Alexandros A Drosos

University of Ioannina | UOI · Division of Rheumatology

Background There are limited data regarding therapy discontinuation in patients with giant cell arteritis (GCA) followed for a long period of time (>5 years). Objectives We aimed to evaluate the long-term rate and factors associated with therapy discontinuation in a real-life GCA cohort. Methods Patient and treatment data were collected at 3 diff...

Background Inflammatory rheumatic diseases (IRDs) are associated with an increased occurrence of comorbidities, including the risk of cancer, and especially lymphoma. It has been also hypothesized that the treatment, in some cases, may further increase this risk, particularly with the biologic disease modifying anti-rheumatic drugs (bDMARDs). Obje...

Background Systemic Sclerosis (SSc) is a complex connective tissue disease, with multiple organ involvement. The heart is frequently involved and all structures of the heart can be affected. Pericardial effusion (PE), although usually asymptomatic, has been associated with reduced survival in SSc cohorts [1,2]. Most studies, however, have focused o...

Introduction: Rheumatoid arthritis (RA) is an autoimmune disorder with a characteristic chronic inflammation of the synovium that may lead to the destruction of the joints in untreated patients. Interestingly, despite the availability of several effective treatments, many patients do not achieve remission or low disease activity or may experience...

Calcium pyrophosphate deposition (CPPD) disease is a form of crystal-induced arthropathy that arises from the accumulation of calcium pyrophosphate crystals within joints and soft tissues. This process leads to inflammation and damage to the affected joints. It can present asymptomatically or as acute or chronic inflammatory arthritis. Risk factors...

Introduction Psoriasis is an inflammatory skin disease that in some cases is accompanied by systemic manifestations. Given the varied clinical manifestations, the term psoriatic disease probably better reflects the clinical picture of these patients. Literature review In most cases, the skin lesions precede joint involvement as well as other poten...

The rates of relapses and therapy discontinuation in patients with giant cell arteritis (GCA) in the modern therapeutic era have not been defined. We aimed to evaluate the glucocorticoid (GC) discontinuation rate and the factors associated with relapses in a contemporary GCA cohort. Patient and treatment data were collected cross-sectionally at fir...

Vasculitis is the umbrella term for a spectrum of heterogeneous inflammatory vascular diseases. Due to a considerable overlap between different types of diseases, in 1992 the Chapel Hill consensus conference introduced a general classification according to the size of the involved vessels, differentiating between large, medium size and small vessel...

A wide spectrum of various laboratory and immunological tests are available in the everyday clinical practice for patients with rheumatic diseases. Some tests help physicians in establishing a diagnosis or simply categorising/classifying a suspected disease. Others, demonstrate the extent but also the nature of any pathological changes, while other...

Relapsing polychondritis (RP) is an uncommon disorder of unknown aetiology which is at the crossroad between auto-inflammatory and autoimmune diseases. It is characterised by recurrent inflammation of cartilaginous structures throughout the body especially of the ears, nose, eyes and tracheobronchial tree. It was described by Jaksch-Wartenhorst as...

The history of ultrasound as a phenomenon, dates back to 1794 when an Italian biologist discovered that bats can navigate and find their prey using sound waves that cannot be heard by the human ear. This discovery was the responsible for the understanding of sound waves and their applications. In 1880, Pierre and Jacques Curie described the piezoel...

Osteoarthritis (OA) is the most common form of arthritis worldwide. It is a degenerative chronic condition of the joints that affects all of the weight-bearing components of the joint (articular cartilage, menisci, bone) and most often affects the knees, hips, lower back, neck, small joints of the fingers and the bases of the thumbs and big toe. Ri...

Systemic Lupus Erythematosus (SLE) is an autoimmune disease affecting multiple organ systems. The course of the disease is unpredictable with mild to life-threatening complications. Circulating autoantibodies directed against cell nuclear components is the main laboratory characteristic. As in other autoimmune diseases, the direct (health care cost...

The Spondyloarthropathies (SpA) are a group of chronic inflammatory diseases that affect young adults of both sexes and involves predominantly the axial skeleton (axSpA), sacroiliac joints and spine and is called axSpA, or the peripheral (p) joints and entheses named p-SpA.

