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methotrexate and long term effects

A D Irvine, A P Jones, P Beattie, S Baron, F Browne, F Ashoor, L O'Neill, A Rosala-Hallas, T Sach, C Spowart, L Taams, C Walker, M Wan, N Webb, P Williamson, C Flohr
Atopic eczema is a skin disease affecting around 20% of UK children, 16% of whom have moderate to severe disease. Severe atopic eczema can cause sleep disturbance, poor school attendance and social withdrawal, as well as attention-deficit hyperactivity disorder, anxiety and clinical depression. Skin can become infected and this can be a reason for hospital admission. Although most cases of atopic eczema can be treated with emollients, topical anti-inflammatory treatments and/or ultraviolet (UV) therapy, around 2% of children require oral (taken by mouth) immuno-suppressive treatment...
December 2018: British Journal of Dermatology
Elias Jabbour, Nicholas J Short, Farhad Ravandi, Xuelin Huang, Naval Daver, Courtney D DiNardo, Marina Konopleva, Naveen Pemmaraju, William Wierda, Guillermo Garcia-Manero, Koji Sasaki, Jorge Cortes, Rebecca Garris, Joseph D Khoury, Jeffrey Jorgensen, Nitin Jain, Joie Alvarez, Susan O'Brien, Hagop Kantarjian
BACKGROUND: The combination of chemotherapy and ponatinib in Philadelphia chromosome-positive acute lymphoblastic leukaemia has the potential to be a new standard of care for the disease; however, long-term efficacy and safety data are needed. Our aim was to evaluate the long-term efficacy and safety of this regimen in patients with newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukaemia in this ongoing phase 2 trial. METHODS: In our single-centre, phase 2, single-arm trial in the USA, adult patients with previously untreated Philadelphia chromosome-positive acute lymphoblastic leukaemia were sequentially enrolled...
December 2018: Lancet Haematology
Yasmeen Thandar, Rivesh Maharajh, Firoza Haffejee, Anisa Mosam
BACKGROUND: Although numerous medications are available for the treatment of cutaneous lichen planus (CLP), recurrence is common and there is a lack of evidence of efficacy of many treatment options. Part 1 reviewed consolidated evidence from topical therapies and phototherapy. In Part 2, all systemic treatments are assessed. METHODS: All English studies, regardless of design, investigating the outcome of systemic treatment for CLP, until January 2018, were included...
November 17, 2018: Journal of Dermatological Treatment
Fabio Cacciapaglia, Maria Grazia Anelli, Angela Rinaldi, Marco Fornaro, Giuseppe Lopalco, Crescenzio Scioscia, Giovanni Lapadula, Florenzo Iannone
Rheumatoid arthritis (RA) patients are at high risk of cardiovascular (CV) events, and the chronic inflammatory state may generate quantitative and qualitative changes in lipoprotein fractions. The anti-IL-6 receptor tocilizumab (TCZ), even if effective in inflammation and joint damage prevention, determined significant alterations to RA patients' lipid levels in randomized controlled trials, but real-world data are lacking. We evaluated the changes in lipid fraction levels and disease activity in a longitudinal cohort of RA patients on long-term treatment with tocilizumab (TCZ) in a community setting...
2018: Mediators of Inflammation
Brian Liu, Robert A Schwartz
Psoriasis management can be challenging, complicated sometimes by being associated with other systematic inflammatory diseases including metabolic syndrome, myocardial infarction, hypertension, obesity, diabetes mellitus, and hyperlipidemia. Of particularly concern is its cardiovascular linkage. It is noteworthy and reassuring that some therapeutic options for psoriasis may be cardio-protective. We highlight phototherapy, methotrexate, and TNF alpha inhibitors and other biological agents for psoriasis that may lower the risk of cardiovascular events...
