Ilaria Tinazzi

Ospedale Sacro Cuore-Don Calabria · Reumatologia

Background Nuclear medicine positron emission tomography (PET) has limited evidence in the clinical management of axial Spondylarthritis (AxSpA). The 18F-fluoride isotope is a bone-specific tracer that is incorporated in the skeleton during bone remodelling. Osteoblastic bone remodeling, that culminates in new bone formation in SpA can be molecular...

Background The transition from psoriasis (PsO) to PsA is of considerable interest for potential prevention and interception of PsA [1] . Objectives To formulate EULAR points to consider (PtC) for the development of data-driven guidance and consensus for clinical trials and clinical practice in the field of prevention/interception of PsA. Methods...

Background Magnetic resonance enterography (MRE) is usually performed in patients with Crohn’s disease (CD) for evaluating small bowel involvement. Inflammatory bowel disease (IBD) mainly affect the gastrointestinal tract, although patients may present extraintestinal manifestations (1). Musculoskeletal symptoms are the most frequent extraintestina...

Background Previous studies have reported an association between psoriasis (PsO) and inflammatory bowel disease (IBD). Coexistence of IBD and PsO has been associated with significant higher prevalence of enthesitis and dactylitis ¹ . Objectives To compare the prevalence of clinical and ultrasonographic peripheral enthesis abnormalities in a consec...

Background Up to 30% of Psoriasis (PsO) patients are prone to develop Psoriatic Arthritis (PsA). Agreement on how to identify PsO patients at risk of developing PsA is still lacking (1). Objectives To identify predictors of PsA development in PsO patients through a systematic literature review (SLR) and meta-analyses (MA). Methods MEDLINE, EMBASE...

Background The UPSTREAM (NCT03330769) is a 24-month multi-center prospective cohort study that primarily aims to evaluate the additional value of musculoskeletal ultrasound (msk-US) over clinical examination in predicting 6-month minimal disease activity in Psoriatic Arthritis (PsA). (1) Objectives To develop and preliminarily validate an activity...

The temporal relationship between the onset of skin psoriasis (Pso) and psoriatic arthritis (PsA) is a long and well‐known feature of psoriatic disease. Psoriatic skin lesions emerge years before the development of musculoskeletal manifestations in nearly 75% of PsA patients. While skin and joint manifestations develop within one year in 15‐20% of...

In excess of three quarters of patients with psoriatic arthritis (PsA) have preceding psoriasis (PsO), which offers a clinical biomarker for the recognition of early PsA. Numerous surveys have shown a remarkably high frequency of clinically occult musculoskeletal symptoms in psoriasis patients. Imaging studies, particularly ultrasound, show a high...

Objectives: To explore the impact of early versus late-onset psoriasis (PsO) on the disease characteristics of psoriatic arthritis (PsA) in a large-multicentre cohort. Methods: The data from a multicentre psoriatic arthritis database was analysed. Patients were grouped according to age at psoriasis onset (early onset; <40 years of age, late-onse...

Objective Joints with different sizes and anatomical locations can be affected in psoriatic arthritis (PsA). Our aim was to explore the effect of different joint patterns on patient‐reported outcomes (PROs) in patients with mono‐oligoarthritis. Methods Within PsArt‐ID (Psoriatic Arthritis‐ International Database), 387/1670 patients who had mono‐ol...

Background The association between PsA and cardiovascular disease is generally thought to be greater than the risk between psoriasis and cardiovascular disease. Vascular calcifications (VC) are considered an early marker of atherogenesis and accurate VC scores including Carotid, Aortic and Lower limbs vascular Calcifications (CALC) were published²....

Background Dactylitis is a common feature of PsA, occurring in 16 to 49% of PsA patients,mostly in early disease. Objectives To assess the effectiveness of steroid injection (local treatment, LT) into the digital flexor tendon sheath for the treatment of active dactylitis in PsA patients as compared to systemic treatment (ST) alone. Methods 73 ha...