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease that affects the spine and the sacroiliac joints (SI). It makes part of the “seronegative spondyloarthropathies” or spondyloarthritides (SpA). SpA describes a group of inflammatory arthritis diseases that are clinically and genetically related, but have distinct features from o...

Psoriatic arthritis (PsA) is a chronic, progressive, seronegative inflammatory arthropathy that often results in permanent joint damage and disability. Skin psoriasis, dactylitis and enthesitis are the hallmarks of the disease. Psoriasis comes from the Greek word “psora” which means “to itch”. The father of medicine, Hippocrates, used tar and arsen...

This chapter is focusing on disease metrics and activity scores. Rheumatic diseases can sometimes be difficult to treat and disease progression or disease improvement may be difficult to be distinguished by just asking the patients of how they feel. We present some of the mostly used disease activity scores in order to be easier for our readers to...

Crystal arthropathies are a group of joint disorders due to deposition of crystals in and around joints which lead to joint destruction and soft tissue disturbances (swelling, redness, masses etc.). Clinical presentations of the different types of crystal arthropathies are often characteristic enough to differentiate them from each other, but mista...

There is a high probability of developing adverse drug reactions (ADRs) in rheumatology. Corticosteroids (CS) as well as different classes of disease-modifying anti-rheumatic drugs (DMARDs) are the commonest suspected drugs for variable ADRs. Even if these drugs are widely known for their efficacy on rheumatic diseases, it is necessary to know what...

The inflammatory myopathies (IM) are a group of heterogeneous disorders and include dermatomyositis (DM), polymyositis (PM), necrotising autoimmune myositis (NAM), and inclusion-body myositis (IBM).

Sarcoidosis is a chronic, systemic inflammatory disorder characterised by the presence of epithelioid non-caseating granulomata in the affected organs. The lungs are affected in about 90% of the cases, and pulmonary disease accounts for most of the morbidity and mortality associated with sarcoidosis. Virtually every organ of the body can be affecte...

Rheumatology deals with autoimmune diseases that in great part affect the joints. Thus, the examination of the musculoskeletal system is of great importance. All joints can be affected, so a thorough and minute examination should be carried out for each patient.

Sjögren’s syndrome (SS) is a chronic, slowly progressive autoimmune exocrinopathy characterised by mixed cellular infiltration of exocrine glands, notably the lacrimal glands and salivary glands.

Rheumatoid Arthritis (RA) is an autoimmune disease that is characterised by progressive joint disorder with significant pain and stiffness, which lead to functional disability and systemic complications if left untreated. The direct (health care costs) and indirect (productivity loss) socioeconomic costs of the disease are of major significance.

Osteoporosis (OP) is a generalised metabolic bone disease characterised by insufficient formation or increased resorption of bone matrix, resulting in decreased bone mass and susceptibility to bone fractures. OP has a variety of possible causes and consequently manifests in a number of different forms, but the result is the same which is bone fract...

Scleroderma or systemic sclerosis (SCL) is an autoimmune disorder of unknown aetiology, characterised by fibrosis and microvascular injury in affected organs. The hallmark of the disease is thickening and tightness of the skin and of subcutaneous tissue. SCL may be confined to the skin (localised) or it may be generalised (systemic sclerosis). In t...

Background Tumor necrosis factor alpha (TNFα) is a pivotal cytokine involved in the pathogenesis of certain inflammatory diseases, such as rheumatoid arthritis (RA), spondyloarthropathies, and inflammatory bowel diseases. In the last two decades, TNFα inhibitors (TNFi) have revolutionized the treatment and outcome of the above disorders. However, t...

Rheumatoid arthritis (RA) is a prevalent chronic inflammatory arthritis worldwide, significantly impacting patients and population health. The disease affects women primarily, with a female-to-male ratio of three to one. Its pathogenesis is multifactorial, including genetic and environmental risk factors. Epidemiological studies highlight the link...

Introduction: Rheumatoid arthritis (RA) is a complex autoimmune disease that affects millions of people worldwide, with a systemic impact. This review explores the role of non-biological conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) in its management. Areas covered: We discuss the effectiveness and safety of key csDMARD...

Polymyalgia Rheumatica (PMR) and Giant Cell Arteritis (GCA) are chronic inflammatory disorders that usually affect older people. Although the aetiology of these diseases remains unknown, genetic, environmental, and immune factors have been implicated. Specific cytokines such as the IL-6, IL-1β, IL-12, IL-17, and interferon –γ seem to play an essent...

