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Öğe Characteristics Predicting Tuberculosis Risk under Tumor Necrosis Factor-? Inhibitors: Report from a Large Multicenter Cohort with High Background Prevalence(J Rheumatol Publ Co, 2016) Kisacik, Bunyamin; Pamuk, Omer Nuri; Onat, Ahmet Mesut; Erer, Sait Burak; Hatemi, Gulen; Ozguler, Yesim; Pehlivan, YavuzObjective. Screening strategies for latent tuberculosis (TB) before starting tumor necrosis factor (TNF)-alpha inhibitors have decreased the prevalence of TB among patients who are treated with these agents. However, despite vigilant screening, TB continues to be an important problem, especially in parts of the world with a high background TB prevalence. The aim of this study was to determine the factors related to TB among a large multicenter cohort of patients who were treated with anti-TNF. Methods. Fifteen rheumatology centers participated in this study. Among the 10,434 patients who were treated with anti-TNF between September 2002 and September 2012, 73 (0.69%) had developed TB. We described the demographic features and disease characteristics of these 73 patients and compared them to 7695 patients who were treated with anti-TNF, did not develop TB, and had complete data available. Results. Among the 73 patients diagnosed with TB (39 men, 34 women, mean age 43.6 +/- 13 yrs), the most frequent diagnoses were ankylosing spondylitis (n = 38) and rheumatoid arthritis (n = 25). More than half of the patients had extrapulmonary TB (39/73, 53%). Six patients died (8.2%). In the logistic regression model, types of anti-TNF drugs [infliximab (IFX), OR 3.4, 95% CI 1.88-6.10, p = 0.001] and insufficient and irregular isoniazid use (<9 mos; OR 3.15, 95% CI 1.43-6.9, p = 0.004) were independent predictors of TB development. Conclusion. Our results suggest that TB is an important complication of anti-TNF therapies in Turkey. TB chemoprophylaxis less than 9 months and the use of IFX therapy were independent risk factors for TB development.Öğe Evidence-Based Recommendations for the Management of Enteropathic Arthritis: A Rheumatology - Gastroenterology Collaborative Initiative(Wiley, 2019) Hatemi, Gulen; Akar, Servet; Akpinar, Hale; Atagunduz, Pamir; Bengi, Goksel; Can, Gercek; Celik, Aykut Ferhat[Abstract Not Available]Öğe The papulopustular lesion/arthritis cluster of Behcet's syndrome also clusters in families(Oxford Univ Press, 2012) Karaca, Mehmet; Hatemi, Gulen; Sut, Necdet; Yazici, HasanObjective. We have previously reported distinct symptom clusters among our patients with Behcet's syndrome (BS). The presence of such clusters suggests that more than one pathogenetic mechanism might be operative in BS. Increases in the frequency of certain clusters in familial BS cases, if present, would further support this notion. To test this hypothesis, we compared the frequency of symptom clusters between familial (Group F) and non-familial (Group NF) cases of BS. Methods. We identified 380 BS patients who had reported a first-degree relative by reviewing 6031 patient charts. We were able to contact 186 (Group F). From the same initial pool, 500 patients were randomly selected. Of those, patients who did not report a family history of BS and who had attended our clinic during the previous 3 months made up Group NF (n = 221). Both groups were questioned about their symptoms within the previous 3 months. Data were analysed using factor analysis, cluster analysis and chi(2) tests. Results. The make-up of the symptom clusters were very similar for the factor and the cluster analyses. The frequency of papulopustular lesions and joint involvement cluster was significantly higher in Group F (39.2 vs 21.5%, P < 0.001). Furthermore, the same cluster was shared in 5/17 related pairs from Group F and in only 5/110 unrelated pairs from Group NF [29 vs 4.5%, P = 0.004; risk ratio (RR) = 6.47, 95% CI 2.15, 18.89]. Conclusion. The papulopustular lesions and arthritis cluster in BS appears to cluster in familial BS as well. This further supports the notion that the pathogenesis of BS may entail several distinct mechanisms resulting in separate phenotype clusters.Öğe PPD REACTION IS NOT AUGMENTED IN BEHCET'S SYNDROME PATIENTS(Clinical & Exper Rheumatology, 2008) Hatemi, Gulen; Melikoglu, Melike; Sut, Needet; Yazici, Hasan[Abstract Not Available]Öğe Prognosis of Behcet's syndrome among men with mucocutaneous involvement at disease onset: long-term outcome of patients enrolled in a controlled trial(Oxford Univ Press, 2010) Hamuryudan, Vedat; Hatemi, Gulen; Tascilar, Koray; Sut, Necdet; Ozyazgan, Yilmaz; Seyahi, Emire; Mat, CemObjective. To assess the influence of being free of major organ involvement during the early years of the disease on the prognosis of men with Behcet's syndrome (BS). Methods. Ninety-six men with BS, who had only active mucocutaneous manifestations when entering a controlled trial of thalidomide mean (S. D.) 11.7 (0.8) years ago, were re-evaluated for the use of immunosuppressives as an indication of major organ involvement during the post-trial period. Results. Outcome information was obtained in 91 (95%) patients. Thirty-nine (43%) patients had to use immunosuppressives during the post-trial period. Immunosuppressive use was significantly more frequent among patients developing BS at younger age (76%; 424 years) than older age (30%; 525 years). Developing BS at young age (OR 6.3; 95% CI 2.09, 19.04) and not using colchicine during the post-trial period (OR = 3.860; 95% CI 1.484, 10.034) were risk factors for immunosuppressive use. However, 82% of the patients using colchicine had onset during old age. Colchicine showed a significant effect in decreasing the use of immunosuppressives only among patients of old age at onset (Fisher's exact test = 5.026; P = 0.031) in the subgroup analysis. Eye disease (18 patients) and vascular involvement (14 patients) were the most frequent indications for immunosuppressive use. Conclusions. Being free of major organ involvement during the early years of BS does not indicate a mild prognosis for men developing BS at young age. Whether colchicine will reduce the need for immunosuppressive use among men developing BS at old age awaits formal studies.Öğe Tuberculosis Reactivation Risk in Patients Treated with Tumor Necrosis Factor Alpha Inhibitors: A Turkish Experience with Higher Mortality and Different Background Diseases.(Wiley, 2014) Kisacik, Bunyamin; Pamuk, Omer; Onat, Ahmet Mesut; Erer, B.; Hatemi, Gulen; Ozguler, Yesim; Pehlivan, Yavuz[Abstract Not Available]
