B Marasini

Istituto Clinico Humanitas IRCCS, Milano, Lombardy, Italy

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Publications (103)416.09 Total impact

  • M. Massarotti · C. Crotti · N. Ughi · F. Uboldi · L. Belloli · B. Marasini ·
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    ABSTRACT: Background Carpometacarpal osteoarthritis (CMC OA) is highly prevalent in older adults, and is often unresponsive to medical treatment. Intra-articular hyaluronic acid (HA) has been widely shown to improve pain and function in patients with knee OA and it seems to be a promising therapy also for CMC OA. To date no studies compared the efficacy of different HA compounds in CMC OA. Objectives To investigate the three-month efficacy of two different HA compounds on pain relief in CMC OA. Methods Eighty female patients affected by symptomatic CMC OA (aged 65±8 years, mean ± SD) were treated with three once-weekly intra-articular injections of HA (Hyalgan 1ml, MW 500-700 kDalton, or Jointex 1ml, MW 800-1200 kDalton). All subjects met ACR criteria for hand OA and had CMC OA grade 1-4 according to Kellgren and Lawrence on standard X-ray performed within 6 months before the inclusion. Fourty patients (aged 64±8 years, mean ± SD) were treated with Hyalgan while 40 patients (aged 67±8 years, mean ± SD) were treated with Jointex. All the patients were followed for a 3-month period after the last injection. Treatment efficacy was assessed through visual analogue scale (VAS) pain quantification (baseline; 2nd and 3rd injection; one and three months after the last injection). Side effects were recorded. Results In both groups VAS was significantly reduced after the first injection and reached the slowest score one month after the last injection (Hyalgan: 2nd injection vs baseline, p=0.0019; 3rd injection vs baseline, p<0.0001; 3rd injection vs 2nd injection, p=0.057; Jointex: 2nd injection vs baseline, p=0.0008; 3rd injection vs baseline, p<0.0001; 3rd injection vs 2nd injection, p=0.0096). The efficacy was maintained for all the whole follow-up period (Hyalgan and Jointex: one month vs baseline, p<0.0001; three months vs baseline, p<0.0001 - one month vs 3rd injection, p=n.s.;three months vs 3rd injection, p=n.s.). No significant differences in VAS score were found between the two groups at baseline and during the follow-up period (Hyalgan vs Jointex: baseline 7.05±2.33 vs 7.08±2.07; 3rd injection 4.35±2.85 vs 4.30±2.29; 1month 3.75±2.65 vs 3.25±2.22; 3months 4.23±2.90 vs 4.03±2.56; p=n.s.). Only minor side effects were observed in both treatment groups (mild pain and/or ecchymosis in injection site). Conclusions Our study supports viscosupplementation with HA as a safe and efficacious approach for symptomatic CMC OA. In our preliminary study no significant differences were found between intra-articular Hyalgan and Jointex for pain relief. Further studies are needed to determine the long-term efficacy and the optimal treatment schedule. Disclosure of Interest None Declared
    Annals of the Rheumatic Diseases 01/2014; 71(Suppl 3):695-695. DOI:10.1136/annrheumdis-2012-eular.985 · 10.38 Impact Factor
  • L. Belloli · C. Crotti · N. Ughi · M. Massarotti · B. Marasini ·
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    ABSTRACT: Background Anticentromere antibody (ACA) are considered a serological marker of systemic sclerosis (SSc), in particular of its limited form (lcSSc). They are rarely observed in other connective tissue diseases, but seldom are found associated with primary biliary cirrhosis (PBC). Objectives To evaluate the clinical heterogeneity of patients with anticentromere antibodies (ACA). Methods One hundred of patients sent to our Center because of ACA positivity, were retrospectively analyzed. There were 99 females with a follow-up period of at least 5 years. Results All patients had an autoimmune disease. Eighty-four had systemic sclerosis (SSc): 71 had lcSSc, 8 diffuse SSc (dcSSc) and 5 SSc sine scleroderma. In 17 patients (20.2%) SSc was associated with other autoimmune diseases, mostly with PBC (12 patients, 9 with lcSSc) and autoimmune thyroiditis (7 patients, 6 lcSSc). Two patients had SSc in overlap with rheumatoid arthritis (RA) and Sjögren’s syndrome (SS), respectively. Sixteen patients did not have SSc, but other rheumatic diseases: 9 had Undifferentiated Connective Tissue Disease, 2 Systemic Lupus Erythematosus, 2 SS and 2 RA in overlap with SS. Conclusions The presence of ACA does indicate an autoimmune disorder, mainly lcSSc, often in overlap with PBC. Therefore, the presence of ACA should deserve further examination, because marker of autoimmune disease. Disclosure of Interest None Declared
    Annals of the Rheumatic Diseases 01/2014; 71(Suppl 3):715-715. DOI:10.1136/annrheumdis-2012-eular.1342 · 10.38 Impact Factor
