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Öğe The cost of care of rheumatoid arthritis and ankylosing spondylitis patients in tertiary care rheumatology units in Turkey(Clinical & Exper Rheumatology, 2012) Malhan, S.; Pay, S.; Ataman, S.; Dalkilic, E.; Dinc, A.; Erken, E.; Ertenli, I.; Ertugrul, E.; Gogus, F.; Hamuryudan, V.; Inanc, M.; Karaaslan, Y.; Karadag, O.; Karakoc, Y.; Keskin, G.; Kisacik, B.; Kiraz, S.; Oksel, F.; Oksuz, E.; Pirildar, T.; Sari, I.; Soy, M.; Senturk, T.; Taylan, A.Objectives To determine the direct and indirect costs due to rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients in Turkey. Methods An expert panel was convened to estimate the direct and indirect costs of care of patients with RA and AS in Turkey. The panel was composed of 22 experts chosen from all national tertiary care rheumatology units (n=53). To calculate direct costs, the medical management of RA and AS patients was estimated using "cost-of-illness" methodology. To measure indirect costs, the number of days of sick leave, the extent of disability, and the levels of early retirement and early death were also evaluated. Lost productivity costs were calculated using the "human capital approach", based on the minimum wage. Results The total annual direct costs were 2,917.03 Euros per RA patient and 3,565.9 Euros for each AS patient. The direct costs were thus substantial, but the indirect costs were much higher because of extensive morbidity and mortality rates. The total annual indirect costs were 7,058.99 Euros per RA patient and 6,989.81 for each AS patient. Thus, the total cost for each RA patient was 9,976.01 Euros and that for an AS patient 10,555.72 Euros, in Turkey. Conclusion From the societal perspective, both RA and AS have become burden in Turkey. The cost of lost productivity is higher than the medical cost. Another important conclusion is that indirect costs constitute 70% and 66% of total costs in patients with RA and AS, respectively.Öğe THE COST OF CARE OF RHEUMATOID ARTHRITIS AND ANKYLOSING SPONDYLITIS PATIENTS IN TERTIARY CARE RHEUMATOLOGY UNITS IN TURKEY(Elsevier Science Inc, 2011) Malhan, S.; Pay, S.; Ataman, S.; Dalkilic, E.; Dinc, A.; Erken, E.; Ertenli, I; Ertugrul, E.; Gogus, F.; Hamuryudan, V; Inanc, M.; Karaaslan, Y.; Karadag, O.; Karakoc, Y.; Keskin, G.; Kisacik, B.; Kiraz, S.; Oksel, F.; Oksuz, E.; Parildar, T.; Sari, I; Soy, M.; Senturk, T.; Taylan, A.Öğe Direct and indirect healthcare costs of rheumatoid arthritis patients in Turkey(Clinical & Exper Rheumatology, 2016) Hamuryudan, V.; Direskeneli, H.; Ertenli, I.; Inanc, M.; Karaaslan, Y.; Oksel, F.; Ozbek, S.; Pay, S.; Terzioglu, E.; Tezer, D. Balkan; Hacibedel, B.; Akkoc, N.Objective To estimate the annual cost of rheumatoid arthritis (RA) in Turkey by obtaining real-world data directly from patients. Methods In this cross-sectional study, RA patients from the rheumatology outpatient clinics of 10 university hospitals were interviewed with a standardised questionnaire on RA-related healthcare care costs. Results The study included 689 RA patients (565 females) with a mean age of 51.2 +/- 13.2 years and mean disease duration of 9.4 +/- 7.8 years. The mean scores of the Routine Assessment of Patient Index Data 3 and the Health Assessment Questionnaire Disability Index (5.08 +/- 2.34 and 1.08 +/- 0.68, respectively) indicated moderate disease activity and severity for the whole group. One-third of the patients were