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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
Fatma Nur Korkmaz, Gulsen Ozen, Ali Uğur Ünal, Pınar Kahraman Koytak, Nese Tuncer, Haner Direskeneli
Abstract/ Resumo Behcet's disease (BD) is a multisystem inflammatory disorder characterized by recurrent oral and genital ulcers, skin lesions and uveitis. The nervous system involvement of BD, neuro-Behcet's disease (NBD), is one of the important causes of mortality of the disease. Herein, we present a 29-year-old male with parenchymal NBD who has progressed rapidly and was managed with an uncommon aggressive immunosuppresive combination therapy. The patient first presented six years ago with vertigo and difficulty in talking and walking...
September 28, 2016: Acta Reumatológica Portuguesa
Carmelo Guerrero-Laleona, Joan Calzada-Hernández, Matilde Bustillo-Alonso, Jorge Gil-Albarova, Marta Medrano-San Ildefonso, Estibaliz Iglesias-Jiménez, Antoni Noguera-Julian
Treatment with tumor necrosis factor-α inhibitors is a risk factor for tuberculosis. Despite previous treatment with isoniazid for latent tuberculosis, a 9-year-old girl with juvenile idiopathic arthritis developed disseminated tuberculosis after changing therapy with etanercept to adalimumab and after new contact with a smear-positive relative. Genotyping strain matches and susceptibility to isoniazid make reinfection more likely than reactivation in our patient.
October 3, 2016: Pediatric Infectious Disease Journal
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
Peter Nash, Johan Vanhoof, Stephen Hall, Udayasankar Arulmani, Rita Tarzynski-Potempa, Kristina Unnebrink, Andrew N Payne, Alfred Cividino
INTRODUCTION: Adalimumab, an anti-tumor necrosis factor antibody, is currently available in a 40 mg/0.8 mL formulation. The objective of this analysis was to evaluate injection site-related pain, safety, and tolerability of a 40 mg/0.4 mL formulation of adalimumab that had fewer excipients, a smaller volume, and a delivery presentation with a smaller gauge needle, versus the current 40 mg/0.8 mL formulation in patients with rheumatoid arthritis (RA). METHODS: Two identically designed, phase 2, randomized, single-blind, two-period crossover studies were conducted in Belgium and the Czech Republic (Study 1) and Australia, Canada, and Germany (Study 2)...
August 18, 2016: Rheumatol Ther
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
Sergio Iannazzo, Gianluca Furneri, Federica Demma, Chiara Distante, Simone Parisi, Veronica Berti, Enrico Fusaro
INTRODUCTION: Chronic inflammatory rheumatic diseases (RDs) trigger high costs for healthcare systems and society due to the disability and comorbidity associated with these disease entities. The aim of this study was to analyze patients with RD, assess the use of conventional synthetic and biologic therapies, and estimate the overall cost of treatment in Italy. METHODS: Administrative healthcare claims from the Piedmont region in Northwest Italy were reviewed to identify patients who received disease-modifying antirheumatic drugs (DMARDs) between 2007 and 2010...
June 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
Takao Koike, Masayoshi Harigai, Naoki Ishiguro, Shigeko Inokuma, Syuji Takei, Tsutomu Takeuchi, Hisashi Yamanaka, Yoshinari Takasaki, Tsuneyo Mimori, Katsutoshi Hiramatsu, Shuichi Komatsu, Yoshiya Tanaka
INTRODUCTION: There is insufficient evidence regarding the appropriate dose of methotrexate (MTX) required to achieve specific treatment goals in patients with rheumatoid arthritis (RA) receiving biologic drugs in Japan. The present study aimed to assess the dose-response effect of MTX in combination with adalimumab (ADA) to achieve low disease activity (LDA) and/or remission at 24 weeks in RA patients. METHODS: This analysis used data of the ADA all-case survey in Japan (n = 7740), and 5494 patients who received ADA and MTX were classified into five groups by weighted average MTX dose (>0-<4, 4-<6, 6-<8, 8-< 10, and ≥10 mg/week)...
