Browsing by Author "Kimyon, Gezmiş"

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Behçet disease with vascular involvement: Effects of different therapeutic regimens on the incidence of new relapses
(Lippincott Williams & Wilkins, 2015-02) Öner, Fatma Alibaz; Karadeniz, Aslı; Yılmaz, Sema; Balkarlı, Ayşe; Kimyon, Gezmiş; Yazıcı, Ayten; Çınar, Muhammet; Yılmaz, Sedat; Yıldız, Fatih; Bilge, Şule Yaşar; Bilgin, Emre; Omma, Ahmet; Çetin, Gözde Yıldırım; Çağatay, Yonca; Karaaslan, Yaşar; Sayarlıoğlu, Mehmet; Kalyoncu, Umut; Karadağ, Ömer; Kaşifoğlu, Timuçin; Erken, Eren; Pay, Salih; Çefle, Ayşe; Kısacık, Bünyamin; Onat, Ahmet Mesut; Çobankara, Veli; Direskeneli, Haner; Coşkun, Belkıs Nihan; Pehlivan, Yavuz; Uludağ Üniversitesi/Tıp Fakültesi/Romatoloji Anabilim Dalı.; 0000-0003-0298-4157; AAG-7155-2021; AAG-8227-2021; 55646165400; 13205593600
Vascular involvement is one of the major causes of mortality and morbidity in Behcet disease (BD). There are no controlled studies for the management of vascular BD (VBD), and according to the EULAR recommendations, only immunosuppressive (IS) agents are recommended. In this study, we aimed to investigate the therapeutic approaches chosen by Turkish physicians during the initial event and relapses of VBD and the association of different treatment options with the relapses retrospectively. Patients with BD (n = 936, female/male: 347/589, mean age: 37.6 +/- 10.8) classified according to ISG criteria from 15 rheumatology centers in Turkey were included. The demographic data, clinical characteristics of the first vascular event and relapses, treatment protocols, and data about complications were acquired. VBD was observed in 27.7% (n = 260) of the patients during follow-up. In 57.3% of the VBD patients, vascular involvement was the presenting sign of the disease. After the first vascular event, ISs were given to 88.8% and AC treatment to 59.8% of the patients. Median duration of AC treatment was 13 months (1-204) and ISs, 22 months (1-204). Minor hemorrhage related to AC treatment was observed in 7 (4.7%) patients. Asecond vascular event developed in 32.9% (n = 86) of the patients. The vascular relapse rate was similar between patients taking only ISs and AC plus IS treatments after the first vascular event (29.1% vs 22.4%, P = 0.28) and was significantly higher in group taking only ACs than taking only ISs (91.6% vs 29.1%, P < 0.001). During follow-up, a third vascular event developed in 17 (n = 6.5%) patients. The relapse rate was also similar between the patients taking only ISs and AC plus IS treatments after second vascular event (25.3% vs 20.8%, P = 0.93). When multivariate analysis was performed, development of vascular relapse negatively correlated with only IS treatments. We did not find any additional positive effect of AC treatment used in combination with ISs in the course of vascular involvement in patients with BD. Severe complications related to AC treatment were also not detected. Our results suggest that short duration of IS treatments and compliance issues of treatment are the major problems in VBD associated with vascular relapses during follow-up.
