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Rituximab biology

Sarah Löw, Catherine H Han, Tracy T Batchelor
Primary central nervous system lymphoma (PCNSL) is a rare and aggressive extranodal non-Hodgkin lymphoma (NHL), confined to the brain, eyes, spinal cord or leptomeninges without systemic involvement. Overall prognosis, diagnosis and management of PCNSL differ from other types of NHL. Prompt diagnosis and initiation of treatment are vital to improving clinical outcomes. PCNSL is responsive to radiation therapy, however whole-brain radiotherapy (WBRT) inadequately controls the disease when used alone and its delayed neurotoxicity causes neurocognitive impairment, especially in elderly patients...
2018: Therapeutic Advances in Neurological Disorders
Hans-Peter Tony, Klaus Krüger, Stanley Cohen, Hendrik Schulze-Koops, Alan Kivitz, Slawomir Jeka, Edit Vereckei, Liyi Cen, Laura Kring, Dmitrij Kollins
OBJECTIVES: Comparable clinical efficacy of the rituximab biosimilar GP2013 and reference rituximab (RTX) has been established in blinded randomized trials. However, when switching from a reference biologic to a biosimilar, potential safety implications are often an important consideration. Therefore, this study evaluated the safety of switching from reference RTX to rituximab biosimilar GP2013, compared with treatment continuation with reference RTX, in patients with rheumatoid arthritis (RA)...
October 8, 2018: Arthritis Care & Research
Manoela Manova, Alexandra Savova, Maria Vasileva, Silvia Terezova, Maria Kamusheva, Daniela Grekova, Valentina Petkova, Guenka Petrova
Biological products for treatment of rheumatoid arthritis usually are cost effective for healthcare systems in Europe, but they are huge financial burden due to the high number of patients and the significant budget impact. The expected saving from introduction on the market of biosimilars are significant and are linked to better access and affordability. The aim of this study was to conduct comparative price analysis of biological products for rheumatoid arthritis therapy among seventeen EU countries. The point of view is that of the Bulgarian pricing and reimbursement system and the chosen countries are those from external reference basket for prices comparison at manufacturing level...
2018: Frontiers in Pharmacology
K Chatzidionysiou, G Lukina, C Gabay, M L Hetland, E M Hauge, K Pavelka, D Nordström, H Canhão, M Tomsic, Z Rotar, E Lie, T K Kvien, R F van Vollenhoven, S Saevarsdottir
OBJECTIVES: To investigate whether smoking habits predict response to rituximab (RTX) in rheumatoid arthritis (RA). METHOD: We included patients from the CERERRA international cohort receiving the first treatment cycle with available smoking status (n = 2481, smokers n = 528, non-current smokers n = 1953) and at least one follow-up visit. Outcome measures were change in Disease Activity Score based on 28-joint count (ΔDAS28) and European League Against Rheumatism (EULAR) good response at 6 months, with non-current smokers as the referent group...
September 27, 2018: Scandinavian Journal of Rheumatology
John MacIsaac, Reda Siddiqi, Erin Jamula, Na Li, Steven Baker, Kathryn E Webert, Denise Evanovitch, Nancy M Heddle, Donald M Arnold
BACKGROUND: The anti-CD20 monoclonal antibody rituximab has immune-modulatory effects similar to intravenous immunoglobulin (IVIG). We performed a systematic review and meta-analysis to determine the efficacy and safety of rituximab in autoimmune diseases that are also treated with IVIG. STUDY DESIGN AND METHODS: The most common indications for immune modulation with IVIG, as identified from a 2012 regional audit in Canada, were chronic inflammatory demyelinating polyneuropathy (CIDP), immune thrombocytopenia (ITP), myasthenia gravis, multifocal motor neuropathy, Guillain-Barré syndrome, systemic lupus erythematosus (SLE), Sjogren's syndrome, and pemphigus vulgaris...
September 23, 2018: Transfusion
M Heitz, P L Carron, G Clavarino, T Jouve, N Pinel, F Guebre-Egziabher, L Rostaing
BACKGROUND: Anti-glomerular basement-membrane (anti-GBM) disease (or Goodpasture disease) is characterized by severe kidney and lung involvement. Prognoses have improved with treatments that combine plasma exchange and immunosuppressive drugs. However, patients with severe renal involvement can have poor renal outcomes and cyclophosphamide can cause significant complications. Anti-GBM antibodies have a direct pathogenic effect on the disease: thus, therapeutics that can decrease their production, such as rituximab, could be a good alternative...
September 20, 2018: BMC Nephrology
Maria Gerosa, Lorenza Maria Argolini, Carolina Artusi, Cecilia Beatrice Chighizola
Biological agents have radically changed the prognosis of rheumatic patients. Current evidence demonstrates that tight disease control during pregnancy is mandatory to minimize adverse outcome risk. As the new therapeutic tools are pivotal to maintain appropriate disease activity, it is timely to review available evidence about the safety of biologics and small molecules in pregnancy. Areas covered: A comprehensive literature review has been performed, reporting available data about the passage into breast milk, rate of pregnancy loss and fetal malformations, and long-term complications due to in utero exposure to biological agents and small molecules...
