Evaluation of changes in bone metabolism in patients with rheumatoid arthritis and psoriatic arthritis treated with biological drugs DMARDs

Introduzione: Le malattie reumatiche infiammatorie croniche sono in grado di modificare il normale processo di rimodellamento osseo, in quanto possono determinare un aumento del riassorbimento o un decremento della neoapposizione ossea, o entrambi. Nell'artrite reumatoide (RA) e nell'artrite psoriasica (PsA) si osserva una significativa alterazione di tali meccanismi, dipendente in modo critico dagli osteoclasti. Scopo: Lo scopo del presente studio è stato quello di valutare la variazione di BMD e TBS in una popolazione di soggetti affetti da RA e PsA trattati con farmaci bDMARD non convenzionali (anti- TNF-α); valutare l'effetto dei bDMARD anti-TNF-α sull'osteoclastogenesi spontanea in soggetti affetti da RA e PsA in cellule mononucleate del sangue periferico (peripheral blood mononuclear cells – PMBCs) e di valutare gli effetti dei bDMARD anti-TNF-α sulla produzione di RANKL/OPG e regolatori del sistema Wnt (Dkk-1 e sclerostina) su campioni di siero pre-raccolto e sovranatante delle colture cellulari di PBMCs. Materiali e Metodi: Lo studio ha coinvolto 13 soggetti affetti da RA e 15 soggetti affetti da PsA, i quali sono stati assegnati a ricevere un trattamento con farmaci anti-TNF-α. Al baseline (per i soggetti sani e per i soggetti affetti da RA e PsA) ed ogni 3 mesi (per i soggetti con RA e PsA) per 12 mesi di follow-up è stato effettuato un prelievo ematico ai fini della valutazione in vitro della osteoclastogenesi spontanea da monociti-macrofagi isolati dal sangue periferico (PBMCs) e la quantificazione dei livelli sierici e nel sovranatante delle colture di PBMCs di RANKL, OPG e molecole regolatrici del sistema Wnt (Dkk-1 e scelrostina). Nei soggetti con RA e PsA è stata effettuata la valutazione della BMD e del TBS al basale e al termine del follow-up (12mesi). Risultati e Conclusioni: In questo studio è stato dimostrato che i pazienti con RA e PsA presentano una alterata modulazione dei sistemi RANKL/OPG e delle molecole regolatrici Wnt e che presentano una tendenza alla osteoclastogenesi spontanea che probabilmente gioca un ruolo fondamentale nella patogenesi del danno osseo, locale e sistemico. Inoltre la terapia con anti-TNF-α è in grado di modulare il sistema RANKL/OPG e anche le molecole regolatrici del sistema Wnt (Dkk-1 e sclerostina) e di esercitare un effetto inibitorio sulla osteoclastogenesi. I processi del danno osseo in RA e in SpA (ed in particolare in PsA) sono differenti ed estremamente complessi, in quanto sottointendono una stretta e complessa interazione tra cellule ossee, cellule midollari e cellule del sistema immunitario e probabilmente variano a seconda dello stadio evolutivo della malattia

Annual report

Fusionada amb: Annual report / Banca Intesa per a convertir-se en: Annual report / Intesa Sanpaol

Social and environmental report

Fusió de dos grans grups de banca italians: Banca Intesa i Sanpaolo IMI.Altres títols: Social report, Sustainability Repor

AB0691 ANALYSIS OF SARS-COV-2 ANTIBODIES IN NON-COVID-19 PATIENTS: COMPARISON BETWEEN SYSTEMIC SCLEROSIS PATIENTS AND HEALTHY CONTROLS