Background Methotrexate (MTX) is the most common first-line disease-modified anti-rheumatic drugs in psoriatic arthritis (PsA), despite the controversies. Objectives In this study, we aimed to determine the rate of withdrawal rate of MTX in PsA and reasons for discontinuing. Objectives In this study, we aimed to determine the rate of withdrawal r...

Background Ultrasonography (US) is a well established technique both for diagnosis and follow up in Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PSA)¹. To date, there is no consensus regarding a standardized US evaluation of joint involvement by a validated score to be used for differential diagnosis. Objectives 1) To differentiate the ultra...

Objectives Dactylitis is one of the most typical features of psoriatic arthritis (PsA), with a high lifetime prevalence and inclusion in PsA clinical indices. Musculoskeletal ultrasonography (Msk-US) can readily detect inflammatory involvement of finger anatomical structures particular to dactylitis and monitor therapeutic effects. In this study, w...

Objective To assess the effectiveness of steroid injection (local treatment, LT) into the digital flexor tendon sheath of dactylitis in psoriatic arthritis (PsA) patients as compared with systemic treatment (ST).Methods Forty-six PsA patients with a total of 73 dactylitic fingers were assessed in an observational, multicentre, prospective study by...

Purpose of review: To describe the recent advances in the field towards the prevention and early recognition of Psoriatic Arthritis (PsA). Recent findings: Defining the preclinical phase of PsA remains challenging since up to 50% of subjects with psoriasis have subclinical imaging enthesopathy, but many of these do not progress to PsA. Neverthel...

Background and aimes: Both peripheral and axial spondyloarthritis (SpA) occurs in inflammatory bowel disease (IBD) and represents the commonest extra-intestinal manifestation. We aimed to develop an easy and quick questionnaire through psycometric analysis to identify peripheral and axial SpA in IBD patients within an integrated combined multidisc...

Objectives: The aim of this study was to explore the link between specific sonographic findings and Leeds Dactylitis Index basic (LDI-b) score in psoriatic arthritis (PsA) patients with hand dactylitis. Methods: Ninety-one hand dactylitis were evaluated in a multicentre study for the presence of pain, functional limitation and tenderness (2-poin...

Introduction: Enthesitis is a key feature of spondyloarthritis (SpA). Several studies have underlined the role of interleukin (IL)-23 in SpA development as a crucial cytokine in the pathogenesis of enthesitis. Area covered: This review summarizes recent evidence of the role of IL-23 in the pathogenesis of and as a target of the treatment of enthesi...

Objectives: Joint pain is common in subjects with IBD and is linked to several factors including SpA, drug therapy, concomitant OA or FM. The primary aim of this study was to estimate the prevalence of primary FM and concomitant FM and SpA in a cohort of patients with IBD utilizing clinical and US assessment. Methods: A total of 301 consecutive...

Background Joint pain is common in subjects affected by Inflammatory bowel disease (IBD) and is linked to several factors including spondyloarthritis (SpA), drug therapy, concomitant osteoarthritis and fibromyalgia (FM). The primary aim of this study was to estimate the prevalence of primary FM and concomitant FM and SpA in a cohort of IBD patients...

Objective: The digital accessory pulleys are highly mechanically stressed mini-entheses that are thickened in patients with a history of PsA-related dactylits. This study explored whether these pulleys are involved in PsA dactylitis as assessed by intra-pulley US power Doppler changes. Methods: Fifty-eight PsA patients with dactylitis had US of...

Objective The effect of smoking in psoriatic arthritis (PsA) is controversial. Our aim was to test if smoking is increased in axial PsA (axPsA). Methods 1535 patients from PsArt-ID (PsA-International Database) were included in the analysis. The effect of smoking on axPsA (compared to other PsA phenotypes) and radiographic sacroiliitis were investi...

