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Carlos Walter Sobrado, Lucas Faraco Sobrado
Introduction: Acute severe colitis is a potentially lethal medical emergency and, even today, its treatment remains a challenge for clinicians and surgeons. Intravenous corticoid therapy, which was introduced into the therapeutic arsenal in the 1950s, continues to be the first-line treatment and, for patients who are refractory to this, the rescue therapy may consist of clinical measures or emergency colectomy. Objective: To evaluate the indications for and results from drug rescue therapy (cyclosporine, infliximab and tacrolimus), and to suggest a practical guide for clinical approaches...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Mohammad Adawi, Bishara Bisharat, Abdalla Bowirrat
BACKGROUND: Erdheim-Chester disease (ECD) is an uncommon aggressive, multisystem form of non-Langerhans' cell histocytosis, which was firstly reported by Jakob Erdheim and William chester in 1930. The disease pathological features encompass an aberrant multiplication, overproduction and accumulation of white blood cells called histiocytes within multiple tissues and organs. Herein, we present a case of ECD owing to the rarity of this disease (roughly 550 cases have been described in the literature to date)...
October 2016: Medicine (Baltimore)
N Kappelmann, G Lewis, R Dantzer, P B Jones, G M Khandaker
Inflammatory cytokines are commonly elevated in acute depression and are associated with resistance to monoaminergic treatment. To examine the potential role of cytokines in the pathogenesis and treatment of depression, we carried out a systematic review and meta-analysis of antidepressant activity of anti-cytokine treatment using clinical trials of chronic inflammatory conditions where depressive symptoms were measured as a secondary outcome. Systematic search of the PubMed, EMBASE, PsycINFO and Cochrane databases, search of reference lists and conference abstracts, followed by study selection process yielded 20 clinical trials...
October 18, 2016: Molecular Psychiatry
Margot Taks, Phillipe A R R Pijls, Luc J J Derijks, Robert Ten Broeke, Rene J Grouls, Joyce Curvers, Lennard P L Gilissen
INTRODUCTION: The effective, but expensive, drug infliximab is used in patients with inflammatory bowel disease (IBD). Monitoring infliximab trough levels and anti-infliximab antibody (ATI) formation can lead to a more cost-effective use of infliximab therapy. The aim of our study was to investigate the effect of implementation of a treatment algorithm for infliximab in a single-centre IBD cohort, focussing on remission rates and drug costs. METHODS: IBD patients aged 18 years or older treated with infliximab were asked to participate in this study...
October 4, 2016: European Journal of Gastroenterology & Hepatology
Kay-Martin Johnsen, Rasmus Goll, Vegard Hansen, Trine Olsen, Renathe Rismo, Richard Heitmann, Mona D Gundersen, Jan M Kvamme, Eyvind J Paulssen, Hege Kileng, Knut Johnsen, Jon Florholmen
BACKGROUND: Anti-tumour necrosis factor (TNF) agents play a pivotal role in the treatment of moderate to severe ulcerative colitis (UC), and yet, no international consensus on when to discontinue therapy exists. OBJECTIVE: The aim of this study is to study the long-term performance of a treatment algorithm of repeated intensified induction therapy with infliximab (IFX) to remission, followed by discontinuation in patients with UC. PATIENTS AND METHODS: Patients with moderate to severe UC were enroled in an open prospective study design...
October 4, 2016: European Journal of Gastroenterology & Hepatology
Phillip Minar, Kimberly Jackson, Yi-Ting Tsai, Michael J Rosen, Michael Northcutt, Marat Khodoun, Fred D Finkelman, Lee A Denson
BACKGROUND: We have previously shown that CD64 surface expression on circulating neutrophils is significantly elevated in children with newly diagnosed Crohn's disease (CD). Our primary aim was to investigate whether elevations in neutrophil CD64 in asymptomatic patients could be used to predict treatment failure during maintenance infliximab. METHODS: Pediatric CD subjects receiving maintenance infliximab in clinical remission (short pediatric CD activity index [shPCDAI] <15) were enrolled...
November 2016: Inflammatory Bowel Diseases
Benjamin A Fisher, Philippe Donatien, Andrew Filer, C Peter Winlove, Iain B McInnes, Christopher D Buckley, Peter C Taylor
OBJECTIVES: An important feature of rheumatoid arthritis (RA) is hypoxia-driven synovial angiogenesis, but the relationship between change in vascularity, as measured by power Doppler ultrasound (PDUS), and oxygen tensions is unaddressed. METHODS: Metacarpophalangeal (MCP) joint PDUS was assessed in 23 patients with RA, alongside arthroscopic synovitis and oxygen tension measurements, at baseline and 4 weeks after anti-tumour necrosis factor (TNF) inhibitors. RESULTS: Anti-TNF reduced PDUS scores, which were negatively correlated with rise in oxygen tensions...
