Maurizio Rossini

University of Verona | UNIVR · Rheumatology Unit, Department of Medicine

Background Psoriatic arthritis (PsA) is a chronic inflammatory musculoskeletal disease involving several articular and extra-articular structures. Despite the important progresses recently made in all of the aspects of this disease, its management is still burdened by unresolved issues. The aim of this exercise was to provide a set of statements th...

Background Bone metabolism is disrupted in rheumatoid arthritis (RA); however, the bone metabolic signature of RA is poorly known. The objective of the study is to further characterize the bone metabolic profile of RA and compare it to psoriatic arthritis (PsA), systemic sclerosis (SSc) and healthy controls. Methods We did a cross-sectional case-c...

Purpose Since vertebral fragility fractures (VFFs) might increase the risk of subsequent fractures, we evaluated the incidence rate and the refracture risk of subsequent vertebral and non-vertebral fragility fractures (nVFFs) in untreated patients with a previous VFF. Methods We systematically searched PubMed, Embase, and Cochrane Library up to Fe...

The mechanisms underlying the development of bone damage in the context of spondyloarthritis (SpA) are not completely understood. To date, a considerable amount of evidence indicates that several developmental pathways are crucially involved in osteoimmunology. The present review explores the biological mechanisms underlying the relationship betwee...

Background Biological DMARDs (bDMARDs) have been proven to prevent joint damage and bone erosions. Nevertheless, approximately 15% of rheumatoid arthritis (RA) patients on bDMARDs will progress despite good control of joint inflammation. Objectives The objective of our study is to investigate the factors associated with radiological progression of...

Objectives: We aimed to investigate the effectiveness of tumour necrosis factor inhibitors (TNFi), anti-interleukin-17 or interleukin-12/23 monoclonal antibodies (anti-IL) on comorbidities in a cohort of patients with spondyloarthritis (SpA), using an average treatment effect (ATE) analysis. Methods: SpA patients from the multicentre Italian GIS...

Unlabelled: Randomized clinical trials and observational studies on the implementation of clinical governance models, in patients who had experienced a fragility fracture, were examined. Literature was systematically reviewed and summarized by a panel of experts who formulated recommendations for the Italian guideline. Purpose: After experiencin...

Background: Noncommunicable, chronic diseases need pharmacological interventions for long periods or even throughout life. The temporary or permanent cessation of medication for a specific period, known as a ‘medication holiday,’ should be planned by healthcare professionals. Objectives: We evaluated the association between continuity (adherence or...

Background Various clinical (disease activity, seropositive RA etc.) and metabolic risk factors (Dkk1 etc.) have been associated with erosive rheumatoid arthritis (RA). However, such risk factors might be intertwined, and multicollinearity might reduce our ability to discern the individual contribution to erosive score. Principal component analysis...

Background Osteoporotic fractures continue to be a major cause of global health concerns around the world. The most common risk scores (FRAX, DeFRA) are evaluating this risk within a 10-yearstime window, which might not be suitable for evaluating shorter term risk, or quickly progressing patients. Objectives The objective of the present analysis i...

Background The negative effects of glucocorticoids (GCs) on the bone depend on dose and treatment duration. However, it is unclear whether a safe dose exists, especially for patients with inflammatory rheumatic musculoskeletal diseases (iRMDs). Objectives The primary objective of the present study was to determine, in a real-life setting, the risk...

Background The bone mineral density (BMD) surrogate threshold effect (STE) is the change in BMD that can predict a fracture risk reduction with 95% certainty. The STE estimates for changes in total hip BMD have been recently validated by the FNIH-ASBMR SABRE Project. Objectives We evaluated the proportion of patients reaching the STEs with anti-os...

Background Glucocorticoids are still a mainstream of rheumatoid arthritis (RA) treatment. Reducing glucocorticoids should be attempted in all patients. However, choosing the right tapering strategy is challenging. Objectives The primary aim of our study is to determine the dose-response association between glucocorticoid tapering and risk of flare...