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    ABSTRACT: Systemic sclerosis (SSc) is a rare disease requiring multicentre collaboration to reveal comprehensive details of disease-related causes for morbidity and mortality. The European League Against Rheumatism (EULAR) Scleroderma Trials and Research (EUSTAR) group initiated a database to prospectively gather key data of patients with SSc using a minimal essential dataset that was reorganised in 2008 introducing new items. Baseline visit data of patients who were registered between 2004 and 2011 were analysed using descriptive statistics. In June 2011, 7655 patients (2838 with diffuse cutaneous (dc) and 4481 with limited cutaneous (lc) SSc who fulfilled the American College of Rheumatology diagnostic criteria had been registered in 174 centres, mainly European. The most prominent hallmarks of disease were Raynaud's phenomenon (96.3%), antinuclear antibodies (93.4%) and a typical capillaroscopic pattern (90.9%). Scleroderma was more common on fingers and hands than on any other part of the skin. Proton pump inhibitors (65.2%), calcium channel blockers (52.7%), and corticosteroids (45.3%) were most often prescribed. Among the immunosuppressant agents, cyclophosphamide was used more often in dcSSc than in lcSSc. The EUSTAR database provides an abundance of information on the true clinical face of SSc that will be helpful in improving the classification of SSc and its subsets and for developing more specific therapeutic recommendations.
    Annals of the rheumatic diseases 05/2012; 71(8):1355-60. DOI:10.1136/annrheumdis-2011-200742 · 10.38 Impact Factor
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    ABSTRACT: Tenofovir is widely used as first-line treatment of HIV infection, although its use is sometimes complicated by a reversible proximal renal tubulopathy. We report the case of a 45-year-old woman with chronic HIV infection and personality disorder, who after 12 months of tenofovir, complained of fatigue, diffuse bone pain and gait disturbances. The elevated level of alkaline phosphatase, hypophosphatemia and inappropriate phosphaturia suggested the diagnosis of hypophosphatemic osteomalacia secondary to proximal renal tubulopathy. A dual-energy x-ray absorptiometry showed a bone mineral density below the expected range for age (lumbar spine Z-score −3.3, femoral neck Z-score −2.1). A whole body 99mTc-methylene diphosphonate bone scan showed multiple areas of increased focal activity in the lumbar and thoracic spine and in sacroiliac and hip joints consistent with pseudofractures. Two months after tenofovir discontinuation and administration of vitamin D and phosphate, osteomalacia-related symptoms disappeared. Eleven months later, bone and mineral metabolism data were normal and bone scintigraphy did not show any pathological findings. This report highlights the importance of considering the diagnosis of osteomalacia in patients treated with tenofovir and emphasizes the need for monitoring alkaline phosphatase, blood and urinary phosphate and creatinine, especially in patients with risk factors for bone disease.
    Mediterranean Journal of Hematology and Infectious Diseases 01/2012; 4(1):e2012025. DOI:10.4084/MJHID.2012.025
  • B Marasini · M Massarotti ·
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    ABSTRACT: Chronic inflammatory rheumatic diseases are associated with an increased risk of cardiovascular (CV) atherosclerotic events. The inflammatory state, which is the hallmark of chronic rheumatic diseases, is the important driving force for accelerated atherogenesis. Since the control of traditional risk factors alone is insufficient in reducing the risk, much attention has been directed towards the potential use of statins. Statins, a family of drugs that suppress cholesterol biosynthesis by inhibiting the hydroxymethyl glutaryl coenzyme A reductase, have been shown to significantly reduce CV-related morbidity and mortality. In addition to lower lipid levels, several non-lipid lowering pleiotropic effects, including anti-inflammatory and immunomodulatory activities, make statins potential therapeutic agents in chronic rheumatic diseases. However, lipid metabolism in chronic rheumatic diseases is complex, since inflammatory states can induce alterations in lipid levels and function, so that cholesterol target levels from general guidelines may not be adequate in chronic inflammatory rheumatic diseases. Larger trials are needed to refine the precise benefits and health-utility associated with this therapy.
    International journal of immunopathology and pharmacology 01/2012; 25(1):25-30. · 1.62 Impact Factor
  • L Belloli · M Cugno · M C D'Agostino · N Ughi · A Tedeschi · S Respizzi · B Marasini ·

