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viral arthritis guidelines

Tomoe Matsuzaki, Kumiko Ohkubo, Makiko Yuki, Hironobu Kawashima, Akira Matsunaga
OBJECTIVES: Anti-cancer and immunosuppressive drugs often induce hepatitis B virus (HBV) reactivation, resulting in lethal hepatitis in the worst cases. It is to elucidate the clinical characteristics of the patients in our hospital, who underwent HBV-related examinations to help prevent HBV-associated hepatitis by reactivation during the two-year period after the announcement of new guidelines by the Ministry of Health, Labour and Welfare of Japan in January 2009. STUDY DESIGN: We enrolled 811 patients who were examined for HBs antigen, anti-HBc antibody, anti-HBs antibody and HBV DNA regarding HBV reactivation...
March 2015: Rinsho Byori. the Japanese Journal of Clinical Pathology
Christine S Ahn, Emily H Dothard, Michael L Garner, Steven R Feldman, William W Huang
BACKGROUND: Safety profiles of systemic biologic agents for the treatment of psoriasis and psoriatic arthritis (PsA) encompass a wide spectrum of adverse events. To date, no uniform evidence-based guidelines exist regarding screening and monitoring patients who are undergoing biologic therapy. OBJECTIVE: We sought to identify studies evaluating screening and monitoring tests in the treatment of psoriasis and PsA with systemic biologic agents, and to propose evidence-based practical guidelines...
September 2015: Journal of the American Academy of Dermatology
Francesca De Nard, Monica Todoerti, Vittorio Grosso, Sara Monti, Silvia Breda, Silvia Rossi, Carlomaurizio Montecucco, Roberto Caporali
Hepatitis B virus (HBV) reactivation in rheumatoid arthritis (RA) patients undergoing biological therapy is not infrequent. This condition can occur in patients with chronic hepatitis B as well as in patients with resolved HBV infection. Current recommendations are mainly focused on prevention and management strategies of viral reactivation under tumor necrosis factor-α inhibitors or chimeric monoclonal antibody rituximab. In recent years, growing data concerning HBV reactivation in RA patients treated with newer biological drugs like tocilizumab and abatacept have cumulated...
March 27, 2015: World Journal of Hepatology
A Notarnicola, F Iannone, G Lopalco, M Covelli, G Lapadula
Despite lacking of international guidelines about the management of patients with occult hepatitis B virus infection (OBI) starting TNF-α blockers, there is some evidence from real life settings that these drugs are safe in OBI patients with rheumatic diseases. On the contrary, the management of the so-called false OBI patients appears still undefined. We describe a case of acute hepatitis B virus (HBV) infection occurred in an anti-HBs and anti- HBc positive patient affected by psoriatic arthritis, who had been treated for five years with infliximab...
2013: Reumatismo
Thomas Hügle, Thomas Daikeler, Alan Tyndall
The successful use of a chimeric monoclonal antibody targeting TNF alpha (infliximab) to treat rheumatoid arthritis (RA) two decades ago, ushered in a new era of therapy with the so-called biopharmaceuticals, commonly referred to as "biologics". Their use rapidly spread to other indications such as Crohns disease, and their commercial success led to rapid extension of the concept using other forms of monoclonal antibodies and receptor recombinant molecules with specificities to other cytokines, growth factors and immune cell subsets...
January 2014: Therapeutische Umschau. Revue Thérapeutique
Eleonora Ruocco, Ronni Wolf, Vincenzo Ruocco, Giampiero Brunetti, Francesca Romano, Ada Lo Schiavo
Pemphigus, a prototypical organ-specific human autoimmune disease, may be associated with other immunity-related disorders, viral infections, and different types of tumors. Coexistence with immune diseases is fairly frequent and, for some of them (eg, myasthenia gravis, Basedow's disease, rheumatoid arthritis, or lupus erythematosus), common pathogenic mechanisms can be considered. The association with viral infections (mainly herpesvirus infections) raises the question of whether the virus triggers the outbreak of the disease or simply complicates its clinical course...
July 2013: Clinics in Dermatology
Atul Deodhar
No abstract text is available yet for this article.
June 18, 2013: Annals of Internal Medicine
Sam R Dalvi, Resit Yildirim, Yusuf Yazici
Behcet's syndrome (BS) is a vasculitis, seen more commonly around the Mediterranean and the Far East, and manifests with oral and genital ulcerations, skin lesions, uveitis, and vascular, central nervous system and gastrointestinal involvement. Its natural history of getting less severe over time, more severe disease in males and lack of specific diagnostic testing separates it from other commonly seen conditions in rheumatology. Most of the serious manifestations respond well to immunosuppression, and these are the mainstays of treatment for BS...