Objectives: The aim of this study was to investigate the relation among atherosclerosis, antibodies against oxidized LDL (anti-oxLDL), and inflammation in rheumatoid arthritis (RA) patients treated with biological (b) disease-modifying anti-rheumatic drugs (DMARDs). Methods: Fifty-nine patients who were receiving conventional synthetic DMARDs an...

Capillaroscopy is a non-invasive and safe imaging method that allows the evaluation of the microcirculation of the small vessels of the skin. The method’s main advantage is the early detection of microvascular changes that may occur in certain connective tissue diseases (CTDs). Today, the presence of specific autoantibodies and capillaroscopic find...

Spondyloarthritis (SpA) is a chronic inflammatory disease that affects the axial skeleton (axSpA) and/or the peripheral joints (p-SpA) and entheses. The natural history of SpA in the decades of the 80 and 90 s involved a progressive disease with pain, spinal stiffness, ankylosis of the axial skeleton, structural damage of peripheral joints, and a p...

Relapsing polychondritis (RP) is a rare autoimmune disease characterized by inflammation of the cartilage structures of the body with typical features of auricular chondritis, nasal and ocular inflammation, audio-vestibular damage, as well as respiratory tract manifestations. It is associated with several autoimmune diseases and many other disorder...

Background traditionally, the diagnosis of inflammatory myopathies has been based on clinical signs and symptoms (muscle weakness and characteristic skin involvement, especially in dermatomyositis), increased muscle enzymes, electromyographic findings, skin or muscle biopsy, as well as anti-Jo1 antibodies (antisynthetase syndrome). However, this ap...

Background Patients with pre-existing rheumatic diseases may be exacerbated during SARS-CoV-2 infection, or may develop new autoimmune features. Furthermore, immunosuppressive agents used to treat autoimmunity-inflammation as well as comorbidities can also affect the disease outcome. Objectives To evaluate the outcome of rheumatic diseases after C...

Background Patients with autoimmune rheumatic diseases (ARDs) under moderate/severe immunosuppression are considered a high-risk population to develop severe Covid-19 infection. Objectives The aim of our study was to describe the clinical characteristics and the outcome of patients with ARD who contracted a Sars-Cov-2 infection. Methods Among pat...

Background Systemic Sclerosis (SSc) is a connective tissue disease affecting multiple systems, including the respiratory and cardiovascular systems. Among the various disease complications, interstitial lung disease (ILD), pulmonary arterial hypertension (PAH) and -lately recognized- myocardial fibrosis (MF), are those mainly related to reduced lif...

Rheumatoid arthritis (RA) is considered the most common form of autoimmune arthritis. The disease's prevalence is around 0.5-1% worldwide, but it seems to vary among different populations. The aim of this study was to estimate the prevalence of self-reported diagnosed RA in the general adult population in Greece. The data were derived from the Gree...

Introduction Patients with rheumatoid arthritis (RA) are at increased risk for serious infections. Pneumococcal vaccination is among the most important preventive measures, however, vaccine uptake is suboptimal. We explored the rate and factors associated with pneumococcal vaccination in a contemporary RA cohort. Materials and methods Multi-center...

Introduction: Rheumatoid arthritis (RA) is a chronic systemic disease characterized by articular involvement and extra-articular manifestations. The incidence and prevalence of the disease vary across populations, and there is an ongoing debate on whether a change of RA occurrence over time exists or is due to methodological issues and other biase...

Fibroblastic rheumatism (FR) is an uncommon disease of the skin, characterized by the presence of non-tender cutaneous nodules accompanied often by other rheumatic manifestations. This condition shows male predominance, no age preference and unpredictable course, resulting frequently in permanent joint damage. A 60-year-old man came to our departme...

Alopecia areata (AA) is a common non-scaring hair loss associated with many inflammatory and autoimmune disorders. Anti-tumor necrosis factor alpha (TNFα) therapy is used to treat many chronic inflammatory disorders and has been proven to be effective and relatively safe. However, several immune-mediated skin reactions have been described with the...