Background Complex Regional Pain Syndrome (CRPS) is a painful disease that can lead to chronic pain and disability. Bisphosphonates are largely used in the real-life for the treatment of CRPS, but data on long-term effectiveness and its predictors are lacking. Objectives The aim of the present study is to describe the real-life effectiveness of IV...

Background The ANCA-associated vasculitis patient-reported outcome (AAV-PRO) questionnaire is a 29-item disease-specific PRO measure for AAV [1]. Originally only available in English, it has been translated into several languages in recent years to spread its use. The Italian version of the AAV-PRO questionnaire (AAV-PRO_ita) was translated in coll...

Background Serum C-terminal telopeptide of type I collagen (CTX - a marker of bone resorption) and ACPA titer have been associated to higher erosive score in rheumatoid arthritis (RA) and lower bone mineral density (BMD), even in patients with pre-arthritis. Prominent inflammatory status cannot totally explain such association. The interplay betwee...

Background Articular involvement (69-95%) in patients with systemic lupus erythematosus (SLE) is traditionally considered non-erosive. SLE arthritis with radiographic erosions with or without rheumatoid factor (RF) and/or anti-citrullinated peptide antibody (ACPA) positivity is often described as “rhupus” and is considered an overlap between SLE an...

Background An increased number of elderly patients with rheumatoid arthritis (RA) has been observed in the last years mainly due to the increase of life expectancy. In this group it is possible to include two different categories: patients with onset of RA in advanced age (60-65 years old), and patients with an early occurrence of RA aged with the...

The aim of this study is to characterise lupus-related arthritis and assess if the presence of ultrasound-detected erosions could be associated with belimumab in the treatment of systemic lupus erythematosus (SLE) articular manifestations. We performed a spontaneous, monocentric, retrospective, and observational study. We enrolled patients affected...

Background Immune and vascular ageing are proposed risk factors for giant cell arteritis (GCA). Data on the impact of age at diagnosis of GCA on the clinical presentation and course of the disease are scarce. Methods Patients with GCA followed at referral centres within the Italian Society of Rheumatology Vasculitis Study Group were enrolled up to...

Psoriatic arthritis (PsA) is an inflammatory disease characterized by peripheral and axial involvement. Biological disease-modifying antirheumatic drugs (bDMARDs) are the mainstream treatment for PsA and bDMARDs retention rate is a proxy for the drug's overall effectiveness. However, it is unclear whether IL-17 inhibitors can have a higher retentio...

Background: The negative effects of glucocorticoids (GCs) on the bone depend on dose and treatment duration. However, it is unclear whether a safe dose exists, especially for patients with inflammatory rheumatic musculoskeletal diseases (iRMDs). Methods: We conducted a longitudinal cohort study on women with iRMD. Bone mineral density and fractu...

Aim: To assess the efficacy of belimumab in joint and skin manifestations in a nationwide cohort of patients with SLE. Methods: All patients with skin and joint involvement enrolled in the BeRLiSS cohort were considered. Belimumab (intravenous, 10 mg/kg) effectiveness in joint and skin manifestations was assessed by DAS28 and CLASI, respectively...

Background: Fragility fractures are a major public health concern owing to their worrying and growing burden and their onerous burden upon health systems. There is now a substantial body of evidence that individuals who have already suffered a fragility fracture are at a greater risk for further fractures, thus suggesting the potential for seconda...

Purpose Preventing fragility fractures by treating osteoporosis may reduce disability and mortality worldwide. Algorithms combining clinical risk factors with bone mineral density have been developed to better estimate fracture risk and possible treatment thresholds. This systematic review supported panel members of the Italian Fragility Fracture G...

Osteoporosis is a common non-communicable disease with enormous societal costs. Antiosteoporosis medications have been proven efficacious in reducing the refracture rate and mortality; moreover, we have now convincing evidence about the cost-effectiveness of antiosteoporotic medications. However, albeit preventable and treatable, osteoporosis has b...

