Sedat Kiraz

Introduction Colchicine is the cornerstone of familial Mediterranean fever (FMF) treatment, effectively preventing attacks and amyloid A (AA) amyloidosis. Its effectiveness depends on long-term adherence; however, data on adult adherence remain sparse. We aimed to evaluate colchicine adherence in adults with FMF and identify factors associated with low adherence. Methods This cross-sectional study consecutively enrolled adults with FMF fulfilling Livneh/Tel-Hashomer criteria and receiving colchicine for ≥ 3 months. Adherence was assessed using the Turkish 8-item Morisky Medication Adherence Scale (MMAS-8™) alongside sociodemographic and clinical characteristics. Results Of 104 patients (median age 37.6 years; 32.7% male), adherence was low, moderate, and high in 28.8%, 45.2%, and 26.0%, respectively. MMAS-8™ scores correlated with physician- and patient-rated adherence (r = 0.53 and 0.50, respectively; p < 0.001 for both). Low-adherence patients were younger (median ages of 31.2, 42.6, and 43.1 years; p < 0.001), and age increased across adherence categories (p = 0.001). In multivariable analysis, low income (≤ 1 × national minimum wage; odds ratio (OR) 4.78; 95% confidence interval (CI) 1.01–22.56; p = 0.04) was associated with higher odds of low adherence, whereas older age (OR 0.92 per year; 95% CI 0.87–0.96; p < 0.001) was associated with lower odds of low adherence (vs. moderate-high adherence). No statistically significant associations were detected between adherence and the evaluated disease activity measures, family history, or immune-mediated inflammatory diseases, and no robust association was identified between available Mediterranean fever gene (MEFV) genotype data and colchicine adherence. Conclusion Nearly one-third of adult patients with FMF exhibit low adherence to colchicine. Younger age and low household income were associated with low adherence. Routine adherence assessment and targeted support for potentially vulnerable subgroups may help optimize long-term outcomes. Graphical Abstract available for this article. Graphical Abstract

Purpose: The aim of this study was to investigate the effects of the biopsychosocial exercise model applied via telerehabilitation on individuals with rheumatism during the COVID-19 epidemic.Methods: Individuals with rheumatic diseases received telerehabilitation 3 times a week for 24 weeks via a social messaging program intervention sessions formed from 10 minutes of dance therapy-authentic movement, 40 minutes of exercises, and 10 minutes of dance therapy. This exercise content was based on the biopsychosocial model, named as Cognitive Exercise Therapy Approach (BETY) which was a method that individuals had already practiced before the pandemic. The Health Assessment Questionnaire (HAQ) was used to assess the level of disability, the Hospital Anxiety and Depression Scale (HADS) was used to assess mood involvement, and the BETY Biopsychosocial Questionnaire (BETY-BQ) was used to assess biopsychosocial involvement level. Evaluations were made at the beginning of the study and repeated at the 12th and 24th weeks.Results: A total of 28 individuals with rheumatic diseases were included in the study and their mean age was 56.50 ± 5.51 years. There was a significant difference between the first and second assessment of HAQ (p= 0.031), between the first and second assessment of BETY-BQ (p= 0.004) and between the third and first assessment (p= 0.015).Conclusion: The application of BETY with telerehabilitation helped individuals maintain the level of recovery they had previously achieved in terms of disability, mood level and biopsychosocial. These results indicate that individuals with rheumatic diseases can continue the remote application via telerehabilitation to support their health after experiencing biopsychosocial exercise approaches face-to-face.

Immunocompromised (IC) patients are at increased risk of herpes zoster (HZ; i.e. shingles) and subsequent complications which can significantly impact quality of life. While current evidence indicates a strong disease presence of HZ in Türkiye, literature on the management of HZ in this population is lacking. We conducted a survey with 6 disease experts from various medical specialties in Türkiye to understand their opinions on the burden of HZ and the challenges faced by IC patients, in order to establish a comprehensive and evidence-based expert consensus. Experts agreed that the burden of HZ is significant among IC patients in Türkiye. However, they identified a need for increased local epidemiological data to better understand the health impact of HZ in Türkiye. Improved dissemination of information regarding HZ to physicians was also highlighted to increase awareness of HZ. Strategies to enhance current practices and increase vaccine coverage should include incorporation of HZ vaccination into official guidelines and recommendations, with full or partial reimbursement for HZ vaccination in IC patients. Setting up official or society-initiated online platforms could also support ongoing collaboration and provide continuously updated guidelines reflecting the latest advances in HZ vaccination and disease management.

