Rheumatoid Arthritis: Benucci M

Manfredi M, Benucci M. · U.O.S. Laboratorio Immunologia Allergologia, Nuovo Ospedale S.Giovanni di Dio, ASL 10 Firenze. · Recenti Prog Med. · Pubmed #18710059 No free full text.

Abstract: Cytokines such as TNF-alpha and IL-1beta play key roles in driving the inflammation and synovial cell proliferation that characterize rheumatoid arthritis (RA) joint destruction. It is, therefore, not surprising that therapies for RA have targeted these cytokines. While blockade of TNF-alpha or IL-1beta has been efficacious for many patients with RA, adequacy and maintenance of response are not universal, and increased risk of adverse events such as infections and malignancy remain a concern. Therefore, new targets in the treatment of RA continue to be examined. As interleukin-6 (IL-6) has been implicated in the pathogenesis of RA, blockade of its activity is of both scientific and clinical interest. Tocilizumab has been assessed in a number of studies in recent years, mainly in patients with rheumatoid arthritis. Data from randomized controlled clinical trials demonstrate the effectiveness of tocilizumab in improving the signs and symptoms of RA. In addition, it appears that such inhibition of IL-6 can have positive effects on functional status, an important outcome for RA patients. Finally, data suggest that treatment with this agent may also inhibit the progression of disease as assessed radiographically. Data from recent studies will help to refine the ultimate use of this novel approach to treatment, and help clinicians to optimize therapy using this approach.

Galeazzi M, Giannitti C, Manganelli S, Benucci M, Scarpato S, Bazzani C, Caporali R, Sebastiani GD. · Sezione di Reumatologia, Dipartimento di Medicina Clinica e Scienze Imunologiche, Università di Siena, Italy. · Autoimmun Rev. · Pubmed #18694850 No free full text.

Abstract: A wide variety of rheumatic diseases has been documented in the presence of hepatitis C virus (HCV) infection and in human immunodeficiency virus (HIV) infection. In this conditions, physicians are refrained from using corticosteroids and/or immunosuppressants agents because of the risk of favouring viral replication and the progression of the underlying viral disease. In the present review we have focused our attention on the possible role of cyclosporine A (CsA), anti-Tumour Necrosis Factor (TNF) alpha agents in the treatment of HIV or HCV infected autoimmune patients. The results drown from the literature and from our personal experience confirm the safety of CsA and anti-TNF alpha agents, in terms of viral load and liver toxicity. A limited experience also suggest that both therapies can be given in combination in rheumatoid arthritis patients without increasing the risk of adverse events.

Benucci M, Dolenti S, Saviola G, Manfredi M. · Sezione di Reumatologia, Dipartimento Medicina Interna, Nuovo Ospedale S.Giovanni di Dio, ASL 10, Firenze. · Recenti Prog Med. · Pubmed #16535926 No free full text.

Abstract: Almost 30-50% of patients on long-term therapy with glucocorticoids (GC), especially those affected by rheumatic diseases, develop glucocorticoid induced osteoporosis (GIOP) and osteoporosis-related fractures. To assess the effects of neridronate versus placebo on markers of bone resorption in rheumatic patients affected by GIOP (as defined by a T Score reduction > 2.5; mean BMD L2-L4), sixty-two female patients [age: 68.89 +/- 9.45 (mean +/- SD)] affected by different rheumatic diseases, like rheumatoid arthritis, polymyalgia rheumatica, Sjögren syndrome in treatment with a mean prednisone-equivalent daily dose of 6.44 +/- 2.4 mg/day, were enrolled in an open trial. The patients were divided in 2 groups: group A (26 patients) assuming daily calcium 1 g and vitamin D 800 UI and group B (36 patients) assuming daily calcium (1000 mg) and vitamin D (800 UI) and neridronate (25 mg im /30 days). The patients were evaluated for serum and urinary bone markers, basely (T0) and after 6 months of therapy (T6). After 6 months of therapy (T6), bone markers were significantly reduced in group B in respect to group A: OHPr - 41.64% (p < 0.001), D-Pyr - 34.96% (p < 0.001), NTX - 50.9% (p < 0.001). These preliminary data show that neridronate may be considered an useful agent for the treatment of GIOP in rheumatic patients.

Giannitti C, Benucci M, Caporali R, Manganelli S, Bellisai F, Sebastiani GD, Galeazzi M. · No affiliation provided · Int J Immunopathol Pharmacol. · Pubmed #19505408 No free full text.

