. Ker ima tehnika magnetnih nanodelcev veliko prednosti pri ločevanju, cenejši proizvodnji in nima negativnih učinkov na biološko aktivnost, se lahko potencialno uporablja pri encimski imobilizaciji

Development of Chitosan Functionalized Magnetic Nanoparticles with Bioactive Compounds

In this study, magnetic maghemite nanoparticles, which belong to the group of metal oxides, were functionalized with chitosan, a non-toxic, hydrophilic, biocompatible, biodegradable biopolymer with anti-bacterial effects. This was done using different synthesis methods, and a comparison of the properties of the synthesized chitosan functionalized maghemite nanoparticles was conducted. Characterization was performed using scanning electron microscopy (SEM) and vibrating sample magnetometry (VSM). Characterizations of size distribution were performed using dynamic light scattering (DLS) measurements and laser granulometry. A chitosan functionalization layer was confirmed using potentiometric titration on variously synthesized chitosan functionalized maghemite nanoparticles, which is important for further immobilization of bioactive compounds. Furthermore, after activation of chitosan functionalized maghemite nanoparticles with glutaraldehyde (GA) or pentaethylenehexamine (PEHA), immobilization studies of enzyme cholesterol oxidase (ChOx) and horseradish peroxidase (HRP) were conducted. Factors influencing the immobilization of enzymes, such as type and concentration of activating reagent, mass ratio between carrier and enzyme, immobilization time and enzyme concentration, were investigated. Briefly, microparticles made using the chitosan suspension cross-linking process (MC2) proved to be the most suitable for obtaining the highest activity of immobilized enzyme, and nanoparticles functionalized with chitosan using the covalent binding method (MC3) could compete with MC2 for their applications

Enzyme Activity and Physiochemical Properties of Flour after Supercritical Carbon Dioxide Processing

The objectives of this study were to inactivate the enzymes &alpha;-amylase, lipase, protease, and peroxidase in flour with supercritical carbon dioxide (scCO2), and to optimize the enzymatic treatment conditions. Enzyme inactivation is important, due to the undesirability of certain flour enzymes that cause adverse reactions during storage as unpleasant rancidity of flour, and, at the same time, reduce the shelf life of flour. Therefore, crude enzymes and flour were initially exposed to scCO2 to determine the effect on specific enzyme activity under appropriate conditions. The activity of the unwanted enzymes lipase and peroxidase decreased under optimal process conditions of scCO2 exposure, lipase by 30%, and peroxidase by 12%, respectively. It was discovered that the inactivation of enzymes in wheat flour occurred, where, at the same time, this sustainable method allows the regulation of enzyme activity in the baking process. Afterwards, the effect of scCO2 on the physicochemical properties of flour, morphological changes on starch granules, and content of total lipids was studied. In scCO2-treated white wheat flour, the fat content decreased by 46.15 &plusmn; 0.5%, the grain structure was not damaged, and the bread as the final product had a lower specific surface volume. Therefore, this could be a promising technology for flour pretreatment, potentially impacting the prolonging of its shelf-life

Transition towards sustainability

Transition to sustainability is a long-term challenge which should also actively engage consumers, as consumption causes environmental stress. In order to understand how consumers adopt eco-products, we conducted an extensive literature review of green consumerism and presented findings of 47 previous research works. In addition, this study’s aim was to explore whether consumers remain only concerned about the environment or whether they actually make a difference. Moreover, we examined gender differences. Because the relationship between consumers’ environmental concern and purchase intention is not straightforward, we aimed to explore the effect of consumers’ environmental concern on their purchase intention. The purpose of this paper was to explore how consumers’ familiarity with and consciousness of eco-products and their perceived sense of environmental responsibility mediate the relationship between consumers’ environmental concern and their purchase intention. We used structural equation modeling to test the proposed conceptual model based on a sample of 705 Slovenian consumers. Our findings suggest that all the above-mentioned constructs mediate the relationship between consumers’ environmental concern and their purchase intention in relation to eco-products. However, consumers’ consciousness of eco-products has the greatest effect in channeling environmental concern into purchase intention of eco-products. In addition, the findings indicate that female consumers express greater environmental concern, consciousness of eco-products, and perceived environmental responsibility than male consumers. The paper concludes with policy and managerial implications, theoretical implications, limitations of the study, and future research directions based on the findings of consumers’ perspectives