Reply to Wimalawansa, S.J. Comment on “Bertoldo et al. Definition, Assessment, and Management of Vitamin D Inadequacy: Suggestions, Recommendations, and Warnings from the Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS). Nutrients 2022, 14, 4148”

Objectives To investigate whether meticulously following a treat-to-target (T2T)-strategy in daily clinical practice will lead to less radiographic progression in patients with active rheumatoid arthritis (RA) who start (new) DMARD-therapy. Methods Patients with RA from 10 countries starting/changing conventional synthetic or biologic DMARDs becau...

While precision medicine is still a challenge in rheumatic disease, in recent years many advances have been made regarding pathogenesis, the treatment of inflammatory arthropathies, and their interaction. New insight into the role of inflammasome and synovial tissue macrophage subsets as predictors of drug response give hope for future tailored the...

Introduction Glucocorticoids are still a mainstream of rheumatoid arthritis (RA) treatment. Reducing glucocorticoids should be attempted in all patients. However, choosing the right tapering strategy is challenging. The primary aim of our study is to determine the dose–response association between glucocorticoid tapering and risk of flare in RA. M...

Background Preclinical data suggest that tofacitinib would protect bone health in patients with rheumatoid arthritis (RA). Objective To assess fracture risk in tofacitinib RA clinical trials. Design Post hoc analysis. Methods We analyzed pooled data of phase I/II/III and long-term extension studies (‘ P123LTE cohort’), pooled data of placebo-con...

Background No data on the permanent and curative effect of bisphosphonate treatment in patients with complex regional pain syndrome type-1 (CRPS-1) are currently available. The aim of this pre-specified, open-label, observational study was to evaluate the long-term efficacy and safety of neridronate treatment. Design A pre-specified, open-label, e...

Background Systemic sclerosis (SSc) is an autoimmune disease characterized by vasospasm and microvascular involvement. Iloprost (ILO), a prostaglandin analogous, is used for the treatment of SSc-related Raynaud’s phenomenon and digital ulcers. The suggested dose is 0.5–2 ng/kg/min for 6–8 h, and the maximum dose is decided upon the patient’s tolera...

The effects of different cholecalciferol supplementation regimens on serum inflammatory cytokines in healthy subjects with vitamin D deficiency are still lacking. This is a single-center, open-label, randomized, parallel group study involving healthy subjects deficient in vitamin D (baseline 25OHD < 20 ng/mL) receiving oral cholecalciferol with thr...

Background The aim of this real-life cross-sectional explorative study was to compare radiofrequency echographic multi-spectrometry (REMS) with dual-energy X-rays absorptiometry (DXA) in the BMD assessment of patients receiving peritoneal dialysis (PD). Furthermore, we investigated the relationship between lumbar aortic calcifications (AOCs) and th...

Background Fragility hip fractures (HF) are a major cause of disability in the elderly. Air pollution has been linked with higher risk of osteoporosis. However, the association between acute exposure to air pollution and fractures is still unclear. Methods We conducted a case-crossover study on patients with fragility HF admitted to the Orthopedic...

In the recent years, both the prescriptions of serum 25(OH)D levels assay, and vitamin D supplementation are constantly increasing, as well as the costs to be incurred relating to these specific aspects. As in many other countries, the risk of vitamin D deficiency is particularly high in Italy, as recently confirmed by cohort studies in the general...

Objectives To investigate whether concomitant autoimmune inflammatory rheumatic diseases (AIIRDs) represent a risk factor for denosumab discontinuation and to explore other possible predictors. Design This is a real-life retrospective study conducted at our centre on consecutive patients who started treatment with denosumab from January 2014 to Oc...