December 3, 2012: Drugs
Inge Nordgaard-Lassen, Jens Frederik Dahlerup, Erika Belard, Jan Gerstoft, Jens Kjeldsen, Knud Kragballe, Pernille Ravn, Inge Juul Sørensen, Klaus Theede, Lone Tjellesen
These national clinical guidelines outlining the screening, prophylaxis and critical information required prior to initiating anti-TNF-alpha treatment have been approved by the Danish Society for Gastroenterology. Anti-TNF-alpha therapy is widely used in gastroenterology (for inflammatory bowel disease), rheumatology (for rheumatoid arthritis, psoriatic arthritis and spondyloarthropathies) and dermatology (for psoriasis). With this background, the Danish Society for Gastroenterology established a group of experts to assess evidence for actions recommended before treatment with anti-TNF-alpha agents...
July 2012: Danish Medical Journal
Tim L Jansen, C J J Mulder
Effective and less toxic biologics have revolutionized rheumatology as well as hepatology over the last decennia resulting in higher therapeutic goals. Traditional disease modifying anti-rheumatic drugs (tDMARDs) failing to achieve a quiescent chronic rheumatoid arthritis (RA) or spondylarthropathic arthritis (SA) inflammatory disease, nowadays are to be switched into a more potent strategy with ultimately a combination of tDMARD plus TNF inhibitors (TNFi) early in disease. Patients with previous microbiological infections however present a challenge for a modern rheumatologist aiming at complete remission, particularly in carriers of viral infections...
April 2012: Expert Opinion on Biological Therapy
Han Hee Ryu, Eun Young Lee, Kichul Shin, In Ah Choi, Yun Jong Lee, Bin Yoo, Min-Chan Park, Yong-Beom Park, Sang-Cheol Bae, Wan Hee Yoo, Sung Il Kim, Eun Bong Lee, Yeong Wook Song
Clinical guidelines regarding anti-viral prophylaxis for HBV surface antigen (HBsAg) carriers starting anti-TNFα agents are not yet fully established, even in endemic regions of HBV infection. We retrospectively collected the clinical data of 52 HBsAg carriers with rheumatoid arthritis (RA) or ankylosing spondylitis (AS) that had been administered anti-TNFα treatment at seven medical centers in South Korea. Periodic data of liver function tests and serum HBV DNA were both utilized to assess HBV reactivation...
June 2012: Clinical Rheumatology
Joana Nunes, Rui Tato Marinho, J E Fonseca, Josã A Pereira da Silva, Josã Velosa
Reactivation of infection with hepatitis B virus (HBV) is a potentially serious complication of immunosuppression, which can be identified and efficiently prevented. There have been an increasing number of cases of HBV reactivation in patients receiving immunosuppression in the context of rheumatic diseases such as rheumatoid arthritis or systemic lupus erythematosus. The recommendations in this area should be individualized taking into account two aspects: immunosuppressive regimens used (high or low risk of reactivation) and the different stages of HBV infection: chronic hepatitis B, inactive HBV carrier, occult hepatitis B infection defined by HB surface antigen (HBsAg) negative and antibody anti-HB core (anti-HBc) positive...
April 2011: Acta Reumatológica Portuguesa
Sonia Raquel Cabrera Villalba, María Victoria Hernández Miguel, Raimon Sanmartí Sala
Chronic viral infections in rheumatic patients are a diagnostic and therapeutic challenge. Some of the disease-modifying antirheumatic drugs (DMARD) commonly used in rheumatoid arthritis, such as methotrexate and leflunomide, are hepatotoxic. With biological therapy, which is now widely used in patients refractory to these and other DMARD, some cases of reactivation of hepatitis B, even fulminant cases, have been reported, especially when employing TNF antagonists and rituximab, so their use must be carefully assessed and usually accompanied by antiviral therapy...