Abstract: This study further expands our previous observation demonstrating the usefulness of combination therapy of anti-TNF-alpha and cyclosporine A in the treatment of rheumatoid arthritis and concurrent hepatitis C virus infection, as well its efficacy and safety in controlling HCV viremia and liver toxicity. Seven patients were included in the study; transaminase levels remained unchanged, HCV RNA serum levels decreased significantly and DAS 28 significantly improved after twelve month follow-up. No side effects were registered.

Benucci M, Manfredi M, Saviola G, Baiardi P, Campi P. · Rheumatology Unit, Nuovo Ospedale S. Giovanni di Dio, ASL 10 Florence Italy. · Clin Exp Rheumatol. · Pubmed #19473578 No free full text.

Abstract: OBJECTIVE: The use of TNF-alpha antagon-ists (infliximab, etanercept, adalimumab) has changed the course of many rheumatic diseases including rheumatoid arthritis (RA). Since their approval, some questions regarding their safety have been raised. Both acute and delayed reactions have been described. METHODS: The aim of our work was to detect if there is a different incidence of hypersensitivity reactions - infusion reactions to infliximab or injection site reactions with etanercept or adalimumab - in atopic patients versus non- atopic patients. In 90 patients (82 females, 8 males) with rheumatoid arthritis we evaluated, during the first year of therapy with three different TNF-alpha blocking agents, total serum IgE (normal value <100 KU/L) (method ImmunoCAP PHADIA) and serum specific IgE performing a qualitative multi-allergen test for inhal-ant allergens (PHADIATOP, method ImmunoCAP PHADIA). In all patients we evaluated injection site reactions (ISR) to etanercept and adalimumab - erythema, edema and itching at the site of subcutaneous administration - and infusion reactions to infliximab - hypotension/hypertension, chest pain, dyspnea, laryngospasm, fever, urticaria angioedema. RESULTS: We obtained the following results: patients with high value of tot-al IgE were 15/90 (16.6 %), patients with total IgE in normal range were 75/90 (83.4.%), reactions in patients with high total IgE were 6.7% and in patients with normal total IgE were 18.7% (p=0.255 ns). As regards serum specific IgE, patients with specific IgE were 17/90 (18.8%) patients without specific IgE were 73/90 (81.2%), reactions in patients with specific IgE were 11.8% and in patients without specific IgE were 17.8% (p=0.547 ns). Also, when the data were divided for the three groups, the differences were not statistically significant. CONCLUSION: Adverse reactions to biological agents have been categorized into five types. In hypersensitivity reactions - the Beta type reactions - an immune mechanism is suspected. Our data showed that there was no correlation between the atopic status and the incidence of hypersensitivity reactions during the first year of therapy with three different TNF-alpha blocking agents.

Benucci M, Manfredi M, Mecocci L. · Rheumatology Unit, Nuovo Ospedale S. Giovanni di Dio, ASL 10, Florence, via di Torregalli 3, Florence, Italy. · J Clin Rheumatol. · Pubmed #18766129 No free full text.

This publication has no abstract.

Benucci M, Nenci G, Cappelletti C, Manfredi M. · U.O.S. Reumatologia, Nuovo Ospedale S. Giovanni di Dio, ASL 10 Firenze. · Recenti Prog Med. · Pubmed #18751615 No free full text.

Abstract: Since anti-TNFalpha treatments were introduced in the therapy of rheumatoid arthritis, some cases of patients with drugs induced Lupus during clinical trials with infliximab treatment for rheumatoid arthritis (RA) were reported. We report three cases with history of refractory RA (two patients) and of psoriatic arthritis (one patient) with a diagnosis of Drug Induced Lupus, after treatment with infliximab, with different clinical features such as pericardial and pleural effusion, skin lesions and piastrinopenia and with autoantibody assessment. We also reviewed the development of anti nuclear and anti double-strand DNA antibodies and drug induced lupus in patients treated with anti-TNFalpha agents (infliximab, etanercept and adalimumab).

Benucci M, Li Gobbi F, Saviola G, Manfredi M. · Rheumatology Unit, Nuovo Ospedale S. Giovanni di Dio, ASL 10 Florence via di Torregalli 3, Florence, Italy. · Rheumatol Int. · Pubmed #18493770 No free full text.

