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Öğe Evaluation of hepatitis serology and frequency of viral reactivation in patients with inflammatory arthritis receiving biologic agents: a multicenter observational study(Springer Science and Business Media Deutschland GmbH, 2023) Çapkın, Erhan; Yazıcı, Ali; Karkucak, Murat; Durmaz, Yunus; Toprak, Murat; Ataman, Sebnem; Bulut Keskin, Ayşe SelcenTo evaluate of hepatitis serology and reactivation frequency in patients with rheumatic disease receiving biologic agents. Our study included patients with inflammatory rheumatic diseases from 23 centers, who were followed up with biological therapy. Demographic and clinical characteristics of the patients, duration of drug use and hepatitis serology and the state of viral reactivation were analyzed. A total of 4060 patients, 2095 being males, were included in our study. Of the patients, 2463 had Ankylosing Spondylitis (AS), 1154 had Rheumatoid Arthritis (RA), 325 had Psoriatic Arthritis (PsA), and 118 had other inflammatory rheumatic diseases. When the viral serology of the patients was evaluated, 79 patients (2%) who were identified as HBs Ag positive, 486 (12%) patients who were HBs Ag negative and anti-HBc IgG positive and 20 patients (0.5%) who were anti-HCV positive. When evaluated on a disease-by-disease basis, the rate of HBsAg was found to be 2.5% in RA, 2% in AS and 0.9% in PsA. Viral reactivation was detected in 13 patients while receiving biologic agents. HBs Ag was positive in nine patients with reactivation and negative in four patients. Anti-HBc IgG, however, was positive. Six of these patients had AS, four had RA, and three had PsA. The development of hepatitis reactivation in 11.4% of HBs Ag positive patients and 0.82% of anti-HBc IgG positive patients due to the use of biologic agents is an important problem for this group of patients. Antiviral prophylaxis is recommended to be started especially in patients who are HBs Ag positive and who are using biologic agents due to viral reactivation. Therefore, it is important to carry out hepatitis screenings before biologic agent treatment and to carefully evaluate the vaccination and prophylaxis requirements.Öğe Plasma leptin status and the relationship between different medical treatments used in ankylosing spondylitis(2013) Güler, Mustafa; Çapkin, Erhan; Karkucak, Murat; Aydin, Teoman; Türkyilmaz, Ayşegül Küçükali; Karaca, Adem; Gökmen, FerhatObjective: To determine plasma leptin level in ankylosing spondylitis (AS) and its correlation with disease activity measurements. To examine the effects of different treatment modalities on leptin levels. Material and Method: One hundred eight patients diagnosed with AS according to New York Criteria and 65 healthy individuals were enrolled in the study. The Bath AS Disease Activity Index (BASDAI) was used for disease activity. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, acute phase reactants, plasma leptin levels, serum interleukin-6 (IL-6) and serum tumor necrosis factor-? (TNF-?) levels were investigated. Results: Plasma leptin levels in AS patients were statistically significantly lower compared with those in the healthy control group (p=0.003). There was no significant difference among sub-groups established on the basis of medical treatments and disease activity. No statistically significant correlation was determined between leptin level and disease activity parameters, radiological score and functional indices (p>0.05). Conclusion: Plasma leptin was lower in AS patients compared with the control group. This is not correlated with disease activation and medical treatment utilized.Öğe PLASMA LEPTIN STATUS AND THE RELATIONSHIP BETWEEN DIFFERENT MEDICAL TREATMENTS USED IN ANKYLOSING SPONDYLITIS(Nobel Ilac, 2013) Guler, Mustafa; Capkin, Erhan; Karkucak, Murat; Aydin, Teoman; Turkyilmaz, Aysegul Kucukali; Karaca, Adem; Gokmen, FerhatObjective: To determine plasma leptin level in ankylosing spondylitis (AS) and its correlation with disease activity measurements. To examine the effects of different treatment modalities on leptin levels. Material and Method: One hundred eight patients diagnosed with AS according to New York Criteria and 65 healthy individuals were enrolled in the study The Bath AS Disease Activity Index (BASDAI) was used for disease activity Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, acute phase reactants, plasma leptin levels, serum interleukin-6 (IL-6) and serum tumor necrosis factor-alpha (TNF-alpha) levels were investigated. Results: Plasma leptin levels in AS patients were statistically significantly lower compared with those in the healthy control group (p=0.003). There was no significant difference among sub-groups established on the basis of medical treatments and disease activity. No statistically significant correlation was determined between leptin level and disease activity parameters, radiological score and functional indices (p>0.05). Conclusion: Plasma leptin was lower in AS patients compared with the control group. This is not correlated with disease activation and medical treatment utilized.