on biologic agents and 12% had co-morbid conditions. The mean number of annual outpatient visits was 11.7 +/- 9.6 per patient. Of the patients, 15% required hospitalisation and 4% underwent surgery. The mean annual direct cost was 4,954 (median, 1,805), whereas the mean annual indirect cost was 2,802 (median, 608). Pharmacy costs accounted for the highest expenditure (mean, 2,777; median, 791), followed by the RA-related consultations and expenses (mean, 1,600; median, 696). Conclusion RA has a substantial economic burden in Turkey, direct costs being higher than indirect costs. Although both direct and indirect costs are lower in Turkey than in Europe with respect to nominal Euro terms, they are higher from the perspectives of purchasing power parity and gross domestic product. Early diagnosis and treatment of RA may positively affect the national economy considering the positive correlation between health care utilisations and increased cost with disease severity.Öğe Endothelial nitric oxide synthase gene Glu298Asp polymorphism is associated with Behcet's disease(Clinical & Exper Rheumatology, 2006) Oksel, F.; Keser, G.; Ozmen, M.; Aksu, K.; Kitapcioglu, G.; Berdeli, A.; Doganavsargil, E.Objective. The 894 G -> T (Glu298Asp) polymorphism in exon 7 of the endothelial nitric oxide synthase (eNOS) gene was previously reported to be associated with Behcet's Disease (BD) susceptibility in Italian origin and Korean patients, but not in a group of unrelated Turkish patients. We analyzed whether this polymorphism is associated with BD, in another group of Turkish patients. Methods. We studied 132 consecutive Turkish BD patients being followed up by Ege University Rheumatology Department and 91 healthy controls. All individuals were genotyped by PCR-RFLP for 894 G -> T in exon 7 (Glu298Asp). Results. The frequency of the T allele in BD group (1011264) was significantly higher than in healthy controls (OR 1.88, %95 CI 1.27-2.49, p < 0.001). The frequency of the homozygote (TT) Glu298Asp polymorphism in BD (27/132) was also significantly higher than in healthy controls (5/91) (OR 3.72, %95 CI 3.44-4.0, p < 0.001). However, no association was found between the Glu298Asp polymorphism and clinical parameters in BD. Conclusions. In this study, we found that Glu298Asp polymorphism of the eNOS gene was associated with BD in Turkish patients.Öğe Factors effective on regional breast milk 25(OH) D2 and 25(OH) D3.(1998) Oksel, F.; Taneli, Baha; Ertan, Pelin; Çoker, Işıl; Hüseyinov, Afig…Öğe Incomplete thymus involution in systemic sclerosis(B M J Publishing Group, 2007) Tarhan, E.; Biteroglu, S.; Terzioglu, E.; Savas, R.; Keser, G.; Oksel, F.Öğe INDIRECT COSTS ASSOCIATED WITH RHEUMATOID ARTHRITIS IN TURKEY(Elsevier Science Inc, 2012) Hamuryudan, V; Direskeneli, H.; Ertenli, I; Inanc, M.; Karaaslan, Y.; Oksel, F.; Ozbek, S.; Pay, S.; Terzioglu, E.; Durguner, B.; Baser, O.; Akkoc, N.Öğe Magnetic resonance imaging of the sacroiliac joints in ankylosing spondylitis before and after therapy with anti-tumor necrosis factor alpha(B M J Publishing Group, 2007) Kobak, S.; Oksel, F.; Kabasakal, Y.; Doganavsargil, E.Öğe MEDICAL COSTS OF PATIENTS WITH RHEUMATOID ARTHRITIS AND ASSOCIATION WITH GLOBAL DISEASE ACTIVITY IN TURKEY(Elsevier Science Inc, 2013) Hamuryudan, V; Direskeneli, H.; Ertenli, I; Inanc, M.; Karaaslan, Y.; Oksel, F.; Ozbek, S.; Pay, S.; Terzioglu, E.; Durguner, B.; Baser, O.; Akkoc, N.