    Rheumatology International 12/2011; 33(4). DOI:10.1007/s00296-011-2277-0 · 1.52 Impact Factor
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    B Marasini · M Massarotti · R Cossutta · L Massironi · A Mantero ·
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    ABSTRACT: Pulmonary hypertension is a severe and rapidly progressive disease, particularly frequent in patients with rheumatic diseases. The aims of this study were the following: to determine the prevalence of pulmonary hypertension in Italian patients with autoimmune rheumatic diseases, and to evaluate if the presence of a rheumatic disease in general, or of a specific autoimmune rheumatic disease, is a risk factor for the development of pulmonary hypertension. One hundred and thirteen Italian patients with connective tissue diseases (105 females, 8 males), aged 19 to 83 yrs, entered the study. Fifty-one had systemic sclerosis (SSc): 49 were females, 2 males, aged 34 to 83 yrs; 41 had limited cutaneous SSc, 8 diffuse cutaneous SSc, and 2 SSc sine scleroderma. Thirty-three patients had systemic lupus erythematosus (SLE): all but one were females, their age ranged from 19 to 82 yrs. Twenty-five had rheumatoid arthritis (RA): 21 females, 4 males, aged 26 to 45 yrs. Three females and one male, 51-77 yrs, had mixed connective tissue disease (MCTD). Systolic pulmonary arterial pressure (SPAP) was assessed by Doppler echocardiography. Twenty three patients had pulmonary hypertension, which was more frequent in MCTD than in SLE (75% vs 6.1%, p=0.0002) or in AR (20%, p=0.0313). Pulmonary hypertension was more frequent in SSc than in SLE (25.5% vs 6.1%, p=0.0028) and in limited than in diffuse SSc (21.6% vs 3.9%). SPAP was significantly related to age (r=0.35, p=0.0275), with patients with pulmonary hypertension older than patients with normal SPAP (66+/-13 vs 52+/-16 yrs, p=0.0003). These data show a significant association between pulmonary hypertension and autoimmune rheumatic diseases. Therefore, pulmonary hypertension assessment seems mandatory, at least in MCTD and SSc. However, more studies are needed to clarify the relationship between age and pulmonary hypertension and to verify whether the low prevalence of pulmonary hypertension we found in our SLE patients is related or not to their lower age.
    Reumatismo 09/2011; 57(2):114-8. DOI:10.4081/reumatismo.2005.114
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    ABSTRACT: The risk of cancer with the use of biologic agents in rheumatic diseases is still a matter of debate. Published data suggest that the extent of cancer risk might differ according to the type of cancer, and there is recent clinical evidence for a significant increased risk for skin cancer, including melanoma. In contrast with the extensive literature on cancer risk in rheumatoid arthritis, little has been reported on the development of malignancies in spondyloarthroparthies. We report the case of an otherwise healthy 31-year-old Italian woman with psoriasic arthritis who developed a melanoma of left third toe with metastatic involvement of regional lymphnodes after a 3-year treatment with the TNF-alpha inhibitor adalimumab. This case illustrates the possibility of a causal relationship between TNF-alpha inhibitors and melanoma. We believe that vigilance should continue in patients treated with TNF-alpha blocking agents, until the question on the increased incidence of cancers, including skin cancers, associated with these drugs will be defined.
    09/2011; 6(4):275-6. DOI:10.2174/157488611798280915
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    Scandinavian Journal of Infectious Diseases 05/2011; 43(11-12):990-2. DOI:10.3109/00365548.2011.581307 · 1.50 Impact Factor
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    ABSTRACT: To obtain experiences and expert opinion on treatment of SSc patients with TNF-α antagonists. An investigation was carried out among the EUSTAR centres into their expertise on use of TNF-α antagonists. Assessment forms on the frequency of TNF-α inhibitor use were distributed to EULAR Scleroderma Trials and Research Group (EUSTAR) centres. Afterwards, a three round Delphi exercise was performed to obtain expert consensus on the use of TNF-α inhibitors in SSc. Seventy-nine centres returned information on use of TNF-α antagonists in SSc patients. A total of 65 patients were treated with TNF-α inhibitors in 14 different centres. Forty-eight of the 65 patients treated with TNF-α inhibitors improved. Improvement was mainly seen in patients with arthritis, whereas the effects on fibrosis varied. In the first round of the subsequent Delphi approach, 71 out of 79 experts stated that they would use TNF-α antagonists in SSc. Arthritis was suggested as an indication for TNF-α antagonists by 75% of the experts. However, after the third stage of the Delphi exercise, the acceptance for the off-label use of TNF-α antagonists decreased and 59% recommended that TNF-α antagonists should not be used or only used in clinical trials in SSc patients, while 38% of the experts suggested the use of TNF-α antagonists for arthritis associated with SSc. Most of the experts do not recommend the routine use of TNF-α antagonists in systemic sclerosis. Arthritis might be a potential indication in SSc, although controlled clinical trials with TNF-α antagonists are needed before general recommendations can be given.
    Clinical and experimental rheumatology 01/2011; 29(2 Suppl 65):S40-5. · 2.72 Impact Factor