We aimed to evaluate the impact of biologic treatment on subclinical atherosclerosis and risk factors for cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA). Forty-nine biologic naïve RA patients, treated with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), who were eligible for treatment with a biolog...

Objective: Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown aetiology that affects approximately 1% of the population. The disease presents a temporal variability in different geographic areas. We investigated RA incidence over a 40-year-period in a defined area of north-west Greece, with a total population of about 400 000 i...

Introduction: In recent decades, Rheumatoid arthritis (RA) treatment landscape has evolved with the induction of new biological and targeted therapies that provide significant therapeutic benefits in patients with sustained disease. Areas covered: Tumor necrosis factor inhibitors (TNFi) were the first biologics used in the treatment of RA. Altho...

The clinical progression of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) to critical illness is associated with a systemic and uncontrolled inflammatory response of the innate and adaptive immunity with the release of a plethora of proinflammatory cytokines termed “cytokine storm”. In the absence of an effective treatment, many...

Current data demonstrated that in patients with coronavirus disease-19 (COVID-19), there is a dysregulation of the immune system during the severe form of the disease. This dysregulation is expressed with an uncontrolled release of pro-inflammatory cytokines such as interleukin-1 (IL-1), IL-6, IL-17, tumour necrosis factor alpha (TNFa) and chemokin...

Introduction: Glucocorticoids are steroid hormones broadly used for the treatment of several inflammatory and autoimmune diseases among other numerous indications, including rheumatoid arthritis. Areas covered: For the purposes of this article, the authors have performed an extensive review of the literature to present the latest studies on gluc...

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a matter of concern worldwide and a huge challenge for rheumatologists. Indeed, several antirheumatic drugs are currently used at different stages of COVID-19, such as several cytokine inhibitors and colchicine. Colchicine is one of the...

Purpose of review: Among the imaging modalities for the investigation of articular damage of patients with peripheral inflammatory arthropathies, conventional radiography (CR) is the mostly used. Other imaging modalities such as the musculoskeletal ultrasonography, magnetic resonance imaging, and dual-energy computed tomography scans are often use...

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affecting mostly the respiratory system, but several other organs and systems can be involved. Extrapulmonary manifestations and autoimmune phenomena following SARS-CoV-2 infection are frequent events occurring during the first 2 weeks...

Nowadays, tumor necrosis factor alpha (TNFα) inhibitors have revolutionised the treatment of inflammatory arthritides by demonstrating efficacy with an acceptable toxicity profile. However, autoimmune phenomena and clinical entities have been reported ranging from an isolated presence of autoantibodies to full-blown autoimmune diseases, among them,...

Background: Rheumatoid arthritis (RA) may affect any diarthrodial joint with a predilection on the peripheral skeleton in a symmetrical manner. When the axial skeleton is affected, it is the cervical spine (CS) that gets involved with potentially detrimental effects, if not treated promptly. Case: A 60-year-old female suffering from RA presented wi...

Current data demonstrated that severe cases of coronavirus-disease-19 (COVID-19) require treatment with antiviral therapy, dexamethasone, supportive care, as well as some anti-rheumatic drugs, among them, cytokine inhibitors and colchicine. Colchicine is an anti-inflammatory drug that is being used in rheumatology for many years to treat mostly gou...

The use of biologic medications has represented a great advancement in the treatment of autoimmune rheumatic diseases. Despite their excellent efficacy, during the last years, a growing number of reports of autoimmune phenomena and paradoxical inflammation has emerged. These phenomena may range from the discovery of an isolated autoantibody to full...

Background COVID-19 has been shown to significantly affect the vulnerable population [1,2]. Among them, patients suffering from inflammatory rheumatic diseases, and especially the immunosuppressed [3]. Objectives to assess the effect of SARS-CoV-2 on the course and the treatment of rheumatic inflammatory diseases. Methods from February to Decembe...

Background The risk of cardiovascular disease in patients with rheumatoid arthritis (RA) is 1.5-2 fold higher than in people of the same age and sex of the general population. 1,2,3 This marked risk is attributed to the systemic chronic inflammation which is characteristic of the disease. Objectives The aim of this study is to evaluate cardiovascu...

To examine whether patients with inflammatory arthritis (IA) treated with conventional synthetic (cs) disease-modifying anti-rheumatic drugs (DMARDs) and/or biologic (b) DMARDs, could be affected from SARS-CoV-2 infection and to explore the COVID-19 disease course and outcome in this population. This is a prospective observational study. During the...