Öğe QUALITY OF LIFE IN PSORIATIC ARTHRITIS PATIENTS-ASSOCIATION WITH DISEASE ACTIVITY AND DIAGNOSTIC DELAY TIME(Nobel Ilac, 2014) Gokmen, Ferhat; Karkucak, Murat; Capkin, Arzu; Karaca, Adem; Turkyilmaz, Aysegul Kucukali; Capkin, Erhan; Akbal, AylaObjective: The purpose of this study was to determine the socio-demographic and clinical characteristics of patients with psoriatic arthritis (PsA) and to examine their effects on quality of life. Material and Method: 37 patients with PsA and 30 healthy controls were included in the study. To determine disease activity, clinical [disease activity score (DAS-28), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)] and laboratoly [Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)] parameters were used. To evaluate quality of life, the Nottingham health profile (NHP) and Short form-36 (SF-36) were used. Results: The mean age of the patients was 43.9 +/- 11.2 years. The diagnostic delay time had a median of I year (mnin-max=0-18). We examined NHP NHP scores showed that NHP pain, physical activity, tiredness and social isolation of PsA patients were higher than for control subjects. We evaluated SF-36. SF-36 scores indicated that physical function, physical role limitation, body pain, overall health, vitality and emotional role limitation were significantly decreased in PsA patients compared to control subjects. Correlation analysis was performed; Statistically significant correlations were observed between NHP scores (positive correlation) and SF-36 scores (negative correlation) with disease activity parameters (DAS-28, BASDAI, ESR and CRP). Furthermore, statistically significant correlations were observed between NHP scores (positive correlation) and SF-36 scores (negative correlation) with diagnostic delay time. Conclusion: We determined that quality of life was less in patients with PsA compared to control subjects. In addition, we have also found that disease activity and prolongation of diagnostic delay are associated with quality of life.Öğe Quality of life in psoriatic arthritis patients-association with disease activity and diagnostic delay time(Nobelmedicus, 2014) Gökmen, Ferhat; Karkucak, Murat; Çapkın, Arzu; Karaca, Adem; Türkyılmaz, Ayşegül Küçükali; Çapkın, Erhan; Akbal, AylaObjective: The purpose of this study was to determine the socio-demographic and clinical characteristics of patients with psoriatic arthritis (PsA) and to examine their effects on quality of life.; Material and Method: 37 patients with PsA and 30 healthy controls were included in the study. To determine disease activity, clinical [disease activity score (DAS-28), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)] and laboratory [Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)] parameters were used. To evaluate quality of life, the Nottingham health profile (NHP) and Short form-36 (SF-36) were used.; Results: The mean age of the patients was 43.9±11.2 years. The diagnostic delay time had a median of 1 year (min-max=0-18). We examined NHP. NHP scores showed that NHP pain, physical activity, tiredness and social isolation of PsA patients were higher than for control subjects. We evaluated SF-36. SF-36 scores indicated that physical function, physical role limitation, body pain, overall health, vitality and emotional role limitation were significantly decreased in PsA patients compared to control subjects. Correlation analysis was performed; Statistically significant correlations were observed between NHP scores (positive correlation) and SF-36 scores (negative correlation) with disease activity parameters (DAS-28, BASDAI, ESR and CRP). Furthermore, statistically significant correlations were observed between NHP scores (positive correlation) and SF-36 scores (negative correlation) with diagnostic delay time.; Conclusion: We determined that quality of life was less in patients with PsA compared to control subjects. In addition, we have also found that disease activity and prolongation of diagnostic delay are associated with quality of life. © 2014, Nobelmedicus. All rights reserved.Öğe Relationship between pulse wave velocity and serum YKL-40 level in patients with early rheumatoid arthritis(Springer Heidelberg, 2013) Turkyilmaz, Aysegul Kucukali; Devrimsel, Gul; Kirbas, Aynur; Cicek, Yuksel; Karkucak, Murat; Capkin, Erhan; Gokmen, FerhatSubclinical atherosclerosis has been demonstrated in patients with early rheumatoid arthritis (ERA) without any signs of cardiovascular disease (CVD). The aim of this study was to investigate the relationship between serum YKL-40 level and arterial stiffness in patients with ERA. Forty two patients with ERA and 35 healthy controls with no history or current sign of CVD were included in the study. ERA patients with active disease, defined as DAS28 a parts per thousand yen3.2, and symptoms onset < 12 months were recruited. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (CF-PWV), and the intima-media thickness carotid (IMT-C) was measured by carotid ultrasonography. Serum YKL-40 levels were measured by an enzyme-linked immunoassay method. The mean age was 43.1 +/- A 5.8 years in ERA patients and 41.0 +/- A 5.9 years in control group. The CF-PWV and IMT-C of the ERA patients were determined significantly higher than the control group (P = .001, P < .001, respectively). YKL-40 levels were significantly elevated in ERA patients than controls (P = .008). The serum levels of YKL-40 in the ERA patients showed a strong correlation with CF-PWV (r = .711, P < .001) and IMT-C (r = .733, P < .001). Multiple linear regression analysis revealed that CF-PWV could be explained by serum YKL-40 levels (adjusted RA(2)A = .493, P < .001). We have shown that patients with ERA had increased CF-PWV and serum YKL-40 levels. In addition, there was an association between CF-PWV values and serum YKL-40 levels in patients with ERA. As a result, we believe that serum YKL-40 level and CF-PWV might reflect early atherosclerosis in patients with ERA.