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Mycophenolate intravenous

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https://www.readbyqxmd.com/read/29142145/clinical-course-therapeutic-responses-and-outcomes-in-relapsing-mog-antibody-associated-demyelination
#1
Sudarshini Ramanathan, Shekeeb Mohammad, Esther Tantsis, Tina Kim Nguyen, Vera Merheb, Victor S C Fung, Owen Bruce White, Simon Broadley, Jeannette Lechner-Scott, Steve Vucic, Andrew P D Henderson, Michael Harry Barnett, Stephen W Reddel, Fabienne Brilot, Russell C Dale
OBJECTIVE: We characterised the clinical course, treatment and outcomes in 59 patients with relapsing myelin oligodendrocyte glycoprotein (MOG) antibody-associated demyelination. METHODS: We evaluated clinical phenotypes, annualised relapse rates (ARR) prior and on immunotherapy and Expanded Disability Status Scale (EDSS), in 218 demyelinating episodes from 33 paediatric and 26 adult patients. RESULTS: The most common initial presentation in the cohort was optic neuritis (ON) in 54% (bilateral (BON) 32%, unilateral (UON) 22%), followed by acute disseminated encephalomyelitis (ADEM) (20%), which occurred exclusively in children...
November 15, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29127744/-endocrine-orbitopathy-the-present-view-of-a-clinical-endocrinologist
#2
Jan Jiskra
Graves orbitopathy (GO) occurs in 25-50 % cases of Graves disease. Only in 5 % of patients the eye threatening GO is present. About 5-10 % and 10 % cases are present in euthyroid and hypothyroid patients respectively. All patients with GO should be assessed for activity (clinical activity score - CAS) and severity of the disease. Basic preconditions of the treatment are maintenance of euthyroidism, an effort to stop smoking, and referring of patients with moderate to severe and sight threatening GO to specialized thyroid eye centers...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29107213/current-and-future-treatment-options-for-pemphigus-is-it-time-to-move-towards-more-effective-treatments
#3
REVIEW
Soheil Tavakolpour
Systemic administration of corticosteroid (CS) remains the standard gold treatment for pemphigus. However, because of several long-term adverse effects, steroid-sparing agents are usually prescribed in combination with CSs. Despite the high number of available studies, the choice of best drugs to treat pemphigus remains controversial. Therapeutic approaches for pemphigus can be divided into traditional treatment and emerging ones. Personalized medicine, which aims to increase the efficacy as well as reduce adverse effects of treatments, could be considered as the future option...
December 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/29103429/immunotherapeutics-in-pediatric-autoimmune-central-nervous-system-disease-agents-and-mechanisms
#4
Margherita Nosadini, Stefano Sartori, Suvasini Sharma, Russell C Dale
Beyond the major advances produced by careful clinical-radiological phenotyping and biomarker development in autoimmune central nervous system disorders, a comprehensive knowledge of the range of available immune therapies and a deeper understanding of their action should benefit therapeutic decision-making. This review discusses the agents used in neuroimmunology and their mechanisms of action. First-line treatments typically include corticosteroids, intravenous immunoglobulin, and plasmapheresis, while for severe disease second-line "induction" agents such as rituximab or cyclophosphamide are used...
August 2017: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/29102373/transcriptomic-analysis-uncovers-novel-synergistic-mechanisms-in-combination-therapy-for-lupus-nephritis
#5
Jia Fu, Zichen Wang, Kyung Lee, Chengguo Wei, Zhengzhao Liu, Mingchao Zhang, Minlin Zhou, Minchao Cai, Weijia Zhang, Peter Y Chuang, Avi Ma'ayan, John Cijiang He, Zhihong Liu
A recent clinical study showed that combination therapy consisting of mycophenolate mofetil, tacrolimus and steroids was shown to be more effective in achieving complete remission in patients with severe forms of lupus nephritis than conventional therapy consisting of intravenous cyclophosphamide and steroids. To explore the underlying molecular and cellular mechanisms of increased efficacy of the combination therapy regimen, we employed a mouse model of lupus nephritis, MRL/lpr mice, and treated them with monotherapies of prednisone, mycophenolate mofetil, or tacrolimus, or with their combination...