The aim of this study was to examine whether scar imaging echocardiography with ultrasound multi-pulse scheme (eSCAR) can detect subclinical myocardial involvement in systemic lupus erythematosus (SLE). We consecutively recruited SLE patients and controls matched for age, sex, and cardiovascular risk factors. Participants with cardiac symptoms or a...

Objectives Few data are available on the role of emotional distress as a possible mediator of the relationship between coping strategies and the Patient Global Assessment (PGA). This study aims to investigate, in a large cohort of patients affected by Rheumatoid Arthritis (RA), the relationship between specific copying strategies and PGA, and the r...

Objective: To promote advanced research using magnetic resonance imaging (MRI) in the diagnosis of and screening for osteoporosis by looking for correlations among the T-scores measured by dual-energy X-ray absorptiometry (DEXA), the apparent diffusion coefficient (ADC) values on diffusion-weighted imaging (DWI), and the T1-weighted signal intensi...

Introduction: Psoriatic arthritis (PsA) is a chronic inflammatory condition characterised by skin and joints involvement, and with a great burden of comorbidity that could affect the choice of treatment. Chronic obstructive pulmonary disease (COPD) is one of the primary causes of morbidity and mortality. Medical therapy can improve symptoms and th...

Introduction Randomized clinical trials have shown that anti-osteoporotic treatments can increase bone mineral density (BMD) and reduce the incidence of fragility fractures. However, data on the real-life effectiveness of anti-osteoporotic medications are still scarce. Methods We conducted a cohort study on women at high risk of fracture. We retri...

Background Data from randomized clinical trials showed that anti-osteoporotic treatments increase bone mineral density (BMD) and reduce the risk of fragility fractures. However, data on the real-life effectiveness of such medications is still scarce. Objectives The primary objective of the present study is to assess the real-life effectiveness of...

Background The determinants of the susceptibility to SARS-CoV-2 infection and severe Coronavirus Disease 19 (COVID-19) manifestations are yet not fully understood. Amino-bisphosphonates (N-BPs) have anti-inflammatory properties and have been shown to reduce the incidence of lower respiratory infections, cardiovascular events and cancer. Objectives...

Background Fragility femoral fracture is a common, world-spread, medical condition, that has a relevant impact both clinically and economically. Chronic exposure to environmental air pollution has been linked with a higher risk of developing osteoporosis. However, little is known regarding the relationship between short-term exposure to air polluti...

Background Systemic Sclerosis (SSc) is an autoimmune disease characterized by vasospasm and microvascular involvement. Iloprost (ILO), a prostaglandin analogous, is used for the treatment of SSc-related Raynaud’s Phenomenon and digital ulcers. The indicated dosage is 0-5-2 ng/kg/min for 6-8 hours and the maximum dose is decided upon the patient’s t...

Background Data on the relationship between peritoneal dialysis (PD), BMD and aortic calcifications (AOC) are lacking. Objectives to study the relationship between the degree of AOC and DXA and Radiofrequency Echographic Multi-Spectrometry (REMS) acquisitions. Methods Consecutive patients referring to the PD our clinic were enrolled. Lumbar spine...

Background The ANCA-associated vasculitis patient-reported outcome (AAV-PRO) questionnaire is a 29-item disease-specific PRO measure for AAV[1]. The Italian version of the AAV-PRO questionnaire (AAV-PRO_ita) was translated in collaboration with Oxford and Bristol University (UK) and was preliminarily tested on a single-center Italian cohort[2]. Ob...

Background Sarcopenia is a progressive and generalized skeletal muscle loss associated with falls, fractures, physical disability, and mortality, described as age-related or secondary. Systemic inflammatory diseases, such as rheumatoid arthritis (RA), are well-known causes of secondary sarcopenia. However, the exact prevalence of sarcopenia in pati...

Background Over 80% of patients affected with SLE experience skin involvement. The anti-BLyS drug belimumab was shown effective in ameliorating mucocutaneous SLE manifestations in clinical trials and real-life studies. Cutaneous response is quantified through the CLASI (cutaneous lupus erythematosus area and severity index). Clinically relevant imp...