  • The Journal of Rheumatology 12/2010; 37(12):2638-9. DOI:10.3899/jrheum.100627 · 3.19 Impact Factor
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    ABSTRACT: Paget disease of bone (PD) is a common skeletal disease. It is usually polyostotic and most frequently involves the pelvis, femur, spine, skull, and tibia. The bones of the upper extremity in poly- or monostotic PD are rarely affected. A patient with PD involving the third left metacarpal bone and carpal bones of the right hand is described.
    Southern medical journal 10/2010; 103(12):1253-5. DOI:10.1097/SMJ.0b013e3181e66b66 · 0.93 Impact Factor
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    M. Massarotti · L. Belloli · F. Uboldi · N. Ughi · A. Migliore · B. Marasini ·

    Osteoarthritis and Cartilage 10/2010; 18. DOI:10.1016/S1063-4584(10)60565-1 · 4.17 Impact Factor
  • Laura Belloli · Nicola Ughi · Bianca Marasini ·

    Clinical Rheumatology 09/2010; 30(1):145-6. DOI:10.1007/s10067-010-1564-6 · 1.77 Impact Factor

    The Journal of Rheumatology 12/2009; 36(12):2844-2844. DOI:10.3899/jrheum.090649 · 3.19 Impact Factor
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    American Journal of Respiratory and Critical Care Medicine 07/2009; 179(12):1167; author reply 1167-8. DOI:10.1164/ajrccm.179.12.1167 · 13.00 Impact Factor
  • B Marasini · L Conciato · L Belloli · M Massarotti ·
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    ABSTRACT: To review recent advances and current controversies on the association between systemic sclerosis (SSc) and cancer, PUBMED was searched from 1966 to the present using the terms: systemic sclerosis, cancer, morphoea, sclerotic diseases. Malignancies, mainly in lung and breast, coexist with idiopathic SSc or with SSc-like disorders, but not with localized forms of scleroderma (morphoea), with the exception of squamous cell carcinoma in patients with pansclerotic morphoea and skin ulcers. The mechanisms connecting SSc and malignancies are unknown. The occurrence of different cancer types with SSc or SSc-like disorders suggest different underlying mechanisms, including altered immune response, common genetic and environmental links, disease-dependent factors, tumor-derived biologic substances and therapies. The process of sclerosis itself may favour cancer in certain sites, and a reaction between T cells and neoantigens formed during irradiation has been suggested to explain the frequent development of morphoea after breast irradiation. Radiotherapy, especially when used for breast cancer, may trigger idiopathic SSc or morphoea and influence the severity of preexisting SSc, with the consequence that SSc is considered a relative contraindication to breast radiotherapy. In conclusion, cancer and SSc may be associated, but it is still controversial as to whether there is a causal relationship. Continuing interest in these associations, in particular in the different modalities of associations, may help to understand the underlying biological mechanisms and to identify patients at risk.
    International journal of immunopathology and pharmacology 07/2009; 22(3):573-8. · 1.62 Impact Factor
  • Bianca Marasini · Marco Massarotti ·

    The Journal of Rheumatology 05/2009; 36(4):854-5. DOI:10.3899/jrheum.081039 · 3.19 Impact Factor

  • Gastroenterology 05/2009; 136(5). DOI:10.1016/S0016-5085(09)63399-0 · 16.72 Impact Factor
  • M Massarotti · B Marasini ·
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    ABSTRACT: Inhibitors of tumor necrosis factor (TNF) alpha (infliximab, etanercept, adalimumab) are nowadays widely used for the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS), not responding to conventional therapies. Anti-TNF alpha drugs have demonstrated great efficacy in slowing the disease, however, to date, concern still remains regarding acute and long-term toxicity related to TNF block. Increase in liver tests may be observed during treatment with anti-TNF agents, more often related to concomitant drugs (i.e. NSAIDS, methotrexate) or to reactivation of chronic HBV or HCV infections. However, liver damage directly induced by the drug has been described in patients treated with infliximab or adalimumab. To our knowledge, no cases of liver injury closely related to etanercept have been reported so far. We report the case of a patient with PsA who presented liver dysfunction during adalimumab, subsequently successfully treated with etanercept.
    International journal of immunopathology and pharmacology 04/2009; 22(2):547-9. · 1.62 Impact Factor

Publication Stats

1k Citations
416.09 Total Impact Points


  • 2008-2012
    • Istituto Clinico Humanitas IRCCS
      Milano, Lombardy, Italy
  • 2011
    • University Hospital Zürich
      Zürich, Zurich, Switzerland
  • 1969-2011
    • University of Milan
      • Department of Internal Medicine
      Milano, Lombardy, Italy
  • 1975
    • Fondazione IRCCS Istituto Nazionale dei Tumori di Milano
      Milano, Lombardy, Italy