October 2018: Acta Dermatovenerologica Croatica: ADC
Laila M Sherief, Reda Sanad, Alaa ElHaddad, Adel Shebl, Elhamy R Abdelkhalek, Eman R Elsafy, Tamer H Hassan, Nelly Raafat, Naglaa M Kamal, Eman I Attia
Introduction: Subtle neurocognitive deficits have been recently observed in Acute Lymphoblastic Leukemia (ALL) survivors. Aim: We aim to assess the neurocognitive functions of ALL survivors who had been treated with chemotherapy only using two different protocols, and to identify treatment-related risk factors. Patients and Methods: We carried a multicenter study involving 3 pediatric oncology centers on 100 children who were treated for ALL. Fifty patients were treated by the modified Children’s Cancer Group (CCG) 1991 protocol with low dose methotrexate and 50 children were treated by Total XV protocol with high dose methotrexate...
October 31, 2018: Current Pediatric Reviews
Maria V Hernandez, Carlos Sanchez-Piedra, Blanca Garcia-Magallon, Eduardo Cuende, Javier Manero, Cristina Campos-Fernandez, Raquel Martin-Domenech, Javier Del Pino-Montes, Sara Manrique, Maria C Castro-Villegas, Dolores Ruiz-Montesinos, Fernando Sanchez-Alonso, Federico Diaz-Gonzalez, Luis Cea-Calvo, Juan J Gómez-Reino
The retention rate of a biological drug (percentage of patients remaining on treatment over time) provides an index of a drug's overall effectiveness. The golimumab retention rate as first-line biological therapy was high in clinical trial extensions lasting 5 years. Real-world studies also indicate good retention rates but have been of shorter duration. The probability of retention with golimumab treatment was assessed, as any line of anti-tumor necrosis factor-alpha therapy, for up to 5 years in patients with rheumatoid arthritis (RA), axial spondyloarthritis (SpA) or psoriatic arthritis (PsA), associated factors were analyzed...
October 24, 2018: Rheumatology International
Saeed Akhlaghi, Maryam Sahebari, Mahmoud Mahmoodi, Mehdi Yaseri, Mohammad Ali Mansournia, Houshang Rafatpanah, Hojjat Zeraati
Purpose: One of the most important long-term side effects of therapy for rheumatoid arthritis (RA) is the elevation of liver function tests, with earlier studies reporting an elevation of more than 1× the upper limit of normal (>1 × ULN). The current study expands the literature by comparing the trends of transaminase changes caused by conventional and biologic disease-modifying antirheumatic drugs (DMARDs). Patients and methods: The drug categories examined were methotrexate (MTX) and all other nonbiologic DMARDs...
2018: Therapeutics and Clinical Risk Management
Dyfrig A Hughes, Giovanna Culeddu, Catrin Plumpton, Eifiona Wood, Andrew D Dick, Ashley P Jones, Andrew McKay, Paula R Williamson, Sandrine Compeyrot Lacassagne, Ben Hardwick, Helen Hickey, Patricia Woo, Michael W Beresford, Athimalaipet V Ramanan
OBJECTIVES: To investigate the cost-effectiveness of adalimumab in combination with methotrexate, compared with methotrexate alone, for the management of uveitis associated with Juvenile Idiopathic Arthritis (JIA-U). DESIGN: A cost-utility analysis based on a clinical trial and decision analytic model. PARTICIPANTS: Children and adolescents aged 2 to 18 years with persistently active JIA-U, despite optimized methotrexate treatment for at least 12 weeks...
October 15, 2018: Ophthalmology
Peter L Thompson, S Mark Nidorf
PURPOSE OF REVIEW: Inflammation has been shown to be central to the development and progression of atherosclerosis. Despite detailed understanding of its central role and the cellular dynamics, which contribute to atherosclerotic inflammation, there has been slow progress in finding suitable agents to treat it. The recent CANTOS trial showed that the interleukin-1β inhibitor canakinumab can improve outcomes after acute coronary syndromes. Being a monoclonal antibody, it is expensive and inconvenient to administer for long-term treatment...