Hair dye (HD) and its component para-phenylenediamine (PPD) are commonly used to enhance beauty and youth. HD is associated with allergic contact reactions and the development of autoimmune phenomena. A 28-year-old woman presented to us complaining of pain and swelling affecting the small joints of the hands bilaterally lasting for 7 weeks. Laborat...

Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis. Pulmonary involvement is a rare extra-articular manifestation of the disease characterized by rigidity of the chest wall and apical pulmonary fibrosis. Pleural effusion is uncommon in PsA. We present four cases of patients with PsA who developed pleural effusions...

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multiorgan involvement, including heart. Pericarditis—the most common cardiac manifestation—occurs in up to 50% of cases, resulting in positive treatment outcomes. Rarely, it evolves to hazardous complications. A 50-year-old woman with SLE in clinical remission, receiving hydro...

Objectives Predicting serious infections (SI) in patients with rheumatoid arthritis (RA) is crucial for the implementation of appropriate preventive measures. Here we aimed to identify risk factors for SI and to validate the RA Observation of Biologic Therapy (RABBIT) risk score in real-life settings. Methods A multi-centre, prospective, RA cohort...

Background Psoriasis (Pso) is a common chronic inflammatory disease affecting the skin, both sexes, and all ages. It can be associated with other chronic inflammatory musculoskeletal disorders and certain drugs, including tumor necrosis factor α (TNFα) antagonists. Case Presentation A 64-year-old man with seronegative rheumatoid arthritis (RA) ref...

Introduction: Rheumatoid arthritis (RA) is an autoimmune disease that is characterized by progressive joint disorders with significant pain and stiffness. In the past, RA was a difficult -to-treat ailment, but nowadays with the advent of biologics and better treatment strategies, disease remission is an achievable goal. Tumor necrosis factor α (TNF...

Introduction Opioids are used for severe forms of acute and cancer pain. Over the last years, their potential use in patients with noncancer pain such as those with rheumatoid arthritis (RA) has been postulated. A recent population-based comparative study showed that chronic opioid use was 12% vs. 4% among RA and non-RA patients, respectively. Anot...

Myasthenia gravis (MG) is an autoimmune disease characterised by the presence of acetylcholine receptor antibodies and by blocking the transmission of the signal in the neuromuscular junction causing muscle weakness. It can be associated with several autoimmune diseases and certain drugs, between them Etanercept an anti-tumour necrosis factor (TNF)...

Abstract Background The long-term outcome of rheumatoid arthritis (RA) patients who in clinical practice exhibit persistent moderate disease activity (pMDA) despite treatment with biologics has not been adequately studied. Herein, we analyzed the 5-year outcome of the pMDA group and assessed for within-group heterogeneity. Methods We included longi...

Background Data regarding the real-life predictors of low disease activity (LDA) in rheumatoid arthritis (RA) patients are limited. Our aim was to evaluate the rate and predictors of LDA and treatment patterns in RA. Methods This was a multicenter, prospective, RA cohort study where patients were evaluated in two different time points approximatel...

SARS-CoV-2 is a positive-sense single-stranded RNA virus that causes the COVID-19 infection. Spike proteins are the most important proteins found on its capsule using the host's ACE2 receptors to invade respiratory cells. The natural course of the COVID-19 infection is variable, from asymptomatic to severe and potentially fatal. A small percentage...

Juvenile idiopathic arthritis [JIA] is a chronic inflammatory disease and an exclusion diagnosis that includes all forms of arthritis that persist more than 6 weeks under the age of 16. Although there is not yet a cure for JIA, recent advances in the therapeutic field have created a more hopeful present and future for the patients. In the past, the...

Objectives: Several epidemiologic studies of spondylarthritis (SpA) and its subtypes have been reported during the last decades. The majority of these studies provided prevalence estimates and showed a considerable variation in the reported frequency of SpA subtypes. Most systematic reviews published in this field aimed to summarise the results of...

Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation that, if left untreated, can cause joint destruction and physical impairments. The inflammatory process is systematic, and it is associated with increased morbidity and mortality. Over the last years, mortality presents a decreasing trend; still, there is a hig...