Disease activity indices and body mass index: Cross-sectional analysis of a large psoriatic arthritis cohort
(Wiley, 2015-10-01) Kalyoncu, Umut; Bayndar, Ozun; Yilmazer, Barış; Dalkılıç, Hüseyin Ediz; Aksu, Kenan; Öksüz, Mustafa Ferhat; Tarhan, E. Figen; Can, Meryem; Küçükşahin, Orhan; Kimyon, Gezmiş; Akyol, Lütfi; Onat, Ahmet Mesut; Kısacık, Bünyamin; Erden, Abdülsamet; Omma, Ahmet; Bakırlı, Duygu Ersözlü; Özişler, Cem; Gönüllü, Emel; Pehlevan, Seval; Solmaz, Dilek; Çınar, Muhammet; Çetin, Gözde; Tufan, Abdurrahman; Tufan, Müge Aydın; Kılıç, Levent; Erten, Şükran; Kaşifoğlu, Timuçin; Kobak, Şenol; Şenel, Soner; Akar, Servet; Özgen, Metin; Kasapoğlu-Günal, Esen; Yazısız, Veli; Yılmaz, Sedat; Dönmez, Salim; Doğan, İsmail; Köseoğlu, Hamide Kart; Erbasan, Funda; Yıldız, Fatih; Beş, Cemal; Balkarlı, Ayşe; Şahin, Ali; Mercan, Rıdvan; Arslan, Fatoş; Doğru, Atalay; Pay, Salih; Yavuz, Şule; Çakır, Necati; Kabasakal, Yasemin; Aydın, Sibel Z.; DALKILIÇ, HÜSEYİN EDİZ; CMF-4757-2022
Factors that may be associated with uveitis in patients with spondyloarthritis
(Wiley, 2018-09-01) Kaşifoğlu, Timuçin; Bilge, Nazife Şule Yaşar; Kiraz, Sedat; Ertenli, İhsan; Küçükşahin, Orhan; Dalkılıc, Ediz; Bes, Cemal; Kanitez, Nilüfer Alpay; Atagündüz, Pamir; Coşkun, Belkıs Nihan; Yağız, Burcu; Koca, Süleyman Serdar; Çinar, Muhammed; Ateş, Aşkın; Akar, Servet; Gercik, Onay; Bakırlı, Duygu Ersözlü; Yazısız, Veli; Kimyon, Gezmiş; Tufan, Müge Aydın; Emmungil, Hakan; Mercan, Rıdvan; Bodakçı, Erdal; Öz, Burak; Akar, Zeynel Abidin; Karadağ, Ömer; Keleşoğlu, Bahar; Yılmaz, Sedat; İlgen, Ufuk; Pehlivan, Yavuz; Terzioğlu, Ender; Kılıç, Levent; Erten, Şükran; Taşçılar, Koray; Kalyoncu, Umut; DALKILIÇ, HÜSEYİN EDİZ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Dahili Tıp Bölümü; CMF-4757-2022
Incidence of cyclophosphamide-induced urotoxicity and protective effect of mesna in rheumatic diseases
(J Rheumatol Publication, 2015-09) Yılmaz, Neslihan; Emmungil, Hakan; Gücenmez, Sercan; Özen, Gülşen; Yıldız, Fatih; Balkarlı, Ayşe; Kimyon, Gezmiş; Doğan, İsmail; Pamuk, Ömer Nuri; Yaşar, Şule; Çetin, Gözde Yıldırım; Yazıcı, Ayten; Eşmen, Serpil Ergülü; Cağatay, Yonca; Yılmaz, Sema; Cefle, Ayşe; Sayarlıoğlu, Mehmet; Kaşifoğlu, Timuçin; Karadağ, Ömer; KIsacık, Bünyamin; Çobankara, Veli; Erken, Eren; Direskeneli, Haner; Aksu, Kenan; Yavuz, Şule; Coşkun, Belkıs Nihan; Pehlivan, Yavuz; Dalkılıç, Ediz; Uludağ Üniversitesi/Tıp Fakültesi/Romatoloji Anabilim Dalı.; 0000-0003-0298-4157; AAG-8227-2021; AAG-7155-2021; 55646165400; 57220381538; 6506739457
Objective. To assess bladder toxicity of cyclophosphamide (CYC) and uroprotective effect of mesna in rheumatic diseases. Methods. Data of 1018 patients (725 women/293 men) treated with CYC were evaluated in this retrospective study. All of the following information was obtained: the cumulative CYC dose, route of CYC administration, duration of therapy, concomitant mesna usage, and hemorrhagic cystitis. Cox proportional hazard model was used for statistics. Results. We identified 17 patients (1.67%) with hemorrhagic cystitis and 2 patients (0.19%) with bladder cancer in 4224 patient-years. The median time for diagnosis to hemorrhagic cystitis was 10 months (4-48) and bladder cancer was 8 years (6-10.9). There were 583 patients (57.2%) who received mesna with intravenous CYC therapy. We observed similar incidence rate for hemorrhagic cystitis in both patient groups concomitantly treated with or without mesna [9/583 (1.5%) vs 8/425 (1.8%) respectively, p = 0.08]. Cumulative CYC dose (HR for 10-g increments 1.24, p < 0.001) was associated with hemorrhagic cystitis. Conclusion. Cumulative dose was the only risk factor for hemorrhagic cystitis in patients treated with CYC. No proof was obtained for the uroprotective effect of mesna in our cohort.