September 8, 2016: Clinical and Experimental Rheumatology
Gerd Horneff, Ariane Klein, Prasad T Oommen, Anton Hospach, Ivan Foeldvari, Isa Feddersen, Kirsten Minden
OBJECTIVES: While tumour necrosis factor (TNF)-α-inhibitor treatment improved outcome of juvenile idiopathic arthritis (JIA) management markedly, concerns have been raised about an association of TNF-α-inhibitor treatment and an increased risk for malignancies especially lymphoma. METHODS: Cases of suspected malignancies documented in the German Biker Registry are reviewed in detail. RESULTS: Until Dec 31, 2015, 3695 JIA patients were prospectively followed with a total of more than 13,198 observation years...
September 8, 2016: Clinical and Experimental Rheumatology
Maddalena Napolitano, Nicola Balato, Francesco Caso, Luisa Costa, Matteo Megna, Teresa Cirillo, Anna Balato, Raffaele Scarpa
OBJECTIVES: To evaluate the incidence of new cases of psoriatic arthritis (PsA) in patients with plaque psoriasis receiving biologic drugs. METHODS: A retrospective study was performed on 434 psoriatic patients under biologic treatment, attending the Psoriasis Care Centre of Dermatology at the University Federico II of Naples from January 2011 to November 2015. As part of the routine clinical practice, assessment of disease activity was made at baseline, and every 3 months...
September 8, 2016: Clinical and Experimental Rheumatology
Bindu Madhavi Mudduluru, Shalin Shah, Steven Shamah, Arun Swaminath
Tumor necrosis factor alpha (TNF alpha) antagonists are biologic agents used in the management of inflammatory conditions such as rheumatoid arthritis, seronegative spondyloarthropathies and inflammatory bowel disease. These agents have been recently shown to cause a syndrome called anti-TNF induced lupus (ATIL), a rare condition which has similar clinical manifestations to idiopathic systemic lupus erythematosus (SLE). Given that extra-intestinal manifestations of inflammatory bowel disease include arthritis, it can be difficult to separate arthritis due to underlying disease from drug-induced arthritis...
October 17, 2016: Postgraduate Medicine
Mona Dixon Gundersen, Rasmus Goll, Johanna Hol, Trine Olsen, Renathe Rismo, Sveinung W Sørbye, Olav Sundnes, Guttorm Haraldsen, Jon Florholmen
Interleukin 33 (IL-33) is a cytokine preferentially elevated in acute ulcerative colitis (UC), inferring a role in its pathogenesis. The role of IL-33 in intestinal inflammation is incompletely understood, with both pro-inflammatory and regulatory properties described. There are also conflicting reports on cellular sources and subcellular location of IL-33 in the colonic mucosa, justifying a closer look at IL-33 expression in well-defined clinical stages of UC. A total of 50 study participants (29 UC patients and 21 healthy controls) were included from a prospective cohort of inflammatory bowel disease patients treated to disease remission with infliximab, a tumour necrosis factor alpha (TNF) inhibitor...
October 17, 2016: Scientific Reports
Laila Alawdah, Ahmad Nahari, Dayel Alshahrani, Musa Fagih, Shahid Ghazi, Abdulrahman Al-Hussaini
Gastrointestinal sarcoidosis is a rare disease with very limited data in children. Here we report the first pediatric case of successful treatment with infliximab. The first case was an 8-year-old Saudi girl who presented with fever, weight loss, and abdominal pain that was followed in a few months with hematemesis and development of hepatosplenomegaly. The second case was a 9-year-old Sudanese boy who manifested with vomiting, epigastric pain, and weight loss. On upper endoscopy, both cases demonstrated severe erosive nodular gastric mucosa...
September 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Keith A Betts, Jenny Griffith, Yan Song, Manish Mittal, Avani Joshi, Eric Q Wu, Arijit Ganguli
INTRODUCTION: Biologic therapies have improved the clinical management of ankylosing spondylitis (AS). Few head-to-head studies have directly compared the efficacy of these agents. This study was conducted to indirectly compare the efficacy of biologic agents for treatment of active AS. METHODS: A targeted literature review was conducted to identify randomized clinical trials for adalimumab, infliximab, golimumab, certolizumab pegol, etanercept, and secukinumab for the treatment of active AS...