October 2018: Expert Review of Clinical Pharmacology
Maria Mouyis, Julia D Flint, Ian P Giles
There is limited evidence relating to the impact of disease modifying anti-rheumatic drugs (DMARDs) upon male fertility and peri-conception paternal exposure in men with rheumatic disease. Therefore, we conducted a systematic review of available evidence to update information on this subject and guide paternal counselling. A systematic search of PubMed and Embase was carried out up to September 2017, to find relevant peer-reviewed papers, using keywords for fertility/spermatogenesis/conception, men, and disease modifying or biologic drugs commonly prescribed in patients with rheumatic disease...
August 17, 2018: Seminars in Arthritis and Rheumatism
Catherine Thieblemont, Sophie Bernard, Michel Meignan, Thierry Molina
Diffuse large B-cell lymphoma (DLBCL) is a group of lymphomas comprising heterogeneous molecular and biological subtypes, reflected in a broad range of clinical outcomes. With the standard R-CHOP regimen of cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab administered every 21 days, the treatment failure rate remains unacceptably high in certain DLBCL subsets. Here we review possible avenues for optimizing initial therapy. The role of functional imaging and biological features, such as double-hit lymphomas, defined by the dual translocation of MYC and BCL2, and dual protein-expresser lymphomas, defined by the overexpression of MYC and BCL2, activated B-cell (ABC)-like DLBCL, to better define these high-risk patient subsets, and their use to guide and personalize treatment decisions are discussed...
September 2018: Best Practice & Research. Clinical Haematology
Fenglong Xie, Huifeng Yun, Emily B Levitan, Paul Muntner, Jeffrey R Curtis
BACKGROUND: Multiple studies have observed seemingly unfavorable changes in lipid profiles associated with IL6 receptor antagonists (IL-6R) and some other rheumatoid arthritis (RA) therapies. The real-world cardiovascular disease (CVD) risk associated with the first approved anti IL-6R medication for RA, tocilizumab, remains uncertain. METHODS: A cohort study using 2006-2015 Medicare and MarketScan claims data was conducted, studying RA patients who initiated biologic disease-modifying antirheumatic drugs after January 1, 2010...
September 3, 2018: Arthritis Care & Research
Neila Fathallah, Bouraoui Ouni, Sana Mokni, Khadija Baccouche, Amira Atig, Najat Ghariani, Awatef Azzabi, Mohamed Denguezli, Raoudha Slim, Chaker Ben Salem
INTRODUCTION: Drug-induced vasculitis is reported in almost 10-20 % of vasculitis. Several drugs may be incriminated in their occurrence. Our study aimed to study the epidemiological, clinical, histopathological and evolutionary characteristics of drug-indced vasculitis from a series of cases and to specify the different drugs involved. METHODS: We conducted a retrospective study during the period from January 2006 to December 2015 from the cases notified to the regional pharmacovigilance center of Sousse, Tunisia...
July 24, 2018: Thérapie
Abhijeet Kumar, Muhammad Asad Fraz, Muhammad Usman, Saad Ullah Malik, Awais Ijaz, Ceren Durer, Seren Durer, Muhammad Junaid Tariq, Ali Younas Khan, Anum Qureshi, Warda Faridi, Aboo Nasar, Faiz Anwer
R-CHOP has been the standard of care for diffuse large B cell lymphoma (DLBCL), curing approximately 60% of patients for more than 2 decades. However, the optimal treatment of patients who are too frail to tolerate this regimen and/or are not candidates for anthracycline therapy continues to be debated. MInT and GELA trials established addition of rituximab to CHOP in DLBCL but excluded patients older than 80 years. Multiple regimens have been tried with varying success in the very elderly, including R-mini-CHOP, R-mini CEOP, R-split CHOP, pre-phase strategies, and R-GCVP...
September 1, 2018: Current Treatment Options in Oncology
Sanket Shah, Chengappa G Kavadichanda, Pooja Belani, Rajesh N Ganesh, Vir Singh Negi
Biologics have emerged as an important modality of treatment in rheumatic diseases and have allowed the rheumatologist to explore varied therapeutic uses of these drugs. Rituximab, a monoclonal antibody against CD20 receptor is an important member of the biologic armamentarium for the treatment of various refractory autoimmune inflammatory rheumatic diseases. The drug is now widely used in systemic lupus erythematosus for several complications which are refractory to conventional therapy. Although relatively safe, the post-marketing surveillance of rituximab has revealed a few rare but important adverse reactions...