December 2018: Current Opinion in Lipidology
Sarah J Nagle, Nirav N Shah, Alex Ganetsky, Daniel J Landsburg, Sunita D Nasta, Anthony Mato, Stephen J Schuster, Ran Reshef, Donald E Tsai, Jakub Svoboda
Aim: To describe the long-term outcomes of patients with lymphoma in the CNS treated with rituximab, temozolomide and high-dose methotrexate without consolidation therapy. Patients & methods: A retrospective cohort study of 46 consecutive patients with primary CNS lymphoma (PCNSL, 27 patients) or secondary CNS involvement of diffuse large B-cell lymphoma (DLBCL, 19 patients) who were treated with rituximab on day 1 in combination with high-dose methotrexate (days 1 and 15) and temozolomide (days 1-5) in 28-day cycles without further consolidation...
December 2017: International Journal of Hematologic Oncology
Wei-Ning Ku, Chun-Ju Lin, Yi-Yu Tsai
We report the rescue effects of adalimumab (HUMIRA® ) therapy in a case of refractory pediatric panuveitis complicated with steroid-induced glaucoma. A 13-year-old girl had suffered from blurred vision since January 2013. Bilateral idiopathic panuveitis with macular edema (ME) was diagnosed. She had previously been treated with systemic steroids, methotrexate, cyclosporine, and mycophenolate. All treatments had failed to suppress the ocular inflammation and ME persisted. Intravitreal dexamethasone implant injections were given to both eyes and ME subsided; however, complications with steroid-induced glaucoma and cataract occurred...
July 2018: Taiwan Journal of Ophthalmology
Nobunori Takahashi, Toshihisa Kojima, Daihei Kida, Atsushi Kaneko, Yuji Hirano, Takayoshi Fujibayashi, Yuichiro Yabe, Hideki Takagi, Takeshi Oguchi, Masahiro Hanabayashi, Takefumi Kato, Koji Funahashi, Masatoshi Hayashi, Seiji Tsuboi, Yasuhide Kanayama, Yasumori Sobue, Nobuyuki Asai, Takuya Matsumoto, Tatsuo Watanabe, Shuji Asai, Naoki Ishiguro
OBJECTIVE: To study the clinical effectiveness and long-term retention rate of abatacept (ABA) in elderly rheumatoid arthritis (RA) patients in daily clinical practice. METHODS: A retrospective cohort study was performed using data from a multicenter registry. Our study population comprised 500 consecutive RA patients treated with ABA. We compared clinical effectiveness and ABA retention rates between the Young (≤ 62 years), Middle (62 to 72 years), and Elderly (≥ 72 years) groups...
September 15, 2018: Modern Rheumatology
Gene Schwartz, Amy S Paller
Children who are recalcitrant to topical therapy for their moderate to severe plaque psoriasis and/or highly visible lesions may be candidates for systemic therapy. Methotrexate has been the most commonly used systemic agent in children. However, at least 25% of patients are now treated with biologics, especially tumor necrosis factor-α inhibitors, and their use is expanding as their availability, demonstrated safety and efficacy, and practitioner experience are increasing. In the United States, etanercept is Food and Drug Administration approved for ages 6 years and older and ustekinumab for 12 years of age and older...
September 2018: Seminars in Cutaneous Medicine and Surgery
Jackson M May, Mark R Waddle, Daniel H Miller, William C Stross, Tasneem A Kaleem, Byron C May, Robert C Miller, Liuyan Jiang, Gerald W Strong, Daniel M Trifiletti, Kaisorn L Chaichana, Ronald Reimer, Han W Tun, Jennifer L Peterson
BACKGROUND: Histiocytic sarcoma (HS) is an aggressive malignant neoplasm. HS in the central nervous system is exceptionally rare and associated with a poor prognosis. This report documents a case of primary HS of the central nervous system with treatment including surgery, radiotherapy, and chemotherapy. CASE PRESENTATION: Our patient was a 47 year old female presenting with progressive ataxia, headaches, imbalance, nausea, vomiting, and diplopia. MRI showed a heterogeneously enhancing lesion approximately 2...