Abstract: Rheumatoid vasculitis (RV) is an uncommon but potentially catastrophic complication of rheumatoid arthritis (RA). There are few current extensive studies and no consensus regarding the clinical, laboratory, histologic features and management or prognosis of RV. We report a case of RV in a 74-year old woman with a long (14 years) history of RA, who developed vasculitis of distal arteries with gangrene of digits of upper and lower extremities. After the failure of various immunosuppressive drugs (cyclophosphamide, methotrexate), the patient was treated with anti-TNFalpha infliximab. Digital gangrene healed within four months from the start of anti-TNFalpha treatment.

Benucci M, Cammelli E, Manfredi M, Saviola G, Baiardi P, Mannoni A, Anonymous00323. · Rheumatology Unit, Nuovo Ospedale S Giovanni di Dio, Florence, Italy. · Rheumatol Int. · Pubmed #18231795 No free full text.

Abstract: The concept of Early Arthritis represents a new diagnostic-therapeutic strategy in modern rheumatology. Even if many Early Arthritis clinics are starting up, we do not yet know the frequency of this pathology in the Italian population. With the collaboration of 20 general practictioners (GPs) operating in the municipalities of Scandicci, Lastra a Signa and Signa, we assessed the incidence of rheumatoid arthritis and of new cases of Early Rheumatoid Arthritis (ERA) in the period from 1.09.2005 to 31.08.2006. The general population over 18 years old in the three municipalities according to the political electoral lists in April 2006 was as follows: Scandicci 42,474 (Males 20,290; Females 22,184), Lastra a Signa 15,368 (M 7,458; F 7,910) and Signa 13,372 (M 6,439; F 6,933). The total number of patients followed by the 20 GPs was 32,521 according to the records of ASL10 Florence. In one year 920 patients were referred by their GPs to a rheumatologist with suspected early undifferentiated arthritis according to Emery's criteria. The patients underwent a rheumatological examination and the rheumatoid factor IgM, hidden rheumatoid factors (IgG and IgA) and IgG antibodies anti-CCP (anti-cyclic citrullinate peptides) with a semiquantitative immuno-enzymatic test ELISA were investigated. In one year we observed 32 new cases of Rheumatoid Arthritis, of which 8 were males and 24 were females. The rate of incidence with respective intervals of confidence of 95% was 0.98 per thousand (0.64-1.32 per thousand). The average age was 47.7 +/- 10.5 in the females and 54.9 +/- 10.3 in the males. The patients had an average history of illness in months of 5.2 +/- 1.3 F versus 4.6 +/- 1.1 M, number of tender joints 6.2 +/- 2.3 F versus 5.3 +/- 2.2 M, number of swollen joints 4.8 +/- 1.4 F versus 4.2 +/- 1.5 M, a global assessment of 64.3 +/- 10 F versus 53 +/- 12 M, ESR (mm/h) 49.2 +/- 11.3 F versus 43.3 +/- 12.5 M, CRP (mg/dl) 2.8 +/- 1.3 F versus 2.3 +/- 1.4 M, DAS28 5.55 +/- 1.2 F versus 5.19 +/- 1.3 M, HAQ 2.5 +/- 0.4 F, 2.2 +/- 0.3 M. The rates of incidence in the Italian population affected by early rheumatoid arthritis are higher than those found in some European populations, such as those of the UK and Finland, but less than those found in the population of USA. The different data reported in the literature seem to be due to the different methods of assessing ERA and to the different types of samples studied.

Benucci M, Saviola G, Baiardi P, Cammelli E, Manfredi M. · Rheumatology Unit, Nuovo Ospedale S. Giovanni di Dio, ASL 10, via di Torregalli 3, Florence, Italy. · Clin Rheumatol. · Pubmed #17929076 No free full text.