November 1, 2017: Kidney International
https://www.readbyqxmd.com/read/29073351/belimumab-for-the-treatment-of-early-diffuse-systemic-sclerosis-results-of-a-randomized-double-blind-placebo-controlled-pilot-trial
#6
Jessica K Gordon, Viktor Martyanov, Jennifer M Franks, Elana J Bernstein, Jackie Szymonifka, Cynthia Magro, Horatio F Wildman, Tammara A Wood, Michael L Whitfield, Robert F Spiera
OBJECTIVE: To assess the safety and efficacy of treatment with belimumab in patients with early diffuse cutaneous systemic sclerosis (dcSSc) treated with background mycophenolate mofetil (MMF). METHODS: In this 52-week, investigator-initiated, single-center, double-blind, placebo-controlled, pilot study, 20 patients recently started on MMF were randomized 1:1 to additionally receive belimumab 10 mg/kg intravenously or placebo. We assessed safety, efficacy and differential gene expression (NCT01670565)...
October 26, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29069848/efficacy-and-safety-of-immunosuppressive-medications-for-steroid-resistant-nephrotic-syndrome-in-children-a-systematic-review-and-network-meta-analysis
#7
Shaojun Li, Haiping Yang, Pengfei Guo, Xiaoxiao Ao, Junli Wan, Qiu Li, Liping Tan
BACKGROUND: Conventional meta-analyses and randomized controlled trials have shown inconsistent results regarding the efficacy of immunosuppressants for pediatric steroid-resistant nephrotic syndrome (SRNS). OBJECTIVE: To conduct a network meta-analysis aimed at evaluating the efficacy and safety of available immunosuppressive agents in pediatric patients with SRNS. STUDY METHODS: MEDLINE, the Cochrane Central Register of Controlled Trials, and EMBASE were searched on January 2017...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/29049232/case-report-central-nervous-system-involvement-of-human-graft-versus-host-disease-report-of-7-cases-and-a-review-of-literature
#8
Mathilde Ruggiu, Wendy Cuccuini, Karima Mokhtari, Véronique Meignin, Régis Peffault de Latour, Marie Robin, Flore Sicre de Fontbrune, Aliénor Xhaard, Gérard Socié, David Michonneau
RATIONALE: Central nervous system (CNS) involvement of graft versus host disease (GvHD) is a rare cause of CNS disorders after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Chronic CNS GvHD symptoms are heterogeneous and include cerebrovascular manifestations, demyelinating disease and immune-mediated encephalitis. CNS-Acute GvHD is not formally defined in literature. PATIENTS CONCERNS AND DIAGNOSES: We report 7 cases of CNS-GvHD among which two had histological-proven disease...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29025172/-anti-myelin-oligodendrocyte-glycoprotein-antibodies-in-paediatric-patients-with-optic-neuritis
#9
Helmut Tegetmeyer, Andreas Merkenschlager
Background Myelin oligodendrocyte glycoprotein (MOG) is located on the surface of oligodendrocytes and myelin in the central nervous system. MOG-IgG is associated with acute disseminated encephalomyelitis (ADEM), relapsing and bilateral optic neuritis (NNO), and transverse myelitis (TM) in both paediatric and adult patients. The combination of NNO and TM or other inflammatory brain lesions is a typical feature of neuromyelitis optica spectrum disorders (NMO-SD) which are associated with specific pathogenic autoantibodies against the water channel aquaporin-4 (AQP4-IgG)...
October 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28990220/low-dose-basiliximab-induction-therapy-in-heart-transplantation
#10
Veraprapas Kittipibul, Pakpoom Tantrachoti, Pat Ongcharit, Aekarach Ariyachaipanich, Sarawut Siwamogsatham, Supaporn Sritangsirikul, Kanokwan Thammanatsakul, Sarinya Puwanant
We prospectively studied efficacy and safety outcomes of two 10-mg doses of intravenous basiliximab on day 0 and day 4 for induction therapy in 17 consecutive de novo heart transplant recipients. By the 2-week assessment post-transplant, there were no deaths, graft failures, or acute cellular rejections (ACRs) ISHLT grade ≥ 2R. By the 1-year assessment post-transplant, there were 1 (6%) infectious death, no graft failure, 2 (12%) grade 2R ACRs, 6 (35%) asymptomatic CMV infections, and 4 (25%) treated infections...