June 2016: Rheumatol Ther
Tim B van der Houwen, P Martin van Hagen, Wilhemina M C Timmermans, Sophinus J W Bartol, King H Lam, Jasper H Kappen, Menno C van Zelm, Jan A M van Laar
OBJECTIVES: Behçet's disease (BD), an auto-inflammatory vasculitis with oro-genital ulcerations, skin lesions and uveitis, is regarded as T cell mediated. A successful trial with rituximab suggests an additive role for B cells in the pathogenesis. Therefore, we studied B cell abnormalities in BD patients and the effect of TNF-blocking therapy. METHODS: B cells in blood (n = 36) and tissue (n = 6) of BD patients were analysed with flow cytometry and/or immunohistochemistry and compared with healthy controls (n = 22)...
October 15, 2016: Rheumatology
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
Alice Gottlieb, Alan Menter, April Armstrong, Christopher Ocampo, Yihua Gu, Henrique D Teixeira
BACKGROUND: Hidradenitis Suppurativa (HS), also known as acne inversa, is a painful, chronic, debilitating, inflammatory skin disease and has shown response to anti-TNF-α therapy. Efficacy and safety of the anti-TNF-α agent, adalimumab, was assessed in a post hoc analysis of women from the first 16 weeks of a phase 2 study of men and women with HS. METHODS: Patients with moderate-to-severe HS in at least 2 body areas, unresponsive or intolerant to oral antibiotics for treatment of their HS, and with no previous anti-TNF-a or systemic non-biologic treatment, were randomized 1:1:1 to 40 mg adalimumab-weekly or every-other-week, or placebo...
October 1, 2016: Journal of Drugs in Dermatology: JDD
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
Tiffany Y Loh, Philip R Cohen
BACKGROUND: Tumor necrosis factor-α (TNF-α) inhibitors, such as infliximab, adalimumab, and certolizumab pegol are effective agents in the treatment of inflammatory bowel disease. Some individuals undergoing anti-TNF-α therapy for Crohn's disease or ulcerative colitis develop psoriasiform lesions. This is a paradoxical finding, as classical psoriasis is known to respond to these agents. PURPOSE: The clinical features of anti-TNF-α-induced psoriatic dermatitis are described...
September 9, 2016: Curēus
Roger A Levy, Renato Guzman, Gilberto Castañeda-Hernández, Manuel Martinez-Vazquez, Guilherme Damian, Carlos Cara
Biologics are increasingly being used to modify the course of immune-mediated inflammatory diseases. Some main agents are monoclonal antibodies and a fusion-protein that target TNF. This group includes adalimumab, infliximab, certolizumab pegol, golimumab and etanercept. Although the efficacy of anti-TNFs is supported by numerous randomized clinical trials, their pharmacokinetics depend on many factors, in particular immunogenicity, which can cause marked and rapid clearance and a consequent decrease in efficacy...
October 14, 2016: Immunotherapy
Hisako Karube, Koju Kamoi, Kyoko Ohno-Matsui
BACKGROUND: Ocular symptoms in Behçet's disease (BD) begin mostly before 30 years of age according to international surveys, and BD activity may decrease with age. Information regarding the treatment of ocular symptoms in elderly BD patients is thus scant. Anti-TNFα antibody has recently demonstrated strong effects against recurrent uveitis in BD, but the efficacy and safety of anti-TNFα therapy in elderly patients remain unclear. We report herein the case of an elderly patient with long-standing uveitis due to BD who was successfully treated with two types of anti-TNF therapy...
2016: International Medical Case Reports Journal
Michael A Mancano
The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA's) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. Write to Dr. Mancano at ISMP, 200 Lakeside Drive, Suite 200, Horsham, PA 19044 (phone: 215-707-4936; e-mail: Your report will be published anonymously unless otherwise requested...
November 2015: Hospital Pharmacy
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