Aim: The dynamics of coronavirus disease 2019 (COVID‐19) pandemic has become of special concern to the rheumatology community. Rheumatic patients are required to engage in effective health management but their behavior is often influenced by intrinsic and extrinsic factors. This cross‐sectional study aims to examine patients’ experiences during the current pandemic and its implication on their health perception and behavior.Method: A patient‐centered electronic survey was used, randomly sampling rheumatic patients in Saudi Arabia during March and April 2020. Questions included patients’ socio‐demographics, diseases, medications, COVID‐19 knowledge, source of information, fear level, disease activity perception, health care utilization, medication accessibility, and therapeutic compliance (measured using a modified version of Medication Adherence Reporting Scale). Correlation and regression coefficients were used to evaluate associations among the aforementioned variables.Results: A total of 637 respondents were included. The majority were rheumatoid arthritis patients (42.7%). Patients' knowledge about COVID‐19 was correlated with social media use (P = .012). Fear of COVID‐19 infection correlated with healthcare facility for follow‐up visits (P = .024) and fear of disease deterioration if contracting the infection correlated with patients’ levels of knowledge (P = .035). Both types of fear did not correlate with patients’ perceptions of disease activity. However, patients’ perceptions of worsened disease activity were correlated with unplanned healthcare visits (P < .001), medication non‐adherence, and difficulty accessing medication (P = .010 and .006, respectively).Conclusion: The COVID‐19 pandemic and surrounding public health measures could affect rheumatic patients’ health management which might contribute to disease flare‐up and subsequently taxing healthcare systems even further.

Systemic Lupus erythematosus (SLE) is a chronic multisystem, multifactorial inflammatory autoimmune disease. The SLE patients have 3 times increased risk of mortality based on international data with ethnicity playing an important impact on patients’ morbidity and mortality. Descriptive studies from Saudi Arabia showed variation in clinical features from one region to another. Moreover, reliable inference from these studies is limited by study methodology and lack of translational data using biological samples to understand clinical phenotypes of Saudi SLE patients. The aim of this report is to describe the prospective study protocol of the National Systemic Lupus Erythematosus Cohort in Saudi Arabia. The purpose of this cohort study is multifold: first, to examine clinical characteristics and molecular phenotypes of Saudi SLE patients in relation to local environment and practices/lifestyles; second, to assess long-term outcomes of SLE in Saudi population and factors that influence favorable outcomes; third, to compare the effectiveness of various treatment regimens in Saudi SLE population. This study is a longitudinal prospective cohort study of adult, Saudi SLE patients using open cohort study design. Primary outcomes include disease-related outcomes (activity, improvement, and organ damage) and patient-reported outcomes (quality of life). Secondary outcomes include physiological and molecular modifications associated with changes in disease activity states.Results and analysis are in on-going study. This study provides a source of reliable data for clinical and translational research. This will allow us to have a holistic approach to SLE pathogenesis especially in Saudi population and may take us a step further toward much more personalized medicine. This protocol has been registered in NIH ClinicalTrial.gov (ClinicalTrial.gov identifier: NCT04604990) on October 27, 2020.

The role of inflammation in colon cancer is understood as a well-accepted factor that has the tendency to release multiple pro- and anti-tumorigenic inflammatory mediators. Inflammation-induced increased expression of anti-tumorigenic inflammatory mediators and decreased expression of pro-tumorigenic inflammatory mediators encourage beneficial inflammatory effects in terms of powerful anti-tumor immunity. The present study aims to screen the beneficial inflammatory effects of Walterinnesia aegyptia venom via determining its modulatory tendency on the expression of 40 pro- and anti-tumorigenic inflammatory mediators (cytokines/growth factors/chemokines) in LoVo human colon cancer cell line. LoVo-cells were treated with varying doses of crude venom of W. aegyptia. Cell viability was checked utilizing flow cytometry, and IC50 of venom was determined. Venom-induced inflammatory effects were evaluated on the expression of 40 different inflammatory mediators (12 anti-tumorigenic cytokines, 11 pro-tumorigenic cytokines, 7 pro-tumorigenic growth factors, 9 pro-tumorigenic chemokines and 1 anti-tumorigenic chemokine) in treated LoVo-cells [utilizing enzyme-linked immunosorbent assay (ELISA)] and compared with controls. Treatment of venom induced significant cytotoxic effects on inflamed LoVo-cells. IC50 treatment of venom caused significant modulations on the expression of 22 inflammatory mediators in treated LoVo-cells. The beneficial modulatory effects of venom were screened via its capability to significantly increase the expression of five powerful anti-tumorigenic mediators (IL-9, IL-12p40, IL-15, IL-1RA and Fractalkine) and decrease the expression of four major pro-tumorigenic mediators (IL-1β, VEGF, MCP-1 and MCP-3). Walterinnesia aegyptia venom-induced beneficial modulations on the expression of nine crucial pro/anti-tumorigenic inflammatory mediators can be effectively used to enhance powerful anti-tumor immunity against colon cancer.