Isotretinoin-induced spondyloarthropathy-related symptoms: A prospective study
(Journal of Rheumatology Publishing Company, 2015-11) Alkan, Samet; Kayıran, Nuriye; Zengin, Orhan; Kalem, Ali; Kimyon, Gezmiş; Kılınç, Emine Özkul; Kırtak, Necmettin; Onat, Ahmet Mesut; Kısacık, Bünyamin; Pehlivan, Yavuz; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Romatoloji Bilim Dalı.; 0000-0002-1201-8836; AAG-8227-2021; 13205593600
Objective. Acne vulgaris is a chronic inflammatory disease involving the pilosebaceous unit of the skin. Isotretinoin is a systemic retinoid that is often used as an effective treatment option for severe and treatment-resistant acne. Isotretinoin may also cause rheumatologic symptoms. The aim of this prospective observational study was to present followup results regarding the rheumatologic symptoms of patients who received systemic therapy for the treatment of acne (isotretinoin and tetracycline). Methods. For inclusion in the study, all consecutive patients with acne who were aged > 18 years were evaluated by the same dermatologist. The first 42 consecutive patients were included in the isotretinoin group, and after matching for age and sex, 32 consecutive patients were included in the tetracycline group. Isotretinoin treatment was planned as an average dose of 30 mg daily and a total dose of 120-150 mg/kg for 4-6 months. The patients were administered a dose of 1 g/day of tetracycline as 2 equal doses for 3 months. Results. Forty-two patients diagnosed with acne vulgaris were treated with isotretinoin 20.6 ± 4.4 (male/female: 17/22), and 32 patients were treated with tetracycline 20.6 ± 2.7 (male/female: 8/24). There was no significant difference between the 2 groups with respect to age and sex. Unilateral Achilles enthesopathy developed in 3 patients, whereas both Achilles enthesopathy and unilateral sacroiliitis developed in 1 patient. Inflammatory back pain developed in 6 patients in the isotretinoin group. Conclusion. To our knowledge, this was the first prospective observational study that assessed the rheumatologic symptoms of isotretinoin treatment. The spondyloarthropathy findings were identified in 23.1% of the patients who used isotretinoin.
Leflunomide as a concomitant dmard choice for the biological treatment era of rheumatoid arthritis
(Wiley, 2018-09-01) Kimyon, Gezmiş; Kiraz, Sedat; Ertenli, İhsan; Küçükşahin, Orhan; Dalkılıç, Ediz; Beş, Cemal; Kanitez, Nilüfer Alpay; Kaşifoğlu, Timuçin; Emmungil, Hakan; Coşkun, Belkıs Nihan; Yağız, Burcu; Koca, Süleyman Serdar; Çınar, Muhammet; Ateş, Askin; Akar, Servet; Bakırlı, Duygu Ersözlü; Yazısız, Veli; Bilge, Nazife Şule Yaşar; Tufan, Müge Aydın; Mercan, Rıdvan; Karadağ, Ömer; Keleşoğlu, Ayşe Bahar; Gercik, Onay; Öz, Burak; Akar, Zeynel Abidin; Yılmaz, Sedat; Turan, Sezin; Pehlivan, Yavuz; Terzioğlu, Ender; Kılıç, Levent; Erten, Şükran; Tekgöz, Emre; Taşçılar, Koray; Kalyoncu, Umut; DALKILIÇ, HÜSEYİN EDİZ; COŞKUN, BELKIS NİHAN; YAĞIZ, BURCU; PEHLİVAN, YAVUZ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ramotoloji Bölümü; 0000-0003-0298-4157; JQW-5031-2023; AAG-7155-2021; AAG-8227-2021; CMF-4757-2022
Mi-RNA profile of active vascular behcet's patients.