August 30, 2018: International Journal of Rheumatic Diseases
Suresh Mc Babu, Sunny Garg, Govinda Babu Kanakasetty, Lakshmaiah Chinnagiriyappa Kuntegowdanahalli, Lokanatha Dasappa, Suparna Ajit Rao
Introduction: Diffuse large B-cell lymphoma (DLBCL) is an aggressive lymphoma whose outcomes have significantly improved with rituximab in addition to anthracycline-based chemotherapy. Objective: This study aimed to study the epidemiology, treatment, and outcomes of patients with DLBCL. Materials and Methods: A total of 526 patients diagnosed with DLBCL between 2006 and 2015 were retrospectively analyzed. Results: The median age was 50 years with a male preponderance...
January 2018: Indian Journal of Cancer
Majd A Hamaly, Samer R Abulateefeh, Khaled M Al-Qaoud, Alaaldin M Alkilany
Maintaining colloidal stability of nanoparticles in suspensions is a major challenge. Therefore, freeze-drying (lyophilization) is recently proposed to preserve colloidal stability of nanoparticles through maintaining them in a solid state. However, freeze-drying would itself induce nanoparticle aggregation unless proper formulation with a careful selection of cryoprotectants is considered. Herein, we evaluate the colloidal stability of gold nanorods (GNRs) conjugated with a rituximab as a model monoclonal antibody upon freeze-drying in the presence of various cryoprotectants (mannitol, trehalose and sucrose)...
August 23, 2018: International Journal of Pharmaceutics
Adalgisa Condoluci, Davide Rossi, Emanuele Zucca, Franco Cavalli
PURPOSE OF REVIEW: Mantle cell lymphoma (MCL) prognosis is strictly related to the characteristics of the disease, which can range from very indolent cases to highly aggressive and refractory ones. Here we will review the current knowledge on MCL biomarkers. RECENT FINDINGS: Biomarker-informed diagnosis is essential for differentiating MCL from other mature B cell tumors. Diagnosis of MCL relies on the identification of the t(11;14) translocation by FISH or the consequently aberrant expression of cyclin D1 by immunohistochemistry...
August 22, 2018: Current Oncology Reports
Eva-Maria Didden, Yann Ruffieux, Noemi Hummel, Orestis Efthimiou, Stephan Reichenbach, Sandro Gsteiger, Axel Finckh, Christine Fletcher, Georgia Salanti, Matthias Egger
BACKGROUND: Decision makers often need to assess the real-world effectiveness of new drugs prelaunch, when phase II/III randomized controlled trials (RCTs) but no other data are available. OBJECTIVE: To develop a method to predict drug effectiveness prelaunch and to apply it in a case study in rheumatoid arthritis (RA). METHODS: The approach 1) identifies a market-approved treatment ( S) currently used in a target population similar to that of the new drug ( N); 2) quantifies the impact of treatment, prognostic factors, and effect modifiers on clinical outcome; 3) determines the characteristics of patients likely to receive N in routine care; and 4) predicts treatment outcome in simulated patients with these characteristics...
August 2018: Medical Decision Making: An International Journal of the Society for Medical Decision Making
Vladimira V Boyadzieva, Nikolay Stoilov, Rumen M Stoilov, Konstantin Tachkov, Maria Kamusheva, Konstantin Mitov, Guenka I Petrova
Biological medicines are considered as a cornerstone in the therapy of rheumatoid arthritis (RA). They change the course of the disease and improve the quality of life of patients. To this date there has been no study comparing the quality of life of and cost of RA therapy in Bulgaria. This fact is what provoked our interest toward this research. The aim of this study is to analyse the cost and quality of life of patients with RA threated with biological medicines in Bulgaria. This is an observational, real life study of 124 patients treated with biological medicines during 2012-2016 at the University hospital "St...
2018: Frontiers in Pharmacology
Samanan Intongkam, Parinya Samakarnthai, Rattapol Pakchotanon, Pongthorn Narongroeknawin, Paijit Assavatanabodee, Sumapa Chaiamnuay
OBJECTIVES: The aims of this study were to assess efficacy and safety of the hepatitis B vaccination in rheumatoid arthritis (RA) patients receiving conventional and/or biological disease-modifying antirheumatic drugs (DMARDs). METHODS: A prospective open-label study was conducted. Of 46 RA patients, 33 received only conventional synthetic DMARDs, and 13 received both conventional synthetic DMARDs and biological DMARDs, and 9 healthy age- and sex-matched control subjects were vaccinated with 20 μg recombinant hepatitis B vaccine (EuVax B) at weeks 0, 4, and 24...
July 27, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Ioannis Parodis, Angie H Lopez Benavides, Agneta Zickert, Susanne Pettersson, Sonia Möller, Elisabet Welin Henriksson, Anne Voss, Iva Gunnarsson
OBJECTIVE: Accumulating evidence supports an impaired health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE). We investigated the effects of two biologic treatments on SLE patients' HRQoL. METHODS: SLE patients from the Karolinska University Hospital treated with belimumab (n=34) or rituximab (n=35) were included; Swedish population-based age- and sex-matched norms served as controls. Data were collected prospectively at treatment initiation and at months 3, 6, 12 and 24; these included the SF-36, FACIT-Fatigue, EQ-5D, and Stanford HAQ-DI...
July 28, 2018: Arthritis Care & Research
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