Background:Previous study evidenced a cross-reactivity between Sars-Cov-2 antibodies and autoimmune tissue antigen involved in connective tissue diseases, as nuclear antigen (NA), extractable nuclear antigen (ENA), histone and collagen (1). No study has been published about the titer of Sars-Cov-2 antibodies in non-infected patients with autoimmune disease.Objectives:To evaluate the titer of SARS-CoV-2 antibodies in non-COVID-19 patients and compare it between systemic sclerosis (SSc) patients and healthy controls (HC).Methods:A total of 58 patients with SSc (who fulfilled ACR/EULAR 2013 SSc classification criteria) and 18 HC were enrolled. Sera of all participants were collected, and SARS-CoV-2 antibodies (IgG and IgM) were evaluated by means ELISA. In all participants swabs for SARS-CoV-2 by real-time reverse-transcriptase-polymerase-chain-reaction assay were reported negative. Demographic, clinical, and autoimmune serological characteristics of SSc patients were recorded. The normal distribution was assessed using the Shapiro–Wilk's test. Exclusion criteria was previous or actual Sars-Cov-2 infection. Comparisons between study groups of patients were evaluated by the Student's t-test or Mann – Whitney U-test as appropriate. The differences between categorial variables were assessed by Pearson chi-square or Fisher's exact test, as opportune. Statistical significance was set at p ≤ 0.05.Results:We observed significant differences between SSc patients and HC in serum levels of Sars-Cov-2 antibodies (IgG: 1,4±2,1 AU/ml vs 0,36±0,19 AU/ml respectively (p=0,001); and IgM: 2,5±3,1 AU/ml vs 0,8±0,7 AU/ml (p=0,022)). In 5 SSc patients was found titer of Sars-Cov-2 antibodies (IgG) exceeding the cut-off, but the control of swabs for SARS-CoV-2 by real-time reverse-transcriptase-polymerase-chain-reaction assay were negative. No significative differences in Sars-Cov-2 autoantibodies titer were found in subgroup of SSc patients with or without ILD or PAH, limited or diffuse skin subset, and different autoantibodies profile. Furthermore, antibodies titer was not associated with different drugs (steroid, methotrexate, mofetil-mycophenolate and bosentan) in use.Conclusion:A cross mimicking between Sars-Cov-2 antibodies and antinuclear antibodies or anti ENA could be hypothesized. Further studies are necessary to unravel the reliability of Sars-Cov-2 antibodies detection in autoimmune disease.References:[1]Vojdani, A., Vojdani, E., & Kharrazian, D. (2021). Reaction of human monoclonal antibodies to SARS-CoV-2 proteins with tissue antigens: Implications for autoimmune diseases. Frontiers in Immunology, 11, 3679Disclosure of Interests:None declare

Role of external radiation therapy in urinary cancers

n/

Early lenalidomide treatment for low and intermediate-1 International Prognostic Scoring System risk myelodysplastic syndromes with del(5q) before transfusion dependence

Lenalidomide is approved for the treatment of transfusion-dependent (TD) del(5q) myelodysplastic syndromes (MDS). However, few data are available in patients with transfusion-independent (TI) del(5q) MDS. In the first, observational, part of this 2-part study, we assessed the impact of transfusion dependence on overall survival (OS) and non-leukemic death in untreated del(5q) MDS patients who were TD (n = 136),TI with hemoglobin (Hb) >= 10 mg/dL (n = 88),or TI with Hb = 10 g/dL],108 months;TI [Hb <10 g/dL],77 months;TD, 44 months). Transfusion dependence also negatively impacted non-leukemic death rates. In the interventional part of the study, baseline Hb levels were found to correlate significantly with physical (R = 0.666, P = 0.035) and fatigue (R = 0.604, P = 0.049) QoL scores. Median physical QoL scores improved significantly after 12 weeks' treatment with lenalidomide (+12.5;P = 0.020). Evaluable TI patients experienced early increases in Hb levels, and all attained an erythroid response. Our findings suggest that TI patients with moderate anemia may benefit from early treatment with lenalidomide

Prevalence, severity and correlates of fatigue in newly diagnosed patients with myelodysplastic syndromes

The primary objective of this study was to investigate factors associated with fatigue severity in newly diagnosed patients with higher-risk myelodysplastic syndromes (MDS). The secondary objectives were to assess symptom prevalence and to examine the relationships between fatigue, quality of life (QoL) and overall symptom burden in these patients. The analyses were conducted in 280 higher-risk MDS patients. Pre-treatment patient-reported fatigue was evaluated with the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale and QoL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Female gender (P = 0·018), poor performance status (i.e., ECOG of 2-4) (P < 0·001) and lower levels of haemoglobin (Hb) (P = 0·026) were independently associated with higher fatigue severity. The three most prevalent symptoms were as follows: fatigue (92%), dyspnoea (63%) and pain (55%). Patients with higher levels of fatigue also had greater overall symptom burdens. The mean global QoL scores of patients with the highest versus those with the lowest levels of fatigue were 29·2 [standard deviation (SD), 18·3] and 69·0 (SD, 18·8), respectively and this difference was four times the magnitude of a clinically meaningful difference. Patient-reported fatigue severity revealed the effects of disease burden on overall QoL more accurately than did degree of anaemia. Special attention should be given to the female patients in the management of fatigue