Author
Tomas R. Vazquez-Rodriguez
Bio: Tomas R. Vazquez-Rodriguez is an academic researcher from University of Cantabria. The author has contributed to research in topics: Giant cell arteritis & Gene polymorphism. The author has an hindex of 24, co-authored 61 publications receiving 2571 citations.
Papers
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TL;DR: Giant cell arteritis and Polymyalgia rheumatica are relatively common diseases in the elderly due to the progressive aging of the population in Western countries.
Abstract: Giant cell arteritis (GCA), also called Horton or granulomatous arteritis, is a largeand medium-sized blood vessel systemic vasculitis characterized by the granulomatous involvement of the aorta and its major branches (1,2). Polymyalgia rheumatica (PMR) is a disease characterized by severe bilateral pain and aching involving the neck, shoulder, and pelvic girdles associated with morning stiffness (1). GCA and PMR mainly occur in white individuals age 50 years. Due to the progressive aging of the population in Western countries, both conditions have emerged as relatively common diseases in the elderly (1,2).
463 citations
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TL;DR: Results of the current study show an increased risk of strokes, in the vertebrobasilar territory in particular, at the time of GCA diagnosis and suggest a potential protective role of anemia against the development of these cerebrovascular complications.
196 citations
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TL;DR: Results of the present study show that patients with ankylosing spondylitis without clinically evident cardiovascular disease have a high prevalence of subclinical macrovascular disease in the form of increased carotid IMT andCarotid plaques compared to matched controls.
144 citations
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TL;DR: A dramatic improvement of insulin resistance and insulin sensitivity was observed and a long‐term positive effect of TNF‐α antagonists infliximab and etanercept on insulin resistance in RA patients with severe disease was reported.
Abstract: Increased prevalence of insulin resistance has been observed in patients with rheumatoid arthritis (RA). High-grade systemic inflammation is implicated in the development of insulin resistance in these patients. Tumor necrosis factor (TNF)-alpha is a potent proinflammatory cytokine that plays a role in the initiation and progression of inflammation and the mechanisms associated with accelerated atherosclerosis in RA. In assessing data immediately prior to and after intravenous infusion of the anti-TNF-alpha monoclonal antibody-infliximab in RA patients on period treatment with this drug attributable to disease refractory to conventional disease-modifying antirheumatic drugs, a dramatic improvement of insulin resistance and insulin sensitivity was observed. A long-term positive effect of TNF-alpha antagonists infliximab and etanercept on insulin resistance in RA patients with severe disease was also reported. These results highlight the importance of therapies that act blocking TNF-alpha function to reduce the mechanisms implicated in the development of the metabolic syndrome observed in RA.
136 citations
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TL;DR: The results show that TNFA rs1800629 gene polymorphism is associated with predisposition to CV complications in patients with RA, and this predisposition is restricted to individuals carrying the rheumatoid SE.
127 citations
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TL;DR: Preliminary results from clinical trials with salicylates and interleukin-1 antagonists support the notion that inflammation participates in the pathogenesis of type 2 diabetes and have opened the door for immunomodulatory strategies for the treatment of T2D that simultaneously lower blood glucose levels and potentially reduce the severity and prevalence of the associated complications of this disease.
Abstract: Components of the immune system are altered in obesity and type 2 diabetes (T2D), with the most apparent changes occurring in adipose tissue, the liver, pancreatic islets, the vasculature and circulating leukocytes. These immunological changes include altered levels of specific cytokines and chemokines, changes in the number and activation state of various leukocyte populations and increased apoptosis and tissue fibrosis. Together, these changes suggest that inflammation participates in the pathogenesis of T2D. Preliminary results from clinical trials with salicylates and interleukin-1 antagonists support this notion and have opened the door for immunomodulatory strategies for the treatment of T2D that simultaneously lower blood glucose levels and potentially reduce the severity and prevalence of the associated complications of this disease.
2,845 citations
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VU University Medical Center1, University of Glasgow2, Paris Descartes University3, Medical University of Vienna4, University of Southern Denmark5, Umeå University6, University of Oslo7, University of Gothenburg8, Katholieke Universiteit Leuven9, University of Cantabria10, Dudley Group NHS Foundation Trust11, University of Debrecen12, University of Manchester13
TL;DR: The present update extends on the evidence that CVD risk in the whole spectrum of IJD is increased, which underscores the need for CVDrisk management in these patients.