Background A Treat-to-Target approach (T2T) is broadly considered to lead to better clinical outcomes and recommended in patients with RA. However, very few studies have analyzed the effect of T2T on radiographic progression, and any such studies have provided inconsistent results. Objectives To investigate whether meticulously following a treat-t...

Background Ultrasonography of the nails with high frequency linear transducers can properly perform morphological images, achieving highly descriptive power but the lack of standardization may hesitate in lack of reproducibility and scarce usefulness. Objectives The aim of this study was to provide a detailed scan protocol of nail plate, including...

Background So far, few studies provided detailed data for the incidence of disease flare after the vaccination against Coronavirus (Covid)-19 in patients with psoriatic arthritis (PsA). Results from small cohorts report an incidence of flares after Covid-19 vaccination of 0-7.7% and disease activity does not seems to be influenced by Covid-19 vacci...

Background The effects of cholecalciferol supplementation on the regulation of inflammatory cytokines are still unclear. Objectives This is a preliminary analysis on exploratory outcomes the DIBA/11 RCT [1,2] and aimed to compare the effects on serum inflammatory cytokines of three different regimes of cholecalciferol supplementation in vitamin D-...

Background Psoriasis is a chronic inflammatory disease with a relapsing-remitting course. Selected environmental factors such as infections, stressful life events or drugs may trigger disease flares. Whether the air pollution could trigger psoriasis flares is still unknown. Objectives To investigate whether the short-term exposure to environmental...

Background Scar imaging echocardiography with ultrasound multi-pulse scheme (eSCAR) is a novel technique allowing detection of myocardial scars. eSCAR has never been explored in patients with systemic sclerosis (SSc). Objectives The aim of our study was to examine whether eSCAR may detect subclinical myocardial fibrosis in SSc. Methods In this cr...

Background The best way to manage disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatic and musculoskeletal diseases (RMDs) undergoing the Coronavirus disease (Covid)-19 vaccination and the recommendations regarding the use and timing of immunomodulatory therapies around the time of vaccination are still a matter of debate, due...

Background In real-life setting, a greater number of elderly rheumatoid arthritis (RA) patients with impaired glomerular filtration rate (GFR) needs treatment with biologic or target synthetic disease-modifying anti-rheumatic drugs (b/tsDMARD) to achieve disease control and reduce NSAIDs intake. Long-term observational data from the real-life on th...

Background Environmental air pollution has been associated with disruption of the immune system at a molecular level. Objectives The primary aim of the present study is to describe the association between long-term exposure to air pollution and risk of developing immune-mediated conditions. Methods We conducted a retrospective observational study...

Background Environmental air pollution has been associated with disruption of bone health at a molecular level. Particulate matter (PM) exposure can simultaneously stimulate bone resorption and halt bone formation. Objectives The primary aim of the present study is to describe the association between long-term exposure to PM and osteoporosis in a...

Background Radiofrequency echographic multi-spectrometry (REMS) is a novel ultrasound-based technique that has shown good reliability in the assessment of bone mineral density (BMD). Objectives The aim of this study was to compare the performance of the REMS BMD assessment with dual-energy X-rays absorptiometry (DXA) in a cohort of patients affect...

In October 2019, the Italian Drug Agency (AIFA) restricted reimbursement criteria for vitamin D (VD) use outside the osteoporosis setting (Note 96). However, whether this restriction could also have involved patients at risk for or with osteoporotic fractures has not yet been investigated. We retrospectively analyzed databases from five Italian Loc...

Bone Biopsy (BB) with histomorphometric analysis still represents the gold standard for the diagnosis and classification of different forms of renal osteodystrophy. Bone biopsy is the only technique able to provide comprehensive information on all bone parameters, measuring static and dynamic parameters of turnover, cortical and trabecular microarc...