Research ArticleAccepted Articles
Patient care pathways for pregnancy in rare and complex rheumatic diseases: results from an international survey
Chiara Tani, Dina Zucchi, Elisa Bellis, Mehret Birru Talabi, Charlotte Frise, Guilherme Ramires de Jesús, Hege Svean Koksvik, Gema Maria Lledó, Arsène Mekinian, Diana Marinello, Ilaria Palla, Puja Mehta, Luis Sáez Comet, Shoela Shaimaa, Hieronymus T.W. Smeele, Rosaria Talarico, Antonio Brucato, Munther Khamashta, Yehuda Shoenfeld, Angela Tincani and Marta Mosca
The Journal of Rheumatology January 2023, jrheum.220773; DOI: https://doi.org/10.3899/jrheum.220773
Chiara Tani
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Dina Zucchi
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Elisa Bellis
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Mehret Birru Talabi
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Charlotte Frise
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Guilherme Ramires de Jesús
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Hege Svean Koksvik
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Gema Maria Lledó
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Arsène Mekinian
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Diana Marinello
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Ilaria Palla
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Puja Mehta
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Luis Sáez Comet
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Shoela Shaimaa
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Hieronymus T.W. Smeele
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Rosaria Talarico
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Antonio Brucato
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Munther Khamashta
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Yehuda Shoenfeld
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Angela Tincani
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Marta Mosca
C Tani, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. D Zucchi, MD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa; Department of Medical Biotechnologies, University of Siena, Italy. E Bellis, MD, Rheumatology Unit, Mauriziano Umberto I Hospital, Turin Italy; Rheumatology Unit, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. M Birru Talabi, MD, PhD, University of Pittsburgh School of Medicine C Frise, MD, Oxford University Hospitals NHS Foundation Trust, UK. GR de Jesús, MD, Universidade do Estado do Rio de Janeiro, Brazil. HS Koksvik, MD, Norwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs hospital, Trondheim University Hospital, Norway. GM Lledó, MD, Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain. A Mekinian, MD, Sorbonne University, Internal Medicine Department, Saint Antoine Hospital, Paris, France. D Marinello, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa. I Palla, Institute of Management, Scuola Superiore Sant'Anna. P Mehta, MD, Centre for Inflammation and Tissue Repair, UCL Respiratory. LS Comet, MD, Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain. S Shaimaa, MD, Internal Medicine & Rheumatology Department, Alexandria Faculty of Medicine. HTW Smeele, MD, Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands. R Talarico, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. A Brucato, MD, Università di Milano, Department of biomedical and clinical sciences. M Khamashta, MD, FRCP, PhD, Department of Women and Children's Health, King's College London, UK; Gulf Medical Expert-Lupus, GSK, Dubai, United Arab Emirates. Y Shoenfeld, MD, FRCP, Ariel University, Ariel, Israel. A Tincani, MD, Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy. M Mosca, MD, PhD, Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa. Conflict of interest: Munther Khamashta: full time employee at GSK, received shares from the company (GSK); The other authors declared no competing interests. Corresponding author: Marta Mosca, MD, PhD; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy. marta.mosca@med.unipi.it.
Abstract
Objective To map existing organizational care pathways in clinical centers of expertise that care for pregnant women affected by rare and complex connective tissue diseases (rcCTDs).
Methods An international working group composed of experts in the field of pregnancy in rcCTDs co-designed a survey focused on organizational aspects related to the patient's pathway before, during and after pregnancy. The survey was deployed to subject experts via referral sampling.
Results Answers were collected from 69 centers in 21 countries. Patients with systemic lupus erythematosus and/or antiphospholipid syndrome were followed by more than 90% of centers, while diseases such as IgG4-related diseases were rarely covered. In the majority of centers, a multidisciplinary team was involved, including an obstetrician/gynaecologist in 91.3% of cases and other healthcare professionals less frequently. Respondents indicated that 96.0% of the centers provided routine pre-pregnancy care, while the number of patient visits during pregnancy varied across centers. A formalized care-pathway was described in 49.2% of centers, and 20.3% of centers had a pre-defined protocol for the monitoring of pregnant patients. Access to therapies during pregnancy also was heterogeneous among different centers.
Conclusion In international referral centers, a high level of care is provided to patients with rcCTDs before, during and after pregnancy. No significant discrepancies were found between European and non-European countries. However, this work highlights a potential benefit to streamline the care approaches across countries in order to optimize pregnancy and perinatal outcomes among patients with rcCTDs.
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In this issue
The Journal of Rheumatology
Vol. 50, Issue 1
1 Jan 2023
Accepted manuscript
Patient care pathways for pregnancy in rare and complex rheumatic diseases: results from an international survey
Chiara Tani, Dina Zucchi, Elisa Bellis, Mehret Birru Talabi, Charlotte Frise, Guilherme Ramires de Jesús, Hege Svean Koksvik, Gema Maria Lledó, Arsène Mekinian, Diana Marinello, Ilaria Palla, Puja Mehta, Luis Sáez Comet, Shoela Shaimaa, Hieronymus T.W. Smeele, Rosaria Talarico, Antonio Brucato, Munther Khamashta, Yehuda Shoenfeld, Angela Tincani, Marta Mosca
The Journal of Rheumatology Jan 2023, jrheum.220773; DOI: 10.3899/jrheum.220773
Accepted manuscript
Patient care pathways for pregnancy in rare and complex rheumatic diseases: results from an international survey
Chiara Tani, Dina Zucchi, Elisa Bellis, Mehret Birru Talabi, Charlotte Frise, Guilherme Ramires de Jesús, Hege Svean Koksvik, Gema Maria Lledó, Arsène Mekinian, Diana Marinello, Ilaria Palla, Puja Mehta, Luis Sáez Comet, Shoela Shaimaa, Hieronymus T.W. Smeele, Rosaria Talarico, Antonio Brucato, Munther Khamashta, Yehuda Shoenfeld, Angela Tincani, Marta Mosca
The Journal of Rheumatology Jan 2023, jrheum.220773; DOI: 10.3899/jrheum.220773