Abstract: Patients with rheumatoid arthritis (RA) and other inflammatory joint disorders (IJD) have increased cardiovascular disease (CVD) risk compared with the general population. In 2009, the European League Against Rheumatism (EULAR) taskforce recommended screening, identification of CVD risk factors and CVD risk management largely based on expert opinion. In view of substantial new evidence, an update was conducted with the aim of producing CVD risk management recommendations for patients with IJD that now incorporates an increasing evidence base. A multidisciplinary steering committee (representing 13 European countries) comprised 26 members including patient representatives, rheumatologists, cardiologists, internists, epidemiologists, a health professional and fellows. Systematic literature searches were performed and evidence was categorised according to standard guidelines. The evidence was discussed and summarised by the experts in the course of a consensus finding and voting process. Three overarching principles were defined. First, there is a higher risk for CVD in patients with RA, and this may also apply to ankylosing spondylitis and psoriatic arthritis. Second, the rheumatologist is responsible for CVD risk management in patients with IJD. Third, the use of non-steroidal anti-inflammatory drugs and corticosteroids should be in accordance with treatment-specific recommendations from EULAR and Assessment of Spondyloarthritis International Society. Ten recommendations were defined, of which one is new and six were changed compared with the 2009 recommendations. Each designated an appropriate evidence support level. The present update extends on the evidence that CVD risk in the whole spectrum of IJD is increased. This underscores the need for CVD risk management in these patients. These recommendations are defined to provide assistance in CVD risk management in IJD, based on expert opinion and scientific evidence.
865 citations
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TL;DR: Overall, data support a tendency for autoimmune diseases to co-occur at greater than expected rates within proband patients and their families, but this does not appear to be a uniform phenomenon across all diseases.
598 citations
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University of Tübingen1, University of Pavia2, Charité3, University of Leicester4, University of Barcelona5, University of Graz6, Istanbul University7, Paris Diderot University8, University of Birmingham9, Norfolk and Norwich University Hospital10, Instituto de Medicina Molecular11, Peking Union Medical College Hospital12, University of Iceland13, University of East Anglia14, University of Oxford15
TL;DR: The recommendations for the management of LVV have been updated to facilitate the translation of current scientific evidence and expert opinion into better management and improved outcome of patients in clinical practice.
Abstract: BACKGROUND
Since the publication of the European League Against Rheumatism (EULAR) recommendations for the management of large vessel vasculitis (LVV) in 2009, several relevant randomised clinical trials and cohort analyses have been published, which have the potential to change clinical care and therefore supporting the need to update the original recommendations.
METHODS
Using EULAR standardised operating procedures for EULAR-endorsed recommendations, the EULAR task force undertook a systematic literature review and sought opinion from 20 experts from 13 countries. We modified existing recommendations and created new recommendations.
RESULTS
Three overarching principles and 10 recommendations were formulated. We recommend that a suspected diagnosis of LVV should be confirmed by imaging or histology. High dose glucocorticoid therapy (40-60 mg/day prednisone-equivalent) should be initiated immediately for induction of remission in active giant cell arteritis (GCA) or Takayasu arteritis (TAK). We recommend adjunctive therapy in selected patients with GCA (refractory or relapsing disease, presence of an increased risk for glucocorticoid-related adverse events or complications) using tocilizumab. Methotrexate may be used as an alternative. Non-biological glucocorticoid-sparing agents should be given in combination with glucocorticoids in all patients with TAK and biological agents may be used in refractory or relapsing patients. We no longer recommend the routine use of antiplatelet or anticoagulant therapy for treatment of LVV unless it is indicated for other reasons.
CONCLUSIONS
We have updated the recommendations for the management of LVV to facilitate the translation of current scientific evidence and expert opinion into better management and improved outcome of patients in clinical practice.
564 citations
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TL;DR: Obesity appears to be a major environmental factor contributing to the onset and progression of autoimmune diseases.
515 citations