Aim: To define and score finger soft tissue oedema in psoriatic dactylitis by ultrasound. Material and methods: A systematic literature review (SLR) on ultrasound-detected finger soft tissue oedema was performed. Subsequently, based on the SLR, a Delphi survey was developed and circulated among a group of 13 expert sonographers, in order to obta...

Objective Non-specific musculoskeletal pain is common in subjects destined to develop psoriatic arthritis (PsA). We evaluated psoriatic patients with arthralgia (PsOAr) compared with psoriasis alone (PsO) and healthy controls (HCs) using ultrasonography (US) to investigate the anatomical basis for joint symptoms in PsOAr and the link between these...

Objective Despite diffuse digital swelling, dactylitis may sometimes be asymptomatic. The objective of this study was to compare the clinical and ultrasonographic features of symptomatic with asymptomatic psoriatic arthritis (PsA) dactylitis. Methods One hundred and twenty-five hand dactylitis were evaluated in a multicenter cross-sectional study...

Background Tenosynovitis (TS) is a common, often clinically undetectable finding in Rheumatoid Arthritis (RA). Recent data showed TS on ultrasound (US) has a role in predicting outcome in early disease and flare in clinical remission. However data is limited on US measured TS in healthy subjects (HS), none specifically encompassing the older age ra...

Background Extra-intestinal manifestations (EIM) are frequent in IBD with peripheral and axial spondyloarthritis (SpA) being the commonest EIM,being reported in up to 23% of subjects.. Early detection of SpA is clinically relevant to drive the therapeutic management including the right treatment at the right time to prevent disability and improve t...

Background Joint pain is frequently reported by IBD patients and can be associated to extra-intestinal manifestations of diseases or adverse events associated to anti-TNF or vedolizumab therapy and also associated with other non-SpA-disease related factors including mechanical/degenerative problems. An appropriate rheumatological referral pathway i...

Objectives To conduct initial assessment of the early arthritis for psoriatic patients (EARP) questionnaire for Australian, Korean and Chinese populations using translated and linguistically validated versions. To measure the proportion of patients with psoriatic arthritis (PsA) among patients with psoriasis who attended dermatology clinics. Metho...

Objective To use ultrasonography to explore whether the duration of psoriatic dactylitis was associated with different patterns of extracapsular and synovial based involvement. Methods One hundred cases of hand dactylitis from 85 psoriatic arthritis (PsA) patients were consecutively enrolled in a multicentre cross-sectional study and divided into...

Background Extraintestinal manifestations (EIM) are frequent in IBD and spondyloarthritis (SpA) are the commonest EIM (4%–23%). However, the reported delay to diagnosis ranges from 8 to 11 years. Early detection of SpA is clinically relevant to drive the therapeutic management. The aim of this study was to develop a questionnaire able to identify S...

Background Joint pain is frequently reported by IBD patients and can be associated to extraintestinal manifestations of diseases, comorbidity or adverse events associated to anti-TNF or vedolizumab therapy. An appropriate rheumatological referral is crucial to drive an appropriate therapeutic strategy in case of concomitant spondyloarthritis. Fybro...

Objectives: Vedolizumab (VDZ) blocks α4β7 integrin and is licenced for the treatment of IBD. It has been associated with mild SpA-related features, including sacroiliitis and synovitis. Herein we report a series of cases demonstrating the emergence of severe SpA-associated enthesitis/osteitis following successful IBD therapy with VDZ. Methods: W...

Background Dactylitis is a hallmark of psoriatic arthritis (PsA) occurring in around 40% of cases at some point in the disease course. At the micro anatomical level PsA is strongly linked to disease localisation to entheses and other sites of high mechanical stress. Recently high resolution MRI has shown prominent abnormalities at the mini-entheses...

Background Identify the preclinical phase of arthritis could be clinically relevant. In this scenario, musculoskeletal ultrasonography (US) may play an important role, since it may detect subclinical disease. Psoriatic Arthritis (PsA) is a perfect disease to identify risk factors, since the risk pool group [i.e. patients with only cutaneous Psorias...