Objective: Due to the increasing prevalence of rheumatological conditions worldwide, especially among women, and their known negative impact on body image, there is a growing demand for cosmetic procedures. Therefore, it is imperative to develop an evidence-based understanding of the safety of these procedures and their potential effects on the disease course to prevent undesirable exacerbations. Methods: An observational cross-sectional survey was conducted among adult patients diagnosed with rheumatic diseases. Data were collected using an electronic questionnaire that addressed demographics, disease characteristics, comorbidities, and perceptions of cosmetic procedures. Ethical approval was obtained from the Institutional Review Board of King Saud University and King Saud University Medical City. Appropriate descriptive and inferential statistical analyses were performed. Results: A total of 212 participants were included; among them, 92 participants considered or underwent cosmetic procedures, while 120 did not. A significant difference was observed between groups regarding disease-related impact on self-confidence (p = 0.01). Factors associated with undergoing cosmetic procedures included gender (female sex) (OR 12.02; 95% CI: 1.55–93.17; p = 0.017), higher educational level (OR 14.00; 95% CI: 1.32–147.42; p = 0.028), a monthly income of SAR 1000–5000 (OR 2.39; 95% CI: 1.03–5.53; p = 0.041) or SAR 5000–10,000 (OR 2.75; 95% CI: 1.19–6.33; p = 0.017), and employment status (OR 1.81; 95% CI: 1.03–3.18; p = 0.038). Conclusions: A substantial proportion of patients with rheumatic diseases considered or had undergone cosmetic procedures, primarily driven by appearance-related concerns and reduced self-confidence. Female sex, higher education, higher income, and employment status were significant predictors. Fear of disease flare-ups and potential side effects were the most common reasons for avoiding cosmetic procedures.

Background: Systemic lupus erythematosus (SLE) disease activity and damage assessments are crucial for understanding the disease burden across different lupus populations. This study aims to describe the disease characteristics, treatment, and disease activity and damage in the Saudi national prospective SLE cohort. Methods: Saudi SLE patients over 18 years of age were recruited prospectively from January 2020 to December 2023 from the national prospective cohort of SLE, Saudi Arabia. Data retrieved included patients’ sociodemographic characteristics, medical history, clinical manifestations and laboratory features, comorbidities, and medications at baseline visit, first follow-up at 3 months, and subsequent follow-up visits every 6 months. The SLE disease activity index 2000 (SLEDAI-2K) and Systemic Lupus International Collaboration Clinics/American College of Rheumatology (SLICC/ACR) damage index (SDI) scores were computed at baseline and follow-up visits following a standardized protocol. The generalized linear model was employed to assess organ damage based on the SDI scores. Kaplan–Meier survival analysis was performed to assess major adverse cardiovascular events (MACEs) and mortality. The Cox regression model was used to adjust for lupus disease and cardiovascular risk factors. Results: The mean age at SLE diagnosis of the 488 patients was 30.6 ± 11.9 years. The mean SLEDAI-2K and SDI scores were 8.0 ± 7.2 and 0.61 ± 1.1, respectively. The SLEDAI-2K scores declined initially and increased in follow-up visits. The SDI scores also increased at the follow-up visits. Musculoskeletal organ damage was found in 10.7% of the patients, neuropsychiatric damage in 9.2%, skin damage in 6.1%, renal damage in 5.9%, and cardiovascular damage in 4.4%. The parameters analyzed for predicting organ damage progression did not reach statistical significance, which may be due to the limited statistical power of the study and may not reflect an absence of relationship. Oral prednisolone was administered to 43.1% of the patients and hydroxychloroquine to 89.2%. The Kaplan–Meier 5- and 10-year survival rates were 99% and 98%, respectively. The initial findings using Cox regression analysis indicated that a longer SLE duration is protective of MACEs. However, a sensitivity analysis with a time-dependent approach did not retain significance of the SLE duration on the outcome of early MACEs. There was a trend of obesity and earlier MACE occurrence. Conclusion: Lupus disease activity and disease damage increased from the baseline visit over time. The most prevalent organ damage included musculoskeletal, neuropsychiatric, renal, and cardiovascular systems, consistent with previous studies. Time-invariant analysis showed an association between a longer SLE duration and MACEs, but such findings did not retain significance with a time-dependent approach, which may be due to immortal time bias. Obesity was found to contribute to early MACEs.