October 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28937065/mycophenolate-mofetil-or-cyclophosphamide-in-indian-patients-with-lupus-nephritis-which-is-better-a-single-center-experience
#11
Satish Mendonca, Devika Gupta, Sofia Ali, Pooja Gupta
Mycophenolate mofetil (MMF) is used extensively for the induction therapy of lupus nephritis (LN) and has even outpaced intravenous (i.v.) cyclophosphamide (CyP) as the initial choice of therapy. There are no studies comparing the response of MMF with standard dose i.v. CyP in Indian patients with LN. We conducted a 24-week prospective, randomized, open-label trial comparing oral MMF with monthly i.v. CyP as induction therapy for active biopsy proven Class III and IV LN. The primary end-point was response to treatment at 24 weeks, and the secondary end-points were complete remission, Systemic Lupus Erythematosus Disease Activity Index scores (SLEDAI) and adverse reactions...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28892209/pharmacokinetics-of-mycophenolic-acid-after-intravenous-administration-of-mycophenolate-mofetil-to-healthy-cats
#12
J E Slovak, S M Rivera, J K Hwang, M H Court, N F Villarino
BACKGROUND: Mycophenolate mofetil (MMF), the prodrug of mycophenolic acid (MPA), is becoming increasingly popular as an alternative immunosuppressant in feline medicine. Pharmacokinetic information is not available for cats. OBJECTIVE: The purpose of this study was to determine whether MMF is biotransformed into the active metabolite MPA and to evaluate the disposition of MPA after a 2-hour constant rate intravenous (IV) infusion of MMF in healthy cats. ANIMALS: Healthy cats (n = 6)...
September 11, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28877866/european-evidence-based-recommendations-for-the-diagnosis-and-treatment-of-childhood-onset-lupus-nephritis-the-share-initiative
#13
Noortje Groot, Nienke de Graeff, Stephen D Marks, Paul Brogan, Tadej Avcin, Brigitte Bader-Meunier, Pavla Dolezalova, Brian M Feldman, Isabelle Kone-Paut, Pekka Lahdenne, Liza McCann, Seza Özen, Clarissa A Pilkington, Angelo Ravelli, Annet van Royen-Kerkhof, Yosef Uziel, Bas J Vastert, Nico M Wulffraat, Michael W Beresford, Sylvia Kamphuis
Lupus nephritis (LN) occurs in 50%-60% of patients with childhood-onset systemic lupus erythematosus (cSLE), leading to significant morbidity. Timely recognition of renal involvement and appropriate treatment are essential to prevent renal damage. The Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) initiative aimed to generate diagnostic and management regimens for children and adolescents with rheumatic diseases including cSLE. Here, we provide evidence-based recommendations for diagnosis and treatment of childhood LN...
December 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28838458/successful-simultaneous-pancreas-kidney-re-transplantation-in-a-highly-human-leukocyte-antigen-sensitized-patient
#14
S Kykalos, A Wunsch, T Klein, R Viebahn, P Schenker
BACKGROUND: The waiting time for re-transplantation for sensitized patients is greatly prolonged, given the lack of transplants that are available for this group and additional immunologic barriers. We report the case of a successful re-transplantation in a patient with very high levels of panel reactive antibodies ([PRA] >85%). METHODS: A 45-year-old woman had repetitive rejections after simultaneous pancreas-kidney transplantation, with consequent loss of function of both transplanted organs...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28817755/measuring-toxic-effects-and-time-to-treatment-failure-for-nivolumab-plus-ipilimumab-in-melanoma
#15
Alexander N Shoushtari, Claire F Friedman, Pedram Navid-Azarbaijani, Michael A Postow, Margaret K Callahan, Parisa Momtaz, Katherine S Panageas, Jedd D Wolchok, Paul B Chapman
Importance: Nivolumab plus ipilimumab (nivo + ipi) is a standard treatment of advanced melanoma. Two randomized trials describe high objective response rates by Response Evaluation Criteria in Solid Tumors. The trials assessed toxic effects using the Common Terminology Criteria for Adverse Events (CTCAE), which may underestimate incidence of clinically significant immune-related adverse events (AEs). Objective: To describe detailed toxic effects and time to treatment failure of patients with melanoma treated with nivo + ipi in a prospective cohort...