Objectives: Skin and joint involvement in psoriasis (PsO) and psoriatic arthritis (PsA) are thought to relate to the so-called Koebner response. Given that dactylitis is non-randomly distributed in the digits, this study tested the hypothesis that the accessory pulleys linked to the flexor tendons were thickened in PsA and thus exhibited koebneris...

Objectives: To determine whether a detailed sonographic evaluation of the hand flexor tendon compartment could help differentiate between psoriatic arthritis (PsA) and rheumatoid arthritis (RA). Methods: Thirty-seven patients with PsA, 47 with RA and 10 healthy controls (HC) had flexor tendon (FT) compartment imaging of the dominant hand 2nd to...

Introduction and objectives The Early Arthritis for Psoriatic patients (EARP) questionnaire is a screening tool for psoriatic arthritis. The original Italian version has good measurement properties but the EARP required translation and adaptation for use in Spain. This article describes the cultural adaptation process as a step prior to validation....

Psoriatic arthritis is a systemic inflammatory disease in which enthesitis and dactylitis are two of the main hallmarks of the disease. In the last years, ultrasonography is increasingly playing a key role in the diagnosis of psoriatic arthritis and ultrasonography of the entheses, particularly of the lower limbs, is commonly used to assess patient...

Introduction and objectives: The Early Arthritis for Psoriatic patients (EARP) questionnaire is a screening tool for psoriatic arthritis with good measuring properties in its original Italian version but has not been culturally adapted to Spanish. This article presents the adaptation for Spanish population, prior to validation step. Material and...

Background Psoriatic Arthritis (PsA) is often associated with hand involvement including synovitis and tenosynovitis and dactylitis. At the micro anatomical level PsA is strongly linked to disease localisation to entheses and other sites of high mechanical stressing. Recently high resolution MRI has shown prominent abnormalities at the mini-enthese...

The recognition of the primacy of enthesitis in animal models of spondyloarthritis and the prevalence of clinically occult enthesopathy in psoriatic subjects and of persistent joint pain in PsA subjects who have ostensibly good reduction of joint swelling under biological therapy has highlighted the potential impact of polyenthesitis in psoriatic d...

Key Points CD10 as a marker discriminating mature from immature neutrophils within heterogeneous neutrophil populations in pathological settings. Immunosuppressive mature CD66b+CD10+ and immunostimulatory immature CD66b+CD10− neutrophils coexist in G-CSF–treated donors.

Background Both RA and PsA are associated with hand involvement including synovitis and tenosynovitis. Differentiation between RA and PsA can sometimes be impossible using existing serological, genetic and imaging biomarkers. At the micro anatomical level PsA is strongly linked to disease localisation to entheses and other sites of high mechanical...

The early psoriatic arthritis screening questionnaire (EARP) is a simple and fast method for the identification of arthritis in patients with psoriasis. We established the Japanese version of the EARP (J-EARP) questionnaire, which includes 10 items with two choices for each. This study aimed to evaluate the utility of the J-EARP questionnaire. A to...

Chronic graft-versus-host disease (cGvHD) is a common complication of allogeneic bone marrow transplantation, and has a major effect on the long-term prognosis. The molecular mechanisms underlying cGvHD have been only partially revealed, and molecular targeted therapies have not yet been established for clinical use. We examined the effects of the...

Chronic graft-versus-host disease (cGVHD) is a prognosis limiting complication of allogeneic stem cell transplantation. The molecular mechanisms underlying cGVHD are incompletely understood, and targeted therapies are not yet established for clinical use. Here we examined the role of the hedgehog pathway in sclerodermatous cGVHD. Hedgehog signaling...

