Publications by authors named "Francesca Trentin"

7 Publications

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One year in review 2021: systemic lupus erythematosus.

Clin Exp Rheumatol 2021 Mar-Apr;39(2):231-241. Epub 2021 Apr 9.

Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.

In 2020 many contributions have been produced on SLE. Our critical digest of the recent literature will be focused on genetic factors that contribute to the development of the disease, novel potential therapeutic targets (including IL-23, IL-17, interferons and JAKs), diagnostic and prognostic biomarkers, classification criteria, clinical manifestations and comorbidities. We will then present new treatment options (with a special focus on belimumab, anifrolumab, tacrolimus, voclosporin and EULAR/ERA-EDTA recommendations for the management of LN) and treat-to-target strategy. Lastly, we will concentrate on some of the aspects that influence patients' disease perception and quality of life.
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April 2021

The effectiveness of median nerve electrical stimulation in patients with disorders of consciousness: a systematic review.

Brain Inj 2021 Mar 22;35(4):385-394. Epub 2021 Feb 22.

Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands.

Objective: To examine the effectiveness of median nerve electrical stimulation on consciousness level in subjects with disorders of consciousness.

Methods: Electronic databases PubMed, EMBASE, CENTRAL, and PEDro, as well as manual search and gray literature were searched from inception until May 2019. We included only randomized controlled trials. Two reviewers independently conducted the search strategy, study selection, data extraction, risk of bias assessment, and evidence judgment quality.

Results: Five studies met the inclusion criteria. Overall, no clear conclusion can be drawn about the intervention's effectiveness on the level of consciousness. One study reported a benefit of the intervention on the number of hospitalization days in the intensive care unit. Furthermore, another study reported a higher percentage of patients who regained consciousness six months from the event in the experimental group.

Conclusion: Due to the limited number of studies that met the inclusion criteria and overall high risk of bias, it is impossible to draw a definitive conclusion. The results of this systematic review should be used to improve future research in this field.
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http://dx.doi.org/10.1080/02699052.2021.1887522DOI Listing
March 2021

Impact of first wave of SARS-CoV-2 infection in patients with Systemic Lupus Erythematosus: Weighting the risk of infection and flare.

PLoS One 2021 13;16(1):e0245274. Epub 2021 Jan 13.

Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Introduction: The aim of this study was to investigate the incidence and clinical presentation of SARS-CoV-2 infections in a Systemic Lupus Erythematosus (SLE) cohort; to assess correlations with disease characteristics and rheumatic therapy; and to evaluate the occurrence of treatment discontinuation and its impact on disease activity.

Materials And Methods: SLE patients monitored by a single Italian centre were interviewed between February and July 2020. Patients were considered to be positive for SARS-CoV-2 infections in case of 1) positive nasopharyngeal swab; 2) positive serology associated with COVID19 suggesting symptoms. The following data were also recorded: clinical symptoms, adoption of social distancing measures, disease activity and treatment discontinuation.

Results: 332 patients were enrolled in the study. Six patients (1.8%) tested positive for SARS-CoV-2 infection, with the incidence being significantly higher in the subgroup of patients treated with biological Disease-Modifying Anti-Rheumatic Drugs (p = 0.005), while no difference was observed for other therapies, age at enrollment, disease duration, type of cumulative organ involvement or adoption of social isolation. The course of the disease was mild. Thirty-six patients (11.1%) discontinued at least part of their therapy during this time period, and 27 (8.1%) cases of disease flare were recorded. Correlation between flare and discontinuation of therapy was statistically significant (p<0.001). No significant increase of rate of flare in a subgroup of the same patients during 2020 was observed.

Conclusion: Treatment discontinuation seems to be an important cause of disease flare. Our findings suggest that abrupt drug withdrawal should be avoided or evaluated with caution on the basis of individual infection risk and comorbidities.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245274PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7806138PMC
January 2021

One year in review 2020: systemic lupus erythematosus.

Clin Exp Rheumatol 2020 Jul-Aug;38(4):592-601. Epub 2020 Jul 10.

Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a relapsing-remitting course that can affect various organs or systems, leading to a broad spectrum of clinical manifestations. In the past year, many studies have been published on SLE, providing a significant advancement in disease knowledge and patient management. The aim of this review is to summarise the most relevant scientific contributions on SLE pathogenesis, clinical manifestations and comorbidities, biomarkers and treatment strategies published in 2019.
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September 2020

One year in review 2020: vasculitis.

Clin Exp Rheumatol 2020 Mar-Apr;38 Suppl 124(2):3-14. Epub 2020 Apr 28.

Clinic of Rheumatology, Department of Medicine, University of Udine, Italy.

Systemic vasculitides are a group of diseases that could potentially affect any organ with heterogeneous clinical manifestations that usually depend on the size of the most involved vessels. These diseases could be associated with a relevant burden of mortality and morbidity if not early recognised and treated. Moreover, even if they are usually rare diseases, their incidence and prevalence seem to be increasing in the last decade, partially because of improved awareness and management of vasculitis from physicians. Like in the previous annual reviews of this series, in this paper we revised the most recent literature on pathogenesis, clinical manifestations and treatment options in small- and large-vessel vasculitis.
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September 2020

Correction to: Effectiveness, Tolerability, and Safety of Belimumab in Patients with Refractory SLE: a Review of Observational Clinical-Practice-Based Studies.

Clin Rev Allergy Immunol 2018 10;55(2):237

Division of Rheumatology, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy.

The following changes are made for this article: (1.) Maddalena Larosa's given name and surname were inadvertently interchanged. The authorgroup section is now corrected. (2.) The author(s)' decision to opt for Open Choice.
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http://dx.doi.org/10.1007/s12016-018-8704-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6182622PMC
October 2018

Effectiveness, Tolerability, and Safety of Belimumab in Patients with Refractory SLE: a Review of Observational Clinical-Practice-Based Studies.

Clin Rev Allergy Immunol 2018 04;54(2):331-343

Division of Rheumatology, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy.

To date, belimumab is the only biological drug approved for the treatment of patients with active refractory SLE. We compared and critically analyzed the results of 11 observational clinical-practice-based studies, conducted in SLE referral centers. Despite the differences in endpoints and follow-up duration, all studies remarked that belimumab provides additional benefits when used as an add-on to existing treatment, allowing a higher rate of patients to reach remission and to taper or discontinue corticosteroids. In the OBSErve studies, 2-9.6% of patients discontinued corticosteroids and 72-88.4% achieved a ≥ 20% improvement by physician's judgment at 6 months. In Hui-Yuen's study, 51% of patients attained response by simplified SRI at month 6. In Sthoeger's study, 72.3% of patients discontinued corticosteroids and 69.4% achieved clinical remission by PGA after a median follow-up of 2.3 years. In the multicentric Italian study, 77 and 68.7% of patients reached SRI-4 response at months 6 and 12, respectively. In all the studies, disease activity indices decreased over time. Retention rates at 6, 9, and 12 months were 82-94.1, 61.2-83.3, and 56.7-79.2%, respectively. The main limitations of these studies include the lack of a control group, the short period of observation (6-24 months) and the lack of precise restrictions regarding concomitant medication management. This notwithstanding, these experiences provide a more realistic picture of real-life effectiveness of the drug compared with the randomized controlled clinical trials, where stringent inclusion/exclusion criteria and changes in background therapy could limit the inference of data to the routine clinical care.
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http://dx.doi.org/10.1007/s12016-018-8675-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132773PMC
April 2018
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