Abstract: Anti-nucleosome antibodies have a role in the diagnosis and follow-up of systemic lupus erythematosus (SLE) and have a possible correlation with SLE activity and with kidney and hematological involvement. The aim of our study was to detect in 91 patients with rheumatoid arthritis (RA) the positivity of anti-nucleosome antibodies during therapy with three different TNFalpha blocking agents and to underline the possible correlation with the development of antinuclear autoantibodies (ANA) and anti-dsDNA autoantibodies. We detected anti-nucleosome antibodies, ANA, and anti-dsDNA during therapy with three different TNFalpha blocking agents at T-0 and after 12 and 24 weeks of treatment, respectively. Anti-nucleosome antibodies (IgG class) were analyzed by ELISA technique (Orgentec Diagnostika GmbH, Mainz, Germany), ANA both by indirect immunofluorescence (IIF) technique on Hep-2 (Scimedx, USA) and by ELISA (Autoimmune EIA ANA screening test Bio-Rad Laboratories, CA, USA), and anti-dsDNA (IgG and IgM classes) by ELISA (Kallestad, Bio-Rad Laboratories, CA, USA) and confirmed by IIF on Crithidia luciliae (ImmunoConcepts N.A., Sacramento, CA, USA). We observed 19 patients on infliximab treatment at 3 mg/kg every 8 weeks, 43 patients on etanercept treatment at 25 mg twice a week, and 29 patients on adalimumab treatment at 40 mg every other week. At baseline, we observed positivity as follow: in the group of patients treated with infliximab-anti-nucleosome 1/19 (5.26%), ANA 3/19 (15.7%), anti-dsDNA 1/19 (5.26%); in the group treated with etanercept--anti-nucleosome 2/43 (4.65%), ANA 1/43 (2.43%), anti-dsDNA 0/43; and in the group treated with adalimumab--anti-nucleosome 2/29 (6.89%), ANA 1/29 (3.44%), anti-dsDNA 0/29. The results at 12 weeks for the three autoantibodies were: for infliximab--3/19 (15.7%), 10/19 (52.6%), 2/19 (10.5%); for etanercept--3/43 (6.9%), 10/43 (23.2%), 1/43 (2.32%); and for adalimumab--3/29 (10.3%), 4/29 (13.7%), 1/29 (3.4%). At 24 weeks, the results were for infliximab 6/19 (31.5%), 12/19 (63.1%), 2/19 (10.5%); for etanercept 11/43 (25.5%), 22/43 (51.1%), 2/43 (4.65%); and for adalimumab 4/29 (13.7%), 13/29 (44.8%), 1/29 (3.4%). We observed a concordance anti-nucleosome/ANA antibodies of 85.5% (p < 0.001). Our data showed a concordance between anti-nucleosome antibodies and ANA positivity in patients with RA during therapy with TNFalpha blocking agents. The induction of autoantibodies positivity is different for each TNFalpha blocking agent.

Vitali C, Palombi G, Baldini C, Benucci M, Bombardieri S, Covelli M, Del Papa N, De Vita S, Epis O, Franceschini F, Gerli R, Govoni M, Bongi SM, Maglione W, Migliaresi S, Montecucco C, Orefice M, Priori R, Tavoni A, Valesini G. · Villamarina Hospital, Piombino, Italy. · Arthritis Rheum. · Pubmed #17599741 links to  free full text

Abstract: OBJECTIVE: To develop valid instruments for the assessment of disease-related damage and disease activity in Sjögren's syndrome (SS). METHODS: Data on 206 patients with primary SS were collected in 12 Italian centers. Each patient was scored by 1 investigator, on the basis of a global assessment of the degree of disease damage and disease activity. Patients judged to have active disease at the time of enrollment underwent a second evaluation after 3 months. Univariate and multivariate analyses were performed to select the clinical and serologic variables that were the best predictors of damage and of disease activity, and these variables were used to construct the Sjögren's Syndrome Disease Damage Index (SSDDI) and the Sjögren's Syndrome Disease Activity Index (SSDAI). The weight of each variable in the index was determined by the beta coefficients in multivariate regression models. Scores obtained using the SSDDI and the SSDAI were compared with scores initially given by the investigators. Finally, a receiver operating characteristic (ROC) curve was used to determine the cutoff value in the SSDAI with the highest level of accuracy in identifying patients with a significant level of disease activity. RESULTS: A multivariate model with 9 variables was the best predictor of investigator scores of damage. The scores obtained using the SSDDI were closely correlated with investigator ratings (R = 0.760, P < 0.0001). A model composed of 11 variables was the best predictor of investigator scores of disease activity. The scores obtained using the SSDAI were strongly correlated with the investigator ratings both at the time of enrollment and 3 months after enrollment (R = 0.872, P < 0.0001, and R = 0.817, P < 0.0001, respectively). The differences between scores given by investigators at study enrollment and after 3 months, a measure of variation of disease activity over time, were also closely correlated with the differences calculated using the SSDAI (R = 0.683, P < 0.0001). The ROC curve analysis showed that patients with the highest level of disease activity could be identified on the basis of an SSDAI score of >or=5. CONCLUSION: Our findings indicate that the SSDDI is an adequate instrument to objectively measure damage in patients with SS, and that the SSDAI is a valid tool to measure disease activity when used either as a single-state index or as a transition index.