August 17, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28805142/intravenous-immunoglobulins-modify-relapsing-membranous-glomerulonephritis-after-kidney-transplantation-a-case-report
#16
Sanne Steyaert, Jo Van Dorpe, Anne Hoorens, Wim Van Biesen, Steven Van Laecke
OBJECTIVES: Recurrence of membranous glomerulonephritis after transplant is common and is an important cause of loss of renal graft. This case supports the effect of immunoglobulins in the treatment of this disease after transplantation. It is the first report in the literature with a follow-up of more than 10 years and because of the sustained effect of the immunoglobulins, it strengthens the idea that this can alter long-term outcome. METHODS: Single case study and search of the literature...
August 14, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28767349/igg-endopeptidase-in-highly-sensitized-patients-undergoing-transplantation
#17
MULTICENTER STUDY
Stanley C Jordan, Tomas Lorant, Jua Choi, Christian Kjellman, Lena Winstedt, Mats Bengtsson, Xiaohai Zhang, Torsten Eich, Mieko Toyoda, Britt-Marie Eriksson, Shili Ge, Alice Peng, Sofia Järnum, Kathryn J Wood, Torbjorn Lundgren, Lars Wennberg, Lars Bäckman, Erik Larsson, Rafael Villicana, Joe Kahwaji, Sabrina Louie, Alexis Kang, Mark Haas, Cynthia Nast, Ashley Vo, Gunnar Tufveson
BACKGROUND: Donor-specific antibodies create an immunologic barrier to transplantation. Current therapies to modify donor-specific antibodies are limited and ineffective in the most highly HLA-sensitized patients. The IgG-degrading enzyme derived from Streptococcus pyogenes (IdeS), an endopeptidase, cleaves human IgG into F(ab')2 and Fc fragments inhibiting complement-dependent cytotoxicity and antibody-dependent cellular cytotoxicity, which suggests that IdeS might be useful for desensitization...
August 3, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28760751/multitarget-therapy-for-maintenance-treatment-of-lupus-nephritis
#18
Haitao Zhang, Zhengzhao Liu, Minlin Zhou, Zhangsuo Liu, Jianghua Chen, Changying Xing, Hongli Lin, Zhaohui Ni, Ping Fu, Fuyou Liu, Nan Chen, Yongcheng He, Jianshe Liu, Caihong Zeng, Zhihong Liu
Our previous studies showed that multitarget therapy is superior in efficacy to intravenous cyclophosphamide as an induction treatment for lupus nephritis in Asian populations. We conducted an open label, multicenter study for 18 months as an extension of the prior induction therapy trial in 19 renal centers in China to assess the efficacy and safety of multitarget maintenance therapy in patients who had responded at 24 weeks during the induction phase. Patients who had undergone multitarget induction therapy continued to receive multitarget therapy (tacrolimus, 2-3 mg/d; mycophenolate mofetil, 0...
July 31, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28748879/early-clinical-manifestations-and-laboratory-findings-before-and-after-treatment-of-cytomegalovirus-infection-in-kidney-transplant-patients
#19
Wasim Ahmed Siddiqui, Issa Al Salmi, Amitabh Jha, Abbas Pakkyara, Mohammad Yasir, Faissal A M Shaheen
Cytomegalovirus (CMV) is one of the most frequently encountered opportunistic viral pathogens in kidney transplant recipients. In this study, we retrospectively reviewed all living related and unrelated kidney transplant recipients on regular follow-up from January 2006 to June 2015, who were suspected to have CMV clinically and confirmed by DNA polymerase chain reaction (PCR). CMV PCR was detected in 102 kidney transplant recipients. The median time of detection after kidney transplant was 21 months, ranging from 15 days to 84 months...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28683778/unusual-acute-lupus-hemophagocytic-syndrome-a-test-of-diagnostic-criteria-a-case-report
#20
Wijetunga Mudalige Udai Akalanka Wijetunga, Ravindra Laxman Satarasinghe, Balasuriya Mudiyanselage Dayananda, Ganhewage Kokila Darshani
BACKGROUND: Hemophagocytic lymphohistiocytosis is an aggressive life-threatening syndrome of excessive immune activation. Hemophagocytic lymphohistiocytosis due to systemic lupus erythematosus is described as acute lupus hemophagocytic syndrome. Acute lupus hemophagocytic syndrome presenting with negative antinuclear antibody is uncommon. CASE PRESENTATION: A 57-year-old Sri Lankan woman presented with intermittent fever, weight loss, episodic confusion, and alopecia for 3 months...
July 7, 2017: Journal of Medical Case Reports
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