Objective: Dermatologists usually see patients with psoriasis before arthritis develops, making them well placed to diagnose early PsA (ePsA). This study aimed to develop a rapid and robust screening questionnaire for predicting PsA in patients with psoriasis referred to a specialized joint dermatology-rheumatology combined clinic. Methods: In a...

Background Subclinical enthesopathy is recognised in both psoriasis and psoriatic arthritis (PsA). However, there is limited work directly comparing power Doppler (PD) changes at the insertions between patients with PsA and psoriasis. Objectives This study used ultrasonography (US) with PD to test the hypothesis that subclinical enthesopathy in PsA...

To evaluate the prevalence of digital necrosis requiring surgical amputation in a single-center group of patients with systemic sclerosis (SSc) and to compare the characteristics of patients with and those without this severe complication. We reviewed the medical records of 188 patients with SSc [162 women, 26 men, mean age 59.2 yrs, mean disease d...

Caveolin-1 (CAV1) is an inhibitor of tissue fibrosis and has been implicated in the pathogenesis of systemic sclerosis (SSc). The aim of the study was to analyse the possible association of CAV1 gene single nucleotide polymorphisms (SNP) with SSc. A total population of 3974 individuals (1355 SSc patients, 2619 controls) was studied. Genotype data f...

Enthesopathy is a major feature of psoriatic arthritis (PsA), which is supported by imaging studies. Given that nail disease often predates PsA and that the nail is directly anchored to entheses, the authors asked whether nail involvement in psoriasis equates with a systemic enthesopathy. Forty-six patients with psoriasis (31 with nail disease) and...

To the Editor: The importance of enthesitis as the key pathological lesion underpinning the pathogenesis of psoriatic arthritis (PsA) has been increasingly recognized1. Studies for more than 3 decades have shown a high frequency of osseous and entheseal abnormalities in patients with psoriasis without clinical signs of arthritis2,3. From a clinic...

To the Editor: Successful desensitization to hydroxychloroquine (HCQ) was reported in The Journal in 20061; the authors described 2 patients with systemic lupus erythematosus (SLE) and 2 patients with polyarthritis who were given HCQ. The drug was withdrawn 7–14 days later due to the appearance of a maculopapular rash. After resolution of the ski...

The objective of this study was to evaluate the incidence of the most severe vascular complications, such as pulmonary arterial hypertension, scleroderma renal crisis, and digital necrosis requiring amputation, in a monocentric group of systemic sclerosis (SSc) patients cyclically treated with intravenous iloprost. We reviewed the record-charts of...

Background Systemic sclerosis is a chronic fibrotic disease highly heterogeneous in clinical outcome, involving autoimmune activation, fibroproliferative vasculopathy and tissue fibrosis of skin and multiple internal organs. The mechanisms linking immune activation and tissue fibrosis are still not fully characterised. A widely accepted model of im...

Psoriasis is a complex disease involving the skin, nails and musculoskeletal structures. Psoriatic arthritis (PsA) affects peripheral joints, entheses, the synovial sheaths of tendons and the axial skeleton. PsA is now recognised as a potentially debilitating disease, with bone erosions and deformities affecting about half of patients and arising e...

Contexte La maladie de Behçet (MB) peut se compliquer de thrombose artérielle et veineuse. L’objectif de ce travail a été d’évaluer dans un groupe de patients italiens atteints de MB avec évènements thrombotiques, un large panel de facteurs thrombophiliques héréditaires et acquis. Méthodes Trente patients atteints de MB, parmi lesquels neuf avaien...

Background: Behcet's disease (BD) may complicate with arterial and venous thrombosis. The purpose of this work is to evaluate in an Italian group of BD patients with thrombotic events a large panel of inherited and acquired thrombophilic factors. Methods: Thirty BD patients, of which nine with previously arterial or venous thrombosis and 21 with...

Vitamin D displays many extraosseous immunomodulatory effects. The aim of the study was to evaluate the level of vitamin D in patients with systemic sclerosis (SSc) and to analyze the associations between the concentration of the vitamin and clinical manifestations. In March-April 2009, 65 consecutive SSc patients underwent evaluation of vitamin D...