Benucci M, Maniscalchi F, Manfredi M. · Unità Operativa Semplice di Reumatologia, Dipartimento Medicina Interna Nuovo Ospedale S. Giovanni di Dio, Azienda Sanitaria di Firenze. · Recenti Prog Med. · Pubmed #17345875 No free full text.

Abstract: Amyloidosis refers to the extracellular deposition of proteinaceous insoluble fibrils in various tissues, resulting in organ compromise. The most common form of amyloidosis occurs secondary to chronic inflammatory disease, in which AA fibrils, derived from the acute phase protein, serum amyloid-A (SAA). We evaluated the prevalence of AA with lip biopsy on 106 rheumatoid arthritis patients (according to 1988 ARA criteria), asymptomaticwith regard to amyloidosis (90 females, 16 males). On histological salivary gland samples we evaluated the presence of AA by an immunohistochemical method [Anti Human Amiloid clone MC-1 (DAKO, Italy)]. We observed a positivity of AA on 8/106 patients (5 F/3 M) 7.54%. When the total data were divided into three groups considering the different lenght of the disease (number of years) we observed the following prevalence data: group A, years of disease < 3, 2/45, 4.44% (F 1/M 1), group B, years of disease 3-5, 2/26, 7.69% (F 1/M 1), group C, years of disease > 5, 4/35, 11.42%. The statistical analysis showed a significative difference between group A and B (p < 0.025), between group B and C (p < 0.025) and between group A and C (p < 0.01). The 8 patients with AA positivity showed also an high disease activity in comparison with 98 negative patients: DAS 5.62 +/- 0.48 vs 4.36 +/- 0.79, DAS28 5.84 +/- 0.76 vs 4.48 +/- 0.87 (p < 0.05). Our data showed that secondary AA amyloidosis prevalence in asymptomatic Italian rheumatoid arthritis patients was 7.54%; moreover this complication was present in 4.44% of early rheumatoid arthritis patients.

Benucci M, Turchini S, Parrochi P, Boccaccini P, Manetti R, Cammelli E, Manfredi M. · Unità Operativa Semplice di Reumatologia, Dipartimento Medicina Interna, Nuovo Ospedale S. Giovanni di Dio, Firenze. · Recenti Prog Med. · Pubmed #16700418 No free full text.

Abstract: TNF-alpha role in RA is confirmed by the improvement on joint inflammation and physical function and by the slowing of radiographic damage induced by TNF-alpha blockers, that also reduce Rheumatoid Factor (RF) and anti-CC-P titres. (1) To evaluate the effects of 3 TNF-alpha blockers on (a) disability (HAQ), disease activity (DAS28), acute phase reactants (ERS, CRP); (b) autoantibodies: IgM RF, anti-CCP abs. (2) To evaluate if anti-CCP abs could be useful for testing the efficacy of anti-TNF-alpha agents in the follow-up of RA patients. 34 patients with RA (25 F, 9 M; mean age: 59.1 +/- 12.1 years, mean disease duration: 9.6 +/- 2.3 years; 23/34 positive for anti-CCP abs, 19/34 for IgM RF) were enrolled: 18 received Etanercept (25 mg twice weekly subcutaneously), 8 received Infliximab (3 mg/kg intravenously every 8 weeks) and 8 Adalimumab (40 mg every 14 days). All the patients were evaluated for the above mentioned parameters at baseline (t0) and after 6 months of therapy (t6). Anti-TNF-alpha agents differently reduced HAQ and DAS28, ERS and CRP, RF and anti-CCP ab titres RA patients whose RF (14) and/or anti-CCP abs (17) titres were significantly lowered at the end of the study, at t6 presented a significant reduction in respect to t0 of VES, PCR, DAS28 and HAQ values (p < 0.05 for all comparison). This effect was not shown in patients in whose RF (5) and/or anti-CCP abs (6) titres were not reduced in respect to baseline. In RA, anti-TNF-alpha agents, especially Etanercept, reduce disability, disease activity and acute phase reactants expecially in patients showing reduction of RF and anti CC-P titres.

Benucci M, Li Gobbi F, Fossi F, Manfredi M, Del Rosso A. · Section of Rheumatology, Nuovo Ospedale di S. Giovanni di Dio ASL 10, Via di Torregalli 3, 50143 Florence, Italy. · J Clin Rheumatol. · Pubmed #16357696 No free full text.