September 5, 2018: Radiation Oncology
Maya H Buch, Alyssa Johnsen, Michael Schiff
OBJECTIVES: To explore antinuclear autoantibody (ANA) and anti-double-stranded DNA (anti-dsDNA) autoantibody development during abatacept and tumour necrosis factor inhibitor (TNFi) treatment, and effects of switching from TNFi to abatacept in ANA/anti-dsDNA autoantibody-positive patients. METHODS: This was a post hoc analysis of biologic-naïve patients with active RA in ATTEST and AMPLE. In AMPLE, patients received subcutaneous abatacept or adalimumab (2 years)...
August 21, 2018: Clinical and Experimental Rheumatology
Slavica Pavlov-Dolijanovic, Nada Vujasinovic Stupar, Vladimir Zugic, Predrag Ostojic, Ana Zekovic, Tatjana Zivanovic Radnic, Ivan Jeremic, Ivana Tadic
The study aims to analyze the effects of induction treatment with cyclophosphamide (CYC) pulse therapy followed by maintenance treatment with other mild immunosuppressive agents on lung function in scleroderma (SSc) patients. Thirty patients with SSc (mean age 52 years, mean disease duration < 2 years) with forced vital capacity (FVC) ≤ 80% and/or diffusing capacity of carbon monoxide (DLco) ≤ 70% were included. Monthly CYC pulses were given for 6 months (induction treatment), followed by 3-monthly maintenance pulses for the next 18 months, and during the next 5 years patients received other mild immunosupressive therapy brought by the competent rheumatologist...
November 2018: Clinical Rheumatology
Zuzana Sipkova, Elizabeth A Insull, Joel David, Helen E Turner, Shay Keren, Jonathan H Norris
OBJECTIVES: The current first-line treatment for management of active thyroid eye disease (TED) is high-dose intravenous corticosteroids, which have the potential for serious adverse effects. Our aim was to evaluate the effect of steroid-sparing agents (SSAs) in patients with moderate-to-severe active TED, using methotrexate as first-line. METHODS: Presented is a retrospective, four-year, single-centre, consecutive case series of patients with moderate-to-severe TED treated using the Oxford protocol...
December 2018: Clinical Endocrinology
Morouj Ismail, Hiba Hasan, Youmna El-Orfali, Hanan Ismail, Ghada Khawaja
Rheumatoid arthritis (RA) is a painful chronic autoimmune disease affecting the joints. Its first-line therapy, Methotrexate (MTX), although effective in ameliorating the progress of the disease, induces hepatotoxicity over long-term usage. Thus, seeking natural compounds with fewer side effects could be an alternative therapeutic approach. This study aimed to investigate the anti-inflammatory, antiarthritic, and antioxidative effects of synthetic trans -Δ9-tetrahydrocannabinol (Δ9-THC) dissolved in sesame oil (Dronabinol) against MTX in adjuvant-induced arthritis (AIA) rat model...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Tarek Ben Othman, Hela Ghedira, Nour Ben Abdejlil, Amel Lakhal, Lamia Torjemane, Leila Ben Hamed, Slama Hamida, Bechir Zouari, Saloua Ladeb
Human recombinant granulocyte colony stimulating factor reduces the duration of neutropenia following HLA-identical allogeneic bone marrow transplantation. However, its use remains controversial due to the risk of increasing the incidence of acute graft-versus-host disease (GVHD) and slower platelet recovery. To clarify these risks, we conducted a prospective randomized placebo-controlled trial of filgrastim 5 µg/kg/day i.v. from day 7 post-transplant until neutrophil recovery in 145 consecutive adults undergoing HLA-identical allogeneic bone marrow transplantation, with cyclosporine and methotrexate as GVHD prophylaxis...
July 21, 2018: Biology of Blood and Marrow Transplantation
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