Browsing by Author "Govoni, M"
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- Disease Activity Assessment of Rheumatic Diseases During Pregnancy: a Comprehensive Review of Indices Used in Clinical StudiesPublication . Andreoli, L; Gerardi, MC; Fernandes, M; Bortoluzzi, A; Bellando-Randone, S; Brucato, A; Caporali, R; Chighizola, C; Chimenti, MS; Conigliaro, P; Cutolo, M; Cutro, MS; D'Angelo, S; Doria, A; Elefante, E; Fredi, M; Galeazzi, M; Gerosa, M; Govoni, M; Iuliano, A; Larosa, M; Lazzaroni, MG; Matucci-Cerinic, M; Meroni, M; Meroni, P; Mosca, M; Patanè, M; Pazzola, G; Pendolino, M; Perricone, R; Ramoni, V; Salvarani, C; Sebastiani, G; Selmi, C; Spinelli, F; Valesini, G; Scirè, CA; Tincani, APregnancy requires a special management in women with inflammatory rheumatic diseases (RDs), with the aim of controlling maternal disease activity and avoiding fetal complications. Despite the heterogeneous course of RDs during pregnancy, their impact on pregnancy largely relates to the extent of active inflammation at the time of conception. Therefore, accurate evaluation of disease activity is crucial for the best management of pregnant patients. Nevertheless, there are limitations in using conventional measures of disease activity in pregnancy, as some items included in these instruments can be biased by symptoms or by physiological changes related to pregnancy and the pregnancy itself may influence laboratory parameters used to assess disease activity. This article aims to summarize the current literature about the available instruments to measure disease activity during pregnancy in RDs. Systemic lupus erythematosus is the only disease with instruments that have been modified to account for several adaptations which might interfere with the attribution of signs or symptoms to disease activity during pregnancy. No modified-pregnancy indices exist for women affected by other RDs, but standard indices have been applied to pregnant patients. The current body of knowledge shows that the physiologic changes that occur during pregnancy need to be either adapted from existing instruments or developed to improve the management of pregnant women with RDs. Standardized instruments to assess disease activity during pregnancy would be helpful not only for clinical practice but also for research purposes.
- Systemic Lupus Erythematosus: State of the Art on Clinical Practice GuidelinesPublication . Tamirou, F; Arnaud, L; Talarico, R; Scirè, CA; Alexander, T; Amoura, Z; Avcin, T; Bortoluzzi, A; Cervera, R; Conti, F; Cornet, A; Devilliers, H; Doria, A; Frassi, M; Fredi, M; Govoni, M; Houssiau, F; Lladò, A; Macieira, C; Martin, T; Massaro, Laura; Moraes-Fontes, MF; Pamfil, C; Paolino, S; Tani, C; Tas, SW; Tektonidou, M; Tincani, A; Van Vollenhoven, RF; Bombardieri, S; Burmester, G; Eurico, FJ; Galetti, I; Hachulla, E; Mueller-Ladner, U; Schneider, M; Smith, V; Cutolo, M; Mosca, M; Costedoat-Chalumeau, NSystemic lupus erythematosus (SLE) is the paradigm of systemic autoimmune diseases characterised by a wide spectrum of clinical manifestations with an unpredictable relapsing-remitting course. The aim of the present work was to identify current available clinical practice guidelines (CPGs) for SLE, to provide their review and to identify physicians' and patients' unmet needs. Twenty-three original guidelines published between 2004 and 2017 were identified. Many aspects of disease management are covered, including global disease management, lupus nephritis and neuropsychiatric involvement, management of pregnancies, vaccinations and comorbidities monitoring. Unmet needs relate with disease management of some clinical manifestations and adherence to treatment. Many patient's unmet needs have been identified starting with faster diagnosis, need for more therapeutic options, guidelines on lifestyle issues, attention to quality of life and adequate education.
- Undifferentiated connective tissue disease: state of the art on clinical practice guidelinesPublication . Antunes, M; Scirè, CA; Talarico, R; Alexander, T; Avcin, T; Belocchi, C; Doria, A; Franceschini, F; Galetti, I; Govoni, M; Hachulla, E; Launay, D; Lepri, G; Macieira, C; Matucci-Cerinic, M; Montecucco, CM; Moraes-Fontes, MF; Mouthon, L; Paolino, S; Ramoni, V; Tani, C; Tas, SW; Tincani, A; Van Vollenhoven, R; Zen, M; Fonseca, J; Bombardieri, S; Fonseca, JE; Schneider, M; Smith, V; Cutolo, M; Mosca, M; Beretta, LThe term 'undifferentiated connective tissue disease' (UCTD) is generally used to describe clinical entities characterised by clinical and serological manifestations of systemic autoimmune diseases but not fulfilling the criteria for defined connective tissue diseases (CTDs). In this narrative review, we summarise the results of a systematic literature research, which was performed as part of the ERN ReCONNET project, aimed at evaluating existing clinical practice guidelines (CPGs) or recommendations. No specific CPG on UCTD were found, potential areas of intervention are absence of a consensus definition of UCTD, need for specific monitoring and therapeutic protocols, stratification of UCTD based on the risk of developing a defined CTD and preventive measure for the future development of a more severe condition. Patients feel uncertainty regarding the name of the disease and feel the need of a better education and understanding of these conditions and its possible changes over time.