The role of the immune system in the pathogenesis of systemic sclerosis (SSc) is still unclear. Chronic allograft rejection and sclerodermoid graft-versus-host disease (Scl-GVHD) show a tissue pathology similar to SSc providing a indirect evidence of this role. We have shown that allograft inflammatory factor-1 (AIF-1) and caveolin-1 (cav-1) play a...

Chronic graft versus host disease (cGVHD), the most common late complication of allogeneic haematopoietic stem cell transplantation (HSCT), may present with sclerodermatous lesions resembling in some cases the cutaneous involvement of systemic sclerosis (SSc). Certain pathogenetic findings connect the two diseases. In this report we describe ten su...

Les agents bloquants du TNFalpha sont largement utilisés dans le traitement des maladies inflammatoires chroniques et leur administration est parfois associée à la génération d’autoanticorps. Cette revue porte sur les phénomènes auto-immuns liés à l’inhibition du TNFalpha, sur les mécanismes pathogènes et les implications cliniques qui lui sont ass...

Anti-TNFalpha blockers are extensively used in the management of chronic inflammatory disorders. Their administration may be associated with the generation of autoantibodies; this review focuses on the autoimmune phenomena linked to anti-TNFalpha inhibition, on the hypothesized pathogenetic mechanisms and on the clinical implications. While the dev...

The objective of this study is to evaluate nailfold videocapillaroscopy changes in scleroderma patients treated regularly on cyclic basis with iloprost and to find associations with clinical, serologic, and pharmacological variables. Forty-nine patients affected by systemic sclerosis (44 women and five men, mean age 52.4 years, mean disease duratio...

A single series of patients affected by systemic sclerosis (SSc) and cyclically treated with iloprost was reviewed in order to evaluate the incidence of digital ulcers (DUs) and to compare the characteristics between the patients with and without this painful and disabling vascular complication. The record charts of 85 SSc patients were revised. Is...

Behcets disease (BD) is a chronic, relapsing, multi-system inflammatory disorder, clinically characterized by recurrent oral and genital ulcers, skin lesions, and uveitis. Other manifestations include arthritis, a positive pathergy test, thrombophlebitis, central nervous system disease and gastrointestinal ulcerations. The majority of affected indi...

The aim of this study was to assess the association between anti-CENP-B and anti-Scl70 antibody levels, measured by multiplexed fluorescent microsphere immunoassay, and the clinical features in patients affected by systemic sclerosis. Clinical evaluation of 80 scleroderma patients was performed in order to evaluate disease activity and organ involv...

In the last decade hyperhomocysteinemia has become an element of great interest as a recognized factor of independent risk for atherotrombosis. Moreover a role has been suggested in some different diseases, like rheumatic ones. Hyperhomocysteinemia could represent a mechanism of amplification of vascular damage in rheumatic disease, therefore it co...

Psoriasis is associated with a form of spondyloarthropathy in 10-30% of cases. A major feature of psoriatic arthritis is enthesitis. In some patients with psoriasis the presence of enthesitis could be underdiagnosed. To investigate the presence of lower limbs entheseal abnormalities in patients with chronic plaque psoriasis without signs and sympto...

This paper describes a 48-year-old woman admitted to surgical department with mid-epigastric pain. Ultrasonography of the abdomen and magnetic resonance imaging revealed an ipoechoic mass in the head of pancreas suggestive for malignant tumor. She underwent pancreaticoduodenectomy; histologic examination showed a granulomatous inflammation with nec...

Sulfasalazine is a well established disease-modifying anti-rheumatic drug commonly used in the treatment of rheumatic disorders and inflammatory bowel disease. Sulfasalazine was generally well tolerated in clinical trials, the most frequently reported adverse effects being adverse gastrointestinal effects, headache, dizziness and rash; myelosuppres...