Abstract: We report a case of a 45-year-old man with an 8-month history of rheumatoid arthritis, who was treated with hydroxychloroquine 400 mg per day and 15 mg intramuscular methotrexate per week without reaching a good control of the disease. The patient was successfully treated with 3 mg/kg infliximab for 20 weeks. Before the last infusion, drug-induced lupus (DIL) was diagnosed based on the clinical features of fever > 37.5 degrees C, recurrence of active synovitis, myalgia, erythematosus rash, pericardial and pleural effusion, and of some laboratory findings (antinuclear antibodies 1:160 and anti double-strand DNA positive by DNA recombinant plasmid assay dsDNA). After infliximab discontinuation and the beginning of therapy with methylprednisolone, lupus symptoms resolved within 6 weeks. A new rheumatoid arthritis flare, occurring after 8 weeks, was controlled by methotrexate plus leflunomide. We also review the development of antinuclear and antidouble-strand DNA antibodies and drug-induced lupus in patients treated with anti-TNFalpha agents (infliximab, etanercept, and adalimumab).

Benucci M, Li Gobbi F, Fossi F, Cammelli E, Manfredi M. · Sezione di Reumatologia, Dipartimento Medicina Interna, Nuovo Ospedale S.Giovanni di Dio, ASL 10, Firenze. · Recenti Prog Med. · Pubmed #16229322 No free full text.

Abstract: The aim of the study was to evaluate the composition and functional integrity of the various components of immune response in patients with rheumatoid arthritis (RA). We evaluated in 14 patients with RA with stable methotrexate therapy 12.5 mg/weekly, the number of peripheral mononuclear (PMN) cells lymphocytes, monocytes and the circulating levels of TNFalpha, IL-6 and IL-10 before and during adalimumab therapy 40 mg every other week for 6 months. No difference in baseline versus 6 months values between two treated group for PMN cells. Data about cytokines show a reduction for TNFalpha, IL-6 circulating levels and an increase for IL-10 circulating levels. Our data reveal that adalimumab doesn't reduce lymphocyte population and subsets such as CD14 or CD56 cells that have an important role against infections.

Benucci M, Li Gobbi F, Del Gobbo A, Gambacorta G, Mannoni A. · Sezione Aggregata di Reumatologia, Nuovo Ospedale S. Giovanni di Dio, Florence, Italy. · Reumatismo. · Pubmed #12874643 links to  free full text

Abstract: OBJECTIVES: The presence of secondary amyloidosis is a complication of different rheumatic diseases. We investigated the presence of Serum Amyloid A (SAA), marker of secondary amyloidosis, in salivary glands of patients (pts) with Sjögren Syndrome (SS) and correlated it to biohumoral parameters. MATERIALS AND METHODS: 141 pts with sicca syndrome who fulfilled 3 items of the European Criteria for SS by Vitali et al underwent biopsies of labial salivary glands, that were scored according to Chisholm and Mason index and evaluated for the presence of SAA. All pts were evaluated for ANA, ENA, rheumatoid factor, gamma-globulins, IgA, IgG, IgM, C3, C4, beta 2-microglobulin, erythrosedimentation rate, C reactive protein. RESULTS: Forty out of 141 pts, showed sialoadenitis (SL) with focus score 3-4 (definite SS), and 101 pts showed SL with focus score 1-2. Fourteen out of 101 pts (13.8%) with score 1-2 and 12/40 pts (30%) with definite SS were positive for SAA, respectively. SS pts were further divided in group A (positive for SAA) and group B (negative for SAA). These groups were compared to detect if differences could exist in biohumoral parameters: group A showed higher levels of biohumoral parameters than group B, but the difference was significant only for beta 2-microglobulin: 2653+610 ng/ml versus 1848+440 ng/ml; p< 0.025. CONCLUSION: Secondary amyloidosis is a complication of SS. In pts with SAA in salivary glands were detected high levels of beta 2-microglobulin, that could be considered a factor predicting the development of amyloidosis in SS.

Saviola G, Benucci M, Cirino G. · No affiliation provided · Curr Med Res Opin. · Pubmed #17903346 No free full text.

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Li Gobbi F, Benucci M, Del Rosso A. · No affiliation provided · J Clin Rheumatol. · Pubmed #16357717 No free full text.

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Benucci M, Li GF, Del Rosso A, Manfredi M. · No affiliation provided · Clin Exp Rheumatol. · Pubmed #16173267 No free full text.

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Benucci M, Bardazzi G, Magarò L, Li Gobbi F, Mannoni A, Serni U. · No affiliation provided · Clin Exp Rheumatol. · Pubmed #11491510 No free full text.

This publication has no abstract.