Öğe MEDICAL COSTS OF PATIENTS WITH RHEUMATOID ARTHRITIS AND ASSOCIATION WITH GLOBAL DISEASE ACTIVITY IN TURKEY(Bmj Publishing Group, 2013) Hamuryudan, V.; Direskeneli, H.; Ertenli, I.; Inanc, M.; Karaaslan, Y.; Oksel, F.; Ozbek, S.; Pay, S.; Terzioglu, E.; Durguner, B.; Baser, O.; Akkoc, N.Öğe MEDICAL COSTS OF PATIENTS WITH RHEUMATOID ARTHRITIS AND ITS ASSOCIATION WITH GLOBAL DISEASE ACTIVITY IN TURKEY(Elsevier Science Inc, 2013) Hamuryudan, V; Direskeneli, H.; Ertenli, I; Inanc, M.; Karaaslan, Y.; Oksel, F.; Ozbek, S.; Pay, S.; Terzioglu, E.; Durguner, B.; Baser, O.; Akkoc, N.Öğe Pregnancy outcome in our patients with systemic lupus erythematosus(B M J Publishing Group, 2006) Ocakci, P. T.; Keser, G.; Aksu, K.; Kocanaogullari, H.; Kabasakal, Y.; Oksel, F.; Doganavsargil, E.Öğe Retrospective analysis of 11 Turkish patients with anti Jo-1 syndrome(B M J Publishing Group, 2006) Oder, G.; Oksel, F.; Keser, G.; Aksu, K.; Kabasakal, Y.; Gulbahar, O.; Inal, V.; Tarhan, F.; Gokmen, N.; Kocanaogullari, H.; Doganavsargil, E.Öğe The role of HLA-DRB1 shared epitope alleles in predicting short-term response to leflunomide in rheumatoid arthritis(Oxford Univ Press, 2007) Saruhan-Direskeneli, G.; Inanc, M.; Fresko, I.; Akkoc, N.; Dalkilic, E.; Erken, E.; Karaaslan, Y.; Kinikli, G.; Oksel, F.; Pay, S.; Yucel, E.; Yentuer, S. P.; Duymaz-Tozkir, J.; Yilmaz, V.; Inanc, N.; Yazici, H.; Konice, M.; Direskeneli, H.Objectives. To investigate the role of shared epitope (SE) alleles in the short-term clinical response to leflunomide for the treatment of active RA. Methods. In an open-label, multi-centre study of 16-weeks duration, 93 patients (82% female) fulfilling ARA 1987 RA criteria were treated with leflunomide (100 mg loading dose for 3 days, then 20 mg/day as the maintenance dose). The primary efficacy criterion was the response status according to the European League Against Rheumatism (EULAR) response criteria using Disease Activity Score-28 (DAS28) activity measure. SE determinations have been undertaken by polymerase chain reaction and sequencespecific oligonucleotide genotyping methods. Results. The mean (S.D) Disease Activity Score-28 (DAS28) was 5.1 (1.3) before the treatment, which was significantly decreased after 16 weeks [3.0 (1.1), P < 0.001]. According to the EULAR response criteria, 55 patients (59.1%) were classified as good responders. SE was positive in 51 (54.8) of the patients, with 13 (13.9%) having SE homozygosity or carrying any two SE alleles. Among SE-positive patients, 68.6% (35/51) were good responders, compared with 47.6% (20/42) in SE negatives (P < 0.04). No difference was present according to SE hetero- or homozygosity (68.4 vs 69.2%). RF was also present significantly more frequently in the SE-positive group compared with negatives (78.4 vs 57.1%, P = 0.03). However, no significant difference was observed in the prevalence of RF positivity in patients with a good clinical response (72.7 vs 63.2%, P = 0.32). Conclusions. The results suggest that HLA-DRB1 SE presence may favourably affect the outcome of leflunomide monotherapy in an unselected group of RA patients with an active disease and naive to leflunomide.Öğe Secondary amyloidosis in three patients with ankylosing spondylitis responded well to etanercept(B M J Publishing Group, 2007) Kobak, S.; Oksel, F.Öğe Sjogren's syndrome in systemic sclerosis and rheumatoid arthritis. A prospective study(B M J Publishing Group, 2007) Kobak, S.; Oksel, F.; Doganavsargil, E.