(Wiley, 2014-10) Onat, Ahmet Mesut; Gerenli, Ozan; Kısacık, Bünyamin; Ulaşlı, Mustafa; Kimyon, Gezmiş; Öztuzcu, Serdar; Pehlivan, Yavuz; Uludağ Üniversitesi/Tıp Fakültesi.; AAG-8227-2021
Patients' concerns regarding biological agents in rheumatology
(Wiley, 2018-01) Kimyon, Gezmiş; Zengin, Orhan; Küçük, Adem; Şahin, Ali; Tomas, Nazmiye; Kısacık, Bünyamin; Akar, Servet; Onat, Ahmet Mesut; Pehlivan, Yavuz; Oruçoğlu, Nurdan; Pehlivan, Seda; Öksüz, Mustafa Ferhat; Dalkılıç, Ediz; Uludağ Üniversitesi/Tıp Fakültesi/Romatoloji Anabilim Dalı.; Uludağ Üniversitesi/Sağlık Bilimleri Fakültesi/Hemşirelik Bölümü.; 0000-0002-1670-0672; 0000-0002-8613-5373; B-5037-2017; AAG-8227-2021; ABG-1164-2020; 13205593600; 57199625557; 23095733400; 56016440100; 6506739457
ObjectiveThe potential side effects of biological agents may increase the anxiety levels of patients and influence not only their desire to use these therapies but also their concordance to treatment. This study aimed to determine the level and prevalence of drug-related concern in patients treated with biological agents and to acquire additional information regarding the related causes. Materials and MethodsA total of 1134 patients who were using biological agents for at least 3months with a diagnosis of rheumatic diseases were enrolled. General anxiety levels were evaluated using the State-Trait Anxiety Inventory (STAI). ResultsThe most common cause for drug-related concerns was the potential side effects of the drugs (59.5%). Among the potential side effects, cancer risk was the most common cause for concern (40.1%), followed by the risk of tuberculosis activation (30.7%). Anxiety levels were higher in patients who experienced side effects than in other patients, and this difference was statistically significant (P<0.05). STAI trait and state scores were moderately correlated with anxiety levels related to the drug (P<0.001). ConclusionAnxiety related to biological agents may significantly affect the patients' anxiety levels. Awareness regarding the patients' concerns and expectations related to the drug is important to ensure drug adherence and concordance to treatment.
Preferences of inflammatory arthritis patients for biological disease-modifying antirheumatic drugs in the first 100 days of the COVID-19 pandemic
(TÜBİTAK, 2021-01-01) Kalyoncu, Umut; Pehlivan, Yavuz; Akar, Servet; Kaşifoğlu, Timuçin; Kimyon, Gezmiş; Karadağ, Ömer; Dalkılıç, Ediz; Ertenli, Ali İhsan; Kılıç, Levent; Ersözlü, Duygu; Beş, Cemal; Emmungil, Hakan; Mercan, Rıdvan; Ediboğlu, Elif Durak; Kanıtez, Nilüfer; Bilgin, Emre; Çolak, Seda; Koca, Süleyman Serdar; Gönüllü, Emel; Küçükşahin, Orhan; Coşkun, Nihan; Yağız, Burcu; Kiraz, Sedat; PEHLİVAN, YAVUZ; DALKILIÇ, HÜSEYİN EDİZ; COŞKUN, BELKIS NİHAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0002-3734-1242; 0000-0003-1372-1555; 0000-0001-5184-4404; 0000-0003-1185-5816; 0000-0002-2260-4660; 0000-0003-4995-430X; 0000-0002-6990-4206; W-7332-2019; AAK-7851-2021; AAD-5448-2019; AAZ-5845-2021; AAG-8227-2021; C-8092-2015; JQW-5031-2023; GZA-3287-2022
Background/aim: To evaluate treatment adherence and predictors of drug discontinuation among patients with inflammatory arthritis receiving bDMARDs within the first 100 days after the announcement of the COVID-19 pandemic. Materials and methods: A total of 1871 patients recorded in TReasure registry for whom advanced therapy was prescribed for rheumatoid arthritis (RA) or spondyloarthritis (SpA) within the 3 months (6-9 months for rituximab) before the declaration of COVID-19 pandemic were evaluated, and 1394 (74.5%) responded to the phone survey. Patients' data regarding demographic, clinical characteristics and disease activity before the pandemic were recorded. The patients were inquired about the diagnosis of COVID-19, the rate of continuation on bDMARDs, the reasons for treatment discontinuation, if any, and the current general disease activity (visual analog scale, [VAS]). Results: A total of 1394 patients (493 RA [47.3% on anti-TNF] patients and 901 SpA [90.0% on anti-TNF] patients) were included in the study. Overall, 2.8% of the patients had symptoms suggesting COVID-19, and 2 (0.15%) patients had PCR-confirmed COVID-19. Overall, 18.1% of all patients (13.8% of the RA and 20.5% of the SpA; p = 0.003) discontinued their bDMARDs. In the SpA group, the patients who discontinued bDMARDs were younger (40 [21-73] vs. 44 years [20-79]; p = 0.005) and had higher general disease activity; however, no difference was relevant for RA patients. Conclusion: Although the COVID-19 was quite uncommon in the first 100 days of the pandemic, nearly one-fifth of the patients discontinued bDMARDs within this period. The long-term effects of the pandemic should be monitored.