This retrospective study aimed to evaluate the comparison of functionality, mood, and biopsychosocial status in rheumatic patients with and without self-reported bowel problems and the evaluation of Bilişsel Egzersiz Terapi Yaklaşımı (BETY)- (Cognitive Exercise Therapy Approach in English)'s impact on these factors. The study included 718 patients with eight different diagnoses of rheumatism. The presence of self-reported bowel problems in rheumatic patients was assessed with item 10 of the BETY-Biopsychosocial Questionnaire (BETY-BQ), functionality with the Health Assessment Questionnaire (HAQ), emotional status with the Hospital Anxiety and Depression Scale (HADS), and biopsychosocial status (BPS) with the BETY-BQ. Sixty-five rheumatic patients were included in BETY group exercise sessions for three months, three days a week. The rate of self-reporting bowel problems in the total cohort was 61.6%. Among all BPS parameters examined, a significant difference was found in favor of rheumatic individuals who did not report bowel symptoms (p < 0.005). All patients included in the BETY sessions achieved improvement in all parameters, including bowel symptoms (p < 0.005). Many patients suffered from bowel problems, including study. Investigated parameters of rheumatic patients with bowel symptoms were negatively affected. BETY improved all parameters, including bowel symptoms. BPS features should be considered in disease management in rheumatic patients reporting bowel problems. BETY should be used as an exercise intervention based on the BPS model in these patients.

Objectives: This study aimed to examine the frequency and associated factors of extra-musculoskeletal manifestations (EMMs) and peripheral manifestations in an axial spondyloarthritis (axSpA) cohort and their impact on the choice of first biologic treatment. Patients and methods: A total of 1,687 patients with axSpA (978 males, 709 females; mean age: 38.5±11 years) who started their first biologic disease modifying antirheumatic drug (bDMARD) were included from a national prospective database of TReasure between its inception and 2018-2021. Demographic and clinical characteristics, disease-related features, and treatment patterns were compared between patients with and without EMMs or peripheral involvement. Results: Of the patients, 1,283 had radiographic axSpA (r-axSpA), while 404 had nonradiographic axSpA (nr-axSpA). Acute anterior uveitis (AAU) was the most common (11.4%) EMM, and older age, female sex, human leukocyte antigen B27 (HLA-B27) positivity, and a lower Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score were associated with AAU. Female sex, methotrexate use, dactylitis, and higher Ankylosing Spondylitis Disease Activity Score (ASDAS)-serum C-reactive protein (CRP) scores were related to psoriasis (PsO). Inflammatory bowel disease (IBD) and PsO were negatively associated with HLA-B27 positivity. Enthesitis was the most frequent (28.2%) peripheral manifestations, and peripheral arthritis, dactylitis, and enthesitis were independent predictor of each other. In addition, dactylitis and peripheral arthritis were related to more frequent use of conventional disease modifying antirheumatic drugs. In addition, IBD history was associated with less frequent use of etanercept. Older age, less use of sulfasalazine, the absence of enthesitis, and lower Bath Ankylosing Spondylitis Functional Disease Index (BASFI) scores were associated with secukinumab use. Conclusion: Acute anterior uveitis was associated with HLA-B27 positivity, while PsO or IBD were negatively associated with HLA-B27 in patients with axSpA. Peripheral manifestations appeared to be related to each other. Among EMMs, we found that only IBD had an effect on the bDMARD preference.

Aims and Objectives: To investigate the effectiveness and acceptability, and thus practicability of a biopsychosocial‐based exercise model in rheumatic diseases by a mixed method.Method: This study is within the framework of mixed‐method research that combines the strengths of quantitative and qualitative research methodologies. For the quantitative part of the study, 81 patients were divided into two groups Bilişsel Egzersiz Terapi Yaklaşımı (BETY)‐ (Cognitive Exercise Therapy Approach in English) exercise group (BETY Group‐BG) and control group (CG). BG participants engaged in supervised exercise sessions with a physiotherapist for 1 h, three times weekly, over 12‐week periods, while CG participants continued only routine medical treatment. Biopsychosocial status (BETY‐Biopsychosocial Questionnaire [BETY‐BQ]), functionality (Health Assessment Questionnaire [HAQ]), emotional status (Hospital Anxiety and Depression Scale [HADS]), and quality‐of‐life (Short Form‐36 [SF‐36]) was evaluated at baseline and 12 weeks. Qualitative data was collected from 20 patients who have acquired the habit of regular exercise by attending the BETY group exercise programme. Individual, semi‐structured, face‐to‐face interviews were recorded, transcribed, and condensed and interpreted based on pre‐established themes.Result: There were differences in the BETY‐BQ, HAQ, HADS‐D, and SF‐36 scores between baseline and 12 weeks in the BG (p < 0.05). Additionally, in post‐intervention, the BETY‐BQ, HADS‐A, and SF‐36 scores differences between groups were in favour of the BG (p < 0.05). In qualitative analysis, four sections were investigated, which were subdivided into ‘Biopsychosocial Status’, ‘Functionality’, ‘Emotional Status’ and ‘Quality of Life’.Conclusion: BETY is an effective and acceptable exercise model for managing the symptoms of patients with rheumatic diseases.