July 25, 2016: Rheumatol Ther
Marina Amaral de Ávila Machado, Felipe Ferre, Cristiano Soares de Moura, Alessandra Maciel Almeida, Eli Iola Gurgel Andrade, Mariângela Leal Cherchiglia, Francisco de Assis Acurcio
INTRODUCTION: The Brazilian Public Health System offers free-of-charge drug treatment for ankylosing spondylitis (AS) to all Brazilian citizens. We report here the first population-based cohort study on patients with AS in Brazil. The aim of this study was to evaluate the costs of the tumour necrosis factor (anti-TNF) blockers and disease-modifying antirheumatic drugs (DMARDs) that were used in the treatments of patients with AS in Brazil between March 2010 and September 2013. METHODS: A retrospective cohort study was performed using administrative databases...
July 11, 2016: Rheumatol Ther
Marina Amaral de Ávila de Machado, Alessandra Maciel Almeida, Adriana Maria Kakehasi, Francisco de Assis Acurcio
INTRODUCTION: In Brazil, patients with ankylosing spondylitis (AS) have access to free-of-charge comprehensive therapeutic care through the Brazilian National Health System. We collected prospective data on patients with AS receiving anti-tumor necrosis factor (anti-TNF) therapy through the Brazilian National Health System in Belo Horizonte City in order to evaluate the effectiveness, quality-of-life outcomes and safety of this therapy. METHODS: This was a prospective study that included 87 patients receiving their first course of anti-TNF agents (adalimumab, etanercept or infliximab)...
June 2016: Rheumatol Ther
Satoko Hayashi, Katsuya Suzuki, Keiko Yoshimoto, Masaru Takeshita, Takahiko Kurasawa, Kunihiro Yamaoka, Tsutomu Takeuchi
INTRODUCTION: Early prognostic factors for the clinical response in patients with rheumatoid arthritis (RA) after 1 year of treatment with infliximab (IFX) as part of routine clinical practice were investigated. METHODS: Thirty-five patients with RA with an inadequate response to methotrexate were enrolled and administered IFX (3-9 mg/kg, every 4-8 weeks). Serum trough levels of IFX and levels of 9 cytokines were measured at baseline and at 3, 6 months, and 1 year...
June 2016: Rheumatol Ther
Ai Matsumoto, Mayumi Komine, Masaru Karakawa, Megumi Kishimoto, Mamitaro Ohtsuki
We report a case of a 70-year-old woman with generalized pustular psoriasis (GPP) who responded well to infliximab therapy and adalimumab therapy after secondary failure of infliximab therapy, but did not respond to ustekinumab therapy. We speculate that the pathogenic factor in this case favored anti-tumor necrosis factor (TNF)-α therapy to anti-interleukin-12/23 therapy. Herein, we also briefly present three additional cases of treatment with adalimumab after secondary failure of infliximab. GPP is often difficult to treat, and no placebo-controlled trials have been conducted to guide the use of biologics against it because of a paucity of cases...
October 15, 2016: Journal of Dermatology
Hongmei Wang, Jianmin Liu, Xuemei Hu, Shanshan Liu, Baojun He
BACKGROUND Hepatocellular carcinoma (HCC) causes many deaths worldwide every year, especially in Asia. It is characterized by high malignancy, recurrence, and short survival time. Inflammation is closely related to the initiation and development of HCC. Tumor necrosis factor-α (TNF-α), an essential inflammatory mediator, has been studied as a potential therapy target in many cancers. However, its potential role in HCC diagnosis and therapy is still unclear. MATERIAL AND METHODS In our study, we detected the TNF-α expression in both human HCC tumor tissue and HCC cell lines HepG2 and HuH7...
October 14, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Kazuhiko Kotani, Michiaki Miyamoto, Hitoshi Ando
Rheumatoid arthritis (RA) is a chronic inflammatory disease with a potential cardiovascular (CV) risk. Flow-mediated vasodilation (FMD) is an ultrasonic method to evaluate endothelial function. RA is a contributor to endothelial dysfunction, a CV risk. Relevant insights on the improvement of the CV outcomes in RA patients may be obtained by a systematic review of trials that investigated the effects of RA treatment on FMD in RA patients. This review found that treatments with antirheumatic drugs and some non-antirheumatic drugs could improve the FMD in RA patients...
October 13, 2016: Current Vascular Pharmacology
A Paganelli, S Ciardo, G Odorici, G Pellacani, A Conti
Pityriasis rubra pilaris (PRP) is a rare, chronic inflammatory skin disorder characterized by the presence of small follicular hyperkeratotic papules that coalesce into yellow-pink (salmon-colored) patches, usually beginning at the head and neck and often resulting in generalized erythroderma(1) . Other main clinical features are "islands" of sparing within the affected skin, palmoplantar keratoderma, nail dystrophy, oral involvement and eventually ectropion. The age of onset has a peak between 50 and 70 years but a juvenile presentation is not uncommon...
October 14, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
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