May 2011: Reumatología Clinica
Whitney A Buckley, Amy L Stump, Robert M Monger, Sara K Lookabill
OBJECTIVE: To describe a case of gold sodium thiomalate use for the treatment of rheumatoid arthritis (RA) in a patient with hepatitis B. CASE SUMMARY: A 53-year-old Korean American woman with mild RA and chronic hepatitis B infection was treated for worsening RA symptoms with subcutaneous injections of gold sodium thiomalate for 21 months, with the dosage decreased from the initial 40 mg per week to 40 mg every 3 weeks after 51 weeks of successful treatment. She had undergone treatment for hepatitis B in the past with lamivudine; however, she had not received that medication for at least 1 year prior to initiating treatment with gold sodium thiomalate injections...
April 2011: Annals of Pharmacotherapy
Akihiro Tamori, Tatsuya Koike, Hitoshi Goto, Shigeyuki Wakitani, Masahiro Tada, Hiroyasu Morikawa, Masaru Enomoto, Masaaki Inaba, Tatsuya Nakatani, Masayuki Hino, Norifumi Kawada
BACKGROUND: Screening and prophylactic treatment for hepatitis B virus (HBV) reactivation is recommended for patients who receive immunosuppressive or cytotoxic therapy. The aim of this study was to clarify the prevalence of HBV reactivation in rheumatoid arthritis (RA) patients who had received more than 1 year of immunosuppressive therapy. This study also evaluated guidelines for determining HBV reactivation in patients with RA. METHODS: This was a prospective non-randomized, non-controlled study...
April 2011: Journal of Gastroenterology
Maxwell C Kling, Amir A Larian, Irini Scordi-Bello, Jason Emer, Mark G Lebwohl
BACKGROUND: The use of biologic agents represents a remarkable advance for patients with psoriasis and psoriatic arthritis who have experienced an incomplete response to other therapeutic modalities. Decreased mortality and improved quality of life have been reported in patients undergoing treatment with these agents. Increased risk of bacterial, viral, granulomatous, and opportunistic infections also has been associated with the use of these medications. Enhanced patient education, watchful monitoring to promote early detection of infections, discontinuation of the medication when clinical symptoms are identified, and immediate availability of supportive care are advised to balance the benefit of treatment with biologic agents against the potential risk of infection...
June 2010: Archives of Dermatology
Binh Y Nguyen, John D Reveille
PURPOSE OF REVIEW: To evaluate the rheumatic manifestations associated with HIV infection in the highly active antiretroviral therapy (HAART) era. RECENT FINDINGS: The overall prevalence of rheumatic manifestations in HIV population is approximately 9% with various clinical features. Anti-TNF agents do not appear to adversely affect the CD4 cell counts or viral load if the HIV infection is well controlled prior to initiation of therapy. SUMMARY: In the HAART era, HIV-infected individuals can be affected by various rheumatic syndromes including arthritis, spondyloarthritis, DILS, vasculitides, connective tissue disease, myopathies, and musculoskeletal diseases...
July 2009: Current Opinion in Rheumatology
Camelia Ionescu, Laurenţiu Micu, Ileana Constantinescu, Monica Hortopan, Cornel Ursaciuc, Mihai Voiculescu
The antiviral treatment of chronic C hepatitis has improved significantly over the past decade with the introduction of interferons (IFNs), and more recently, pegylated IFNs. Up to two-thirds of all patients treated with pegylated IFN combined with ribavirin can now achieve viral eradication if treated according to current guidelines. Despite this success rate, hematological, immunological, rheumatological and dermatological side effects have been reported in chronic hepatitis C patients treated with IFN-alpha...
June 2008: Journal of Gastrointestinal and Liver Diseases: JGLD
Yvette L Rooks, Brian Corwell
The patient who presents with an acute painful synovitis of a single joint provides a significant diagnostic and therapeutic challenge to the primary care physician. An aggressive approach is required to differentiate a potential infectious arthritis, with its attendant morbidity and potential mortality, from other causes of monarthritis that are not immediately life-threatening. This article reviews the common causes of acute monarthritis in the adult, including the presentation, as well as guidelines for rapid and efficient diagnosis and management...
September 2006: Primary Care
Jose L Sánchez Carazo, Laura Mahiques Santos, Vicente Oliver Martinez
Conventional systemic treatments for patients with psoriasis are associated with multiple adverse effects that require continuous monitoring. The introduction of new biological agents such as etanercept, a fully human fusion protein, has permitted individualisation of patients' treatment according to disease stage. The drug is a competitive inhibitor of tumour necrosis factor-alpha (TNFalpha) that prevents interaction between this cytokine and its cell surface receptors. Etanercept also modulates the activity of other inflammatory cytokines and does not induce complement-mediated cell lysis in vitro...
2006: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
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