Amiodarone, a bi-iodinated benzofuran derivative, is among the most commonly used antiarrhythmic drugs due to its high level of effectiveness. Though initially categorized as a class III agent, amiodarone exhibits antiarrhythmic properties across all four classes of antiarrhythmic drugs. Amiodarone is highly effective in maintaining sinus rhythm in patients with paroxysmal atrial fibrillation while also playing a crucial role in preventing a range of ventricular arrhythmias. Amiodarone has a complex pharmacokinetic profile, characterized by a large volume of distribution and a long half-life, which can range from several weeks to months, resulting in prolonged effects even after discontinuation. Side effects may include thyroid dysfunction, pulmonary fibrosis, and hepatic injury, necessitating regular follow-ups. Additionally, amiodarone interacts with several drugs, including anticoagulants, which must be managed to prevent adverse effects. Therefore, a deep understanding of both oral and intravenous formulations, as well as proper dosage adjustments, is essential. The aim of this paper is to provide a comprehensive and updated review on amiodarone’s indications, contraindications, recommended dosages, drug interactions, side effects, and monitoring protocols.

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that can lead to ankylosis by secondary ossification of inflammatory lesions, with progressive disability and a significant impact on quality of life. It is also a risk factor for the occurrence of comorbidities, especially cardiovascular diseases (CVDs), mood disorders, osteoporosis, and malignancies. Early diagnosis and treatment are needed to prevent or decrease functional decline and to improve the patient’s prognosis. In respect of axSpA, there is an unmet need for biomarkers that can help to diagnose the disease, define disease activity and prognosis, and establish personalized treatment approaches. The aim of this review was to summarize the available information regarding the most promising biomarkers for axSpA. We classified and identified six core categories of biomarkers: (i) systemic markers of inflammation; (ii) molecules involved in bone homeostasis; (iii) HLA-B27 and newer genetic biomarkers; (iv) antibody-based biomarkers; (v) microbiome biomarkers; and (vi) miscellaneous biomarkers. Unfortunately, despite efforts to validate new biomarkers, few of them are used in clinical practice; however, we believe that these studies provide useful data that could aid in better disease management.

Background. Systemic sclerosis (SSc) is a chronic multisystem autoimmune condition defined by a complex pathobiology, comprising excessive fibrosis of skin and internal organs, peripheral vasculopathy with endothelial cell dysfunction, inadequate vascular repair and neovascularization, and aberrant immunity. Vitamin D is a steroid hormone with pleiotropic effects beyond its traditional role in calcium and bone homeostasis. Since vitamin D has immunomodulatory, cardioprotective, and antifibrotic properties, it could potentially interfere with SSc pathogenesis. Suboptimal vitamin D levels are classically recognized in scleroderma, irrespective of clinical and serological phenotype. Aim. This systematic review is aimed at investigating and clarifying the role of vitamin D in SSc and emphasizing the association of vitamin D status with different clinical settings. Methods and Results. A systematic online search was performed, using PubMed databases to collect articles on the topic of vitamin D in SSc. The final analysis included 40 eligible articles. Conclusions. Hypovitaminosis D is common in SSc patients and could be associated with clinical and serologic patterns of the disease. Intervention for low serum vitamin D levels in SSc pathogenesis remains controversial, as well as the significance of vitamin D supplementation in such patients.

Chronic obstructive pulmonary disease (COPD) is a global healthcare problem, characterized by a progressive and irreversible decline in lung function, primarily due to airflow limitation caused by inflammation and emphysema. While smoking is the main risk factor, systemic inflammation also plays a significant role in the development and progression of the disease, particularly in relation to autoimmune conditions. This literature review provides an overview of current evidence regarding the underlying pathophysiological mechanisms that link autoimmune inflammatory processes to COPD. It also examines the clinical relevance of these associations, with a focus on potential diagnostic and therapeutic implications. To ensure a comprehensive perspective, a broad literature search was conducted in PubMed and Embase in March 2025, using a wide range of search terms related to COPD and multiple autoimmune conditions. Relevant studies of any design were included if they provided valuable insights into the interplay between autoimmune processes and COPD, while non-English publications and commentaries were excluded. Studies suggest a potential association between COPD and autoimmune processes, with chronic systemic inflammation playing a central role. The evidence points to immune dysregulation as a contributing factor to both COPD progression and its connection to autoimmune conditions. The complex interactions between COPD and autoimmune diseases require further investigation. Gaining a better understanding of these interactions may provide new insights into managing patients with concurrent pulmonary and autoimmune conditions, emphasizing a growing area of clinical research.

Background: Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease predominantly affecting young individuals; however, its late-onset manifestation poses distinct clinical and diagnostic challenges. Methods: This report describes the case of a 93-year-old patient who presented in the Emergency Department with exertional dyspnea, lower limb edema, fatiguability, diffuse abdominal pain, predominantly in the hypogastric region, and loss of appetite. Results: Based on the clinical examination, laboratory tests, and imagistic investigations, we excluded the most common etiologies of edema (decompensated chronic heart failure, glomerular nephropathy/chronic kidney disease, decompensated vascular cirrhosis, hypothyroidism, and hypoproteinemia). Further diagnostic evaluation revealed elevated levels of anti-nuclear antibodies and anti-dsDNA antibodies, along with reduced complement levels, indicating active SLE as the underlying cause of the patient’s edema. During hospitalization, the patient received corticosteroid therapy and, after discharge, was referred to the Rheumatology Department for further treatment. Conclusions: In elderly patients, late-onset SLE exhibits distinct clinical manifestations compared to its early-onset counterpart, likely due to age-related alterations in immune system function.

Introduction: Background. Direct oral anticoagulants (DOACs) have become standard of care in long term anticoagulation. Extensive research has focused on this new class of drugs that despite their benefits, have an associated risk of bleeding with lack of evidence for management following an episode of gastrointestinal bleeding (GIB). Our meta-analysis and systematic review provide an updated perspective on the rate of rebleeding in patients with an episode of GIB while on DOACs.Material and methods: Materials and methods. A systematic search of PubMed, EMBASE and Cochrane databases was performed for all comparative studies examining outcomes in patients that resumed versus withheld DOACs after a baseline episode of GIB. The initial search found 1823 studies. After excluding duplicates and unrelated studies based on abstract triage, 29 full texts were assessed for eligibility, out of which five matched the inclusion criteria and were systematically reviewed.Results: Results. Five studies containing data comparing clinical outcomes between patients were included. All studies were retrospective including a total of 2837 patients with a case control design. Both groups showed similar rebleeding rates with lower GIB as the primary site of rebleeding. Type of DOAC, timing of anticoagulation resumption and patients characteristics may influence rebleeding rates.Conclusions: Conclusions: Looking at the overall risk/benefit ratio of anticoagulation post GIB, we suggest there is a benefit for oral anticoagulation continuation. Further large scale studies are needed to provide optimal management strategies in this population.