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Öğe Characteristics predicting tuberculosis risk under tumor necrosis factor-? inhibitors: Report from a large multicenter cohort with high background prevalence(Journal of Rheumatology, 2016) Kisacik B.; Pamuk O.N.; Onat A.M.; Erer S.B.; Hatemi G.; Ozguler Y.; Pehlivan Y.; Kilic L.; Ertenli I.; Can M.; Direskeneli H.; Keser G.; Oksel F.; Dalkilic E.; Yilmaz S.; Pay S.; Balkarli A.; Cobankara V.; Cetin G.Y.; Sayarlioglu M.; Cefle A.; Yazici A.; Avci A.B.; Terzioglu E.; Ozbek S.; Akar S.; Gul A.Objective. Screening strategies for latent tuberculosis (TB) before starting tumor necrosis factor (TNF)- 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. Copyright © 2016 The Journal of Rheumatology. All rights reserved.Öğe Familial Mediterranean Fever (FMF) in Turkey: Results of a nationwide multicenter study(Lippincott Williams and Wilkins, 2005) Tunca M.; Ozdogan H.; Kasapcopur O.; Yalcinkaya F.; Tutar E.; Topaloglu R.; Yilmaz E.; Arici M.; Bakkaloglu A.; Besbas N.; Akpolat T.; Dinc A.; Erken E.; Tirpan K.; Ozer H.T.E.; Soyturk M.; Senturk T.; Balci B.; Ozguc M.; Dundar M.; Akar E.; Ozel D.; Dundar M.; Gunesacar R.; Booth D.R.; Hawkins P.N.; Touitou I.; Aksentijevich I.; Matzner Y.; Arslan S.; Balaban Y.; Batman F.; Bayraktar Y.; Apras S.; Calguneri M.; Duzova A.; Kav T.; Ozaltin F.; Simsek H.; Sivri B.; Tatar G.; Akkoc N.; Kavukcu S.; Soylu A.; Turkmen M.; Unsal E.; Arisoy N.; Caliskan S.; Gogus F.; Masatlioglu S.; Sever L.; Akkok N.; Cakar N.; Kara N.; Kocak H.; Ozalp S.; Bilge I.; Sevinc E.; Gul A.; Kamali S.; Sadikoglu B.; Selcukbiricik F.; Sirin A.; Sucu A.; Bek K.; Bulbul M.; Delibas A.; Demircin G.; Erdogan O.; Oner A.; Mesiha M.; Ozkaya N.; Tekin M.; Demirkaya E.; Erdem H.; Gok F.; Pay S.; Islek I.; Kabasakal Y.; Keser G.; Ozmen M.; Akoglu E.; Atagunduz P.; Direskeneli H.; Temel M.; Tuglular S.; Buyan N.; Bakkaloglu S.; Derici U.; Goker B.; Kalman S.; Ozkaya O.; Dusunsel R.; Gunduz Z.; Poyrazoglu M.H.; Korkmaz C.; Baskin E.; Koseoglu H.K.; Saatci U.; Yucel E.; Coban E.; Yakupoglu G.; Oktem F.; Tunc E.; Cobankara V.Familial Mediterranean fever (FMF) is an autosomal recessive disease that is prevalent among eastern Mediterranean populations, mainly non-Ashkenazi Jews, Armenians, Turks, and Arabs. Since a large proportion of all the FMF patients in the world live in Turkey, the Turkish FMF Study Group (FMF-TR) was founded to develop a patient registry database and analyze demographic, clinical, and genetic features. The cohort was composed of 2838 patients (mean age, 23.0 ± 13.33 yr; range, 2-87 yr), with a male:female ratio of 1.2:1. There was a mean period of 6.9 ± 7.65 years from disease onset to diagnosis; the period was about 2 years shorter for each decade since 1981. Ninety-four percent of patients were living in the central-western parts of the country; however, their familial origins (70% from the central-eastern and Black Sea regions) reflected not only the ongoing east to west migration, but also the historical roots of FMF in Turkey. Patients' clinical features included peritonitis (93.7%), fever (92.5%), arthritis (47.4%), pleuritis (31.2%), myalgia (39.6%), and erysipelas-like erythema (20.9%). Arthritis, arthralgia, myalgia, and erysipelas-like erythema were significantly more frequent (p < 0.001) among patients with disease onset before the age of 18 years. Genetic analysis of 1090 patients revealed that M694V was the most frequent mutation (51.4%), followed by M680I (14.4%) and V726A (8.6%). Patients with the M694V/M694V genotype were found to have an earlier age of onset and higher frequencies of arthritis and arthralgia compared with the other groups (both p < 0.001). In contrast to other reported studies, there was no correlation between amyloidosis and M694V homozygosity in this cohort. However, amyloidosis was still remarkably frequent in our patients (12.9%), and it was prevalent (27.8%) even among the 18 patients with a disease onset after age 40 years. Twenty-two patients (0.8%) had nonamyloid glomerular diseases. The high prevalence of vasculitides (0.9% for polyarteritis nodosa and 2.7% for Henoch-Schönlein purpura) and high frequency of pericarditis (1.4%) were striking findings in the cohort. Phenotype II cases (those patients with amyloidosis as the presenting or only manifestation of disease) were rare (0.3% or less). There was a high rate of a past diagnosis of acute rheumatic fever, which suggested a possible misdiagnosis in children with FMF presenting with recurrent arthritis. To our knowledge, this is the largest series of patients with FMF reported from 1 country. We describe the features of the disease in the Turkish population and show that amyloidosis is still a substantial problem.Öğe Risk of cancer in Turkish patients after treatment with TNF antagonists(Oxford University Press, 2008) Pay S.; Öztürk M.A.; Can G.; Cefle A.; Çobankara V.; Erer B.; Gögüş F.; Hatemi G.; Inanç N.; Karaaslan Y.; Karadag Ö.; Krakoç Y.; Kasapoglu E.; Kaşifoglu T.; Keser G.; Koca S.; Öktem S.; Özer H.T.E.; Sayarhoglu M.; Soy M.; Şentürk T.; Temel M.; Terzioglu E.; Tiryaki O.; Türk T.; Yücel E.[No abstract available]
