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001-es BibID:	BIBFORM114387
035-os BibID:	(Scopus)85169934513
Első szerző:	Caporali, Roberto
Cím:	Start RA Treatment - Biologics or JAK-Inhibitors? / Roberto Caporali, Sabino Germinario, Dorottya Kacsándi, Ernest Choy, Zoltán Szekanecz
Dátum:	2024
ISSN:	1568-9972
Megjegyzések:	Janus Kinase inhibitors (JAKi) have been approved for the treatment of Rheumatoid Arthritis (RA) for several years. They are the first oral advanced treatment with efficacy similar to, if not greater than, biologic agents. Recently, concerns over their safety was raised by the results from Oral Surveillance trial suggesting that tofacitinib, one of the JAKi, was associated with higher cardiovascular adverse events and malignancies than TNF inhibitors (TNFi). Since then, regulatory authorities have added warnings to the labels of JAKi. On this purpose, whether rheumatologists should use JAKi as first line advance treatment has become a controversial topic. Some rheumatologists have argued that biologics should be first line advance treatment since there are extensive effectiveness and safety data. In addition, with the advent of biosimilar drugs, they are the most cost-effective treatment. On the other hand, JAKi are very efficacious and are generally safe apart from older and high-risk patients. When TNFi are contraindicated and in certain RA patients, especially when an oral drug is preferable, JAKi have significant advantage providing patients are involved in the decision-making process.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Autoimmunity Reviews. - 23 : 1 (2024), p.1-4. _
További szerzők:	Germinario, Sabino Kacsándi Dorottya Choy, Ernest Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat http://dx.doi.org/10.1016/j.autrev.2023.103429
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001-es BibID:	BIBFORM115235
035-os BibID:	(cikkazonosító)1226760 (WoS)001090239400001 (Scopus)85174827391
Első szerző:	Kacsándi Dorottya
Cím:	Effect of tofacitinib therapy on angiotensin converting enzyme activity in rheumatoid arthritis / Dorottya Kacsándi, Miklós Fagyas, Ágnes Horváth, Edit Végh, Anita Pusztai, Monika Czókolyová, Boglárka Soós, Attila Ádám Szabó, Attila Hamar, Zsófia Pethő, Nóra Bodnár, György Kerekes, Katalin Hodosi, Szilvia Szamosi, Gabriella Szűcs, Zoltán Papp, Zoltán Szekanecz
Dátum:	2023
ISSN:	2296-858X
Megjegyzések:	Introduction The Renin-Angiotensin-Aldosterone system (RAAS) has been implicated in the regulation of the cardiovascular system and linked to rheumatoid arthritis (RA). Little information has become available on the effects of Janus kinase (JAK) inhibition on RAAS. Here we studied the effects of 12-month tofacitinib treatment on angiotensin converting enzyme (ACE), ACE2 production and ACE/ACE2 ratios in RA along with numerous other biomarkers.Patients and methods Thirty RA patients were treated with tofacitinib in this prospective study. Serum ACE concentrations were assessed by ELISA. ACE2 activity was determined by a specific quenched fluorescent substrate. ACE/ACE2 ratios were calculated. We also determined common carotid intima-media thickness (ccIMT), brachial artery flow-mediated vasodilation (FMD) and carotid-femoral pulse-wave velocity (cfPWV) by ultrasound. C-reactive protein (CRP), rheumatoid factor (RF) and anti-citrullinated protein autoantibodies (ACPA) were also determined. All measurements were performed at baseline, as well as after 6 and 12 months of tofacitinib treatment.Results After the dropout of 4 patients, 26 completed the study. Tofacitinib treatment increased ACE levels after 6 and 12 months, while ACE2 activity only transiently increased at 6 months. The ACE/ACE2 ratio increased after 1 year of therapy (p < 0.05). Logistic regression analyses identified correlations between ACE, ACE2 or ACE/ACE2 ratios and RF at various time points. Baseline disease duration also correlated with erythrocyte sedimentation rate (ESR) (p < 0.05). One-year changes of ACE or ACE2 were determined by tofacitinib treatment plus ACPA or RF, respectively (p < 0.05).Conclusion JAK inhibition increases serum ACE and ACE/ACE2 ratio in RA. Baseline inflammation (ESR), disease duration and ACPA, as well as RF levels at various time points can be coupled to the regulation of ACE/ACE2 ratio. The effect of tofacitinib on RAAS provides a plausible explanation for the cardiovascular effects of JAK inhibition in RA.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Frontiers in Medicine. - 10 (2023), p. 1-8. -