Öğe The association between radiographic features in patients with lumbar spine degenerative changes and body mass index; a preliminary stereological study(2013) Güler, Mustafa; Çapkin, Erhan; Barçak, Ömer Faruk; Karkucak, Murat; Aydin, Teoman; Türkyilmaz, Ayşegül Küçükali; Karaca, AdemObjective: To evaluate the association between radiographic features (osteophytes, disc space narrowing) in patients with lumbar spine degenerative changes and body mass index (BMI), with quantitative methods. Material and Method: One-hundred and three women with lumbar spine degenerative changes who had lower back pain were included in the study. Patients were divided into two groups according to their BMI. Pain and functional status of patients were evaluated using visual analog scale (VAS) and Roland Morris Questionnaire (RMQ), respectively. The size of osteophytes and disc space narrowing were calculated on lateral roentgenogram of the lumbar vertebrae by using computer based stereological methods. Results: No significant correlation was detected between the BMI and radiological findings. But, there was a positive correlation between the osteophyte surface area and RMQ, and VAS and RMQ (p<0.05). Conclusion: No significant correlation was detected between the BMI and radiographic findings in lumbar spine degenerative changes. To our knowledge, this is the first study quantitatively assessing the association between radiographic findings and BMI in lumbar spine degenerative changes.Öğe THE ASSOCIATION BETWEEN RADIOGRAPHIC FEATURES IN PATIENTS WITH LUMBAR SPINE DEGENERATIVE CHANGES AND BODY MASS INDEX; A PRELIMINARY STEREOLOGICAL STUDY(Nobel Ilac, 2013) Guler, Mustafa; Capkin, Erhan; Barcak, Omer Faruk; Karkucak, Murat; Aydin, Teoman; Turkyilmaz, Aysegul Kucukali; Karaca, AdemObjective: To evaluate the association between radiographic features (osteophytes, disc space narrowing) in patients with lumbar spine degenerative changes and body mass index (BMI), with quantitative methods. Material and Method: One-hundred and three women with lumbar spine degenerative changes who had lower back pain were included in the study. Patients were divided into two groups according to their BMI. Pain and functional status of patients were evaluated using visual analog scale (VAS) and Roland Morris Questionnaire (RMQ), respectively. The size of osteophytes and disc space narrowing were calculated on lateral roentgenogram of the lumbar vertebrae by using computer based stereological methods. Results: No significant correlation was detected between the BMI and radiological findings. But, there was a positive correlation between the osteophyte surface area and RMQ, and VAS and RMQ (p<0.05). Conclusion: No significant correlation was detected between the BMI and radiographic findings in lumbar spine degenerative changes. To our knowledge, this is the first study quantitatively assessing the association between radiographic findings and BMI in lumbar spine degenerative changes.Öğe Treatment of ankylosing spondylitis with TNF inhibitors does not have adverse effect on results of liver function tests: a longitudinal study(Wiley, 2015) Capkin, Erhan; Karkucak, Murat; Cosar, Arif M.; Ak, Emel; Karaca, Adem; Gokmen, Ferhat; Budak, Bayram S.AimTo retrospectively investigate and compare the effects of tumor necrosis factor alpha inhibitors (TNFi) on hepatic enzymes in ankylosing spondylitis (AS) patients. MethodsA retrospective analysis of the records of 94 AS (66 male, 28 female) patients using TNFi was performed. Patients' clinical data, Bath Ankylosing Spondylitis Disease Activity (BASDAI) scores, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were all examined. Liver function test (LFTs) results of patients before the treatment and 3, 6 and 12months after treatment with TNFi were investigated. Aspartate transaminase (AST) and alanine transaminase (ALT) levels were investigated as indicators of LFTs. ResultsThe TNFi drugs used were infliximab (n=28), adalimumab (n=32) and etanercept (n=34). Pre-treatment values of ESR, CRP and BASDAI scores were 28.320.1mm/h, 1.5 +/- 1.2ng/dL and 5.2 +/- 0.8, respectively. Following TNFi use there was a statistically significant decrease in disease activity score (P=0.001). There was a significant increase in LFT at the third month evaluation compared to the initial values, while the average value was within normal range (baseline AST 19.6 +/- 10.8U/L, ALT 19.1 +/- 6.4U/L, third month AST 31.3 +/- 21.6U/L, ALT 28.1 +/- 18.1U/L, P=0.001). Drug group comparison analysis revealed a significant difference in the adalimumab group value at the end of the first year, but no other significant difference in the data for the other months (P>0.05). No significant correlation was determined between initial disease activity scores and LFT. ConclusionTNFi use-associated rises in hepatic enzymes were determined compared to pre-treatment but the mean values remained within normal limits. Considering the cases in the literature, in daily practice patients must be carefully monitored for liver function before treatment and at follow-up.