Background The long-term outcome of rheumatoid arthritis (RA) patients who in clinical practice, exhibit persistent moderate disease activity (pMDA) despite treatment with biologics has not been adequately studied. Herein, we analyzed the 5-year outcome of the pMDA group and assessed for within-group heterogeneity. Methods We included longitudinal...

Background The long-term outcome of rheumatoid arthritis (RA) patients who in clinical practice exhibit persistent moderate disease activity (pMDA) despite treatment with biologics has not been adequately studied. Herein, we analyzed the 5-year outcome of the pMDA group and assessed for within-group heterogeneity. Methods We included longitudinall...

Objectives: Evidence on comorbidity prevalence in antiphospholipid syndrome (APS) and its difference from high comorbidity burden rheumatic diseases is limited. Herein, we compare multiple comorbidities between APS and RA. Methods: A total of 326 patients from the Greek APS registry [237 women, mean age 48.7 (13.4) years, 161 primary APS (PAPS),...

Purpose of review: During the last two decades, the therapeutic decisions and strategies for rheumatoid arthritis (RA) management have improved dramatically. Today, the therapeutic armamentarium is significantly augmented, and by using both old and new drugs, remission or low disease activity is a reasonable goal. The use of conventional synthetic...

Psoriatic arthritis (PsA) is an inflammatory form of arthritis that belongs to the family of spondyloarthritis (SpA) and is related to skin psoriasis. The incidence and prevalence of the disease vary considerably between countries. PsA is classified into axial PsA and peripheral PsA, with a wide range of other extra-articular manifestations. Althou...

Background Comorbidities in rheumatic diseases (RDs) have been associated with increased morbidity and mortality. Evidence on prevalence of comorbidities in antiphospholipid syndrome (APS) and its difference from high comorbidity burden RDs is limited. Objectives To compare the prevalence of common comorbidities between APS [primary (PAPS) and Sys...

Background Despite the increased incidence of influenza infection in rheumatoid arthritis (RA) patients, vaccination coverage has been shown to be suboptimal. Prospective data regarding the current rate and predictors of influenza vaccination adherence in RA patients are limited. Objectives To calculate the current rate and predictors of influenza...

Objectives To investigate possible associations between rheumatoid arthritis (RA) patient-expressed preferences over anti-tumour necrosis factor (anti-TNF) treatment and clinical and patient-reported outcomes.MethodsPANORAMA was a non-interventional, prospective, multicentre, cohort study of 12 months duration, in patients with moderate-to-severe R...

Purpose of review: Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting mainly the peripheral skeleton in a symmetrical manner rather than the axial skeleton, but when it occurs it can affect the cervical spine (CS). Although CS involvement is a frequent radiographic finding in RA, the clinical features are scarce, but potentially...

Objective To investigate whether tumour necrosis factor inhibitor (TNFi) combination therapy with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) is more effective for psoriatic arthritis (PsA) and/or improves TNFi drug survival compared to TNFi monotherapy. Methods Five PsA biologics cohorts were investigated between 2000...

Background: European data indicate that systemic sclerosis (SSc)-related death rates are increasing, thus raising concerns about SSc's optimal management. Herein, we describe current treatment modalities and drug survival in a real-life SSc cohort. Methods: Details on immunosuppressive/antiproliferative (methotrexate, mycophenolate, cyclophospha...

The treatment of inflammatory arthritides has been changed dramatically in the past two decades with the introduction of the biological (b) disease-modifying anti-rheumatic drugs (DMARDs) as well as the targeting synthetic (ts) DMARDs that can be used as monotherapy or in combination with conventional synthetic (cs) DMARDs. The concept of treat to...

Low back pain (LBP) in young adults is a common condition that needs to be appropriately examined in cases of refractory to classic treatment strategies. We present two cases of chronic LBP with challenging diagnosis and treatment refractoriness. The first case corresponds to a young lady that has been treated mistakenly with an anti-tumor necrosis...

Recent data suggests that rituximab may favorably affect skin fibrosis and lung function in patients with systemic sclerosis. Based on experimental data suggesting a key role of B and T cells in scleroderma we aimed to explore the effect(s) of rituximab treatment on T cell subpopulations. Fifteen patients with scleroderma who received rituximab tre...