További szerzők:	Fagyas Miklós (1984-) (orvos) Horváth Ágnes (1985-) (reumatológus) Végh Edit Karancsiné Pusztai Anita (1989-) (tudományos segédmunkatárs) Czókolyová Mónika (1993-) (molekuláris biológus) Soós Boglárka (1988-) (általános orvos) Szabó Attila Ádám (1996-) (orvos) Hamar Attila Béla (1990-) (általános orvos) Pethő Zsófia (1981-) (reumatológus, immunológus) Bodnár Nóra (1980-) (reumatológus) Kerekes György (1973-) (belgyógyász, kardiológus, angiológus) Hódosi Katalin Szamosi Szilvia (1975-) (belgyógyász, reumatológus) Szűcs Gabriella (1963-) (belgyógyász, allergológus és klinikai immunológus, reumatológus) Papp Zoltán (1965-) (kardiológus, élettanász) Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
Pályázati támogatás:	TÁMOP-4.2.4.A/2-11-1-2012*0001 TÁMOP GINOP-2.3.2-15-2016-00050 GINOP ÚNKP-22-5-DE-408 Egyéb ÚNKP-22-3-I-DE-248
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM119560
035-os BibID:	(cikkazonosító)3429
Első szerző:	Simon Diána
Cím:	Natural Autoantibodies in Biologic-Treated Rheumatoid Arthritis and Ankylosing Spondylitis Patients : associations with Vascular Pathophysiology / Diána Simon, Dorottya Kacsándi, Anita Pusztai, Boglárka Soós, Edit Végh, György Kerekes, Monika Bodoki, Szilvia Szamosi, Gabriella Szűcs, Zoltán Prohászka, Péter Németh, Tímea Berki, Zoltán Szekanecz
Dátum:	2024
ISSN:	1422-0067
Megjegyzések:	Cardiovascular (CV) morbidity and mortality have been associated with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Natural autoantibodies (nAAb) are involved in innate immunity, as well as autoimmunity, inflammation, and atherosclerosis. There have not been any studies assessing the effects of biologics on nAAbs in RA and AS, also in relation to vascular pathophysiology. Fifty-three anti-TNF-treated RA and AS patients were included in a 12-month follow-up study. Anti-citrate synthase (CS) and anti-topoisomerase I fragment 4 (TOPO-F4) IgM and IgG levels were determined by ELISA. Ultrasonography was performed to assess brachial artery flow-mediated vasodilation (FMD), common carotid intima-media thickness (ccIMT), and arterial pulse-wave velocity (PWV). Other variables were also evaluated at baseline and 6 and 12 months after treatment initiation. Anti-TNF therapy improved FMD in RA and PWV in AS and stabilized ccIMT. TNF inhibition increased anti-CS IgM and IgG, and possibly also anti-TOPO-F4 IgG levels. Various correlation analyses revealed that nAAbs might be independently involved in autoimmunity as well as changes in inflammation and vascular pathology over time in biologic-treated patients (p < 0.05). We also found associations between anti-TOPO-F4 IgG and anti-Hsp60 IgG (p < 0.05). Baseline nAAb levels or nAAb level changes might determine changes in CRP, disease activity, FMD, PWV, and ccIMT over time (p < 0.05). The interplay between arthritis and inflammatory atherosclerosis, as well as the effects of anti-TNF biologics on these pathologies, might independently involve nAAbs.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk rheumatoid arthritis ankylosing spondylitis natural autoantibodies anti-TNF therapy biomarkers
Megjelenés:	International Journal Of Molecular Sciences. - 25 : 6 (2024), p. 1-14. -
További szerzők:	Kacsándi Dorottya Karancsiné Pusztai Anita (1989-) (tudományos segédmunkatárs) Soós Boglárka (1988-) (általános orvos) Végh Edit (1978-) (reumatológus, belgyógyász) Kerekes György (1973-) (belgyógyász, kardiológus, angiológus) Czókolyová Mónika (1993-) (molekuláris biológus) Szamosi Szilvia (1975-) (belgyógyász, reumatológus) Szűcs Gabriella (1963-) (belgyógyász, allergológus és klinikai immunológus, reumatológus) Prohászka Zoltán Németh Péter Berki Tímea Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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